1980 년대와 1990 년대의 불명열 원인의 비교분석

김영근(Young Keun Kim),김명수(Myoung Soo Kim),이꽃실(Kkot Sil Lee),허애정(Ae Jung Huh),염준섭(Joon Sup Yeom),홍성관(Sung Kwan Hong),장경희(Kyung Hee Chang),송영구(Young Goo Song),김준명(June Myung Kim) 대한내과학회 2001 대한내과학회지 Vol.61 No.5

N/A Background : Physicians find fever of unknown origin (FUO) a difficult problem to solve. Analysis of the causes of FUO may be useful in the diagnosis of FUO. We investigated the causes of FUO in the last two decades from 1980 to 1999 and compared the two decades to seek for a trend of changes of the causes of FUO. Methods : Among 854 patient s diagnosed as FUO on discharge, we retrospectively reviewed 278 patient s compatible with the Petersdorf`s criteria through inpatient and outpatient medical records . Results : There were 144 (51.5%) men and 134 (48.2%) women. Among the 98 patients in the 1980s, infectious disease was the cause in 37 (37.8%) patients, collagen vascular disease in 17 (17.3%), malignancy in 8 (8.2%), miscellaneous in 11 (11.2%), and unidentifiable cause in 25 (25.5%) patients. Among the 180 patients in the 1990s, infectious disease was the cause in 45 (25.0%) patients, collagen vascular disease in 37 (20.5%), malignancy in 34 (18.9%), miscellaneous in 45 (25.0%), and unidentifiable cause in 19 (10.6%) patients. According t o the order of frequency, the causes of infectious disease were pulmonary tuberculosis (19.4%), extrapulmonary tuberculosis (8.2%), liver abscess (4.1%) in the 1980s and extrapulmonary tuberculosis (17.2%), pulmonary tuberculosis (4.4%), liver abscess (1.1%) in the 1990s. The diagnostic methods for evaluation of FUO were culture (45.6%), radiology (17.6%), serology (16.2%), and biopsy (10.3%) in the 1980s and radiology (31.5%), biopsy (26.9%), culture (21.5%) and serology (20.0%) in the 1990s. Conclusion : Among the causes of FUO, infectious disease decreased and collagen disease and malignancy increased with time. The most common cause of infectious disease was pulmonary tuberculosis in the 1980s but extrapulmonary tuberculosis in the 1990s. Use of radiology and biopsy as diagnostic methods for FUO increased.(Korean J Med 61:546- 552, 2001)

지속성 외래 복막투석 환자에서 발생한 반코마이신 내성 장구균 복막염에 대한 리네졸리드 (Linezolid)치료 경험

유동은 ( Dong Eun Yoo ),김민경 ( Min Kyeung Kim ),허애정 ( Ae Jung Huh ),김영아 ( Young Ah Kim ),강이화 ( Ea Wha Kang ),유태현 ( Tae Hyun Yoo ),신석균 ( Sug Kyun Shin ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2

Peritonitis is one of the major complications of CAPD (continuous ambulatory peritoneal dialysis). Among its causative organisms, vancomycin-resistant enterococcus (VRE) is rare, but serious causative organism, because it is refractory to antibiotics commonly used for CAPD peritonitis. Some drugs such as linezolid and dalfopristin have been introduced for VRE infections nowadays, but reports about usefulness of those drugs in VRE peritonitis are rare. We experienced a case of CAPD peritonitis caused by VRE, which was treated successfully with removal of CAPD catheter and use of linezolid. We report our experience with review of the literature.

간경변 환자에서 발생한 Vibrio cholerae에 의한 괴사성 근막염 1예

양우인 ( Woo In Yang ),박세미 ( Se Mi Park ),김유진 ( Yu Jin Kim ),김준명 ( Jun Myeon Kim ),최준용 ( Jun Yong Choi ),강이화 ( Ea Wha Kang ),허애정 ( Ae Jung Huh ) 대한내과학회 2008 대한내과학회지 Vol.74 No.1S

체지방분포도가 당대사, 지질대사 및 성장호르몬 분비에 미치는 영향

허갑범,이현철,임승길,김경래,송영득,남수연,김경욱,정대호,최병기,허애정 대한내분비학회 1999 Endocrinology and metabolism Vol.14 No.3

Background: Body fat distribution, rather than the level of obesity per se, appears to be a strong predictor of abnormalities in metabolic complication. Visceral fat accumulation is significantly correlated with glucose intolerance and constitutes as an independent risk factor for the diabetes mellitus. Methods: We investigated the impact of body fat distribution on the glucose, lipid metabolism and growth hormone secretion in obese subjects with varying glucose tolerance and lean controls matched with sex and age. 69 obese Koreans (34 men, 35 women; 43.8 yrs) and 21 lean Koreans (10 men, 11 women; 40.8 yrs) were recruited. Anthropometric measurement and impedence for measurement of total body fat, and computed tomography for visceral and subcutaneous fat area at umbilicus level were performed. All subjects underwent a standard oral glucose tolerance test and GH stimulation test by L-dopa. Results: The results are summarized as follows. 1. Obese patients had greater ideal body weight (%, IBW) and lean body mass (LBM) than lean controls. But no significant differences were found in IBW and LBM between 3 obese groups. 2. The 25 obese NIDDM had the highest FFA-AUC during OGTI and the lowest GH-AUC to L-Dopa stimulation test. The insulin-AUC during OGTT was the highest in 24 obese subjects with normal glucose tolerance. 3. All male groups have VSR of more than 0.4, which has been designated visceral fat obesity. In contrast all female groups have VSR of lesser than 0.4 but obese DM subjects have the highest VSR. Visceral fat area per body weight ratio(VWR) showed increasing tendency in obese, IGT, and DM group. 4. Waist circumference and VWR showed strong correlation with metabolic parameters among anthropometric parameters. They were positively correlated with FFA-AUC during OGTT and negatively correlated with GH-AUC to L-dopa stimulation. Conclusion: Visceral fat accumulation are associated with insulin resistance, dyslipidemia and impairment of growth hormone secretion via increase of free fatty acid. The simple waist circumference may provide a more practical indicator that correlated with aMominal fat distribution and metabolic complications associated with obesity (J Kor Soc Endocrinol 14:541-552, 1999).

인면역결핍바이러스감염에서 Ribavirin의 Lamivudine에 대한 길항효과

허애정,남정구,장경희,염준섭,최준용,송영구,김성순,이주실,이꽃실,김영근,김명수,박우일,김준명 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.1

배경 : HIV 감염자 수의 증가와 다양한 치료제 개발로 인해 HIV 감염자의 수명이 연장되면서 HCV 감염이 HIV 감염의 자연경과 및 사망률에 악영향을 미치는 중요한 병원균으로 대두되고 있다. 또한 HIV가 HCV의 질병경화를 악화시킬 수 있음이 밝혀지면서 동시감염의 치료에 대한 관심이 높아지고 있으며, 약물 상호작용도 그 주요 관심사 중 하나이다 RBV과 다양한 항레트로바이러스제제들간의 약물 상호작용에 대한 연구가 진행된 결과 ZDV과 d4T에 대하서 길항작용을, ddI에 대해서는 상승작용을 보임이 밝혀져 있다. 본 연구에서는 이러한 뉴클레오시드 유사체들과 세포내 대사과정을 달리하는 3TC에 대한 영향을 알아보고자 하였다. 방법 : 분주하여 부관되어 있던 세포주 MT-4를 48-72시간마다 계대배양하여 1.96×10^(6)cell/㎖의 수준으로 유지하였고, 96 well plate에 각 well 당 1.0×10⁴cells/㎖씩 분주하였다. ZDV(0.0001-1000μM/L)과 3TC(0.00001-100mM/L)의 농도를 각각 10배씩 희석하여 투여한 후 세포를 5일간 배양하여 각농도에서의 세포독성을 MTT assay로 평가하였으며, RBV(2μM/L) 투여전후의 변화를 비교하였다. 항바이러스 효과를 평가하기 위하여 MT-4세포에 각 well 당 100 TCID_(50)의 HIV-1 strain HTLV-Ⅲ을 첨가하여 감염시킨 상태에서 유사한 방법으로 ZDV과 3TC의 농도를 10배씩 희석하여 투여한 후 37℃, 5% CO₂ incubator에서 배양하였다. 배양 1주일후 상층액을 얻어 HIV-1 p24 core profile ELISA를 사용하여 p24 Ag을 정량적으로 측정하였고, IC_(50)를 평가하였다. 약물들과 함께 RBV을 투여한 후 같은 방법으로 세포독성 및 항바이러스 효과를 평가하였다. ZDV, 3TC를 단독투여한 결과와 RBV을 함께 투여한 결과를 비교분석 하기 위하여 Wilcoxon rank sum test로 분석하였다. 결과 : ZDV 단독투여시 CD_(50)는 36.8μM이었고 RBV을 함께 투여시 CD_(50)가 39.9μM로 증가하였으며, 3TC의 경우 RBV 투여전후의 CD_(50)는 각각 2357.2μM, 2248.8μM이었다. MTT assay상 ZDV 0.01 및 0.1μM/L 농도에서 (p=0.003, 0.039), 3TC 100μM/L 농도에서(p=0.027) RBV 투여 전후 세포생존율의 차이를 보였다. 3TC 단독 투여시에 비해 RBV과 병용투여한 경우 통계적으로 유의하게 p24 Ag 생성이 증가하였고 (p=0.007) 이러한 결과는 ZDV에서와 유사하였다(p=0.026). ZDV 단독투여시 IC_(50)는 0.03μM였고, ribavirin을 함께 투여후 0.067μM에서 0.152μM로 2.3배 증가된 소견을 보였다. 결론 : 이상의 실험결과로부터 RBV 투여가 3TC의 세포독성 및 항바이러스효과를 감소시키며 이러한 길항작용은 농도의존적임을 알 수 있었다. 본연구는 이전에 제시된 연구들과 함께 RBV이 항레트로바이러스제제와 병합투여 되었을 때 약물대사에 미치는 영향을 보여준 중요한 자료중 하나가 될 것이다. HIV/HCV 동시감염자에서 상용량의 RBV을 병용투여할 경우 3TC의 농도가 낮게 유지되어 HIV의 내성을 유도할 가능성을 내포한다고 볼 수 있겠으나, 실제로 직접 임상에 적용하기는 어려우며 생체내에서의 이들 약물의 상호작용 및 대사변화를 평가하기 위해서는 생체내에서의 약동학 및 약력학적 평가를 포함한 광범위한 임상연구가 필요할 것으로 생각된다. Background : One of the main concerns of interferon/ribavirin(RBV) treatment in Human immunodeficiency virus(HIV)/Hepatitis C virus(HCV) coinfected patients is that of drug-drug interactions. Recent studies reveal that RBV is antagonistic with zidovudine(ZDV), stavudine(d4T) and synergistic with didanosine(ddl). The phosphorylation of lamivudine(3TC) utilizes the enzyme deoxycytidine kinase. Manipulation of 3TC phosphorylation is a possible therapeutic strategy for modulating antiretroviral efficacy and cytotoxicity of 3TC. Methods : MT-4 cell lines were maintained in RPMI 1640 growth medium as a cell suspension 1.96 × 106cells/㎖), doubling approximately every 48-72 hr. Cells were incubated with ZDV(0.0001-1000mM) and 3TC(0.00001-100mM) in the presence and absence of RBV(2uM) in 96-well microtiter plates and cytotoxicity was determined using modified MTT assay. At the end of the 7 days, the cell-free supernatant was serially diluted and samples(100uL) were then assayed for p24 antigen with ELISA to evaluate the inhibitory effect on HIV-1 replication. The results were expressed in terms of the 50% inhibitory concentration(IC50). Analysis was done by Wilcoxon rank sum test. Results : 3TC alone significantly reduced p24 antigen production, with an IC50 0.067mM and addition of RBV increased the IC50 approximately 8.4 fold (0.563mM). However, at higher concentration of 3TC, the antagonistc effect of RBV was lost The decrease in the cytotoxic and antiviral efficacy of ZDV in the presence of RBV is consistent with previous studies that have demonstrated reduced ZDV activation. Conclusion : The addition of RBV siginificantly reduced cytotoxicity and antiretroviral efficacy of 3TC in MT-4 cell lines and the antagonistic effect of RBV is concentration dependent. This study provides further insight into the complex interaction between RBV and 3TC in vitro.

진균성 부비동염의 병리학적 유형에 따른 치료 효과 및 임상 양상

김유미,허애정,임홍석,허규연,장경희,홍성관,김창오,염준섭,최영화,송영구,김준명 대한의진균학회 2001 대한의진균학회지 Vol.6 No.3

Background: There are three basic types of fungal sinusitis: noninvasive, invasive, and allergic. Both noninvasive and invasive fungal sinusitis necessarily require surgery with or without antifungal treatment. This study was performed to evaluate the efficacy of treatment modalities and clinical characteristics between pathologically proven noninvasive and invasive fungal sinusitis. Methods: 40 patients pathologically proven to have fungal sinusitis from July, 1990 to January, 2000 were enrolled in this study. This retrospective study was performed in Severance Hospital, Yong-Dong Severance Hostpital and Ah-Joo University Hospital. The efficacy of treatment modalities and prognosis between pathologically proven noninvasive group (group A) and invasive group (group B) were evaluated. Results: Of the to total 140 patients, 13 were male and 27 were female, and the mean age was 51.6± 14.2 years, 32 patients belonged to noninvasive group and 8 Patients belonged to invasive group. Of the total 40 patients, 20 (50%) patients had underlying diseases, such as 8 cases of Diabetes Mellitus, 3 cases of hematologic malignancy, 2 cases of solid cancer, 1 case of steroid overuse, and the others 6 cases. In group A, only 12 patients (37.5%) had underlying diseases, however, all 8 patients (100%) in groups B had underlying diseases. All 32 patients of groups A went chronic course but in group B, all 8 patients appeard to be acute in course. The pathogens were classified to 36 cases of Aspergillus spp. (69.2%),3 cases of Rhizopus spp. (5.8%), and 1 case of Candida spp. (1.9%). As for the treatment modalities, in group A, 30 cases had surgery only and 2 cases performed surgery and antifungal treatment. Both showed 100% of treatment efficacy. In group B, 5 cases were treated with antifungal therapy only and 2 cases performed surgery and antifungal treatment. The former showed 20% and the latter, 33% of treatment efficacy. Noninvasive fungal sinusitis revealed good results even in surgery only therapy, but invasive fungal sinusitis tended to reveal better results in both surgery and antifungal treatment. Conclusion: The pathologic type of fungal sinusitis is now thought to be very important for the choice of treatment modalities and efficacy of treatment. Also the type of pathogens, immunologic state of patients, and early diagnosis of fungal sinusitis attribute to the treatment efficacy of fungal sinusitis. [Kor J Mee Mycol 6(3): 167-173]

서울·경기지역 병원직원의 혈액매개 감염노출에 대한 다기관 조사연구

박미라,김정은,박은숙,최정실,정선영,송영구,홍성관,김준명,허애정,양동규,조영주 대한병원감염관리학회 2003 의료관련감염관리 Vol.8 No.1

현미경적 폐전이를 동반한 갑상선 유두암 1예

정현주,허갑범,이현철,임승길,김경래,남수연,최병기,최소래,허애정,송영득 대한내과학회 1999 대한내과학회지 Vol.56 No.6

Although the papillary thyroid carcinoma generally follows an indolent course characterized by slow growth and abscence of distant metastasis, distant metastases to extrathyroid organ may occur in the lung, bone and brain in about 5% of patients. The lung metastases are usually diagnosed by plain X-ray, chest CT and 131I whole body scan. However, we present a case of papillary thyroid carcinoma with microscopic pulmonary metastasis that could not be detected by conventional method, such as chest X-ray, chest CT and 131I whole body scan. A 62-year-old female visited due to traumatic hemopneumothorax. In the pathology of resected tissues from lacerated lung parenchyme, metastatic papillary carcinoma was diagnosed without evidence of abnormality in radiologic examination and we diagnosed and treated an asymptomatic papillary thyroid carcinoma.

호흡기 감염증과 발열성 과립구 감소증 환자를 대상으로 한 치료적 항생제 사용의 적정성 평가

송영구,장경희,김효열,홍성관,박윤수,조정호,김창호,허애정,박은숙,김영숙,최영화,김준명 대한화학요법학회 2000 대한화학요법학회지 Vol.18 No.2

목적 : 국내에서 항생제 과다사용의 문제는 이미 위험수위에 도달하였다. 항생제의 오ㆍ남용은 내성균의 증가와 병원감염의 위험을 높히는 의학적인 부작용 뿐만 아니라 더 비싼 새로운 약을 개발하여야 하는 고비용의 문제 등 매우 심각한 사회, 경제적인 문제를 야기시키고 있다. 따라서 본 연구에서는 국내에서 일부 내과적 질환을 대상으로 치료적 항생제 사용 양상을 파악하고 이의 적정성 평가를 통한 항생제 사용지침 수립의 기초자료를 구축하고자 하였다. 방법 : 내과계 영역에서 항생제 사용이 가장 많은 호흡기 질환과 중증으로서의 발열성 과립구 감소증 환자를 대상으로 조사하였다. 호흡기 질환 중에서는 감기, 급성 인두염, 폐렴을 대상으로 하였다. 호흡기 질환의 경우 전국 123개 병ㆍ의원에서 3699명의 환자들의 실제 처방내용을 조사하여 분석하였으며, 발열성 과립구감소증 환자에 대해서는 전국 15개 대학 병원을 대상으로 설문을 통한 항생제 사용지침을 조사하였다. 호흡기 질환에 대해서는 설문을 통해 회수된 62개 병ㆍ의원 자료들을 같이 비교 분석하였다. 각 대상 질환에 대하여 조사 지역을 서울, 부산, 중부(경기, 충청, 강원 포함), 호남(제주 포함), 영남 등 5개 지역으로 나누어 분석하였으며, 병원규모별, 진료과별, 성별 등에 따른 항생제 사용 양상도 비교 분석하였다. 결과 : 폐렴과 급성 인두염의 경우 99.8%에서 항생제를 사용하고 있었으며, 감기의 경우대부분 항생제를 사용할 필요가 없는데도 불구하고 97.2%에서 항생제를 처방하고 있었다. 그러나 설문조사를 통한 분석에서는 감기의 경우 통상적으로 항생제를 사용한다고 대답한 경우가 37.1%, 급성 인두염의 경우 61.3% 정도로, 실제 처방 내용을 조사한 결과보다 낮게 나타났다. 주사제 처방은 서울지역의 처방률이 가장 낮았으며, 병원규모가 클수록 낮았다. 항생제 처방의 적절성 평가에 대한 분석 결과 전체적으로 9.9%만이 적절한 처방으로 분석되었다. 부적절한 처방의 내용으로는 항생제 처방이 불필요했던 경우, 불필요하게 병합 사용한 경우, 투여기간이 길었던 경우 등이 가장 많은 부분을 차지하였다. 발열성 과립구 감소증 환자에 대한 조사에서는 전국 15개 대학병원 중 명문화된 지침이 있는 병원은 4곳 이었으며 대부분 외국 문헌에서 제시하는 지침을 따르고 있었다. 결론 : 본 조사의 결과 이전에 보고되었던 설문조사를 통한 자료보다 항생제의 오ㆍ남용이 훨씬 심각하다는 것을 알 수 있었다. 이와같은 문제점은 의사들이 항생제를 처방하는데 있어서 아무런 규제조치나 적절한 항생제 사용에 대한 동기부여가 없으며, 항생제 사용에 대한 적절한 지침이 없고, 병ㆍ의원의 항생제 관리를 위한 제도적 방안이 부재한 결과라고 생각된다. Background : Abuse and inappropriate use of antibiotics result in many serious medical and socioeconomical problems, such as emergence of multidrug-resistant bacteria, increase of nosocomial infection, and high health care costs for developing new drugs against resistant bacteria. The purpose of this study is to evaluate the appropriateness of therapeutic use of antibiotics in patients with respiratory tract infections and in patients with febrile neutropenia in Korea. Methods : Patients with respiratory tract infection and febrile neutropenic patients were investigated. Nationwide, 3699 patients of 123 private clinics and general hospitals were included for respiratory tract infection and their prescriptions were investigated. We also investigated the guidelines of antibiotic use for neutropenic febrile patients of 15 university hospitals. We analyzed the data according to the districts (Seoul, Pusan, Middle districts including Kyungki. Choongchung, and Kangwon, Honam district including Cheju, and Youngnam district), hospital size, and department. Current status and appropriateness of therapeutic use of antibiotics were evaluated. Results : Antibiotics were used in 99.8% of patients with pneumonia or acute pharyngitis. In patients with common cold. although most of them did not need antibiotics, antibiotics were used in 97.2% of them. But in questionnaire survey, physicians answered that they used antibiotics in only 37.1% of patients with common cold and 61.3% of patients with acute pharyngitis. The rate of use of parenteral antibiotics was lowest in Seoul, and larger hospitals used fewer parenteral antibiotics. Evaluation for appropriateness of therapeutic use of antibiotics showed that only 9.9% was appropriate. Unnecessary use, unnecessary combination, and prolonged duration of therapy were included in inappropriate use of antibiotcis. For febrile neutropenic patients. 4 out of 15 university hospitals had protocol for use of antibiotics and most of them were following the guidelines recommended by many articles. Conclusions : These results show that the problems of abuse or inappropriate use of antibiotics are more serious than reported before. Therefore, the appropriate guidelines and control programs for therapeutic use of antibiotics are needed.

신 및 신주위 농양의 최근 임상 경향

최준용,김명수,김영근,이꽃실,장경희,허애정,염준섭,송영구,김준명 대한화학요법학회 2002 대한화학요법학회지 Vol.20 No.2

목적 : 신 및 신주의 농양의 최근 임상 양상에 대해 알아보고자 하였다. 방법 : 1997년 1월부터 2001년 6월까지 세브란스 병원에서 신농양 및 신주의 농양으로 진단 받은 34예를 대상으로 연령 분포, 성별, 입원 전 증상의 지속 기간, 검사실 소견, 원인균, 유발인자, 방사선 소견 및 진단과 치료 등에 대하여 후향적으로 조사하였다. 결과 : 신농양은 16예, 신주위 농양은 18예였다. 평균 연령은 52.9±12.9(19-82세)세였고 성별비는 1:1.4였다. 기저 상태로는 당뇨 18례(52.9%), 간질환 7례(20.5%), 스테로이드 복용 5례(14.7%), 악성종양 3례(8.8%), 신경원성 방광 2례(5.8%), 다낭신 2례(5.8%), 신결석 1례(2.9%) 등이 있었다. 입원 시 증상은 발열(82.3%)과 측복부 동통(67.6%)이 대부분이었다. Escherichia coli, Klebsiella pneumoniae 등의 그람 음성균이 가장 흔한 원인균이었다. 신 및 신주위 농양의 치료에 있어 항생제 치료, 경피적 배농, 수술적 치료가 재원 기간, 치료 기간 등의 치료 양상에 있어 유사한 결과를 나타냈다. 신농양과 신주위 농양간에 임상적 특성은 유의한 차이를 나타내지 않았다. 결과 : 본 연구를 통해 신 및 신주위 농양에서 원인균, 치료방법, 예후 등의 임상 양상이 외국의 보고와 비슷한 양상으로 변화했다는 점을 확인할 수 있었고, 향후 신 및 신주위 농양의 치료에 있어 비수술적인 치료 방법의 치료 효과에 대한 보다 많은 예에서의 전향적인 연구가 필요하리라 생각된다. Background : The clinical aspects of renal or perirenal abscess has changed over the decades. In Korea, there were no recent reports about clinical aspects of renal or perirenal abscesses. Methods : We retrospectively reviewed charts of 34 patients diagnosed as renal or perirenal abscesses about age, sex, clinical manifestations, laboratory findings, culture studies, underlying conditions, radiologic findings, treatment modalities, duration of treatment, and treatment outcomes. Results : A total of 54 patients with renal or perirenal abscess was identified. The mean age of overall patients was 52.9?12.9 years. Underlying conditions were diabetes mellitus(52.9%), liver disease(20.5%), steroid use(14.7%), malignancy(8.8%), neurogenic bladder(5.8%), polyeystic kidnev(5.8%) and renal stone(2.9%). Common clinical manifestations were fever(82.3%) and flank pain(67.6%). Gram negative strains such as Escherichia coli, Klebsiella pneumoniae were common causative organisms. Mean size of abscess was 5.27 ±3.05㎝(0.5-13.0㎝). There were no significant differences in the hospital days or treatment duration between treatment modalities such as antibiotics, percutaneous drainage and surgery. There were no significant differences in the clinical characteristics between renal and perirenal±renal abscess. Conclusion : In our study, there were changes of clinical characteristics such as causative organisms or treatment modalities similar with that in foreign countries. The prospective study should be processed about treatment outcomes of noninvasive treatment in renal or perirenal abscess.