• Advances in pediatric surgery
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• 제2권2호
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• pp.119-128
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• 1996

The survey on branchial anomalies was conducted by Korean Association of Pediatric Surgeons. A total of 173 cases were reported, which were managed by 36 members and cooperators during the three years from January 1, 1993 through December 31, 1995. The following results were obtained by retrospective analysis of the 173 cases of branchial anomalies. The presenting symptoms were cervical mass in 101 cases, pit with or without discharge in 71, cervical abscess in 47 and respiratory difficulty in 3. The average age of the patients with cervical abscess was 52 months. Seventy(79%) of 89 patients with branchial anomalies and a cystic mass had their first clinical manifestations by 1 year of age, while 40(51%) of 78 patients with only a branchial cyst had their first clinical manifestation in first year of life. Radiologic studies were carried out in 77 patients (43%). The preferred diagnostic modalities were ultrasonography(47 patients), simple neck radiogram(19) and CT scan(17). Preoperative diagnosis was correctly made in 156(91%) of 173 patients. Seventeen patients were incorrectly diagnosed as thyroglossal duct cyst in 5 patients, cystic hygroma in 4, dermoid cyst in 3, and lymphadenopathy in 3. There were no remarkable difference in sex and laterality of presentation but bilateral lesions were found in 9(5%) patients and unusual locations of the anomalies were the manubrium, left subclavicular area, median cervial area, preauricular and parotid area. There were 78(45%) patients with cyst, 52(30%) patients with sinus, 35(20%) patients with fistula and 8(5%) patient with skin tag. Embryological classification was possible in only 64(37%) patients. The 2nd branchial anomaly was present in 50(78%), the 1st branchial anomaly in 10(18%), and the 3rd or 4th branchial anomaly in 4(6%). Histopathological study of the lining epithelium(N=134) is recorded that 45% were lined with squamous epithelium, 17% with respiratory epithelium, 6% with. squamous and respiratory epithelium, 14% with inflammatory change. Lymphoid tissue was common(62%) in the wall of the lesions. Twelve(7%) of 158 patients had postoperative complications including wound complication, recurrence and facial nerve palsy.

• 대한두경부종양학회지
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• 제9권2호
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• pp.210-220
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• 1993

Histologically proven 465 cases of neck mass in children were analized for the determination of the nature of lesions. Pathologic specimens were obtained during 10 years from January 1981 to December 1989 at Severance Hospital, Yonsei University, College of Medicine. 1) Congenital lesion was most common in neonate(80%) and congenital lesion and inflamatory disease were common in infancy and inflammatory disease was most common in more than one year old children. Thyroglossal duct cyst was most common(35.4%) disease of the congenital lesion. followed by cytic hygroma(34%) and branchial cleft remnants(29.2%). 2) Benign tumors were discovered most frequently in adolescence (55.2%) and thyroid adenoma(23.7%) and epithelial tumor(21.1%) and hemangiomas(19.7%) were most common. Most common malignant tumors were malignant lymphoma (50%) and Hodgkin's disease and were present in the older children. Metastatic cancers were very rare and their primary sites were deductable in all cases. 3) Reactive hyperplasia of lymph node was most common in inflammatory disease(23.7%). Tuberculosis lymphadenitis was more common than nonspecific lymphadenitis. 4) Bilaterality of lesion was commonly seen in malignant disease(41.7%), reactive hyperplasia of lymph node (38.85%) and metastatic disease(33.3%). Size and duration of the masses were not helpful in the differential diagnosis of the cause of the masses. Pediatric neck mass must be evaluated with its characteristics. sites, bilaterality, size and its cange, duration and patient's age but any of these alone cant not be predicted its causes without biopsy or excision. Biopsy or excision can be done with few complication but biopsy of lymph node for diagnosis is carefully made because a large number of lymph node biopsy showed no definite diagnosis in these selected cases of patients.

• Clinical and Experimental Pediatrics
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• 제48권8호
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• pp.839-845
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• 2005

목 적 : 소아에서 경부 종류는 다양한 원인에 의해 나타나는데 대부분이 양성 경과를 보이며, 감염에 의한 염증성 반응인 경우가 많지만 선천성 낭종이나 악성 종양의 가능성도 있어 주의를 요한다. 본 연구에서는 경부 종류를 주소로 내원하여 조직검사를 시행한 환아들에서 그 원인과 임상 양상, 치료 경과를 알아보고자 하였다. 방 법 : 2000년 1월부터 2004년 3월까지 충남대학교병원 소아과에 경부 종류를 주소로 내원하여 조직검사를 시행 받았던 환아 28례의 진료 기록을 중심으로 후향적으로 연구하였으며 조직검사 방법을 세침 흡인생검술, 심부생검술, 절제생검으로 나누어 연령, 성별, 임상 양상 및 조직검사 결과와 치료에 대한 반응 등을 조사하였다. 결 과 : 조직검사를 받은 환아들은 총 28례로 남아가 14례(50%), 여아가 14례(50%)였고 종류의 위치로 구분하면 목빗근 뒷부위가 19례(67.9%)로 가장 많았다. 말초혈액 검사나 혈청학적 검사 등의 검사실 검사 상 특이할만한 의미 있는 소견은 없었다. 세침 흡인생검술과 심부생검술을 먼저 시행 받은 환아들은 25례(89.3%) 있었는데 반응성 증식인 경우가 10례(40%)로 가장 많았고 육아종성 염증상태가 8례(32%), 괴사성 염증을 보였던 환아들은 4례(16%), 화농성 병변을 보였던 경우가 3례(12%) 있었다. 처음부터 절제생검을 하였던 환아들은 3례(10.7%)로 선천성 이상에 의한 갑상설관 낭과 표피 낭종이 있었으며 1례는 림프아구성 림프종으로 진단되었다. 결 론 : 소아에게서 흔하게 나타나는 경부 종류는 그 원인이 다양하지만 대부분 양성 경과를 보이며 세침 흡인생검술과 심부생검술은 전신 마취를 하지 않고도 안전하게 조직을 얻을 수 있는 방법으로 치료적 절제가 필요한 경우를 제외하고는 경부 종류의 조직을 얻어 조기에 진단하고 치료하는데 도움이 되고 있다.