• Title/Summary/Keyword: Pediatric X-ray

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Currarino Triad

  • Lee, Ho-Jin;Kong, Min-Ho;Kim, Dong-Seok;Kim, Tae-Sung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.63-66
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    • 2005
  • The authors report a case of Currarino triad which had a congenital anorectal stenosis associated with a sacral defect and a presacral mass. A 1-year-old female presented with constipation since birth. Neurological deficits were not found on admission. She had had a diverting colostomy due to anorectal stenosis at another hospital before admission. Lumbar X-ray films showed bony defect caudal to the third sacral vertebra. Magnetic resonance image demonstrated a round cystic pelvic mass which was connected with a dural sac via anterior sacral defect. Posterior approach with Intradural removal of the presacral cystic mass was performed and followed by anoplasty by a pediatric surgeon. The cystic mass was verified histologically as mature teratoma with cystic change. Postoperatively, the urinary function and bowel movement remained intact. Currarino triad should be suspected and evaluated physically and radiographically in a case of congenital anorectal stenosis. Prompt recognition and close cooperation between pediatric surgeons and neurosurgeons is advisable to ensure adequate surgical treatment.

Mesalizine-Induced Acute Pancreatitis and Interstitial Pneumonitis in a Patient with Ulcerative Colitis

  • Chung, Min Jae;Lee, Jae Hee;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.286-291
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    • 2015
  • Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.

Spontaneous Rupture of the Diaphragm in an 8 Years-old Girl with Nephrotic Syndrome (저절로 파열된 횡경막 이완증 1예)

  • Lee, Seong-Cheol;Kim, Ki-Hong
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.60-63
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    • 2000
  • Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

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Meconium Peritonitis: A Rare Treatable Cause of Non-Immune Hydrops

  • Rajendran, Usha Devi;Govindarajan, Jeyanthi;Balakrishnan, Umamaheswari;Chandrasekaran, Ashok;Amboiram, Prakash
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.576-580
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    • 2019
  • Meconium peritonitis as a cause of non-immune hydrops in neonates is rarely reported. Here we report such a rare occurrence. In our case, a routine antenatal scan at 25 weeks revealed isolated ascites. By 31 weeks of gestation, all features of hydrops were observed in scans. However, antenatal workup for immune and non-immune hydrops was negative. Subsequently, a preterm hydropic female baby was delivered at 32 weeks. She required intubation and ventilator support. An X-ray revealed calcification in the abdomen suggestive of meconium peritonitis. Ultrasound showed gross ascites, a giant cyst compressing the inferior vena cava, and minimal bilateral pleural effusion. Emergency laparotomy revealed meconium pellets and perforation of the ileum. Double-barrel ileostomy was performed, and the edema resolved and activity improved. The baby was discharged after 3 weeks. Ileostomy closure was done at follow-up. The baby is growing well.

A STUDY OF THE MECHANISM OF IMPROVING ACID RESISTANCE OF BOVINE TOOTH ENAMEL AFTER PULSED Nd-YAG LASER IRRADIATION (펄스형 Nd-YAG 레이저 조사에 의한 법랑질 내산성 증가 기전에 관한 연구)

  • Lee, Young-Soon;Shon, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.23 no.3
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    • pp.640-658
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    • 1996
  • The purpose of this study was to examine the mechanism of improving acid resistance of Nd-YAG laser irradiated tooth enamel and determine the most effective energy density for improving acid resistance. The bovine tooth enamel were lased with a pulsed Nd-YAG laser. The energy densities of exposed laser beam were varied from 10 to $70\;J/cm^2$. To investigate the degree of improving acid resistance by irradiation, all the samples were submerged to demineralize in 0.5 N $HClO_4$ solution for 1 minute. After 1 minute, 0.05 % $LaCl_3$ was added to the solution for interrupting the demineralization reaction. The amounts of dissolved calcium and phosphate in the solution were measured by using an atomic absorption spectrophotometer and the UV/VIS spectrophotometer, respectively. To examine the mechanism of improving acid resistance, X-ray diffraction analysis, infrared spectroscopy, and scanning electron microscopy were taken. The X-ray diffraction pattern of the samples were obtained in the $10^{\circ}{\sim}80^{\circ}2{\theta}$ range with $Cu-K{\alpha}$ radiation using M18HF(Mac Science Co.) with X-ray diffractometer operating at 40 KV and 300 mA. The infra-red spectra of the ground samples in 300 mg KBr pellets 10 mm diameter were obtained in the $4000cm^{-1}\;to\;400cm^{-1}$ range using JASCO 300E spectrophotometer. The scanning electron microscopy was carried out using JSM6400(JEOL Co.) with $500{\sim}2000$ times magnification. The results were as follow 1. The concentration of calcium dissolved from laser irradiated enamel with $50J/cm^2$ was significantly lesser than that of unlased control group (p<0.05) 2. From the result of the X-ray diffraction analysis, $\beta$-TCP, which increases acid solubility, was identified in lased enamel but the diffraction peaks of (002) and (004) became sharp with increasing energy density of laser irradiation. This means that the crystals in lased samples were grown through the c-axis and subsequently, the acid solubility of enamel decreased. 3. The a-axis parameter was slightly increased by laser irradiation, whereas the c-axis parameter was almost constant except for a little decrease at $50J/cm^2$. 4. In the infra-red spectra of lased enamels, phosphate bands ($600{\sim}500cm^{-1}$), B-carbonate bands (870, $1415{\sim}1455cm^{-1}$), and A-carbonate band ($1545cm^{-1}$) were observed. The amounts of phosphate bands and the B-carbonate bands were reduced, on the other hand, the amount of the A-carbonate band was increased by increase the energy density. 5. The SEM experiments reveal that the surface melting and recrystallization were appeared at $30J/cm^2$ and the cracks were observed at $70J/cm^2$. From above results, It may be suggested that the most effective energy density for improving acid resistance of tooth enamel with the irradiation of Nd-YAG laser was $50J/cm^2$. The mechanism of improving acid resistance were reduction of permeability due to surface melting and recrystallization of lased enamel and reduction of acid solubility of enamel due to decrease of carbonate content and growth of crystal.

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Use of Dual-Energy X-ray Absorptiometry in Children with Inflammatory Bowel Disease: A Large Single Centre Study

  • Jois, Asha;Perera, Sajini;Simm, Peter;Alex, George
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.6
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    • pp.473-480
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    • 2022
  • Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

Colon Perforation in Hyperimmunoglobulin E Syndrome - A Case Report - (Hyperimmunoglobulin E 증후군에서의 결장천공 - 증례보고 -)

  • Oh, Jung-Tak;Kim, In-Gyu;Han, Seok-Joo;Kim, Ho-Guen;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.151-155
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    • 1996
  • Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

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A Study on the Relationship of Hypertropied Palatine Tonsil with Maxillary Sinusitis and Adenoid Vegetation (소아에서 구개편도 비대와 상악동염, 아데노이드 비대의 상관성에 관한 연구)

  • Lee, Young-Gyu;Chae, Byung-Yoon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.9 no.1
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    • pp.173-179
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    • 1996
  • Hypertropied palatine tonsil is a common disorder in pediatric otolaryngology. It could be easily observed and adenoid vegetation could induce maxillary sinusitis by the obstruction of nasopharynx and choanae. This is a study on the relationship of the hypertropied palatine tonsil, 42cases, with maxillary sinusitis and adenoid vegetation The results was as followings ; 1. The sex distribution was male 30cases($71.4\%$), female 12cases($28.6\%$) and age distribution was from 3 to 17year-old. 2. Hypertropied palatine tonsil distribution was the degree of both 3, 2cases($4.8\%$), one 3 the other 2, 3cases($7.l\%$), both 2, 22cases($52.4\%$), one 2 the other 1, 9cases($21.4\%$), both 1, 5 cases($11.9\%$). and only one 1, 1case($2.3\%$). 3. By the PNS X-ray, there were resulted 29 cases($69.0\%$) both maxillary sintis, 4cases($9.5\%$) only one maxillary sinusitis and 9cases($21.4\%$) norma] sinus. 4. By the Head latera] X-ray, there were resulted 13cases($31.0\%$) large adenoid, 24cases($57.l\%$) mediate adenoid, and 5cases($l1.9\%$) small adenoid.

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DiGeorge syndrome who developed lymphoproliferative mediastinal mass

  • Kim, Kyu Yeun;Hur, Ji Ae;Kim, Ki Hwan;Cha, Yoon Jin;Lee, Mi Jung;Kim, Dong Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.3
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    • pp.108-111
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    • 2015
  • DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion.

Study on the Effectiveness of Radiological Technologist's Thyroid Shielding in Pediatric Paranasal Sinus X-ray Examination (어린이 부비동 엑스선 검사에서 검사자의 갑상선 차폐 효과성에 관한 연구)

  • Chang-Kyo Kwak;Jeong-Taek Kwon;Kwang-Je Lee;Il-Hwan Bae;Hye-Jung Kim;So-Mi Lee;Do-Byung Rhee
    • Journal of radiological science and technology
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    • v.47 no.3
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    • pp.197-203
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    • 2024
  • During paranasal sinus X-ray examinations in children, the radiological technologist's thyroid shield is often not implemented to shorten the examination time. This study measured the radiation exposure before and after the implementation of thyroid shielding by analyzing the difference in radiation exposure, the radiological technologist's could receive depending on the actual thyroid shielding. In the left TLD, when thyroid shielding was not performed(N), the radiation exposure dose(mSv) was 2.869 for the depth dose[Hp(10)] and 2.886 for the surface dose[H(3)], and when thyroid shielding was performed(Y), the Hp(10) was 0.033 and the H(3) was 0.034. In the right TLD, when thyroid shielding was not performed(N), the radiation exposure dose was 3.149 for Hp(10) and 3.137 for H(3), and when thyroid shielding was performed, the Hp(10) of (Y) was 0.013 and the H(3) was 0.015. The differences in the overall exposure dose measurement values are all statistically significant (p<0.05). The difference in radiation dose between when thyroid shielding was not performed and when thyroid shielding was performed was more than 99.2% in both cases, indicating a high radiation shielding rate.