• Clinical and Experimental Pediatrics
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• 제63권12호
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• pp.491-498
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• 2020

Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.

• Clinical and Experimental Pediatrics
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• 제57권1호
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• pp.41-45
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• 2014

Purpose: Renal size is an important indicator to determine adequate organ growth in children. The aim of this study was to estimate renal size with Technesium-99m dimercaptosuccinic acid (DMSA) scan and propose a simple formula for predicting renal length in normal Korean children. Methods: This study included 346 children (148 boys and 198 girls; age range, 1 month to 17 years) in whom renal length was measured using the DMSA scan. Patients with anatomical renal abnormalities or acute pyelonephritis were excluded. Children were divided into two groups: 214 children (61.8%) were less than a year old (group 1) and 132 (38.2%) were ${\geq}1$ year (group 2). Results: Renal length was larger on the left side than the right side, and there was no significant gender-related difference in renal length. We propose the following formula for renal length based on the analysis of the 346 children in our study: the formula was as follows: $4.682{\times}age(month)^{0.137}$, $R^2=0.780$. In group 1, the formula was renal length $(cm)=0.127{\times}age(month)+5.144$, $R^2=0.354$, and in group 2, the formula was $0.334{\times}age(year)+6.477$, $R^2=0.829$. Conclusion: It is difficult to establish simple formulae in infants ($R^2=0.354$). Therefore, further studies including relevant variables are needed for this age group. We proposed formulae to estimate renal length in Korean children over 1 year of age by using the DMSA scan.

• 핵의학기술
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• 제25권1호
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• pp.15-20
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• 2021

핵의학 영상 검사 중에서 ^99mTc-DMSA Renal scan은 비침습적이면서도 신장의 기능과 형태를 동시에 평가할 수 있으며 좌우 양측 신장에 섭취를 분석함으로써 신기능을 정량적이면서 정확하게 분석할 수 있다. 신장의 크기 및 길이 평가도 신장 이상의 주요 평가 항목이며, ^99mTc-DMSA Renal scan을 이용한 신장 길이의 측정은 호흡에 의한 흔들림이나 해상력의 한계로 인해서 CT 보다 신장의 길이가 과대 또는 과소평가 될 수 있다. 본 연구는 해부학적인 평가가 우수한 CT 검사와 기능적인 평가가 우수한 ^99mTc-DMSA Renal scan에서 측정한 신장 길이의 차이 및 상관관계를 분석하고, ^99mTc-DMSA Renal scan에서 측정한 신장 길이의 정확성을 예측하는데 그 목적이 있었다. 신장 CT 검사와 ^99mTc-DMSA Renal scan을 검사한 200명의 환자 자료를 대상으로 연구 분석하였고, 통계 분석을 위해 SPSS Ver. 17.0 프로그램을 사용하였다. 호흡에 의한 영향과 해상력의 차이에 의해서 CT 검사 보다 ^99mTc-DMSA Renal scan에서 측정한 신장의 길이가 더 큰 것으로 분석되었다. 그러나 감마카메라와 연령에 따른 신장 길의 차이는 없었으나 신장 길이를 분석한 방사선사 별로는 차이가 있었다. 따라서 신장 길이 측정에서 방법의 표준화를 통한 정량 분석 결과의 일반화는 매우 중요할 것이며, 이는 ^99mTc-DMSA Renal scan에서 츠정한 신장 길이의 정확성을 향상할 수 있을 것이다. 또한 CT 영상과 ^99mTc-DMSA Renal scan에서 측정한 신장길이는 좌우측 신장 모두 매우 강한 양(+)의 상관관계가 있었다. 다수의 신장 질환에서 신기능 변화뿐만 아니라 길이나 크기가 변화하는 경우가 많으며 신장 길이를 정확하게 측정하는 방법과 표준화는 임상적인 진단에 매우 중요할 것으로 판단된다. 특히 소아의 경우에서는 다량의 방사선 피폭이 있는 CT 검사보다 ^99mTc-DMSA Renal scan을 이용하여 형태학적인 평가와 기능적인 평가를 모두 시행하는 경우 많으므로 ^99mTc-DMSA Renal scan에서 신장에 대한 기능적인 정보뿐만 아니라 크기나 길이, 위치 등과 같은 해부학적 정보를 정확하게 제공하는 것은 더욱 중요할 것으로 판단된다.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.131-135
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• 2015

Purpose: The aim of this study was to establish a simple formula to predict renal length in children using a Technesium-99m dimercaptosuccinic acid (DMSA) scan data, and to compare it with the formula derived from ultrasonography, which is widely accepted. Methods: Children who underwent a DMSA scan and ultrasonography were reviewed retrospectively, and those who had anatomical urinary tract abnormalities or urinary tract infections were excluded. Results: A total of 230 children (84 males and 146 females; age, 1 month to 16 years; mean age, $16.8{\pm}27.4$ months). Mean renal length measured by DMSA scan was longer than that by ultrasonography ($6.38{\pm}1.16$ vs. $6.02{\pm}1.14cm$; P < 0.001). Renal length was correlated with age, weight, height, and body surface area on the DMSA scan and ultrasonography, and showed the strongest positive correlation with height. The following formulae were established to predict renal length: mean renal length (cm) = 5.433 ${\times}$ height (m) + 2.330 (R2, 0.833) using the DMSA scan data, and mean renal length (cm) = 5.367 ${\times}$ height (m) + 2.027 (R2, 0.853) using ultrasonography data. Conclusion: We propose a simple height-based formula to predict renal length in children using a DMSA scan data, and validate it by comparing with ultrasonography formula.

• 한국임상수의학회지
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• 제23권4권
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• pp.437-441
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• 2006

Renal length, width, and ratio to the length of the second lumbar vertebrae body were assessed on survey radiographs and excretory urograms in 50 Korean domestic cats. Renal dimensions on plain radiographs were: right kidney length $4.31{\pm}0.50cm\;(mean{\pm}SD)$, right kidney width $3.10{\pm}0.36cm$, left kidney length $4.17{\pm}0.48cm$, left kidney width $3.03{\pm}0.34cm$, right kidney length ratio $2.37{\pm}0.21$, right kidney width ratio $1.71{\pm}0.15$, left kidney length ratio $2.30{\pm}0.20$, and left kidney width ratio $1.38{\pm}0.08$, respectively. Renal dimensions on excretory urograms were: right kidney length $4.56{\pm}0.53cm$, right kidney width $3.29{\pm}0.37cm$, left kidney length $4.43{\pm}0.47cm$, left kidney width $3.22{\pm}0.33cm$, right kidney length ratio $2.51{\pm}0.22$, right kidney width ratio $1.81{\pm}0.17$, left kidney length ratio $2.45{\pm}0.20$, and left kidney width ratio $1.78{\pm}0.16$, respectively. There were significant difference in renal size and renal dimension ratio measured from contrast studies compared with survey radiographs (P<0.05). There were also significant difference in renal size and renal length ratio between right and left kidneys (p<0.05).

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.54-57
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• 2012

Purpose: Somatic growth is an important indicator of health in children. Adequate organ growth is essential in growth and directly related to body growth. We consider renal length as a surrogate of organ growth in growing children. Measurement of weight, height, and many anthropometric indices, such as body surface area (BSA), body mass index (BMI), and Rohrer and Kaup indices, are used to evaluate growth status. The aim of this study was to evaluate the association between renal length and somatic parameters and analyze the affecting factors for renal size during growth. Methods: The data for renal length in 66 children (age, $12.9{\pm}15.6$ months; male/female, 34/32) were obtained. Each kidney was measured with ultrasonography and dimercaptosuccinic acid scan. The data on age, sex, height, and weight were obtained from the medical records. BSA, BMI, and Rohrer and Kaup indices were calculated from measured height and weight. BSA was calculated by 2 methods, and is expressed as BSA I and BSA II. Results: There were significant correlations between renal size and age, weight, height, BSA I, BSA II, and Rohrer index. In the regression analysis, the most significant contributing factor to renal growth was height ($R^2$=0.636, $P$ <0.001). Conclusion: Height seems to be the most important factor associated with organ growth in growing children. Further studies to evaluate adequate organ growth should be carried out.

• 대한수의학회지
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• 제36권4호
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• pp.991-995
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• 1996

토끼에서 신장의 크기(길이, 폭 및 높이)를 측정하고 이에 대한 기본자료로 삼고자 53마리의 토끼(Newzealand White)의 신장을 방사선 촬영과 초음파 신장촬영 그리고 신장을 적출하여 실제 길이를 재고 이들간의 측정치를 비교하였다. 방사선 촬영에서는 우측신장은 T13-L2에서 관찰되었고 좌측신장은 L2-L4에서 관찰되었다. 초음파 신장촬영상에서는 신장 피질은 작고 균등하며 주변조직에 비하여 저에코상을 보였고 신장의 신우는 무에코 내지는 약간의 저에코상을 보였다. 토끼의 좌측신장에서 길이, 폭 및 높이는 각각 $35.84{\pm}3.12(mean{\pm}SD)$, $23.52{\pm}3.21$ 및 $15.11{\pm}2.58cm$ 였으며 우측신장에서는 $36.02{\pm}3.42$, $23.69{\pm}3.50$ 및 $14.13{\pm}3.55cm$ 이었다. 방사선 사진상에서 양쪽 신장의 길이와 폭은 실제 크기에 비하여 약간 확대되었으며(102~104%), 초음파신장 촬영상에서 양쪽 신장의 길이, 폭 및 높이는 실제 크기에 비하여 적게 축소된 상을 보였다(70~96%). 복배상 방사선 사진에서 신장의 길이와 폭의 제2요추 길이의 대비에서 1.85와 1.25배로 나타났다. 체중과 신장의 각 측정치와의 상관관계에서는 서로간에 유의치 있는 상관관계가 있었다.

• Journal of Chest Surgery
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• 제27권2호
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• pp.122-127
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• 1994

A retrospective study of 737 consecutive patients surviving the first 24 hours who underwent valve replacement surgery from July 1980 to June 1993 was undertaken to determine the prevalence, variables that could be used to predict outcome and results of therapy for postoperative acute renal failure[ARF]. Twenty-one patients[2.8 %] developed acute renal failure. Positive risk factors noted in the development of postoperative renal failure included age, New York Heart Association class III & IV, endocarditis and elevated preoperative concentration of serum creatinine. The duration of cardiopulmonary bypass, aortic cross-clamping and the total duration of the operation also closely correlated with the incidence of ARF. The mortality rate for established ARF was 38.1% and ARF was associated with a significant increase in the length of hospitalization, ventilator support and intensive care unit stay. The incidence and mortality rate of oliguric renal failure was 38.1% and 85.7%. The highest mortality rate was associated with two or more postoperative complications and serum creatinine value exceeded 5 mg/dl. We concluded that therapy should be aimed at prevention of oliguric renal failure, or at least its conversion to nonoliguric renal failure, and early institution of renal replacement therapy with intensive support probably gives the best chance for survival.

• 대한수의학회지
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• 제42권3호
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• pp.321-326
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• 2002

The effect of nitric oxide synthase(NOS) inhibita, $N^G$-nitro-L-arginine-methyl ester(L-NAME) and prostanoid synthesis inhibiter, indomethacin on the photorelaxation, when was exposed to the long-wave length UV-light, was examined on the precontraction by the phenylephrine in the isolated pig renal artery. 1. UV-light relaxed both with-endothelium and without-endothelium in the pig renal arterial ring contracted by the phenylephrine. The magnitude of photorelaxation was dependent on the exposure time for UV-light. 2. UV-Iight induced relaxation was inhibited by L-NAME and indomethacin on the precontraction by the phenylephrine in the isolated pig renal artery. 3. UV-Iight induced relaxation was inhibited by methylene blue on the precontraction by the phenylephrine in the isolated pig renal artery. These results suggest that UV-light induced photorelaxation may be due to cGMP involved both nitric oxide and prostanoid on the precontraction by the phenylephrine in the isolated pig renal artery.

• Journal of Korean Neurosurgical Society
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• 제48권3호
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• pp.263-267
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• 2010

Although cerebellar hemangioblastomas are histopathologically benign, they yield a degree of malignant clinical behavior in long-term follow-up. We present two cases of long-term progression of renal cell carcinoma, which had been diagnosed as renal cysts during treatment for cerebellar hemangioblastoma. A 14-year-old male with von Hippel-Lindau disease was admitted for a cerebellar hemangioblastoma with multiple spinal hemangioblastomas and a renal cyst. After primary total resection of the cerebellar hemangioblastoma, the patient required two further surgeries after 111 and 209 months for a recurrent cerebellar hemangioblastoma. Furthermore, he underwent radical nephrectomy as his renal cyst had progressed to renal cell carcinoma 209 months after initial diagnosis. A 26-year-old male presented with multiple cerebellar hemangioblastomas associated with von Hippel-Lindau disease and accompanied by multiple spinal hemangioblastomas and multiple cystic lesions in the liver, kidney, and pancreas. He underwent primary resect'lon of the cerebellar hemangioblastoma in association with craniospinal radiation for multiple intracranial/spinal masses. Unexpectedly, a malignant glioma developed 83 months after discovery of the cerebellar hemangioblastoma. At the same time, renal cell carcinoma, which had developed from an initial renal cyst, was diagnosed, and a radical nephrectomy was performed. In the view of long term clinical course, cerebellar hemangioblastoma associated with von Hipple-Lindau disease may redevelop even after primary total resection. In addition, associated lesions such as renal cysts may also progress to malignancy after the passing of a sufficient length of time.