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노준량,Rho, Joon Ryang 대한흉부심장혈관외과학회 1976 Journal of Chest Surgery (J Chest Surg) Vol.9 No.2
Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.
Kartagener's Syndrome ; 2례 보고 (Kartagener 증후군의 기관지확장증의 와과적 치료)
곽상룡,노준량,Kwack, Sang-Ryong,Rho, Joon-Rhyang 대한흉부심장혈관외과학회 1979 Journal of Chest Surgery (J Chest Surg) Vol.12 No.3
Kartagener`s syndrome is a clinical entity comprising a combination of situs inversus, bronchiectasis, and sinusitis or nasal polyposis. This syndrome is rare and is usually seen in a young age group. The syndrome is punctated by recurrent upper respiratory tract infection and pneumonia. This is a report of Kartagener`s syndrome found in 18 years old male and 21 years old female patients who were received surgical treatment of bronchiectasis. The male patient was performed right transposed lingular segmentectomy and lower lobectomy and female patient was perforated left transposed middle lobectomy and lower lobectomy. Both patients were discharged with good results.
조대윤,노준량,이영균,Jo, Dae-Yoon,Rho, Joon-Rhyang,Lee, Yung-Kyoon 대한흉부심장혈관외과학회 1979 Journal of Chest Surgery (J Chest Surg) Vol.12 No.3
Obstruction of the right ventricular outflow tract occurs in many various positions. Recently, obstruction due to anomalous muscle bundle has been clearly recognized. This anomaly is caused by a large anomalous muscle bundle, which creates an obstruction low in the body of the right ventricle and divides it into two chambers. Three cases of double chambered right ventricle were treated surgically utilizing cardiopulmonary bypass in the Department of Chest Surgery, College of Medicine, Seoul National University. 1] All of the 3 cases were female. 2] In 2 cases, FKG findings were RVH and RAD, but in case 2, normal EKG findings. 3] In case 2, no pressure gradient between the inflow portion and outflow portion of the right ventricle was observed, but in case 1 and 3, pressure gradients were 70 and 64 mmHg, respectively. 4] In 2 of the 3 cases, type II VSD was combined to double chambered right ventricle. 5] All of the 3 cases were discharged with symptomatic improvement after operation.
김자억,노준량,Kim, Ja-Eark,Rho, Joon-Rhyang 대한흉부심장혈관외과학회 1979 Journal of Chest Surgery (J Chest Surg) Vol.12 No.2
A case of congenital bronchoesophageal fistula was treated surgically. A 45 year-old woman has been suffered from coughing with liquid diet and recurrent pneumonia for 20 years. Esophagogram and bronchoscopy revealed a fistula tract between midesophagus and right lower lobe bronchus just opposite site of the orifice of the superior segmental bronchus. Preoperative laboratory results were normal and Mantoux test was also negative. The fistula was dissected without difficulty and the lumen was covered with intact mucosa and there were no calcified lymph nodes around the lesion. The fistula was divided and closed with interrupted silk sutures on both sides. The postoperative course was uneventful.
안혁,노준량,Ahn, Hyuk,Rho, Joon-Ryang 대한흉부심장혈관외과학회 1991 Journal of Chest Surgery (J Chest Surg) Vol.24 No.4
From April, 1981, to April, 1990, 20 male and 7 female patients ranging in age from 17 to 63, were operated on for aortic insufficiency with an aneurysm of the ascending aorta. Ten patients were in New York Heart Association functional class II, 7 in class III, and ten in class IV. The surgical treatment in all cases consisted of total replacement of the ascending aorta with composite graft containing a prosthetic aortic valve and reimplantation of the coronary arteries by an intermediate tube graft. In 15 patients an uncomplicated annulo-aortic ectasia existed, and in 12 an aortic dissection; three of the latter group were operated during the acute phase. 17 patients showed typical Marfan syndrome, and 3 patients showed severe ascending aortic aneurysm secondary to the aortic valve disease. The overall operative mortality was 7%[2 deaths]. Those 2 deaths occurred following emergency operation due to associated aortic dissection, but no death during elective operation. All survivors have been followed-up during a period ranging 1 to 108 month[average 34 months]. There was no late mortality. Among the survivors, clinical improvement is readily apparent[2,3 in class I, 2 in class II ]. In conclusion, the treatment of aortic insufficiency associated with an aneurysm of the ascending aorta by insertion of a composite graft and reimplantation of the coronary arteries through an intermediate Dacron tube is a reliable method with low mortality and excellent results.