• Advances in pediatric surgery
• /
• v.8 no.2
• /
• pp.161-165
• /
• 2002

This is a case of tracheomalacia associated with esophageal atresia. An 11-month-old- male boy presented with a life-threatening apneic spell after correction of esophageal atresia (Gross type C). After complete exclusion of the other possible causes of the apneic spell, the presumptive diagnosis of tracheomalacia was made with fluoroscopy and 3-dimensional chest CT. The final diagnosis was made with rigid bronchoscopy under spontaneous respiration. The aortopexy was performed with intraoperative bronchoscopic examination. The postoperative period was unremarkably uneventful. The patient was discharged 9 days after the aortopexy and has remained well to date (5 months after the aortopexy).

• Clinical and Experimental Pediatrics
• /
• v.53 no.2
• /
• pp.244-247
• /
• 2010

Spontaneous pneumomediastinum in the absence of predisposing risk factors has been rarely observed in full-term neonates. A 3-day-old neonate, delivered vaginally at term without any perinatal complications or signs of respiratory difficulty, was referred to the Seoul National University Children's Hospital because of reduced heart sound detected during routine neonatal examination. Chest computed tomography (CT) showed air collection in the anterior mediastinum. The baby developed respiratory distress on the fourth day and required supplemental oxygen. On the seventh day, there was no sign of respiratory difficulty, and x-ray examination showed no demonstrable pneumomediastinum. Hence, careful neonatal physical examination is essential during the postnatal assessment of newborns, and spontaneous pneumomediastinum should be considered when a healthy newborn presents with reduced heart sound.

• Journal of the Korean Society of Radiology
• /
• v.17 no.3
• /
• pp.297-303
• /
• 2023

Pediatric Computed Tomography (CT) examinations can often result in exam failures or the need for frequent retests due to the difficulty of cooperation from young patients. Deep Learning Image Reconstruction (DLIR) methods offer the potential to obtain diagnostically valuable images while reducing the retest rate in CT examinations of pediatric patients with high radiation sensitivity. In this study, we investigated the possibility of applying DLIR to reduce artifacts caused by respiration or motion and obtain clinically useful images in pediatric chest CT examinations. Retrospective analysis was conducted on chest CT examination data of 43 children under the age of 7 from P Hospital in Gyeongsangnam-do. The images reconstructed using Filtered Back Projection (FBP), Adaptive Statistical Iterative Reconstruction (ASIR-50), and the deep learning algorithm TrueFidelity-Middle (TF-M) were compared. Regions of interest (ROI) were drawn on the right ascending aorta (AA) and back muscle (BM) in contrast-enhanced chest images, and noise (standard deviation, SD) was measured using Hounsfield units (HU) in each image. Statistical analysis was performed using SPSS (ver. 22.0), analyzing the mean values of the three measurements with one-way analysis of variance (ANOVA). The results showed that the SD values for AA were FBP=25.65±3.75, ASIR-50=19.08±3.93, and TF-M=17.05±4.45 (F=66.72, p=0.00), while the SD values for BM were FBP=26.64±3.81, ASIR-50=19.19±3.37, and TF-M=19.87±4.25 (F=49.54, p=0.00). Post-hoc tests revealed significant differences among the three groups. DLIR using TF-M demonstrated significantly lower noise values compared to conventional reconstruction methods. Therefore, the application of the deep learning algorithm TrueFidelity-Middle (TF-M) is expected to be clinically valuable in pediatric chest CT examinations by reducing the degradation of image quality caused by respiration or motion.

• The Journal of the Korea Contents Association
• /
• v.19 no.8
• /
• pp.284-292
• /
• 2019

To evaluate the usefulness of pediatric chest CT scans by comparing the dose, examination time, and image quality by applying Helical mode, High-pitch mode, and Volume Axial mode to minimize the radiation exposure and obtain high diagnostic value. Revolution (GE Healthcare, Wisconsin USA) was used to divide PBU-70 phantom into Helical mode, High-pitch mode, and Volume Axial mode. After acquiring images, ROI is set for each image, heart, bone, lung, and back-ground air, and the average value is obtained by measuring CT number (HU) and noise (SD). SNR and CNR were measured and compared with DLP values provided directly by the equipment. Determining statistical significance Statistical analysis was performed using ONE-WAY-ANAOVA using SPSS 21.0. In this experiment, it was possible to inspect at a short time without deterioration of image quality with the lowest dose when using volume axial mode. Although the detector coverage of 16 cm is limited to all pediatric chest CT scans, it is recommended to be actively used in pediatric patients, and further study is needed to apply other test sites in volume axial mode.

• Clinical and Experimental Pediatrics
• /
• v.46 no.12
• /
• pp.1248-1252
• /
• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Korean Journal of Digital Imaging in Medicine
• /
• v.14 no.2
• /
• pp.9-14
• /
• 2012

Exposed dose of young child should be managed necessarily. Young child is more sensitive than adult of a Radioactivity, especially, and lives longer than adult. Must reduce exposed dose which follows The ALARA(As Low As Reasonably Achievable)rule is recommended by ICRP(International Commission on Radiological Protection)within diagnostic useful range. Therefore, We have to prepare Pediatric DRL(Diagnostic Reference Level) in Korea as soon as possible. Consequently, in this study, wish to estimate organ dose and effective dose using PCXMC Program(a PC-Based Monte Carlo Program), and measure ESD(Entrance surface dose)and organ dose using Glass dosimeter, and then compare with DRL which follows EC(European Commission)and NRPB(National Radiological Protection Board). Using glass dosimeter and PCXMC programs conforming to the International Committee for Radioactivity Prevention(ICRP)-103 tissue weighting factor based on the item before the organs contained in the Chest, Skull, Pelvis, Abdomen in the organ doses and effective dose and dose measurements were evaluated convenience. In a straightforward way to RANDO phantom inserted glass dosimeter(GD352M)by using the hospital pediatric protocol, and in a indirect way was PCXMC the program through a virtual simulation of organ doses and effective dose were calculated. The ESD in Chest PA is 0.076mGy which is slightly higher than the DRL of NRPB(UK) is 0.07mGy, and is lower than the DRL of EC(Europe) which is 0.1mGy. The ESD in Chest Lateral is 0.130mGy which is lower than the DRL of EC(Europe) is 0.2mGy. The ESD in Skull PA is 0.423mGy which is 40 percent lower than the DRL of NRPB(UK) is 1.1mGy and is 28 percent lower than the DRL of EC(Europe) is 1.5mGy. The ESD in Skull Lateral is 0.478mGy which is half than the DRL of NRPB(UK) is 0.8mGy, is 40 percent lower than the DRL of EC(Europe) is 1mGy. The ESD in Pelvis AP is 0.293mGy which is half than the DRL of NRPB(UK) is 0.60mGy, is 30 percent lower than the DRL of EC(Europe)is 0.9mGy. Finally, the ESD in Abdomen AP is 0.223mGy which is half than the DRL of NRPB(UK) is 0.5mGy, and is 20 percent lower than the DRL of EC is 1.0mGy. The six kind of diagnostic radiological examination is generally lower than the DRL of NRPB(UK)and EC(Europe) except for Chest PA. Shouldn't overlook the age, body, other factors. Radiological technician must realize organ dose, effective dose, ESD when examining young child in hospital. That's why young child is more sensitive than adult of a Radioactivity.

• The Journal of the Korea Contents Association
• /
• v.14 no.1
• /
• pp.356-363
• /
• 2014

Recently pediatric CT has been performed by reduced dose according to tube current modulation이라고, this fact has a possibility more reduce a dose because of strong affect depend on tube current modulation. Almost all MDCT snow show and allow storage of the volume CT dose index (CTDIvol), dose length product (DLP), and effective dose estimations on dose reports, which are essential to assess patient radiation exposure and risks. To decrease these radiation exposure risks, the principles of justification and optimization should be followed. justification means that the examination must be medically indicated and useful. Results is using tube current modulation이라고 tend to the lower kV, the lower effective dose. In case of use a low dose CT protocol, we found a relatively lower effective dose than using tube current modulation. Average effective dose of our studies(brain, chest, abdomen-pelvis) less than 47%, 13.8%, 25.7% of germany reference dose, and 55.7%, 10.2%, 43.6% of UK(United Kingdom) reference dose respectively. when performed examination for reduced dose, we must use tube current modulation and low dose CT protocol including body-weight based tube current adaption.

• Pediatric Infection and Vaccine
• /
• v.4 no.1
• /
• pp.167-173
• /
• 1997

Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

• Clinical and Experimental Pediatrics
• /
• v.54 no.11
• /
• pp.436-442
• /
• 2011

An anthropometric survey is one of the most important approaches to use when evaluating the health status of children. Secular trends in body sizes, such as height, weight, head circumference, chest circumference, and body mass index showed significant changes over 40 years in Korea. A series of periodic surveys were conducted in 1967, 1975, 1985, 1997, and 2005 by the Korean Pediatric Society and Ministry of Health and Welfare. The quality of data from school health examinations and the Korea National Health and Nutrition Examination Survey has improved, so we can use them now as resources for anthropometric analysis. The final height differences between 1965 and 1997 were 4.5 cm both in boys (168.9 cm in 1965; 173.4 cm in 1997) and girls (155.9 cm in 1965; 160.4 cm in 1997). The differences between 1997 and 2005 were 0.9 cm in boys (174.3cm in 2005) and 0.8 cm in girls (161.2 cm in 2005). There was no difference in final height measurements between 2005 and 2010. An increase in body size at earlier teen ages was pronounced during these decades compared to the previous generation; however, little change has been identified more recently. Body size has been increasing, and obesity has become more prevalent. Systems that gather data should be updated in order to cope with these secular trends. In an upcoming era of secular trends that would be in a slow transition, several surveys that include body measurements should be prepared to meet future needs.

• Advances in pediatric surgery
• /
• v.15 no.1
• /
• pp.68-72
• /
• 2009

Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.