• 대한소아치과학회지
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• 제48권1호
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• pp.31-41
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• 2021

연구의 목적은 7세부터 15세 사이 소아청소년을 대상으로 정중구개봉합의 성숙도와 SMI 및 MP3 방법으로 평가된 골 성숙도와의 연관성을 분석하고 수완부 골 성숙도와 중지의 중절골 성숙도가 정중구개봉합 성숙 단계를 예측할 수 있는 지표로 사용될 수 있는지 알아보기 위함이다. 이번 연구 대상은 무작위로 선택된 7세부터 15세 사이 남자 132명과 여자 135명으로 교정 치료 전 교정 진단을 위해 촬영 되었던 CBCT 수평면 영상 이용하여 정중구개봉합의 성숙도를 5단계로 평가하였고 수완부 방사선 사진을 이용하여 골 성숙도를 평가하였다. 정중구개봉합 성숙도와 SMI 방법으로 평가된 골 성숙도는0.905, MP3 방법으로 평가된 골 성숙도는 0.830으로 강한 상관관계를 보였다. 정중구개봉합 성숙도와 연령의 상관관계는 0.868으로 나타나 비교적 높은 상관관계를 보였다. 이번 후향적 연구를 통해 골 성숙도 평가를 위한 SMI와 MP3 방법은 정중구개봉합 성숙도를 예측할 수 있는 지표로 사용될 수 있음이 증명 되었으며 SMI 방법이 MP3 방법보다 더 나은 신뢰성을 보였다. 따라서 정중구개봉합 성숙도 평가가 필요한 모든 소아환자들을 대상으로 CBCT촬영하는 것은 불필요할 수 있으며 CBCT와 대체 가능한 SMI 와 MP3 방법은 최소의 방사선 피폭으로 간단하게 성장기 아동의 악정형 장치의 최적의 치료 시기 결정의 참고자료로 활용될 수 있을 것이다.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.528-533
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• 2012

Objective : In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. Methods : One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. Results : Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was $50{\pm}45$ months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. Conclusion : In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.

• 대한소아치과학회지
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• 제49권2호
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• pp.131-139
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• 2022

이번 연구는 소아의 인접면 우식을 진단하는데 있어 사용하고 있는 구내방사선 사진에서 심층학습(deep learning) 알고리즘을 활용하여 치아우식을 진단하는 모델의 성능을 평가하고자 하였다. 제1유구치와 제2유구치 사이의 인접면이 포함된 500개의 구내방사선 사진을 대상으로 연구를 시행하였다. 치아우식을 진단하는 모델의 학습에는 Resnet50 기반의 인공신경망 모델을 사용하였다. 평가자료군에서 진단모델의 정확도, 민감도, 특이도를 구하고, ROC 곡선을 얻어 AUC 값을 바탕으로 분류 모델의 성능을 평가하였다. 학습 모델의 정확도는 0.84, 민감도는 0.74, 특이도는 0.94로 나타났으며 AUC는 0.86으로 나타났다. 인공신경망을 기반으로 하는 소아의 구내방사선 사진에서의 인접면 우식의 진단 모델은 비교적 높은 정확도를 보여주었다. 심층학습 모델은 구내방사선 사진상에서 인접면 우식을 진단하는데 있어 향후 치과의사를 보조하는 진단 도구로서 활용될 수 있을 것이다.

• 치과방사선
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• 제25권2호
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• pp.437-445
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• 1995

The purpose of this study was to evaluate the equivalent and effective dose, and estimate radiation risk to the critical organs of head and neck region from the use of adult and child mode in panoramic radiography. The results were as follows. 1. The salivary glands showed the highest equivalent and effective dose in adult and child mode. the equivalent and effective dose in adult mode were 837μSv and 20.93μSv, those in child mode were 462μSv and 11.54μSv, respectively. 2. Total effective doses to the critical head and neck organs were estimated 34.21μSv in adult mode, 20.14μSv in child mode. From these datas, the probabilities of stochastic effect from adult and child mode were 2.50x10/sup -6/ and 1.47x10/sup -6/. 3. The other remainder showed the greatest risk of fatal cancer. The risk estimate were 4.5 and 2.7 fatal malignancies in adult and child mode from million panoramic examinations. The bone marrow and thyroid gland showed about 0.1 fatal cancer in adult and child mode from these examinations.

• Clinical and Experimental Pediatrics
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• 제54권3호
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• pp.123-127
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• 2011

Purpose: Kawasaki disease (KD) is the main cause of acquired heart disease in children. In addition to cardiovascular involvement, many complications have been recognized in KD. However, respiratory complications have been rarely reported. We investigated the differences in clinical characteristics, laboratory findings, radiography findings, and echocardiography findings of Mycoplasma pneumoniae infection and other types of pneumonia in KD patients. Methods: Among 358 patients with KD, 54 developed concurrent pneumonia. Among the 54 patients, 12 (22.2%) with high titers of anti-M. pneumoniae antibody (AMA) (>1:640) were grouped in the M. pneumoniae group and 42 were included in the control group. Serum AMA was measured in each patient. Clinical laboratory findings and total duration of fever were analyzed. Results: The duration of fever, serum hemoglobin, white blood cell count, platelet count, erythrocyte sedimentation rate, C-reactive protein level, albumin level, and the incidence of coronary arterial lesions showed no statistical difference in the 2 groups. Neutrophil count was significantly higher in the M. pneumoniae group than in the control group. Among various radiography findings observed in pneumonia, consolidation and pleural effusion were more frequent in the M. pneumoniae group than in the control group. On the other hand, parahilar peribronchial opacification, diffuse interstitial lesion, and normal findings prevailed in the control group. Conclusion: KD patients can have concurrent infections, especially pulmonary symptoms. The cause of KD is likely to be associated with M. pneumoniae infection. Thus, immediate treatment of M. pneumoniae infection in KD patients is very important.

• Advances in pediatric surgery
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• 제12권2호
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• pp.167-174
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• 2006

Central venous catheter (CVC) for long-term venous access is indispensable for various reasons including hyperalimentation, frequent blood sampling, frequent IV drug use in pediatric patients. We report clinical experience of surgical neonates in whom CVC was inserted primarily via great saphenous vein into suprarenal inferior vena cava. From March 2004 to March 2006, we performed CVC insertion via saphenous vein - contralateral side to main wound - into suprarenal inferior vena cava in surgeries of neonates. 2.7Fr or 4.2Fr, single lumen, tunneled Broviac catheters (Bard Access system, Inc, Salt Lake City, Utah) were used. Skin exit site of tunneled catheter was located in ipsilateral flank area just below edge lower rib. At the end of the procedure, location of the catheter tip was confirmed by plain radiography of abdomen. We retrospectively reviewed the admission records of the patients including nursing staff charts. Nine (50.0 %) patients were male and nine (50.0%) were female. Median gestational age was 38 weeks (range, 29-42 weeks) and median birth weight was 3,105 gm (range, 1,040-3,720 gm). Median age at catheter insertion was 38.5 days (range, 1-236 days). The purpose of CVC insertion was short-and long-term hyperalimentation in nine (50.0 %) patients. CVC insertion was performed in operation room under general anesthesia in sixteen (88.9 %) patients (in these cases, CVC insertion was performed just prior to concurrent operation) and neonatal intensive care unit (NICU) under local anesthesia with adequate sedation in two (11.2%). During the admission period (total catheter-indwelling time: 553 days), CVC functioned well without any significant side effects. Transient swelling of the ipsilateral leg (n=1, 5.6 %) and transient migration of catheter tip (n=1, 5.6 %) were noted, which did not affect function of the indwelled CVC. Mean catheter-indwelling time was 30.7days (range, 3-72 days). All catheters were removed electively except two mortality case. Complications, such as thrombosis, infection, kinking or extravasation of drugs, were not observed in our study period. Tunneled trans-great saphenous vein inferior vena cava catheters are not only comparable to cervical CVCs in terms of function and complication rates, but also very beneficial in selected patients, especially those in whom cervical approach is technically impossible or contraindicated.

• 대한소아치과학회지
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• 제45권1호
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• pp.57-64
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• 2018

Pre-eruptive intracoronal resorption (PEIR)은 맹출 전 치아의 치관 내에서 나타나는 발달 상의 결함을 의미한다. 본 연구의 목적은 파노라마 방사선 사진의 미맹출 하악 제1대구치 협측 소와에서 PEIR로 의심되는 방사선 투과상과 맹출 중인 하악 제1대구치에서 협측소와의 수복 필요성과의 관계를 조사하는 것이다. 실험군은 맹출 중일 때 협측 소와에 한정된 수복이 필요한 병소가 관찰되었던 35개의 하악 제1대구치를 대상으로 하였고, 대조군은 맹출 후 건전했던 하악 제1대구치 64개를 포함하였다. 실험군은 대조군에 비하여 맹출 전 파노라마 방사선 사진에서 측정된 협측 소와의 크기가 통계적으로 유의하게 컸다. 실험군 내에서 성별, 나이, 치아형성단계, 수복 방법에 따른 협측 소와 크기의 유의한 차이는 없었다. Receiver operating characteristic 커브를 그렸을 때, 커브 아래 면적이 $0.813{\pm}0.047$으로 방사선 사진 상의 협측 소와 크기를 근거로 수복 필요성을 예측했을 때 중등도의 정확성을 보였다. 파노라마 방사선 사진에서 맹출 전 하악 제1대구치의 협측 소와 부위에서 방사선 투과상이 관찰되는 경우 임상적으로 PEIR을 의심하고 주기적인 관찰과 맹출 후 검사가 필요할 수 있다.

• 대한치과의사협회지
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• 제55권8호
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• pp.516-526
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• 2017

Objective: To suggest diagnostic reference levels (DRLs) for dental panoramic radiography in adults and children through the nationwide survey in Korea. Materials and Methods: Two hundred twelve dental institutions on a national basis were visited. The radiographic examination protocols were surveyed and their patient doses at the clinical exposure setting for adult and children (5- and 10-year old) were measured at 244 panoramic radiographic equipment. The measured DAP were analyzed and compared according to age group, the size of hospital, the type of radiographic system, the installation duration of equipment. Results: The mean exposure parameters were 70.1 kV, 9.2 mA, 14.4 second for adult and 66.6 kV, 7.9 mA, 13.8 second for 10-year old child and 65.5 kV, 7.3 mA, 13.7 second for 5-year old child. The mean and third quartile patient DAPs were $138.3mGy\;cm^2$ and $151.0mGy\;cm^2$ for adult, $99.5mGy\;cm^2$ and $104.8mGy\;cm^2$ for 10-year old child and $89.5mGy\;cm^2$ and $95.5mGy\;cm^2$ for 5-year old child. The mean patient dose at the university dental hospital was lower than that at the dental clinic (p<0.05). The mean patient dose of direct digital radiography type was higher than that of film-based type. However, the difference did not show statistically significance. Conclusion: DRLs for dental panoramic radiography in adult, 10- and 5-year old child were suggested to be $151mGy\;cm^2$, $105mGy\;cm^2$, and $96mGy\;cm^2$ in Korea based on this nationwide survey.

• 대한소아치과학회지
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• 제30권3호
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• pp.448-452
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• 2003

법랑모세포 섬유치아종(Ameloblastic fibro-odontoma)은 하악 구치부에 호발하는 드문 혼합 치성종양이다. 방사선적 소견으로는 경계가 명확하고, 대부분에서 방사선 투과상과 불규칙적인 크기와 형태의 불투과상이 혼재된 양상으로 관찰된다. 조직학적으로 법랑모세포 섬유치아종은 법랑모세포 섬유종의 연조직 성분과 복합성 치아종의 경조직 성분을 모두 가지고 있다. 본 증례의 13세 2개월된 남자 환아는 원광대학교 치과대학 치과병원 소아치과에 하악 좌측 견치의 맹출 지연을 주소로 내원하였다. 맹출을 방해하는 병소를 적출하고 조직 생검한 결과, 법랑모세포섬유치아종으로 진단하였다. 지속적인 예후관찰 중 병소 제거 수개월 후 견치는 정상적으로 맹출하였다.

• Imaging Science in Dentistry
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• 제41권2호
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• pp.63-69
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• 2011

Purpose : The purpose of this study was to evaluate a new technique for localizing impacted mesiodens using its horizontal magnification ratio on panoramic radiographs. Materials and Methods : Location-magnification equation of a panoramic equipment was obtained from horizontal magnification ratio of a metal ball which was located variable positions from the center of image layer at interval of 2 mm. Panoramic radiographs were obtained from a skull phantom with a metal ball which was a substitute for impacted mesiodens and was embedded 10mm(Group 1), 15mm(Group 2), and 20mm(Group 3) posterior to the central incisor. Each group obtained 7 panoramic radiographs at variable positions and one periapical radiograph. Three methods were used to estimate the actual width of the incisors and the balls which were used to calculate the magnification ratio. The methods included using the actual incisor width and the calculated ball width (Method 1), using the actual incisor width and the ball widths measured on periapical radiograph (Method 2), and using the incisor and the ball widths measured on periapical radiograph (Method 3). The location of the metal ball was calculated by using the location-magnification equation. Results : The smallest difference between the calculated and the actual distance was $0.1{\pm}0.7 \;mm$ in Group 1/ Method 3. The largest difference was $-4.2{\pm}1.6 \;mm$ in Group 3/Method 2. In all groups, method 3 was the most accurate. Conclusion : Quantitative localization of impacted mesiodens is possible by using panoramic radiograph.