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        • SCOPUSKCI등재

          석회유담즙(石灰乳膽汁)의 1예

          박인서,최흥재,백승진,박호길 대한소화기학회 1972 대한소화기학회지 Vol.4 No.2

          The earliesi zeport of curious deposition of calcium salts within the gallbladder was made by Churchman in 1911. In 1926, Volkmann reported two cases and first used the term Kalkmilchgalle or milk of calcium bile. Milk of calcium bile is a relatively rare disease, and has never been reported in Korea. A 40-year-old male was admitted to the Severance Hospital with chief complaint of dull pain in R.U.Q. of 3 months duration under the clinical impression of chronic cholecystitis due to gallstone. Oral cholecystogram revealed well opacified gallbladder showing a variety of shape with the change of the position of the patient. A visible gallbladder of calcium density on upper G.I. Series taken 2 days later and repeated plain films of the abdomen successively taken aroused a suspicion of milk of cacium bile. The plain film of the abdomen taken about one month after discharge to confirm the visualization of gallbladder without cholecystography still showed similar findings of opacified gallbladder, with multiple radiolucency suggesting the presence of gallstones in the cystic duct and gallbladder by which preoperative diagnosis of milk of caIcum bile could be made with certainty.

        • KCI등재

          악성난소종양의 임상 및 병리학적 고찰

          박인서,김용철,조성진,구은주,한병수,송준 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.5

          1982년 1월부터 1988년 7월말까지 만 6년 7개월동안 국립의료원 산부인과에서 악성난소종양으로 수술을 받고 병리조직학적 검사로 확진된 45예에 대하여 다음과 같은 결론을 얻었다. 1. 악성난소종양의 발생빈도는 전 난소종양의 16.7%이었다. 2. 환자의 연령분포는 50~59세에서 가장 빈도가 높았고 평균연령은 45.6세이었다. 3. 환자중 무경산군은 28.9%이었고 원발성 불임증이 11.1%이었다. 4. 내원전 1년간의 월경이 규칙적이었던 예가 42.1%, 폐경이 35.6%, 생리적 무월경 6.7%였고, 월경장애를 나타낸 경우는 15.5%였다. 5. 자각증상은 복부종양 촉지가 62.2%, 하복통이 31.1%, 단순 복부팽대가 11.1%, 월경장애가 8.9% 순이었다. 6. 복수의 세포진검사의 양성율은 60%이었다. 7. FIGO 분류법에 의하면 제1기 64.4%, 제2기 8.9%, 제3기 11.1%, 제4기 15.6%이었다. 8. 난소종양의 병리조직학적 분류는 점액성낭성암이 19예로 42.2%, 장액성낭성암 13예로 29.0%로 Krukenberg종양이 5예로 11.1%, Dysgerminoma와 악성내막성상피암이 각각 2예로 4.5%, 과립세포종, 임파종, 혈관성육종이 각각 1예씩 있었다. 9. 병리조직학에 의한 악성난소종양의 양측성은 31.1%이었다. 10. 수술요법으로는 전자궁적출술과 양측난소 및 난관절제술을 시행한 예가 51.1%로 가장 많았고, 일측난소 및 난관절제술을 시행한 예가 26.7%, 전자궁절제술과 일측 난소난관절제술 예가 15.5%, 전자궁적출술과 양측 난소난관절제술과 대망절제술 예가 13.3%, 시험적 개복술과 생검만을 시행한 경우도 6.7%이었다. 11. 수술후 합병증으로는 발열 5예, 창상감염 4예, 요로감염 4예, 장폐쇄 1예가 있었다. 12. 수술 및 보조적 요법을 시행한 예의 5년 생존율은 추적조사가 안되어 정확한 수치를 알 수 없었다. A clinicopathological studies were made on a series of 45 malignant ovarian tumors treated at the Department of Obstetrics and Gynecology, National Medical Center from January 1, 1982 to July 31, 1988. The results were as follows: 1. The incidence of malignancy was 16.7 % among all ovarian tumors. 2. The average age was 45.6 years old with the highest frequency in 6th decade. 3. Patients of nulliparity and primary infertility occupied 28.9 % and 11.1 % respectively. 4. Previous menstrual cycles has been normal in 42.1 %, postmenopause in 35.6 %, physiologic amenorrhea in 6.7 % and some menstrual abnormalities in 15.6 %. 5. In relation to the clinical stages based on FIGO classification, stage I was 64.4 %, stage II in 8.9 %, stage III in 11.1 % and stage IV in 15.6 %. 6. Peritoneal cytology was reported as positive in 60.0 %. 7. Histologic incidence was as follow: mucinous cystadenocarcinoma in 42.5 %m serous cystadenocarcinoma 29.0 %, Krukenberg tumors in 11.1 %, endometrioid adenocarcinoma 4.4 %, dysgerminoma in 4.4 % and single case of malignant teratoma, granulosa cell tumor, lymphoma, hemangiosarcoma. 8. Bilaterality were noted in 31.1 % by microscopic examination. 9. Treatment was surgical, primarily and its principle was total hysterectomy with bilateral salpingo-oophorectomy with or without omentectomy. Adjuvant treatments, chemotherapy with Mephalan or Cisplatin or CAP and external irradiation were performed. 10. It was difficult to get 5 year survival rate because of insufficient follow up study.

        • KCI등재

          근치적 외음부절제술 , 서혜부 임파절제술 및 박근 근피판 이식술로 치료한 외음부암 1 례

          박인서,김혜경,박찬용,박창서,홍성미 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.3

          저자들은 국립의료원 산부인과에서 50세의 여성에서 발생한 외음부 편평상피암을 외음부절제술, 심층서혜부 임파 절제술을 시행하고 박근 근피판을 이용한 회음부 재건술로 만족할 만한 결과를 얻었기에 간단한 문헌고찰과 함께 보고하는 바이다. Extensive en bloc surgery is recommended as the treatment method of choice for invasive carcinoma of the vulva and has enhanced the probabilities of increased 5-year survival. At the same time, reconstruction of vulvar defect following radical surgery has been great concern to surgeon. Among surgeries for vulvovaginal reconstruction, gracilis myocutaneous falps can afford simple and save methods. Our experience with myocutaneous gracilis flap at the time of radical vulvectomy for vulvar cancer will lead us to adopt it as our routine procedure.

        • SCOPUSKCI등재

          큰 특발성 비신단락이 있는 문맥압항진증 환자에서의 비정맥 혈류방향과 혼수와의 관계

          박인서,김원호,이문형,강진경,최흥재,천선희,한광협 대한소화기학회 1989 대한소화기학회지 Vol.21 No.2

          In patients with portal hypertension, the splenorenal shunt is one of the most common portosystemic collaterals. Spontaneous hepatic encephalopathy frequently occurs in these patients, due to neurotoxic substances that bypass the liver and act on the central nervous system directly. Therefore it is important to assess portal hemodynamics in portal hypertensive patient with porto-systemic shunt. We examined the portal blood flow by the Doppler flowmetry system in 9 patients with liver cirrhosis and 3 patients with hepatocellular carcinoma associated with liver cirrhosis who had large spontaneous splenorenal shunts. Of the 12 subjects, 7 patients had a history of spontaneous hepatic encephalopathy and 5 patients did not. One of the 5 patients with a history of spontaneous hepatic encephalopathy and 4 of the 5 patients without such a history had mild esophageal varices. We could assess the direction of splenic venous flow in 6 patients with a history of spontaneous hepatic encephalopathy and they all showed reversed flow. Only one patient among the 5 patients without such a history showed reversed splenic venous flow. The portal vein diameter was significantly smaller in patients with a history of spontaneous hepatic encephalopathy (0.88±0.27 cm) than in patients without this history (1.32±0.08 cm)(p$lt;0.01). We conc1uded that the direction of splenic venous flow and the diameter of the portal vein in portal hypertensive patients with a large splenorenal shunt may be important factors in the development of spontaneous hepatic encephalopathy.

        • KCI등재

          제왕절개술 후 발생한 급성 신부전증 1 례

          박인서,조성진,박창서,김영석,노은배,한지현 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.10

          임신 초기에 발생하는 급성 신부전의 원인인 패혈성유산은 무균조작과 항생제의 영향으로 현저하게 감소하였다. 임신 말기나 분만시에 발생하는 과도한 출혈이나 임신 중독증 또는 태반 조기박리에 병발하는 경우도 감소되고, 전체 ARF중 임신예는 4%정도이다. 이는 혈관내 혈액 응고현상이 있거나 다량의 출혈이 있을 때, 혈량을 적시에 보충 유지하고, 신장 혈류를 유지함으로써 비가역적인 신피질괴사로 이행하는 것을 예방할 수 있게 되었기 때문이다. 이에 최근 본 교실에서 경험한 제왕절개술후 속발한 급성신부전증 1예를 문헌고찰과 함께 보고하는 바이다. Acute renal failure refers to a serious rapid suppression of renal function, resulting in accumulation of nitrogen wastage materials. To reduce the mortality and chronic sequele, it can`t be overemphasized to avoid and correct several predisposing factors and to manage meticulously if the condition supervenes especially pregnancy and puerperium. We experienced a case of acute renal failure following Cesarean section and reported this case with brief of literatures concerned.

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