• Journal of Veterinary Clinics
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• v.41 no.1
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• pp.43-48
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• 2024

A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.153-159
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• 2017

Chronic kidney disease can be treated if it is detected early, but as the disease progresses, it becomes impossible to recover. Finally, renal replacement therapy such as transplantation or dialysis should be used. Ultrasonography is used to diagnose kidney cancer, inflammatory disease, nodular disease, and chronic kidney disease. It is used to identify information about degree of inflammation using information such as kidney size, internal echo characteristics. Currently, the degree of disease in the clinic uses the value of glomerular filtration rate. However, even in ultrasound, changes in the degree of inflammation and disease can be observed. In this study, we used ultrasound images to quantify the changes in brightness, size, cortex, and subclinical changes of the kidney with progression of the disease, and compared them with the glomerular filtration rate used in clinical practice. In 105 cases, we performed 35 cases of normal kidney, 35 cases of early kidney disease, and 35 cases of terminal kidney. The brightness of the cortex of the image was obtained and the difference in brightness between the cortex and the proximal portion was obtained by the slope. The graph of the portion which was not smooth due to the ultrasonic characteristics was used as the function regrass. The size reduction was obtained from the original data. The results were as follows: It was proportional to the glomerular filtration rate. It is considered that the algorithm can be applied to the disease if the algorithm study continues.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.154-161
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• 2010

Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The anomaly is characterized by absence of communication with the tracheobronchial tree and isolated blood supply from an anomalous systemic vessels. With the utilization of antenatal ultrasound, the diagnosis of asymptomatic neonatal PS has increased. Treatment options include observation, arterial embolization and surgical resection. The aim of the present study is to review the clinical course of PS and to share our experience with thoracoscopic resection. A total of 96 patients with PS were treated at Asan Children's Hospital between 1999 and 2010. The diagnosis of PS was established by CT in the cases managed by observation or embolization, and by tissue pathology in the surgical cases. Medical records and radiographic images were retrospectively reviewed. Thirty-nine patients were managed by embolization and 30 patients by surgery. The remaining 27 patients have been under observation without any procedures. Among 27 observation patients, 1 patient regressed completely and 10 patients were lost to follow up. Of the 39 embolizations patients, 2 had their lesion regress and sepsis was suspected after embolization. In 1 patient, the microcoil migrated to the iliac artery during the embolization procedure, and another patient developed renal abscess caused by renal artery embolization. Among 30 surgical cases, resection by thoracotomy was performed in 27 at the Department of Thoracic Surgery, and thoracoscopic resection in 3 at the Division of Pediatric Sugery. Only one wound complication ocurred. We conclud that surgical excision should be recommended for pulmonary sequestration, whether the sequestration is symptomatic or not because of the risk of infection, the low rate of natural regress, poor compliance, severe complications after embolization, and to exclude other pathology. In summary, thoracoscopic resection of the pulmonary sequestration is feasible, efficacious, safe and cosmetically superior even in neonatal period.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.17 no.2
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• pp.98-103
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• 2014

Purpose: Gallbladder (GB) wall thickening can be found in various conditions unrelated to intrinsic GB disease. We investigated the predisposing etiologies and the outcome of acalculous GB wall thickening in children. Methods: We retrospectively analyzed 67 children with acalculous GB wall thickening who had visited our institute from June 2010 to June 2013. GB wall thickening was defined as a GB wall diameter > 3.5 mm on abdominal ultrasound examination or computed tomography. Underlying diseases associated with GB wall thickening, treatment, and outcomes were studied. Results: There were 36 boys and 31 girls (mean age, $8.5{\pm}4.8years$ [range, 7 months-16 years]). Systemic infection in 24 patients (35.8%), acute hepatitis in 18 (26.9%), systemic disease in 11 (16.4%), hemophagocytic lymphohistiocytosis in 4 (6.0%), acute pancreatitis in 3 (4.5%), and specific liver disease in 3 (4.5%) predisposed patients to GB wall thickening. Systemic infections were caused by bacteria in 10 patients (41.7%), viruses in 5 patients (20.8%), and fungi in 2 patients (8.3%). Systemic diseases observed were systemic lupus erythematosus in 2, drug-induced hypersensitivity in 2, congestive heart failure in 2, renal disorder in 2. Sixty-one patients (91.0%) received symptomatic treatments or treatment for underlying diseases. Five patients (7.5%) died from underlying diseases. Cholecystectomy was performed in 3 patients during treatment of the underlying disease. Conclusion: A wide range of extracholecystic conditions cause diffuse GB wall thickening that resolves spontaneously or with treatment of underlying diseases. Surgical treatments should be avoided if there are no definite clinical manifestations of cholecystitis.

• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.219-223
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• 2011

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.

• Urogenital Tract Infection
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• v.13 no.3
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• pp.58-65
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• 2018

Purpose: This study aimed to investigate the relationship between uropathogens of infants with febrile urinary tract infection (UTI) and vesicoureteral reflux (VUR). Materials and Methods: We analyzed 308 infants hospitalized for febrile UTI between January 2010 and December 2015, and assessed the voiding cystourethrography (VCUG). The medical records, including clinical symptoms, laboratory findings, urinalysis, urine culture tests, ultrasound (US), dimercaptosuccinic acid scan, and VCUG, were retrospectively obtained. The incidences of VUR and high-grade VURs (III, IV, and V) were analyzed in 4 groups categorized by uropathogens and renal US findings. Results: The mean age of 308 infants was $3.29{\pm}2.18months$. The male-to-female ratio was 3.46:1. In urine culture tests, 267 infants (86.69%) showed single bacterial uropathogen; Escherichia coli in 241 infants (78.25%) and non-E. coli uropathogens in 26 infants (8.44%). Multiple distinctive microorganisms were identified as causative uropathogens in 41 infants (13.31%). Abnormal findings of US and VCUG were identified in 216 and 64 patients, respectively. In 308 infants, the incidences of VUR and high-grade VUR were not different among the 4 groups. In 239 male infants, the incidences of high-grade VUR were higher in patients with non-E. coli single or multiple uropathogen and with abnormal US findings (p=0.042). Conclusions: In male infants with non-E. coli uropathogen or multiple uropathogens and with abnormal US findings at febrile UTI, there was an increased chance of finding high-grade VURs on subsequent VCUG tests.

• Journal of Veterinary Science
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• v.25 no.4
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• pp.52.1-52.10
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• 2024

Importance: Kidney disease is prevalent among veterinary species, including zoo animals; however, investigations into this condition in striped skunks (Mephitis mephitis) are scarce. Diagnostic tools for kidney diseases in this species also remain limited. Objective: This study aimed to assess the utility of symmetric dimethylarginine as a biomarker for kidney disease in captive striped skunks in Korea. Methods: This retrospective study analysed 11 striped skunks housed at the Everland Zoo between 2017 and 2021. Blood samples were collected during health checks. Kidney function was assessed through blood analysis and diagnostic ultrasound, with necropsies conducted on deceased animals. Symmetric dimethylarginine levels were measured in 27 plasma samples collected from 11 skunks. Results: Over the study period, seven skunks were diagnosed with kidney disease. Analysis of 27 blood samples revealed a concurrent increase in SDMA levels with concentrations of blood urea nitrogen and blood creatinine. In 3 of the 7 skunks with kidney disease, symmetric dimethylarginine exceeded 14 ㎍/dL prior to the elevation of blood urea nitrogen and blood creatinine above the upper reference limit. Conclusions and Relevance: To our knowledge, this is the first study investigating symmetric dimethylarginine in captive striped skunks in Korea. Our findings suggest that symmetric dimethylarginine may serve as an early and consistent biomarker for renal dysfunction in striped skunks. Further studies with larger clinical sample size from striped skunks are needed to validate the clinical utility of blood symmetric dimethylarginine concentration.

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.459-463
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• 2015

A 14-year-old, castrated male mixed-breed dog weighing 9 kg was presented for hematuria and dysuria. Abdominal ultrasound showed unilateral hydronephrosis and hydroureter with focal thickening of the ureteral wall. Surgical exploration revealed an intraluminal mass arising from the proximal left ureter. Mass resection was performed. Histopathology of the ureteral mass was consistent with a papillary transitional cell carcinoma. The patient recovered well post-operatively, but was diagnosed with another tumor three months later, this time in the right kidney. Fine-needle aspiration cytology of the renal mass revealed an epithelial cell tumor with mesenchymal features.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.222-228
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• 2009

Purpose : We checked voiding cystourethrography (VCUG) in patients with congenital hydronephrosis (CHN) and followed up the occurrence of urinary tract infection(UTI) in these patients. And we tried to figure out the relationship between CHN and VUR and UTI. Methods : We performed a retrospective study in 122 CHN patients who received VCUG from 2002 to 2008 at Ajou University Hospital. We executed logistic regression, chi-square test and T-test using version 16.0 SPSS package for the statistical analysis. P<0.05 was regarded as significant. Results : Most patients with CHN were male (73%) and there was a tendency of preferences for unilateral (77%) and left (84%) occurrence of hydronephrosis. The incidence of VUR was 18.9% among 122 CHN patients and no laterality difference was found to the severity of VUR or hydronephrosis. The incidences of VUR and UTI was higher in group of higher grade (III-IV) CHN patients, when compared to the lower group, respectively. When VUR was present in CHN patients, the incidence of UTI during infancy was also higher. Conclusion : The incidence of VUR was higher in patients with higher grades of CHN. The incidence of UTI during infancy was higher when VUR was present in the CHN patients.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.33-42
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• 1988

The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows : 1. Neuroblastoma was the most common(6 cases) and wi1m's tumor(5 cases), choledocal cyst(4 cases), ovarian mass(3 cases), hydronephrosis(2 cases), were descending order in frequency. 2. The most common site was retroperitoneum(60%). Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic(cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless ultrasonography wes paticullary useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogenous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.