• 제목/요약/키워드: renal pelvis

검색결과 54건 처리시간 0.035초

Primary Transitional Cell Carcinoma of the Renal Pelvis in a Dog

  • Park, Ju-yong;Kang, Min-Hee
    • 한국임상수의학회지
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    • 제37권4호
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    • pp.204-207
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    • 2020
  • A 12-year-old dog was evaluated for depression and anorexia. The results of complete blood count and serum biochemistry were normal. Survey radiographs revealed markedly enlarged right kidney and abdominal ultrasound showed a renomegaly and hydronephrosis filled with mixed echogenic fluid. Primary renal tumor was suspected in this dog. Nephroureterectomy of the right kidney was performed, and no regional metastases have been identified. Transitional cell carcinoma (TCC) arising from renal pelvis accompanied hydronephrosis of the right kidney was diagnosed on histology. TCC usually affects trigone of the bladder, and renal origin of TCC is a very rare finding in dogs. This is the first case report to present the clinical features, diagnostic imaging findings and histopathological characteristics of a dog with TCC originating from the renal pelvis in Korea.

수신증을 진단 받은 소아 환자의 DMSA 신장 검사에서 정확한 관심영역 설정에 대한 고찰 (The Consideration of the Region of Interest on $^{99m}Tc$-DMSA Renal Scan in Pediatric Hydronephrosis Patients)

  • 남궁혁;이동혁;오신현;조석원;박훈희;김정열;김재삼;이창호
    • 핵의학기술
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    • 제16권1호
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    • pp.27-33
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    • 2012
  • 수신증 진단을 받은 소아 환자 $^{99m}Tc$-DMSA 신장 검사에서 영상 획득 후 좌-우측 신장의 섭취 비율을 분석하기 위해 관심영역을 설정하는데, 장비의 자동 관심영역 설정 시 수신증으로 확장되어 있는 신우 부위까지 관심영역에 포함되어 정확한 좌-우 신장의 섭취율이라 할 수 없기에 본 연구는 신장 모형과 확장된 신우의 모형을 이용한 실험을 통해 수신증으로 인해 확장된 신우를 포함한 관심영역과 포함하지 않은 관심영역을 비교하여 보다 개선된 관심영역의 설정 방법을 제시 하고자 한다. 또한, 확장된 신우에 섭취된 방사성 의약품이 신장 피질 세포에서의 섭취인지 아니면 요관의 막힘으로 인한 잔류 소변 인지를 알아 보기 위해 판독의의 도움을 받아 알아 보기로 한다. 두 개의 신장 모형에 같은 양의 물을 채우고 $^{99m}TcO_4$ 111 MBq를 각각 넣어 섞었다. 확장된 신우를 표현하기 위해 5개의 고무 풍선에 물 용량을 각각 10 mL로 채운 후 $^{99m}TcO_4$를 각각 18.5, 37, 55.5, 74, 92.5 MBq를 각각 섞어 준비 하였다. 또한, 고무 풍선에 $^{99m}TcO_4$를 37 MBq으로 고정하고 물 용량을 각각 5, 10, 15, 20, 25 mL를 섞어 준비하였다. 좌측 신장은 모양 그대로 유지하고 우측 신장 모형에 이 고무 풍선을 붙여 수신증의 신장과 비슷한 모형을 만든 후 각각 200만 계수를 수집하였다. 수집된 영상을 확장된 신우를 포함한 관심영역과 포함하지 않은 관심영역을 그려서 좌-우 신장의 섭취비율을 비교 하였고, 재현성을 위해 한 영상당 5회씩 관심 영역을 설정하였다. 환자의 경우 $^{99m}Tc$-DMSA를 1.5~1.9 MBq/kg 주사하고, 3~4시간 후에 검사하였고, 숙련된 3명의 방사선사가 각각 1회씩 관심 영역을 설정하여 비교 평가 하였다. 두 자료 간의 통계적 유의성을 알아보기 위해 SPSS (ver. 17) Wilcoxon Signed Ranks Test 사용하였다. 신장 모형 실험 결과로 확장된 신우를 포함하여 관심영역을 설정한 것과 포함하지 않고 관심영역을 설정한 두 집단간에 수집계수, 주변 계수, 섭취율을 비교해 본 결과 수집계수와 섭취율의 변화된 결과를 얻을 수 있었고, 환자 검사 영상에서 또한 섭취율의 변화된 결과를 얻을 수 있었다. 또한, 확장된 신우에 섭취된 방사성 의약품은 확장된 신우에 의해 요관으로 내려가지 못한 잔류 된 소변이라는 것이 확인되었다. 위 결과에서 보여 주듯이 신장의 좌-우측 섭취율 도출 시에 수신증으로 인해 신우가 확장된 신장에서 신우를 포함하여 관심영역을 설정했을 때의 섭취율이 포함하지 않았을 때의 섭취율에 비해 과섭취율을 보여 주고 있다. 검사자의 작업 편의성과 결과의 신속성을 위해 자동 관심영역으로 설정하여 결과를 도출해 내고 있지만, 이러한 수신증 환자의 경우에는 확장된 신우에 방사성의약품이 섭취가 되어있는 것은 잔류된 소변이므로 관심영역 설정 시에 확장된 신우 부분을 제외하고 수동으로 관심영역을 설정해야 정확한 좌-우측 신장의 섭취율을 도출할 수 있을 것이라 사료된다.

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포유동물의 신유두 및 신우상피에 대한 비교형태학적 연구 (Comparative Renal Papillary and Pelvic Epithelial Morphology of the Mammalian Kidney)

  • 김진;오수자;박인선;정진웅
    • Applied Microscopy
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    • 제17권1호
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    • pp.131-160
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    • 1987
  • Anatomical features of the renal papilla and pelvis and ultrastructures of the epithelium covering these areas in four species of mammals were studied by means of light, scanning and transmission electron microscopy. In terms of the morphology of mammalian kidney types distinguished by Sperber(1944), Pfeiffer(1968) and Schmidt-Nielsen(1977), the kidneys of animal species used in this experiment were; 1) the mouse kidney with the fornix between a long conical papilla and the funnel-shaped pelvis, 2) the guinea pig kidney with the peripelvic column and pelvic pouch between a short conical papilla and the funnel-shaped pelvis, 3) the dog kidney with the peripelvic column and pelvic pouch between the crest-shaped papilla and the funnel-shaped pelvis, and 4) the cattle kidney which is divided into multiple renculi with minor and major calyces and pelvis. The renal papilla was lined with the simple or pseudostratified columnar epithelium which covered the inner zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained a few organelles. In the mouse, the fornix was lined with one to two cell-layered cuboidal epithelium which covered the outer zone of the renal medulla and a part of the cortex. The epithelial cells of the fornix with numerous short microvilli or microridges on the surface had well-developed organelles. In the guinea pig, the peripelvic column was lined with the simple cuboidal or low columnar epithelium which covered the outer zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained well-developed organelles. The pelvic pouch was lined with the pseudostratified columnar epithelium which was composed of four kinds of cells; the secretory cell with small electron-dense granules (310 nm), the secretory cell with large granules (720 nm) showing various electron densities, the mitochondria-rich cell with a single cilium, and the basal cell. Pelves of the mouse and guinea pig, peripelvic column, pelvic pouch and pelvis of the dog, and minor and major calyces and pelvis of the cattle were lined with the transitional epithelium. The fusiform vesicles in the superficial cells of the epithelium were highly developed in the dog, relatively well developed in the mouse and guinea pig, and poorly developed in the cattle. From the above findings, it is suggested that the transport of solutes and water of the urine in the pelvic cavity can take place through the epithelia covering the renal papilla and fornix of the mouse, papilla and peripelvic column of the guinea pig, and papillae of the dog and the cattle. And specialized cell types in the epithelium of the guinea pig pelvic pouch, two kinds of secretory cells and mitochondria-rich cell with a single cilium, could have peculiar functions in the renal pelvis, respectively.

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개에서 신 절개를 통한 신 결석 제거 2례 (Nephrotomy for Removal of Renal Calculi in Two Dog)

  • 김혜진;장화석;송영성;김성미;김순신;최치봉;김휘율
    • 한국임상수의학회지
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    • 제21권1호
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    • pp.66-71
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    • 2004
  • 2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

신세포암종의 요세포학적 소견 - 11예의 분석 - (Urine Cytology of Renal Cell Carcinoma - Analysis of 11 cases -)

  • 전이경;조혜제;고일향
    • 대한세포병리학회지
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    • 제5권2호
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    • pp.137-142
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    • 1994
  • Urine cytology is of limited value in the diagnosis of renal cell carcinoma with reported detection rates of $0\sim80%$. The aim of this study is to demonstrate the usefulness of urine cytology in renal cell carcinoma. In the eleven histologically proven cases of renal cell carcinoma, urinary smears were reevaluated. The cytologic results were as follows; positive for malignant cells in 3 cases(27%), suspicious in 2 cases(18%) and negative in 6 cases(55%). The average diameter of the tumor of the 5 cases reported as positive or suspicious for malignant cells was 9.7cm and 3 had invaded the renal pelvis. The other 6 tumors, reported as negative, were 5.7 cm in average diameter and one of them showed involvement of the renal pelvis. These results suggest that urine cytology is considered unsatisfactory in the early defection of renal cell carcinoma. However, careful examination of urinary smear could improve the detection rate especially in more advanced cases involving the renal pelvis as well as those of larger tumors.

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양(羊)의 신우상피에 대한 광학 및 주사전자현미경적 연구 (Light and Scanning Electron Microscopic Study on the Pelvic Epithelium of the Sheep Kidney)

  • 김진;오수자;정진웅
    • Applied Microscopy
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    • 제15권2호
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    • pp.98-110
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    • 1985
  • This study was performed to clarify the morphological structures of the epithelia of the renal papilla, renal pelvis and ureter of the sheep (Ovis aries L.) through the light and scanning electron microscopes, Tissue specimens were taken from the renal papilla (common renal papilla and peripelvic column) and the renal pelvis (pelvis proper and pelvic pouch) of the kidney and the ureter. For the light microscopy, tissue blocks were fixed in 10 % neutral buffered formalin and embedded in paraffin wax, serially sectioned at a thickness of $6{\mu}m$. These sections were stained with hematoxylin-eosin and periodic acid-Schiff reaction. For the scanning electron microscopy, tissue blocks were prefixed in 1% glutaral-dehyde-1.5% paraformaldehyde solution and postfixed in 1% osmium tetroxide solution, dehydrated in graded alcohol, transferred to isoamyl acetate, and then dried by the critical point dryer (Polaron E 3000). These dried tissues were coated with gold and observed with a scanning electron microscope (JSM-35C), The results were as follows: The apex of the common renal papilla was lined with simple columnar epithelium having many microvilli on its luminal surface. Lateral portion of the papilla was lined with stratified epithelium $2{\sim}3$ layers thick, and its superficial cells were microvillar cells having many microvilli. The epithelium lining the peripelvic column was $1{\sim}2$ layers thick. The superficial layer was made of the microvillar cells, but a few microplica cells were appeared in the region near the pelvic pouch. The epithelium of the pelvic pouch was $1{\sim}2$ layered transitional type, and its superficial cells were microplica cells. The epithelia of the pelvis proper and ureter were $4{\sim}6$ layered transitional type, and their superficial cells were typical facet cells existing many round depressions and ridges of cell membranes of the luminal side.

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개의 신우 이행상피암종의 면역조직화학적 진단 (Immunohistochemical Diagnosis of Renal Pelvis Transitional Cell Carcinoma in a Dog)

  • 양형석;강상철;김재훈
    • 한국임상수의학회지
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    • 제30권4호
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    • pp.292-295
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    • 2013
  • 9세령의 수컷 도베르만견이 5개월간 간헐적인 혈뇨, 구토 및 당뇨증상을 보여 동물병원에 내원하였다. 초음파상에서 종대된 좌측 신장의 수질부위에 종괴가 발견되었다. 육안적으로 좌측 신장의 피질 및 수질부는 현저하게 위축되어 있었으며 신우 부위는 종괴로 인하여 확장된 수신증을 나타내었다. 크기 4~5.5 cm의 유두상으로 돌출된 꽃자루와 같은 단일종괴가 신우 부위에 있으며, 요관으로 뻗어 있었다. 병리조직학적으로 종괴는 나뭇가지 모양으로 무수히 돌출된 유두상의 돌기들로 구성되어 있었다. 이 돌기들은 섬유혈관성 중심부와 뚜렷한 이형태성을 가지는 여러 층의 종양화된 이행상피들로 피복되어 있었다. 면역조직화학염색을 실시한 결과 종양세포들은 사이토케라틴(cytokeratin: CK) 7, 19, CK clone MNF116 및 CK HMW에 대해서 양성을 보였으나 CK 8 LMW에서는 음성 반응을 나타내었다. 육안적인 특징, 병리조직학적 소견 및 면역조직화학염색에 의한 사이토케라틴의 반응성을 토대로 이 종괴는 개의 신우에서 발생한 이행상피암종으로 진단되었다.

Hydronephrosis during Conservative Treatment for a Renal Injury Patient

  • Kim, Maru;Kim, Joongsuck;Kim, Sung Jeep;Cho, Hang Joo
    • Journal of Trauma and Injury
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    • 제30권2호
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    • pp.47-50
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    • 2017
  • A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.

집박쥐 신유두(腎乳頭) 및 신우상피(腎盂上皮)에 미세구조(微細構造) (The Papillar and Pelvic Epithelia of the Bat: A Scanning and Transmission Electron Microscopic Study)

  • 김진;오수자;정진웅
    • Applied Microscopy
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    • 제16권2호
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    • pp.61-74
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    • 1986
  • The anatomy of the renal papilla and pelvis of the bat(Pipistrellus abramus abramus Temminck) and their ultrastructure of the epithelium has been studied by means of light, scanning and transmission electron microscopy. The bats were captured at Ondal cave located in Yangchun-Myun, Tanyang-Kun, Chungchongpuk-Do, Korea in the active(July) and hibernating(January) phases. A conical renal papilla with several papillary foramina at the apex was curved toward the ureter. At the margin of the funnel-shaped renal pelvis, the fornix extended deeply into the kidney parenchyme was formed between the outer zone of the medulla and the cortex. The epithelium of the papilla covered the inner zone of the medulla. The epithelium of the fornix medially overlayed the outer zone of the medulla, and laterally the cortex. The surface epithelium of the papilla was simple columnar in shape with the scanty organelles and the short microvilli on their luminal surface. The fornix was Jined with $1{\sim}2$ cell layered squamous epithelium. On the medial surface of the fornix, two types of the superficial epithelial cells were identified; one had numerous short microvilli and the other had the microplicae and plaques on their luminal surface. The lateral surface of the fornix lined with the epithelial cells showed microridges and plaques on the luminal surface. The epithelial cells on the medial and lateral surfaces of the fornix were similar to their internal ultrastructures. The pelvic epithelium was a typical transitional type, which was composed of a layer of basal cells, one or two layers of intermediate cells, and a layer of superficial(facet) cells. The fusiform vesicles were observed in the cytoplasm of the intermediate and facet cells. There were no noticeable morphological changes in the epithelium of the papilla, fornix and pelvis except the medial epithelium of the fornix in the hibernating cycle. The microvillar cells were more numerous in the hibernating phase than in the active phase. The morphology, of the renal papilla and fornix of bats, indicates that a functional relationship may exist between the pelvic urine and the renal parenchyme.

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Seeding Metastasis of Chromophobe Renal Cell Carcinoma after Robot-Assisted Laparoscopic Partial Nephrectomy

  • Lee, Kanghun;Choi, Moon Hyung
    • Investigative Magnetic Resonance Imaging
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    • 제21권2호
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    • pp.119-124
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    • 2017
  • Chromophobe renal cell carcinoma (RCC) is an uncommon subtype of RCC having a better prognosis than clear cell RCC. Although there are several reports of seeding metastasis of RCC after biopsy, seeding metastasis of chromophobe RCC after surgical resection has seldom been reported. Here, we describe a case of multiple seeding metastases in the abdomen and pelvis 78 months after robot-assisted laparoscopic partial nephrectomy, without prior history of biopsy for chromophobe RCC in the right kidney. As magnetic resonance imaging (MRI) of the pelvic mass showed a similar appearance to the primary renal mass and displayed separate margins with the rectum and prostate gland, we were able to make a diagnosis before pathologic confirmation.