완전대혈관 전위의 심방내 교정술 후 추적 관찰

김연우,노정일,허준,윤명자,김호성,최정연,윤용수,양세원,이정렬,김용진,노준량 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.5

開心手術에 있어서 Epsilon의 術後 止血効果

盧浚亮(Joon Ryang Rho) 대한외과학회 1975 Annals of Surgical Treatment and Research Vol.17 No.2

各種 氣泡型酸化器에 對한 臨床的 考察

盧浚亮,李勳二 최신의학사 1976 最新醫學 Vol.19 No.1

The importance in open-heart surgery of full oxygenation of blood during cardiopulmonary bypass, with elimination of adequate amount of carbon dioxide without significant destruction, denaturation, or metabolic changes in the blood, together with the ability to lower or raise the blood temperatures in minimal time, is well recognized. The ideal oxygenator which would simulate the normal human lung in all of these aspects has not yet devised; however, the bubble oxygenator has stood the test of time and widespread usage for the limited intervals usually necessary for open-heart surgery. The clinical cases of fortytwo consecutive intracardiac operations under the cardiopulmonary bypass with disposable bubble oxygenator; Rygg-Kyvsgaard on 17 cases, Temptrol on 18 cases and Harvey on 7 cases, and American Optical roller pump during the period from August 1974 to May 1975 were reviewed to evaluate the ability of gas exchange and the blood trauma of the three different models of bubble oxygenator. In most cases the general tendency of arterial blood gas analyses performed on the blood samples taken during bypass was toward moderate respiratory alkalosis and mild metabolic acidosis. The respiratory component of the alterations were mainly the moderately lowered carbon dioxide tension and elevated oxygen tension in the blood during perfusion. This means that the oxygenation and carbon dioxide elimination by the oxygenator was too excessive than normal. These alterations were almost same in different models. It was suggested that the addition of small amounts of carbon dioxide to the oxygenator may be benificial to avoid these potentially dangerous respiratory imbalance during perfusion. In comparative studies of blood trauma produced by the oxygenator, the most useful indices appear to be rates of hemolysis and platelet loss. The rate of hemolysis was highest in the Harvey oxygenator group and lowest in Rygg-Kyvsgaard group. However, the plasma free hemoglobin has been well accepted physiologic range of 1 mg % per minute of cardiopulmonary bypass in all three groups. The platelet counts were decreased markedly along with bypass, especially in Rygg-Kyvsgaard group but there was no marked difference in platelet loss during perfusion between the three group. These alterations did not result in clinically related significant complications. In most cases the defoaming capacity and the heat exchanger efficiency were excellent. There was no death related to the bypass itself. All of these oxygenating units have been demonstrated to be satisfactory for general use in open heart surgery, and also seems that the significant difference-in the-clinical cardiopulmonary bypass with these different oxygenators were not observed.

Molecular Investigation of Two Consecutive Nosocomial Clusters of Candida tropicalis Candiduria Using Pulsed-Field Gel Electrophoresis

Joon Rho,Jong Hee Shin,Jeong Won Song,Mi-Ra Park,Seung Jung Kee,Sook Jin Jang,Young Kyu Park,Soon Pal Suh,Dong Wook Ryang 한국미생물학회 2004 The journal of microbiology Vol.42 No.2

Pulsed-field gel electrophoresis (PFGE) typing was applied to the epidemiological investigation of 21 Candida tropicalis isolates collected from urine specimens of 11 patients and one healthcare worker, in an intensive care unit (ICU) over a 4-month period. Seventeen epidemiologically unrelated strains from 14 patients were also tested to determine the discriminatory power of PFGE. PFGE typing consisted of electrophoretic karyotyping (EK) and restriction endonuclease analysis of genomic DNA (REAG), using two restriction enzymes (BssHII and SfiI). The EK pattern was the same in all 38 isolates, while REAG using SfiI separated the isolates into nine types. However, 16 different PFGE types were identified by REAG with BssHII, and the same results were obtained when the results of both REAG tests were combined. In serial urinary isolates from 10 patients, all strains from each patient had the same PFGE pattern. While the epidemiologically unrelated strains from 14 patients consisted of 13 different PFGE types, the 20 isolates from the 11 ICU patients fell into only two PFGE types (types C1 and C2), and these apparently originated from the two different outbreaks. All strains of type C1 (n = 12) were isolated from six patients, between November 1999 and January 2000, and all of the type C2 strains (n=8) were isolated from five patients, during January and February 2000. This study shows two consecutive clusters of C. tropicalis candiduria in an ICU, defined by PFGE typing, and also demonstrates that a PFGE typing method using BssHII is perhaps the most useful method for investigating C. tropicalis candiduria.

대동맥질환에 대한 외과적 고찰

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.

양방향성 상대정맥-폐동맥 단락술 후의 폐혈관 저항의 변화에 관한 연구

김욱성,노준량,장우익,김연수,류지윤 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.3

Objectives : Despite the increasing use of the bidirectional cavopulmonary shunt there are limited reports about the effects of bi-directional cavopulmonary shunt on pulmonary vascular resistance. We compared the preoperative and postoperative cardiac catheterization and angiographic data. Materials and Methods : Twenty-three patients, who underwent bi-directional cavopulmonary shunt from Aguest 1993 were included. Age range at the surgery was from 6 month to 108 months(mean, 18.5 months). Results : Systemic arterial oxygen saturation increased from a mean of 70.1±8.7% before surgery to a mean of 85.2±3.3% after surgery(p valve =0.001). Mean pulmonary arterial pressure and pulmonary vascular resistance decreased from a mean of 9.8±2.7㎜Hg and a mean of 11.8±4.5㎜Hg and a mean of 1.9±0.9U㎡ before surgery to a mean of 9.8±2.7㎜Hg and 1.2±0.5U㎡ after surgery respectively(p valve=0.0067, p valve=0.0065). End diastolic ventricular pressure and atrioventricular valve regurgitation did not changed significantly after surgery. Conclusions : We conclude that the bidirectional cavopulmonary shunt relieve hypoxemia and decrease mean pulmonary arterial pressure and pulmonary vascular resistance after surgery, thus yielding a more suitable Fontan candidate.

대동맥관 폐쇄부전을 동반한 상행대동맥의 외과적 치료

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.

흉부외상에 의한 하행흉부대동맥파열 (수술 치험 1예 보고)

채헌,노준량,Chae, Hurn,Rho, Joon-Ryang 대한흉부심장혈관외과학회 1980 Journal of Chest Surgery (J Chest Surg) Vol.13 No.1

A successful repair of transected descending thoracic aorta was performed in a 44-year-old man. The patient had once been hospitalized in a local clinic for 7 days after a steering wheel injury. Dealing with right Colle`s fracture, he was transferred to this hospital to rule out aortic injury. On admission, a chest PA film and concomitant aortogram revealed an aneurysm of the descending thoracic aorta just distal to the origin of the left subclavian artery measuring 6 cm in diameter and 8 cm in length. He underwent urgent thoracotomy and the injured part of the aorta was replaced with a woven Dacron graft utilizing a Gott`s heparinized aortic shunt. The postoperative course was very smooth except hoarseness and left phrenic nerve palsy due to a blind clamping of the proximal aorta during the operation.

Aprotinin Attenuates the Elevation of Pulmonary Vascular Resistance After Cardiopulmonary Bypass

Tae Jin Yun,Joon Ryang Rho 대한의학회 2006 Journal of Korean medical science Vol.21 No.1

소아에 흔한 흉부외과 영역의 질환

김용진,노준량,서경필 한국의학사 1986 診斷과治療 Vol.6 No.5