• Title/Summary/Keyword: Multiple-Chain

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Retail Product Development and Brand Management Collaboration between Industry and University Student Teams (산업여대학학생단대지간적령수산품개발화품패관리협작(产业与大学学生团队之间的零售产品开发和品牌管理协作))

  • Carroll, Katherine Emma
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.239-248
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    • 2010
  • This paper describes a collaborative project between academia and industry which focused on improving the marketing and product development strategies for two private label apparel brands of a large regional department store chain in the southeastern United States. The goal of the project was to revitalize product lines of the two brands by incorporating student ideas for new solutions, thereby giving the students practical experience with a real-life industry situation. There were a number of key players involved in the project. A privately-owned department store chain based in the southeastern United States which was seeking an academic partner had recognized a need to update two existing private label brands. They targeted middle-aged consumers looking for casual, moderately priced merchandise. The company was seeking to change direction with both packaging and presentation, and possibly product design. The branding and product development divisions of the company contacted professors in an academic department of a large southeastern state university. Two of the professors agreed that the task would be a good fit for their classes - one was a junior-level Intermediate Brand Management class; the other was a senior-level Fashion Product Development class. The professors felt that by working collaboratively on the project, students would be exposed to a real world scenario, within the security of an academic learning environment. Collaboration within an interdisciplinary team has the advantage of providing experiences and resources beyond the capabilities of a single student and adds "brainpower" to problem-solving processes (Lowman 2000). This goal of improving the capabilities of students directed the instructors in each class to form interdisciplinary teams between the Branding and Product Development classes. In addition, many universities are employing industry partnerships in research and teaching, where collaboration within temporal (semester) and physical (classroom/lab) constraints help to increase students' knowledge and experience of a real-world situation. At the University of Tennessee, the Center of Industrial Services and UT-Knoxville's College of Engineering worked with a company to develop design improvements in its U.S. operations. In this study, Because should be lower case b with a private label retail brand, Wickett, Gaskill and Damhorst's (1999) revised Retail Apparel Product Development Model was used by the product development and brand management teams. This framework was chosen because it addresses apparel product development from the concept to the retail stage. Two classes were involved in this project: a junior level Brand Management class and a senior level Fashion Product Development class. Seven teams were formed which included four students from Brand Management and two students from Product Development. The classes were taught the same semester, but not at the same time. At the beginning of the semester, each class was introduced to the industry partner and given the problem. Half the teams were assigned to the men's brand and half to the women's brand. The teams were responsible for devising approaches to the problem, formulating a timeline for their work, staying in touch with industry representatives and making sure that each member of the team contributed in a positive way. The objective for the teams was to plan, develop, and present a product line using merchandising processes (following the Wickett, Gaskill and Damhorst model) and develop new branding strategies for the proposed lines. The teams performed trend, color, fabrication and target market research; developed sketches for a line; edited the sketches and presented their line plans; wrote specifications; fitted prototypes on fit models, and developed final production samples for presentation to industry. The branding students developed a SWOT analysis, a Brand Measurement report, a mind-map for the brands and a fully integrated Marketing Report which was presented alongside the ideas for the new lines. In future if the opportunity arises to work in this collaborative way with an existing company who wishes to look both at branding and product development strategies, classes will be scheduled at the same time so that students have more time to meet and discuss timelines and assigned tasks. As it was, student groups had to meet outside of each class time and this proved to be a challenging though not uncommon part of teamwork (Pfaff and Huddleston, 2003). Although the logistics of this exercise were time-consuming to set up and administer, professors felt that the benefits to students were multiple. The most important benefit, according to student feedback from both classes, was the opportunity to work with industry professionals, follow their process, and see the results of their work evaluated by the people who made the decisions at the company level. Faculty members were grateful to have a "real-world" case to work with in the classroom to provide focus. Creative ideas and strategies were traded as plans were made, extending and strengthening the departmental links be tween the branding and product development areas. By working not only with students coming from a different knowledge base, but also having to keep in contact with the industry partner and follow the framework and timeline of industry practice, student teams were challenged to produce excellent and innovative work under new circumstances. Working on the product development and branding for "real-life" brands that are struggling gave students an opportunity to see how closely their coursework ties in with the real-world and how creativity, collaboration and flexibility are necessary components of both the design and business aspects of company operations. Industry personnel were impressed by (a) the level and depth of knowledge and execution in the student projects, and (b) the creativity of new ideas for the brands.

Evolutionary Explanation for Beauveria bassiana Being a Potent Biological Control Agent Against Agricultural Pests

  • Han, Jae-Gu
    • 한국균학회소식:학술대회논문집
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    • 2014.05a
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    • pp.27-28
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    • 2014
  • Beauveria bassiana (Cordycipitaceae, Hypocreales, Ascomycota) is an anamorphic fungus having a potential to be used as a biological control agent because it parasitizes a wide range of arthropod hosts including termites, aphids, beetles and many other insects. A number of bioactive secondary metabolites (SMs) have been isolated from B. bassiana and functionally verified. Among them, beauvericin and bassianolide are cyclic depsipeptides with antibiotic and insecticidal effects belonging to the enniatin family. Non-ribosomal peptide synthetases (NRPSs) play a crucial role in the synthesis of these secondary metabolites. NRPSs are modularly organized multienzyme complexes in which each module is responsible for the elongation of proteinogenic and non-protein amino acids, as well as carboxyl and hydroxyacids. A minimum of three domains are necessary for one NRPS elongation module: an adenylation (A) domain for substrate recognition and activation; a tholation (T) domain that tethers the growing peptide chain and the incoming aminoacyl unit; and a condensation (C) domain to catalyze peptide bond formation. Some of the optional domains include epimerization (E), heterocyclization (Cy) and oxidation (Ox) domains, which may modify the enzyme-bound precursors or intermediates. In the present study, we analyzed genomes of B. bassiana and its allied species in Hypocreales to verify the distribution of NRPS-encoding genes involving biosynthesis of beauvericin and bassianolide, and to unveil the evolutionary processes of the gene clusters. Initially, we retrieved completely or partially assembled genomic sequences of fungal species belonging to Hypocreales from public databases. SM biosynthesizing genes were predicted from the selected genomes using antiSMASH program. Adenylation (A) domains were extracted from the predicted NRPS, NRPS-like and NRPS-PKS hybrid genes, and used them to construct a phylogenetic tree. Based on the preliminary results of SM biosynthetic gene prediction in B. bassiana, we analyzed the conserved gene orders of beauvericin and bassianolide biosynthetic gene clusters among the hypocrealean fungi. Reciprocal best blast hit (RBH) approach was performed to identify the regions orthologous to the biosynthetic gene cluster in the selected fungal genomes. A clear recombination pattern was recognized in the inferred A-domain tree in which A-domains in the 1st and 2nd modules of beauvericin and bassianolide synthetases were grouped in CYCLO and EAS clades, respectively, suggesting that two modules of each synthetase have evolved independently. In addition, inferred topologies were congruent with the species phylogeny of Cordycipitaceae, indicating that the gene fusion event have occurred before the species divergence. Beauvericin and bassianolide synthetases turned out to possess identical domain organization as C-A-T-C-A-NM-T-T-C. We also predicted precursors of beauvericin and bassianolide synthetases based on the extracted signature residues in A-domain core motifs. The result showed that the A-domains in the 1st module of both synthetases select D-2-hydroxyisovalerate (D-Hiv), while A-domains in the 2nd modules specifically activate L-phenylalanine (Phe) in beauvericin synthetase and leucine (Leu) in bassianolide synthetase. antiSMASH ver. 2.0 predicted 15 genes in the beauvericin biosynthetic gene cluster of the B. bassiana genome dispersed across a total length of approximately 50kb. The beauvericin biosynthetic gene cluster contains beauvericin synthetase as well as kivr gene encoding NADPH-dependent ketoisovalerate reductase which is necessary to convert 2-ketoisovalarate to D-Hiv and a gene encoding a putative Gal4-like transcriptional regulator. Our syntenic comparison showed that species in Cordycipitaceae have almost conserved beauvericin biosynthetic gene cluster although the gene order and direction were sometimes variable. It is intriguing that there is no region orthologous to beauvericin synthetase gene in Cordyceps militaris genome. It is likely that beauvericin synthetase was present in common ancestor of Cordycipitaceae but selective gene loss has occurred in several species including C. militaris. Putative bassianolide biosynthetic gene cluster consisted of 16 genes including bassianolide synthetase, cytochrome P450 monooxygenase, and putative Gal4-like transcriptional regulator genes. Our synteny analysis found that only B. bassiana possessed a bassianolide synthetase gene among the studied fungi. This result is consistent with the groupings in A-domain tree in which bassianolide synthetase gene found in B. bassiana was not grouped with NRPS genes predicted in other species. We hypothesized that bassianolide biosynthesizing cluster genes in B. bassiana are possibly acquired by horizontal gene transfer (HGT) from distantly related fungi. The present study showed that B. bassiana is the only species capable of producing both beauvericin and bassianolide. This property led to B. bassiana infect multiple hosts and to be a potential biological control agent against agricultural pests.

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Application of the CRISPR/Cas System for Point-of-care Diagnosis of Cattle Disease (현장에서 가축질병을 진단하기 위한 CRISPR/Cas 시스템의 활용)

  • Lee, Wonhee;Lee, Yoonseok
    • Journal of Life Science
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    • v.30 no.3
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    • pp.313-319
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    • 2020
  • Recently, cattle epidemic diseases are caused by a pathogen such as a virus or bacterium. Such diseases can spread through various pathways, such as feed intake, respiration, and contact between livestock. Diagnosis based on the ELISA (Enzyme-linked immunosorbent assay) and PCR (Polymerase chain reaction) methods has limitations because these traditional diagnostic methods are time consuming assays that require multiple steps and dedicated equipment. In this review, we propose the use of the CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) Cas system based on DNA and RNA levels for early point-of-care diagnosis in cattle. In the CRISPR/Cas system, Cas effectors are classified into two classes and six subtypes. The Cas effectors included in class 2 are typically Cas9 in type II, Cas12 in type V (Cas12a and Cas12b) and Cas13 in type VI (Cas13a and Cas13b). The CRISPR/Cas system uses reporter molecules that are attached to the ssDNA strands. When the Cas enzyme cuts the ssDNA, these reporters either fluoresce or change color, indicating the presence of a specific disease marker. There are several steps in the development of a CRISPR/Cas system. The first is to select the Cas enzyme depending on DNA or RNA from pathogens (viruses or bacteria). Based on that, the next step is to integrate the optimal amplification, transducing method, and signal reporter. The CRISPR/Cas system is a powerful diagnostic tool using a gene-editing method, which is faster, better, and cheaper than traditional methods. This system could be used for early diagnosis of epidemic cattle diseases and help to control their spread.

Development and Validation of Multiplex Polymerase Chain Reaction to Determine Squid Species Based on 16s rRNA Gene (오징어류 종 판별을 위한 다중 유전자 검사법 개발 및 검증)

  • Kim, Hyunsu;Seo, Yong Bae;Choi, Seong-Seok;Kim, Jin-Hee;Shin, Jiyoung;Yang, Ji-Young;Kim, Gun-Do
    • Journal of Food Hygiene and Safety
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    • v.30 no.1
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    • pp.43-50
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    • 2015
  • In this study, single PCR and multiplex PCR tests were examined for identification of four types of squid species (giant squid, cuttlefish, octopus, beka squid) purchased from fish market as well as aquatic processed products in Busan. To design the specific primers against each species, the nucleotide sequences of the mitochondrial 16s rRNA gene of Architeuthis dux, Todarodes pacificus, Enteroctopus dofleini, Enteroctopus megalocyathus, Uroteuthis chinensis, Uroteuthis duvauceli, Uroteuthis edulis groups were analyzed for the identification of each species registered in the GeneBank (www.ncbi.nlm.nih.gov) and have been used for comparative analysis. In order to obtain the size variation of amplified fragments on multiplex PCR, we designed KOJ-F, OJ-F, OCT-F, HAN-F, ALLR primers for each species. The optimal PCR conditions and primers were selected for four types of squid species to determine target base sequences in its PCR products. In the case of single PCR, giant squid was only amplified by KOJ-F/ALLR primer; cuttlefish was only amplified by OJ-F/ALLR primer; octopus was only amplified by OCT-F/ALLR primer; and beka squid was only amplified by HAN-F/ALLR primer. For multiplex PCR, the mixture of four kinds of genomic DNA (giant squid, cuttlefish, octopus, beka squid) been prepared as a template and used together with the mixture of KOJ-F/OJ-F/OCT-F/HAN-F/ALLR primers in the reaction. By the multiplex PCR, it is confirmed that four samples are correspond to multiple simultaneous amplicon. Finally, we validated the established methods of multiplex PCR in the aquatic processed products. Although the mitochondrial 16s rRNA primers used in this study was useful as a marker for detection of each species among them, the study indicated that the established multiplex PCR method can be more useful tool for monitoring the processed products.

The Meaning of Collective Relationships Becoming by Large-scale Interview Project - Focused on the media exhibition art <70mk> - (대규모 인터뷰 작업이 생성하는 집단적 관계성의 의미 - 미디어전시예술 <70mK>를 중심으로)

  • OH, Se Hyun
    • Trans-
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    • v.7
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    • pp.19-48
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    • 2019
  • This study was described to examine the meaning of the media exhibition work <70mK>, which aims to capture the topography of the collective consciousness of the Korean people through large-scale interviews. <70mK> edits and organizes interview images of individual beings in mosaic-like layouts and forms, creating video exhibitions and holding exhibitions. The objects in the split frame show the continuity of differences that reveal their own thoughts and personalities. This is a synchronic and conscious collective typology in which the intrinsic nature of the individuals is embodied in a simultaneous and holistic image. Interview images reveal their own form as a actual being and convey the intrinsic nature of one's own as oral information. <70mK> constructs a new individualization by aesthetically structuring the forms and information of life individuals in the extension of a specific group. The beings in the frame are not communicating with each other and are looking straight ahead. it conveys to visitors their relationship and personality as the preindividual reality. It is the repetitive arrangement and composition of heterogeneity and difference that each individual shows, and is a chain operation that includes collective identity behind it. <70mK> constructs the direct images and sounds of individual interviewee, creating a new form of information transfer called Video Art Exhibition. This makes metaphors and perceptions of the meaning and process of transindividual relationships and the meaning of psychic individuation and collective individuation. This is an appropriate case to explain with modern technology and individualization of Gilbert Simondon thought together with the meaning of becoming and relation of individualization. The exhibition space constructed by <70mK> is an aesthetic methodology of the psychic and collective meaning and its relationship to a particular group of individuals through which they are connected. Simondon studied the meaning of the process of individualization and the meaning of becoming, and is a philosopher who positively considered the potential of modern technology. <70mK> is a new individual as structured and generated ethical reality mediated by modern technology mechanisms and network behaviors. It is an case of an aesthetic and practical methodology of how interviews function as 'transduction' in the process of individualization in which technology is cooperated. The direct images and sounds of <70mK> are systems in which the information of life individuals is carried, amplified, accumulated and transmitted. It is also a new individual as a psychic and collective landscape. It is a newly became exhibition art work through the multiple individualization, and is a representation of transindividual meanings and process. The media exhibition art of individualized metastable states leads to new relationships in which viewers perceive the same preindividual reality and feel affectivity. The exhibition space of <70mK> becomes a stage for preparing the actual possibility of the transindividual group beyond the representation of the semantic function.

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Mushroom consumption patterns in the capital area (수도권 도시가구의 버섯 소비양상)

  • Lee, Yun-Hae;Jeong, Gu-Hyoen;Kim, Yeon-Jin;Chi, Jeong-Hyun;Lee, Hae-Kil
    • Journal of Mushroom
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    • v.15 no.1
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    • pp.45-53
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    • 2017
  • Profitability of farmers has decreased mainly owing to low price while the gross amount of mushroom production has increased continuously in South Korea. In this regard, analyzing patterns of mushroom consumption is believed to be meaningful. We used a panel data set consisting of 667 families, from 2010 to 2015. Based on the panel data, mushroom consumption patterns of people living in city areas were examined. Multiple descriptive analysis methods and frequency analysis approaches were adopted in this study in terms of time and space dimensions, demographic properties, and purchase behaviors. The findings of this studyshow that mushroom purchase is highly dependent on seasonal events, which implies that the product consumption timing is predictable. In addition, yearly purchase amount patterns reflect that superstores have become the major mushroomtrading venues. This directly supports the need to establish supply chain capabilities for mushroom farmers so that they gain more bargaining power against enterprise-type groceries. Finally, functional features of mushroom can be linked with marketing promotion because purchase patterns demonstrate potential needs for healthcare food in mushroom categories. Based on the analyzed patterns, this paper provides insightful implications for policy makers who want to promote mushroom consumption.

Gene Expression of Metalloproteinases, Tissue Inhibitors of Metalloproteinases and Cytokines in Adriamycin-induced Cardiomyopathy (아드리아마이신으로 유도된 심근증에서 Metalloproteinase, Metalloproteinase 조직억제자, Cytokine 유전자 발현에 대한 연구)

  • Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.197-203
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    • 2005
  • Purpose : Changes in metalloproteinases(MMP) activity have been demonstrated in several disease states, including rheumatoid arthritis and tumor metastasis. More importantly, increased myocardial MMP activity has been reported to occur in both clinical and experimental forms of dilated cardiomyopathy. There was no report about MMP in adriamycin(ADR)-induced cardiomyopathy. The purpose of this study was to investigate gene expression of MMP and tissue inhibitor of metalloproteinases(TIMP) in ADR-induced cardiomyopathy and clarify the relationship between MMP and cytokines. Methods : Male Sprague-Dawley rats were divided into two groups. The first group was control. The second group was given intraperitoneal injections of ADR(5 mg/kg) twice a week over two weeks. Serum concentrations of MMP, TIMP, interleukin(IL)-6 and tumor necrosis factor(TNF)-${\alpha}$ were measured. RNA extraction was performed from frozen rat hearts. Reverse transcription polymerase chain reaction(RT-PCR) was employed. cDNA Microarray analysis was performed by using a set of 5,184 sequence-verified rat cDNA clones. Results : Serum MMP and TIMP levels were not significantly different between the two groups. IL-6 was $36.8{\pm}2.8pg/mL$ and TNF-${\alpha}$ $2.2{\pm}2.7pg/mL$ in the ADR group. They were significantly higher than in the control group. Serum MMP correlated significantly with TNF-${\alpha}$(r=0.41, P<0.05). There was no gene expression of MMP, IL-6 or TNF-${\alpha}$ in the hearts of both groups. Gene expression of TIMP was significantly depressed in the hearts of the ADR group. Conclusion : These results suggested a potential role for TNF-${\alpha}$ in the regulation of extracellular matrix remodeling in ADR induced cardiomyopathy. Rapid screening of multiple decreased gene expression by DNA chip may be a useful diagnostic test to detect early cardiac injury before developing ADR induced cardiomyopathy.

Effects of Garcinia cambogia Extract on the Adipogenic Differentiation and Lipotoxicity (가르시니아 캄보지아 추출물의 지방세포 분화 및 지방 독성에 미치는 영향)

  • Kang, Eun Sil;Ham, Sun Ah;Hwang, Jung Seok;Lee, Chang-Kwon;Seo, Han Geuk
    • Food Science of Animal Resources
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    • v.33 no.3
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    • pp.411-416
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    • 2013
  • This study aimed to examine the mechanisms underlying the effects of Garcinia cambogia extract on the adipogenic differentiation of 3T3-L1 cells and long-chain saturated fatty acid-induced lipotoxicity of HepG2 cells. 3T3-L1 preadipocytes, mouse embryonic fibroblast-adipose like cell line, were treated with MDI solution (0.5 mM IBMX, 1 ${\mu}M$ dexamethasone, 10 ${\mu}g/mL$ insulin) to generate a cellular model of adipocyte differentiation. Using this cellular model, the anti-obesity effect of Garcinia cambogia extract was evaluated. MDI-induced lipid accumulation and expression of adipogenesis-related genes were detected by Oil red O staining, Nile Red staining, and Western blot analysis. Effects Garcinia cambogia extract on palmitate-induced lipotoxicity was also analyzed by MTT assay, LDH release, and DAPI staining in HepG2 cells. Garcinia cambogia extract significantly suppressed the adipogenic differentiation of preadipocytes and intracellular lipid accumulation in the differentiating adipocytes. Garcinia cambogia extract also markedly inhibited the expression of peroxisome proliferator- activated receptor ${\gamma}2$ ($PPAR{\gamma}2$), CCAT/enhancer-binding protein ${\alpha}$ ($C/EBP{\alpha}$), and adipocyte protein aP2 (aP2). In addition, Garcinia cambogia extract significantly attenuated palmitate-induced lipotoxicity in HepG2 cells. Palmitateinduced cellular damage and reactive aldehydes were also significantly reduced in the presence of Garcinia cambogia extract. These findings suggest that the Garcinia cambogia extract inhibits the adipogenic differentiation of 3T3-L1 preadipocytes, probably by regulating the expression of multiple genes associated with adipogenesis such as $PPAR{\gamma}2$, $C/EBP{\alpha}$, aP2, and thereby modulating fatty acid-induced lipotoxicity to reduce cellular injury in hepatocytes.

Detection of Campylobacter jejuni in food and poultry visors using immunomagnetic separation and microtitre hybridization

  • Simard, Ronald-E.
    • Proceedings of the Korean Society of Fisheries Technology Conference
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    • 2000.05a
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    • pp.71-73
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    • 2000
  • Campylobacter jejuni is most frequently identified cause of cause of acute diarrhoeal infections in developeed countries, exceeding rates of illness caused by both salmonella and shigilla(Skirrow, 1990 ; Lior 1994). Previous studies on campylobacter jejuni contamination of commercial broiler carcasses in u.s.(Stern, 1992). Most cases of the disease result from indirect transmission of Campylobactor from animals via milk, water and meat. In addition to Campylobactor jejuni. the closely relates species Campylobactor coli and Campylobactor lari have also been implicated as agents of gastroenteritis in humans. Campylobactor coli represented only approximately 3% of the Campylobactor isolates from patients with Campylobactor enteritis(Griffiths and Park, 1990) whereas Campylobactor coli is mainly isolated from pork(Lmmerding et al., 1988). Campylobactor jejuni has also been isolated from cases of bacteremia, appendicitis and, recently, has been associated with Guillai-Barre syndrome(Allos and Blaser, 1994; von Wulffen et al., 1994; Phillips, 1995). Studies in volunteers indicated that the infectious dose for Campylobactor jejuni is low(about 500 organisms)(Robinson, 1981). The methods traditionally used to detect Campylobactor ssp. in food require at least two days of incubation in an enrichment broth followed by plating and two days of incubation on complex culture media containing many antibiotics(Goossens and Butzler, 1992). Finnaly, several biochemical tests must be done to confirm the indentification at the species level. Therfore, sensitive and specific methods for the detection of small numbers of Campylobactor cells in food are needed. Polymerase chain reaction(PCR) assays targeting specific DNA sequences have been developed for the detection of Campylobactor(Giesendorf and Quint, 1995; Hemandex et al., 1995; Winter and Slavidk, 1995). In most cases, a short enrichment step is needed to enhance the sensitivity of the assay prior to detection by PCR as the number of bacteria in the food products is low in comparison with those found in dinical samples, and because the complex composition of food matrices can hinder the PCR and lower its sensitivity. However, these PCR systems are technically demanding to carry out and cumbersome when processing a large number of samples simutaneously. In this paper, an immunomagnetic method to concentrate Campylobactor cells present in food or clinical samples after an enrichment step is described. To detect specifically the thermophilic Campylobactor. a monoclonal antibody was adsorbed on the surface of the magnetic beads which react against a major porin of 45kDa present on the surface of the cells(Huyer et al., 1986). After this partial purification and concentration step, detection of bound cells was achieved using a simple, inexpensive microtitre plate-based hybridization system. We examined two alternative detection systems, one specific for thermophilic Campylobactor based on the detection of 23S rRNA using an immobilized DNA probe. The second system is less specific but more sensitive because of the high copy number of the rRNA present in bacterial cell($10^3-10^4$). By using specific immunomagnetic beads against thermophilic Campylobactor, it was possible to concentrate these cells from a heterogeneous media and obtain highly specific hybridization reactions with good sensitivity. There are several advantages in using microtitre plates instead of filter membranes or other matrices for hybridization techniques. Microtitre plates are much easier to handle than filter membranes during the adsorption, washing, hybridization and detection steps, and their use faciilitates the simultanuous analysis of multiple sample. Here we report on the use of a very simple detection procedure based on a monoclonal anti-RNA-DNA hybrid antibody(Fliss et al., 1999) for detection of the RNA-DNA hybrids formed in the wells.

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Retrospective Study about Medical and Surgical Combination Therapy for Advanced Cervical Tuberculous Lymphadenitis (항결핵제와 수술적 병합치료를 시행한 진행된 결핵성 경부 임파선염 환자에 대한 연구)

  • Song, Ha Do;Kim, Chong Kyung;Cho, Dong Il;Hong, In Pyo;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.277-284
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    • 2008
  • Background: In principle, cervical tuberculous lymphadenitis (CTBL) is a medical disease that may require surgical treatment, particularly in young women who complain of psychosocial and cosmetic problems. We encountered 13 cases of aggravated CTBL treated surgically despite the appropriate course of antituberculous chemotherapy. We report the clinical characteristis of these cases. Methods: The clinical data of 13 patients with aggravated CTBL requiring surgical treatment from January 2000 to December 2006 at the Department of Chest Medicine, Internal Medicine and Plastic Surgery, National Medical Center was reviewed retrospectively. Results: Twelve of the 13 cases (92%) were female. The most common age was 21~30 years (69%). Multiple nodes were palpated in 11 cases (85%). The supraclavicular lymph nodes were sites the most commonly involved (54%). The other involved sites in the order of decreasing frequency were the jugular chain, posterior cervical, submandibular and infraauricular lymph nodes. A palpable mass was the most commonsymptom. Neck pain was reported in 3 cases (23%). General symptoms such as weight loss, fatigue, anorexia and night sweats were noted in 5 cases (38%). Respiratory symptoms such as cough, sputum, hemoptysis, dyspnea and chest pain were observed in 4 cases (31%). Pulmonary tuberculosis was noted in 11 cases (85%). Other extrapulmonary tuberculosis coexisted in 4 cases (31%). This suggests that surgical CTBLs may be manifestations of a systemic disease and might be difficult to treat. Most cases (92%) were stages 2 and 3 at the initial diagnostic period but all cases fell into stage 4 and 5 when reassesed before surgery. The average duration of anti-TB chemotherapy before and after surgery was 10.2 and 15.2 months, respectively. The 13 patients were followed up until June. 2008. Among them, 2 cases had newly developed CTBL and the other 11cases showed no recurrence. Conclusion: In principle, CTBL is the medical disease. However, despite the appropriate course of anti-TB chemotherapy, CTBL can progress to a more advanced stages and grow rapidly to a large-sized or fistulous mass with a persistent abscess. Surgical treatment may be inevitable for patients with psychosocial and cosmetic problems caused by these masses, particularly in young women.