Breast Lesions in Children and Adolescents: Diagnosis and Management

Pediatric breast disease is uncommon, and primary breast carcinoma in children is extremely rare. Therefore, the approach used to address breast lesions in pediatric patients differs from that in adults in many ways. Knowledge of the normal imaging features at various stages of development and the characteristics of breast disease in the pediatric population can help the radiologist to make confident diagnoses and manage patients appropriately. Most breast diseases in children are benign or associated with breast development, suggesting a need for conservative treatment. Interventional procedures might affect the developing breast and are only indicated in a limited number of cases. Histologic examination should be performed in pediatric patients, taking into account the size of the lesion and clinical history together with the imaging findings. A core needle biopsy is useful for accurate diagnosis and avoidance of irreparable damage in pediatric patients. Biopsy should be considered in the event of abnormal imaging findings, such as non-circumscribed margins, complex solid and cystic components, posterior acoustic shadowing, size above 3 cm, or an increase in mass size. A clinical history that includes a risk factor for malignancy, such as prior chest irradiation, known concurrent cancer not involving the breast, or family history of breast cancer, should prompt consideration of biopsy even if the lesion has a probably benign appearance on ultrasonography.

Assessment of embryo/fetus during pregnancy by threedimensional ultrasonography using the HD live software: iconographic essay / Avaliação do embrião/feto ao longo da gestação por meio da ultrassonografia tridimensional com o software HD live: ensaio iconográfico

Fetal development is studied since the advent of two-dimensional ultrasonography. However, a detailed assessment of structures and surfaces improved with three-dimensional ultrasonography. Currently, it is possible to identify embryonic components and fetal parts with greater detail, at all pregnancy trimesters, using the HD live software, where the images gain realistic features by means of appropriate control of lighting and shadowing effects. In the present study, the authors utilized this resource to follow-up, by means of images, the development of a normal pregnancy along all trimesters.

O desenvolvimento fetal é estudado desde o advento da ultrassonografia bidimensional. Entretanto, a avaliação pormenorizada de estruturas e superfícies ganhou maior qualidade com a ultrassonografia tridimensional. Atualmente, é possível identificar componentes embrionários e partes do feto com maior riqueza de detalhes, em todos os trimestres da gestação, utilizando o software HD live, no qual a imagem ganha características realísticas mediante controle adequado de luz e sombreamento. Neste estudo utilizamos este recurso, por meio de imagens, para acompanhar a evolução de uma gestação normal em todos os seus trimestres.

Normal Development and Common Psychiatric Illnesses in Adolescence / 신경정신의학

OBJECTIVES: I reviewed the fundamental knowledge about normal development and common psychiatric illnesses in adolescence to provide with a lecture note for resident training seminar. METHODS: Three textbooks were reviewed and summarized. RESULTS: Adolescence is a bridge period between childhood and adulthood. Through adolescence, the development and achievement of interpersonal relationship, character pattern, learning and occupational capabilities occur. In adolescence, lots of both physical and psychological changes are observed. Also the requirement of social role and duty increased. Because of them, many psychiatric illnesses and adaptive problems are developed and exert negative influences on the quality of life of adolescents and their family. CONCLUSION: Adolescence is important period in human development and many psychiatric disabilities are developed and aggravated in this period.

Normal Infancy, Toddlerhood, and Preschool Development and Pervasive Developmental Disorders / 신경정신의학

To understand developmental abnormalities including pervasive developmental disorders, it is essential to understand normal developmental process of children, especially from infancy to preschool years. Infancy refers to the time before the beginning of extensive verbal communication that occurs at about 18 months. Toddlerhood, from 18 months to 3 years, encompasses the most rapid and contextually transactional period of developmental change throughout the postpartum life. Preschool years are characterized by extensive development of language, cognition, and social ability including the blooming of theory of mind. Multiple areas of development are affected in pervasive developmental disorders (PDD), and assessments of various aspects of behavior and development are essential for diagnosis. This review provides the areas of assessment of core features of PDD, including abnormalities in communication, social interaction, and repetitive and stereotyped behavior in the context of deviation from the normal behavioral development from infancy to preschool years.