Current diagnosis and image-guided reduction for intussusception in children

Hwang Jisun,Yoon Hee Mang,Kim Pyeong Hwa,Jung Ah Young,Lee Jin Seong,Cho Young Ah 대한소아청소년과학회 2023 Clinical and Experimental Pediatrics (CEP) Vol.66 No.1

Intussusception involves an invagination of the proximal bowel into the distal bowel, with ileocolic intussusception being the most common type. However, a diagnostic delay can lead to intestinal ischemia, bowel infarction, or even death; therefore, its early diagnosis and management are important. The primary role of abdominal radiography is to detect pneumoperitoneum or high-grade bowel obstruction in cases of suspected intussusception, and ultrasonography is the modality of choice for its diagnosis. Nonoperative enema reduction, the treatment of choice for childhood intussusception in cases without signs of perforation or peritonitis, can be safely performed with a success rate of 82%. Enema reduction can be performed in various ways according to image guidance method (fluoroscopy or ultrasonography) and reduction medium (liquid or air). Successful enema reduction is less likely to be achieved in children with a longer symptom duration, younger age, lethargy, fever, bloody diarrhea, unfavorable radiologic findings (small bowel obstruction, trapped fluid, ascites, absence of flow in the intussusception, intussusception in the left-sided colon), and pathological lead points. This review highlights the current concepts of intussusception diagnosis, nonsurgical enema reduction, success rates, predictors of failed enema reduction, complications, and recurrence to guide general pediatricians in the management of childhood intussusception.

담도폐쇄증의 수술 후 영상 소견

Jisun Hwang,Hee Mang Yoon,Pyeong Hwa Kim,Jung-Man Namgoong,Seak Hee Oh,Ah Young Jung,Jin Seong Lee,Young Ah Cho 대한영상의학회 2022 대한영상의학회지 Vol.83 No.5

The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

Application of the postnatal urinary tract dilation classification system to predict the need for surgical intervention among neonates and young infants

Hwang Jisun,Kim Pyeong Hwa,윤희망,Sang Hoon Song,Ah Young Jung,Jin Seong Lee,Cho Young Ah 대한초음파의학회 2023 ULTRASONOGRAPHY Vol.42 No.1

Purpose: The aim of this study was to validate the postnatal urinary tract dilation (UTD) classification system by correlating it with the need for surgical intervention. Methods: Young infants who underwent ultrasound (US) examinations for prenatal hydronephrosis were retrospectively identified. The kidney units (KUs; right, left, or bilateral) were graded from UTD P0 (very low risk) to P3 (high risk) based on seven US criteria from the UTD system. Surgery-free survival curves were constructed using the Kaplan-Meier method. Univariable and multivariable Cox proportional-hazards regression analysis clustered by patients was performed. Interobserver agreement was analyzed using the weighted kappa coefficient. Results: In total, 504 KUs from 336 patients (mean age, 18.3±15.9 days; range, 1 to 94 days; males, n=276) were included, with a median follow-up of 24.2 months. Fifty-eight KUs underwent surgical intervention. Significant differences were observed among the Kaplan-Meier curves stratified into UTD groups (P<0.001). The presence of anterior-posterior renal pelvic diameter ≥15 mm (hazard ratio [HR], 8.602; 95% confidence interval [CI], 1.558 to 43.065), peripheral calyceal dilation (HR, 8.190; 95% CI, 1.558 to 43.065), ureteral dilation (HR, 2.619; 95% CI, 1.274 to 5.380), parenchymal thickness abnormality (HR, 3.371; 95% CI, 1.574 to 7.223), bladder abnormality (HR, 12.209; 95% CI, 3.616 to 41.225) were significantly associated with the occurrence of surgery. The interobserver agreement was moderate to almost perfect agreement for US features (κ=0.564-0.898) and substantial for final UTD grades (κ=0.716). Conclusion: The UTD classification system is reliable and appropriately stratifies the risk of surgical intervention.

Correlations between the Clinical and Ultrasonographic Parameters of Congenital Muscular Torticollis without a Sternocleidomastoid Mass

Hwang Jisun,Khil Eun Kyung,Jung Soo Jin,Choi Jung-Ah 대한영상의학회 2020 Korean Journal of Radiology Vol.21 No.12

Objective: To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. Materials and Methods: This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1–3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. Results: A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane. The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p < 0.001) and 0.731 (p < 0.001) for group 1 versus groups 2–3. The proportions of heterogeneous echotexture or hyperechogenicity in the involved SCM did not differ significantly among the three clinical groups (all p > 0.05). Conclusion: Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.

Comparison of Extraction Methods for instrumental Flavor analysis of Nuroongji

Jisun Hwang,Mina K. Kim 한국식품영양과학회 2020 한국식품영양과학회 학술대회발표집 Vol.2020 No.10

Comparison of Maximum Fingertip Forces between Healthy and Patients with Spinal Cord Injury

Jisun Hwang,Seonhong Hwang 한국재활복지공학회 2021 한국재활복지공학회 학술대회논문집 Vol.2021 No.11

Chordoid Glioma Originating in the Intrasellar and Suprasellar Regions: Case Report

Hwang, Jisun,Lee, Aleum,Chang, Kee-Hyun,Moon, Ah Rim,Hwang, Sun-Chul,Hong, Hyun Sook Korean Society of Magnetic Resonance in Medicine 2015 Investigative Magnetic Resonance Imaging Vol.19 No.2

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.

Influence of Testing Environment on Consumer Liking of Doenjang Stew

Jisun Hwang,Mina K. Kim 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

The purpose of this study was to determine the influence of testing environment on consumer liking of doenjang Stew. Consumer acceptance testing on doenjang stew was conducted four times, each represent CLT, 3 different HUTs. For HUTs, samples were served in different containers: 50ml of pre-made doenjang stew in plastic 95ml disposable cup, representing CLT conducted at home; 200 ml (one-serving) of pre-made doenjang stew in a 500ml plastic disposable bowl, representing “take-out” from restaurant, designed to represent CLT condition performed at home; doenjang meal kit including doenjang paste, vegetables, broth, and cooking recipe, representing meal-kit consumption scenario (n=82). Differences in product liking were observed according to the testing environment (p<0.05). In the appearance-related attributes (no tasting involved), consumers rated the higher liking scores on doenjang stew evaluated as meal-kit HUT situation (p<0.05). When tasting is involved, consumers rated higher scores on stew samples presented at CLT condition (p<0.05). Finding from this study suggests testing environment can influence the consumer acceptance testing results.

Investigation of individual fingertip forces trend between healthy and spinal cord injury patients

Jisun Hwang,Seonhong Hwang 한국재활복지공학회 2019 한국재활복지공학회 학술대회논문집 Vol.2019 No.11

일회성 유산소 운동이 흡연자의 동맥경직도, 대뇌혈류량 및 인지기능에 미치는 영향: 중강도 지속성 vs. 고강도 인터벌

황지선 ( Jisun Hwang ),이루다 ( Ruda Lee ),김진수 ( Jin-su Kim ),황문현 ( Moon-hyon Hwang ) 한국운동생리학회(구 한국운동과학회) 2020 운동과학 Vol.29 No.3

PURPOSE: This study aimed to compare the acute effects of high-intensity interval exercise (HIIE) with moderate-intensity continuous exercise (MICE) on arterial stiffness, cerebral blood flow and cognitive function in young smokers. METHODS: Young smokers (23.1 years & 7.2 pack years) were randomly assigned to either MICE (n=5) or HIIE (n=4) group. MICE was implemented at 70% of HRmax for 30 minutes. HIIE was performed at 70% and 90% of HRmax for 24 minutes. Central artery stiffness was assessed by aortic pulse wave velocity (cfPWV), augmentation index (AIx) at pre and post-exercise, and 30 minutes, 1 hour, 2 hours, 24 hours following the exercises. Cerebral blood flow was continuously monitored using near-infrared spectroscopy technique before and during exercise, and at 30 minutes, 1 hour, 2 hours, and 24 hours following the exercises. Cognitive function was assessed by Stroop Color-Word test at pre-exercise, and 30 minutes and 24 hours following the exercises. RESULTS: There was no significant group by time interaction in cfPWV, AIx, cerebral blood flow (HbO₂) level, and cognitive function. Compared with MICE, cfPWV was increased (p=.01) at 30 minutes but AIx was decreased (p=.02) at 1 hour following HIIE. When MICE and HIIE combined, arterial stiffness and cerebral blood flow measures, and cognitive function parameters were improved following even one-bout of exercise (p≤.049). Change in AIx was associated with change in cognitive function at 30 minutes following the exercises (r=.69, p=.06). CONCLUSIONS: Even one-bout of either MIIE or HIIT acutely improves aortic wave reflection, cerebral blood flow and cognitive function in young smokers. The intensity of aerobic exercise does not seem to make meaningful differences in the positive effects on arterial stiffness, cerebral blood flow, and cognitive function in young smokers if both exercises have the same volume.