의학정보와 표준화

魯峻良 대한의학협회 1993 대한의학협회지 Vol.36 No.12

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.

결핵성 치루

노준양,이봉화,우제홍,이찬영 대한대장항문학회 1986 Annals of Coloproctolgy Vol.2 No.1

47. 퍼스널 컴퓨터를 이용한 외과 의국 및 환자 관리 시스템

노준양,장창순,김윤식,이성웅,노경빈 대한외과학회 1992 대한외과학회 학술대회 초록집 Vol.1992 No.5

퍼스널 컴퓨터를 이용한 외과 의국 및 환자 관리 시스템

노준양(Joon Yang Noh),장창순(Chang Soon Jang),김윤식(Yoon Sik Kim),이성웅(Seong Oung Lee),노경빈(Kyung Bin Roh) 대한외과학회 1993 Annals of Surgical Treatment and Research(ASRT) Vol.45 No.1

직장암의 원격성적에 의한 예후인자의 분석

노준양(Joon Yang Noh),이봉화(Bong Hwa Lee),우제홍(Ze Hong Woo),이찬영(Chan Young Lee) 대한외과학회 1987 Annals of Surgical Treatment and Research Vol.33 No.4

복부 둔상에서 소장 손상시의 CT 소견

한상원,노준양,이성웅,노경빈,김영형 대한외상학회 1994 大韓外傷學會誌 Vol.7 No.1

Intestinal injuries from the abdominal trauma are relatively uncommon, but may become more frequent with the increased use of seatbelts. Delay in diagnosis of small bowel injury lead to increased morbidity and mortality. Although the diagnostic peritoneal lavage may be the best way to diagnose the small bowel injury, the CT scan is widely used in case of blunt abdominal trauma. Early detection of small bowel injury in CT scan may contribute to reduce the morbidity and mortality. We reviewed 93 patients who had intestinal injuries between August, 1989 and July, 1993. The CT scan could not show the differences regarding the perforation size, the injury frequency, the associated mesentery injury, time lag between the trauma and the CT scanning. But there was significant differential findings related to the injury site. Jejunal injury mostly showed the extravasation of contrast dye, and ileal injury showed the mesentery thickening. In addition, 11 cases of the CT scan were missed initially, but 9 of them showed suggestive intestinal injury retrospectively. To obtain the early and important information from the CT scan, optimal CT techniques and careful interpretation must be required.

대한비뇨기과학회지 자료색인을 위한 컴퓨터프로그램

박광성,노준양,류수방,민병갑 大韓泌尿器科學會 1994 Korean Journal of Urology Vol.35 No.1

복대동맥 재건술후 발병된 대동맥 십이지장간 누공 1예

이정호,이찬영,노준양,양정현 대한혈관외과학회 1986 Vascular Specialist International Vol.2 No.1

Aortoentenc fistula secondary to aortic reconstructive operation, uncornmonly encountered and usually unsuccessfully treated, challenges the surgeon's diagnostic and therapeutic ability. The common site is duodenum, which is affected in over 80g of cases due to the intirnate relationship between duodenum and infrarenal abdominal aorta. Pathogenesis, however, rernains controversial and may involve one or multiple mechanisms and accurate diagnostic informations are not easily obtained in many cases. Successful therapy hinges on recognition of the problem and prompt operative intervention. Herein authors report a case of aortoduodenl fistula following aortic reconstructive surgery with references and investigate all parts of clinical courses of the patient.

외상 환자의 기록과 분석

김윤식,홍윤식,노준양,이성웅,노경빈 대한외상학회 1993 大韓外傷學會誌 Vol.6 No.1

Trauma is rapidly becoming one of the most important and serious challenges for the public health in modern societies. In the U.S.A., the trauma is the top ranking cause of death for the age groups younger than 44 and the fourth ranking cause of death for all age groups. In Korea also, trauma is emerging as an exigent social problem due to the significant economic losses caused by the yearly increase in trauma patients and trauma related deaths. Adequate response to the challenge presented by trauma must be based on intensive and scientific analysis of the problem, which require a systemic recording of the data on the trauma patients. Various objective indices designed for the systematic recording and analysis of the trauma data have been developed and are widely in use in the advanced countries; however, not much effort has been made in such area in Korea. In 1985, the Committee on Trauma Research in the U.S.A., proposed the following five areas for trauma: epidemiology, prevention, biomechanics, acute care and rehabilitation. An EMS trauma system includes the facilities, personnel, transportation, communication, education, training and evaluation. An index must be developed for the purpose of accurate recording and effective evaluation of the data. The present article describes an electronic data processing program developed for the purpose of facilitating evaluation of trauma patients by providing a comprehensive system of classification of patient data. Such classification system would exped!te accurate recording and automatic evaluation of data and thereby promote quality assurance and appropriate analysis of data. 1. Classification of data Categories are established for classifying the demographic data, prehospital data, clinical data, laboratory data, trauma outcome data and other data. Demographic data includes patient identification, the date and time of arrival at the emergency room, cause and type of injury, preinjury status of patient and the use of protective gears. Prehospital data includes the time of injury, mode of transportation and emergency care given before the arrival at the hospital. Clinical data includes vital signs, pertinent history, Glasgow Coma scale, results of procedures and clinical impression according to the International Classification of Diseases. Laboratory data includes the results of variable tests; blood alcohol, serum electrolytes, BUN, Creatinine, blood sugar and arterial blood gas analysis. Trauma outcome data includes final deposition, health outcome results, the stay in hospital and ICU, complications and disabilities. 2. Reclassification of basic reference data The basic reference datas: external cause of injury or poisoning code within the International Classification of Diseases frame work, Abbreviated injury scale, Anatomic profile are classified and modified. 3. Menu for recording of data A menu is designed for each category in order to reduce the occurrence of mistakes in the process of the data entry. 4. Evaluation of data analysis and quality assurance. Revised trauma score (RTS), Injury Severity Score (ISS), RRE chart, TRISS metho-dology and ASCOT were evaluated by author designed computerized program, Also, z and W value were evaluated.