• Journal of Yeungnam Medical Science
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• 제38권3호
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• pp.225-230
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• 2021

Background: We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS). Methods: From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS. Results: Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%). Conclusion: This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.46-51
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• 2022

Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.

• Childhood Kidney Diseases
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• 제18권1호
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• pp.42-46
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• 2014

가와사끼병은 전신성 혈관염을 일으키는 질환중의 하나로 여러 장기들을 침범할 수 있다. 신장증세로는 농뇨, 혈뇨, 단백뇨, 간질성 신염, 급성 신부전증, 용혈성 요독 증후군, 신반흔 등이 있다. 가와사끼병의 신장침범에 대한 병리기전은 아직 알려져 있지 않지만, 자가면역질환으로 인한 것으로 사려된다. 가와사끼병이 요로감염 이 후에 발병한다는 몇몇 보고들이 있었다. 하지만, 이미 보고된 논문들에 포함된 많은 요로감염 환자들은 신장방광 초음파, DMSA 스캔이나 배뇨중 요도방광조영술 등을 모두 받은 경우는 없었다. 이에 저자들은 급성 신우신염이 재발한 후 불완전 가와사끼병이 발생한 고도의 방광요관역류가 있는 8개월 남아를 보고하는 바이다. 급성 신우신염은 가와사끼병의 초기 증세일 수 있다. 그런 경우, 환아가 가와사끼병으로 확진되더라도 요로감염 진료지침에 따라 요로기형에 대한 이미지 검사를 시행할 필요가 있다고 생각한다.

• 대한간호학회지
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• 제24권3호
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• pp.345-363
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• 1994

This study attempted to identify important problems of the factors related to the indwelling catheter with closed drainage and to enhance recognization of Urinary Tract Infection management to protect patients with indwelling catheter from UTI. We selected the 58 patients with indwelling catheter with closed drainage from md-surg. intensive care units, and general neurological and neurosurgical ward, in one hospital in Pusan, Korea from May 30 to October 15, 1993. Patients were examined by urinary analysis before inserting catheter and then by urine cultures three times. The obtained data was analized using an SPSS /PC$^{+}$ The statistical analyses employed here was the frequency, percentage and x$^2$-tests. 1. Analyses for Indwelling Catheter induced UTI and infection rates were found to be presented in patients related to the factors of being on antibiotic drugs (x$^2$=14.105, p=.000) and the duration of the indwelling catheter(x$^2$=58.0, p=.000), both of which were found to affect the UTI. 2. UTI rates according to the duration of the in-dwelling catheter were high 8.6％ for the 2nd day, 27.6 for the 4th day, and 36.2% for the 7th day, and as the duration for the indwelling catheter was longer, UTI rates were higher. 3. The UTI rates according to the duration of the indwelling catheter related re factors, on the 7th day, were high-52.0% for women, 37.0% for more than 50 years in ages, 30.0% for patients under sur-gery, 33.3% for altered mental states outsides the alert, 76.7% for patients not given antibiotic drugs, 36.4% for less than 3500cc of fluids intakes, it was found that these affected to increase the UTI. 4. Causative organisms of UTI were found ; E.Coli appears the most than all other isolated organisms in women and Klebsiella and Pseudomonas in men. For antibiotic susceptibility of causative organisms, all causative organisms were found to be susceptible to Sul -cefoperazone, Trim-prim, and unasyn and Pseudomonas mostly net susceptible.e.

• 한국임상수의학회지
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• 제29권4호
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• pp.352-355
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• 2012

Hypospadias is a rare congenital malformation of the urethra reported in cattle. The urethral lumen of male indigenous Korean calf is open along the ventral aspect of the penis in the perineal region. Renal abscess and renal stone formation causing urinary tact infection has not been reported in hypospadia calves. The objective of this study was investigation for renal abscess and renal stone formation through autopsy. Histopathological examination and laboratory tests were performed. At autopsy, the pustules were formed on the right renal cortex, and the renal medulla abscess were formed on right and left part of the renal pelvis. Histopathological finding, this case was diagnosed as severe acute suppurative and necrotizing pyelonephritis, and severe chronic interstitial nephritis with fibrosis and moderate multifocal acute cystitis with edema. Milky exudate of the kidney has been identified as Actinomyces meyeri using the VITEK-2 system for identification of bacteria, and the stone has been identified as carbonate apatite using FT-IR system for quantification analysis. This case report describe the hypospadias complicated with urinary tract infection due to carbonate apatite stones and Actinomyces meyeri.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.347-354
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• 2021

Background: Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a valuable biomarker of urinary tract infection (UTI) in children. Purpose: This study aimed to compare the diagnostic accuracy of urinary NGAL (uNGAL) with those of serum C-reactive protein (CRP) and white blood cell (WBC) count for predicting UTI and acute pyelonephritis (APN) in febrile children. Methods: The medical charts of children undergoing uNGAL measurements between November 2017 and August 2019 were retrospectively reviewed. Patients with a suspected or diagnosed UTIs were included. The diagnostic accuracies of uNGAL, serum CRP, and WBC count for detecting UTI and APN were investigated. Independent predictors of UTI and APN were investigated using multivariable logistic regression analyses. Results: A total of 321 children were enrolled in this study. The uNGAL levels were higher in the UTI group (n=157) than in the non-UTI group (n=164) (P<0.05). Among children with a UTI, uNGAL levels were higher in the APN group (n=70) than, the non-APN group (n=87) (P<0.05). In the multivariate analysis, uNGAL was independently associated with UTI and APN (both P<0.05). Serum CRP and WBC count were not correlated with the presence of UTI and APN. Receiver operating curve analyses showed that the uNGAL level had the highest area under the curve (AUC) for predicting UTI and APN, respectively (AUC, uNGAL vs. CRP vs. WBC count, 0.860 vs. 0.608 vs. 0.669 for UTI; 0.780 vs. 0.680 vs. 0.639 for APN, all P<0.05, respectively). The predictive values and likelihood ratios of uNGAL were superior to those of serum CRP and WBC count for detecting UTI and APN at each cutoff level. Conclusion: UNGAL may be more useful than serum CRP and WBC count for identifying and assessing UTI in febrile children.

• 대한중풍순환신경학회지
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• 제20권1호
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• pp.17-24
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• 2019

■ Objectives The purpose of this case report is to show the effect of Bojungiki-tang on a patient complaining dysuria and urinary pain caused by repeated urinary tract infection(UTI) occurred after onset of cerebral infarction. ■ Methods A cerebral infarction patient with repeated UTI was treated with herbal medication, Bojungiki-tang. Then we evaluated the improvement with amount of total urine output, nelaton catheterization urine output and self voiding urine output. ■ Results Increase in amount of total and self voiding urine output and decrease in amount of nelaton urine output were observed after taking Bojungiki-tang. ■ Conclusion This case showed the effect of Bojungiki-tang on dysuria and urinary pain caused by repeated UTI.

• 여성건강간호학회지
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• 제8권4호
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• pp.529-537
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• 2002

The purpose of this study was to investigate the prevalence, relative factor and the effects that overactive bladder or urinary incontinence have on women's lives. Data was gathered through an internet survey. The subjects included 3,372 women ranging from 20 years old to 49 years of age. The questionnaire included general characteristics (age, parity, family history, and history of UTI), overactive bladder symptoms (urgency, frequency, nocturia, urgent incontinence), urinary incontinence, discomfort in ADL and sexual activity. The data was analyzed by the SPSS/PC+ program using frequency, $x^2$ test, and multivariate logistic regression. The results were as follows; 1. The prevalence was 12.7 % in overactive bladder and 21.0% in urinary incontinence. 2. 19.2% of the subject have urge incontinence, 5% of them have coped with the use of a pad. 3. The significant factors to overactive bladder were age($x^2$=6.6, p<0.05), history of urinary tract infection ($x^2$=50.8, p<0.01) and family history ($x^2$=26.1, p<0.01). The significant factors to urinary incontinence were age ($x^2$=6.2, p<0.05), occupation ($x^2$=11.0, p<0.05), history of urinary tract infection($x^2$=20.2, p<0.01), parity ($x^2$=8.6, p<0.01), and family history ($x^2$=4.9, p<0.05). 4. Overactive bladder impacts on individual daily life was 5.0 times, urinary incontinence was 2.9 times higher than in non-symptoms. Also, overactive bladder impacts on their sexual activity disturbance was 4.3 times, urinary incontinence has 3.9 times higher than in non-symptoms. In conclusion, overactive bladder symptoms and urinary incontinence were health problems that disturbed women's lives. Also the most problem among overactive bladder may be urgency in Korean. Intervention based on these results needs to be provided for these women.

• Clinical and Experimental Pediatrics
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• 제48권6호
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• pp.575-579
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• 2005

Urinary incontinence is the most common urinary symptom in children and causes considerable anxiety in children and parents. In most cases, there is no underlying organic pathology and the longterm prognosis is excellent. Despite these reassuring facts, children with wetting problems can be a challenge for primary pediatrician. This is probably because the problem is poorly understood, there is no readily identifiable medical pathology, and because treatment is usually time consuming and arduous. There is a great demand for treatment because wetting is an unpleasant symptom that can cause a stress and anxiety in the family. There may also be other coexisting problems such as urinary tract infection, constipation, soiling, and behavioral or emotional difficulties. Despite the frequency and vexing nature of voiding dysfunction, physicians may not always obtain a careful history to identify and to treat children properly with this condition. This article addresses the comprehensive diagnostic and therapeutic approach to such children.

• 대한핵의학회지
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• 제26권2호
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.