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*

Systolic time interval measurements were made sequentially during second, third trimesters and postpartum period. Recordings were made in the supine position after bed rest for at least five minutes in order to obtain a steady state. In second trimester, pre-ejection period index (PEPI) was significantly shortened and left ventricular ejection period index(LVETI) remained normal while PEP/LVET decreased. Four possible mechanisms may be involved to account for the alterations in hemodynamic changes during this period(late stage of second trimester) : (1) increased metabolic demands of pregnancy: (2) hemodynamic effects of hypervolemia: (3) circulatory adjustments secondary to an arteriovenous shunt-like effect of the placental circulation: (4) cardiovascular effect of steroid hormone. The third trimester was characterized-by a markedly shortened LVETI, a prolonged PEPI and PEP/LVET. This findings are consistent with impaired left ventricular performance and are probably due to decreased left ventricular preload resulting from diminished venous return secondary to inferior vena caval obstruction by the large gravid uterus. In the postpartum period, the PEPI and PEP/LVET remained elevated and the LVETI shortened in the supine position. It is concluded that alterations in systolic time intervals occur normally during the course of uncomplicated pregnancy and persist into the postpartum period.
Bed Rest ; Female ; Hemodynamics ; Humans ; Placental Circulation ; Postpartum Period* ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third* ; Supine Position ; Systole* ; Uterus

Pheochromocytomas can arise wherever chromaffin cells are found, and most of them(90%) are in one or both adrenal glands. But they may be located anywhere along the sympathetic chain and rarely in aberrant sites. One of the common extra-adrenal sites from which these tumors can arise is a collection of para-aortic and para-ganglion cells around the origin of the inferior mesenteric artery. We experienced a case of extra-adrenal pheochromocytoma located at the organ of Zukerkandl in a 21-year-old female patient with abdominal colic and paroxysmal hypertension, whose symptoms and blood pressure returned to normal after successful surgical excision of the tumor.
Adrenal Glands ; Blood Pressure ; Chromaffin Cells ; Colic* ; Female ; Humans ; Hypertension* ; Mesenteric Artery, Inferior ; Pheochromocytoma* ; Young Adult

PURPOSE: In order to investigate the incidence of relative afferent pupillary defect (RAPD) in normal adolescence and if there is any interocular difference in the case with RAPD. METHODS: Fifty-eight adolescence in 14 to 36 years of age who showed normal findings on measurement of visual acuity, intraocular pressure, slit lamp examination, and funduscopic examination except refractive errors underwent swinging flashlight test and infrared pupillography. The case with RAPD further underwent optical coherence tomography, color vision test, Humphrey visual field test, and Bryngelson test (hole-in-the-card test). RESULTS: One out of 58 cases, in whom more pronounced myopic astigmatism and lower mean deviation on Humphrey visual field test within normal limits were found, showed RAPD in the dominant right eye with swinging flashlight test and infrared pupillography. CONCLUSIONS: The incidence of RAPD in normal adolescence was 1.7%. Myopic astigmatism was higher in the eye with RAPD.
Adolescent ; Astigmatism ; Color Vision ; Humans ; Incidence ; Intraocular Pressure ; Pupil Disorders* ; Refractive Errors ; Tomography, Optical Coherence ; Visual Acuity ; Visual Field Tests

No abstract available.
Echocardiography, Doppler, Color* ; Mitral Valve Insufficiency*

No abstract available.
Leukemia, Monocytic, Acute* ; Leukemic Infiltration* ; Lymphatic Diseases* ; Skin*