• Childhood Kidney Diseases
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• v.14 no.2
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• pp.195-202
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• 2010

Purpose : The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. Methods : This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by $^{99m}Tc$-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. Results : Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the followup DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. Conclusion : The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.

• 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.

• 대한핵의학회:학술대회논문집
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• 1990.04a
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• pp.204.2-205
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• 1990

• 대한핵의학회:학술대회논문집
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• 1999.11a
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• pp.17.2-17.2
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• 1999

• 대한핵의학회:학술대회논문집
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• 2004.11a
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• pp.408.1-408.1
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• 2004

• 대한핵의학회:학술대회논문집
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• 1989.06a
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• pp.135.1-135.1
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• 1989

• 대한핵의학회:학술대회논문집
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• 1995.05a
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• pp.207-207
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• 1995

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.81-88
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• 1998

The purpose of this study was to examine the radiolabeling and biodistribution of $^{188}Re(V)$-DMSA as a therapeutic cancer radiopharmaceutical. We made a DMSA kit($NaHCO_3$ 1.5 mg, meso-2,3-dimercaptosuccinic acid 1.0 mg, L(+)-ascorbic acid 0.7 mg, $SnCl_2{\cdot}2H_2O$ 0.34 mg, pH 2.9) for labeling with $^{188}Re$. In this kit, $^{188}ReO_4{^-}$ 5 mCi/2 ml added and boiled at $100^{\circ}C$ for 3 hr in water bath. The final pH adjusted to 7.5 with 7% $NaHCO_3$ solution. We checked the labelling efficacy with TLC-SG(n-butanol : acetic acid : $H_2O$ = 3 : 2 : 3) and examined the stability both in room temperature and in serum at $37^{\circ}C$. Biodistribution(1, 3, 13, 24, 48 hr) of $^{188}Re(V)$-DMSA compound was evaluated in Sarcoma 180 tumor-bearing mice. Each labeling efficiency and stability at room temperature for 48 hours was over 98% and 95%, respectively. The stability in serum were 82%(6 hr) and 85%(48 hr). Tumor uptake of $^{188}Re(V)$-DMSA in Sarcoma 180-bearing mice were $0.66{\pm}0.15%$(1 hr), $0.51{\pm}0.10%$(3 hr), $0.19{\pm}0.05%$(24 hr) and $0.13{\pm}0.02%$(48 hr). These result are consistent with those of $^{99m}Tc(V)$-DMSA which were reported previously. In conclusion, $^{188}Re(V)$-DMSA may be a useful therapeutic radiopharmaceutical for treating some cancers and metastatic bone lesion.

• The Korean Journal of Nuclear Medicine
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• v.15 no.1
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• pp.13-20
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• 1981

Using stannous chloride, optimum conditions for $^{99m}Tc$ labelling of some scanning agents such as phytic acid (P A), dimercaptosuccinic acid (DMSA), and calcium diethylenetriaminepentaacetate (Ca-DPTA) were established. Methods of separation and identification of the labelled compounds were practiced by a paper- or thin layer- chromatography. Biodynamic studies of the compounds were also carried out. The results indicate that the molar ratios of the chelating agent and stannous chloride varies only with the concentrations of the chelating agents, and thus the amounts of the stannous chloride per labelling tube were nearly constant $(500\sim600{\mu}g)$ regardless the variation of the molar ratios. It suggests that the given experimental conditions require about $500{\mu}g$ of stannous chloride regardless of the chelating agents. Under alkaline pH, the labelling yields were drastically decreased due to the probable formation of colloidal tin compounds. Biodynamic data showed characteristic patterns with each compound indicating that they are all suitable for the relevant scanning applications.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.110-116
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• 2013

Purpose: The $^{99m}Tc$-Dimercaptosuccinic acid (DMSA) renal scan is used primarily for the diagnosis of renal scarring and acute pyelonephritis in children with urinary tract infections (UTI). This study aimed to evaluate clinical differences based on the positive or negative results of DMSA scans and kidney ultrasonography (US) in pediatric UTI. Method: We retrospectively reviewed 142 pediatric patients with UTI who were admitted to Myongji Hospital from January 2004 to December 2012. We performed a comparative analysis of clinical parameters such as age, sex, white blood cell (WBC) count, neutrophil count, blood urea nitrogen (BUN) level, creatinine (Cr) level, C-reactive protein (CRP) level, and durations of hospitalization and fever, grouped by the results of the DMSA scans and kidney US. Results: The mean age of the patients was $33.8{\pm}48.3$ months, and 78 (55%) were male. Fifty-two patients had abnormal DMSA findings, and 71 patients had abormal kidney US findings (test positive groups). In the DMSA scan positive group, there were significant differences in age, WBC counts, neutrophil counts, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on kidney US, and incidence of vesicoureteral reflux (VUR) compared with the scan negative group. The kidney US positive group had significant differences in age, neutrophil count, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on the DMSA scans, and more frequent VUR compared with the US negative group. Conclusion: Our data suggest that there were no major differences in clinical parameters based on the results of the DMSA scans compared with kidney US in pediatric UTI. However, as kidney US and DMSA scan were performed to predict VUR, the sensitivity and negative predictive value was increased.