• Clinical and Experimental Pediatrics
• /
• v.49 no.1
• /
• pp.64-70
• /
• 2006

Purpose : The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. Methods : Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and $Tc^{99m}$-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. Results : Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. Conclusion : In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.

• Development and Reproduction
• /
• v.21 no.1
• /
• pp.55-62
• /
• 2017

We used flowcytometry to ploidy verification after that investigate difference between diploid and spontaneous triploid through the truss dimension and classical dimension at crucian carp, Carassius auratus, crucian carp C. cuvieri and common carp, Cyprinus carpio collected from Hangang river, Hantangang river, Imjingang river, Geumgang river, Yeongsangang river and Nakdonggang river, Korea. There were significant differences among the three species for the truss dimensions anterior origin of dorsal fin $(2){\times}$ anterior origin of anal fin (5), $2{\times}$ anterior origin of pelvic fin (6), $2{\times}$ origin of pectoral fin (7), posterior origin of dorsal fin $(3){\times}5$, $3{\times}6$, and $3{\times}7$ (P<0.05). There were no significant differences among the three species in the truss dimensions dorsal fin length ($2{\times}9$) and eye diameter (ED)(P>0.05). On the other hand, there were no significant differences in the several classical dimensions of each species (P>0.05). Three classical dimensions, most anterior extension of the head $(1){\times}2$, $1{\times}6$ and $2{\times}$ most posterior scale in lateral line (4) did not differ between the C. auratus diploid and spontaneous triploid (P>0.05). Two classical dimensions, $1{\times}6$ and longest length between most anterior extension of the head and gill cover ($1{\times}8$) did not differ between the C. cuvieri diploid and spontaneous triploid (P>0.05). One classical dimensions, $1{\times}2$ did not differ between the common carp diploid and spontaneous triploid (P>0.05). There were significant differences in the each diploid and triploid species (P<0.05). These results suggest that the classification of each species and classification between diploid and spontaneous triploid morphometrical parameters used in this study are useful indices of morphometrical status in the each species from major river of Korea.

• Journal of radiological science and technology
• /
• v.34 no.2
• /
• pp.91-96
• /
• 2011

The purpose of this study was to analyze the change of morphologic pelvis according to age and gender. Pelvis AP(anterior-posterior) projection were taken from 382 individuals (men: 194, women: 188) at the age of twenty and older. We measured four values of pelvis using CR (computed radiological system) including maximum pelvic breadth (MPB), sacral breadth (SB), transverse diameter of pelvic inlet (TD), and distance between femoral heads (DFH). Average (t-test, ANOVA) and Pearson correlation were calculated for comparison. While there was no significant difference of gender in case of MPB, significant differences were observed in SB (men 97.76 mm, women 102.00 mm), TD (men 138.0 mm, women 149.79 mm), and DFH (men 141.94 mm, women 150.39 mm). The DFH values were negatively correlated with the age (men r=-0.280, women r=-0.207). The morphological changes of pelvis were measured high in the men of 50's and in the women of 60's and 70's. The SB, TD and DFH were greater in the women than in the man. As the ages get higher, the deviation of pelvis were gradually increased, which indicates that the morphological changes of pelvis with respect to the age reflects an aging process.

• Childhood Kidney Diseases
• /
• v.10 no.1
• /
• pp.33-39
• /
• 2006

Purpose : Neonatal hydronephrosis is diagnosed with an incidence of 4.5-7% of pregnancies. Recently, early detection of neonatal hydroneprosis with antenatal ultrasonography has be-come possible. But consensus about its management has not been reached, especially concerning surgical intervention. The purpose of this study is to analyze the natural course of neonatal hydronephrosis and to determine the guideline of surgical intervention and follow up study. Methods : Sixty nine hydronephrotic kidneys were confirmed from April 2001 to April 2005. All cases were rechecked by ultrasonography once at least and had a minimum follow-up of 6 months. We classified the patients into 4 groups according to the anterior posterior pelvic diameter(APPD) on perinatal ultrasonography. Ultrasonography to measure the APPD diameter and Society for Fetal Urology(SFU) grade, $^{99m}Tc-MAG3$ scan were done to a set protocol. Pyeloplasty was peformed according to the protocol. Results : Pyeloplasty was not needed in most cases where the APPD was below 10 mm and where the SFU grade were less than grade 3. Many cases with APPD 10 mm above or SFU grade III above had undergone pyeloplasty. We found a correlation between obstruction grade on MAG3 scan and whether surgery was performed or not. Conclusion : If APPD is above 10 mm, SFU grade is above grade 3 or urinary tract obstruction is suspected by MAG3 scan, pyeloplasty must be considered. In cases where APPD is below 10mm and SFU grade is less than grade 3, we can observe the natural course of neonatal hydronephrosis with consecutive follow-up. (J Korean Soc Pediatr Nephrol 2006;10:33-39)

• Childhood Kidney Diseases
• /
• v.8 no.1
• /
• pp.91-95
• /
• 2004

We report a 2-month-old boy who presented with severe hyponatremia and hyperkalemia secondary to ureteropelvic junction(VPJ) obstruction. By prenatal ultrasonography at 19 weeks of gestation, severe hydronephrosis was found which was confirmed postnatally Pyeloplasty was done on the 45th day of life, and fifteen days after pyeloplasty, non-bilious vomiting, decreased activity and dehydration developed. Severe hyponatremia and hyperkalemia were observed, as a result of elevated serum aldosterone and plasma renin activity. The anterior posterior pelvic diameter(APPD) and Society for Fetal Urology(SFU) grade measured showed no interval change before and after pyeloplasty. Pseudohypoaldosteronism was diagnosed, and 2M NaCl was administrated orally for 7 days. The electrolyte imbalance was corrected, and 8 weeks later, the elevated levels of aldosterone and plasma renin activity were normalized. The left hydronephrosis was improved at 5 months of age. We hereby report a transient pseudohypoaldosteronism secondary to UPJ obstruction with a review of the literature.

• Journal of radiological science and technology
• /
• v.38 no.4
• /
• pp.383-387
• /
• 2015

This study investigated the size specific dose estimates of difference localizer on pediatric CT image. Seventy one cases of pediatric abdomen-pelvic CT (M:F=36:35) were included in this study. Anterior-posterior and lateral diameters were measured in axial CT images. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for effective diameter to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. For the localizer of mid-slice SSDE was 107.63% higher than CTDIvol and that of xiphoid-process slices SSDE was higher than 92.91%. The maximum error of iliac crest slices, xiphoid process slices and femur head slices between mid-slices were 7.48%, 17.81% and 14.04%. In conclusion, despite the SSDE of difference localizer has large number of errors, SSDE should be regarded as the primary evaluation tool of the patient radiation in pediatric CT for evaluation.

• Childhood Kidney Diseases
• /
• v.7 no.1
• /
• pp.60-66
• /
• 2003

Purpose : Neonatal hydronephrosis has been detected with increasing frequency with the widespread use of prenatal ultrasonography, but the consensus about its postnatal management has not yet been reached, especially about surgical intervention. We attempted to determine the guideline of follow-up study and surgical intervention of hydronephrosis by analyzing clinical outcomes of neonates with hydronephrosis. Materials and Methods : Between 1994 and 2000, 128 hydronephrotic kidneys were postnatally confirmed. Cases associated with other urologic anomalies were excluded and 90 unilateral hydronephrotic kidneys with a minimum follow-up of 12 months were enrolled in this study. We classified the patients into 6 groups according to the anterior posterior pelvic diameter(APPD) at initial ultrasonography(USG) within 1 month after birth. Renal USG and $Tc^{99m}-mercaptoacetyl$ triglycerine(MAG3) scan were done according to a set protocol, and pyeloplasty was performed when indicated according to our protocol. Results : Most cases whose APPD were below 10 mm improved or resolved. Only few cases with APPD above 20 mm showed spontaneous improvement and most(88%) had undergone operation. Those with initial APPD within 10-19 mm showed variable outcomes. When the risk factors for irreversible renal functional deterioration were analyzed, the age at pyeloplasty and pre-operative functional deficit were significant. Conclusion : We concluded that in infants with initial APPD below 10 mm, consideration of surgery is not needed, and in those with initial APPD above 20 mm, early operation is recommended. Our set protocol based on initial USG is useful, but the cut-off value of relative renal function(RRF) for operation might be increased to 40% to improve post operative RRF.

• Childhood Kidney Diseases
• /
• v.13 no.1
• /
• pp.26-32
• /
• 2009

Purpose : The increasing use of ultrasonography has allowed for an increase in the of the detection of congenital hydronephrosis, and the clinical outcomes of congenital hydronephrosis are widely varied. In this study, the necessity of voiding cystourethrography in neonate with hydronephrosis to rule out vesicoureteral reflux (VUR) was evaluated. Methods : Between January 2004 and December 2007, we reviewed the medical record of 157 childrens with congenital hydronephrosis detected within 1 month of age. The severity of hydronephrosis was graded by SFU (Society of Fetal Urology) system, and anterior posterior pelvic diameter (APPD). We evaluated the relationship between severity of hydronephrosis and incidence of VUR by using SPSS windows version 16.0. A P-value<0.05 is considered to be statistically significant. Results : Total renal unit number was 254, and 20(7.8%) renal units had VUR. We did not find any relationship between hydronephrosis grade the presence of VUR grade (P>0.05). In addition, there was no statistical significance between APPD, laterality of hydronephrosis and VUR incidence. However, renal units with VUR had lower spontaneous resolution rate (P<0.05), compared to renal units without VUR. Conclusion : In this study, there was no statistical significance between the severity of hydronephrosis and presence of VUR. Therefore, voiding cystourethrogram is recommended for all children with hydronephrosis to rule out VUR, regardless of the severity of hydronephrosis.