• Title/Summary/Keyword: Pediatric chest examination

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Evaluation of Radiography of Ingested and Aspirated Foreign Bodies in Pediatric Patients (이물질 섭취 및 흡인 소아환자의 엑스선 영상 평가)

  • Kweon, Dae Cheol;Choi, Jiwon
    • Journal of Radiation Industry
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    • v.12 no.4
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    • pp.291-295
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    • 2018
  • The purpose of this study was to introduce the radiography for the natural course and clinical diagnosis of foreign body ingestion and aspiration, to help diagnosis and treatment, to evaluate the accuracy of radiographic images of pediatric patients. A 2 to 7 year-old patient who ingested a foreign body was ingested and aspirated with foreign substances such as coin, cloth pin, earring, baduk stone, and hairpins, and chest and abdomen of the plain radiography. The pediatric patient who ingested and aspirated the foreign body of the coins, the clothespins, the earrings, the stones, and the hairpins were examined by chest and abdomen of the plain radiography and fluoroscopic images. The radiography examination can be combined to effectively cope with the treatment and the treatment of the foreign substance removal. It can be applied to the diagnosis of foreign body in pediatric patient's clinic and appropriate treatment and treatment direction.

Primary leiomyosarcoma of the chest wall in a child : a case report (소아의 흉벽에서 진단된 평활근육종 1례)

  • Choi, Jae Hyuk;Chung, David Chanwook;Lee, Mee Jeong
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.98-101
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    • 2008
  • Leiomyosarcoma is an uncommon soft tissue sarcoma of mesenchymal cell origin, which shows smooth muscle differentiation. Leiomyosarcoma is seldom found in the pediatric population, and accounts for fewer than 2% of all soft tissue sarcomas. Leiomyosarcoma of the chest wall is extremely rare in children. We report here a case of an 8-year-old boy with a primary leiomyosarcoma that was incidentally found as a rib mass. The patient underwent a complete resection for a suspected osteochondroma diagnosed by a three-dimensional chest computed tomography examination. Pathological findings of the mass revealed intersecting fascicles of spindle cells showing cigar-shaped nuclei, inconspicuous nuclear pleomorphism and occasional mitotic figures in the background of a suspected osteochondroma of the rib. This report documents the first description of a leiomyosarcoma possibly arising in an osteochondroma of the rib in a child.

Entrance Skin Dose According to Age and Body Size for Pediatric Chest Radiography (소아 흉부촬영 시 나이와 체격에 따른 입사피부선량)

  • Shin, Gwi-Soon;Min, Ki-Yeul;Kim, Doo-Han;Lee, Kwang-Jae;Park, Ji-Hwan;Lee, Gui-Won
    • Journal of radiological science and technology
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    • v.33 no.4
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    • pp.327-334
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    • 2010
  • Exposure during childhood results in higher risk for certain detrimental cancers than exposure during adulthood. We measured entrance skin dose (ESD) under 7-year children undergoing chest imaging and compared the relationship between ESD and age, height, weight, chest thickness. Though it is important to measure chest thickness for setting up the exposure condition of chest examination, it is difficult to measure chest thickness of children. We set up exposure parameters according to age because chest thickness of children has correlation with age. In the exposure parameters, for chest A-P examination under 2 year-children, tube voltage (kVp) in hospital A was higher than that in hospital B while tube current (mAs) was higher in hospital B, thus the ESD values were about 1.7 times higher in hospital B. However, for chest P-A examination over 4 year-children, the tube voltage was 7 kVp higher in hospital B, the tube current were same in all two systems, and focus to image receptor distance (FID) in hospital B (180 cm) was longer than that in hospital A (130 cm), thus the ESD values were 1.4 times higher in hospital A. For same ages, the ESD values for chest A-P examinations were higher than those for chest P-A examinations. Comparing ESD according to age, ESD values were $154{\mu}Gy$, $194{\mu}Gy$ and $138{\mu}Gy$ for children under 1 year, 1 to under 4 years and 4 to under 7 years of age, respectively. These values were lower than reference level ($200{\mu}Gy$) recommended in JART (japan association of radiological technologists), however these were higher than reference values recommended by EC (european commission), NRPB (national radiological protection board) and NIFDS (national institute of food & drug safety evaluation). In conclusion, the values of ESD were affected by exposure parameters from radiographer's past experience more than x-ray system. ESD values for older children were not always higher than those for younger children. Therefore we need to establish our own DRLs (diagnostic reference levels) according to age of the children in order to optimize pediatric patient protection.

Analysis of clinical characteristics and causes of chest pain in children and adolescents

  • Chun, Ji Hye;Kim, Tae Hyeong;Han, Mi Young;Kim, Na Yeon;Yoon, Kyung Lim
    • Clinical and Experimental Pediatrics
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    • v.58 no.11
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    • pp.440-445
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    • 2015
  • Purpose: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. Methods: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. Results: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. Conclusion: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.

Investigation of organ dose difference of age phantoms for medical X-ray examinations (X선 촬영 시 연령별 장기선량 차이 연구)

  • Park, Sang-Hyun;Lee, Choon-Sik;Kim, Woo-Ran;Lee, Jai-Ki
    • Journal of Radiation Protection and Research
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    • v.28 no.1
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    • pp.35-42
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    • 2003
  • Methodology for calculating the organ equivalent doses and the effective doses of pediatric and adult patients undergoing medical X-ray examinations were established. The MIRD-type mathematical phantoms of 4 age groups were constructed with addition of the esophagus to the same phantoms. Two typical examination procedures, chest PA and abdomen AP, were simulated for the pediatric patients as well as the adult as illustrative examples. The results confirmed that patients pick up approximate 0.03 mSv of effective dose from a single chest PA examination, and 0.4 to 1.7 mSv from an abdomen AP examination depending on the ages. For dose calculations where irradiation is made with a limited field, the details of the position, size and shape of the organs and the organ depth from the entrance surface considerably affect the resulting doses. Therefore, it is important to optimize radiation protection by control of X-ray properties and beam examination field. The calculation result, provided in this study, can be used to implement optimization for medical radiation protection.

Suegical treatment of congenital esophageal hiatus hernia (선천성 식도열공탈장의 외과적 치험 1예)

  • O, Bong-Seok;Kim, Sang-Hyeong;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.16 no.3
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    • pp.399-404
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    • 1983
  • In general, hiatal hernia is rare incidence among diaphragmatic hernia in Korea especially in pediatric group. Recently great interest in hiatal hernia has not led to common agreement concerning the pathophysiology, method of diagnosis, clinical picture, Indications, and type of treatment. At 1981 and 1983, two cases of congenital hiatal hernia [type I, III] were surgically treated,which surgical Intervention was modified Hill`s operation and gastropexy. Postoperatively, clinical and radiological examination were proved no regurgitation, no dysphagia and well passage of barium.

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Evaluation of Respiration Reproducibility of Chest General X-ray Examination using Self-made Respiratory Synchronization Device (자체 제작한 호흡 동기화 장치를 통한 흉부 일반촬영 검사의 호흡 재현성 평가)

  • Kwon, Oh-Young;Lee, Chang-Hun;Yong, Keum-Ju;Jin, Seon-Hui;Jung, Da-Bin;Heo, Yeong-Cheol
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.1049-1056
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    • 2021
  • The purpose of this study was to develop a respiratory synchronization device for X-ray (X-RSD) to increase the reproducibility of inspiration when examining the Chest X-ray of a patient who difficulty in breathing coordination. The X-RSD was self-made using an air pressure sensor and air was injected by connecting a ventilator to the mannequin for CPR. At this time, the amount of injected air was quantified using the SkillReporting device. After placing the X-RSD on the chest of the mannequin, the amount of air was tested in 6 steps from 200 to 700 cc by 100 cc increased. For the accuracy evaluation, the sensitivity of X-RSD was measured by repeating a total of 80 measurements, and the sensitivity was 100%, and very precise results were obtained. After that, the images examined while viewing the X-RSD of the chest lateral examination and the images obtained by the blind examination were compared and evaluated. The lung volume of X-RSD was larger than that of the blind test, and the deviation was smaller. Overall, the use of X-RSD can help with chest X-ray examination of patients who have difficulty in cooperating, and it is thought that it will be possible to contribute to the reduction of exposure dose by reducing the repeat rate of general X-ray examinations.

Inversion of Implantable Central Venous Port in Children - 2 Cases Report - (소아에서 피하매몰 중심정맥포트가 전복된 사례에 대한 경험 - 2예 보고 -)

  • Choi, June-Young;Kim, Hyun-Young;Jung, Sung-Eun;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.17-23
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    • 2006
  • A 3-year-old girl with a primitive neuroectodermal tumor (PNET) and a 6-yearold girl with acute lymphoid leukemia were referred to us because of problems with their implantable central venous ports (Port-A-Cath$^{(R)}$). On physical examination, the ports were upside-down, so a needle could notbe inserted through the membrane of the port. Right lateral side view of the chest radiogram confirmed port inversion in both cases. At operation, the ports were inverted and the transfixing sutures were totally absorbed. The ports were rotated 180 degrees and anchoring sutures placed.

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Evaluation of Image Quality When Using Grid During Child Chest X-Ray Examination (소아 흉부검사 시 격자 사용에 따른 영상 화질 평가)

  • Jeung, Seung-Hun;Han, Beom-Hul;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.40 no.3
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    • pp.371-376
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    • 2017
  • Since in case of children, they are sensitive to the radiation compared to the adult and the potential exposure damage lasts longer, the exposure dose should be managed better than for the adult. Therefore, this study was conducted to observe the change in the chest x-ray image by the use of grid, which eliminates the scattering rays but increases the exposure dose during the child chest x-ray examination. As a research method, SNR, CNR and V. Vuichi were measured at 100 cm and 180 cm with the grid varying the kVp to 70, 90 and 110. In addition, SNR, CNR and V. Vuichi were measured fixing 100 cm and 180cm without grid and varying the dose to 6, 8 and 10 mAs. In the results of measuring them by fixing kVp, SNR, VNR and V. Vuichi were represented high when FID is 100cm. And in the results of meaduring them varying mAs, SNR, VNR and V. Vuichi were represented high when FID is 100cm. Currently in our country, the chest x-ray examination is performed at 180 cm. However, as the image is measured high when FID is 100 cm, in case of child, FID is deemed to be 100 cm.

Congenital Tracheomalacia Associated with Esophageal Atresia (선천성 식도폐쇄에서 발생한 선천성 기관연화)

  • Han, Seok-Joo;Jung, Eun-Joo;Kim, Se-Heon;Yoon, Choon-Sik;Shim, Kyu-Dae;Nam, Yong-Taek;Kim, Jai-Eok;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.8 no.2
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    • pp.161-165
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    • 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).

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