• Clinical and Experimental Pediatrics
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• v.62 no.12
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• pp.433-437
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• 2019

Acute pyelonephritis (APN) should be detected and treated as soon as possible to reduce the risk of the development of acquired renal scarring. However, in the medical field, urine culture results are not available or considered when the prompt discrimination of APN is necessary and empirical treatment is started. Furthermore, urine culture cannot discriminate APN among children with febrile urinary tract infection (UTI) (pyelitis, lower UTI with other fever focus). Therefore, the usefulness of urine culture for diagnostic purposes is small and the sampling procedure is invasive. Congenital hypoplastic kidney is the most common cause of chronic kidney injury in children. Thus, it is desirable that a main target be detected as early as possible when imaging studies are performed in children with APN. However, if APN does not recur, no medical or surgical treatment or imaging studies would be needed because the acquired renal scar would not progress further. Therefore, the long-term prognosis of APN in young children, particularly infants, depends on the number of recurrent APN, not other febrile UTI. New methods that enable prompt, practical, and comfortable APN diagnosis in children are needed as alternatives to urinary catheterization for urine culture sampling.

• Childhood Kidney Diseases
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• v.23 no.2
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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.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1412-1417
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• 2022

Renomedullary interstitial cell tumors are often incidentally identified either upon autopsy or kidney resection for other reasons. However, rare renomedullary interstitial cell tumor cases resulting in a clinical symptomatic mass have been reported. We present a case of renomedullary interstitial cell tumor that was manifested as an incidentally detected renal mass and mimicked renal cell carcinoma on the imaging features.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.212-219
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• 2007

Purpose : It is difficult to diagnose acute pyelonephritis(APN) in young children, because of their nonspecific symptoms. The younger the age, the higher the risk of renal scars after APN, which can be prevented by early diagnosis and treatment. We compare the significance of renal imaging studies by age for diagnosis of APN in febrile urinary tract infection(UTI) in children. Methods : Fifty-three hospitalized children(34 patients under age 2 and 19 patients over age 2) with febrile UTI and who had undergone dimercaptosuccinic acid(DMSA) scan, renal ultra sonography(RUS) and voiding cystourethrography(VCUG) during the acute stage were re-viewed. We compared the renal imaging studies between the different age groups. Results : The DMSA scan showed cortical defects in 23.5% of patients under age 2, which was significantly lower than 63.2% of patents over age 2(P<0.05). The renal cortical defects on DMSA scan were associated only with a high peripheral leukocyte count, but not with fever duration, erythrocyte sedimentation rate(ESR), and C-reactive protein(CRP). And there was no correlation between the DMSA scan, VCUG or RUS findings. Conclusions : The DMSA scan is not sensitive for diagnosis of APN in children less than 2 years of age and the findings cannot predict the presence of vesicoureteral reflux(VUR). VCUG may be necessary for proper management in this age group.

• Korean Journal of Oriental Medicine
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• v.15 no.3
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• pp.107-113
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• 2009

Object : This study was designed to evaluate the effects of oriental medicine therapy on a renal atrophy Patient. Methods : The patient was hospitalized from July 31. 2009 to Aug 27. 2009. Patient was treated with herbal medicine, acupuncture and moxa therapy. Result & Conclusion : After the treatment, the symptoms and IPSS, DITI results improved. From These results suggest that oriental medicine is an effective treatment for renal atrophy Patient. But more clinical case reports are needed.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.588-597
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• 2020

Objective: To investigate the value of combined chemical exchange saturation transfer (CEST) and conventional magnetization transfer imaging (MT) in detecting metabolic and structural changes of renal fibrosis in rats with unilateral ureteral obstruction (UUO) at 3T MRI. Materials and Methods: Thirty-five Sprague-Dawley rats underwent UUO surgery (n = 25) or sham surgery (n = 10). The obstructed and contralateral kidneys were evaluated on days 1, 3, 5, and 7 after surgery. After CEST and MT examinations, ¹⁸F-labeled fluoro-2-deoxyglucose positron emission tomography was performed to quantify glucose metabolism. Fibrosis was measured by histology and western blots. Correlations were compared between asymmetrical magnetization transfer ratio at 1.2 ppm (MTR_asym(1.2ppm)) derived from CEST and maximum standard uptake value (SUV_max) and between magnetization transfer ratio (MTR) derived from MT and alpha-smooth muscle actin (α-SMA). Results: On days 3 and 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of contralateral kidneys (p < 0.05). On day 7, MTR_asym(1.2ppm) and MTR of UUO renal cortex and medulla were significantly different from those of sham-operated kidneys (p < 0.05). The MTR_asym(1.2ppm) of UUO renal medulla was fairly negatively correlated with SUV_max (r = -0.350, p = 0.021), whereas MTR of UUO renal medulla was strongly negatively correlated with α-SMA (r = -0.744, p < 0.001). Conclusion: CEST and MT could provide metabolic and structural information for comprehensive assessment of renal fibrosis in UUO rats in 3T MRI and may aid in clinical monitoring of renal fibrosis in patients with chronic kidney disease.

• Journal of Veterinary Clinics
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• v.36 no.6
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• pp.353-357
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• 2019

A two-year-old spayed female Persian cat demonstrated weight loss, anorexia, and vomiting for one week. Hematologic findings suggested chronic renal failure. Radiography and ultrasonography revealed severe bilateral renomegaly with hypoechoic nodules and subcapsular hypoechoic rim. Fine needle aspiration of the kidney revealed malignant lymphoma. The cat received in-hospital treatment for chronic renal failure for seven days, followed by chemotherapy (cyclophosphamide, vincristine, and prednisolone). The cat tolerated chemotherapy well and chronic kidney disease was alleviated. However, complete remission was not achieved. After 93 days of treatment, the cat exhibited anisocoria and mental dullness. Brain magnetic resonance imaging revealed hypertrophy and enhancement of cranial nerves. Chemotherapy was replaced with lomustine (10 mg orally), and two weeks later, cytosine arabinoside (50 mg/㎡ subcutaneously), twice daily for consecutive days. Five days after substitution chemotherapy, the patient showed anemia due to severe intestinal bleeding and died. Post-mortem examination and histopathologic analysis confirmed renal T-cell lymphoma with metastasis to the central nervous system, colon, and nasal cavity. Survival time was 117 days after the diagnosis of renal lymphoma.

• Proceedings of the KSMRM Conference
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• 1996.10a
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• pp.75-75
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• 1996

• Childhood Kidney Diseases
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• v.10 no.2
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• pp.201-212
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• 2006

Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.1 no.1
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• pp.31-37
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• 2015

Chelating agents 1,4,7-triazacyclononanetriacetic acid (NOTA), 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) and 30-amino-3,14,25-trihydroxy-3,9,14,20,25-penta-azatriacontane-2,10,13,21,24-pentaone (desferrioxamine, DFO) were labeled with $^{68}Ga$ and tested in vitro properties to check the feasibility of using DFO as a bifunctional chelating agent or renal imaging agent. The chelating agents of concentration $2{\mu}M$ were labeled with $^{68}Ga$ in 0.1 M HCl at pH 1.7-10.3 at room temperature and $80^{\circ}C$ and the optimal pH for labeling each chelating agent was found. And then, the chelating agents were labeled with $^{68}Ga$ in various concentration of chelating agents at optimal pH. The labeled chelating agents were subject to stability test in human serum and to binding studies to human red blood cell (RBC) and plasma protein. The optimal pH's of NOTA, DOTA and DFO for $^{68}Ga$-labeling were 4.4, 3.6 and 5.6, respectively. DFO ($10{\mu}M$) showed high labeling efficiency (>97%) at pH 5.6. All the labeled chelating agents showed high stability in human serum. $^{68}Ga$-DFO showed low RBC binding but significant amount was bound to plasma protein. The results demonstrated that $^{68}Ga$-DFO can be used as a bifunctional chelating agent but not as a renal imaging agent.