• Childhood Kidney Diseases
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• v.15 no.2
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• pp.163-171
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• 2011

Purpose : To evaluate the prevalence of vesicoureteral reflux (VUR) according to the timing of voiding cystourethrography (VCUG) in infantile urinary tract infection (UTI). Methods : The data of 134 infants (1-12 months) with renal cortical defect in $^{99m}Tc$-2, 3-dimercaptosuccinic acid ($^{99m}Tc$-DMSA) scan with a diagnosis of UTI in two hospitals from 2000 to 2010 were retrospectively analyzed. The VCUG was performed after 2 weeks from the diagnosis of UTI in Group I (n=68), and the VCUG was performed within 2 weeks from the diagnosis of UTI in Group II (n=66). Results : There were no significant differences between the two groups in the duration of fever, white blood cell count, C-reactive protein levels, and abnormalities in ultrasonography (P>0.05). There was no significant difference between the two groups in the prevelence of VUR, bilateral VUR, and severe VUR. VCUG-induced UTI was detected 16 (23.5%) of patients in whom the procedure was performed 2 weeks after the diagnosis, and none of VCUG-induced UTI occurred in those in whom the procedure was performed 2 weeks within the diagnosis. Conclusion : We conclude that the prevalence of VUR according to the timing of VCUG did not differ between the two groups in infantile UTI with renal cortical defect in DMSA scan. We also found that performing VCUG with antibiotics can decrease risk of VCUG-induced UTI.

• Journal of Veterinary Clinics
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• v.26 no.2
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• pp.185-188
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• 2009

A six-month-old Boston terrier presented with an extruded penis caudally, incompletely formed preputial sheath, bifid scrotum, retained testicle and deformity of the os penis. On physical examination, the urethral orifice was located on the surface of the perineum and a fibrous band was observed running from the grans to the urethral orifice on the perineum. The dog also had urethritis that was infected by ascending bacteria entering through the contaminated urethral orifice. Corrective surgery was undertaken to excise the external genitalia and retained testicle. The prepuce, penis and retained testicles were successfully excised. After the urethral orifice was cleaned periodically and antibiotics were administrated, recurrent urethritis disappeared. Using this therapeutic regime it is not necessary to reconstruct the anomaly located urethral orifice, if the location of urethral orifice is not the cause of recurrent urethritis and urinary incontinence.

• Childhood Kidney Diseases
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• v.5 no.1
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• pp.30-35
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• 2001

Purpose : To evaluate tile frequency of urinary tract anomalies in male neonates less than 3 months old who presented with urinary tract infection(UTI) and to evaluate a appropriate imaging approach after first UTI. Materials and methods : During a period of 5 years from March 1994 to February 1999, 65 male infants less than 3months old(range: 4-92 days, mean: 43 days) with UTI were evaluated. Ultrasound(US) and Voiding cystourethrogram(VCUG) were done in 60 patients. Due to refusal and technological problem, 5 patients were missed. 99mTc-dimercaptosuccinic acid renal scan (99mTc-DMSA renal scan) was recommended to most patients but performed in 40 patients. Renal scan was performed at least 3 months later after urinary tract infection. Results : Urinary tract anomalies were found in 26 of 65 infants. Twenty-six had vesicoureteral reflux(VUR), two had both VUR and double ureter, two had both U and posterior urethral valve. In patients with VUR, eight had renal scar or renal atrophies. In case of renal scar or atrophy, grades of VUR were III or above. Conclusion : We suggest that US and VCUG should be routinely performed in infants(<3months)with first UTI. 99mTc-DMSA renal scan should be performed only when renal parenchymal damage was observed in US and VUR grade III or above in VCUG. (J. Korean Soc Pediatr Nephrol 5 : 30- 5, 2001)

• Journal of Nutrition and Health
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• v.10 no.4
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• pp.68-83
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• 1977

영양실태조사 및 사람을 대상으로 하는 많은 영양적 연구에서 요중(尿中) 여러 성분(成分)들의 배설량을 측정하기 위해 만 하루의 소변을 완전히 채취하기는 매우 어려우므로 임의시간(任意時間)의 소변을 채취하여 사용한다. 이 경우엔 흔히 요성분(尿成分)의 농도는 요중(尿中) 크레아티닌을 양(量)을 기준으로 하여 표시되는데, 크레아티닌은 요중(尿中) 일일(一日) 배설량이 개인에 따라 알정하고 요양(尿量)에는 상관없이 비교적 일정한 속도로 배설 된다고 간주되기 때문이다. 그러나 비교적 높은 발생율을 갖는 세균재(細菌在) 요도염(尿道炎)에서는 감염균(感染菌)이 크레아티닌을 파괴할 가능성이 있고 따라서 이 경우의 요중(尿中) 크레아티닌의 여러 용도(用途)는 비합리적으로 될 수 있다. 본 연구에서는 이 가설을 규명하려고 한다. 첫 실험에서는 감염균(感染菌)이 요소(尿素)를 암모니아로 파괴함으로써 형성되는 요(尿)의 알칼리성에 대한 크레아티닌의 안정성(安定性)을 알아 보았다. 건강인(健康人)의 요중(尿中) 크레아티닌과 완충액에 용해시킨 순수 크레아티닌을 pH $4.5{\sim}9.0$으로 조정하여 $37^{\circ}C$에서 6일간 배양시켰다. 잔존한 크레아티닌을 측량한 결과, 크레아티닌은 완충용액이나 요(尿)에서서 모두 산성 pH에서 보다 알칼리 pH에서 더욱 안정(安定)함을 보여주었다. 1일간 배양 후엔 거의 변화(變化)가 없었고 6일 후에나 $4.2{\sim}8.0%$의 감소율을 나타냈을 뿐이다. 두번째 실험에서는 감염균이 크레아티닌을 성장(成長)을 위한 질소급원으로 사용하는지를 결정하기 위해 세균성(細菌性) 요도염(尿道炎)에서 자주 발견되는 13종류(種類)의 박테리아를 건강인(健康人)의 요(尿)와 크레아티닌을 질소급원으로 하는 합성배지(合成培地)에 $37^{\circ}C$로 배양하였다. 대부분의 박테리아는 크레아티닌함양(含量)을 감소시키지 않았다. 그러나 Pseudomonas aeruginosa와 Klebsiella pneumoniae는 합성배지중(合成培地中)의 크레아티닌을 상당량 파괴시켰고, 그 파괴율은 그들 성장율과 평행하였다. 배양 6일후에는 크레아티닌이 Pseudomonas aeruginosa에 의해 처음 양(量)(500mg/100m1) 의 12.8%가, Kleobsiella pneumoniae에 의해서는 11.8%가 감소되었다. 감소율은 크레아티닌의 처음 농도가 낮을수록 커져서 50mg/100ml 일 때는 각각 21.1%와 28.2%이었다. 더욱이 Klebsiella pneumoniae는 황산암모늄과 요소(尿素)같은 다른 질소급원이 크레아티닌과 공존(共存)할 때에도 크레아티닌을 어느 정도 파괴함을 보여 주었다. 결론으로, 세균성(細菌性) 요도염(尿道炎)환자의 요(尿)의 알칼리성은 요중(尿中) 크레아티닌양(量)에 중요한 영항을 주지 못한다. 그러나 본(本) 연구(硏究)에서 사용된 Klebsiella pneumoniae와 가능하게는 Pseudomonas aeruginosa 같은 몇 감염균(感染菌)은 크레아티닌을 그들 성장(成長)의 질소급원으로 사용하여 요중(尿中) 크레아티닌양(量)을 저하시킬지도 모른다. 특히 요(尿)에 요소(尿素), 요산(尿酸)같은 다른 질소급원이 크레아티닌에 비해 비교적 낮은 비율로 존재할 때에, 예(例)를 들면 저(低)단백식사(食事)인 경우, 감염균에 의한 크레아티닌의 파괴율이 더 클 것으로 기대된다.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.203-211
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• 2007

Purpose : We attempted to compare the independent factors such as age, sex, C-reactive protein(CRP), and white blood cell count(WBC) in children with radiologic studies and assess the necessity of performing voiding cystourethrography(VCUG). Method : 98 children who have been diagnosed their first time febrile urinary tract infection from Janurary 2002 to Januray 2005 were enrolled. In all patient, the duration of fever which occurred before and after treatment was recorded, and CRP, WBC, $^{99m}Tc$-2,3-dimercaptosuccinic acid($^{99m}Tc$-DMSA) renal scans, renal ultrasound and VCUG were analyzed. Results : Of the 98 children diagnosed with urinary tract infection(UTI), 52 were male and 46 were female. 18 had abnormalities in VCUG, 17 had abnormalities in kidney ultrasound, and 20 had partial defects or diffuse uptake decrease in $^{99m}Tc$-DMSA renal scans. There were no significant relationship between incidence of radiologic abnormalities and age. The risk of renal scar was significantly higher in children who had a longer febrile period before treatment than in those with shorter period. Both CRP and WBC were significantly elevated in children with the radiological abnormalities. A positive of $^{99m}Tc$-DMSA renal scans and renal ultrasound were highly associated with vesicoureteral reflux(VUR). Conclusion : If there are abnormalities in the kidney ultrasound and $^{99m}Tc$-DMSA renal scan of a child with initial UTI, a VCUG is recommended. Even in cases without abnormal findings in $^{99m}Tc$-DMSA renal scan and renal ultrasound, clinical data such as CRP and WBC should be assessed, and VCUG should be Performed for the undetected VUR.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.453-456
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• 2010

A one-month-old, 0.9 kg BW, male Korean Sapsal dog with anorexia, anuria, ataxia and depression was referred. On physical examination, the dog was showed tachycardia, hypothermia and pale mucous membrane. Hematologic values showed leukocytosis and mild anemia. Serum chemistry profile results revealed increased BUN (57.3 mg/dl) and $NH_3$ ($584\;{\mu}g/dl$), decreased albumin, sodium and potassium. Urinalysis showed hematuria, proteinuria, glucosuria, bacteriuria (Staphylococcus spp.) and magnesium ammonium phosphate crystalluria. On radiographic finding, urinary bladder was enlarged and 2 mm diameter radiopaque urolith was showed between os penis and prescrotal region. Urolithiasis was surgically corrected by urethrostomy.

• Childhood Kidney Diseases
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• v.7 no.1
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• pp.106-111
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• 2003

We experienced a 4-month-old boy presenting with fever and painful scrotal swelling. Diagnostic work-up showed the presence of urinary tract infection and concurrent acute epididymitis. On the voiding cystourethrography, vesicoureteral reflux and urinary reflux through the ejaculatory duct and the seminal vesicle were detected without obvious urethral obstruction. In general, urinary reflux into the seminal vesicle can take place with obstructive lesions of the urethra and may cause epididymitis in infants. We report a case of urinary reflux without urethral obstruction with a brief review of related literatures.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.220-228
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• 2007

Purpose : We studied the value of clinical signs, laboratory findings and $^{99m}technetium$ dime-rcaptosuccinic acid(DMSA) scan in predicting the presence of vesicoureteral reflux(VUR) in children with first febrile urinary tract infection(UTI). Methods : A retrospective analysis of 84 hospitalized children with first febrile UTI was performed. They underwent DMSA scan and voiding cystourethrography(VCUG) during the acute phase, and were divided into three groups according to the results of the VCUG: absence of VUR, mild(grade I-II) and severe VUR(grade III-V). We studied the relation of VUR to age, gender, fever duration, causative organism, white blood cell count, serum C-reactive protein and result of DMSA scan. Results : Among 84 patients, 6 had mild and 17 had severe VUR. Thirty-eight had abnormal DMSA scan. results Patients with VUR were older than those without VUR(P<0.01). There was a lower probability of infection with Escherichia coli in patients with severe VUR than in those with mild and absent VUR(P<0.01). An abnormal DMSA scan correlated with the presence and severity of VUR(P<0.05). Severe VUR was present in 10.9% of patients with normal DMSA scan. The sensitivity, specificity, positive and negative predictive values of the DMSA scan in predicting the presence of VUR were 69.6%, 63.9%, 42.1%, and 84.8%, respectively. Conclusion : An abnormal DMSA scan correlated to the presence and severity of VUR, but the sensitivity, specificity and positive predictive value of the DMSA scan were low. There-fore, patient with an abnormal DMSA scan requires a VCUG. In order to prevent missing the 10.9% of patients with severe VUR but normal DMSA scans, a VCUG should be performed in patient with normal DMSA scan.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.2
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• pp.131-137
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• 1995

Improving validity and reliability is the important components of clinical laboratory tests. And the quality control of the test should be started with the accurate collection of specimen. Urinalysis is one of the useful and common tests in diseases diagnosis and determining the process of medical treatment. Since urinalysis is requested routinely in hospital setting, the importance of the quality control for urine specimen is often ignored. To improve the validity of urinalysis, a clinical trial was done on the method of collecting urine specimen. The result was as follows : 1. The rate of presumtive UTI(urinary tract infection) was decreased in 21.6% with experiment method for collecting urine specimen. 2. The rate of presumtive UTI in female patients was decreased in 43.2% with the experiment method. 3. The rate of negative urine culture was decreased in 6.6% with the experiment method.

• Polymer(Korea)
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• v.30 no.3
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• pp.247-252
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• 2006

The long-term use of indwelling urinary catheters can allow bacterial adhesion to their surfaces, followed by the catheter-associated urinary tract infection. In an attempt to minimize the bacterial adhesion, various amphiphilic polyurethanes (APUs) were synthesized as potential coating materials for urinary catheters. By varying composition of the soft segments such as PEO, PTMO, and PDMS, four different polyurethanes were synthesized. All the APU-coated urinary catheters had the smooth surfaces and showed higher hydrophilicity, compared to the commercial silicone catheters. In particular, the use of APUs with the higher PEG content significantly augmented hydrophilicity and remarkably reduced the total amount of bacteria adhering to the surface. Overall, the APUs prepared in this study provided the promising potential as coating materials for urinary catheters.