• Korean Journal of Radiology
• /
• v.22 no.7
• /
• pp.1185-1193
• /
• 2021

Objective: Clear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms' tumor and to assess the features with diagnostic value for identifying CCSK. Materials and Methods: We reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3-10 years), 7 with CCSK, and 51 with Wilms' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher's exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed. Results: The age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770-104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337-25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively. Conclusion: Perinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms' tumor in children aged below 10 years.

• Journal of Chest Surgery
• /
• v.35 no.10
• /
• pp.755-759
• /
• 2002

A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

• Journal of Veterinary Clinics
• /
• v.40 no.6
• /
• pp.423-428
• /
• 2023

The mouse kidney transplantation model serves as an invaluable tool for exploring various aspects of the transplant process, including acute rejection, cellular and humoral rejection, ischemia-reperfusion injury, and the evaluation of novel therapeutic strategies. However, conducting venous anastomosis in this model poses a significant challenge due to the thin and pliable characteristics of the renal vein, which often obstruct clear visualization of the resected vein's edge. This study proposes the adoption of a two stay suture technique to enhance the visualization of the renal vein's edge, thereby facilitating efficient and successful venous anastomosis. A total of 22 mice served as kidney donors in this study. The conventional anchoring suture technique was employed for venous anastomosis in 11 of these mice, while the remaining 11 underwent the two stay suture technique. The anastomosis duration and completion rates were then compared between these two groups. The conventional anchoring suture technique yielded an average anastomosis time of 29 minutes and a completion rate of 64%. In contrast, the two stay suture technique demonstrated a substantial improvement, with an average anastomosis time of 14 minutes and a completion rate of 100%. The two stay suture technique offers a promising solution to enhance visualization during venous anastomosis in murine kidney transplantation. This technique may particularly benefit novices by enabling them to perform venous anastomosis more easily, swiftly, and successfully.

• YAKHAK HOEJI
• /
• v.22 no.3
• /
• pp.138-147
• /
• 1978

Bethanidine, which is known as a sympathetic blocking agent, was injected into the vein of a dog in an attempt to investigate the influence on renal funciton. Bethanidine resulted in an increased urine flow and glomerular filtration rate, and it produced an increase of urinary sodium and potassium excretion and a decrease of reabsorption rate of sodium and potassium in renal tubules, whereas renal plasma flow showed no significant changes. After pretreatment of phentolamine, a specific alpha adrenergic blocking agent, bethanidine did not significantly increase glomerular filtration rate and diuresis, significantly increased urinary sodium and potassium excretion although the magnitudes were reduced when compared with that of bethanidine alone. In conclusion, bethanidine-induced diuresis appears to be the result of an inhibited tubuler reabsorpting of electrolytes within the kidney through its sympathetic blockade of renal nerves and of an increased glomerular filtration rate, which was caused by the constriction of vas efferense in the glomeruli.

• Childhood Kidney Diseases
• /
• v.5 no.1
• /
• pp.64-68
• /
• 2001

The nutcracker syndrome is the congestion of left renal vein due to the compression of left renal vein by the aorta and the superior mesenteric artery and has been known as tile cause of hematuria with or without left renal flank pain, mild to moderate proteinuria and orthostatic proteinuria. We present here one case of 13.5 year of girl has severe typical nutcracker syndrome with orthostatic protinuria and idiopathic chronic fatigue. (J. Korean Soc Pediatr Nephrol 5 . 64- 8, 2001)

• Childhood Kidney Diseases
• /
• v.14 no.2
• /
• pp.240-245
• /
• 2010

Nutcracker syndrome refers to the compression of the left renal vein between the abdominal aorta and superior mesenteric artery which can lead to renal vein hypertension. Patients can present with hematuria, proteinuria, dysuria or abdominal pain. In diagnosing the nutcracker syndrome, measurement of the peak velocity ratio of aorto-mesenteric border versus renal hilum by Doppler sonography is useful. Currently, there are few reports about the genetic correlation in this syndrome. We report two cases of the nutcracker syndrome found in male siblings with hematuria.

• Archives of Reconstructive Microsurgery
• /
• v.23 no.2
• /
• pp.97-100
• /
• 2014

The number of patients with chronic renal failure who require renal replacement therapy is increasing and dialysis is still the mainly used renal replacement therapy. The first choice of surgical technique currently used is side-to-end anastomosis of the radial artery and the cephalic vein. The authors report on a case of an effective arteriovenous shunt operation performed using microscopy. A 53-year-old male with chronic renal failure was referred to plastic and reconstructive surgery department to undergo an arteriovenous shunt operation. Venography was performed before surgery in order to find the appropriate vessel for the arteriovenous shunt operation. The cephalic vein on the wrist showed a diameter of over 4 mm, which was appropriate for an arteriovenous shunt operation. Anastomosis of the vessels was performed under microscopy using Nylon #9-0. Blood flow and vessel diameter were evaluated by venography after surgery and showed well maintained function of the shunt. Complications such as bleeding, edema of the upper arm, and wound dehiscence did not occur. Many factors and certain complications may affect the long-term patency of an arteriovenous shunt; however, exquisite surgical technique is the most important factor in a successful operation. Thus, arteriovenous shunt operation using microscopy is thought to be a good treatment option.

• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.970-974
• /
• 2003

There has been an improvement in the prognosis of tumor thrombi invading the inferior vena cava(IVC) and the right atrium(RA) of renal cell carcinoma with radical nephrectomy and tumor thrombectomy with the aid of cardiopulmonary bypass in the last 10 years. A 30 year old woman was diagnosed with right renal tumor with tumor thrombi invading the right renal vein and the IVC above the right renal vein to the RA. She received radical nephrectomy and removal of tumor thrombi in the infrarenal IVC under hypothermic total circulatory arrest using the cardiopulmonary bypass. The tumor recurred 12 months after the initial operation, she received a second operation for tumor removal from the retroperitoneum, suprarenal IVC, and RA. She died 11 months after the second operation due to lung metastases and recurred hepatic vein tumor extended to the RA and right ventricle.

• YAKHAK HOEJI
• /
• v.44 no.3
• /
• pp.205-212
• /
• 2000

The effect of BRL 34915, a $K^{+}$ channe$Na^{+}$l opener, on renal function was investigated in anesthetized dog. BRL 34915, when given into the vein, elicited the decrease of urine volume accompanied with the reduction of renal plasma flow (RPF), osmolar clearance ($C_{osm}$) and amounts of sodium excreted into urine ($E_{na}$), whereas reabsorption rate of sodium in renal tubules ($R_{na}$), ratio of $K^{+}$ against $Na^{+}$ in urine ($K^{+}$ /$Na^{+}$) were elevated significantly with a partial fall of mean arterial pressure (MAP). BRL 34915 injected into a renal artery produced the diuretic action along with the increase in RPF $C_{osm}$, $E_{na}$ and amounts of potassium excreted in urine ($E_{k}$), and the decrease in $R_{na}$, reabsorption rate of potassium in renal tubules ($R_{k}$), free water clearance ($C_{H20}$) and $K^{+}/Na^{+}$ ratio in only ipsilateral kidney, however changes of the renal function were not observed in control kidney. BRL 34915 given into carotid artery exhibited the same aspect as changes of renal function induced by intravenous BRL 34915. These results suggest that BRL 34915 has dual effects, renally acting diuretic and centrally acting antidiuretic action.n.

• YAKHAK HOEJI
• /
• v.45 no.2
• /
• pp.205-213
• /
• 2001

The dopaminergic receptors were consisted of two distinct subtypes, $D_1$and $D_2$, each having different function. The present study was attempted to investigate the effects of R(-)-2,10,11-trihydroxy-N-n-propylnoraporphine (TNPA), a dopamine $D_2$receptor agonist, on renal function in dog. TNPA (5.0~15.0 $\mu$g/kg), when given into the vein, produced a dose-dependently antidiuresis along with the decrease in osmolar clearance ( $C_{osm}$) and urinary excretion of sodium and potassium ( $E_{Na}$ , and $E_{K}$). It also increased reabsorption rates of sodium and potassium in renal tubules ( $R_{Na}$ , $R_{K}$) without any changes in glomerular filtration rate (GFR), renal plasma flow (RPF) and free water clearance ( $C_{H2o}$). TNPA (0.5~1.5 $\mu$g/kg/min) infused into a renal artery decreased urine flow both in the experimental and the control kidneys. TNPA (1.5~5.0 $\mu$g/kg) administered via the carotid artery also greatly exhibited antidiuresis even at intravenously ineffective doses. Changes of renal function by TNPA given into both the renal artery and the carotid artery were almost the same aspect to those induced by intravenous TNPA. These results obtained from the present study suggest that TNPA produces antidiuresis by increasing the reabsorption rates of electrolytes in renal tubules, mainly distal tubule, through changing of central function.unction.