1.Gastrointestinal Emergency in Neonates and Infants: A Pictorial Essay
Gayoung CHOI ; Bo-Kyung JE ; Yu Jin KIM
Korean Journal of Radiology 2022;23(1):124-138
Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. In this paper, we discuss the radiological findings of essential neonatal and infantile GI emergencies, including esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, duodenal atresia, malrotation, midgut volvulus for upper GI emergencies, and jejunoileal atresia, meconium ileus, meconium plug syndrome, meconium peritonitis, Hirschsprung disease, anorectal malformation, necrotizing enterocolitis, and intussusception for lower GI emergencies.
2.Extrahepatic Bile Duct Duplication with Intraductal Papillary Neoplasm:A Case Report
Journal of the Korean Radiological Society 2021;82(4):964-970
Extrahepatic duct duplication is an extremely rare congenital anomaly. Hilar cholangiocarcinoma with extrahepatic bile duct duplication was reported; however, intraductal papillary neoplasm of the bile duct (IPNB) with extrahepatic bile duct duplication has not been reported to the best of our knowledge. We report a rare case of IPNB with extrahepatic bile duct duplication of a 64-year-old female. The patient underwent extended right hepatectomy, and the results of a subsequence histopathological examination were consistent with an IPNB with extrahepatic bile duct duplication. We report this rare case with radiologic imaging findings and a brief review of the current literature.
3.Extrahepatic Bile Duct Duplication with Intraductal Papillary Neoplasm:A Case Report
Journal of the Korean Radiological Society 2021;82(4):964-970
Extrahepatic duct duplication is an extremely rare congenital anomaly. Hilar cholangiocarcinoma with extrahepatic bile duct duplication was reported; however, intraductal papillary neoplasm of the bile duct (IPNB) with extrahepatic bile duct duplication has not been reported to the best of our knowledge. We report a rare case of IPNB with extrahepatic bile duct duplication of a 64-year-old female. The patient underwent extended right hepatectomy, and the results of a subsequence histopathological examination were consistent with an IPNB with extrahepatic bile duct duplication. We report this rare case with radiologic imaging findings and a brief review of the current literature.
4.The Relation Between the Presence of Aspiration or Penetration and the Clinical Indicators of Dysphagia in Poststroke Survivors.
Hyeju HAN ; Gayoung SHIN ; Ahyoung JUN ; Taeok PARK ; Doheung KO ; Eunhee CHOI ; Youngsun KIM
Annals of Rehabilitation Medicine 2016;40(1):88-94
OBJECTIVE: To examine the relation between the presence of penetration or aspiration and the occurrence of the clinical indicators of dysphagia. The presence of penetration or aspiration is closely related to the clinical indicators of dysphagia. It is essential to understand these relationships in order to implement proper diagnosis and treatment of dysphagia. METHODS: Fifty-eight poststroke survivors were divided into two groups: patients with or without penetration or aspiration. Medical records and videofluoroscopic swallowing examinations were reviewed. The occurrence of clinical indicators of dysphagia between two groups was analyzed with Cross Tabulation and the Pearson chi-square test (p<0.05). RESULTS: Poststroke survivors with penetration or aspiration had significantly high occurrences of delayed initiation of the swallow (p=0.04) and reduced hyolaryngeal elevation (p<0.01) than those without penetration or aspiration. CONCLUSION: The results of this study indicate that delayed initiation of the swallow is a strong physiological indicator of penetration or aspiration during the oral stage of swallowing in poststroke survivors. For the pharyngeal stage of swallowing, hyoid and laryngeal elevation is a key event related to occurrence of penetration or aspiration. Clinical indicators should be investigated further to allow appropriate implementation of treatment strategies for stroke survivors.
Deglutition
;
Deglutition Disorders*
;
Diagnosis
;
Humans
;
Medical Records
;
Oral Stage
;
Stroke
;
Survivors*
5.Color Change of Esthetic Restorative Materials for Different Staining and Whitening Dentifrices
EunJung CHOI ; HyeonSoo JANG ; YeLim SEO ; YoungJu KIM ; GaYoung LEE ; YouLim KIM ; Soo-Jeong HWANG
Journal of Dental Hygiene Science 2021;21(3):178-184
Background:
As the importance of the esthetic function of teeth increases, the use of esthetic restoration materials and whitening treatment are increasing. The purpose of this study was to investigate the color change of esthetic restoration materials upon using staining and whitening toothpaste.
Methods:
Light curing (LC) packable composite resin, LC flowable resin, LC glass ionomer (GI), and self-curing GI specimens were colored in coffee or curry for three hours a day for seven days. After that, regular toothpaste, whitening toothpaste containing hydrogen peroxide, and whitening toothpaste containing activated charcoal were applied for three minutes three times a day for two weeks. Luminosity (L), chromaticity a (a), and chromaticity b (b) were measured using a spectrophotometer once a week.
Results:
In the coffee-colored group, the change in L2 *a2 *b2 (E2 ) with time was significant (p=0.004), there was no difference for different toothpaste types (p=0.646), and there was significant difference (p<0.001) for different esthetic restorative materials.The change of E2 in the curry-colored group was significant only for different esthetic restorative materials (p<0.001). In the coffee-colored group, the L, a, and b values of the light-curing GI showed greater change than other materials after staining and one week after whitening, turning dark, red, and yellow. In the curry-colored group, L did not differ for different materials and times, and a and b showed the greatest difference in light-curing GI after staining and one and two weeks after whitening.
Conclusion
The use of whitening toothpaste for two weeks was not different from the use of general toothpaste in the removal of staining or whitening. Since light-curing GI is the most vulnerable to coloration, it is recommended that coloring by food chromogen should be explained in advance, before using light-curing GI for teeth restoration.
6.Contrast-enhanced voiding urosonography for the diagnosis of vesicoureteral reflux and intrarenal reflux: a comparison of diagnostic performance with fluoroscopic voiding cystourethrography
Daehee KIM ; Young Hun CHOI ; Gayoung CHOI ; Seulbi LEE ; Seunghyun LEE ; Yeon Jin CHO ; Seon Hee LIM ; Hee Gyung KANG ; Jung-Eun CHEON
Ultrasonography 2021;40(4):530-537
Purpose:
This study evaluated the diagnostic performance of contrast-enhanced voiding urosonography (ce-VUS) using a second-generation ultrasound contrast agent for the diagnosis of vesicoureteral reflux (VUR) and intrarenal reflux (IRR), and compared it with that of standard fluoroscopic voiding cystourethrography (VCUG).
Methods:
Thirty-two consecutive children from April to October 2019 were included in this study. ce-VUS and VCUG were performed simultaneously by two operators with intravesical infusion of a mixture of ultrasound contrast medium, iodinated contrast medium and water. Two pediatric radiologists independently reviewed the ce-VUS and VCUG images and reported the presence and degree of VUR (grades I-V), and the presence and type of IRR.
Results:
Twenty-seven of 63 urinary systems showed VUR. Interobserver agreement for VUR grading was very good for both examinations (κ=0.87; 95% confidence interval [CI], 0.82 to 0.92 for ce-VUS and κ=0.92; 95% CI, 0.87 to 0.96 for VCUG). The detection rate of VUR showed no significant difference between the two examinations (P=0.370). Four cases of VUR were missed on ce-VUS, while one case of VUR was missed on VCUG. All four false-negative cases on ce-VUS were grade 1 VUR. The two examinations showed very good agreement regarding VUR grading (κ =0.89; 95% CI, 0.81 to 0.96). IRR was more frequently detected with ce-VUS than with VCUG (10 cases with ce-VUS vs. 3 cases with VCUG, P=0.016).
Conclusion
ce-VUS showed very good agreement with VCUG for detecting grade 2 VUR and above, while grade 1 VUR was sometimes missed with ce-VUS. IRR was more frequently detected with ce-VUS than with VCUG.
7.Diagnostic Performance of a New Convolutional Neural Network Algorithm for Detecting Developmental Dysplasia of the Hip on Anteroposterior Radiographs
Hyoung Suk PARK ; Kiwan JEON ; Yeon Jin CHO ; Se Woo KIM ; Seul Bi LEE ; Gayoung CHOI ; Seunghyun LEE ; Young Hun CHOI ; Jung-Eun CHEON ; Woo Sun KIM ; Young Jin RYU ; Jae-Yeon HWANG
Korean Journal of Radiology 2021;22(4):612-623
Objective:
To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs.
Materials and Methods:
Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience.
Results:
The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001).
Conclusion
The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.
8.Diagnostic Performance of a New Convolutional Neural Network Algorithm for Detecting Developmental Dysplasia of the Hip on Anteroposterior Radiographs
Hyoung Suk PARK ; Kiwan JEON ; Yeon Jin CHO ; Se Woo KIM ; Seul Bi LEE ; Gayoung CHOI ; Seunghyun LEE ; Young Hun CHOI ; Jung-Eun CHEON ; Woo Sun KIM ; Young Jin RYU ; Jae-Yeon HWANG
Korean Journal of Radiology 2021;22(4):612-623
Objective:
To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs.
Materials and Methods:
Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience.
Results:
The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001).
Conclusion
The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.
9.Incidence and Risk Factors of Nausea and Vomiting after Exposure to Low-Osmolality Iodinated Contrast Media in Children: A Focus on Preparative Fasting
Ji Young HA ; Young Hun CHOI ; Yeon Jin CHO ; Seunghyun LEE ; Seul Bi LEE ; Gayoung CHOI ; Jung-Eun CHEON ; Woo Sun KIM
Korean Journal of Radiology 2020;21(10):1178-1186
Objective:
To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT).
Materials and Methods:
All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included.Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses.
Results:
Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia.The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3–21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0–24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323;95% confidence interval [CI] = 1.430–13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442–36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350–20.346;p = 0.017) were independent risk factors for emetic complications.
Conclusion
Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM.Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.
10.A Case of Pseudoisodicentric Chromosome 18q Detected at Prenatal Diagnosis.
Sun Young CHO ; Gayoung LIM ; So Young KIM ; Min Jin KIM ; Kyung A LEE ; Jong Rak CHOI ; Hee Joo LEE ; Jin Tae SUH ; Tae Sung PARK ; Eui JUNG
The Korean Journal of Laboratory Medicine 2010;30(4):440-443
Although trisomy 18 (Edwards' syndrome) or the terminal deletion syndromes of 18p and 18q have been occasionally detected, pseudoisodicentric chromosome 18 is a very rare constitutional chromosomal abnormality. We describe a case of pseudoisodicentric chromosome 18q without mosaicism, which was confirmed from fetal cells in the amniotic fluid used for prenatal diagnosis of multiple congenital anomalies. A 23-yr-old pregnant woman was suspected of having a fetal anomaly at 18(+3) weeks gestation. In sonography, the fetus showed multiple anomalies: bilateral overt ventriculomegaly in the brain, ventricular septal defect and valve anomaly in the heart, bilateral club foot, polydactyly, meningocele, and a single umbilical artery. The pregnancy was terminated and a conventional G-banded chromosome study was performed using amniotic fluid. Twenty metaphase cells among the cultured amniocytes showed a 46,XX,psu idic(18)(q22). Consequently, the fetus had partial trisomy (18pter-->q22) and partial monosomy (18q22-->qter). Both parents were confirmed to have a normal karyotype.
Abnormalities, Multiple/diagnosis/*genetics
;
Centromere
;
*Chromosomes, Human, Pair 18
;
Female
;
Gestational Age
;
Humans
;
Karyotyping
;
Pregnancy
;
Prenatal Diagnosis/*methods
;
Trisomy
;
Ultrasonography, Prenatal
;
Young Adult