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      • 胃癌 및 胃潰瘍에서 나타나는 異形成의 形態學的 比較檢索

        黃奎興,郭精植,李東久 慶北大學校 醫科大學 1985 慶北醫大誌 Vol.26 No.4

        胃癌發生의 形態學的 前段階라고 알려진 異形成이 胃癌 및 胃潰瘍에서 어떠한 頻度와 分布를 가지는지를 分析하여 胃癌組織發生의 一端 및 胃潰瘍과 癌과의 關係를 究明하고자 外科的으로 切除한 胃癌 107例와 胃潰瘍 84例를 組織構築的으로 檢索한 結果를 要約하면 다음과 같다. 胃內 部位別로 癌이나 潰瘍 모두 小彎의 中央部에 가장 흔하였으며 幽門部에서는 癌의 頻度가 더 높았다. 胃潰瘍은 84.6%가 4㎝미만이었으나 4㎝以上도 15.4%가 있었고 깊이는 潰瘍이 클수록 깊어지는 傾向이었다. 胃癌은 63.6%가 6㎝ 以上이었으며 潰瘍形成은 4㎝미만이 33.3%, 4∼6㎝사이가 55.6%, 6㎝以上이 70.6%로서 癌가 커질수록 潰瘍形成이 많았다. 胃癌과 胃潰瘍 周邊粘膜에는 病巢에서 조금 떨어진 곳에 慢性萎縮性胃炎과 腸上皮化生이 흔히 觀察되었으며 異形成은 주로 病巢에 隣接하여 나타났고 幽門部에 더 넓게 分布하고 있었다. 異形成同伴率은 胃潰瘍이 2㎝ 미만에서 64.4%, 2∼4㎝사이는 69.2%, 4㎝以上은 92.3%였으며 胃癌은 4㎝미만이 83.3%, 4∼6㎝사이가 88.9%, 6㎝以上은 97.1%로서 全體的으로 胃潰瘍에서 보다 胃癌에서 훨씬 많이 異形成을 同伴하고 있었으나 모든 胃癌이 異形性을 가지지는 않았고 胃潰瘍에서도 높은 頻度의 異形成을 나타내었다. 以上의 成績으로 보아 胃癌은 形態學的으로 반드시 異形成의 과정을 거친다고 할 수는 없지만 異形成은 胃癌을 誘發하는데 하나의 可能性있는 病變으로 생각된다. 따라서 異形成을 同伴하는 胃潰瘍은 다른 조건이 부합되면 胃癌으로 進行될 수도 있다고 推定된다. This study was designed to examine the histogenesis of gastric cancer and the relationship between gastric cancer and chronic gastric ulcer. The frequency and distribution of dysplasia known for precancerous lesion were analyzed by investigating 107 cases of gastric cancer and 84 cases of ulcer topographically. The results obtained were as follows: The gartric cancer and ulcer tended to occur most frequently in middle third of lesser curvature as far as the regional distribution was concerned. The ulcer tended to be deeper in proportion to its size. The ulcer of less than 4㎝ was 84.6% ; that of more than 4㎝ 15.4%, while the cancer of more than 6㎝ was 63.6%. The ulcer formation in cancer was more frequent in proportion to the size of cancer lesions: the rates of ulcer formation were 33.3% in less than 4㎝, 55.6% in those of 4-6㎝ and 70.6% in those of more than 6㎝. The atrophic gastritis and intestinal metaplasia were frequently observed in the surrounding mucosa near the gastric cancer and ulcer. Dysplasia which was more widely distributed in the pyloric region occurred adjacent to the lesions, As far as the dysplasia-accompanying rate was concerned, the ulcer of less than 2㎝ was 64.4%; that of 2-4㎝ 69.2%; that of more than 4㎝ 92.3%. And the cancer of less than 4㎝ was 83.3%; that of 4-6 88.9%; that of more than 6㎝ 97.1%. The dysplasia was more frequently noted in the cancer than in the ulcer. However, it was not always to accompany dysplasia in gastric cancers. In conclusion, it seemed that the gastric cancer didn't necessarily pass through the process of dysplasia pathologically. Yet the dysplasia seemed to become the potential lesion in developing cancer. Therefore it was assumed that the ulcer accompanying dysplasia might developed into the cancer.

      • KCI등재

        嫉妬妄想에 關한 臨床的 考察

        黃奎興 大韓神經精神醫學會 1977 신경정신의학 Vol.16 No.4

        The delusion of jealousy as a psychopathology of thought content is a common symptom frequently met in nearly all of the psychotic disorders, psychogenic as well as organic, including alcoholoic and senile patients. And it also has a special relevance to legal problem such as homicide due to violent behaviors in severe delusional state. The subject have been widely studied, however, mostly on psychoanalytic basis, and interestingly enough, few systematic clinical works could be found, especially in Korean patient. In this study, the author attempted to delineate and evaluate some clinical aspects of the delusion of jealousy; basic demographic data, family structure, precipitating factors of symptom formation and characteristics of the delusion. For the above purpose, the author analyzed clinical data of 63 cases of delusional jealousy who had been hospitalized from January, 1974 to December, 1976 in psychiatric wards of general hospitals and private psychiatric clinics in Taegu area. The results could be summarized as follows: 1. Out of 63 cases, the male patients numbered 41 and the female, 22, the ratio being 2:1. The mean age of the male was 41 and that of the female, 33 years. 2. As to the diagnostic distribution, the incidence of schizophrenia was the highest(54%), the next being the paranoid state (27%), followed by alcoholic disorders (14%). and others(5%). In male patients, the incidence of alcohoic disorders and paranoid state was predominantly high, while that of schizophrehia was higher in female. 3. Among all cases, 24% of the subjects lost one of their parents before age of nine. As to the family structure, nuclear patterns were much frequent, but the marital mode was mostly traditional "match-making" ones. 4. The author could analyze precipitating factor of delusion formation in about two third of all cases: 1) promiscuous sexual life and sexual inferiority of the patient himself, 2) the patient's perception in his marital partner, of clue of intimate relation with others, and 3) frustration of social life. The objects involved in the delusion of jealousy could be classified as 1) vague “somebody", 2) neighbors and 3) concrete persons. The concrete objectsusually represented sexually potent, socially powerful or incestuous symbolic persons. 5. Lastly, other symptoms associasted with the delusion of jealousy were physical violence (54%), heavy alcoholic intake (37%), and in 43% delusion of persecution other than jealousy were found.

      • KCI등재

        成人遺尿症의 精神力動

        朴炳卓,黃奎興 大韓神經精神醫學會 1983 신경정신의학 Vol.22 No.3

        思春期 以後까지 유뇨증을 나타내는 9중례를 一般臨床樣相 및 精神力動的인 측면에서 살펴보았다. 그 결과를 요약하면 다음과 같다. 1. 대부분의 증례에서 同性의 父母인 아버지가 엄격 딱딱하거나 柔弱하여 적절한 同一視의 對象이 되지 못했다. 2. 1차성유뇨증은 어머니에 의해 심히 과잉보호를 받았고 이로 인해 自律性, 獨立性이 결여되고 幼兒的이고 未熟한 반응을 보였다. 3. 2차성유뇨증은 어머니가 심히 엄격하여 두려움의 對象이 됐거나 일시적인 父母와의 隔離를 겪었고 심한 敵對的 감정, 憂鬱, 不安등 神經病的 경향이 많았다. The authors undertook a study of psychodynamics and general clinical aspect of 9 cases of adult male enuretics who were admitted during the period from May 1982 to April 1983 at the Department of Neuropsychiatry, Taegu Armed Forces General Hospital. The pertinent result are as follows: 1. In most of the cases, fathers were rather strict, rigid or weak. Therefore they were not adequate objects of identification for the enuretics. 2. Primary enuretics were overprotected by their mothers and showed lacks of autonomy and independence and were childish and immature. 3. In the secondary enuretics, mothers were more rigid or strict, so they became the objects of fear to the subjects. Some of the secondary enuretics suffered transient separation from their parents and showed highly neurotic tendencies of hostility, depression or anxiety.

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