Nuclear medicine departments use the camera-based method for determining glomerular filtration rate (GFR) with 99mTc-DPTA. Camera based techniques provide a fast and convenient way of determining GFR with excellent reproducubility however its accuracy remains in question. The accuracy of camera-based renal scintigraphy depends on an attenuation correlation from estimating for renal depth and an attenuation correction from estimating for renal depth and an attenuation coefficient. Algorithms were formulated by Tonnesen, Taylor, and Inoue to calculate the estimated renal depth through multiple stepwise linear regression analysis. The goal of this study was to analyze the accuracy of these algorithms in Filipino patients. Renal depth was determined from CT scans of 41 consecutive patients. We calculated the mean absolute error of the estimated kidney depths and compared them with each other to determine the accuracy of each algorithm. The Tonnesen algorithm had the highest mean absolute error of 1.25 cm plus minus 0.88 cm in the left kidney estimates while the Taylor algorithm had the lowest mean absolute error of 0.81 cm plus minus 0.58 cm in the left kidney estimate and 1.04 cm plus minus 0.82 cm in the right kidney estimate (p-value = 0.01 left kidney estimates and p-value = 0.02 right kidney estimates). The Tonnesen algorithm was the least accurate in predicting kidney depth. There was no significant difference between the Taylor and Inoue algorithms, which were more accurate in predicting kidney depth
Human ; Male ; Female ; KIDNEY ; UROGENITAL SYSTEM ; URINARY TRACT ; GLOMERULAR FILTRATION RATE ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES AND PROCEDURES ; DIAGNOSTIC TECHNIQUES, UROLOGICAL ; KIDNEY FUNCTION TESTS ; RENAL SCINTIGRAPHY

INTRODUCTIONThis study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability.

METHODSWe retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopacified kidney on one side but normal excretion on the contralateral side. Affected kidneys with split glomerular filtration rate (GFR) < 10 mL/min/1.73 m2 on 99mTc-diethylenetriaminepentaacetic acid diuretic renal scintigraphy were considered nonsalvageable. Non-function was defined based on cutoff points (< 15% and < 20%) to determine the sensitivity and specificity of differential renal function. Differences in IVU and renal scintigraphy findings, with respect to the duration of delayed filming on IVU, were analysed for significance.

RESULTSThe results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96).

CONCLUSIONAlthough most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU.

Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; diagnostic imaging ; Kidney Diseases ; diagnostic imaging ; therapy ; Kidney Function Tests ; Male ; Middle Aged ; Pentetic Acid ; Radioisotope Renography ; methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Technetium ; Treatment Outcome ; Ureteral Obstruction ; diagnostic imaging ; therapy ; Urography ; methods

Urodynamic investigation in conscious rats is widely employed to explore functional bladder disorders of various etiologies and pathogeneses. Rats can be placed in restraining cages or wide cabinets where they are allowed to move freely during cystometry. However, the requirements of special devices hampered the application of urodynamic test in freely moving rats, and whether the restraint has any effects on urodynamic parameters in conscious rats remains obscure. In the present study, we described a novel approach for urodynamic investigation in both restrained and freely moving conscious rats. In addition, we for the first time systematically compared the urodynamic parameters of rats in the two conditions. With the current method, we successfully recorded stable and repeatable intravesical pressure traces and collected expected reliable data, which supported the idea that the restraint does not affect the activity of the micturition reflex in rats, provided sufficient and appropriate measures could be applied during cystometry. Fewer technique problems were encountered during urodynamic examination in restrained rats than in freely moving ones. Taken together, conscious cystometry in rats placed in restraining cages with proper managements is a reliable and practical approach for evaluating the detrusor activity and bladder function.
Animals ; Diagnostic Techniques, Urological ; instrumentation ; Female ; Movement ; Rats ; Rats, Sprague-Dawley ; Reflex ; Restraint, Physical ; Urinary Bladder ; physiology ; Urodynamics ; Wakefulness

Since 1954. radioisotope renography has been performed as a useful kidney function test in the urological field The author using Hypaque-I which has no liver interference, performed radioisotope renography on 25 cases, in which 10 cases of normal, 5 cases of obstructive uropathy, 7 cases of renal dysfunction, 1 case of acute glomerulonephritis and 2 cases of hypertensive uropathy were included In the normal cases, the Hypaque-I renogram has 3 typical segments, namely vascular segment, functional segment and evacuation phase. The vascular segment begins 8~20 seconds after a rapid intravenous injection of Hypaque-I, lasting 30-40 seconds and occurs the functional segment. The functional segment is completed within 3~10 minuets, having a peak And then, the evacuation phase appears, inclining down rapidly. In the renogram of obstructive uropathy, the vascular and functional segments are almost normal together, but the evacuation phase is either prolonged or increased In the renogram of renal dysfunction, the vascular segment is not only reduced, but also the functional segment is low and the evacuation phase shows a dull inclining curve. In the renogram of acute glomerulonephritis, shows no changes of each segment. The renogram of hypertensive uropathy represents the remarkably lower vascular and functional segments and evacuation phase than those of renal dysfunction. The Hypaque-I renogram has many practical advantage, offering rapid and immediate results, being easily performed, being non-traumatic and innocuous, making each kidney to be tested separately, being able to be repeated frequently, and being free from any preparation and anesthesia of patients.
Anesthesia ; Glomerulonephritis ; Humans ; Injections, Intravenous ; Kidney ; Kidney Function Tests ; Liver ; Radioisotope Renography

OBJECTIVETo explore the procedures of dynamic infusion cavernosometry and cavernosography (DICC) and their application in the diagnosis and classification of venous erectile dysfunction (VED).

METHODSThis study included 103 ED patients, aged 20 to 43 years, highly suspected of VED, with disease courses of 4 months to 6 years. DICC was performed and analyses were made on the results, especially the parameters of flow-to-maintain (FTM) and pressure decay (PD) in the corpus cavernosum.

RESULTSBased on the parameters of FTM and PD, 21 of the patients were normal, 5 were suspected of VED, 39 had mild VED, 25 had moderate VED, and 13 had severe VED. Penile subcutaneous hematoma was found in 4 of the patients, all recovered after 3 to 5 days, with no other complications.

CONCLUSIONDICC is a reliable, safe and minimally invasive method for the diagnosis and classification of VED.

Diagnostic Techniques, Urological ; adverse effects ; Hematoma ; etiology ; Humans ; Impotence, Vasculogenic ; classification ; diagnosis ; Male ; Penile Diseases ; etiology ; Penis ; blood supply ; diagnostic imaging ; Radiography ; Veins

Experimental hydronephrosis in rabbit induced by ureteral ligation a been studied on its development and recovery angiographically. Intrarenal arteries were perfused with 7.5% barium sulfate under pressure from 60mm. to 180mm. Hg over a period of 15-20 minutes after various periods of uretera1 ligation or after release of obstruction and angiographic results were as follows: l. Ligation of ureter for 3 to 7 days maintains almost normal intrarenal vascular architecture though the size of the kidney increases. Deligation restores completely normal vascularity within one Week. 2. Ligation for 1l to 2l days causes irregular pattern of vascular distribution. Restoration begins at one week, significant restoration occurs at two weeks but no complete recovery at three weeks. 3. Ligation for 30 to 60 days looses intrarenal vascular architecture. Restoration seems to begin at two weeks. No complete recovery is observed at three weeks. 4. Size of hydronephrosis and severity of intrarenal vascular changes do not correlate. 5. Intravenous pyelography and radioisotope renography are not very suitable to reveal detailed information on development and recovery process of hydronephrosis.
Arteries ; Barium Sulfate ; Hydronephrosis* ; Kidney* ; Ligation* ; Radioisotope Renography ; Ureter* ; Urography

Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved.
Abdominal Pain ; Acute Kidney Injury ; Ascites ; Catheterization ; Catheters ; Creatinine ; Cystoscopy ; Diagnosis ; Diagnostic Errors ; Dilatation ; Female ; Humans ; Hydronephrosis ; Hysterectomy ; Middle Aged ; Neoplasm Metastasis* ; Nephrostomy, Percutaneous ; Oliguria ; Peritoneal Cavity ; Radiotherapy ; Rupture* ; Rupture, Spontaneous ; Urethral Stricture* ; Urinary Bladder* ; Urography ; Uterine Cervical Neoplasms

Multiple measurements of nocturnal penile tumescence and rigidity (NPTR) are widely accepted as a method to differentiate psychogenic erectile dysfunction (ED) from organic ED. However, direct evidence remains limited regarding the first-night effect on NPTR measurement using the RigiScan. Here, we evaluated the first-night effect on the results of NPTR measurement to validate the necessity of NPTR measurement for two consecutive nights, particularly when abnormal first-night measurements are recorded in a laboratory setting. We retrospectively reviewed 105 patients with a complaint of ED, who underwent NPTR measurement using the RigiScan in the Department of Infertility and Sexual Medicine, the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China), for two consecutive nights, during the period from November 2015 to May 2016. NPTR parameters were collected and analyzed. We found that more effective nocturnal erections were detected during the second night than during the first night (P <0.001). Twenty percent of all patients had no effective erection during the first night, but exhibited at least one effective erection during the second night. The negative predictive value of NPTR measurement during the first night was 43.2%; this was significantly lower than that on the second night (84.2%; P = 0.003). Most NPTR parameters were better on the second night than on the first night. The first-night effect might be greater among patients younger than 40 years of age. In conclusion, two consecutive nightly measurements of NPTR can avoid a false-abnormal result caused by the first-night effect; moreover, these measurements more accurately reflect erectile capacity, especially when the first-night record is abnormal in a laboratory setting.
Adult ; Diagnosis, Differential ; Diagnostic Techniques, Urological ; Erectile Dysfunction/etiology* ; Humans ; Male ; Penile Erection ; Predictive Value of Tests ; Reproducibility of Results ; Retrospective Studies ; Sexual Dysfunction, Physiological/diagnosis* ; Sexual Dysfunctions, Psychological/diagnosis* ; Sleep ; Young Adult

It is well recognized that dilation of upper urinary tract can occur in the absence of either reflux or mechanical obstruction. The demonstration of the cause of upper urinary tract dilation may critically alter the management of a patient. So several diagnostic methods were designed to demonstrate it, but their clinical application were not satisfactory due to inaccuracy, invasiveness and technical difficulty. Diuresis renography has recently been introduced as a method of evaluating upper urinary tract dilation found on intravenous urography. It is a simple, rapid, non invasive test which has enable to define the cause. 23 cases which have equivocal upper urinary tract dilation on intravenous urography were examined by diuresis renography in the Department of Urology, Kyung Hee University Hospital, during the period from October 1980 to March 1982 and three differential categories were obtained as follows. 1. Normal type (9 cases): Both standard and diuresis renograms were normal. 2. Obstructive type (3 cases): Initial renogram was obstructive and remained so during diuresis. 3 cases in this category were confirmed by operation and follow-up intravenous urography. 3. Atonic type (11 cases): Initial renogram tracing was obstructive but rapid isotope elimination occurred after diuresis.
Diuresis* ; Follow-Up Studies ; Humans ; Radioisotope Renography* ; Urinary Tract* ; Urography ; Urology

PURPOSE: Split renal function on diuretic renography has been considered to be a good tool for evaluating renal function, selecting treatment modalities and assessing efficacy of surgery in hydronephrosis, especially in ureteropelvic junction(UPJ) obstruction. However, contradictory supranormal function on renography has provided controversy with urologists. Is the phenomenon the result of fact or artifact? The authers thought that contradictory supranormal renal function measured with 99mTc-DTPA Is fundamentally related with a question. How accurately does the split renal function test represent the real renal function, namely, glomerular filtration rate(GFR)? To know relation of split renal function with real renal function(GFR) and to disclose clinical significance of contradictory supranormal renal function on diuretic renal scan, a prospective study was performed. MATERIALS AND METHODS: Diuretic renography was done in 14patients with upper urinary tract obstruction including UPJ obstruction, ureteral stone and lower urethral obstruction. Afer the first diuretic renography using 99mTc-DTPA percutaneous nephrostomy was performed on affected kidney, which was followed by the second diuretic renography. Endogenous creatinine clearance tests were done on the patients. Urine was collected through the nephrostomy tube, self voiding or indwelling Foley catheter, respectively So the endogenous creatinine clearance was determined respectively on both the renal unit. Also the endogenous creatinine clearance ratio of affected kidney was determined to compare with split renal function on renography. RESULTS: In 7patients, ratio of endogenous creatinine clearance on affected kidney was less than 40%. In the other 7patients, the ratio was more than 48%. In patients with less than 40% of endogenous creatinine clearance ratio on affected kidney, split renal function was overestimated by 10.3% to 27.5%(19.5+/-4.9%) comparing to endogenous creatinine clearance ratio. In the other 7patients split renal function had a little difference from endogenous creatinine clearance ratio (4.5+/-2.5%). The endogenous creatinine clearance ratio was not closely related with split renal function(correlation coefficients: 0.65). Split renal function of the first renography was closely related with that of the second renography(correlation coefficients: 0.88). Contradictory supranormal function occurred in 4cases. In 2cases it was real finding, in the other it was not. CONCLUSIONS: It appears that split renal function is overestimated in poor renal function and split renal function is closely related with real renal function in good renal function slate. Supranormal renal function is real finding in part, not in part. Clinical significance of split renal function should be cautiously and basically reevaluated through further study.
Artifacts ; Catheters ; Creatinine* ; Filtration ; Humans ; Hydronephrosis ; Kidney ; Nephrostomy, Percutaneous ; Pentetic Acid* ; Prospective Studies ; Radioisotope Renography ; Ureteral Obstruction ; Urethral Obstruction ; Urinary Tract*