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Purpose@#Appendectomy is one of the most common surgeries in children. Although various radiological examinations are performed, they do not always reveal a definitive diagnosis of appendicitis. This study aimed to investigate the clinical course of equivocal appendicitis, identify the factors associated with appendectomy, and suggest appropriate management for these patients. @*Methods@#Patients younger than 19 years who visited Seoul National University Bundang Hospital with a differential diagnosis of appendicitis from January 2013 to December 2017 were included. All participants conducted ‘appendiceal CT’ with a scoring scale of 1–5. The higher the score, the higher the likelihood of a radiologic diagnosis of appendicitis. We defined the appendicitis CT score of 2–4 as equivocal appendicitis (n = 143). Medical records were reviewed retrospectively for demographics, further examination as abdominal ultrasonography, and appendectomy status (yes or no). The mean follow-up period was 15.6 ± 71 days. @*Results@#Equivocal appendicitis accounted for 16.7%. Additional ultrasonography test was performed in 24.5% (35 of 143). In total, 34 patients (23.8%) underwent appendectomy. Among the patients with appendiceal CT scores 2, 3, and 4, 4.9%, 50.0%, and 87.5% underwent appendectomy, respectively. Higher WBC count, higher appendicitis CT score, and readmission were significantly associated with appendectomy in patients with equivocal appendicitis. @*Conclusion@#Higher appendicitis CT score and WBC level were positively associated with appendectomy. Careful observation can be a treatment option in appendicitis CT score 2 or 3 groups. Appendectomy is the first-line treatment for patients with appendicitis score 4. Additional ultrasonography test is advisable to determine treatment modality for equivocal appendicitis.
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Background@#Semi-rigid neck collars to protect the cervical spine can limit the extent of neck movement and mouth opening; this may further complicate orotracheal intubation. We aimed to compare intubation environments obtained with videolaryngoscopy using the technique of gliding a blade under the epiglottis and that obtained using the conventional Macintosh blade technique of blade tip placement on the vallecula. @*Methods@#This prospective randomized study included patients aged ≥ 20 years with American Society of Anesthesiologists physical status I–III scheduled for cervical spine surgery between October 2020 and August 2021. Patients were divided into two groups according to the placement of the blade of the McGrathTM videolaryngoscope: the gliding and conventional groups. The percentage of glottic opening (POGO) score was the primary endpoint. We also recorded the time to obtain the optimal laryngoscopic view, intubation duration, and ease and satisfaction of the researcher performing intubation. @*Results@#Among 176 patients, the POGO scores were significantly higher in the gliding group than in the conventional group (88.9 ± 14.7 vs. 63.8 ± 27.4, P < 0.001). The time to achieve the optimal glottic view for intubation and duration of intubation were also shorter, and ease and satisfaction in performing intubation were better in the gliding group than in the conventional group. @*Conclusion@#Our findings demonstrated a superior glottic view and more favorable intubation environments when the blade tip was placed under the epiglottis than using the conventional Macintosh technique in patients with immobilized cervical spine.
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Purpose@#The aim of the study was to investigate the effects of a mindfulness-based stress reduction program on the perceived stress, internalized stigma, and psychological well-being of psychiatric inpatients. @*Methods@#A non-equivalent control group study with a pretest-posttest design was used. Participants were obtained from the closed wards of a psychiatric hospital in K-city. A total of 45 people were included in this study, 22 in the experimental group and 23 in the control group. The pre, post, and follow-up scores of both the experimental and control groups were obtained using the Korea Perceived Stress Scale, the Korea Internalized Stigma of Mental Illness Scale, and the Korea Psychological Well-Being Scale to validate the effectiveness of the program. A 45 minute program was performed twice weekly for three weeks. @*Results@#There was a statistically significant reduction in perceived stress (F=6.92, p=.002) and internalized stigma (F=22.76, p<.001), and a significant improvement in psychological well-being (F=38.34, p<.001) in the experimental group. @*Conclusion@#A mindfulness-based stress reduction program could be implemented as an intervention to reduce perceived stress and internalized stigma and enhance psychological well-being in psychiatric inpatients.
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Purpose@#This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents. @*Methods@#Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis. @*Results@#The results yielded 5 main themes and 18 subthemes. The main themes were ‘a silent cry to an indifferent world’, ‘a heartache that one endures with scars’, ‘an inescapable cycle’, ‘filling the space in one’s heart’, and ‘healing the wounds’. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so. @*Conclusion@#This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.
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Spinal epidermoid cysts are extremely rare benign tumors and can be congenital or acquired.Acquired spinal epidermoid cysts are found in the lumbosacral region. To our knowledge, no case of epidermoid cyst related to spinal cord stimulator insertion has yet been reported. We report the MRI findings of a rare case of thoracic intradural epidermoid cyst acquired after spinal cord stimulator insertion in a 50-year-old female.
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As North Korea’s healthcare sector loses functionality under the collapsing socialist system, the gap in medical care between North and South Korea is widening. As a result, we expect that the social safety network will disintegrate in the medical field after unification, and in view of this, our study analyzes the infants and mothers who are likely to be most affected at this time to establish a direction for the promotion of unification in the future. Maternal health in North and South Korea was analyzed by the prevalence of anemia, maternal mortality ratio, prenatal and postpartum visits, and child health was analyzed by chronic malnutrition, vaccination penetration rate, and infant mortality rate to evaluate North Korea's poor nutritional conditions and medical system. The introduction of the legal system related to maternal and child health in North and South Korea includes prenatal and postpartum management and labor. Under this legal system, North Korea includes accessibility to hospitals and children's nutrition management issues, and South Korea includes subfertility treatment and postpartum care centers. As a countermeasure to the low birth rate problem emerging in both countries, the governments are providing work leave and economic support. In order to make effective use of the maternal health indicators from a unified scientific perspective, they should be calculated and codeveloped by both North and South Korea, and a multifaceted approach is needed through the setting of additional indicators such as the perinatal mortality rate.
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Purpose@#This study developed an integrated health management program for metabolic syndrome in psychiatric patients and examined its effects on self-efficacy, healthy lifestyle, physiological indicators, knowledge of metabolic syndrome, attitudes toward healthy behavior, and social support. @*Methods@#A non-equivalent control group pretest posttest design was used. The participants were 65 psychiatric patients with metabolic syndrome in psychiatric rehabilitation centers, with 33 in the experimental group and 32 in the control group. The experimental group participants engaged in daily mobile application and walking exercises three times a week for more than 40 minutes over 8 weeks, while those in the control group were provided education booklets. The outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. Intervention effects were analyzed using the independent t-test, Mann—Whitney U test, ANCOVA, and Ranked ANCOVA. @*Results@#The experimental group showed a significant increase in self-efficacy (F = 8.85, p = .004, ηp2 = .13) and knowledge of metabolic syndrome (t = 2.60, p = .012, d = 0.60) compared to the control group. Additionally, the experimental group demonstrated a significant decrease in waist circumference (Z = - 2.34, p = .009, d = 0.58) and body mass index (Z = - 1.91, p = .028, d = 0.47) compared to the control group. @*Conclusion@#The integrated health management program for psychiatric patients with metabolic syndrome is effective in improving self-efficacy and knowledge of metabolic syndrome and decreasing physiological indicators such as waist circumference and body mass index.
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Purpose@#We evaluated the relationship between breast pathologic complete response (BpCR) and axillary pathologic complete response (ApCR) after neoadjuvant chemotherapy (NACT) according to nodal burden at presentation. As the indications for NACT have expanded, clinicians have started clinical trials for the omission of surgery from the treatment plan in patients with excellent responses to NACT. However, the appropriate indications for axillary surgery omission after excellent NACT response remain unclear. @*Methods@#Data were collected from patients in the Korean Breast Cancer Society Registry who underwent NACT followed by surgery between 2010 and 2020. We analyzed pathologic axillary nodal positivity after NACT according to BpCR stratified by tumor subtype in patients with cT1-3/N0-2 disease at diagnosis. @*Results@#A total of 6,597 patients were identified. Regarding cT stage, 528 (9.5%), 3,778 (67.8%), and 1,268 (22.7%) patients had cT1, cT2, and cT3 disease, respectively. Regarding cN stage, 1,539 (27.7%), 2,976 (53.6%), and 1,036 (18.7%) patients had cN0, cN1, and cN2 disease, respectively. BpCR occurred in 21.6% (n = 1,427) of patients, while ApCR and pathologic complete response (ypCR) occurred in 59.7% (n = 3,929) and ypCR 19.4% (n = 1,285) of patients, respectively. The distribution of biologic subtypes included 2,329 (39.3%) patients with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative disease, 1,122 (18.9%) with HR-positive/HER2-positive disease, 405 (6.8%) with HR-negative/HER2-positive disease, and 2,072 (35.0%) with triple-negative breast cancer . Among the patients with BpCR, 89.6% (1,122/1,252) had ApCR. Of those with cN0 disease, most (99.0%, 301/304) showed ApCR. Among patients with cN1-2 disease, 86.6% (821/948) had ApCR. @*Conclusion@#BpCR was highly correlated with ApCR after NACT. In patients with cN0 and BpCR, the risk of missing axillary nodal metastasis was low after NACT. Further research on axillary surgery omission in patients with cN0 disease is needed.
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Purpose@#The purpose of this study was to use shear-wave elastography (SWE) to assess testicular stiffness changes during the Valsalva maneuver in adolescents and young adults with varicocele, to compare these changes according to clinical severity, and to evaluate the role of SWE in the diagnosis of varicocele. @*Methods@#This study included patients undergoing testicular ultrasonography for the diagnosis of varicocele or for post-varicocelectomy follow-up between June 2016 and February 2017. Fifty-four testicles of 27 consecutive patients (mean age, 15.9 years) were classified by clinical grade (grade 0-3). Using SWE, mean testicular stiffness (Emean) was measured at rest and during the Valsalva maneuver. The correlations between multiple ultrasonographic parameters (volume asymmetry, Emean at rest, and absolute and percentage changes in Emean during the Valsalva maneuver) and clinical grade were assessed using the Spearman correlation test. @*Results@#The Emean at rest was similar across clinical grades. During the Valsalva maneuver, increased testicular stiffness was frequently observed in patients with grade 2 or 3 varicocele but rarely observed in those with grade 0 or 1 varicocele. The changes in Emean were positively correlated with the clinical grade (all P0.05). @*Conclusion@#A transient, reversible increase in testicular stiffness during the Valsalva maneuver was observed in adolescents with high-grade varicocele, and the degree of stiffness change was correlated with the clinical grade. Stiffness change identified using SWE during the Valsalva maneuver is a potential surrogate indicator of venous congestion.
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Purpose@#This study assessed the performance of transperineal ultrasonography (TPUS) in evaluating the treatment response in children with perianal Crohn’s disease (PACD) compared with pelvic magnetic resonance imaging (MRI). @*Methods@#This retrospective study was approved by the Institutional Review Board of our institution, which waived the requirement for informed consent. Twenty-nine patients (19 boys and 10 girls; median age, 14 years [range, 8 to 18 years]) with 56 fistulas were examined. Each fistula’s thickness and abscess size were measured using both modalities, and treatment response was classified as positive or negative based on each modality. The concordance of the classifications was compared between TPUS and pelvic MRI. A receiver operating characteristic curve (ROC) was used to evaluate the performance of TPUS. @*Results@#TPUS found 80.4% (45/56) of the fistulas. On MRI, 39 fistulas (70%) were classified as having positive treatment responses, and the remaining 17 as having no response. The agreement of the classifications between TPUS and MRI was moderate (κ=0.486; P<0.001; Spearman ρ=0.573; P<0.001). Based on the ROC analysis with the MRI findings as a reference to distinguish positive from negative treatment responses, TPUS exhibited sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 63.3%, 93.3%, 95.0%, 56.0%, and 73.3%, respectively. @*Conclusion@#TPUS can be an appropriate adjuvant imaging modality for pelvic MRI to evaluate the treatment response of PACD in children when initial TPUS detects PACD with a location and imaging features comparable to those visualized on MRI.
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Background@#The rapid rise in coronavirus disease worldwide has drastically limited the availability of hospital facilities for patients. Residential treatment centers were opened in South Korea for the admission of asymptomatic or patients with mild symptoms. This study discusses the appropriateness of the admission criteria set by the centers in a pandemic situation, the prioritization of patients for admission, and ways to minimize the risk of self-isolation. @*Methods@#A total of 217 low-risk patients (n=217) were admitted to the Nowon Residential Treatment Center between August 22 and October 14, 2020. The following criteria were met at the time of admission: patients (1) were asymptomatic or had mild symptoms, (2) had either a controlled or no underlying chronic disease, and (3) did not need oxygen treatment. Among them, 202 patients who were eligible for inclusion in the study were retrospectively investigated through periodic interviews. @*Results@#Of the 202 patients, 153 satisfied the criteria for symptomatic isolation standards, and 25 for asymptomatic isolation standards. The clinical conditions of 24 patients were aggravated, and these patients were transferred to other hospitals, among which 12 had persistent fever and 13 were suffering dyspnea with oxygen saturation (SpO2) <95%. @*Conclusion@#In the event of another large-scale epidemic, it would be appropriate to prioritize accommodating patients who are elderly or have underlying diseases and self-isolate young patients with no underlying diseases and provide them with SpO2 meters and thermometers to self-measure SpO2 and body temperature.
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Objective@#This study analyzed the relationship between sociodemographics and health behaviors that affect depression and stress of the aged 65 or older living in Seoul in 2018. @*Methods@#The subjects were selected according to the purpose by receiving raw data from the Korea Centers for Disease Control and Prevention, and 5,753 respondents were analyzed. @*Results@#In depression, the demographic and sociological factors with differences were sex, marriage, single-person household,current basic living, economic activity and monthly income, and the health behaviors with significant differences were past smoking, diabetes and insufficient annual medical use. In the stress level, the demographic and sociological factors with differences were age, sex, current basic living, monthly income and education, and the health behaviors with significant differences were current/past smoking, diabetes and insufficient annual medical use. The factors affecting depression and stress were not completely consistent but similar, and both had low rates of expert counseling. @*Conclusion@#This study is meaningful in that it identified the factors affecting the depression and stress of the elderly especially in Seoul, the metropolitan city. If future research reveals additional factors, it will be helpful to suggest the direction of government policy and contribute to improving the quality of life of the elderly in the super-aged era.
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Plexiform neurofibromas (PNFs) represent an uncommon variant (30%) of neurofibromatosis type 1 (NF-1), in which neurofibromas arise from multiple nerves as bulging and deforming masses involving connective tissue and skin folds. We report the case of a 17-year-old man with known NF-1 presenting with bilateral occipital neuralgia that began in his late adolescence. His chief complaint was radiating pain in the occiput induced by protective helmet wear when riding alpine skiing. Craniofacial magnetic resonance imaging (MRI) confirmed the presence of fusiform masses arising from the bilateral greater occipital nerves. Histopathological examination of the biopsy samples showed PNFs. After surgical treatment, the patient's symptoms completely improved. Unlike cutaneous neurofibromas, PNFs have different clinical characteristics and have the risk of malignant mutations. Correct diagnosis and adequate surgical treatment are necessary for PNFs.
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Purpose@#This study aimed to evaluate the utility of the 16-cm axial volume scan technique for calculating the coronary artery calcium score (CACS) using non-enhanced chest CT. @*Materials and Methods@#This study prospectively enrolled 20 participants who underwent both, non-enhanced chest CT (16-cm-coverage axial volume scan technique) and calciumscore CT, with the same parameters, differing only in slice thickness (in non-enhanced chest CT = 0.625, 1.25, 2.5 mm; in calcium score CT = 2.5 mm). The CACS was calculated using the conventional Agatston method. The difference between the CACS obtained from the two CT scans was compared, and the degree of agreement for the clinical significance of the CACS was confirmed through sectional analysis. Each calcified lesion was classified by location and size, and a one-to-one comparison of non-contrast-enhanced chest CT and calcium score CT was performed. @*Results@#The correlation coefficients of the CACS obtained from the two CT scans for slice thickness of 2.5, 1.25, and 0.625 mm were 0.9850, 0.9688, and 0.9834, respectively. The mean differences between the CACS were -21.4% at 0.625 mm, -39.4% at 1.25 mm, and -76.2% at 2.5 mm slice thicknesses. Sectional analysis revealed that 16 (80%), 16 (80%), and 13 (65%) patients showed agreement for the degree of coronary artery disease at each slice interval, respectively. Inter-reader agreement was high for each slice interval. The 0.625 mm CT showed the highest sensitivity for detecting calcified lesions. @*Conclusion@#The values in the non-contrast-enhanced chest CT, using the 16-cm axial volume scan technique, were similar to those obtained using the CACS in the calcium score CT, at 0.625 mm slice thickness without electrocardiogram gating. This can ultimately help predict cardiovascular risk without additional radiation exposure.
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Purpose@#The purpose of this study was to investigate the factors influencing osteoporosis awareness depending on the family structure in postmenopausal women aged over 50 years with osteoporosis. @*Methods@#The study was a cross-sectional study that used secondary data. Postmenopausal women with osteoporosis aged over 50 years (n = 567) from the National Health Nutrition Survey of the 5th (2010, 2011) were selected for analysis. Data were analyzed by complex sampling design multiple regression analysis. @*Results@#Among the patients with osteoporosis, the osteoporosis awareness was very low at 29.0%, and 32.5% for single households and 28.1% for household with spouses. There were significant differences in the factors influencing osteoporosis awareness depending on the family structure. For single household, factors that influenced osteoporosis awareness included sleeping for more than 9 hours (OR, 4.32), anxiety and depression (OR, 3.21), a history of fracture (OR, 0.29), and a family history of osteoporosis (OR, 0.29). In the household with a spouse, osteoporosis awareness was highest in women in their 60 seconds (OR, 3.45), unhealthy group (OR, 2.27), and underweight group (OR, 5.31). Other factors that influenced osteoporosis awareness included pain/discomfort (OR, 2.31), smoking (OR, 7.71), and a history of fracture (OR, 0.36). @*Conclusion@#It is necessary to improve osteoporosis awareness for effective osteoporosis management through osteoporosis screening and counseling, and continuous osteoporosis education programs.
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Purpose@#This study aimed to compare the value congruence of nurse-patient assignment (NPA) with work performance in the neonatal intensive care unit (NICU). @*Methods@#Data were collected with 30-items on factors that affect NPA and 17-items on work performance. Two questionnaire surveys each were conducted with 79 nurses from the NICU. The difference between expectations and actual experience on NPA were analyzed, and the effects of NPA on work performance and overtimes were investigated. The collected data were analyzed with a paired t-test, analysis of variance, and Pearson’s correlation coefficients using the SPSS software version 20.0. @*Results@#The NPA criteria were surveyed with 30 items, with 13 patient-related, and 17 nurse-related. The validity of the tool was S-CVI .95 and the reliability (Cronbach’s ⍺) was .942. There were significant differences based on age (F=3.69, p=.029) and caring for patients on an artificial ventilator (t=2.55, p=.013). The higher the patient-related actual assignment score, the higher the nurse-related actual assignment score (r=.68, p<.001) and work performance (r=.48, p<.001). As the nurse-related actual assignment score increased, work performance also increased significantly (r=.36, p=.001). @*Conclusion@#It was confirmed that the value congruence of NPA is positively correlated with work performance.
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Hepatitis B virus X (HBx) protein has been reported as a key protein regulating the pathogenesis of HBV-induced hepatocellular carcinoma (HCC). Recent evidence has shown that HBx is implicated in the activation of autophagy in hepatic cells. Nevertheless, the precise molecular and cellular mechanism by which HBx induces autophagy is still controversial.Herein, we investigated the molecular and cellular mechanism by which HBx is involved in the TRAF6-BECN1-Bcl-2 signaling for the regulation of autophagy in response to TLR4 stimulation, therefore influencing the HCC progression. HBx interacts with BECN1 (Beclin 1) and inhibits the association of the BECN1-Bcl-2 complex, which is known to prevent the assembly of the pre-autophagosomal structure. Furthermore, HBx enhances the interaction between VPS34 and TRAF6-BECN1 complex, increases the ubiquitination of BECN1, and subsequently enhances autophagy induction in response to LPS stimulation. To verify the functional role of HBx in liver cancer progression, we utilized different HCC cell lines, HepG2, SK-Hep-1, and SNU-761. HBx-expressing HepG2 cells exhibited enhanced cell migration, invasion, and cell mobility in response to LPS stimulation compared to those of control HepG2 cells. These results were consistently observed in HBx-expressed SK-Hep-1 and HBx-expressed SNU-761 cells. Taken together, our findings suggest that HBx positively regulates the induction of autophagy through the inhibition of the BECN1-Bcl-2 complex and enhancement of the TRAF6-BECN1-VPS34 complex, leading to enhance liver cancer migration and invasion.
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Background: Bone grafts can provide an optimal environment for permanent tooth to erupt and enhance the stability of the alveolar maxilla. Although autologous bone is an optimal source for osteogenesis, its inevitable donor site morbidity has led to active research on bone substitutes. This study was designed to evaluate the safety and feasibility of using biphasic calcium phosphate (BCP; Osteon) as a bone substitute in dogs. Methods: Bilateral third and fourth premolars of four 15-week-old mongrel dogs were used. All teeth were extracted except the third premolar of the right mandible, which was used as a control. After extraction of the premolars, each dog was administered BCP (Osteon), demineralized bone matrix (DBM; DBX), and no graft in the hollow sockets of the right fourth premolar, left fourth premolar, and left third premolar, respectively. Radiographs were taken at 2-week intervals to check for tooth eruption. After 8 weeks, each dog was sacrificed, and tooth and bone biopsies were performed to check for the presence of tooth and bone substitute particle remnants. Results: Four weeks after the operation, permanent tooth eruptions had started at all the extraction sites in each dog. Eight weeks after the operation, all teeth had normally erupted, and histological examination revealed BCP particles at the right fourth premolar. Conclusion: In all four dogs, no delay in the eruption of the teeth or shape disfigurement of permanent teeth was observed on gross inspection and radiologic evaluation. On histological examination, most of the BCP and DBM were replaced by new bone. Bone substitutes can be used as graft materials in patients with alveolar clefts.
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Purpose@#This study aimed to evaluate the effect of repeated use of an implant handpiece under an implant placement torque (35 Ncm) and overloading torque condition (50 Ncm) on an output torque. @*Materials and Methods@#Two types of implant handpiece systems (Surgicpro/X-DSG20L [NSK, Kanuma, Japan] and SIP20/CRB46LN [SAESHIN, Daegu, South Korea]) were used. The output torque was measured using a digital torque gauge. The height and angle (x, y, and z axes) of the digital torque gauge and implant handpiece were adjusted through a jig for passive connection. The experiment was conducted under the setting torque value of 35 Ncm (implant placement torque) and 50 Ncm (overloading torque condition) and 30 times per set; a total of 5 sets were performed (N = 150).For statistical analysis, the difference between the groups was analyzed using the Mann–Whitney U test and the Friedman test was used to confirm the change in output torque (α=.05). @*Results@#NSK and SAESHIN implant handpieces showed significant differences in output torque results at the setting torques of 35 Ncm and 50 Ncm (P <.001). The type of implant handpiece and repeated use influenced the output torque (P <.001). @*Conclusion@#. There may be a difference between the setting torque and actual output torque due to repeated use, and the implant handpiece should be managed and repaired during long-term use. In addition, for successful implant results in dental clinics, the output torque of the implant handpiece system should be checked before implant placement.
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Objective@#To describe the anatomic locations and imaging features of posterior lung herniation in unilateral pulmonary agenesis and aplasia, focusing on radiograph-CT/MRI correlation. @*Materials and Methods@#A total of 10 patients (seven with pulmonary agenesis and three with pulmonary aplasia, male:female = 1:9, mean age 7.3 years, age range from 1 month to 20 years) were included. Chest radiographs (n = 9), CT (n = 9), and MRI (n = 1) were reviewed to assess the type of lung underdevelopment, presence of anterior and posterior lung herniation, bronchus origin, supplying artery, and draining vein of the herniated lung. @*Results@#Pulmonary agenesis/aplasia more commonly affected the left lung (n = 7) than the right lung (n = 3). Anterior lung herniation was observed in nine of the 10 patients. Posterior lung herniation was observed in seven patients with left pulmonary agenesis/aplasia. Two patients showed posterior lung herniation crossing the midline but not beyond the aorta, and five patients showed the posteriorly herniated right lower lobe crossing the midline to extend into the left hemithorax farther beyond the descending thoracic aorta through the space between the esophagus and the aorta. This anatomical configuration resulted in a characteristic radiographic finding of a radiolucent area with a convex lateral border and a vertical medial border in the left lower lung zone, revealing a tongue-like projection on CT and MRI. @*Conclusion@#Posterior lung herniation occurs in unilateral left lung agenesis/aplasia. Approximately 70% of the cases of posterior lung herniation reveal a unique radiolucent tongue-like projection in the left lower lung zone on imaging studies, which is caused by the extension of the posteriorly herniated right lung farther beyond the descending aorta.