• 대한방사선기술학회지:방사선기술과학
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• 제28권4호
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• pp.287-291
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• 2005

완전 폐색을 동반한 상부 요관 결석의 크기에 따른 치료 방법의 적절한 시기를 결정하기 위해 2002년 1월부터 2004년 8월까지 Dornier사의 MPL 9000 체외충격파쇄석기에 의해 치료 받은 201명을 대상으로 하였다. 전체 대상 201명 중, 완전 폐색을 동반하지 않은 경우는 142명이었으며, 완전 폐색을 동반한 경우는 59명이었다. 완전 폐색을 동반하지 않은 경우의 체외충격파쇄석술의 1회, 2회, 3회 누적 성공률은 각각 68.3%, 86.6%, 94.4%이었으며, 결석 크기 10 mm 미만, 10 mm에서 20 mm 미만, 20 mm 이상의 3회 누적 성공률은 각각 100%, 90.5%, 00.0%이었다. 완전 폐색을 동반한 경우의 체외충격파쇄석술의 1회, 2회, 3회 누적 성공률은 각각 44.1%, 66.1%, 76.3%이었으며, 결석 크기 10 mm 미만, 10 mm에서 20 mm 미만, 20 mm 이상의 3회 누적 성공률은 각각 완전 폐색을 동반한 경우는 각각 100%, 65.5%, 33.3%이었다. 완전 폐색을 동반한 상부 요관 결석의 크기는 체외충격파쇄석술에 의미 있는 영향을 주었다. 저자 등은 상부 요관 결석의 치료 방법 선택에 있어서, 완전 폐색을 동반하면서 그 크기가 10 mm 이상인 결석에 대해서는 체외충격파쇄석술 보다는 요관경하배석술 등 다른 방법을 일차적으로 선택할 것을 제안한다.

• 한국수정란이식학회지
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• 제30권3호
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• pp.261-263
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• 2015

A 10-year-old spayed female Yorkshire Terrier visited for a physical checkup. The bitch had a history of ovariohysterectomy for treatment of pyometra a year ago. On physical examination, the dog was bright and alert. Complete blood counts, serum biochemistry and blood gas analysis results did not show any deviations within normal ranges. Radiographic and ultrasonographic examinations revealed unilateral hydronephrosis and hydroureter of the right kidney and ureter, and obstruction of the distal ureter was observed. On the basis of these results, nephroureterectomy was performed. During the operation, the adhesion of the distal ureter and surrounding tissue cells were observed without the evidence of the ureteral ligation. The distal ureteral obstruction was presumed to be adhesion caused by fibrous tissue formation between ureter and retained broad ligament, or incompletely removed blood clots following ovariohysterectomy. This case report describes the occurrence of hydroureteronephrosis caused by adhesion of the distal ureter following ovariohysterectomy in a bitch.

• 한국임상수의학회지
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• 제24권2호
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• pp.288-291
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• 2007

Hypospadias is a malformation in which the urethra open on the ventral side of the penis and its frequency is about from 0.3% to 0.5% male birth in human. It is considered a disorder both genetic and environmental factors involves in pathogenesis. A KNC(Korean native calf) showing symptoms of fusion defect of the male ventral urethra, penile defect, bifid scrotum and low body weigh was born. To prevent an ascending urinary tract infection, dermatitis and loss of hair, surgical operation was performed to make a genitals like a female. After the operation, the KNC got a regenerative hair and normal urination. However the KNC became anorexia, loss in weight and weak. Seventy days after birth, the KNC died. The view of autopsy was a yellowish hepatomegaly, hydronephrosis, closed ureter and complex disorder in interanl organ. The symptoms of hepatomegaly and hydronephrosis could be due to a fluid therapy as a consequence of ureter obstruction. The normal urination of the KNC before it got sick, suggested that ureter obstruction in the case of this KNC was formed at its postnatal growth stage.

• Childhood Kidney Diseases
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• 제4권2호
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• pp.170-174
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• 2000

신우요관이행부 폐색에 의한 신생아 편측수신증의 치료가 여전히 논란의 여지가 있는 상황에서 완전 중복요관에 동반한 하극 신우요관이행부의 폐색이 있는 경우 조기에 수술요법으로 치료한 사례가 있어 이를 소개하고자 하였다. 본 증례의 환아들은 산전초음파에서 편측수신증이 있음을 알았고 출생후 정확한 진단과정을 통해 편측 신하극 신우요관이행부 폐색을 동반한 완전 중복요관을 진단받았다. 환아들은 신상극의 신실질은 정상 소견이었지만 신하극의 수신증이 SFU 등급 IV로 심하여 각각 생후 약 1개월과 4개월째 신우요관문합술을 시행받았다. 술후 추적관찰에서 두 환아 모두 합병증없이 회복되었고 환측 신장의 모양 및 기능이 현저히 호전된 결과를 보였다.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.116-120
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• 2019

Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

• The Korean Journal of Physiology
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• 제16권2호
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• pp.165-175
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• 1982

Changes in handling of $Li^+$ by contralateral kidney during acute $Li^+$ loading were investigated immediately after unilateral ureteral obstruction. Carotid artery, jugular vein, renal vein and ureter of experimental animal were catheterized and renal venous flow was shunted to .external jugular vein. In experimental group right ureter was ligated. One to two hours after operation a single shot of LiCl solution (2 mEq/kg) was intravenously injected and then .arterial, renal venous blood and urine samples were taken sequentially for 1 to $1{\frac{1}{2}}$ hours. Urine volume, plasma and urinary concentrations of $Li^+$, $Na^+$ and $K^+$ were measured and urinary excretion of them were calculated. Results obtained were as follows: 1) In experimental group urine volume, urinary excretion of $Na^+$, and $K^+$ by contralateral kidney after unilateral ureteral obstruction were slightly larger than mean value of both kidney in control group. 2) During acute $Li^+$ loading contralateral kidney in experimental group showed limited $K^+$ excretion, but urinary flow and $Na^+$ excretion were comparable to mean value of both kidney in control group. 3) Urinary osmolar concentration in experimental group was much lower than that in control group, and it was maintained at low level even after Li loading. 4) In experimental group plasma$Li^+$ concentration decreased more slowly than in control group after a single shot of LiCl solution. 5) Urinary excretion of $Li^+$ in experimental group was markedly decreased, even lesseer than mean of both kidney in control group. 6) From the above results it was concluded that immediately after unilateral ureteral obstruction contralateral kidney showed normal water and $Na^+$ diuretic response to Li load but urinay $Li^+$ excretion was decreased and reclaimed $Li^+$ to systemic circulation.

• 한국임상수의학회지
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• 제38권5호
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• pp.249-253
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• 2021

We describe the case of a Jindo dog that presented with a 2-month history of an abscess-like mass on the skin of the left hip. The patient was initially diagnosed with a suspected insect bite and was treated with a topical dressing. After observing no improvements, surgical debridement was done to remove the abscess. Nine days after surgery, the patient started showing severe anorexia, vomiting, lethargy, and oliguria. Azotemia was detected, and the patient was diagnosed with acute kidney injury. Ultrasonography depicted an abdominal mass (4.6 × 7.5 cm) in the right ureter, and severe hydronephrosis in the right kidney. The patient was euthanatized. Results of the necropsy, histopathologic examination, and immunohistochemistry for tumor cells, confirmed that the patient had developed hydronephrosis and disseminated histiocytic sarcoma which had metastasized to the lungs. To the best of our knowledge, this is the first report of acute renal failure produced by ureter invasion and urinary tract obstruction resulting from the abdominal mass of disseminated histiocytic sarcoma in dogs.

• 한국임상수의학회지
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• 제26권2호
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• pp.176-180
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• 2009

2년령의 암컷 miniature schnauzer가 침울, 복통 및 식욕부진으로 내원하였다. 신체검사를 통해 빈맥, 발열과 복통을 확인하였다. 총혈구계수 검사에서 호중구수의 증가를 동반한 백혈구증가증이 관찰되었다. 방사선 검사에서 하행결장의 변위와 척추와 평행하게 방사선투과가 감소한 부위가 관찰되었다. 초음파검사시 방광내 결석과 슬러지, 우측 신장의 수신증 및 근위뇨관의 확장이 관찰되었다. 뇨검사결과 단백뇨와 혈뇨가 나타났으며 뇨침사검사에서 다수의 상피세포, calcium oxalate 결정, struvite 결정, 무정형 결정과 과립원주, 백혈구 및 구균이 관찰되었다. 상기의 결과와 배설성 요로 조영술을 통해 신우신염과 편측성 뇨관 완전폐색증으로 진단하였다. 신장절제술을 위한 개복술시 후복막강에 풍선형의 구조물을 발견하였다. 구조물로부터 채취한 시료의 세포검사와 배양검사결과 다수의 퇴행성 호중구와 탐식된 구균을 관찰하였다. 결론적으로 뇨관폐색과 방광결석을 동반한 Staphylococcus intermedius에 의한 복막후농양으로 최종 진단하였고 우측신장의 절제를 실시하여 치료하였다.

• Childhood Kidney Diseases
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• 제19권1호
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• pp.8-13
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• 2015

Antenatal hydronephrosis (ANH) is one of the most common abnormal findings detected on prenatal ultrasound (US), and it has been reported in 1-5% of all pregnancies. The likelihood of significant postnatal pathologic abnormality in the urinary tract correlates with the degree of anterior-posterior diameter (APD) according to the gestational age. Detection of urologic anomalies prenatally permits fetal interventions that avoid complications in rare cases of bladder outlet obstruction with oligohydramnios even though their final benefits still remain controversial. There is no clear consensus on the extent and mode of postnatal imaging after a diagnosis of ANH. US is the mainstay of the postnatal evaluation and helps guide further testing with voiding cystourethrography (VCUG) and diuretic renography. Although most algorithms continue to recommend generous VCUG for identification of lower urinary tract anomalies, VCUG may be safely reserved for high grade ANH cases or any grade of ANH with dilated distal ureter without increasing the risk of urinary tract infection (UTI). There are conflicting studies about efficacy of postnatal prophylactic antibiotics. It still seems reasonable to consider use of a prophylactic antibiotic to prevent infant UTIs in high-risk populations, such as females and uncircumcised males with high grades of hydronephrosis, hydroureteronephrosis, or vesicouretral reflux.

• Advances in pediatric surgery
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• 제7권1호
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• pp.26-30
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• 2001

Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.