The aim of this study was to assess the impact of vesicoureteral reflux (VUR) on renal scar following acute pyelonephritis by comparing the refluxing renal units with nonrefluxing renal units in children with unilateral primary VUR. Forty-eight children with unilateral primary VUR diagnosed after the first pyelonephritis were enrolled. Mean age of patients was 1.0+/-1.6 years (29 boys and 19 girls). All patients underwent renal ultrasonography and renal 99 m-technetium dimercaptosuccinic acid (DMSA) scan within three days following the diagnosis of pyelonephritis, and voiding cystourethrography (VCU) was performed soon after fever subsided and the infection was controlled. The DMSA scan was rechecked six months after the initial study when the first scan showed a renal defect. The first DMSA showed renal defects in 34 (70.8%) out of 48 of the refluxing renal units and in 13 (27.1%) out of 48 of the nonrefluxing renal units (P<0.01, OR: 6.54). At six months after the infection, 23 (47.9%) out of 48 refluxing renal units and seven (14.6%) out of 48 nonrefluxing renal units had renal scars on DMSA scan (P<0.01, OR: 5.39). The prevalence of renal scars did not vary significantly according to the grade of VUR. The CRP level on admission was significantly higher in patients with acute renal defect and scar. In conclusion, VUR increases the risk of post-pyelonephritic renal scars in children.

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Ventilation characteristics of the Columbus module are numerically predicted on the basis of the ReynoldsAveraged Navier-Stokes (RANS) and Large Eddy Simulation (LES) approaches. The steady-state RANS computations were performed using the high-Reynolds-number k-ε turbulence model, and the SmagorinskyLilly subgrid-scale model was used for LES. The computed results were compared with experimental data available for spatial distributions of the time-averaged absolute velocity magnitude. On the basis of LES data, distinctions in the fields of this quantity and the whole mean velocity were analysed. A procedure for evaluation of the time-averaged absolute velocity spatial distributions using RANS data on the mean velocity and the turbulent kinetic energy is suggested and examined.