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- 저자 : 강면식(Meyun Shick Kang) (검색결과 8 건)
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간장 ( 肝腸 ) 및 담도 ( 膽道 ) : 하대정맥 폐쇄시의 Doppler 초음파 검사의 의의
최흥재(Heung Jai Choi),이상인(Sang In Lee),한광협(Kwang Hyub Han),김원호(Won Ho Kim),이승우(Seoung Woo Lee),심원흠(Won Heum Shim),강면식(Meyun Shick Kang) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.3
N/A Budd-Chiari syndrome is a rare condition caused by hepatic venous outflow obstruction. In orient, Budd-Chiari syndrome is commonly caused by the obstruction of inferior vena cava (IVC). Although liver biopsy and venography have been considered to be conclusive in the diagnosis of Budd-Chiari syndrome, those procedures involve a great deal of discomfort and risk for the patient. As the recently developed Doppler ultrtasonograhy is able to define the direction of blood flow and measure the blood flow velocity and volume in the portal vein, IVC and hepatic vein, it can be used in the diagnosis of Budd-Chiari syndrome. We analyzed Doppler ultrasonographic findings in six patients, suspected from Doppler ultrasonography and confirmed by venography. Normally, the IVC and hepatic veins show phasic forward flow. But in membransous obstruction of the IVC, Doppler US showed reversed laminar flow on inspiration and absent flow signal on expiration at the caudal to the obstruction of the IVC. In segmental obstruction of the IVC, flow signal was not detected. After treatment, the flow was changed and directed normally. These findings correlated very well with venography. Our results surggest that Doppler ultarsonography is a simple, non-invasive and effective method for the initial evaluation of patients suspected of having obstruction of the IVC and the evaluation of therapeutic effect.
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정태은,이철주,이동협,강면식 영남대학교 의과대학 1986 Yeungnam University Journal of Medicine Vol.3 No.1
영남대학교 의과대학 흉부외과학교실에서는 1986년 한해동안 111예의 개심술을 시행하였으며 그 결과는 다음과 같았다. 1. 전 111예중 선천성 심질환이 88예로 79.2%를 차지했고 후천성 심질환은 23예로 20.8%를 차지했다. 2. 환자의 연령은 선천성 심질환의 경우 생후 5개월에서 52세까지였고 후천성 심질환의 경우 14세부터 55세까지였다. 3. 남녀의 비는 선천성 및 후천성 심질환 모두 남자가 1.3배 많았다. 4. 선천성 심질환 88예중 심실중격결손증이 45예로 가장 많았으며 다음이 심방중격 결손증으로 16예였고 활로씨 4증후군이 14예였다. 5. 후천성 심질환은 심장판막질환이 대부분으로 23예를 차지했고 1예가 해리성대동맥류이었다. 6. 수술사망은 선청성 심질환에서 2예 후천성 심질환에서 1예로 총 사망율은 2.7%였다. During 1986, 111 cases of open heart surgery were performed at Yeungnam University Hospital consisting 88 cases of congenital heart disease and 23 cases of acquired heart disease. Among 88congenital heart disease, 72 were acyanotic group and 16 were cyanotic. Common cogenital heart diseases were ventricular septal defect(51%), atrial septal defect(18%)and Tetralogy of Fallot(16%). Among 23 acquired heart disease, 22 cases were valvular disease and one was dissecting aortic aneurysm. Three cases of the postoperative death were present resulting 2.7% of surgical mortality rate.
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이철주,정태은,이동협,강면식 영남대학교 의과대학 1986 Yeungnam University Journal of Medicine Vol.3 No.1
영남대학교 의과대학 흉부외과학교실에서는 1984년 4월부터 1986년 12월까지 2년 8개월동안 61명의 동맥관개존증환자를 수술치험하였다. 61명중 53명예에서 Doppler식 심초음파검사만으로 동맥관개존증을 진단하여 수술을 시행, 확인함으로써 Doppler식 심초음파검사만으로의 진단상 감수성(Sensitivity)이 100%이었고 수술은 단순 결찰법으로 전례에서 행하였던 바 좌우 혈단락의 합병증은 없었으며 수술후 원격조사 결과도 매우 양호하였다. 수술사망은 없었으며 3예에서 경한 수술후 합병증이 발생하였으나 쉽게 치료되었다. 이에 수술결과에 더불어 동맥관의 일반적인 변화 및 혈역학적 중요성에 대해 문헌과 함께 고찰하였다. A clinical analysis was performed on 61 cases of patent ductus arteriosus experienced at Yeungnam University Hospital during 3 years period from Aprial, 1984 to December, 1986. Of the 61 patient of PDA, 13 patient were male and 48 patient were female and qge ranged 2 months to 26 years old with the everage age of 9.4 years. The chief complaints on admission were frequent URI and dyspnea on exertion. Main diagnostic procedure were Doppler Echocardiogram(in 53 among 61). All of the operatins were performed the method of ligation of PDA. Three posterative complication were developed, but there was no operative mortality.
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강면식,이철주,정태은,이동협 영남대학교 의과대학 1986 Yeungnam University Journal of Medicine Vol.3 No.1
영남대학교 의과대학 흉부외과학교실에서는 1984년부터 1986년까지 총 99명의 심실중격 결손증 환자들을 수술 치험하였던 바 다음과 같은 결론을 얻었다. 1. 남여비는 1.2:1로 남자가 약간 많았다. 2. 연령분포는 다양하였으며 전체의 ⅔가 3세에서 12세 사이였다. 3. 체중분포는 10㎏미만이 13예이고 21㎏이상이 44예였다. 4. 입원시 주소는 잦은 상기로 감염증이 78예로 제일 많은 빈도를 보였다. 5. 심도자 검사장 폐·체동맥압비가 0.75이상인 경우가 6명, 폐·체 혈관 저항비가 0.5이상인 경우는 0명,폐·체 혈류량비가 3이상인 경우가 13명을 대부분이 중등도의 병변을 보였다. 6. 동반된 심기형은 개방성 난원공, 폐동맥 협착증, 개방성 동맥관 등의 순이었다. 7. 심실중격 결손의 부위는 막변연 유입부 결손이 45예로 제일 많았으며 근육형은 1예로 없었다. 8. 술후 합병증은 완전 혹은 불완전 우각 차단증이 52예로 가장 많았다. 9. 술후 사망은 2예였으며 2%의 발생율을 보였다. Ventricular septal defect is most common congenital cardiac anomaly in Korea and worldwide. And its clinincal spectrum is well known. The anatomic classification had been undertaken by several authors, but recently Dr. Soto and Anderson's classification is widely used instead of Dr. Kirklin's it. From April, 1984 to December 1986, 99 cases of ventricular septal defects had been taken surgical repair under direct vision using conventional cardiopulmonary bypass technique at Yeungnam university hospital. The clinical spectrum was similar to other hospital, and the postoperative mortality was 2%, The most common associated anomaly was patent foramen ovale, and the most common postoperative complication was incomplete or complete right bundle branch block. The rank of defects was as followings : 45 perimembranous inlet type, 21 doubly commited subarterial type, 17, perimembranous trabecular type, and 16 perimembranous outlet type. There was no muscular and mixed type.
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Budd - Chiari 증후군에서 인공혈관 이식 후 개존성 진단에 대한 Doppler 초음파검사의 유용성
김경희,김원호,심원흠,전재윤,한광협,최흥재,강면식,임대순 대한소화기학회 1991 대한소화기학회지 Vol.23 No.1
A graft-interpositioning shunt operation between portal vein, superior mesenteric vein, inferior vena cava and right atrium (meso-atrial, meso-cavo-atrial, porto-cavo-atrial shunt) is indicated in Budd-Chiari syndrome when porta-systemic decompression is required. This is true when the inferior vena cava is not suitable as a receptacle for the shunt because of thrombosis of the inferior vena cava. The occlusion rate of these shunts is high because of their long length and slow flow rates. Thus, follow-up of these patients is essential, and angiography has been the accepted standard for the evaluation of shunt patency. Unfortunately, angiography requires both an in-hospital stay and an invasive procedure. To bypass these inconveniences, using Doppler ultrasonography we have evaluated shunt patency in three patients. From the well-functioning graft, a narrow and phasic flow signal was detected, and the patency of the shunt was confirmed by angiography. From the poor-functioning graft with stenosis, a wide and continuous flow signal was detected. This malfunctioning graft was confirmed by the faint visualization of the graft during angiography and by the high pressure gradient (20 mmHg) between inferior vena cava and right atrium. From the non-functioning graft no flow signal was detected, and the obstruction of the graft was confirmed by angiography. We concluded that Doppler ultrasonography is a simple, noninvasive and very useful way to assess patency of a shunt between the portal vein, superior mesenteric vein, inferior vena cava and right atrium.
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