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1974년 1월부터 1979년 12월까지 서울 백병원 임상병리과에 의뢰된 골수검사 442례에 대한 통계적 검색을 실시하였다. This is an analysis of 442 cases whose marrow aspiration were performed at the Seoul Paik Hospital, In Je Medical College, from Jan. 1974 to Dec. 1979. Follow-up study was done on 37rpatients. 1.Male/female ratio was 1.1 : 1 and age distribution was even for all ages except for slightly higher distribution at age before 10. 2.The initial Hb was less than 12.0gm% in 86.4%, total W.B.C. was 1,001∼20,000/mm3 in 80. 1% and platelets were 100,001∼400,000/mm3 in 43.5%. 3.Leukemia was diagnosed in 118 cases (26.7%), iron deficiency anemia in 58 cases(13.1%), aplastic anemia in 20 cases(4.5%), I.T.P. in 16 cases(3.6), multiple myeloma in 14 cases(3.2%), metastic tumor in 7cases(1.6%) and no specific disease entity in 181 cases(41.0%). 4.In leukemia, male/female ratio was 1.6 : 1 with A.M.L.; 41.5%, A.L. L.; 22.9% and C.M.L.; 13.6%. The incidence of acute leukemia is as 6.5 times higher than chronic leukemia. 5.Age distribution of A.M.L. was even among all ages, A.L.L. predominantly at young age and C.M.L. predominantly at the 4th decade. The male/female ratio was 2.1 : 1 for A.M.L., 1.6 : 1 for A.L.L., but reversed to 1 : 1.3 for C.M.L. 6.Hb was generally lower in A.M.L. and A.L.L. than C.M.L. Total W.B.C. was varying with A.M.L. and but none was fess than 10,000/mm3 with C.M.L. Platelets count of less than 100,000/mm3 was predominantly in A.M.L. and A.L.L. but was more than 200,000/mm3 with most of the C. M. L. 7.Male/female ratio was 1 : 1.9 for iron deficiency anemia and 1.5 : 1 for aplastic anemia. The majority of iron deficiency anemia was at age before 30 and aplastic anemia was predominantly at age 11-20 years. 8.No specific disease entity was referable in 41.0% of cases. The negative studies are as significant as positive marrows because this decisively rules out blood dyscrasias such leukemia, aplastic anemsia, plasma cell myeloma, etc
This is a case of 27 year old male who had had severe pruritis with marked exfoliative dermatitis of 2 year duration, followed by skin tumor and, finally, visceral involvement. The death was complicated by bilateral bronchopneumonia with asperosilosis. In addition to clinical observation, characteristic histologic finding of cellular multiplicity with atypical histiocytes, immature reticulum cells and Pautrier's microab- scesses in the skin & axillary node serially biopsied made confirmed diagnosis of mycosis fungoides. At autopsy, multiple involvement of lymph node, predominantly periaortic nodes, kidneys, adrenals, stomach and pancreas was disclosed. Histopathologic picture of these, without doubt, was that of reticulum cell sarcoma but neither picture of reticulum cell sarcoma nor mycosis fungoides were observed in the skin lesion at autopsy. As clearly demonstrated in this case, the striking similarities of viseral metastasis in mycosis fungoides to lesions of other lymphomas pose quetion of common etiology, pathogenesis and host response. However, it would appear that mycosis fungoides is distinguishable early in the disease from other malignant lymphoma solely on the basis of its characteristic clinical course and cutaneous histopathology.
吸入 細胞檢査(Aspiration Biopsy Cutology, ABC)는 目的 病巢에서 細針을 揷入하여 吸入한 微細組織切片을 細胞學的 檢査法으로 判讀 診斷하는 檢査法이다. 매우 簡單하고 迅速한데 比해 正確性과 安定性이 높고, 뿐만 아니라 患者에게 心的 肉體的 負擔과 合倂症이 적고 低廉한 費用으로 行할 수 있어 最近 우리나라에서도 漸次的으로 利用度가 높아지고 있다. 短點이라면 僞陰性 結果가 不可避하다는 것이다. 이를 最少限으로 줄이기 爲해서는 技法의 熟練과 判讀하는 病理專門醫들의 豊富한 經驗이 必要하다. 本 硏究 結果 診斷의 正確度는 90%이었으며 將次 向上될 것으로 期待된다. An analysis of 1,005 cases of Aspiration Biopsy Cytology (ABC) performed at Seoul Paik Hospital from February 1984 to September 1986 was reviewed. The following results were obtained. 1.Number of the test performed is 173 in 1984, 387 in 1985 and 445 in 1986, respectively. 2.Aspiration Biopsy Cytology was most frequently applied to lymph node with incidence of 394 (39%), breast 296 (29%), thyroid 132 (13%), deep organs 86 (9%) and others 97 cases (10%). 3.The most frequently made Aspiration Biopsy Cytology diagnosis was mammary dysplasia of 144 cases followed by reactive hyperplasia of lymph node 118, lymph node malignancy 73 and adenomatous goiter 50. Malignancy is the most frequent diagnosis made in this study, occupying over 23% of the test performed. The result is indirectly suggested that the Aspiration Biopsy Cytology is an important tool for detection of the malignant lesion. 4.Histological diagnosis was made in 116 cases and diagnostic accuracy of Aspiration Biopsy Cytology ranged from 75.1(81.1)% to 94.3(98.0)%. The mean accuracy is 89.3(91.5)%. 5.There were 3(2.6%) cases of false positive and 9(7.8%) false negative reports of Aspiration Biopsy Cytology. The former consists of 1 case of granuloma and 2 cases of osteomyelitis reported as highly suspicious Aspiration Biopsy Cytology impresssion. The fault was made due to atypical epitheloid cells and active osteoblasts. The false nagative consists of 3 cases of sampling error, 4 cases of misinterpretation and 2 cases of diagnostic difficulty; one well differenciated follicular carcinoma impressed as adenomatous goiter in Aspiration Biopsy Cytology and the other well differenciated duct adenocarcinoma of breast with impression of papilloma in Aspiration Biopsy Cytology. 6.Diagnosis of non-neoplastic lesion is also significantly effective. For example; diagnosis of tuberculosis is more effectively made with combination study of Aspiration Biopsy Cytology and acid fast (rhodamine) stain. 7.Aspiration Biopsy Cytology is an extention of morphologic diagnosis within both diagnostic cytology and histopathology. It is quite valuable method previously underused and wider use of this established and simple procedure is encouraged.
上氣道炎症의 Virus와 非 Virus性 感染 如否 或은 알레르기反應과 感染을 同伴한 알레르기 疾患인지의 監別이 如意치 않을 때가 많다. 이에 急性 Virus感染 때 特異的으로 出現하는 것으로 알려진 Ciliocytophtaoria을 細胞學的으로 檢出함으로 이들 疾患을 鑑別하는데 目的이 있다. Single cytologic study of nasal sscrapings collected from 100 out-patients at the ENT Clinic of Seoul Paik Hospital, Infe Medical College was done from July 1984 to June, 1985. Papanicolaou's technique was applied and Clinical impresssion of the patients varied from allergic rhinitis to acute rhinitis and paranasal sinusitis. 1.Degenerative changes of exfoliated ciliated epithelial cells were observed in 76 cases including ciliocytophthoria(CCP) in 24 cases. 2.cases and acute rhinitis in 1 case, suggesting association of viral infection and vasomotor rhinitis in 2 casses and acute rhinitis in 1 case, suggesting of viral infection and vasomotor rhinitis. 3.A few number of CCP cells were observed in 21 cases and the clinical impression of them varied. Interpretation of this result is uncertain at present and further investigation is needed. 4.Significant eosinophilia (10-100%) was observed in 10 out of 28 cases who were clinically diagnosed as allergic rhinitis and the eosinophilia was over 50% in 8 cases of this group. The eosinophilia was observed in 8 cases of non-allergic rhinitis and over 57% in 5 cases. 5.Squamous metaplasia was observed in 10 cases. The squamous metaplasia and persistent CCP may be correlated according to the literature. Since squamous metaplasia may precede squamous cell carcinoma, further research is indicated in this area. 6.Since significantly large number of CCP is indicative of viral infection, CCP may be useful not only in diagnosis of viral infection but in study of relation between viral infection and other respiratory diseases. 7.This is the first report of CCP in Korea to the author's knowledge.
Pulmonary Echinococcosis (폐포충증)은 아직까지는 우리나라에서 보기드문 질환인 바 근래 국제 교류가 빈번해지면서부터 문제가 되기 시작하고 있으며, 특히 중동 지역에서 근무한 병력이 있는 환자에서 발생한 국내 보고가 수 예 있을 뿐이다. 저자들의 수술 치험 1례를 보고하는 바이다. Echinococcosis (hydatid disease) is endemic to the Mediterranean region, South America, Australia, and New Zealand where livestock, especially, sheep, are kept. The disease is considered to be rare in this country. However, recently, with increasing numbers of Koreans visiting those countries where hydatid disease is endemic especially Mid East region, the reports of hydatidosis are increasing, in the liver, but very rarelly in the lung. Authors experienced a case of pulmonary hydatid disease in the 30 year old male which was removed surgically on July 1985. We report the case to emphasize the need to consider this condition adding to other differential diagnosis of the mass lesion in the lung in our country and the literatures reviewed.
서울白病院의 胃癌 206例에 대하여 病理學的 所見 및 統計學的 分析을 實施하였고, 아울러 釜山白病院의 胃癌 211例의 成績과 比較 검토하였다. Total 206 cases of stomach cancer which were collected from the Seoul Paik Hospital during 1974 and 1987 were examined for the pathological and statistical studies. The figures were compared with those of the Pusan Paik Hospital. The following findings are obtained ; 1) There 133 cases of male and 73 females, the male/female ratio is 2 : 1. 2) Average age of the diagnosis of the stomach cancer is 51 years of age ; male 51.9 years and female 49.3 years. The figures are not much different from those of Pusan Paik Hospital (211 cases) as well as other Korean hospitals. 3) Average diameter of the cancer is 3.9cm, and 75.2% of total cases fall between 1cm and 6cm categories. Male is 4.2cm and female 3.4cm average sue, the difference of the two figures is statistically significant (P < 0.05). 4) Sites of the cancer are the following of the incidence ; body is 40.3%, antrum 29.1% and the least is cardiac and fundic region being 3.9%. 5) Cancer invaded through subserosa or serosa in 75.2% which is higher than 65.8% of Pusan Pik Hospital's figure. 6) Lymphatic nodal metastasis is found in 68.4% in average, and the incidence is proportionally increased with the advancement of the cancer in the stomach wall. This parallel increase is also observed with the size of the cancer, but less prominent than the former. 7) Undifferentiated cancer is 53.3% and differentiated 46.6%. In male and female, the ratio of these forms are 0.8 : 1 and 2.3 : 1, respectively showing twice as many undifferentiated form developed in female patients. 8) Among younger age group (less than 40 years of age), there are more cases of undifferentiated form. This finding can not be explained with the environmental factor alone, suggesting an hereditary factor may work of the carcinogenesis of stomach cancer. 9) Based upon the size of stomach cancer, it can be said that patients from the Pusan region are discovered later than those of Seoul region. And in the Seoul region, female patients are discovered sooner than male patients.