• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.291-298
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• 2016

The aim of the study was to investigate the diagnostic value of the color Doppler twinkling artifact in disease of urinary system. The intensity of twinkling artifact(TA) with color Doppler was classified into 3 levels, 0(non-TA) to 3(distinct TA). In the in vitro study, acorn jelly with various materials on top was examined using color Doppler at B-mode sonography in a water bath for TA. 31 patients with diagnosis of urinary calculi(renal stones 16, urinary stones 15) based on B-mode sonography were studied in vivo for TA. The materials with rough surfaces such as salt, screw and cubics at B-mode sonography with color Doppler contributed to causing TA. At B-mode sonography without color Doppler 37% of renal stones and 60% of ureter stones were detected. but at B-mode sonography with color Doppler TA was demonstrated for all cases. Superficial roughness of materials affected occurrence of TA at B-mode sonography with color Doppler. Therefore, TA at B-mode sonography without color Doppler could play a role in confident diagnosis of the disease of urinary system.

• Journal of Chest Surgery
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• v.39 no.1 s.258
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• pp.72-75
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• 2006

In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

• Clinical and Experimental Reproductive Medicine
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• v.45 no.1
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• pp.44-47
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• 2018

Onco-testicular sperm extraction is used to preserve fertility in patients with bilateral testicular tumors and azoospermia. We report the case of a testicular tumor in the solitary testis of a patient who had previously undergone successful contralateral orchiectomy and whose sperm was preserved by onco-testicular sperm extraction. A 35-year-old patient presented with swelling of his right scrotum that had lasted for 1 month. His medical history included a contralateral orchiectomy during childhood. Ultrasonography revealed a mosaic echoic area in his scrotum, suggesting a testicular tumor. The lesion was palpated within the normal testicular tissue along its edge and semen analysis showed azoospermia. Radical inguinal orchiectomy and onco-testicular sperm extraction were performed simultaneously. Motile spermatozoa were extracted from normal seminiferous tubules under microscopy and were frozen. Eventual intracytoplasmic sperm injection using the frozen spermatozoa is planned. Onco-testicular sperm extraction is an important fertility preservation method in patients with bilateral testicular tumors or a history of a previous contralateral orchiectomy.

• Korean Journal of Head & Neck Oncology
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• v.24 no.1
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• pp.64-68
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• 2008

Purpose：The chronic use of immunosuppressive therapy in transplant recipients can increase the long-term risk of carcinoma. The aim of this study was to determine the incidence, biological behaviors, and treatment outcomes in PTC(papillary thyroid carcinoma) in renal allograft recipients. Material and Methods：The present study examined the incidence and biological behavior of PTCs in RA recipients. A total of 1,739 RA patients treated between January 1986 and December 1999 were followed-up for a median 137(84-238) months. During the follow-up period, 129(7.4%) recipients were identified as having posttransplant malignancies. Of those, 12(0.7%) had PTCs, and these comprised six male and six female patients with a median age of 41(23-57) years. Results：Nine cases(incidentalomas) were diagnosed based on ultrasonography(US) screening. Eight of those nine were TNM stage I, and two of the three clinical carcinomas were TNM stage IVa. During a median follow-up of 94(18-159) months, two(16.7%) PTC patients developed loco-regional recurrence, but no patients showed distant metastasis. Posttransplant PTC showed no gender bias, and was often associated with aggressive lymphatic metastasis. However, most incidentalomas showed a favorable treatment outcome. Conclusion：In conclusion, routine surveillance of the thyroid gland using US screening is recommended to ensure early detection, treatment and favorable prognosis in RA patients with PTC.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.998-1003
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• 2005

Purpose : We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux(VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. Methods : We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection(UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP) were performed initially. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan was performed 4 to 6 months after treatment. Results : Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys(P<0.05). The severity of VUR was significantly correlated with renal scar formation(P<0.05). The duration of fever before treatmen($5.0{\pm}1.3$ vs $2.6{\pm}1.3$) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group(P<0.05). ESR($56.3{\pm}23.8$ vs $27.9{\pm}18.1mm/hr$, P<0.05) and CRP($12.8{\pm}7.3$ vs $3.9{\pm}3.8mg/dL$, P<0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. Conclusion : The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.

• Journal of radiological science and technology
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• v.29 no.1
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• pp.1-6
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• 2006

Purpose: Renal stones are common and typically arise within the collecting system. The renal sinus are contains the collection system, the renal vessels, lymphatcs, fat, and fibrous tissue. Because of the compression of all the large echoes in signal processing, the echo from the renal stone generally cannot be distinguished from large echoes emanating from normal structures of the renal sinus. Use of ultrasonography has been difficult for detecting small renal stone without posterior shadowing and chemical composition of stone. The aim of study was measuring for posterior acoustic shadowing to a stone for various scan parameter and it examines a help in renal stone diagnosis. Material & Methods: The stone was place on sponge examined in a water bath with a 3.5MHz or 7.5MHz transducer(LOGIQ 400, USA). First, tested a variety of gain. Second, tested a variety of dynamic range. Third, tested a variety of focal zone. Fourth, measuring of the echo level for low and high frequency for depth. Results: 1) Average echo level was 98 for low total gain(10 dB) and was 142 for high total gain(40 dB). Posterior acoustic shadowing of renal stone was clear for low gain. 2) Average echo level was 129 for low dynamic range(42 dB) and was 101 for high dynamic range(72 dB). Posterior acoustic shadowing of renal stone was clear for high dynamic range. 3) When stone is in focal zone of transducer, definite posterior acoustic shadow is identified. 4) Stone was clear appeared for high frequency(7.5 MHz) than low frequency(3.5 MHz) and it is not distorted. Conclusion: The demonstration of an posterior acoustic shadow of renal stone dependents on several technical factors such as gain, dynamic range, focus, and frequency. This various factors are a help in renal stone diagnosis.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.40-48
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• 2009

Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.

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

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.232-239
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• 2002

Purpose : Renal cystic diseases comprise a mixed group of heritable, developmental and acquired disorders. Recently the use of imaging modalities such as ultrasonography and radionuclide scanning has increased the detection rate of renal cystic diseases. We studied to review the clinical features and treatment of renal cystic diseases in children. Methods : This study was performed in 95 children with renal cystic diseases in the Department of Pediatrics, Asan Medical Center from October 1989 to June 2001. Results : In 95 patients, there were 55 cases(58.0%) with multicystic dysplastic kidney(MCDK), 19 cases(20.0%) with simple renal cysts, 13 cases(13.7%) with hereditary polycystic kidney diseases( 7 with autosomal recessive type, 5 with autosomal dominant type, 1 with undetermined), 6 cases(6.3%) with renal cysts in tuberous sclerosis and 1 case(1.0%) with medullary cystic disease. All MCDK patients had no renal dysfunction and hypertension during the follow-up period. Three out of 13 with polycystic kidney diseases had progressed to end-stage renal disease during the follow-up period. One case with a simple cyst underwent laparoscopic malsupialization for decompression. Conclusion : Renal cystic diseases have diverse clinicopathologic features and variable prognosis. We emphasize that routine follow-up should be performed to prevent and to detect early treatable complication in renal cystic diseases. Therefore, their natural history and treatment need further investigation and long term follow-up is required.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.201-212
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• 2005

Purpose : Acute pyelonephritis is one of the most common causes of unexplained fever in children. It may lead to the development of progressive renal damage. However, the deteclion of acute pyelonephritis can be difficult, especially in infants. The objective of this study was to evaluate the diagnostic value of various lab tests and imaging studies for acute renal parenchymal changes in children with APN. We correlated the clinical and laboratory manifestations of acute pyelonephritis with the Imaging studies. Methods : We reviewed the records of 115 children (85 males and 30 females) who were hospitalized Outing the period of January 1998 to December 2002 with initial clinical symptoms suggestive of pyelonephritis. The patients' age, sex, duration of fever, laboratory findings, and causative organisms were compared with the findings of imaging studies (Technetium-99m dimercaptosuccinic acid renal scan, renal ultrasonography, intravenous pyelography, voiding cystourethrography). Results : No significant relation between the number of febrile days, leukocyte count, causative organism, and the renal abnormalities in the imaging studies were observed. On the other hand, both C-reactive protein and erythrocyte sedimentation rate levels were significantly elevated in children with positive dimercaptosuccinic acid renal scan. Furthermore, females and children older than 1 year presented with significantly higher rate of abnormal dimercaptosuccinic acid renal scan findings and vesicoureteral reflux presented by voiding cystourethrography. Conclusion : We recommend females and children older than 1 year who are suspected of acute pyelonephritis be evaluated carefully for renal involvement by performing imaging studies including dimercaptosuccinic acid renal scan and voiding cystourethrography. (J Koroan Soc Pediatr Nephrol 2005;9:201-212)