• Journal of Chest Surgery
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• 제31권2호
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• pp.190-193
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• 1998

본 강북삼성병원 흉부외과에서는 병적골절이 동반된 원발성 흉골결핵을 치험 하였다. 22세된 여자환자가 특별한 외상이없이 발생한 흉골부위의 통증 및 골절로 입원 하였다. 입원당시 시행한 흉부단순촬영 및 전산화단층촬영상 흉골의 괴사소견과 연부조직의 부종이 관찰되었다. 세침세포검사상 냉농양을 동반한 결핵성 골수염으로 진단되어 술전 항결핵 치료후 수술을 시행하였다. 수술시 흉골중앙부위의 골괴사 및 다발성 누공을 확인하였으며, 골괴사 부위를 제거한후 환자의 장골능을 골이식 하였다. 병리조직학적 결과는 결핵성 골수염의 소견 및 치즈양괴사를 보였다. 술후 경과는 양호 하였으며, 2개월동안의 추적검사상 흉골의 불안정은 관찰되지 않았다.

• Investigative Magnetic Resonance Imaging
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• 제20권3호
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• pp.200-205
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• 2016

In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extra-axial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.

• 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.

• Advances in pediatric surgery
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• 제12권2호
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• pp.244-250
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• 2006

Splenic abscess is a rare clinical condition with a reported incidence of 0.14 % to 0.70 % in various autopsy series. Primary tuberculosis of the spleen as a cause of splenic abscess is even rarer, especially in the antitubercular era. Infants and children have a higher predisposition to extra-pulmonary tuberculosis than adults and tend to develop severe extra-pulmonary disease such as miliary tuberculosis and meningitis. The diagnosis of tuberculosis in infants and children can be difficult because of nonspecific symptoms and clinical findings. Computed tomography establishes the diagnosis of splenic abscess and demonstrates the number and location of abscesses. Splenectomy is the standard of care in most clinical setting. We present a 4-year-old girl who had multiple tuberculosis splenic abscesses and was treated successfully with splenectomy.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1106-1110
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• 1989

We experienced 53 cases of tuberculous peripleural abscess, which had been proved by histopathological study, from Jan. 1980 to Dec. 1988. In 53 cases of abscesses, mean age was 25 years which was ranged from 1 year and 3 months old boy to 61 years old female [Male: Female=1.4: 1]. The location of the lesion was mainly right-sided [62%] and lateral predilection [53%]. In most of cases [85%], there was history of pulmonary tuberculosis and pleural thickening, but negative mycobacterial culture in the pus. Rib involved cases, confirmed by histopathologic examination, were 38.9% of all cases, which were all removed during operation. Combined pathologic lesions were all cleared at the same time, principally. There were 8 cases of recurred, of which at the same sided, 7 cases and contralateral sided, 1 case.

• 대한기관식도과학회지
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• 제14권2호
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• pp.64-69
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• 2008

Craniovertebral junction (CVJ) tuberculosis is a rare disease, and potentially fatal due to the risk of atlantoaxial dislocation. The disease usually accompanies a retropharyngeal cold abscess, which can cause subsequential otolaryngologic symptoms such asdysphagia, odynophagia, or airway obstruction. Such a patient must be handled with great care to avoid a disaster. The disease is diagnosed with microbiological or other laboratory tests on the pus collected through puncture and aspiration, which will need otolaryngologic skills. For treatment, otolaryngologists play an important role by doing incision and drainage of the retropharyngeal abscess, or by attending the transoral vertebra surgery as partners with spine surgeons who will manage the CVJ lesions and ensure the craniocervical stability.

• 대한세포병리학회지
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• 제12권1호
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• pp.25-30
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• 2001

Tuberculous lymphadenitis is not uncommon in Korea. Therefore, an inexpensive, safe and rapid method is needed to diagnose the tuberculous lymphadenitis. Flne needle aspiration cytology Is a good method for this purpose, but has several limitations in the diagnosis of tuberculous lymphadenitis, especially when the presence of acid-fast bacilli is not proved. To evaluation the usefulness of the polymerase chain reaction with enzyme immunoassay technique in the detection of Mycobacterium tuberculosis (M. tuberculosis) In the cervical Iymph node asplrates, the authors performed fine needle aspiration cytology and M. tuberculosis PCR with enzyme immunoassay for mycobacterial DNA sequences from 15 cases of the fine needle aspirates. Cytomorphologically, the cases were categorized into three types: predominantly necrotic materials; typical epithelioid cell granulomas with or without slant cells and caseous necrosis; and non-tuberculous lesions, such as reactive lymphadenitis, abscess, metastatic carcinoma and malignant lymphoma. M. tuberculosis DNA was found in 8 of 15 cases by PCR with enzyme immunoassay. Negative findings on PCR were achieved in 7 cases, which revealed non-tuberculous tymphadenopathy. In conclusion, we suggest that M. tuberculosis PCR with enzyme immunoassay using the fine needle aspirates is a very useful tool for the diagnosis of tuberculous lymphadenitis.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.317-325
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• 2007

Objective : The purpose of the study was to determine the clinical effects of anterior radical debridement on a series of patients with spontaneous spinal infection. Methods : We retrospectively analyzed the clinical characteristics of 32 patients who underwent surgical treatment from January 2000 to December 2005 in our department. The average follow-up Period was 33.4 months (range, 6 to 87 months). Thirty-two patients presented with the following : 23 cases with pyogenic spondylitis, eight with tuberculous spondylitis and one with fungal spondylitis. The indications for surgery were intractable pain, failure of medical management, neurological impairment with or without an associated abscess, vertebral destruction causing spinal instability and/or segmental kyphosis. Results : The study included 15 (46.9%) males and 17 (53.1%) females ranging in age from 26 to 75 years (mean, 53.1 years). Diabetes mellitus (DM) and pulmonary Tbc were the most common predisposing factors for pyogenic spondylitis and tuberculous spondylitis. Staphylococcus aureus (13%) was the main organism isolated. The most prevalent location was the lumbar spine (75%). Changes in the pain score, Frankel's classification, and laboratory parameters demonstrated a significant clinical improvement in all patients. However, there were recurrent infections in two patients with tuberculous spondylitis and inappropriate debridement and intolerance of medication and noncompliance. Autologous rib, iliac bone and allograft(fibular) were performed in most patients. However, 10 patients were grafted using a titanium mesh cage after anterior radical debridement. There were no recurrent infections in the 10 cases using the mesh cage with radical debridement. Conclusion : The findings of this study indicate that surgery based on appropriate surgical indications is effective for the control of spinal infection and prevention of recurrence with anterior radical debridement, proper drug use and abscess drainage.

• Clinical and Experimental Pediatrics
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• 제56권2호
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• pp.86-89
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• 2013

A retropharyngeal abscess is a rare disease entity in young infants but can develop after nasopharyngeal viral infection. Group B Streptococcus and Staphylococcus aureus are the most common pathogens in young infants, however, Mycobacterium tuberculosis is very rare. We report the case of retropharyngeal abscess and coinfection with S. aureus and M. tuberculosis in a very young infant presenting with respiratory symptoms due to upper airway obstruction. Usually tuberculous retropharyngeal abscesses are caused by the direct invasion of the bacteria from the spine via anterior longitudinal ligament of the spine. However, in this case, no associated spinal disease was observed.

• Journal of Yeungnam Medical Science
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• 제1권1호
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• pp.135-138
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• 1984

결핵성 척추압박골절등 결핵성 척추 골성변화나 결핵성 농양의 흔적이 전혀없이 척수강 배면에 발생한 아주 희귀한 단순성 단발성 경 척수강의 결핵성 육아종에 의해서 초래된 척수신경 압박증예를 치험하고 해부병리학적으로 확진한 후 문헌고찰과 함께 보고한다.