• Journal of the Korean Society of Radiology
• /
• v.84 no.1
• /
• pp.240-252
• /
• 2023

Purpose To assess the effect of deep learning image reconstruction (DLIR) for head CT in pediatric patients. Materials and Methods We collected 126 pediatric head CT images, which were reconstructed using filtered back projection, iterative reconstruction using adaptive statistical iterative reconstruction (ASiR)-V, and all three levels of DLIR (TrueFidelity; GE Healthcare). Each image set group was divided into four subgroups according to the patients' ages. Clinical and dose-related data were reviewed. Quantitative parameters, including the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and qualitative parameters, including noise, gray matter-white matter (GM-WM) differentiation, sharpness, artifact, acceptability, and unfamiliar texture change were evaluated and compared. Results The SNR and CNR of each level in each age group increased among strength levels of DLIR. High-level DLIR showed a significantly improved SNR and CNR (p < 0.05). Sequential reduction of noise, improvement of GM-WM differentiation, and improvement of sharpness was noted among strength levels of DLIR. Those of high-level DLIR showed a similar value as that with ASiR-V. Artifact and acceptability did not show a significant difference among the adapted levels of DLIR. Conclusion Adaptation of high-level DLIR for the pediatric head CT can significantly reduce image noise. Modification is needed while processing artifacts.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.11 no.1
• /
• pp.28-35
• /
• 2008

Purpose: The aim of this study is to report the efficacy of infliximab, a monoclonal antibody directed against tumor necrosis factor alpha which is used for both treatment of refractory pediatric Crohn disease (CD) and induction of remission. Methods: Among pediatric patients who were diagnosed with CD at Samsung Medical Center between March 2001 and August 2007, a total of 16 patients were given infliximab to treat conventional therapyresistant refractory CD and severe active CD for induction of remission. Patients needing maintenance therapy were treated with an infliximab infusion every 8 weeks, and fistulizing CD patients occasionally received the infusion upon the condition that a fistula developed. The efficacy of treatment was assessed by comparing the Pediatric Crohn Disease Activity Index (PCDAI), Hct, ESR, CRP, and serum albumin levels using paired t-test. Results: The male/female ratio was 13:3, and the median age was 13 years (range, 21 months~15 years). The patients included 7 cases of therapy-resistant refractory CD, 7 cases of severe active CD, and 2 cases of fistulizing CD. Mean PCDAI before infliximab therapy was 34.19${\pm}$14.96, and mean follow-up PCDAI within 2 to 4 weeks after the last infusion was significantly lower, at 6.88${\pm}$10.31 (p=0.000). Hematological markers such as ESR (p=0.000), serum albumin (p=0.016), and CRP (p=0.009) also improved significantly after infusion. Remission was achieved in 2 of 4 patients refractory to conventional therapy. Among 3 steroid-dependent patients, 2 were able to discontinue steroid therapy, and dose reduction was possible in 1 patient. Remission after top-down therapy without prior use of other immunomodulators was achieved in 6 weeks in all 7 of the patients who had severe CD. Nine of ten refractory fistulizing CD patients also showed improvement after infliximab therapy. Conclusion: Infliximab was effective in pediatric refractory CD for induction of remission and maintenance therapy, as well as in severe CD for top-down induction therapy. Furthermore, infliximab has contributed to steroid cessation and dose reduction. Long-term follow-up evaluation is needed to determine safety and efficacy of infliximab in the future.

• Clinical and Experimental Pediatrics
• /
• v.50 no.5
• /
• pp.476-483
• /
• 2007

Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

• Clinical and Experimental Pediatrics
• /
• v.51 no.8
• /
• pp.812-819
• /
• 2008

Purpose : Vitamin D plays a key role in bone mineralization of the skeleton and vitamin D deficiency can lead to rickets. It is well known that vitamin D deficiency is common in breast fed infants. Of these patients, clinically, some have no signs of rickets, but laboratory and radiographic findings are diagnostic for vitamin D deficiency rickets (subclinical vitamin D deficiency rickets). The purpose of this study is to clarify current causes and ways to prevent this disease. Methods : We reviewed the clinical and laboratory characteristics of children who were incidentally diagnosed as subclinical rickets during treatment of other disease such as pneumonia, gastroenteritis, urinary tract infection at Eulji Hospital, Seoul, Korea from March, 2003 to July 2007. Results : Eight patients (six boys and two girls) were diagnosed with subclinical vitamin D deficiency rickets. The mean age of the patients was $12.6{\pm}5.8months$, and they were diagnosed from January to July. The associated diseases were pneumonia, urinary tract infection, acute gastroenteritis, and iron deficiency anemia. All patients were breast-fed. Two showed growth failure. The mean serum alkaline phosphatase was $1995.8{\pm}739.5IU/L$, the mean calcium count was $9.5{\pm}0.6mg/dL$, and the mean phosphorus content was $3.6{\pm}1.5mg/dL$. The mean intact parathyroid hormone was $214.8{\pm}155.9pg/mL$ (reference range, 9-65), the mean 1,25-dihydroxyvitamin D was $82.4{\pm}49.3pg/mL$ (reference range, 2070), and the mean 25-hydroxyvitamin D was $29.6{\pm}10.6ng/mL$ (reference range, 1030). A radiographic examination showed cupping, fraying, and flaring of metaphyses in all patients. Six patients were administered calcitriol (400 IU/day) for three months. A consequent radiographic and laboratory examination showed improvement. The first two patients were initially diagnosed with metaphyseal dysplasia, without the detection of vitamin D deficiency and they spontaneously improved without vitamin D supplements. However, two years later, they showed mild scoliosis and metaphyseal dysplasia, respectively. Conclusion : Breast-feeding without supplementation involves high risk of vitamin D deficiency. Some infants may also develop rickets; therefore, such groups should be considered for vitamin D supplementation.

• Clinical and Experimental Pediatrics
• /
• v.48 no.8
• /
• pp.832-838
• /
• 2005

Purpose : Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has been reported rarely in Korea. Methods : A clinical study was performed on 556 patients of M. pneumoniae pneumonia diagnosed serologically at Gil hospital from January 2001 to December 2004. We reviewed 65 cases among these patients, who had elevated level of serum AST and ALT greater than 50 IU/L respectively without evidence of hepatitis A, B, C, Cytomegalovirus and Ebstein-Barr virus infections. Results : Hepatitis occurred in 11.7% of Mycoplasma pneumoniae pneumonia, especially in fall and winter times. Male to female ratio was 1.2 : 1 and the mean age was 4 years and 3 months. Besides hepatitis, cough(95.4%), sputum(52.3%) and dyspnea(12.3%) were common as pulmonary manifestations. And among gastrointestinal manifestations, nausea/vomiting(26.2%) was the most common symptom, followed by poor oral intake(12.3%), diarrhea(12.3%) and abdominal pain(6.2%). In addition to hepatomegaly(4.6%) and splenomegaly(4.6%), coarse breathing sound was the most common physical manifestation, followed by rale(63.1%), pharyngeal injection(26.2%), and rash(10.8%). Anemia was noted in 20.0%, neutrophilia in 10.8%, eosinphilia in 38.5% and thrombocytosis in 6.2%, respectively. Mean level of ESR and CRP was 32.02 mm/hr and 6.69 mg/dL, respectively. Mean level of AST and ALT was 293.80 IU/L and 181.48 IU/L, respectively. Hyperbilirubinemia was noted in 7.7% and hypoalbuminemia was noted in 58.5%. Lobar or lobular pneumonia(78.5%) was the most common finding in chest X-ray and left lower lobe(39.2%) was most commonly affected. Pleural effusion was noted in 26.2%. Mean duration of hospitalization was 9.91 days. Serum AST/ALT level was normalized within 9.94 days and pulmonary consolidation resolved within 14.29 days. Conclusion : The prognosis of M. pneumoniae hepatitis is good. However, liver function should be considerately checked in M. pneumoniae infection because its incidence is not so low.

• Journal of Chest Surgery
• /
• v.42 no.1
• /
• pp.9-13
• /
• 2009

Background: Hypoplastic left heart syndrome is uniformly fatal if this condition is not properly treated. We reviewed the surgical results of treating hypoplastic left heart syndrome, and we evaluated the hemodynamics and functional status of these patients after they underwent a Fontan operation. Material and Method: To assess the surgical results, we retrospectively reviewed the medical records of 6 (M/F=4/2) patients who underwent a staged operation, including a Norwood procedure, a bidirectional Glenn procedure and a Fontan procedure between October 1997 to May 2005. The mean age of the patients was $17.3{\pm}10.8$ days (range: 9~36 days) at the $1^{st}$ staged operation, $8.9{\pm}7.1$ months (4.6~23.3 months) at the $2^{nd}$ staged operation (the Bidirectional Glenn procedure) and $32.4{\pm}9.8$ months at the final staged operation (the Fontan procedure). During the $2^{nd}$ staged operation, one of the patients received tricuspid valve repair due to regurgitation. All the patients underwent an extracardiac Fontan procedure using Gore-Tex conduit (20 mm: 2 patients, 18 mm: 4 patients) and one of them required fenestration. Result: 21 patients underwented a Norwood procedure. There were 7 early deaths and 4 interstage deaths. Bidirectional cavopulmonary shunt was performed in 10 patients and the Fontan procedure was done in 6 (mortality: 1 patient, Flow up loss: 1 patient, Awaiting a Fontan procedure: 2 patients). After the Fontan procedure, there was no complication except for one case of post operative bleedings. All the patients had good ventricular function and 2 had grade I tricuspid regurgitation, as noted on their echocardiography. The average follow up period after the Fontan procedure was $19.6{\pm}14.9$ months (range: 1.5~39.1 month). All the patients had normal sinus rhythm and they were put on aspirin and cardiac medication. During follow up period, all the patients had a good functional status (NYHA functional class I). Conclusion: All the patients who suffered with hypoplastic left heart syndrome and who underwent a Fontan procedure achieved a good hemodynamic and functional status, even though there was a relatively high operative mortality rate after stage I Norwood palliation. Therefore, thise staged operation should be strongly recommended as an important surgical strategy for treating hypoplastic left heart syndrome.

• Clinical and Experimental Pediatrics
• /
• v.49 no.4
• /
• pp.417-423
• /
• 2006

Purpose : The objectives of this study were to assess ventricular function by tissue Doppler imaging in children who were receiving chemotherapy or who had received chemotherapy, and to apply repeated tissue Doppler imaging to make an early assessment in cardiac toxicity studies. Methods : This study was conducted on 23 oncology patients on-treatment or off-treatment from April 2005 to July 2005 at Dongsan Medical Center, Keimyung University. All patients(group 1) were divided into two groups, fractional shortening(FS) over 29 percent(group 2) and FS under 28 percent (group 3) in the first category. These same patients were also divided into the following groups : group treated with anthracyclin(group 4) and group treated without anthracyclin(group 5). Deceleration time(DT), isovolumic relaxation time(IVRT), FS, peak early diastolic(E), and peak late diastolic (A) velocity of transmitral flow were measured by M-mode and pulsed wave Doppler. Systolic(Sm), peak early diastolic(Em), and peak late diastolic(Am) velocity in apical 4-chamber and 2-chamber views were measured by tissue Doppler imaging. The author calculated a modified Tei index, E/A, E/Em ratio by using measured values. Results : Twenty three patients were enrolled : 12 boys and 11 girls. The average age of patients was 8 years and 4 months. Thirteen out of 23 patients were in the group treated with anthracyclin (group 4) and 6 had FS under 28 percent(group 3). E/Em ratio showed a significant difference between group 1 and control group($6.46{\pm}1.85$ vs $7.06{\pm}1.64$, P<0.05). Other parameters had no difference statistically. Conclusion : This study showed that the change of cardiac function developed earlier in diastolic function than in systolic function, as E/Em ratio reflecting the mean LV diastolic pressure showed a significant difference between the control group and chemotherapy groups. Echocardiography using tissue Doppler imaging is a non-invasive, comfortable and reliable method for post-chemotherapy follow up.

• Child Health Nursing Research
• /
• v.5 no.1
• /
• pp.38-47
• /
• 1999

This study is the study on health promoting behaviors of 6th grade students according to sex. The purpose of this study is to find the difference in the value of health in their lives among 6/sup th/ grade students according to sex, to examine the differences in practicing health promoting behaviors, and to determine the correlation between the practice of health promoting behaviors and the characteristics of these students. The subjects of this study were 177 6/sup th/ grade students who were randomly selected from two elementary schools in Taegu City. The tools used to measure health promoting behaviors were the measuring utility for practicing health promoting behaviors developed by Kyung-Suk Ki (1983) and the utility for the values of health in lives developed by Wallston, Maides and Wallston and translated by Gin Yoon (1989). The data collected were analyzed with t-test, Pearson correlation coefficient, and descriptive statistics using SPSS program. The results of the present study were as follows : 1) According to the results of the value placed in health in their lives, the number of students who placed health high in their lives was 69 boys (75%) and 64 girls (75.3%). 2) According to the results obtained from comparing the degree of practicing health promoting behaviors according to sex, in the field of personal hygiene and daily habits, the girls showed a higher degree of practice with 3.26±0.33 and the boys, 3.05±0.45(t=-3.484, p=0.001) : and in the field of contagious diseases, the girls scored significantly higher with 3.40±0.39 than the boys with 2.99±0.54(t=-2.363, p=0.019). In the filed of preventing accidents, the girls showed a meaning high significant result with 3.16±0.46 than the boys with 2.99±0.54(t=-2.362, p=0.019). When the results from the total questions in the field of health promoting behaviors were compared, the girls showed a meaningfully high correlation with 3.19±0.28 than the boys with 3.07±0.36(t=-2.601, p=0.010). Thus, the results showed that the girls, compares with the boys, practice more behaviors of personal hygiene & daily habits, prevention of communicable diseases, and prevention of accidents. 3) According to the results of the relationship between the subjects’ characteristics and their health promoting behaviors according to set in the case of the boys, they showed a meaningful positive correlation with health promoting behaviors and the current status of health (r=0.266, p=0.005). Thus, for the boys, as their health status was better, the more health promoting behaviors they showed. In the case of the girls, the meaningful variables had a correlation with the health promoting behaviors were the number of extra-curricula activities(r=0.182, p=0.047) and the birth order(r=-0.192, p=0. 024). In overall regardless of sex, the health status (r=0.188, p=0.006) and birth order(r=-0.149, p=0.024) showed a meaningful correlation with practicing health promoting behaviors. With the above results, we suggest the following proposals. 1) In elementary children of lower and upper classmen as applied with the current school age, developing a utility to measure health promoting behaviors is needed since the physical, emotional and intellectual development of these children exist. 2) According to the results of this study, developing a program for health promotion is needed in 6/sup th/ grade students.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.25 no.6
• /
• pp.1037-1044
• /
• 1996

This study was conducted to investigate the prevalence of childhood obesity and to figure out the correlation between percentage of body fat and various criteria used for evaluating childhood obesity, and to suggest a new convenient criterion applicable to obesity assessment for large population. subject of 309(male: 153, female: 156) from Uisung elementary school in Kyungbuk, in the age range from 10 to 12 were recruited. The prevalence of obese was evaluated by the methods of Slaughter skinfold equations for children, BMI, and RI. fourteen(4.5%) by Slaughter eq, 39(12.6%) by BMI, 31 (10%) by RI were found to be obese. The results indicate that the evaluation of child obesity is influenced by the methods applied; that is, BMI and RI tend to overpredict the obese while percentage of body fat tend to underestimate. Percentage of body fat by Slaughter equations using triceps and calf skinfold is highly correlated with triceps plus subscapular skinfold thickness(male: r=0.91, female: r=0.88) and with Kim equations for Korean children(male: r=0.93, femlae: r=0.88). The results suggest that, if necessary, practitioners can adequately predict body composition without exposing the upper torso of females.

• Journal of Korean Academy of Nursing
• /
• v.8 no.2
• /
• pp.89-102
• /
• 1978

Owing to the development of modern science, prolonging man's life, the sudden increase of population and betterment of the standard of living has increased health needs. In order to fulfill these health needs, more active plans for developing health should be made. Health education is one of the methods at hand that can improve the health behavior of the community and the individual through the contact of individuals with their groups. Proper understanding of the characteristics of the sampled group and participation of individuals within the community for the development of their health plan are needed for efficient health education. This study was attempted for the purpose of presenting some data helpful for pre-paring the fundamentals of a health education plan that can improve personal health maintenance practice of a community through efficient health education by investigating the relationship between the response of subjects to personal health maintenance practice and selected decisive factors in personal health maintenance practice. The subjects for this study were a systematic sample of 120 housewives selected from 600 housewives from B Zone Apt. Younhi-3-Dong in Seoul. Data was collected for 4 days from May 16th to May 19th, 1578 through personal interviews with questionnaires by well trained interviewers. Percentage, t-test and stepwise multiple regression analysis by use of EDPS were employed for statistical analysis. Results of this study can be summarized : 1. General characteristics of subjects Subjects over 20 and below 40 years of age formed 62.5% of the toed and the rest were subjects of 40 years and upward. 76.7% of the subjects have less than 4 children. 51.3% of the subjects had completed at least the senior high school course. 2. The response of subjects to personal health maintenance practice. Ratios of personal health maintenance practice to the maximum score for each category are as follows; 84.1% in the category of population and family planning, which was the highest ratio; 82.4% in the prevention of accidents; 68.0% in control of communicable disease; 67.8% in personal health care and habits of daily life, 64.3% in mental health and 52.5% in control of parasites, which was the lowest. 3. The response of subjects to selected decisive factors. in personal health maintenance practice. The arithmetic mean of the score for each decisive factor was as follows: the mutual relation between family members marked 18.33, which is under 73,3% of the maximum score; the degree of interest in health marked 34.48, 70.0% of the maximum score: the degree of utilization and demand for health care facilities marked 25.79 or 64.5% of the maximum score and health maintenance of the family marked 11.58, 43.6% of the maximum score. 4. The relationship between personal health maintenance practice and general characteristics of subjects. 1) There was a significant difference in the numbers of children. (t = 1.83, d.f. =117, p< 0.1) 2) There was a significant difference in the contact rates with mass-media, (t = 5.02, d.f. = 118, p< 0,05) 5. The multiple correlation between personal health maintenance practice and their selected decisive factors. 1) The factor“the degree of interest in health”could account for personal health maintenance practice in 43.6% of the sample. (R = 0.6602, R²= 0,4359, F = 91.1678, p< 0.001) 2) When the factor,“health maintenance of family”is added to this, it accounts for 51.2% of personal health maintenance practice. (R = 0.7158, R²= 0.5124, F = 61.4653, p< 0.001) 3) When the factor,“mutual relations between family members”is also included, it accounts for 53.7% of personal health maintenance practice. (R = 0.7324, R²= 0.5365, F = 44.7509, p< 0.001) 4) When the factor, “the degree of utilization and demand for health care facilities”is included, it accounts for 55.1% of personal health maintenance practice. (R = 0.7421, R²= 0.5507, F = 35.2430, p< 0.001).