• Childhood Kidney Diseases
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• 제14권2호
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• pp.223-229
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• 2010

신성 고혈압은 신동맥의 협착 혹은 폐색으로 인해 유발되는 전신성 고혈압이다. 최근에는 신동맥의 재개통을 위해 PTRA가 선호되고 있지만, 복잡한 경우에 있어서는 신 자가이식이 대안적인 치료방법으로서 시행되어 왔다. 저자들은 심각한 고혈압 증상을 보인 14세 남자 환아를 PTRA 및 신 자가이식을 시행하여 성공적으로 치료하였기에 보고하는 바이다. 도플러 초음파 검사와 CT 혈관조영술상 우측 신동맥 기시부에서 약간의 좁아짐과 다발적인 측부순환을 동반한 좌측 신동맥 기시부의 완전폐색이 확인되었다. 우측 신동맥 협착의 치료를 위해 PTRA와 스텐트 삽입술을 시행하였으나 좌측 신동맥은 완전폐색으로 인해 시술이 불가능하여 좌측 신장을 절제한 후 동측 장골와에 자가이식하였다. 수술 후 시행한 도플러 초음파 검사와 MAG-3 신주사 검사상 신혈류와 신기능은 정상이었다. 혈압은 정상화되었으며 항고혈압제 투여도 점차 중단하였다. 임상적인 특성을 고려할 때 신성 고혈압의 원인은 섬유근성 형성이상으로 생각되었다. 결론적으로 신 자가이식은 혈관내 중재적 시술이 실패하였거나 불가능한 경우에 선택할 수 있는 치료방법이다.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 추계학술대회
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• pp.240-240
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• 2009

• Childhood Kidney Diseases
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• 제26권2호
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• pp.80-85
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• 2022

Purpose: To determine the prevalence, clinical manifestations, and outcomes of renal involvements in pediatric Alagille syndrome (ALGS). Methods: A total of 21 patients diagnosed with ALGS at age under 18 years who visited Samsung Medical Center from March 1999 to March 2022 were enrolled. ALGS was diagnosed either by clinical manifestations, targeted JAG1 sequencing, and/or liver biopsy. Medical records including sex, age, renal manifestations, urinalysis, serum creatinine, JAG1 sequencing, and ultrasonography were retrospectively reviewed. Results: The male to female ratio was 9:12. The mean age of patients at confirmative diagnosis of ALGS was 18.4 months. Sanger sequencing was performed for 17 patients. Sixteen of 21 patients (76.1%) showed JAG1 mutations. Renal involvement was found in 10 patients (47.6%). The most common type of anomaly was renal dysplasia (40%). One patient having renal dysplasia was pathologically confirmed with glomerular lipid deposition. Two patients (20%) manifested nephrocalcinosis/nephrolithiasis. Among eight renal-involved patients who survived, four (50%) progressed to chronic kidney disease stage 3. Two of these chronic kidney disease patients were diagnosed with hepatorenal syndrome. The other four patients had renal functions preserved, including two without any interventions and two who underwent urological interventions. Conclusions: The current study revealed a high prevalence of renal involvement in Korean pediatric ALGS with diverse phenotypes.

• Childhood Kidney Diseases
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• 제17권1호
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• pp.25-28
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• 2013

분절형 다낭성 이형성신은 PubMed의 자료 수집에 따르면 산전에 발견된 19명을 포함해 35명의 소아 환자와 1명의 성인 환자의 증례가 보고 되었다. 분절형 다낭성 이형성신에 대한 기록은 부족하며 비전형적으로 나타날 수 있어 진단이 어렵다. 본 연구에서는 분절형 다낭성 이형성신의 37번째 케이스를 보고하는 바다. 본 연구에서 환아의 산전 초음파에서 발견된 다낭성 복부 종양은 신장 초음파와 컴퓨터 단층촬영에 의해 분절형 다낭성 이형성신으로 진단되었다. 영상 검사를 통해 분절형 다낭성 이형성신의 최종 진단이 내려진다면 진단적 생검을 위한 수술은 불필요할 것이다.

• 보험의학회지
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• 제3권1호
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• pp.149-162
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• 1986

We had experienced very rare a case of renal cell carcinoma through ultrasonic diagnosis, september, 1985 at medical dept. Dae Han Kyoyuk Ins. Company. The conclusions that we gained, making a comparative-analysis of operation's view and ultrasonic view are as follows; 1. Echolucent area which was $0.6cm^2$ size in the center of tumor was shown by ultrasonography, we noticed it occured necrosis or cystic change and the extracts grossly after. operation accorded with ultrasonic view. 2. Tumor was 65mm in diameter on ultrasonography and made clear 55mm in diameter after operation 3. There was not fever, anemia, even typical triad of renal cell carcinoma, blood pressure was within normal limits. 4. The case was stage I by Robson's Modification method. 5. The case was clear cell type by classifying of histology. 6. The affected site was left side and origin was lower pole of the kidney. 7. After radical nephrectomy, until present prognosis was favorable and he exists.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.124-127
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• 2019

Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.

• 한국임상수의학회지
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• 제23권4권
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• pp.427-431
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• 2006

Pulse Doppler ultrasonographic evaluation was performed to investigate the resistive index (RI) of the Interlobar renal artery in 17 dogs (32 kidneys) which were diagnosed with an acute renal failure caused by ochratoxin-A and citrinin contaminated commercial diet. RI was investigated in 7 normal beagle dogs and recovered patients. The mean of RI was resulted as $0.69{\pm}0.04$ in normal dog, however, significantly (p<0.001) increased as $0.76{\pm}0.05$ in renal failure dog. But RI had no relationship with the results of blood chemistry, urine analysis, and excretory urographic image quality. From these results, even though the results of the renal function test were within a normal reference range, it was considered that RI index is more reliable to represent a damaged renal parenchyma, and may have the potential to be a useful clinical tool in monitoring of the renal function.

• 한국임상수의학회지
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• 제21권1호
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• pp.66-71
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• 2004

2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.114-120
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• 2017

Purpose: The aim of this study was to determine the clinical characteristics, frequency of renal abnormalities and benefits of a top-down approach in children with their first febrile urinary tract infection (UTI). Methods: We reviewed 308 patients retrospectively who were admitted to Yeungnam University Hospital and were treated for their first febrile UTI from February 2006 to December 2013. We performed a comparative analysis of laboratory findings and results of imaging techniques including a Tc-99m dimercaptosuccinic acid (DMSA) renal scan. Results: Among the patients, 69% (213/308) were males, and 90% (277/308) had their first UTI episode during infancy. A DMSA renal scan was performed on all patients, and showed positive findings in 60% (184/308) of cases. Laboratory indices of inflammation were significantly higher in the DMSA-positive group (P< 0.05). There was a statistically significant difference in the age distribution between the two groups. In the DMSA-positive group, 165 patients underwent voiding cystourethrography (VCUG), and 58 (35%) cases demonstrated vesicoureteral reflux. In total, 110 patients in the DMSA-positive group, underwent repeat scanning at 6 months; 33 children (30%) demonstrated static scarring, but 77 (70%) had improved completely. The concordance of the ultrasonography (US) and VCUG was low. Older patients had more renal scarring. Conclusion: DMSA is a sensitive method for assessing the severity of inflammation and kidney injury. However, the ability of US to predict renal parenchymal damage was limited. A top-down approach in children with their first febrile UTI showed significant value.

• 한국임상수의학회지
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• 제34권3호
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• pp.208-212
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• 2017

This study was performed to retrospectively pursue any correlation between renal cortex thickness (RCT), outer medulla thickness (OMT) on ultrasonography (US) and chronic kidney disease (CKD) with International Renal Interest Society (IRIS) stage. Medical records and US findings of the dogs diagnosed CKD were reviewed for comparing to those of the clinically healthy dogs from March. 2015 through June. 2016. To evaluate the correlation about normal and CKD patients, RCT and the OMT were measured on US images. RCT and OMT were adjusted by dividing body surface area for standardization (RCTS, OMTS). Also the ratio of RCT/OMT were calculated and these indices were evaluated to investigate any tendency between 5 groups (normal and 4 IRIS stages) using Jonckheere-Terpstra trend test (J-T test). The RCTS showed a declining tendency (p < 0.02) and the OMTS showed an inclining tendency from normal through each IRIS stage (p < 0.01). The RCT/OMT showed also declining tendency (p < 0.01). Although the gold standard for renal function including GFR is lack, it is thought that differentiation between normal and CKD patients could be possible on US measurement of renal cortex and outer medulla thickness, which could be an alternative index for kidney function in diagnostic imaging.