Topographical Relationship of the Superficial Temporal Vessels and the Auriculotemporal Nerve / 대한해부학회지

The anatomy of the superficial temporal vessels and the auriculotemporal nerve is important when harvesting various skin flaps in the temporal region. But Anatomy textbooks describe only one pattern of topographical relationship between these structures. A total of 65 Korean cadavers with 121 sides were used. We examined the topographical relationship between the superficial temporal artery and vein and the auriculotemporal nerve. And the bifurcating location of the superficial temporal artery and its distance from the lamina tragi were measured. The running patterns of the superficial temporal vessels were classified into 4 types according to their distance from each other and their parallelism. The artery and vein run parallel to each other in 61.2%. The running patterns of the superficial temporal vessels were classified into 5 types according to their anterior and posterior relationship. The artery runs anterior to the vein in most of the cases (72.7%). The topographic relationships of the auriculotemporal nerve and the superficial temporal vessels were classified into 6 types according to their anterior, posterior, superficial or deep position. In this classification, the relationship between the artery and the vein was not considered. The frequencies of 6 types were within 10~20%. The bifurcation of the artery occurred above the zygomatic arch in 85.3%. The superficial temporal artery ran 5.1 mm anterior to the tragus.

Clinical Outcome of Kidney Retransplantation / 대한이식학회지

Renal transplantation is the optimal treatment for end stage renal disease and it has been improved through the development of operative methods and immunosuppressants. However some patients must receive dialysis or undergo retransplantation after a loss of the primary graft due to rejection or other causes. Recently the frequency of retransplantation has begun to increase gradually. Some articles have reported that retransplantation results do not significantly differ in comparison with initial transplantation results when living related donor kidneys are used. Our study focused on the outcome of 445 first transplantation and 12 retransplantation cases. The sex distribution of retransplanted patients was 11 male and 1 female. The mean age (yrs) for recipients was 32.3 at the first transplantation and 39.1 at the retransplantation. The underlying causes of end stage renal disease were presumed to be chronic glomerulonephritis in all retransplantion patients; the mean duration of graft survival (mo) for first transplantation was 77.92. The causes of previous graft failure were as follows: 10 due to chronic rejection, 1 due to recurrent glomerulonephritis, 1 resulted from a graft rupture due to a motorcar accident. The interval (mo) between graft failure and retransplantation averaged 6.7 and 9 out of 12 patients underwent regrafting within 1 year of their previous graft loss. Recipient-donor relationships in first transplantations were as follows: 9 were living related and 3 were living non-related. Recipient-donor relationships in second transplantations were as follows: 4 were living related and 8 were living non-related. Acute rejection within 1 month of transplantation occurred in 4 primary transplantation patients and 2 retransplantation patients. The incidence of acute rejection within 1 month was as follows: 23% of 445 first renal transplantation patients, 16.7% of 12 second transplantation patients. The 1 year and 2 year graft survival rate was 100% and the mean survival duration (mo) was 33 for retransp

Comparison of Urea Kinetic Modeling, Standardized Creatinine Clearance and Indices of Nutrition in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients / 대한내과학회지

OBJECTIVES: Protein-calorie malnutrition has been shown to be prevalent among patients on chronic dialysis, And assessment of nutritional status of continuous ambulatory peritoneal dialysis(CAPD) patients has assumed greater importance because of the association of protein-calorie malnutrition with increasing morbidity and mortality. So we observed the incidence and clinical effect of protein-calorie malnutrition, and we compared the indices of nutrition with dialysis adequacy utilizing urea kinetic modeling and cretinine clearance in CAPD patients. METHODS: We performed a cross-sectional study in which eight parameters, based on anthropometry, blood chemistry and subjective symptoms, were scored according to the degree of abnormalities in 82CAPD patients. A malnutrition index was derived from these scores. We also performed comparative analysis to identify significant correlations of the indices of urea kinetic modeling and creatinine clearance with the other parameters of nutritional status. RESULTS: The malnutrition index classified 47(57%) patients as normal, 30(37%) intermediately malnourished, and 5(6%) as severely malnourished. Malnutrition index showed a significant correlation with the body mass index(BMI), triceps skinfold thickness(TSF), mid-arm circumference(MAC), mid-arm muscle area (MAMA), duration of CAPD, subjective symptoms, serum albumin, transferrin, cholesterol, and triglyceride. The malnutrition index also showed a significant correlation with residual renal function(RRF), and standardized creatinine clearance(SCCr). The TWR-Kt/V(total Kt/Vurea per week with consideration of residual renal urea clearance) was significantly lower in the severely malnourished group than in the normal group. Serum alkaline phosphatase and BUN levels were higher in the severely malnourished group than in the normal and inter-mediate groups. CONCLUSION: In assessing the nutrition status of CAPD patients, body weight, TSF, MAC, MAMA, subjective symptoms, serum albumin, transferrin, cholesterol, triglyceride, urea nitrogen, and alkaline phosphatase were considered useful parameters. There was a trend of increased BUN and decreased TWR-Kt/V in severely malnourished patients, and the value of SCCr was significantly lower in malnourished patients. However, no meaningful relationships between TW-Kt/V and malnutrition index or between NPCR(normalized protein catabolic rate) and malnutrition index were found m this cross-sectional study. As the number of patients with longer duration of CAPD or negligible RRF has increased in the malnourished patients, regular monitoring of these parameters, especially TWR-Kt/V and SCCr, may be helpful to assess dialysis adequacy to keep good nutritional status of each CAPD patient.