No abstract available.
Humans ; Hydronephrosis* ; Radioisotope Renography*

No abstract available.
Child* ; Humans ; Radioisotope Renography*

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

PURPOSE: Although ultrasonography and diuretic renography are routinely performed for evaluation of ureteropelvic junction obstruction, no reported studies have systemically investigated the correlation of the two methods. We investigated the correlation and values of the two methods. MATERIALS AND METHODS: We studied 44 patients who presented with unilateral hydronephrosis due to ureteropelvic junction obstruction from 1994 to 1999. Patients were evaluated with ultrasound and nuclear renograms with furosemide. Hydronephrosis grade on ultrasonography and the severity of obstruction on diuretic renography were in accordance with the SFU (Society for Fetal Urology) system and "The Well Tempered Renogram", respectively. RESULTS: 27 patients showed grade III hydronephrosis and the remaining 17 patients showed grade IV hydronephrosis on ultrasonography. Kidneys of grade IV hydronephrosis had poorer washout patterns on diuretic renography than those of grade III hydronephrosis (p <0.001). In regard of mean split renal function ratios, there was no statistically significant difference between two groups (p >0.05). In 37.0% (10/27) and 47.1% (8/17) of patients with grade III and grade IV hydronephrosis, hydronephrotic kidney had a differential function greater than 50%. CONCLUSIONS: Our study suggests that diuretic renography is not always indicated in the patients with grade IV hydronephrosis, but, must be performed to confirm the severity of obstruction in the patients with grade III hydronephrosis.
Furosemide ; Humans ; Hydronephrosis ; Infant* ; Kidney ; Radioisotope Renography* ; Ultrasonography*

This study was performed to investigate the proper method for evaluating renal function in miniature pigs with unilateral ureteral obstruction. Experimental unilateral renal damage was induced after ligation of unilateral right ureter in 3 miniature pigs. On the 3rd post-operative day, scintigraphic images were obtained after 12 mCi of 99mTc-diethylentriamene pertaacetate (DTPA) intravenous injection. Renography showed that radiopharmaceutical uptakes in the right kidney were lower than those of left kidney uptakes as early as at 3 days after surgical operation. The static images of 99mTc-DTPA enabled us to measure the relative renal function in miniature pigs with unilateral ureteral obstruction. In conclusion, renography using 99mTc-DTPA was the useful diagnostic method to evaluate the renal function in miniature pigs.
Injections, Intravenous ; Kidney ; Ligation ; Radioisotope Renography ; Swine ; Ureter ; Ureteral Obstruction

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

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

PURPOSE: The purpose of this study was to evaluate the accuracy of Tc-99m DTPA diuretic renal scans in children 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 nonobstructive patterns in 1. In 3 patients who underwent diuretic renal scan within 1 week after birth., nonobstructive patterns of initial scan were coverted 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 standarized 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.
Child* ; Follow-Up Studies ; Humans ; Hydronephrosis ; Infant, Newborn ; Kidney Pelvis ; Parturition ; Pentetic Acid* ; Radioisotope Renography* ; Ultrasonography ; Urinary Tract*

PURPOSE: We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. METHODS: We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl- triglycerine scan and the degree of hydronephrosis by renal ultrasonography. RESULTS: In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. CONCLUSION: We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.
Chungcheongnam-do ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant* ; Infant, Newborn* ; Kidney ; Radioisotope Renography ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Prenatal

The nephrectomy has been one of the important urologic surgery as the final treatment of the various renal diseases. Recently the conservative plastic surgery is preferred with the development of the better assessment of the renal function and operating techniques but the numerous renal diseases like renal malignancies are still indications of the nephrectomy. This study was performed to observe the trend of diagnosis and treatment of the pediatric renal disease which could be treated by the nephrectomy previously, by comparing and classifying the frequency of the kidney of which the function was partially or completely recovered by the conservative plastic surgery. On the patients under the age of 15 who were admitted to the Yonsei University Medical Center from 1968 to 1987, the disease entities(ureteropelvic junction obstruction, renal anomaly, renal tuberculosis, renal injury, wilms` tumor) which could be considered the nephrectomy as a treatment method were studied with the division of 2 periods by 1981 on which the ultrasonography and 99 mTc-DTPA renography were performed. The results are as follows : 1.In the ureteropelvic junction obstruction the nephrectomy was decreased from 67.6% (23 in 34 kidneys) in the period I to 19.5%(8 in 41 kidneys) in the period II and in the grade IV and V hydronephrotic kidneys which showed the change in the treatment method during the 2 periods the pyeloplasty was increased from 23.3%(7 in 30 kidneys) in the period I to 74.2%(23 in 31 kidneys) in the period II. Of the 19 kidneys assessed by diuresis renography both before and after the pyeloplasty in the period II17 kidneys(89.4 %) showed improvement in the excretory function after surgery. 2.The nephrectomy is an indispensable treatment in the Wilms` tumor(54 kidneys) and was performed invariably in the renal tuberculosis(9 kidneys) which had multiple ureteral strictures or destructive changes in the whole kidney. The conservative plastic surgery was performed in the renal anomaly(28 kidneys) inappreciably and the renal injury(9 kidneys) became to be preferred the conservative treatment or partial nephrectomy if possible.
Academic Medical Centers ; Child* ; Constriction, Pathologic ; Diagnosis ; Diuresis ; Humans ; Infant* ; Kidney ; Nephrectomy* ; Radioisotope Renography ; Surgery, Plastic ; Tuberculosis, Renal ; Ultrasonography ; Ureter