• Pediatric Infection and Vaccine
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• v.4 no.2
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• pp.271-275
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• 1997

We experienced a case of Henoch-Sch$\ddot{o}$nlein purpura associated with Mycoplasma pneumoniae pneumonia in a 28 month old male who suffered from cough, abdominal pain and both leg swelling and pain. Physical examination showed varying sized purpura, characteristic of Henoch-Sch$\ddot{o}$nlein purpura, below both knee. Laboratory test revealed Mycoplasma pneumoniae antibody titer >1:2,560 and cold agglutinins titer 1:64. Chest X-ray showed peribronchial blurring in both lung fields. The patient was treated with midecamycin and prednisolone for 7 days and responded to the treatment well. The authors report a case of Henoch-Sch$\ddot{o}$nlein purpura with Mycoplasma pneumoniae pneumonia with brief review of related literatures.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.503-508
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• 2019

In short a binary value according to a change in the tube voltage by using one of VOLUME AXIAL MODE of scanning techniques of chest CT image quality evaluation in order to obtain high image and to present the appropriate tube voltage. CT instruments were GE Revolution (GE Healthcare, Wisconsin USA) model and Phantom used Pediatric Whole Body Phantom PBU-70. The test method was examined in Volume Axial mode using the pediatric protocol used in the Y university hospital of mass-produced material. The tube voltage was set to 70kvp, 80kvp, 100kvp, and mAs was set to smart mA-ODM. The mean SNR difference of the heart was $-4.53{\pm}0.26$ at 70 kvp, $-3.34{\pm}0.18$ at 80 kvp, $-1.87{\pm}0.15$ at 100 kvp, and SNR at 70 kvp was about -2.66 higher than 100 kvp and statistically significant (p<0.05) In the Lung SNR mean difference analysis, $-78.20{\pm}4.16$ at 70 kvp, $-79.10{\pm}4.39$ at 80 kvp, $-77.43{\pm}4.72$ at 100 kvp, and SNR at 70 kvp at about -0.77 higher than 100 kvp were statistically significant. (p<0.05). Lung CNR mean difference was $73.67{\pm}3.95$ at 70 kvp, $75.76{\pm}4.25$ at 80 kvp, $75.57{\pm}4.62$ at 100 kvp and 20.9 CNR at 80 kvp higher than 70 kvp and statistically significant (p<0.05) At 100 kvp of tube voltage, the SNR was close to 1 while maintaining the quality of the heart image when 70 kvp and 80 kvp were compared. However, there is no difference in SNR between 70 kvp and 80 kvp, and 70 kvp can be used to reduce the radiation dose. On the other and, CNR showed an approximate value of 1 at 70 kvp. There is no difference between 80 kvp and 100 kvp. Therefore, 80 kvp can reduce the radiation dose by pediatric chest CT. In addition, it is possible to perform a scan with a short scan time of 0.3 seconds in the volume axial mode test, which is useful for pediatric patients who need to move or relax.

• Progress in Medical Physics
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• v.22 no.4
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• pp.163-171
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• 2011

The purpose of this study was to investigate the effect of various technical parameters for the dose optimization in pediatric chest radiological examinations by evaluating effective dose and effective detective quantum efficiency (eDQE) including the scatter radiation from the object, the blur caused by the focal spot, geometric magnification and detector characteristics. For the tube voltages ranging from 40 to 90 kVp in 10 kVp increments at the FDD of 100, 110, 120, 150, 180 cm, the eDQE was evaluated at the same effective dose. The results showed that the eDQE was largest at 60 kVp when compares the eDQE at different tube voltage. Especially, the eDQE was considerably higher without the use of an anti-scatter grid on equivalent effective dose. This indicates that the reducing the scatter radiation did not compensate for the loss of absorbed effective photons in the grid. When the grid is not used the eDQE increased with increasing FDD because of the greater effective modulation transfer function (eMTF). However, most of major hospitals in Korea employed a short FDD of 100 cm with an anti-scatter grid for the chest radiological examination of a 15 month old infant. As a result, the entrance surface air kerma (ESAK) values for the hospitals of this survey exceeded the Korean DRL (diagnostic reference level) of $100{\mu}Gy$. Therefore, appropriate technical parameters should be established to perform pediatric chest examinations on children of different ages. The results of this study may serve as a baseline to establish detailed reference level of pediatric dose for different ages.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.93-97
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• 2000

We experienced a case of pathologic aerophagia in a 10-year-old girl who has mental retardation. It was observed that the abdomen was non-distended in the morning and became maximally distended in the evening. Increased passage of flatus, but normal eructation, was noted. Roentgenographic examination showed 'esophageal air sign', abnormal air shadow on proximal esophagus adjacent to the trachea, in simple chest X-ray and visible air swallowing fluoroscopically. We tried a percutaneous endoscopic gastrostomy (PEG) to decompress swallowed air in stomach. We suggest that placement of a PEG catheter in early life, especially in mentally retarded patients, that can be used as desufflator, can prevent the complications of aerophagia. 'Esophageal air sign' may be very helpful for early detection of pathologic aerophagia.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.86-90
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• 2018

Non-infectious complications of peritoneal dialysis (PD) are relatively less common than infectious complications but are a potentially serious problem in patients on chronic PD. Here, we present a case of a non-infectious complication of PD in a 13-year- old boy on chronic PD who presented with symptoms such as hypertension, edema, dyspnea, and decreased ultrafiltration. Chest and abdominal radiography showed pleural effusion and migration of the PD catheter tip. Laparoscopic PD catheter reposition was performed because PD catheter malfunction was suspected. However, pleural effusion relapsed whenever the dialysate volume increased. To identify peritoneal leakage, computed tomography (CT) peritoneography was performed, and a defect of the peritoneum in the left lower abdomen with contrast leakage to the left rectus and abdominis muscles was observed. He was treated conservatively by transiently decreasing the volume of night intermittent PD and gradually increasing the volume. At the 2-year follow-up visit, the patient had not experienced similar symptoms. Patients on PD who present with refractory or recurrent pleural effusion that does not respond to therapy should be assessed for the presence of infection, catheter malfunction, and pleuroperitoneal communication. Thoracentesis and CT peritoneography are useful for evaluating pleural effusion, and timely examination is important for identifying the defect or fistula.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.230-235
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• 2002

We experienced a case of herpes zoster in a 9-months aged infant as followings; The patient had no history of chickenpox or varicella vaccination. Also, her mother had no history of varicella infection and no contact history with varicella during pregnancy. The patient had only a history of exposure to chickenpox patient at 7th days after birth, but fortunately chickenpox was not developed. Sequentially, symptoms of cough with fever and tachypnea were developed on admission date(7 days had passed already after development of the initial skin lesion). On physical examination, multiple grouped painless erythematous papulovesicles with small crusts were observed on the right lower back, flank and abdomen along the T11 dermatome. Coarse breathing sound was osculated, and increased linear infiltrations on both parahilar areas were seen on chest radiography. Liver enzymes were slightly elevated. Tzanck test was negative. The initial titers of anti-VZV IgM and IgG on admission were negative, but the following titers of anti-VZV IgM and IgG were positive. The patient received treatment of acyclovir for 7 days, and healed completely without sequelae. We report this case with brief review of related literatures.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.88-91
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• 2016

Esophageal granular cell tumor (GCT) is a rare neoplasm originating from the Schwann cells of the submucosal neuronal plexus. Histology is the gold standard for its diagnosis. Endoscopic resection or surgical excision should be considered, depending on the potential for malignancy. Here, we report a case of an esophageal GCT in an adolescent. A 12-year-old boy presented with a 1-year history of dysphagia and vomiting. Upper gastrointestinal endoscopic examination and esophagography showed narrowing of the midesophagus, and computed tomography angiography of the thoracic aorta revealed an esophageal or periesophageal mass posterior to the paratracheal segment of the esophagus. The tumor was surgically excised, and based on the pathological findings, esophageal GCT was diagnosed.

• Pediatric Infection and Vaccine
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• v.3 no.2
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• pp.154-162
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• 1996

Purpose : Adenoviruses(Ad) have been shown to play an important role in the etiology of severely acute respiratory diseases, particulary in infants and young children, and the occurrence of fatal outcome and chronic pulmonary sequelae in association with adenoviral infection has been a cause of great interest and concern. This report presents the resul of a retrospective analysis on 30 cases of lower respiratory infection from which adenovirus was isolated. Patients & Methods : The 30 patients in this study represent all detected cases of adenovial infection out of 240 children who were admitted to Sang Sung Medical Center between February to June 1996 showing signs and symptoms of lower respiratory tract infection. The diagnosis of adenovirus infection was based on microscopic visualization of typical cytopathic effect in HEp-2 tissue culture and used monoclonal Ab with nasopharyngeal aspiration. Results : The male/female ratio was 2:1 and the majority of age range was below 36months. Clinical diagnoses in all 30 patients were pneumonia(n=21), bronchitis and Bronchiolitis(n=5) and ARDS(n=4). We recieved the most of patients in the month of May. The chief complaints were fever(93.3%) and cough(80%) and extrapulmonary symptoms were diarrhea(n=5), seizure(n=4), abdominal pain(n=1). The mean duration of fever was $11.95{\pm}6.54$days. Physical examination on admission were crackles(73.3%), coarse breathing sounds(60%), hepatosplenomegaly(33.3%), decreased brething sounds(30%). In WBC counts, 8cases were below $4000/mm^3$ and 14 cases were above $10,000/mm^3$. In platelets counts, 4cases were below $150,000/mm^3$ and 10 cases were above $450,000/mm^3$. 21 cases were above 1 in CRP. GOT and GPT were abnormal in some cases. Chest X-ray revealed diffuse pulmonary infiltration(n=15), pleural effusion(n=6), consolidation(n=4) and hyperaeration(n=3). Seven patients were treated at the peditric intensive care unit with respiratory support and high dose of gammaglobulin. However, one patients died even through he was treated with NO ventilation and high frequency ventilation. Conclusion : Those with adenoviral pneumonia and respiratory infection having long fever duration and symptoms like bacterial pneumonia must be carefully differentiated in order to provide proper treatement and preventive measures due to possible fatal outcome.

• Pediatric Infection and Vaccine
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• v.5 no.1
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• pp.69-78
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• 1998

Purpose : The risk of severe tuberculous disease such as meningitis or miliary tuberculosis increases as younger is the child at the time of infection. Therefore, the early diagnosis and prompt treatment is mandatory for infants with tuberculosis. This study was undertaken to describe the epidemiology, clinical and radiographic manifestations, and response to therapy in infants with tuberculous disease. Methods : Medical records of 29 infants with tuberculosis diagnosed at the Seoul National University Children's Hospital from July, 1985, to April, 1997, were reviewed, retrospectively. A case of tuberculosis was confirmed if M. tuberculosis was isolated from any body site or if there was histologic proof of tuberculosis. Otherwise, the diagnoses were individualized considering history of contact with contagious adult case, clinical manifestations, chest X-ray findings, result of a Mantoux test reaction with 5 tuberculin unit of PPD, and the response to therapy. Results : The mean age at diagnosis was $7.00{\pm}2.65$ months (range, 3 to 12 months). Twelve cases had isolated pulmonary diseases, and the rest had pulmonary disease and meningitis, 5 cases; pulmonary disease and cervical lymphadenitis, 3; isolated meningitis, 3; and miliary tuberculosis, 6. Source case was identified in 19 cases, 7 of which were detected with retrograde manner. Twenty seven of 29 were symptomatic at their initial visit. The presenting symptoms were mainly respiratory or neurologic, and respiratory difficulty was accompanied in 7 cases. Physical examination revealed wheezing in 7 cases and decreased breath sounds in 9. Hepatomegaly or hepatosplenomegaly were frequent. Chest radiographs showed lung parenchymal disease with hilar lymphadenopathy in 18 cases, and focal or generalized emphysematous change in 7 cases. Conclusion : Most of the infants with tuberculosis are symptomatic at diagnosis, and many of infants with intrathoracic tuberculosis presented with symptoms of bronchial obstruction. When tuberculosis is suspected in an infant, the adult source case should be vigorously investigated to aid in diagnosis and for the prevention of further transmission of tuberculous disease. Almost half of infant tuberculosis are preventable if prophylaxis were given when adult cases were diagnosed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.163-169
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• 2004

Purpose: Many diagnostic modalities have been used for diagnosis of gastroesophageal reflux disease (GERD). Feeding materials during esophageal pH monitoring may interfere the result of examination and esophageal pH monitoring can not diagnose GER in case of alkaline reflux. The purpose of our study is to evaluate whether scintigraphy can substitiute 24 hr pH monitoring in children with GERD. Methods: From March 2002 to June 2003, 23 patients (12 boys and 11 girls, mean age 27 months) who have been admitted to Hanyang University Hospital presented with GER symptoms (recurrent vomiting, cough, chest pain, irritability) were included in the study. Scintigraphy and 24 hr pH monitoring were performed in all patients. Results: Six out of the 23 patients (26.1%) had evidence of GER on 24 hr pH monitoring, whereas nine of 23 patients (39.2%) exhibited GER by scintigraphy. Two out of the 23 patients could not be tested because of irritability. Three (14.3%) patients had evidence of GER on both 24 hr pH monitoring and scintigraphy, three (14.3%) patients on only 24 hr pH monitoring, six (28.6%) patients on only scintigraphy, and nine (42.9%) patients had no evidence of GER on both methods. No correlation was observed between 24 hr pH monitoring and scintigraphic results by Fisher's exact test (p=0.523) or Kendal's tau (t=0.678). Conclusion: The results of this study demonstrated that there was no correlation between 24 hr pH monitoring and scintigraphy. Therefore these modalities could be used as complementary tests to diagnose GERD.