Diss. (sammanfattning) Stockholm : Karol. inst., 2001. / Härtill 6 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2006. / Härtill 5 uppsatser.

<p>Uvod: Od kada je prvi put opisan pre 30 godina, kod porodica obolelih od melanoma<br />kože, displastični nevus je predmet debate. Klinički najznačajnija kontroverza je da se<br />displastični nevus klinički često smatra sumnjivim i da se te&scaron;ko razlikuje od ranog<br />melnoma kože. Ovakav klinički izgled displastičnog nevusa je razlog čestih nepotrebnih<br />ekscizija, jednog od najče&scaron;ćih nevusa čoveka. Ciljevi: Ispitati kliničke i dermoskopske karakteristike patohistolo&scaron;ki potvrđenih displastičnih nevusa, i utvrditi učestalost displastičnih nevusa među sumnjivim melanocitnim lezijama koje su odabrane kliničko-dermoskopskim pregledom. Metode: U analitičkoj kliničkoj studiji, u prospektivnom delu, koristili smo kliničko-dermoskospki pristup po predloženom protokolu za selekciju sumnjivih melanocitnih lezija za eksciziju. Ekscidirano je 279 lezija. Od ukunog broja, 83 su bile lezije veoma sumnive na melanom kože, kod 116 lezija melanom nije mogao biti isključen u diferencijalnoj dijagnozi, a 80 lezija su imponovale dobroćudne i ekscidirane su zbog smetnji koje su pričinjavale pacijentu. Klinički su lezije opisivane prema ABCD akronimu (A za asimetriju, B za nepravilnost ivica, C za nepravilnu prebojenost i D za veličinu preko 5 mm). Za dermoskopski opis lezija su korisćeni algoritmi Analiza struktura i Lista od sedam tačaka. Rezultati: Nakon histopatolo&scaron;kog pregleda ekscidiranih 279 lezija, 242 lezije su bile nevusi, od kojih 131 displastični nevus, koji je analiziran posebno za potrebe ove studije, dok su 47 lezija činili melanomi kože. Histopatolo&scaron;ki potvrđeni displastični nevusi su proistekli dominantno iz grupa lezija kliničko-dermoskospki upućenih kao sumnjive na melanom ili iz grupe gde melanom nije mogao biti isključen u diferencijalnoj dijagnozi OR 2,49 (95%CI 1,51-4,11) p=0,0003. Svako ispitano kliničko obeležje ponaosob i u svim mogućim kombinacijama, je bilo od značaja samo za melanoma kože p&lt;0,0001. Nije bilo značajnih razlika u grupi displastičnih nevusa i ostalih nevusa. Displastične nevuse su činile sumnivim njihove dermoskopske karakteristike. Kod ovih nevusa je bila če&scaron;ća multikomponentna struktura OR 4,84 (95%CI 2,87-8,16) p&lt;0,0001 i nepravilne globule OR 7,32 (95%CI 3,35-15,99) p&lt;0,0001. Nepravilne mrlje su uočene kod 90/96 displastičnih nevusa i kod 41/47 melanoma bez značajne razlike. Zaključak: Klinički displastični nevusi nisu imali kliničke karakteristike koje se obično koriste za njihov opis, te klinički nisu imali znake sumnjivih lezija. Klinički su izgledali poput banalnih nevusa. Kombinovani kliničko-dermoskospki pristup za odabir sumnjivih lezija je ukazao na značaj nekih dermoskospkih obeležja. Multikomponentna struktura i nepravilne globule su se vi&scaron;e javljale kod displastičnih nevusa. Poseban je značaj nepravilnih mrlja koje su podjednako često bile uočavane i kod displastičnih nevusa i tankih melanoma.</p> / <p>Background: Dysplastic nevus, a benign melanocytic lesion has been a matter of debate over the last thirty years, since its first description in families with melanoma. The most important controversy is that dysplastic nevus is usually considered to be suspicious, not easily distinguishable from early melanoma by its clinical appearance. This is followed by numerous unnecessary excisions of a nevus that is considered to be one of the most common in humans. Objectives: To describe the clinical and dermoscopic characteristics of dysplastic nevus, and&nbsp; to&nbsp; investigate&nbsp; its&nbsp; proportion&nbsp; in&nbsp; suspicious&nbsp; melanocytic&nbsp; lesions&nbsp; using clinicodermoscopic approach. Methods: In an analytical clinical study, in the prospective part of the study, we used a combined&nbsp; clinicodermoscopic&nbsp; approach&nbsp; according&nbsp; to&nbsp; a&nbsp; proposed&nbsp; protocol,&nbsp; to&nbsp; select lesions for excision. A total of 279 lesions were excised. Of the total number, 83 were very suspicious for melanoma, 116 where melanoma could not be excluded, and eighty were considered to be benign. Still they were excised because they were a burden for patients. Clinical appearance was studied using ABCD acronym (A for assimetry, B for border&nbsp; irregularity,&nbsp; C&nbsp; for&nbsp; color&nbsp; variegation,&nbsp; and&nbsp; D&nbsp; for diameter&nbsp; of&nbsp; more&nbsp; than&nbsp; 5mm). Dermoscopic&nbsp; description&nbsp; of&nbsp; lesions&nbsp; was&nbsp; performed&nbsp; according&nbsp; to&nbsp; algorithms Pattern Analysis and Seven-point Checklist. Results:&nbsp; After&nbsp; histopathological&nbsp; analysis&nbsp; of&nbsp; the&nbsp; 279&nbsp; lesions,&nbsp; 242&nbsp; lesions&nbsp; were&nbsp; nevi, among them 131 dysplastic nevi that were analyzed separately for the purpose of this study and 47 lesions were skin melanoma. Histopathologicaly proven dysplastic nevus originated mainly from a group of lesions clinicodermoscopily recognized as suspicious of melanoma, or a group where melanoma could not be excluded OR 2.49 (95%CI 1.51-4.11) p=0.0003. Each examined clinical feature alone or in any possible combination of features&nbsp; was&nbsp; important&nbsp; only&nbsp; for&nbsp; melanoma&nbsp; p&lt;0.0001.&nbsp; There&nbsp; were&nbsp; no&nbsp; significant differences between dysplastic nevus group and a group of nevi. Dermoscopic features were more important for the overall suspicious&nbsp; appearance. Multicomponent structure OR&nbsp; 4.84&nbsp; (95%CI&nbsp; 2.87-8,16)&nbsp; p&lt;0.0001&nbsp; and&nbsp; irregular&nbsp; globules&nbsp; OR&nbsp; 7.32&nbsp; (95%CI&nbsp; 3.35-15.99)&nbsp; p&lt;0.0001&nbsp; were&nbsp; frequent.&nbsp; Irregular&nbsp; blotches&nbsp; were&nbsp; found&nbsp; in&nbsp; 90/96&nbsp; and 41/47, dysplastic nevus and melanoma respectively, without significant differences. Conclusion:&nbsp; Clinically&nbsp; dysplastic&nbsp; nevi&nbsp; did&nbsp; not&nbsp; show&nbsp; clinical&nbsp; characteristics&nbsp; that&nbsp; were usually used to describe them, and did not show signs of suspicious lesions. Clinically, they looked more like banal nevi. The commbined clinicodermoscopic approach to select suspicious melanocytic lesions, revealed some dermoscopic features that were often seen in dysplastic nevi, like the multicomponent structure and the irregular globules, while the irregular blotches were a feature shared both by dysplastic nevi and melanoma.</p>

O carcinoma de cabeça e pescoço é uma neoplasia maligna de origem epitelial que resulta em aproximadamente 500.000 novos casos por ano ao redor do mundo. Diversos estudos têm sido conduzidos de maneira a elucidar os mecanismos de proliferação e invasão desta doença, sendo a via de sinalização Akt/mTOR e proteínas relacionadas, apontada como uma das principais vias envolvidas em sua progressão. Sabe-se que células neoplásicas, bem como células de diferentes tecidos, podem ter seu comportamento modificado após terem sido irradiadas com laser em baixa intensidade (LLLT). Porém, os mecanismos de atuação da luz laser de baixa potência sobre estas células permanecem ainda não completamente esclarecidos. Portanto, o objetivo deste estudo foi o de analisar a viabilidade celular e expressão das proteínas Akt, pAkt, Hsp90, S6, pS6 e Ciclina D1 em duas linhagens celulares de carcinoma de boca (SCC9 e SCC25), bem como em uma linhagem de queratinócitos orais humanos com displasia (DOK) após irradiação com laser em baixa intensidade. O laser utilizado foi um diodo semicondutor de arseneto de Gálio e Alumínio (GaAlAs) operando nos comprimentos de onda vermelho (660nm) e infravermelho (780nm), com potência fixa em 40mW e três densidades de energia para cada comprimento de onda disponível: 2.05J/cm², 3.07J/cm² e 6.15J/cm². A análise de apoptose foi realizada por meio do teste de TUNEL e a expressão proteica foi obtida com imunofluorescência e western blotting. Após análise estatística por meio do método ANOVA dois critérios e testes de Tukey ou teste T de estudante, todos com nível de significância de 5%, pôde-se concluir que a LLLT induziu comportamentos distintos em cada uma das linhagens celulares utilizadas. Foi notado aumento, bem como diminuição da viabilidade celular, dependendo do comprimento de onda utilizado e das células irradiadas. A densidade de energia de 2.05J/cm² foi a que produziu efeitos mais significativos em SCC9. Para a linhagem celular SCC25, a dose mais relevante foi a de 3.07J/cm², enquanto que para a linhagem DOK, a dose de 6.15J/cm² causou efeitos mais proeminentes. Estas respectivas doses foram escolhidas para cada uma das linhagens para dar continuidade aos experimentos de Western Blotting e Imunofluorescência. Dentre os resultados mais relevantes obtidos com estas técnicas, pode-se citar a variação dos níveis de pS6 e Ciclina D1 para a linhagem DOK em determinados períodos. Já a linhagem SCC9 apresentou variação dos níveis de pAkt e Ciclina D1 nos períodos estudados. A linhagem SCC25 também teve as expressões de pAkt, pS6 e Ciclina D1 modificadas por LLLT. De maneira interessante, o aparecimento ou manutenção de uma isoforma de Hsp90 foi encontrado em SCC9 e SCC25 após irradiação laser. Por fim, a indução de apoptose foi detectada na linhagem SCC25. Em conclusão, pode-se dizer que a LLLT, como empregada neste estudo, foi capaz de aumentar a expressão de proteínas relacionadas à progressão e invasão em todas as linhagens estudadas. Além disso, a irradiação laser foi única, apesar de ter causado efeitos prolongados, algumas vezes até o último período estudado. / Head and neck squamous cell carcinoma (HNSCC) is an epithelial malignant neoplasm that accounts for approximately 500.000 new cases yearly around the world. Several studies have been conducted to elucidate the mechanisms of proliferation and invasion of this lesion, whereas the Akt/mTOR signaling pathway with its related proteins is being pointed out as one of the main pathways involved in HNSCC`s progression. Neoplastic cells, as well as cells that originate from different tissues may have their behavior modified by low level laser therapy (LLLT); however, the mechanisms through which the low level laser light interacts with these cells remain poorly understood. Thus, this study sought to evaluate the cell viability and the expression levels of Akt, pAkt, Hsp90, S6, pS6 and Cyclin D1 proteins in two oral squamous cell carcinoma cell lineages (SCC9 and SCC25) and in one oral dysplastic human keratinocyte cell line (DOK) after they had been treated with LLLT. The laser device was a semiconductor diode of Gallium and Aluminum Arsenate (GaAlAs), operating with wavelengths of 660nm (red) and 780nm (infrared), with a fixed power of 40mW and giving three different energy densities: 2.05J/cm², 3.07J/cm² and 6.15J/cm². Apoptosis was analyzed through TUNEL test and the protein expression was accessed with Immunofluorescence and Western blotting. After statistical analysis through two-way ANOVA and Tukey or Student`s T test, all of them with a level of significance of 5%, it was concluded that LLLT induced distinct behaviors to each of the studied cell lines. Increases and inhibitions in cell viabilities were detected depending on the wavelength and also on the irradiated cell line. The energy density of 2.05J/cm² produced the most significant findings over SCC9. On the other hand, in SCC25 the most relevant results were detected with 3.07J/cm², while the most prominent findings were seen with 6.15J/cm² when the cell line DOK was evaluated. In that way, these respective doses were chosen for each cell line to continue with Western blotting and Immunofluorescence. Among the most relevant findings, the variation of pS6 and Cyclin D1 levels can be cited for DOK in some evaluated periods. SCC9 presented both pAkt and Cyclin D1 variations in the studied periods. Besides that, SCC25 also had pAkt, pS6 and Cyclin D1 levels modified by LLLT. Interestingly, the appearance and maintenance of an Hsp90 isoform was found in SCC9 and SCC25 after laser irradiation. Moreover, the induction of apoptosis was detected for the SCC25 cell line. Finally, the LLLT employed herein was able to enhance the expression of proteins related to progression and invasion in all of the studied cell lines. In addition, there was a single laser irradiation, although it caused prolonged effects, sometimes through the latest evaluated period.

O carcinoma de cabeça e pescoço é uma neoplasia maligna de origem epitelial que resulta em aproximadamente 500.000 novos casos por ano ao redor do mundo. Diversos estudos têm sido conduzidos de maneira a elucidar os mecanismos de proliferação e invasão desta doença, sendo a via de sinalização Akt/mTOR e proteínas relacionadas, apontada como uma das principais vias envolvidas em sua progressão. Sabe-se que células neoplásicas, bem como células de diferentes tecidos, podem ter seu comportamento modificado após terem sido irradiadas com laser em baixa intensidade (LLLT). Porém, os mecanismos de atuação da luz laser de baixa potência sobre estas células permanecem ainda não completamente esclarecidos. Portanto, o objetivo deste estudo foi o de analisar a viabilidade celular e expressão das proteínas Akt, pAkt, Hsp90, S6, pS6 e Ciclina D1 em duas linhagens celulares de carcinoma de boca (SCC9 e SCC25), bem como em uma linhagem de queratinócitos orais humanos com displasia (DOK) após irradiação com laser em baixa intensidade. O laser utilizado foi um diodo semicondutor de arseneto de Gálio e Alumínio (GaAlAs) operando nos comprimentos de onda vermelho (660nm) e infravermelho (780nm), com potência fixa em 40mW e três densidades de energia para cada comprimento de onda disponível: 2.05J/cm², 3.07J/cm² e 6.15J/cm². A análise de apoptose foi realizada por meio do teste de TUNEL e a expressão proteica foi obtida com imunofluorescência e western blotting. Após análise estatística por meio do método ANOVA dois critérios e testes de Tukey ou teste T de estudante, todos com nível de significância de 5%, pôde-se concluir que a LLLT induziu comportamentos distintos em cada uma das linhagens celulares utilizadas. Foi notado aumento, bem como diminuição da viabilidade celular, dependendo do comprimento de onda utilizado e das células irradiadas. A densidade de energia de 2.05J/cm² foi a que produziu efeitos mais significativos em SCC9. Para a linhagem celular SCC25, a dose mais relevante foi a de 3.07J/cm², enquanto que para a linhagem DOK, a dose de 6.15J/cm² causou efeitos mais proeminentes. Estas respectivas doses foram escolhidas para cada uma das linhagens para dar continuidade aos experimentos de Western Blotting e Imunofluorescência. Dentre os resultados mais relevantes obtidos com estas técnicas, pode-se citar a variação dos níveis de pS6 e Ciclina D1 para a linhagem DOK em determinados períodos. Já a linhagem SCC9 apresentou variação dos níveis de pAkt e Ciclina D1 nos períodos estudados. A linhagem SCC25 também teve as expressões de pAkt, pS6 e Ciclina D1 modificadas por LLLT. De maneira interessante, o aparecimento ou manutenção de uma isoforma de Hsp90 foi encontrado em SCC9 e SCC25 após irradiação laser. Por fim, a indução de apoptose foi detectada na linhagem SCC25. Em conclusão, pode-se dizer que a LLLT, como empregada neste estudo, foi capaz de aumentar a expressão de proteínas relacionadas à progressão e invasão em todas as linhagens estudadas. Além disso, a irradiação laser foi única, apesar de ter causado efeitos prolongados, algumas vezes até o último período estudado. / Head and neck squamous cell carcinoma (HNSCC) is an epithelial malignant neoplasm that accounts for approximately 500.000 new cases yearly around the world. Several studies have been conducted to elucidate the mechanisms of proliferation and invasion of this lesion, whereas the Akt/mTOR signaling pathway with its related proteins is being pointed out as one of the main pathways involved in HNSCC`s progression. Neoplastic cells, as well as cells that originate from different tissues may have their behavior modified by low level laser therapy (LLLT); however, the mechanisms through which the low level laser light interacts with these cells remain poorly understood. Thus, this study sought to evaluate the cell viability and the expression levels of Akt, pAkt, Hsp90, S6, pS6 and Cyclin D1 proteins in two oral squamous cell carcinoma cell lineages (SCC9 and SCC25) and in one oral dysplastic human keratinocyte cell line (DOK) after they had been treated with LLLT. The laser device was a semiconductor diode of Gallium and Aluminum Arsenate (GaAlAs), operating with wavelengths of 660nm (red) and 780nm (infrared), with a fixed power of 40mW and giving three different energy densities: 2.05J/cm², 3.07J/cm² and 6.15J/cm². Apoptosis was analyzed through TUNEL test and the protein expression was accessed with Immunofluorescence and Western blotting. After statistical analysis through two-way ANOVA and Tukey or Student`s T test, all of them with a level of significance of 5%, it was concluded that LLLT induced distinct behaviors to each of the studied cell lines. Increases and inhibitions in cell viabilities were detected depending on the wavelength and also on the irradiated cell line. The energy density of 2.05J/cm² produced the most significant findings over SCC9. On the other hand, in SCC25 the most relevant results were detected with 3.07J/cm², while the most prominent findings were seen with 6.15J/cm² when the cell line DOK was evaluated. In that way, these respective doses were chosen for each cell line to continue with Western blotting and Immunofluorescence. Among the most relevant findings, the variation of pS6 and Cyclin D1 levels can be cited for DOK in some evaluated periods. SCC9 presented both pAkt and Cyclin D1 variations in the studied periods. Besides that, SCC25 also had pAkt, pS6 and Cyclin D1 levels modified by LLLT. Interestingly, the appearance and maintenance of an Hsp90 isoform was found in SCC9 and SCC25 after laser irradiation. Moreover, the induction of apoptosis was detected for the SCC25 cell line. Finally, the LLLT employed herein was able to enhance the expression of proteins related to progression and invasion in all of the studied cell lines. In addition, there was a single laser irradiation, although it caused prolonged effects, sometimes through the latest evaluated period.

Einleitung: Fehlbildungen der Nieren und ableitenden Harnwege gehören zu den häufigsten angeborenen Anomalien. Ihr Anteil an den pränatal diagnostizierten Fehlbildungen wird mit bis zu 50% angegeben. Die Behandlung urogenitaler Fehlbildungen hat sich nicht zuletzt unter dem Einfluss der Pränatalen Diagnostik erheblich gewandelt. Nach einer Phase der Übertherapie nach Einführung der pränatalen Diagnostik ergab sich nach modernen diagnostischen Kriterien und im Ergebnis von Langzeitstudien des natürlichen Ganges der Fehlbildungen eine wesentlich differenziertere Indikationsstellung für das aktive therapeutische Vorgehen Fragestellung: In der retro- und prospektiv angelegten Studie sollte untersucht werden, inwieweit die pränatale Diagnostik das postnatale Vorgehen beeinflusst. So sollte untersucht werden, aus welchen pränatalen Befunden welche pränatalen Verdachtsdiagnosen gestellt wurden und wie sich diese zu den definitiven postnatalen Diagnosen verhalten. Des weiteren sollte der Aussagewert einzelner pränataler Befunde herausgearbeitet werden. Besondere Beachtung sollte dabei die Frage finden, inwieweit aus den pränatalen Befunden eine Aussage über die postnatale Therapiebedürftigkeit und schließlich auch für die Prognose der Nierenfunktion möglich ist. Patienten und Methoden: Ausgangspunkt waren 21.616 in der Abteilung für pränatale Diagnostik und Therapie in der Zeit von 1984 bis 1996 untersuchte Schwangerschaften. Unter diesen fanden sich 1.574 Feten mit angeborenen Anomalien mit fraglich kinderchirurgischer Relevanz. 1077 Fälle konnten ausgewertet werden. Mit 990 Fällen dominierten die Fehlbildungen des Urogenitalsystems, von denen 693 in die komplette Analyse mit einbezogen werden konnten. Ergebnisse: Bei 7,28% aller untersuchten Feten fanden sich Organfehlbildungen außerhalb des Zentralnervensystems. Unter diesen dominierten Harntraktfehlbildungen mit 63%. Als häufigste Diagnose wurde pränatal eine "Hydronephrose" angegeben. Dieser Begriff umschreibt jedoch in dem hier verwandten Sinne eine Harntransportstörung jeglicher Ursache. Echte Diagnosen obstruktiver Uropathien wurden lediglich zu 30% in den einzelnen Gruppen gestellt. Die pränatalen Verdachtsdiagnosen bestätigen sich zu zwischen 80 und 90% wenn: - eine isolierte Hydronephrose mit einem Nierenbeckendurchmesser von über 10 mm als Ureterabgangsstenose befundet wurde - die typische Konfiguration einer Multizystischen Nierendysplasie gefunden wurde - aus der Kombination von Oligohydramnion, Megazystis und bilateraler Harntransportstörung des männlichen Feten auf Urethralklappen geschlossen wurde. Lediglich bei der unilateralen multizystischen Nierendysplasie und der subpelvinen Obstruktion wird im pränatalen Befund bezüglich der definitiven Diagnose eine akzeptable Sensitivität und Spezifität erreicht. Alle anderen Diagnosen werden zu 70% postnatal gestellt. Der Einfluss der pränatalen Diagnostik auf das postnatale Management bezieht sich in erster Linie auf die Aufdeckung vorerst symptomloser Fehlbildungen. Eine pränatale Aussage über die zu erwartende Nierenfunktion ist bei einseitigen Fehlbildungen derzeit nicht möglich. Zusammenfassung: Obstruktive Uropathien sind häufige, zumeist benigne Fehlbildungen. Sie sind der pränatalen Diagnostik gut zugänglich. Konkrete Diagnosen mit Aussagen zur postnatalen therapeutischen Relevanz können jedoch nur gestellt werden, wenn sonografisch pathognomonische Konstellationen dies ermöglichen. In allen anderen Fällen muss die pränatal beschriebene Auffälligkeit Anlass zu postnataler sorgfältiger Diagnostik sein, um im präsymptomatischen Intervall die Entscheidung zu konservativer oder operativer Therapie stellen zu können. / Introduction: Among congenital dysplasias the anomalies of kidney and urogenital tract are among the most frequent encountered. Their rate in prenatally made diagnoses is about 50 %. Modern prenatal diagnostic facilities have changed the therapeutic access to these anomalies in the last decade. After a phase of overtreatment in the beginning, nowadays new insights in the natural course of these dysplasias and the results of long-term follow-up studies resulted in a more differentiated apporach. Questions and methods: In this retro- and prospective study we looked for the the influence of prenatal diagnostics on the postnatal course and management. The question was to examine the relationship between the prenatal ultrasound results, the suggested prenatal diagnosis and then the defintive postnatal disease. Of interest was the prognostic impact of typical prenatal sonographic imaging on the postnatal course of the baby. Because of its frequency we focused on anomalies of the kidney and urogenital tract. Patients: Between 1984 and 1996 21.616 pregnancies were examined by ultrasound in our Department of Prenatal Medicine. Among these, 1.574 anomalies of surgical relevance were described. 1.077 cases were available for follow-up including 990 cases of urogenital anomalies. Among these, the records of 693 cases were complete and these patients form the collective of this study. Results: When the CNS was excluded we found organic anomalies in 7,28 % of these cases. Among them 63% were attributed to the urogenital system. The most common prenatal diagnosis was "hydronephrosis". But this term was used only in a descriptive manner because proof of a real obstructive uropathy postnatally was made only in 30% of these cases. Concerning all anomalies of the urogenital tract, the prenatal diagnosis proved correct in the overwhelming majority of cases ( 90%) if these sonographic signs have been described: - diameter fo the renal pelvis of more than 10 mm in isolated hydronephrosis predicted ureteropelvic junction obstruction - typical formation of a multicystic dysplastic kidney - combination of oligohydramnion, megacystis and bilateral kidney anomalies in a male fetus predicted posterior urethral valve disease Sensitivity and specifity in regard to the definitive diagnosis were acceptable in multicystic dysplasia of the kidney and ureteropelvic junction obstruction. In all other cases, the correct diagnosis was made postnatally in 70 %. Therefore, the main value of prenatal sonography was to reveal otherwise symptomless dysplasias. Until now, a prenatal prediction of kidney function in the unilateral case is not possible. Conclusion: Obstructive uropathies are common an in most cases benign anomalies. They are easily detected by prenatal ultrasound. Therapeutical consequences, however, only arise in selected cases if typical sonographic signs can be seen. In the majority of cases, therefore, the main purpose of prenatal diagnostic ultrasound points out the necessity for postnatal diagnostic workup in order to detect and treat severe diseases before symptoms occur.