• 대한기관식도과학회지
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• 제5권1호
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• 대한두경부종양학회지
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• 제18권2호
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• pp.192-196
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• 2002

Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

• Pediatric Infection and Vaccine
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• 제7권1호
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• pp.152-158
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• 2000

목 적 : 초기 증상이 발열과 경부림프절종대인 Kawasaki병 환아와 경부 림프절염의 임상적 특징을 비교 관찰함으로써 Kawasaki병의 조기 진단과 치료에 도움을 주고자 하였다. 방 법 : 초기 진단이 임상적으로 경부 림프절염, 경부 농양, 비정형성 Kawasaki병 의증 등으로 치료받다 후에 임상적 진단 기준에 의해 Kawasaki병으로 최종 진단된 환아와 경부 림프절염 환아의 후향적 의무기록 조사를 하였다. 결 과 : 발열과 경부 림프절염이 주증상인 Kawasaki병은 일반적 Kawasaki병 보다 좀 더 나이든 환아에서 발생하였으며, 전신적 염증을 시사하는 소견이 더 높게 나타났다. 경부 림프절염 환아들과 비교하였을 시도 전신적 염증을 시사하는 소견이 의미있게 높았다. 경부 림프절염 환아는 항생제 치료 후 0~3.5일(평균 1.4일)내에 임상적 호전을 보였으나, Kawasaki병의 환아들은 항생제에 반응하지 않거나 다른 소견들이 나타나 입원 1~5일(평균 2.9일)에 감마 글로부린을 사용하였으며, 감마 글로부린 사용 후 평균 11.7시간 내에 발열이 소실되었다. Kawasaki병에서 심장에 나타나는 변화는 3례(20%)였으며, 림프절종대 유무와 관계가 없었다. 결 론 : 발열과 경부 림프절종대를 주소로 경부 림프절염 진단 하에 항생제 치료를 받는 환아 중 항생제에 반응하지 않는 경우, Kawasaki병의 검사실적 소견을 보일 때 다른 감염성 질환 외에 Kawasaki병을 꼭 고려해야 한다. Kawasaki병의 다른 임상적 소견들이 나타나는지 주의 깊게 관찰하여, 신속한 진단과 치료를 통해 심장 합병증을 방지하도록 해야 한다.

• Clinical and Experimental Pediatrics
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• 제53권8호
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• pp.801-804
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• 2010

Purpose: This study aimed to evaluate the usefulness of the needle aspiration alternative to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage. Methods: From January 1998 to June 2008, we retrospectively reviewed 38 children treated with needle aspiration as management with suppurative cervical lymphadenitis instead of open surgical drainage. Results: All 38 children underwent only 1 puncture. Two patients (5.2%) out of 38 patients experienced reformation of an abscess and all recovered completely after re-treatment with antibiotics. Minor complications were detected in 2 patients (5.2%). One complication originated from remnant necrotic tissue and the other involved formation of a small scar in two patients, which resolved spontaneously. There were no major complications. Conclusion: Needle aspiration can be a simple, safe, and effective alternative procedure to open surgical drainage of children with suppurative cervical lymphadenitis requiring surgical drainage.

• 대한두경부종양학회지
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• 제11권1호
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• pp.3-8
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• 1995

Tuberculous cervical lymphadenitis is one of common cause of neck mass in young adult in Korea. Tuberculous cervical lymphadenitis known as scrofula was being treated by the 'Royal Touch' in the 5th century and by surgery in the 17th century, yet the principle of the treatment is still controversal. We report the clinical evaluation and therapeutic result about 121 tuberculous cervical lymphadenitis. The result were as follows: 1) The annual incidence(1985-1994) was 30.5 % (37 cases: 1985-1986), 17.7 % (21 cases: 1990-1992). 19.8%(24 cases: 1994). 2) The age of highest incidence was 20-29 year old age group in 41.3% (50 cases) and female predominated over male by 1.8 : 1. 3) The duration of disease was less than 6 months, in 85.9% (104 cases). 4) The most commonly involved LN group was superficial cervical group in 69.4% (84 cases), and difference between Rt & Lt, was not significant. 5) The most common symptom and local finding(P/E) were, painless swelling of LN in 74.3 % (90 cases) and single mass in 59.5 % (72 cases). 6) In seasonal variation, 85.9% (104 cases) was spring and summer. 7) Procedures except biopsy for evaluation were chest PA, AFB smear & culture(sputum), Mantoux test, USG, CT and, Associated extracervical tuberculous lesions were lung, axilla, breast. 8) In operation method (involving biopsy), Excision was 68.5 % (83 cases), neck dissection was 6.6% (8 cases). 9) The Modality, Duration and side effect of antituberculous medication: INH-Rifampin­Ethambutol was 66.1 % (88 cases), duration was 1 year in 84.3% (102 cases), side effects were severe GI trouble (24.8%), liver function damage (3.3%). 10) 3 cases recurred on the same site after 2 yrs(2 cases) and 4 months(1 case) and its treatment was curretage or I & D, with antituberculous medication.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.35-41
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• 1995

연구배경: 결핵성 경부임파선염의 진단은 임상소견, 흉부 X-선검사, 튜베르큘린검사의 비관혈적 방법으로 내리기 어려워, 경부 임파절 생검을 필요로 하는 경우가 많다. 저자들은 종합효소연쇄반응(polymerase chain reaction, PCR) 기법을 이용하여 결핵성 경부임파선염을 진단할 수 있는지 알아보고, 가능하다면 그 유용성을 평가해 보고자 본 연구를 시행하였다. 방법: 경부 종물로 내원한 환자의 생검 조직과 세침흡인 검체 29예에서 DNA를 추출하여, 결핵균 DNA인 IS6110의 일부를 복제하기 위한 IS-1,-2를 primer로 사용하여 PCR을 시행하였다. 결과는 임상적 진단 및 병리, 세균학적 진단과 비교하였다. 결과: 평균 107.5mg의 생검조직과 2회 세침흡인 검체에서 추출한 DNA의 양은 각각 평균 $32.46{\pm}17.22mg$과 $220{\pm}140ng$이었고 $OD_{260}/OD_{280}$은 각각 $2.11{\pm}0.23,\;2.76{\pm}0.39$이었으며, 상존유전자인 $\beta$-actin 유전자를 목표로 하는 PCR은 전예에서 양성이었다. 병리학적으로 결핵으로 진단한 8예중 8예 전예에서, 병리소견상 확진되지 않았으나 임상적으로 결핵성 경부임파선염으로 진단한 8예중 5예에서, 병리학적으로 악성 임파절전이나 갑상선낭종으로 진단되어 결핵성 경부임파선염이 배제된 6예중 0예에서, 그리고 임상적으로 결핵성 경부임파선염이 배제된 7예중 2예에서, 결핵균 DNA를 목표로 한 PCR 결과가 양성이었다. 결론: 경부 임파절 조직과 세침흡인 검체의 결핵균 PCR 기법은 결핵성 경부임파선염의 진단에 유용한 방법이라고 생각한다.

• Pediatric Infection and Vaccine
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• 제10권1호
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• pp.123-126
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• 2003

저자들은 내원 10일 전부터 발현된 경부 종괴를 주소로 내원한 12세 여아에서 혈청학적 검사상 증명된 Yersinia 감염을 동반한 아급성 괴사성 림프절염 1례를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다.

• 대한두경부종양학회지
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• 제8권2호
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• pp.91-96
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• 1992

The efficacy of the fine needle aspiration biopsy and cytological examination(FNABC) under ultrasonographic(US) guides for the diagnosis of cervical tuberculous lymphadenitis was assessed. There were one hundred and one patients whose neck masses were proven to be tuberculous lymphadenites with cytologic and/or histologic diagnosis. The physical characteristics shown by US revealed that all the cases were multiple lesions. Multiregional lesions were found in 80 cases(79.1%) and 19 cases(18.8%) were the bilateral lesion. The region V was the most prevalent site(n=69, 68.3%). US findings revealed 92 cases(90.9%) showed hypoechoic lesions and 9(9.1%) showed mixed echo patterns. There was no hyperechoic lesion (p<0.05). The sensitivity of FNABC was 77.2% and specificity was 99.0%. Diagnostic accuracy was 85.0%. There was no complication during the procedures. FNABC for the diagnosis of cervical tuberculous lymphadenitis is a safe, convinient procedure and has a high specificity. The pitfall of FNABC the low sensitivity, seemed to be compensated by US evaluations.

• 대한기관식도과학회지
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• 제6권2호
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• pp.164-171
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• 2000

Background and Objectives： Necrotizing lymphadenitis or Kikuchi's disease is characterized by cervical lymphadenopathy of unknown etiology with unique histologic findings in young female patients. The importance of this disease lies in the fact that it can be easily misdiagnosed as malignant lymphoma, hence, clinicians need to aware of this disease entity. The purpose of this study is to report the clinicopathologic findings, radiographic findings, and many laboratory tests in order to contribute to the diagnosis and treatment of necrotizing lymphadenitis. Materials and Methods： We evaluated 31 patients, who were diagnosed as necrotizing lymphadenitis by excisional biopsy or fine needle aspiration cytology or ultrasound guided 18G cutting needle biopsy, retrospectively. Result : The median age was 24.8 years (range 12 to 43 years) and the male to female ratio was 1 : 2.4(9：22), with 14 females (45.1%) under 30 years. The common chief complaints were neck mass, easy fatigue and fever. Lymph node enlargement was limited to the cervical area in most cases (28cases : 90.3%). The involved lymph nodes were usually multiple (20cases : 64.5%), unilateral (26cases 83.9%) and small sized. Leukopenia (19cases : 61.3%) and elevation of ESR (18cases : 58.1%) appeared most frequently in the abnormal laboratory data. These symptoms will be gone spontaneoulsy without any specific treatment in several weeks or months. Conclusion : We should consider open biopsy or fine needle aspiration cytology or ultrasound guided cutting needle biopsy with lymph node in patients who have cervical lymphadenopathy with easy fatigue and fever, especially young women to exclude other conditions such as malignant lymphoma and tuberculosis, etc.

• 대한기관식도과학회지
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• 제2권2호
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• pp.264-267
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• 1996

Necrotizing lymphadenitis is a peculiar reactive condition with a predilection for cervical lymph nodes commonly in young women. It is characterized by persistent, painless cervical adenopathy with or without fever. Although the histologic features may be confused with those of malignant lymphoma, to our knowledge the natural history has been benign in all cases to date. The excised lymph nodes were moderately enlarged and typically showed focal, well-circumscribed, paracortical, necrotizing lesions, and abundant karyorrhectic debris, scattered fibrin deposits, aggregates of large mononuclear cells, and a paucity of plasma cells and neutrophils. Recently we experienced two female cases of necrotizing lymphadenitis and report with a review of literature.