높은 입체선택성을 나타내는 고리카보네이트의 친핵성 치환반응과 광학활성인 β-Hydroxy Ester의 합성

강석구,박동철,노호식,윤승현,홍덕표 성균관대학교 기초과학연구소 1995 論文集 Vol.46 No.1

The nucleophilic ring opening of the cyclic carbonates of optically active threo-2,3-dihydroxy esters afforded α-substituted β-hydroxy esters with highly regio- and stereoselectivity under mild conditions. The α-substituted β-hydroxy esters were transformed to β-hydroxy esters

선박용 폐 FRP 수지의 재활용 공정 개발

강세란,김영우,황덕기,김시영,이민규,주창식 한국환경과학회 2003 한국환경과학회지 Vol.12 No.6

A recycling process for the waste FRP from boats was developed. The recycling process is composed of decomposition of waste FRP with propylene glycol and synthesis of recycled unsaturated polyester resin from the decomposed liquid material. Prior to the decomposition, waste FRP was cut into 2cm × 5cm segments and mechanical impact was applied by press roller to give gaps between cumulated laminates. Propylene glycol effectively decomposed the waste FRP segments and glass fibers were easily separated from decomposed liquid material. Recycled unsaturated polyester resin could be made from the decomposed liquid material by reaction with maleic anhydride and phthalic anhydride.

전자선단층촬영 관상동맥석회화 정량분석과 관상동맥질환의 비교

이종민,강덕식 慶北大學校 醫科大學 1997 慶北醫大誌 Vol.38 No.2

목적 : 전자선단층촬영(EBT)으로 관찰이 가능한 관상동맥의 석회화병변을 정량화 하여 동맥경화성 관상동맥질환과 비교 분석하고 그 연관성을 알아보고자 하였다. 대상 및 방법 : 총 53명의 입원 및 외래환자들을 대상으로 EBT를 시행한 후 201Th 심근스캔, 운동부하 심전도검사, 또는 관상동맥조영술을 실시하여 관상동맥질환을 검사하였다. Kendos와 Rumberger에 의해 제안된 석회화수치환산표를 이용하여 EBT 검사결과를 Negative, Low risk, Moderate risk, high riks, very high risk group으로 구분하고 기존의 검사방법을 이용한 검사결과를 정상군, 무증상질환군, 유증상질환군으로 나누어 서로 비교하였다. 결과 : 정상군에서 관상동맥석회수치검사상 negative group이 26명(76%), low risk group이 4명(12%), moderate risk group과 high risk group이 각각 2명(6%)이었고 무증상질환군에서는 High risk group이 1명(33%), very high risk group이 2명(66%)이었다. 또한 유증상질환군에서는 very high risk group이 7명(44%), high risk group이 4명(25%), moderate risk group이 1명(6%), low risk group이 3명(19%), negative group이 1명(6%)으로 비교적 다양한 분포를 보였다. moderate risk group이하와 그 초과 group들을 묶어 크게 두 집단으로 나누고 정상군과 무증상질환군을 비교한 결과 민감도는 100%였고 특이도는 94%였다. 또한 정상군과 질환군을 비교할 경우 민감도는 74%이고 특이도는 94%였다. 결론 : EBT를 이용한 관상동맥석회화검사는 정상군과 무증상질환군을 구분함으로써 동맥경화성관상동맥질환의 조기발견에 도움이 될 것으로 생각된다. 그러나 더 많은 환자를 대상으로 한 연구가 지속되어야 하겠다. To analyze the relationship between the presence of obstructive coronary arterial disease and the Electron-beam tomographic coronary calcium quantitation, we have examined 53 patients with EBT scan and conventional studies such as 201Th-MIBI scan, exercise-stress EKG and coronary angiography. We divided the coronary calcium values into 5 groups according to Kondos-Rumberger recommendation (unpublished data) and compared them with the results of conventional studies for coronary arterial disease. As results, we could find that normal patients (94%) distributed in groups below moderate risk group, and all asymptomatic positive patients were included in high and very high risk groups. Although larger portion of symptomatic positive patients (69%) were in very high and high risk groups, the distribution was quite broad. Due to the limitation in patient number, statistical data analysis was not performed. However, by combining five coronary calcium score groups into two groups, we carried out two-by-two table analysis. The result was then compared with (1) normal and asymptomatic positive group, and (2) normal and disease-positive group. In these analyses the sensitivity for asymptomatic positive group was 100% and the specificity was 94%. The sensitivity for disease-positive group was 74% and the specificity was 94%. In conclusion, EBT coronary calcium quantitation was useful to differentiate asymptomatic positive patients from normal one and subsequently was valuable in early diagnosis of atherosclerotic coronary areterial disease. However, more-extensive study will be indispensible to acquire more definite result.

1982년 경북지방 우량아 선발대회에 참가한 영유아의 성장발육상

이원석,구순모,강덕식,이건수 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

1982년 경북지방 우량아 선발대회에 참가한 영유아(9-24개월) 442명을 대상으로 이들의 각종 신체계측치 및 혈청단백량, 비타민 D 결핍상황을 살펴본 결과 다음과 같은 결론을 얻었다. (1) 체중에 있어서 한국표준치 및 일본평균치와 비교하여 남녀 모두 2.11∼3.19kg 1.25-2.25kg 우위에 있었고 신장 역시 4.29-6.75cm 및 2.46-2.73cm 우위에 있었으며 흉위 및 두위에 있어서도 각 0.75-4.48cm, 1.33-4.04cm 및 6.54-2.17cm, 0.1-1.06cm 씩 우위임이 측정되었다. (2) 피부두께 측정치에서 Triceps skin fold thickness가 홍등의 계측치에 비해 남아는 0.40-1.48mm, 여아는 1.41-1.93mm, scapular thickness에서는 남아 2.29-2.44mm, 여아가 2.35-2.83mm우위에 있었다. (3) 상완둘레는 홍등의 계측치보다 남아 2.53-2.77cm, 여아 2.19-2.43cm 우위에 있었다. (4) Hand refractometer를 사용하여 측정한 혈청단백량은 남아평균 7.00gm% 여아 7.08gm%로서 연령별 차이는 없었다. (5) kaup지수 20이상은 남아에서 7.8% 여아 6.3%로 나타났다 (6) 수유방법에서는 모유영양이 가장 많아 50.2%였으며 다음이 혼합, 인공영양의 순서였다. (7) 이유시기는 56.6%가 4-6개월에 시작하여 1년이내에 대부분(98.8%)이 시작한 것으로 나타났다. (8) 헤마토크맅치가 33미만인 빈혈환아는 4.75%였고 약 1/3에서 철분투여가 이루어졌으며 빈혈은 철분투여군에서 3.4%, 비투여군에서 5.4% 발생하였다. (9) 약 1/4에서 비타민 D가 투여되었으며 D 부족증상은 12.7%에서 발견되었고 이들의 대부분이 (80%) 이전에 비타민 D 공급을 받지 못했으며 투여군에서 10%, 비투여군에서 13.6% 나타났다. (10) 본 조사군에서는 과거 5년간에 비해 성장발육(체중, 신장, 흉위, 두위, 상완둘레, 피부두께은 큰 차이가 없으나 비만정도, 빈혈, 비타민 D 부족증상은 많은 감소를 보였다. Authors have conducted a study on 442 infants participated in Kyungpook regional wellbaby contest, held in 1982. After through investigation of several parameters including physical growth (body weight, height, chest and head circumferences), nutritional status (Kaup index, serum protein, hematocrit and signs of vitamin C deficiency), and feeding history, along with comparing this with data obtaind from past 5 years (1976-1980), the following results were obtained. Comparing their body weight, height, chest and head circumferences with Korean children's growth standard(K.S.) and Japanese children's growth standard(J.S.), their body weight were superior to those of K.S(2.11-3.19kg) and J.S(1.25-2.25kg), their height superior to those of K.S(4.29-6.75cm) and J.S(2.46-2.73cm) but no remarkable diference between these data and those obtained from past 5 years. Triceps skin fold thickness and scapular thickness were superior to those of Hong(0.4-1.93mm,2.29-2.83mm), the arm circumference were superior to those of Hong(2.19-2.77mm), too. But no remarkable difference between these data and those obtained from past 5 years were found. Total mean serum protein was 7.0gm% in male infants and 7.08gm% in female infants. Kaup index was over 20 in 7.8% in male infants and 6.3% in female infants. Compared to past 5 years, obesity was found less frequently. Breast milk feeding was the most common form of the infant feeding comparing 50.2%, followed by mixed feeding 29.8%, and bottle feeding in 20%. Weaning was started between 4-6 months of age in 56.6% of infants and the vast majority within 12 months of age (98.9%) About 5% of those infants showed anemia, using the cirteria of anemia as being hematocrit less than 33%. They were found in 3.4% of infants with iron-supplemented group, and 5.4% of infants without iron supplementation. In 12.7% of the infants, there were signs of the vitamin D deficiency including Harrison's groove, rachitic rosary, and pigeon chest. They were found in 10% of infants with vitamin D supplementation and 13.6% of infants without supplementation. Compared to past 5 years, anemia and vitamin D deficiency were found less frequently.

개심술시 혈액 응고 인자의 변화

한승세,이성행,강덕식 慶北大學校 醫科大學 1982 慶北醫大誌 Vol.23 No.2

경북의대 흉부외과학 교실에서 1982년도에 개심술을 시행한 환자 중 무작위로 10예를 선택하여 혈액응고인자를 검사한 바 다음과 같은 성적을 얻었다. 혈액응고인자 즉 Ⅰ,Ⅱ,Ⅴ, 및 Ⅷ의 활성치는 모두 관류초기 및 관류말기에 심한 감소를 보였고 (p<0.001) 관류후 2-4시간에 대조치인 전신마취 중의 검사치로 회복하는 추세를 보였다. 술후 출혈량은 517±329ml/M^2/day 였으며 결론적으로 관류중 혈액응고인자의 심한 감소현상이 술후 비교적 빠른시간내에 관류전치로 회복하고 있는 것으로 보아 술후 과도한 출혈의 중요한 원인이 되지는 않는 것으로 본다. This study was performed to analyze the magnitude and duration of changes in certain clotting factors during and following cardiopulmonary bypass and to correlate these changes with excessive bleeding, if it occurred. Ten cases of patients were randomly selected for this study. They were examined factor assays such as Ⅰ,Ⅱ,Ⅴ, and Ⅷ, using a Coag-stat BC-2210 Blood Coagulation Analyzer. Blood samples were obtained during general anesthesia, at the beginning of the bypass, at the end of bypass and 2-4 hours after bypass. Factor activities such as Ⅰ,Ⅱ,Ⅴ, and Ⅷ decreased markedly during bypass(p<0.001) and returned promptly to control levels which are values during general anesthesia at 2-4 hours after bypass. Postoperative bleeding presented as 517±329ml/M^2/day.

Intravenous Injection of Autologous Bile in Dogs

Kang, Duk Sik,Yang, Geun Seok 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.2

담도폐쇄로 인하여 담도내압이 증가되었을 경우에 간을 천자하거나 도관을 삽입하려고 할 때 담도와 간정맥을 동시에 통과하여 단락(shunt)을 형성할 우려가 있다. 개를 실험동물로 하여 자가담즙을 정맥내에 주입하여 이로 인하여 미치는 영향을 연구하고자 하였다. 개는 성별, 나이, 종자에 관계없이 잡종을 사용하였고, 몸무게는 4∼9.5㎏으로 다양하였다. 초음파 유도하에 담낭을 천자하여 담즙을 얻었으며, 이 담즙을 대퇴부 정맥내로 주입하였다. 몸무게 ㎏당 1㎖의 담즙을 주입한 경우를 제1군, 2.5㎖/㎏의 담즙을 주입한 경우를 제2군 그리고 5㎖/㎏의 담즙을 주입한 경우를 제3군으로 하여 각 군마다 6마리씩의 개를 배정하였다. 담즙 주입 속도는 2㎖/분으로 하였다. 개는 수축기 및 이완기 혈압, 맥박, alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood urea nitrogen(BUN), serum creatinine을 살아있는 개에서는 담즙 주입후 24시간까지 시간간격을 두고 측정하였고, 흉부 x-선, 폐관류 스캔, 그리고 광학 및 전자 현미경으로 간, 폐, 신장, 심장, 대뇌조직도 관찰하였다. 제3군의 6마리 개중에서 5마리가, 제1군의 6마리 중 1마리가 1.5∼20분 사이에 죽었으며 이는 담즙이 주입되는 동안에도 혈압이 계속 떨어졌다. 혈압은 모든 개에서 다 떨어졌으며, 생존한 개에서는 2∼6시간 후에는 정상 수준으로 회복되었다. ALT, AST, BUN과 Creatinine이 모두 증가하여 간과 신장에 장해를 준다는 것을 알 수 있었으며, 각 장기를 조직학적으로 광학 및 전자현미경으로 관찰하였던 바, 모세혈관내에 내피세포가 모두 부어있었고, 신장에서는 외피세포도 부어 있었다는 것을 알았다. 간의 Kupffer 세포와 신장의 혈관간세포내에 과립들이 많이 보였으며, 이는 담즙색소로 생각되었다. 심근과 대뇌조직에서는 별 변화가 없었고 폐는 폐포내에 약간의 염증내지 부종액이 있었고, 간질에도 약간의 변화와 모세혈관 내피세포의 부종이 전자현미경으로 관찰되었으나 흉부 x-선 사진이나 폐관류 스캔에서는 정상으로 나타났다. 이상으로 보아 담즙정맥내 유입이 위험한 작용을 일으킬 수 있기 때문에 경간 시술이 담즙의 정맥내 유입이 예상 될 때는 적절한 조치를 취할 수 있는 준비가 필요하다고 본다. OBJECTIVE: When intrabiliary pressure builds up in case of biliary obstruction, inadvertant biliary-venous puncture may cause intravenous bile flow which could result in serious response. This study is to determine the effects of such intravenous bile. MATERIALS AND METHODS: Eighteen mongrel dogs without selection relative to sex, age or breed were used. Autologous bile, aspirated from gall bladder with ultrasound guide was injected into femoral vein. Blood pressure, pulse rate, ALT, AST, BUN, creatinine were checked for 24 hours. Chest x-rays and perfusion lung scans were obtained. Histopathologic changes of the liver, lung, kidney, heart and brain were observed with light and electron microscopes. RESULTS: Five out of six dogs received 5 cc of the bile per kilogram of body weight, and two of six dogs received 1 cc per kilogram of body weight died in 1.5∼20 minutes after intravenous injection of the bile. The cause of death appered to be slow decline of blood pressure to zero, all of the suvived dogs also showed serious decrease in blood pressure during and throughout 5∼10 minutes after the injection. Histopathologic study revealed swelling of endothelial cells in the capiliary of the kidney, the lung and in sinusoid of the liver, Mitochondrial swelling was noted in the liver cells. ALT and AST were increased. Swelling of epithelial cell was also noted in the kidney. BUN and creatinine were elevated. There was increased number of phagosomes in the Kupffer cells in the liver and mesangial cells in the kidney. Chest x-rays and perfusion lung scans were found to be normal. CONCLUSION: Intravenous administration of autologous bile is toxic to the tissue particullary endothelial cells of capillary in the liver, kidney and lungs. The most serious effect of all was on the cardiovascular organ that is decrease of blood pressure. Any biliary procedure needs some armamentarium to fight against sudden drop of blood pressure and development of renal failure, hepatitis and lung damages.

경북대학교 의과대학의 문제중심학습 시행과 그 평가

장봉현(Bong Hyun Chang),이유철(Yoo Chul Lee),김보완(Bo Wan Kim),강덕식(Duk Sik Kang),곽연식(Yun Sik Kwak),강이철(E-cheol Kang),서강석(Kang Suk Seo),김인겸(In Kyeom Kim),이종명(Jong Myung Lee),정성훈(Sung Hoon Jeong),김종열(Jong Yeol 한국의학교육학회 2001 Korean journal of medical education Vol.13 No.1

문제중심학습 (PBL)은 주어진 실제 환자문제를 학생 스스로 파악하여 학습과제를 설정하며, 학습한 내용을 논리적으로 적용하여 타당한 가설을 세워가는 과정을 거침으로써 학습이 이루어지는 새로운 교육 방법이다. 경북대학교 의과대학은 PBL을 도입하기 위하여 캐나다의 McMaster 의과대학을 단기 방문하여 그곳의 의학교육을 경험하고 PBL의 필요성을 절감하여, 1994년부터 2년간 시범적으로 PBL 수업을 운영한 후, 2년간 평가와 보완기간을 가졌다. 1994년부터 1996년까지 전학기에는 4학년과 3학년, 후학기에는 3학년과 2학년을 대상으로 6명을 한 조로, 45개의 소그룹을 만들고, 각 조에는 한 명의 지도교수를 배정하여 격주로 목요일 4교시에 PBL수업을 진행하였다. 설문조사 결과 4학년은 55.1%가, 3학년은 61.4%가 PBL이 필요하다고 응답하였으며 교수들은 83.9%가 필요하다고 답하였다. 이와 같은 결과에 근거하여 1999년도부터 시작하는 개편된 의학교육과정에 PBL이 정규과목으로 채택되었고, 이에 대비하여 1998년도 2학기에 의예과 2학년 학생을 대상으로 하여 PBL을 시행하여 그 결과를 평가하였다. 1999년도에는 의학과 1학년을 대상으로, 2000년도에는 의학과 2학년까지의 학생을 대상으로 PBL수업을 실시하였다. 본 연구자들의 조사에서, 학생들이 PBL에 대하여 상당히 이해하고 있으며, PBL의 학습목적을 대부분 달성한 것으로 나타나, 정규과목으로서의 PBL 시행에 전반적으로 긍정적인 평가를 한 것으로 판단되며, 조사결과에서 나타난 단점과 부족한 부분을 보완하고 개선한다면 PBL를 정착시키고 점차 확대 시행할 수 있을 것으로 생각된다. The effectiveness of Problem-based Learning (PBL) in medical education has already been acclaimed widely. Representatives of the curriculum committee at Kyungpook National University School of Medicine paid a visit to McMaster University School of Medicine in Canada in May, 1994 in order to learn mechanics and effectiveness of PBL in its medical education and they were impressed by the efficacy of PBL. Soon after that the school launched a pilot PBL tutorial for two years from 1994 through 1996 (4-semester) as a non-credit course for senior, junior and sophomore in medical school during one semester each, to introduce PBL to faculty members and students as well. After the pilot, opinion survey on PBL from both faculty and students revealed affirmative for PBL from 55.1% of seniors, 61.4% of juniors and 83.9% of faculty members. The faculty body at medical school was then encouraged by the pilot experience and decided to include the PBL as the part of medical education reform. During the fall semester in 1998, the senior at pre-medical course was given PBL experience to prepare for implementation of PBL at school of medicine. The PBL was implemented as an essential 2-credit-hour course in each semester commencing in 1999 to the freshmen class throughout the year; it was extended to the sophomore in 2000 and to the junior in 2001. Although there had been initial excitements of over expectations, confusion, and disappointments from faculty members and students, majority opinion of both parties on continuation of PBL was positive. The issues to be settled are preparation of study cases, students learning resources, and method of evaluating students performance. The PBL was started as an essential course in medical school in 1999 after 4 years of preparation and on the basis of our interim evaluations the following conclusions were made: we have reached the following consensus that students seem to follow the objectives of PBL and new PBL tutorial has well been accepted by students; and enhancing the program by correcting currently known weaknesses, the PBL tutorials could further be expanded to be a major modality of teaching in our medical school.

후복막강 부신경절종 적출시 Nicardipine과 Esmolol을 사용한 마취관리 : 증례보고 A case report

강규식,김덕,김천숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Paragangliomas are tumors arising from the neuroendocrine elements (Chief cells) of the paraganglia. Paragangliomas are uncommon tumors and are infrequently found in the extraadrenal retroperitoneum. We investigated and treated a patient with retroperitoneal paraganglioma, which was found incidentally at abdominal computer tomograhy. It was confirmed by pathological study. We report a case of retroperitoneal paraganglioma successfully managed intraoperatively with an infusion of nicardipine and an intermittent esmolol injection.

미만성 갑상선종대를 의심하였던 전경부 지방종 1 예

강전홍,서정기,허갑범,이현철,임승길,이은직,김경래,송영득,남문석,남수연,나준식,남이현 대한내분비학회 1995 Endocrinology and metabolism Vol.10 No.4

Lipoma is a benign fatty tumor that can arise in any location of the body where fat is present. It is found most commonly in the upper half of the body, particularly the head and neck, shoulders, and back. A mass in the antero-inferior part of the neck may be initially thought to be thyroid masses and then other cervical masses should be considered. Ultrasongraphic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. Although the location of tumors, its consistency, and its motion with deglutition, seperation from the thyroid on sonographic examination, all pointed to nonthyroidal origin, did not rule out a possible mass that isolated from the lobes of the thyroid. Fine needle aspiration and biopsy can provide clear answer. We herein report a case of anterior cervical mass in a 48-yr-old male patient presenting a non-tender, slightly hard and nodular mass slowly growing for several years and moved with swallowing, and diagnosed his case as benign lipoma using thyroid scan and ultrasonography. When we encounter patients with anterior neck mass, we should consider benign lipoma mimicking diffuse goiter(J Kor Soc Endocrinol 10: 418-423, 1995).

Process Development for the Removal of Copper from Wastewater using Ferric/Limestone Treatment

Kang, Chang Duk,Sim, Sang Jun,Cho, Young Sang,Kim, Woo Sik 한국화학공학회 2003 Korean Journal of Chemical Engineering Vol.20 No.3

The removal of copper from wastewater by ferric/limestone coagulation followed by screen filtration was carried out at a laboratory scale. The optimum coagulant(FeCl_3) dose and working pH were 50 mg/ℓ of Fe(Ⅲ) and pH 7.5, respectively, through jar tests. For the efficient removal of copper from wastewater, we developed a novel process including the co-precipitation of copper with FeCl_3, alkalization in a limestone aeration bed, and separation of precipitates in a sedimentation tank coupled with internal stainless steel screen filter. The performance results showed that removal of copper from the solution was over 99.5%. The pH was effectively maintained over 7.5 in limestone bed during the whole process. Ferric hydroxide/copper aggregates were removed over 99% by stainless steel screen filter of 1,450 mesh. Periodic air backwashing alleviated fouling of the filter surface.