• Title/Summary/Keyword: Renal Ultrasonography

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Ultrasonographic Evaluation of the Thorax and Abdomen in Horse (말에서 흉복부의 초음파상)

  • 김명철;변홍섭;신상태;김용준;이경광;한용만
    • Journal of Veterinary Clinics
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    • v.15 no.1
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    • pp.14-21
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    • 1998
  • Ultrasonogram for kidney, spleens liver, intestine and heart was evaluated 11 Chriu horses and 14 Thoroughbred horse. The kidney was determined at both flan and both 17th intercostal spaces. The spleen was determined at the left 13-17 intercom spacer and the liver was determined at the right 7-13 intercostal space. The heart was determined at the right 4-6 intercostal space and left 3-6 intercostal space. The length, of rig kidney at the Thoroughbred horse, Thoroughbred foul, Cheju horse and Cheju foul were 16.2, 12.6, 13.1 and 11.2 mm, respectively. The width of right kidney at the Thoroughbed horse, Thorughbred foul, Cheju horse and Cheju foul were 5.4, 4.3, 4.6 and 4.2 mm, respectively. The depth of right kidney at the Thoroughbred horsed Thoroughbred foul, Cheju horse and Chrju foul were 5.2, 4.4, 4.5 and 4.3 mm, respectively. Similar ultrasonographic measurements were obtained for the left kidney, The left ventricular end-diastolic diameter at the Thoroughbred horse, Thoroughbred fouls Cheju horst and Cheju foul were 107, 83, 85 and 73 mm, respectively. The left ventricular end-systolic diameter were at the Thoroughbred horse, Thoroughbred foul, Cheiu horse and Cheiu foul were 63, 52, 53 and 45 mm, respectively. Also, the interventricular septum in end-diastole, interventricular septum in end-systoles left ventricular wall end-diastoles left ventricular wall end-systoles right ventricular end-diastole diameter, aorta and left atrium at t Thoroughbred horse, Thoroughbred foul, Chriu horse and Chriu foul were measured. Experimental renal stone and enterolith of colon were observed by ultrasonography.

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Focal Bacterial Nephritis (Lobar Nephronia) in a Four- Month Old Boy (국소성 세균성 신염 (Lobar Nephronia) 1례)

  • Ahn Hye Young;Pai Ki-Soo;Oh Seung Hwan;Lee Jin Yong;Kim Pung-Kil;Lee Jae Seung
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.73-77
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    • 2001
  • Acute lobar nephronia is a focal of acute bacterial nephritis, affecting one or more of the renal lobules. Nephronia is being diagnosed more frequently in accordance with the advancing imaging techniques of urinary tract. We report a case of acute nephronia in a 4 month old boy who presented persisting urinary tract infection after intial antibiotic treatment. Ultrasonography and computerized tomography showed round wedge-shaped, non-enhancing mass in right kidney. Gallium scan also revealed the lesion in the right kidney. This lesion resolved completely on one month follow up examinations. (J. Korean Soc Pediatr Nephrol 5 : 73- 7, 2001)

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Clinical Guideline for Childhood Urinary Tract Infection (Second Revision)

  • Lee, Seung Joo
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.56-64
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    • 2015
  • To revise the clinical guideline for childhood urinary tract infections (UTIs) of the Korean Society of Pediatric Nephrology (2007), the recently updated guidelines and new data were reviewed. The major revisions are as follows. In diagnosis, the criterion for a positive culture of the catheterized or suprapubic aspirated urine is reduced to 50,000 colony forming uits (CFUs)/mL from 100,000 CFU/mL. Diagnosis is more confirmatory if the urinalysis is abnormal. In treating febrile UTI and pyelonephritis, oral antibiotics is considered to be as effective as parenteral antibiotics. In urologic imaging studies, the traditional aggressive approach to find primary vesicoureteral reflux (VUR) and renal scar is shifted to the targeted restrictive approach. A voiding cystourethrography is not routinely recommended and is indicated only in atypical or complex clinical conditions, abnormal ultrasonography and recurrent UTIs. $^{99m}Tc$-DMSA renal scan is valuable in diagnosing pyelonephritis in children with negative culture or normal RBUS. Although it is not routinely recommended, normal scan can safely avoid VCUG. In prevention, a more natural approach is preferred. Antimicrobial prophylaxis is not supported any more even in children with VUR. Topical steroid (2-4 weeks) to non-retractile physiologic phimosis or labial adhesion is a reasonable first-line treatment. Urogenital hygiene is important and must be adequately performed. Breast milk, probiotics and cranberries are dietary factors to prevent UTIs. Voiding dysfunction and constipation should be properly treated and prevented by initiating toilet training at an appropriate age (18-24 months). The follow-up urine test on subsequent unexplained febrile illness is strongly recommended. Changes of this revision is not exclusive and appropriate variation still may be accepted.

Transarterial embolization of renal artery in dogs with experimental hydronephrosis (개의 실험적 수신증에 실시한 신동맥 색전술)

  • Chang, Dongwoo
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.437-445
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    • 2001
  • This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis and to evaluate the embolized kidney using B-mode ultrasonography and selective angiography. Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. Ultrasonographic findings revealed that size of the kidney was significantly increased at 9 days and 17 days and the length of renal cortex was significantly decreased at 17 days after ligation of the unilateral ureter and it was in accordance with dilation of ipsilateral renal pelvis. No significant change of BUN, creatinine, ALT, calcium, and phosphorus was found immediately after unilateral experimental hydronephrosis. Therefore, it was concluded that unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and respiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. Average ethanol dose for renal artery embolization was $1.94{\pm}1.24ml/kg$. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. Ultrasonographically, the mean longitudinal length of the embolized kidney decreased significantly at 2 and 3 months after TAE-RA compared to that of contralateral normal kidney. In summary, marked shrinkage of the embolized kidney was observed in dogs with unilateral experimental hydronephrosis treated by TAE-RA with iohexol-ethanol and no adverse effects were observed throughout the observation period. It is concluded that TAE-RA with iohexol-ethanol solution is a viable alternative to nephrectomy in dogs with unilateral hydronephrosis.

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Clinical Characteristics and Renal Outcomes of Acute Focal Bacterial Nephritis in Children (소아 급성 세균성 신엽염의 임상상 및 신장 예후)

  • Lee Dong-Ki;Kwon Duck-Geun;Lim Yun-Ju;Shin Yun-Hye;Yun Suk-Nam;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.229-238
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    • 2004
  • Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

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Congenital Anomaly of Urinary Tract in Children (소아 선천성 요로계 기형에 관한 고찰)

  • Shin Weon Hye;Ko Cheol Woo;Koo Ja Hoon;Chung Sung Kwang
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.88-94
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    • 1999
  • Purpose : Malformation of urinary tract is among the most common of all congenital anomalies and can progress to irreversible renal damage before diagnosis due to difficulty of early diagnosis. Present study was undertaken to determine the clinical characteristics of urinary tract anomaly and to find out the most appropriate diagnostic and therapeutic measures for children with these anomalies. Methods : During the past 10 years from 1987 to 1998, review of medical records revealed 65 children with congenital anomaly of urinary tract and the following results were obtained. Results : The most common anomalies were ureteropelvic junction obstruction occuring in 26 cases ($36\%$), followed by ureteral duplication in 11 cases, renal agenesis in 10 cases and ureterovesical function obstruction in 7 cases. Complex anomaly of urinary tract was found in 8 cases and anomaly of other systems such as congenital heart disease was detected in 11 cases. The most frequent age group at the time of diagnosis was below 1 year of age constituting 39 cases ($60\%$) and male preponderance was noted as male to female ratio being 2.25:1. Presenting symptoms were urinary tract infection in 25 cases, followed by hematuria, abdominal mass, abdominal pain and voiding difficulty, etc, and in 11 cases, the anomaly was picked up by routine prenatal ultrasonography. Azotemia was noted in 9 cases and the underlying anomaly was obstructive uropathy in 4 out of these 9 cases. Surgical correction was undertaken in 38 cases (most frequently in cases of obstructive uropathy) and in 2 out off cases with obstructive uropathy in whom surgical correction was done, azotemia disappeared during follow up period of 1-5years. No new cases of deteriorating renal function appeared during follow-up period. Conclusion : In spite of high incidence of congenital malformation of urinary tract, early diagnosis is still hampered by nonspecific symptoms and signs. Therefore, in patients with symptoms such as urinary tract infection, abdominal pain and voiding problems, etc, it Is advisable to take various diagnostic tests promptly to pick up any urinary tract anomaly and to apply proper therapy in order to avoid progression to irreversible renal damage. In this regard, prenatal ultrasonography should be utilized more widely as a routine procedure to detect any urinary tract anomalies before birth.

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Post-natal Outcome of Fetal Hydronephrosis Detected with Prenatal Ultrasonography (산전 초음파로 진단된 태아 수신증의 생후 경과 관찰)

  • Park, Youn Jin;Mun, Soon Jung;Bae, Chong Woo;Lee, Bum Ha;Kim, Jin Il
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1213-1218
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    • 2002
  • Purpose : Hydronephrosis constitutes a great portion of fetal anomalies screened by prenatal sonogram. The present authors made an attempt to access its natural courses through follow up neonatal hydronephrosis diagnosed by prenatal sonogram. Methods : The study was composed of 23 neonates(36 renal units) who were diagnosed with hydronephrosis through prenatal sonogram screening and confirmed 3-7 days after birth with sonographic evaluation at Kyung Hee University Hospital. The neonates were closely monitored for 12-24 months with renal sonogram, diuretic renogram, intravenous pyelography(IVP) and voiding cystoureterography(VCUG). Results : The underlying diseases were composed of 16 cases(44%) of functional abnormalities, 14 cases(39%) of ureteropelvic junction(UPJ) obstruction, three cases(8%) of vesicoureteral reflux (VUR) and on case each of multicystic dysplastic kidney, UPJ obstruction with ureteral stenosis and ureterovesical junction(UVJ) obstruction with VUR. The degree of hydronephrosis was divided into three classes according to its severity. In 30 renal units with UPJ obstruction and functional abnormalities, 26(87%) showed mild hydronephrosis, while four(13%) were moderate. During the follow up period, six cases(20%) showed natural resolution of hydronephrosis, 15 cases(50%) showed improvement while two cases(7%) were aggravated with improvement only after surgery of the underlying disease. The cases which showed natural resolution were all mild hydronephrosis at diagnosis and the cases which underwent surgery due to continuous aggravation were mild one case and moderate one case. Conclusion : Those with cases of mild hydronephrosis show rapid natural improvement. On the other hand, in some cases, follow up monitoring reveal aggravation of the situation, emphasizing the necessity for thorough follow up for a long period of time.

Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes (증상이 있는 신생아 자발성 기흉의 관련 질환과 예후)

  • Joo, Ji-Won;Yang, Eun-Mi;Sohn, Young-Jun;Kim, Mi-Jeong;Song, Eun-Song;Choi, Young-Youn;Byun, Hyung-Suck
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.166-171
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    • 2008
  • Purpose : This study was performed to determine the rate of neonatal symptomatic spontaneous pneumothorax, and the corresponding clinical characteristics, co-morbidities, and outcomes. Methods : The demographic characteristics, clinical symptoms and signs, associated abnormalities, methods of treatment, and outcomes were investigated in 22 neonates with symptomatic spontaneous pneumothorax in the neonatal intensive care unit (NICU) of Chonnam University Hospital between March 2003 and February 2008. Results : The rate of spontaneous pneumothorax was 0.55%. Among the 22 neonates, the number of outborns was 15 (68.2%) and the number of males was 12 (54.5%). The main symptoms and signs were chest retraction, tachypnea, and cyanosis. The pneumothoraces were more frequent on the right side (59.1%) and all cases were diagnosed within 3 days of life. Four cases (18.2%) had urologic abnormalities and 7 cases (31.8%) had cranial abnormalities by ultrasonography. The treatments included oxygen (81.8%) and oxygen with chest tube drainage (18.2%). All of the infants survived and the overall outcomes were favorable. Conclusion : When respiratory symptoms and signs are develop abruptly in otherwise healthy newborns, the clinician should suspect a spontaneous pneumothorax and check a chest x-ray as soon as possible. Although the outcome of neonatal symptomatic spontaneous pneumothorax is favorable, renal and cranial ultrasonography are needed because of the higher possibility of urologic abnormalities and germinal matrix/intraventricular hemorrhage than in newborns without a pneumothorax.

Validation of Onen's Alternative Grading System for Congenital Hydronephrosis (선천성 수신증을 위한 Onen 등급 분류법의 임상적인 타당성)

  • Woo, Da Eun;Lim, Myung Hee;Kim, Myung Uk;Kim, Sae Yoon;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.77-84
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    • 2014
  • Purpose: The purpose of this study was to compare the validity of Onen's alternative grading system (AGS) with that of the APDRP and SFU grading systems in patients with isolated and complicated congenital hydronephrosis. Methods: We retrospectively reviewed the medical records of 153 patients (204 renal units) diagnosed with congenital hydronephrosis between January 2002 and December 2011. We classified patients into 2 groups; isolated or complicated hydronephrosis. All renal units were graded according to anterior-posterior diameter of renal pelvis (APDRP), Society for Fetus Urology (SFU) and Onen's grading systems. We analyzed the prognosis of hydronephrosis, according to each grading system, at 2 years of age. Results: There were 152 renal units with isolated hydronephrosis and 52 renal units with complicated hydronephrosis. The isolated hydronephrosis group had a lower grade according to Onen's AGS, and showed more frequent spontaneous remission by 2 years of age. There was more frequent obstruction (P =0.000) and surgical treatment (P =0.000) of units with high-grade hydronephrosis according to Onen's AGS. In the complicated hydronephrosis group the frequencies of spontaneous remission (P =0.015) and renal dysfunction (P =0.013) were significantly higher than those in high-grade hydronephrosis, as indicated by Onen's AGS. There were no significant differences in clinical outcomes among the highest grade groups, according to the 3 systems, in either isolated or complicated hydronephrosis. Conclusion: Onen's AGS reflects the prognosis of hydronephrosis as well as other grading systems in those with isolated hydronephrosis. It was better predictor of renal dysfunction in those with complicated hydronephrosis. However, Onen's AGS was not superior to the other grading systems in terms of predicting prognosis, especially in high-grade hydronephrosis.

Newborn English Bulldogs with Multiple Malformation Syndrome and Lethal Characters

  • Jang, Si-Jung;Kim, Minkyung;Lee, Hyeon-Jeong;You, Young-Sung;Lee, Jaehoon;Lee, Sung-Lim
    • Journal of Animal Reproduction and Biotechnology
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    • v.34 no.3
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    • pp.253-258
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    • 2019
  • A female English bulldog was gave birth two neonates by cesarean section on the sixty one days after mating, but both neonates were died soon after birth. The bodies of neonates were diagnosed using radiography, ultrasonography, computed tomography and necropsy immediately after death. Both neonates had caudal regression syndrome, butterfly vertebra, hydrocephalus, umbilical hernia, cleft palate and bow-legged hind-limb. At necropsy, neonates had mild fetal anasarca, cleft lip and the skull was remained non-union. At thoracic cavity, only three ribs and thoracic spines were existed and patent ductus arteriosus was found. At abnormal cavity, the renal ectopia was found with abnormal morphology. In the present case, those English bulldog neonates with multiple congenital malformation syndromes seriously suffered vertebral column anomalies and that may induced by neural tube defects in during embryonic period. To prevent congenital malformation occurring in English bulldog, further in depth studies are needed for the breed specific genetic diversity and for the reason of behind genetic abnormality in these breed.