• Biomedical Science Letters
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• v.19 no.3
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• pp.275-279
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• 2013

Etiological agents of extended spectrum ${\beta}$-lactamase (ESBL) producing uropathogenic Escherichia coli (UPEC) have become a major problem in urinary tract infections. The purpose of this study was to compare the molecular characteristics of ESBL producing UPEC strains isolated from 1989 and 2010. A total of 301 strains of UPEC clinical isolates was collected from Korean healthcare facility in 1989 (126 strains) and in 2010 (175 strains). UPEC clinical isolates were analyzed by multiplex polymerase chain reaction method (ESBL related bla genes and phylogenetic groups) and amplified fragment length polymorphism (AFLP). Among 301 isolates, ESBL producing UPEC were 8 strains (6.3%) in 1989 isolates and 35 strains (20%) in 2010 isolates. The rate of bla genes in ESBL producing UPEC from 1989 isolates and 2010 isolates were $bla_{TEM}$ (75% and 85.7%), $bla_{CTX-M}$ (0% and 91.4%), $bla_{OXA}$ (25% and 20%), $bla_{PER}$ (0% and 2.9%). The distribution of phylogenetic groups in 1989 isolates and 2010 isolates were A (37.5% and 11.4%), B2 (12.5% and 51.4%), and D (50% and 37.1%). The most prevalent ESBL related bla gene and phylogenetic group were $bla_{CTX-M}$ (91.4%) and B2 (51.4%) in 2010 isolates, while $bla_{CTX-M}$ was not detected in 1989 isolates. Among 43 ESBL producing UPEC were grouped into 12 clusters up to 76% of genetic similarities by AFLP analysis. During past twenty one years, the rate of the ESBL producing UPEC strains in 2010 isolates was increased than that of in 1989 isolates. Also, the most prevalent ESBL related bla gene has been changed from $bla_{TEM}$ to $bla_{CTX-M}$.

• Journal of the Korean Society of Radiology
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• v.8 no.7
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• pp.461-466
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• 2014

The advantages and disadvantages of the various models of crushed ESWL (Extracorporeal Shock Wave Lithotripsy) and their various side effects due to pre-treatment have been reported. We look for the appropriate intensity of the shock wave in the electromagnetic ESWL treatment of patients with lower Inferior Ureter Stones and measure the total running time of C-arm saw. This study is based on the January-June 2014 launch of 65 patients of C university hospital located in Gyeongbuk, who conducted ESWL without pre-treatment. Patients are composed of 48 male and 17 female which were more common in men, while the most common age is 50s. The occurrence of lower urinary tract stones were left and they were more absent than 5mm in size in 39 of the most common. Optimal intensity is one of the suitable intensity of pain, and it is possible to switch the strength of impact to C if one appeals pain. In addition, the C-arm of the total operating time showed $241.73{\pm}30.37$ seconds, which is the size of the lower urinary tract that showed a significant difference (p <0.05). Therefore, ESWL treatment without pre-enforce treatment, the standard for the impact frequency and impact strength depending on the site of ureteral stones is required. The standard for total operating time of C-arm generated for ureteral stones is needed in order to reduce radiation exposure, and the standard for the total operating time for the criteria is needed depending on the site in order to minimize the exposure.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.115-120
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• 1984

To find clinical significance of routine "dipstick" urinalysis on admission, we analyzed the results of the "dipstick" urinalyses performed in 844 patients admitted to the pediatric department of Yeungnam University hospital from May 1, 1983 to October 31, 1984. Ketonuria, proteinuria, hematuria and glucosuria were found in 9.5%, 4.9%, 2.4% and 1.1% of the patients respectively. There were no significant differences by sex, age and presence of fever. However, proteinuria and ketonuria were found more frequently in the patients with dehydration (p<0.05). The degree of ketonuria showed a positive association w:th the severity of dehydration (p<0.005). All of the patients with proteinuria and ketonuria showed negative results on follow up. However, among 13 patients with hematura, 9 patients showed negative results and 4 patients had persistent hematuria on follow up. These 4 patients were found to have chronic pyelonephritis (2), asymptomatic urinary tract infection (1) and benign recurrent hematuria (1). This routine "dipstick" urinalysis on admission seems to be simple test which is useful in detecting unrecognized kidney and other urinary tract disease.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.169-177
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• 1998

Purpose : Renal duplication is a common occurrence, and the range of ureteral and renal anomalies draining the two poles of the duplex kidney leads to a variety of clinical presentations. Method : A series of 61 children with duplicated systems was studied retrospectively who were admitted during last 12years. Results : Of the children $60.6\%$ were accompanied with urologic anomalies that required surgical treatment, and most children initially were presented with urinary tract infection. $42.6\%$ of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : From our point view, children with history of abnormal antenatal renal sonogram, or with symptoms such as urinary tract infection, hematuria, abdominal pain should be evaluated radiologially fully to confirm further abnormality and accompanied complications. And routine follow-up using abdominal ultrasonogram, VCUG, and urine culture should be used to prevent and detect early treatable complications.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1540-1545
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• 2002

Purpose : Vesicoureteral reflux(VUR) is defined as a retrograde flow of urine from the bladder into the upper urinary tract. It has been shown to predispose patients to hypertension, renal scarring, and end-stage renal failure if not recognized and treated. The observation that VUR occurs in siblings of children with reflux at a significantly higher rate than the general pediatric population has been recognized for many years and VUR was detected in 26% to 51% of siblings of patients with VUR. The purpose of this study is to determine the incidence of VUR in asymptomatic siblings of children with VUR and to see if this form of screening would be practical. Methods : We retrospectively reviewed the records of 28 patients with VUR and their siblings. The total number of asymptomatic siblings investigating VUR were 28 persons. All patients and siblings were evaluated for VUR by a voiding cystourethrography and all patients and siblings with VUR were performed $^{99m}Tc$ 2,3-dimercaptosuccinic acid renal scan. Results : A total of 28 patients(14 boys, 14 girls) with VUR were studied; the mean patient age was 2.7 years(range 1 month to 8.4 years). The total number of asymptomatic siblings investigating VUR were 28 persons(17 boys, 11 girls) and the mean age was 3.3 years(range 2 months to 7.4 years). Renal scar was detected in 20 of 28(71.4%) patients with VUR. VUR was noted in three of 28(10.7%) siblings and renal scar was detected in one of three siblings with VUR. Conclusion : In this study, the predictive value of a positive family history alone in identifying VUR was 10.7%. This incidence suggests more investigation of asymptomatic siblings and continued study of this group of patients at risk is needed for clarifying the family screening of patients with VUR.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.57-64
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• 1999

Purpose: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children with dilated upper urinary tract. Materials and Methods: We reviewed diuretic renal scans of 14 pediatric patients (age range: 3 days to 4 years) with unilateral hydronephrosis diagnosed by ultrasonography. Diuretic renal scan was done using Tc-99m DTPA and standardized protocol. In 3 neonates, diuretic renal scans were performed within 1 week and 3-7 months after birth. Results: Six patients required Pyeloplasty and eight were managed conservatively. All 6 patients requiring Pyeloplasty were diagnosed as having ureteropelvic junction obstruction in the diuretic renal scan. In these 6 patients, post-operative renal scans at 3-12 months after surgery were converted to nonobstructive pattern in 5 and a nonfunctioning pattern in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth, nonobstructive patterns of initial scan were converted to obstructive patterns in the follow-up scan. However, all patients with nonobstructive diuretic renal scans performed after the neonatal period did well on serial ultrasonography and showed favorable clinical outcome without progression to obstruction. Conclusion: Tc-99m DTPA diuretic renal scan with standardized protocol is useful in assessing suspected ureteropelvic junction obstruction in children as an initial diagnostic or post-operative follow-up modality. Nonobstructive or indeterminate scan results in the neonatal period requires follow-up scan to monitor development of the obstructive pattern.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.141-145
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• 2017

Purpose: Clinical and laboratory features of two Kawasaki disease (KD) groups were evaluated; the patient with pyuria and those without pyuria. Methods: From January 2015 to December 2016, the medical records of 140 (86 males and 54 females) inpatients with KD were retro-spectively analyzed. Results: Forty-eight KD patients (34.3%) presented with pyuria. KD patients with pyuria showed a higher level of C-reactive protein (CRP) and a higher proportion of elevated liver enzymes than those without pyuria. There were no differences in the proportions of unresponsiveness to intravenous immunoglobulin and coronary artery lesions between the two groups. Six KD patients (12.5%) with pyuria underwent a renal imaging study to rule out the possibility of a urinary tract infections. Thirty-two KD patients (66.7%) with pyuria received treatment with antibiotics in addition to the standard treatment for KD. Conclusions: KD patients with pyuria showed a higher level of CRP and elevated levels of liver enzymes than those without pyuria. These findings suggest that KD patients with pyuria have more severe systemic inflammation than those without pyuria.

• 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.

• Korean Journal of Veterinary Research
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• v.39 no.1
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• pp.230-239
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• 1999

Digital color doppler ultrasonographic system(DCDUS) has a lot of diagnostic functions. One of these is a detection of low velocity vessels in the organs of abdominal cavity. The purpose of study was to determine the clinical usefulness of DCDUS. Interlobar artery resistive index(RI), pulsatility index(PI) and systolic diastolic ratio(SDr) were measured for diagnosis of obstructed urinary tract. RI, PI and SDr were a measure of intrarenal blood flow impedance. This study was consisted of 2 groups. The normal group was studied in 16 normal adult dogs and the study group was studied 7 dogs with surgically induced, unilateral ureteral obstruction. In the study group, parameters were checked in normal condition and on 1, 2, 3, 5, 7 and 10th day after ligation. The result were summarized as follows. In the normal group, RI, PI and SDr of the left kidney was $0.65{\pm}0.04$, $1.25{\pm}0.12$ and $292.45{\pm}29.40$, respectively. RI, PI and SDr of the right kidney were $0.64{\pm}0.05$, $1.28{\pm}0.20$ and $282.25{\pm}37.26$, respectively. In the study group, RI of the left kidney induced ligation was increased significantly on 1, 2, 3, 5, 7 and 10th day. RI of the left kidney on 1, 2, 3, 5, 7 and 10th day were $0.75{\pm}0.05$, $0.71{\pm}0.03$, $0.74{\pm}0.04$, $0.74{\pm}0.02$, $0.73{\pm}0.02$ and $0.73{\pm}0.04$, respectively. PI of the left kidney was increased significantly on 1, 3, 5 and 7th day. PI of the left kidney on 1, 3, 5 and 7th day were $1.57{\pm}0.21$, $1.54{\pm}0.24$, $1.60{\pm}0.15$ and $1.60{\pm}0.26$, respectively. SDr of the left kidney increased significantly on 1, 2, 3, 5 and 7th day. SDr of the left kidney on 1, 2, 3, 5 and 7th day were $412.18{\pm}86.69$, $352.14{\pm}47.05$, $399.77{\pm}65.54$, $369.43{\pm}48.34$ and $365.57{\pm}22.46$, respectively(p<0.05). In the study group, RI of the left kidney was more increased than that of the right kidney on 1, 2, 3, 5, 7 and 10th day. PI of the left kidney was more increased than that of the right kidney on 1, 3, 5, and 7th day. SDr of the left kidney was more increased than that of the right kidney on 1, 2, 3, 5 and 7th day(p<0.05). RI was effective in the diagnosis of an acute unilateral ureteral obstruction. PI and SDr were insufficient in the diagnosis of an acute unilateral ureteral obstruction.

• The Korean Journal of Nuclear Medicine
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• v.9 no.1
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• pp.51-58
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• 1975

It is a great value to find an early detection of involvement of ureteric obstruction in the carcinoma of cervix. Little or no knowledge of the condition of the kidneys or the lower urinary tract are able to elucidate by the biochemical studies such as blood nitrogen or urine creatinine in carcinoma of cervix. Findings of urography delineates the condition of urinary tract stasis in the renal pelvis and ureters, however, slight stasis maybe difficult to demonstrate. On the other hand isotope nephrography is accepted as a sensitive method to observe renal function especially in regarding to the excretory function of kidney. It was attempted to analysis the findings of urography conjunction with isotope nephrography in 50 cases of unselected patients with invasive carcinoma of cervix through pre and post irradiation follow up studies. Urography was done as a routine procedure and.analysed emphasising changes of collecting systems and ureter condition. Isotope nephrography was carried out by means of $15{\mu}ci\;I^{131}$-Hippuran injected intravenously and the curves were analysed as follows. Parameter were; time of maximum amplitude ($T_{max}$), half time of maximum amplitude ($T\frac{1}{2}$), Kac and Kex value calculated from these two parameters in Tobe's method. The excretion index by Aurell defines the ratio between the maximum activity and the activity measured on the slope of the third phase ten minites after it has reached its maximum. Results: 1. 28.8% had an abnormal IVP suggestive of ureteric involvement before irradiation therapy and the patient of stage III and IV were the great part. 2. 21.7% had abnormal findings of per-irradiation renogram whom showed normal IVP. The other group showed normal IVP which group also showed normal renogram prior irradiation. 3. The more severe the ureteric involvement, the change of excretion index was greater. 4. Even in stage I and II patient, abnormal renogram was revealed in 12 cases (39.4%) among 31 cases. 5. All cases of TAH showed abnormal findings of IVP and renogram. 6. No. definite change of renogram was obtained just after the irradiation therapy (point $A:8000{\sim}9000rads,\;B:5000{\sim}6000rads,\;Co:11000{\sim}13000rads$). Each 3 month follow up study was performed and comparing with preirradiation study which showed significant changes of excretion index of renogram were 42.8% in $6{\sim}9$ month follow-up and 75% in $9{\sim}12$ month, respectively. 7. It seems to be important to observe the parameter Kex and excretion index of renogram to determine early abnormality of kidney excretory function by means of post-irradiation follow up study.