• Korean Journal of Radiology
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• v.22 no.8
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• pp.1323-1331
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• 2021

Objective: To identify the association between renal tumor complexity and pathologic renal sinus invasion (RSI) and evaluate the usefulness of computed tomography tumor features for predicting RSI in patients with renal cell carcinoma (RCC). Materials and Methods: This retrospective study included 276 consecutive patients who underwent radical nephrectomy for RCC with a size of ≤ 7 cm between January 2014 and October 2017. Tumor complexity and anatomical renal sinus involvement were evaluated using two standardized scoring systems: the radius (R), exophytic or endophytic (E), nearness to collecting system or sinus (N), anterior or posterior (A), and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomical classification (PADUA) system. CT-based tumor features, including shape, enhancement pattern, margin at the interface of the renal sinus (smooth vs. non-smooth), and finger-like projection of the mass, were also assessed by two independent radiologists. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of RSI. The positive predictive value, negative predictive value (NPV), accuracy of anatomical renal sinus involvement, and tumor features were evaluated. Results: Eighty-one of 276 patients (29.3%) demonstrated RSI. Among highly complex tumors (RENAL or PADUA score ≥ 10), the frequencies of RSI were 42.4% (39/92) and 38.0% (71/187) using RENAL and PADUA scores, respectively. Multivariable analysis showed that a non-smooth margin and the presence of a finger-like projection were significant predictors of RSI. Anatomical renal sinus involvement showed high NPVs (91.7% and 95.2%) but low accuracy (40.2% and 43.1%) for RSI, whereas the presence of a non-smooth margin or finger-like projection demonstrated comparably high NPVs (90.0% and 91.3% for both readers) and improved accuracy (67.0% and 73.9%, respectively). Conclusion: A non-smooth margin or the presence of a finger-like projection can be used as a preoperative CT-based tumor feature for predicting RSI in patients with RCC.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.219-226
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• 2018

Background: Although studies and interest in sarcopenia have increased, it is still a matter of debate which muscle mass index better represents the aging process. We compared 3 indices for muscle mass (appendicular skeletal muscle mass [ASM]/weight, $ASM/height^2$, and the body mass index [BMI]-adjusted muscle mass index [ASM/BMI]) to determine which better reflected the aging process in terms of the decline in bone mineral density (BMD), visual acuity (VA), hearing power, renal function, pulmonary function, and handgrip strength. Methods: We performed a retrospective cross-sectional study using the Korea National Health and Nutrition Examination Survey in the Korean population. Between 2008 and 2011, a total of 14,415 men and 17,971 women aged 10 years or older participated in the study. We plotted the changes in the 3 indices of muscle mass and compared these with changes in BMD, VA, hearing power, renal function, pulmonary function, and handgrip strength according to each age group. Results: The ASM/BMI showed similar changes in terms of surrogate markers of the aging process, while the ASM/weight and $ASM/height^2$ showed no correlation. Conclusions: Among muscle indices for sarcopenia, only the ASM/BMI represented the aging process.

• Journal of Korean Medical Science
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• v.33 no.53
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• pp.298.1-298.10
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• 2018

Background: The renal function of individuals is one of the reasons for the variations in therapeutic response to various drugs. Patients with renal impairment are often exposed to drug toxicity, even with drugs that are usually eliminated by hepatic metabolism. Previous study has reported an increased plasma concentration of indoxyl sulfate and decreased plasma concentration of $4{\beta}$-hydroxy (OH)-cholesterol in stable kidney transplant recipients, implicating indoxyl sulfate as a cytochrome P450 (CYP) inhibiting factor. In this study, we aimed to evaluate the impact of renal impairment severity-dependent accumulation of indoxyl sulfate on hepatic CYP3A activity using metabolic markers. Methods: Sixty-six subjects were enrolled in this study; based on estimated glomerular filtration rate (eGFR), they were classified as having mild, moderate, or severe renal impairment. The plasma concentration of indoxyl sulfate was quantified using liquid chromatography-mass spectrometry (LC-MS). Urinary and plasma markers ($6{\beta}$-OH-cortisol/cortisol, $6{\beta}$-OH-cortisone/cortisone, $4{\beta}$-OH-cholesterol) for hepatic CYP3A activity were quantified using gas chromatography-mass spectrometry (GC-MS). The total plasma concentration of cholesterol was measured using the enzymatic colorimetric assay to calculate the $4{\beta}$-OH-cholesterol/cholesterol ratio. The correlation between variables was assessed using Pearson's correlation test. Results: There was a significant negative correlation between MDRD eGFR and indoxyl sulfate levels. The levels of urinary $6{\beta}$-OH-cortisol/cortisol and $6{\beta}$-OH-cortisone/cortisone as well as plasma $4{\beta}$-OH-cholesterol and $4{\beta}$-OH-cholesterol/cholesterol were not correlated with MDRD eGFR and the plasma concentration of indoxyl sulfate. Conclusion: Hepatic CYP3A activity may not be affected by renal impairment-induced accumulation of plasma indoxyl sulfate.

• Journal of Veterinary Clinics
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• v.17 no.2
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• pp.480-484
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• 2000

A 10 years old female Poodle weighing 4.38 kg and a 10 years old female Maltese weighing 4.33kg were referred to veterinary leaching hospital of college of veterinary medicine, Konkuk uni-versity because of hematuria and severa anorexia. Preoperative hematological and srum chemical values revealed that counts of WBC were $78.4{\times}10^3$,/TEX>/ul in the Poodle and $21.6{\times}10^3$in the Maltese, concentrations of BUN 105 and 13 mg/dl, concentrations of creatinine 4.0 and 1.4 mg/dl, concentration of ALKP 542 U/L in the Poodle and concentration of ALF 37 U/L in the Maltese, respectively. Radiographic findings were observed radiopaque bilateral nephroliths in the Poodle and right renal cal- culus in the Maltese. Ultrasonographic findings were showed hyperechoic mass with severe acoustic shadowing, which were ]ocated in the center of both kidneys parenchyma in the Poodle and in right kidney in the Maltese. Bisectional nephrotomy in right kidney for removal of calculus, which had ,sin- gle stone and more large than splitted stones in lets kidney in the Poodle, was performed under isnf- lurane anesthesia in 100% $O_2$. The time from temporary occlusion of blood flow to suture of incisioned kidney after removal of renal calculi was elapsed 12 minutes. During operation and until 24hrs after operation was infusioned mannitol and tranexanic acid solution. There were normal urination with yellow color in the Poodle at 3 days after operation and in the Maltese at 1 day and good appetite after 7 days and 1 day after operation. At 7 days and 9 days after operation, hematolgoical and seam chemical values repealed that counts of WBC were $29.8{\times}10^3/u1 in the Poodle and 13.1 {\itmes}10^3$/ul in the Mal- tese, concentrations of BUN 13 and 10 mg/dl. concentrations of creatinine 1.3 and 1.1 mg/dl, con-centrations of ALT 34 and 97U/L, concentraion of AST 10 U/L in the Poodle, respectively, By ultra-sonographic view there was not observed hyperechoic mass and radippaque calculus in operated kid-ney in radiographic view.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7497-7500
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• 2013

Background: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms. Materials and Methods: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis. Results: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, $9.5{\pm}4.3cm$, was larger than non palpable masses, $5.3{\pm}2.7cm$ (p<0.001). Conclusions: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

• Molecules and Cells
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• v.38 no.7
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• pp.624-629
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• 2015

Since the emergence of proteomics methods, many proteins specific for renal cell carcinoma (RCC) have been identified. Despite their usefulness for the specific diagnosis of RCC, such proteins do not provide spatial information on the diseased tissue. Therefore, the identification of cancer-specific proteins that include information on their specific location is needed. Recently, matrix-assisted laser desorption ionization (MALDI) mass spectrometry (MS) based imaging mass spectrometry (IMS) has emerged as a new tool for the analysis of spatial distribution as well as identification of either proteins or small molecules in tissues. In this report, surgical tissue sections of papillary RCC were analyzed using MALDI-IMS. Statistical analysis revealed several discriminative cancer-specific m/z-species between normal and diseased tissues. Among these m/z-species, two particular proteins, S100A11 and ferritin light chain, which are specific for papillary RCC cancer regions, were successfully identified using LC-MS/MS following protein extraction from independent RCC samples. The expressions of S100A11 and ferritin light chain were further validated by immunohistochemistry of human tissues and tissue microarrays (TMAs) of RCC. In conclusion, MALDI-IMS followed by LC-MS/MS analysis in human tissue identified that S100A11 and ferritin light chain are differentially expressed proteins in papillary RCC cancer regions.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1116-1120
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• 2022

The kidney is a rare site of ectopic adrenal adenoma. To the best of our knowledge, some cases of ectopic adrenal adenoma have been found in the kidney, but few of these cases explain the CT and MRI findings of the lesion. We reported a case of ectopic adrenal adenoma in the left renal sinus. A 47-year-old male patient underwent abdominal CT for routine health check-ups, which revealed a 1.2 cm enhancing mass in the left renal sinus. The MRI showed a signal drop of the mass in T1 weighted in- and opposed-phase, which indicates fat components. The mass was confirmed as an ectopic adrenal adenoma after surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7351-7354
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• 2013

Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

• Clinical and Experimental Pediatrics
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• v.55 no.2
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• pp.54-57
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• 2012

Purpose: Somatic growth is an important indicator of health in children. Adequate organ growth is essential in growth and directly related to body growth. We consider renal length as a surrogate of organ growth in growing children. Measurement of weight, height, and many anthropometric indices, such as body surface area (BSA), body mass index (BMI), and Rohrer and Kaup indices, are used to evaluate growth status. The aim of this study was to evaluate the association between renal length and somatic parameters and analyze the affecting factors for renal size during growth. Methods: The data for renal length in 66 children (age, $12.9{\pm}15.6$ months; male/female, 34/32) were obtained. Each kidney was measured with ultrasonography and dimercaptosuccinic acid scan. The data on age, sex, height, and weight were obtained from the medical records. BSA, BMI, and Rohrer and Kaup indices were calculated from measured height and weight. BSA was calculated by 2 methods, and is expressed as BSA I and BSA II. Results: There were significant correlations between renal size and age, weight, height, BSA I, BSA II, and Rohrer index. In the regression analysis, the most significant contributing factor to renal growth was height ($R^2$=0.636, $P$ <0.001). Conclusion: Height seems to be the most important factor associated with organ growth in growing children. Further studies to evaluate adequate organ growth should be carried out.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.262-266
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• 2008

Crossed renal ectopia is a congenital malformation in which both kidneys lie on the same side of the spine, usually side by side longitudinally. More often on the right side. Fusion of the two renal units is eight times more common than nonfusion. Although crossed renal ectopia is uncommon, this unusual entity must be considered in an infant when cystic mass in the abdomen or pelvis paticularly if no kidney can be found on the opposite side. In many cases of crossed fused ectopia with multicystic dysplastic kidney(MCDK), the diagnosis can be strongly suspected from the sonogram, and no other studies may be necessary. However, both intravenous urography and isotope renography is useful to assess the function of the crossed kidney. Crossed renal ectopia and MCDKs are associated with a greater incidence of ureteropelvic junction obstruction and reflux. So, screening voiding cystourethrography should be performed. Very few studies of MCDK in the setting of crossed fused ectopia have been reported. We have experienced a 3-year-old boy with crossed fused renal ectopia with multicystic dysplasia.