• Title/Summary/Keyword: 반흔

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Predictive Factors of Renal Scarring in Children with Acute Urinary Tract Infection (급성 요로감염 환아의 신장 반흔 예측요인)

  • Baik, Jun-Hyun;Park, Young-Ha;Hwang, Sung-Su;Jeon, Jung-Su;Kim, Sung-Hoon;Lee, Seong-Yong;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.245-253
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    • 2003
  • Puorpose: The purpose of this study was to evaluate the usefulness of $^{99m}Tc$ DMSA scintigraphy on the dignosis of a renal scar in children with urinary tract infections. Materials and Methods: Eighty three patients were included in this study, who were diagnosed as the urinary tract infection on the basis of symptom, urinalysis and urine culture. $^{99m}Tc$ DMSA scintigraphy and voiding cystoureterography were peformed within 7days before the treatment in all patients. We classified the scintigraphic findings as follow s : 1 ; a large hypoactive upper or lower pole. 2 ; a small hypoactive area. 3 ; single defect resulting in localized deformity of the outlines. 4 ; deformed outlines in a small or normal sized kidney. 5 ; multiple defects. 6 ; diffuse hypoactive kidney without regional impairment. Follow-up scintigraphy was done at least 6 months after the initial study. When the abnormality on the initial scintigraphy was not completely resolved on the follow-up scan, the lesion was defined as containing a scar. Results: One hundred and fifteen renal units of 166 units(69.3%) showed abnormal findings on the DMSA scintigraphy. 65 units(56.5%) was diagnosed as containing renal scars on follow-up scintigraphies. Incidences of renal scar among renal units showing pattern 3, 4 and 5 on the initial scan was 75%, 78% and 78%, respectively. Whereas many of renal units showing 1, 2 and 6 pattern were recovered(65%, 76%, 50%). Sensitivity, specificity and accuracy of pattern-based DMSA scintigraphic findings on the diagnosis of renal scar was 76.9%, 85.1% and 81.9%, respectively. VUR was significantly associated with the renal scar when the initial DMSA shows unrecoverable findings(pattern 3, 4, 5). Odds ratio of the renal scar in a kidney showing unrecoverable initial scintigraphic findings was 19.1. Odds ratio in a kidney with mild or moderate-to-severe VUR was 3.5 and 14.4 respectively. Conclusion: In the urinary tract infection, renal scar was significantly developed in a kidney showing unrecoverable findings on the initial DMSA scan and VUR on voiding cystoureterography.

Factors associated with Renal Scarring in Children with a First Episode of Febrile Urinary Tract Infection (소아의 첫 발열성 요로감염에서 신 반흔에 영향을 미치는 인자)

  • Jung Suk-Won;Jung Kyeong-Hun;Kim Myung-Hyun;Hong Young-Jin;Son, Byong-Kwan;Lee Ji-Eun
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.56-63
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    • 2005
  • Purpose : Development of renal scarring is associated with delayed diagnosis and treatment of urinary tract infection(UTI). This study was performed to clarify how soon treatment should be started to Inhibit renal scarring after onset of UTI and the factors associated with renal scarring in children with a first episode of febrile UTI. Methods : We retrospectively reviewed 163 patients with a first episode of febrile UTI under the age of 2 years from April 2000 to Ap,il 2004. All patients had a DMSA renal scan and voiding cystourethrogram done in the diagnostic period, 6 months after which a follow-up renal scan was done. After patients wet-e divided into 2 groups according to the duration of fever prior to start of treatment, the duration of fever after start of treatment, and total duration of fever, initial and follow-up DMSA scan findings were analyzed among the different groups. We compared the factors associated with renal scars between the groups with and without renal scars. Results : The initial DMSA renal scan identified abnormal finding in 23% of the patients who were treated $\leq$24 hr from the onset of disease and in 43% of those with fever more than 24 hr. Renal scars developed in 33% of patients who were treated $\leq$24 hr and 38% of those with fever >24 hr prior to treatment. Renal scars developed in 34% of patients with remission of fever $\leq$48 hr after treatment and ill 50% of those with fever >48 hr after treatment. The risk for renal scars was significantly higher in children who had total duration of feyer >72 hr(67%) than in those with shorter duration(19%). In children with renal scars, VUR was most highly associated with an increased risk of renal scar formation. Conclusion : Although children with a first episode of febrile UTI are treated within 24 hr after onset of the fever, renal damage cannot be prevented completely and it is mainly associated with VUR. (J Korean Soc Pediatr Nephrol 2005;9:56-63)

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개(犬)에 있어서 크게 손상된 피부의 접합에 관한 두가지의 Tenion Suture (감장봉합)에 관한 술식상의 평가

  • Jacobs Robert Mitchell
    • Journal of the korean veterinary medical association
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    • v.18 no.12
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    • pp.29-34
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    • 1982
  • 두가지 방법의 Tension Suture가 개에서 손상을 입은 피부의 접합에 평가되어졌다. 이들 술식은 Vertical Mattress Tension Suture와 'Walking'봉합이다. 7주후에 타원형으로 손상된 피부의 반흔조직을 추적하여 면적을 측정하였다. 흠손된 피부의 반흔조직의 평균 넓이는 V.M.T.S의 $5.29cm^2$에 비해 'Walking'봉합의 경우는 $2.07cm^2$였다. 이는 'Walking'봉합의 경우가 명백히 반흔조직이 좁다는 것이 관찰되었다. 더구나 어떤 손상의 경우더라도 'Walking'봉합은 열개(봉합한 자국)가 발견되지 아니했다.

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요로감염과 방광요관역류

  • Kim, Gwang-Myeong
    • 학교보건
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    • s.25
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    • pp.50-53
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    • 2004
  • 소아 요로감염이 있을시 방광요관역류가 흔히 관찰되며 만성 신우 신염과 방광요관역류와 깊은 관계가 있는 것이 알려져 있다. 발열을 동반하는 소아 요로감염시 D MSA 신주사에서 급성 신우신염의 뚜렷한 소견이 있더라도 방광요관역류가 발견되지 않는 경우가 더 많다. 하지만 신장에 신 반흔이 있을 경우에는 흔히 방광요관역류가 관찰 된다. 소아 요로감염의 처치는 신 반흔의 형성을 막는데 그 궁극적 목적이 있다 하겠다. 신생아시기 심한 방광요관역류에서 요로감염이 없이 신 이형성증으로 인한 신 반흔이 관찰되기도 한다.

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Scar Formation of the Chronic ACL Rupture (만성 전방 십자 인대 파열의 반흔 형성)

  • Choi Eui-Seong;Won Choong-Hee;Kim Yong-Min;Seo Joong-Bae;Lee Ho-Seung;Lee Sin-Ro
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.17-21
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    • 2001
  • Purpose : To analyze changes of the anterior translation, MRI findings and associated injuries at scarring of the torn ACL in the chronic ACL rupture. Materials & Method : From Dec. 1996 to May 2000, 19 patients who were diagnosed as the chronic ACL rupture were studied. We analyzed KT-2000 side to side difference of maximal manual anterior displacement(MMAD), MRI findings and associated injuries. Results : There was statistically significant difference in the average MMAD between the 7 cases$(37\%)$ with scar formation$(2.78{\pm}2.41mm)$ and the 12 cases without scarring$(5.75{\pm}2.52mm)$. The chronic ACL rupture without scarring had more meniscal injuries$(67\%)$ than with scarring$(28\%)$. MRI showed that relatively straight bands toward expected insertion site with single large fragment(5 cases) and continuous band with focal angulation(2 cases). Conclusion : If relatively straight bands toward expected insertion site with single large fragment or continuous band with focal angulation on MR imaging is showed in the patient without significant anterior translation at arthrometer, the possibility of the scar formation of the torn ACL should be considered. We think that the chronic ACL rupture with scarring had less meniscal injuries than without scarring will give additional information on the natural history of ACL injuries.

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Simultaneous Correction of Depressed Scar Using Dermofat Graft Harvested during Scar Revision (다발성 안면 반흔을 가진 환자의 반흔 절제술에서 얻은 진피지방을 이용한 함몰 반흔의 동시교정)

  • Cho, Min Su;Hong, Yoon Gi;Seo, Sang Won;Chang, Choong Hyun
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.787-790
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    • 2005
  • While no scar can be completely erased, most linear facial scars can result in a relatively good scar after revision. However, in case of round shaped depressed scar, the scar is often lengthened following an incisional technique. This study focuses on the technique of dermofat graft harvested from the adjacent scars for correction of depressed scars. 18 patients having multiple facial scars with a depressed scar among 375 patients who had undergone scar revision were treated from June 2003 to May 2004. Dermofat was harvested from the adjacent linear scar, then it was deepithelialized, reshaped, and grafted to the depressed scar through a small incision. Cosmetic results were generally good. Complications were overcorrection in 4 patients; hyperpigmentation occured in 1 patient. However, 13 patients were satisfied with the results. The advantages of our technique are as follows: it does not require additional operation; dermofat graft has low absorbable rate; it can maintain the volume with an adequate texture.

Fever Duration and Renal Scar in Pediatric Urinary Tract Infection (소아 요로감염에서 발열과 신반흔의 관계)

  • Jung, Ji-In;Lim, Dong-Hee;Yim, Hyung-Eun;Park, Man-Sik;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.70-77
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    • 2008
  • Purpose: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars. Methods: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature $\geq37.5^{\circ}C$, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR). Results: 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2) Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05). Conclusion: Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.

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Prognostic Factors of Renal Defects on the Initial DMSA Scan in Children with Acute Pyelonephritis (급성신우신염 환아에서 DMSA 스캔상 발견된 신결손의 예후 인자)

  • Seon, Yeong-Seon;Kwon, Duck-Geun;Shin, Yun-Hyea;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.195-202
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    • 2010
  • Purpose : The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. Methods : This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by $^{99m}Tc$-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. Results : Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the followup DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. Conclusion : The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.