, Ku Yong Chung, Ho-Seong Han, Yung Man Choi Kimura disease, which was initially described by Kimura et al. in 1948, is a rare entity that occurs primarily in Asian people characterized histopathologically by a lymphofolliculoid granuloma with infiltration of the mass and the surrounding tissue by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum Ig E. The kimura disease frequentlly involves head and neck region and reraly extrimities. When the disease involvews parotid gland, it is very difficult to differentiate clinically with parotid gland tumor. We have experienced a case of Kimura disease. The lesion was initially diagnosed as a parotid gland due to extensive fibrosis surrounding the mass. So, the mass excision was performed without clear identification of the facial nerve. The Kimura disease usually follows a benign course. But when this disease is confused with parotid gland tumor, there will be a danger of nerve injury due to difficulty in dissection of the extensive fibrotic soft tissue surrounding the parotid gland.
, Ku Yong Chung, Jeong Soo Suh, Chung Sik Rhee Our purpose was to discuss the current results of renal transplantation at our institute and to document the usefulness of the ultrasonography in the follow-up of renal allograft.
Thirty five renal allografts who operated and followed-up at our hospital were included. All patients underwent renal duplex and Doppler sonography. According the clinical course of allograft, the sonographic findings were classified into successful renal transplantation(SRT), acute rejection(AR), chronic rejection(CR), and graft failure(GF). We retrogradely analyzed the sonographic findings as follows : renal size(length, width, thickness), cortex echogenicity, corticomedullary differentiation, renal sinus and pyramid, renal pelvis, resistive index(RI).
Results of allografts were as follows : SRT, 24 case(68.6%) ; AR, 6(17.1%) : CR, 3(8.6%) ; and GF, 2(5.7%). The changes of length of allografts were shown no statistically significant changes between the groups, but there is significant increase of thickness of allograft in AC and GF with significance. The mean RI was statistically increased in AR(RI=0.87), and the mean RI's of other groups were 0.65, 0.70, and 0.67 in order to SRT, CR, GF. Parenchymal echogenicities are changed in 66.7% of AC and CR, 25% of SRT, and 50% of GF without clinical significance. There are changes of CMJ, pyramid, sinus echo, renal pelvis of allografts, however, which were shown no statistical significance.
Even though we have small cases and short experiences of renal transplantation at our institute, we considered we have relatively good results and it was guessed there were many efforts for the renal transplantation. The duplex and Doppler sonography were useful tools in the follow-up of allograft, especially deciding acute rejection and graft failure, although it is difficult to decide chronic rejection and can not used to differentiate between the main parenchymal causes of graft failure.
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