In modern society we have been gradually interested in the elderly and easily come into contact with many medical favors to enhance the quality of life, and the elderly are gradually increasing owing to the development of the basic science such as new diagnostic machinery, operative technique and development of the therapeutics. However, the variation of the environment has increased the possibility to be exposed to the dangerous factors, and it has given rise to the problems about the quality of the elderly life. It has also greatly enlarged in medical as well as social. Therefore, the frequency of the elderly reconstructive surgery to increase the quality of the elderly life by operation without life or death has increased in plastic surgery. So authors thought that the safe operative study is necessary. We reviewed the case of 102 elderly patients (65 years of age), who were operated during the period from 1988 to 1995, and analyzed the age & sex distribution, classification & distribution of diseases in elderly, operation of plastic & reconstructive surgery in elderly, anesthetic, methods, underlying diseases, and postoperative complications through the patient records. We also examined postoperative function, aesthetic improvement, progression of the quality of life by telephone and analyzed the elderly classification and elderly plastic & reconstructive surgery. The results are as follows : 1. There were benign neoplasm, facial bone fracture, aesthetic surgery, skin and soft tissue defect, complicated diabetic mellitus, malignant ulcer, malignant neoplasm, pressure sore in elderly diseases of plastic & reconstructive surgery. 2. We mainly performed skin graft, flap surgery, ORIF, aesthetic surgery. 3. The recovery rate after postoperative evaluation shows that ; 1) 52% of total interviewee feel that their QOL has improved. 2) 24% of total interviewee feel that their QOL has not changed. 3) 24% of total interviewee feel that their QOL has deteriorated. We report the point at issue and statistical examination with record investigation.
Aged* ; Classification ; Dermatologic Surgical Procedures ; Facial Neoplasms ; Fractures, Bone ; Humans ; Postoperative Complications ; Pressure Ulcer ; Quality of Life ; Sex Distribution ; Skin ; Surgery, Plastic* ; Telephone ; Transplants ; Ulcer

No abstract available.
Cell Line* ; Intercellular Signaling Peptides and Proteins* ; Osteoblasts*

Onychomycosis can be diagnosed by mycological examination, but it is not easy to detect its causative organisms because the positive rate of culture is lower and its scores are variable due to the contamination inherently introduced in the current method used in sampling the ovychomycosis organisms. It was suggested that the scores depended upon the handicraft of operates and the gainning method of nail material, so we modeled the watch mending drivers into the punching instruments, and holed deeply & widly through the nail plate, from the surface to the bottom. Afterward, the KOH mount & culture were performed to compare this new punch method used with that of standard scrapping method. Through the KOH examination more numerous hypaes were found in the punch methods sample than the scrapping methods sample. Also, the punch methods positive culture rate was found to be 2. 5 times higher than that of the scrapping methods culture rate, with a 5 to 5. 5 times lower amount of contamination. In conclusion, the punch method was found to be a more precise and effective method of obtaining onychomycosis organisms. Although this method required a slight greater time to perform than the standard scrapping method, I believe it will be a valuable aid in the detection of causative organisms of onychamycosis.
Onychomycosis*

The authors investigated the incidence of stratum corneum and upper epidermal cytoplasmic antibodies with 30 untreated and 20 treated psoriasis sera, and normal human sera using normal human skins of 5 different sites and psoriatic lesion by the method of indirect immunofluorescence in order to evaluate immunologic responses i n psoreasis. The results are summarized as follows . I) The positivity of stratum corneum antibodies in untreated psoriasis sera(78.7%) was si, nificantly higher than that in normal sera(64.0%). The incidence of stratum corneum antibodies in untreated psoriasis sera was found to be the highest in the arm, followed by the scalp, leg, abdomen, and face as substrate. 2) The positivity of stratum corneum antibodies in psoriasis and normal human sera was significantly higher when tested with the psoriatic lesion as substrate than norma! skin as substrate, 3) The titer of stratum corneum antibodies in 5 sera using human skin obtained from 5 different sites on the body as substrate are the highest in the arm, and leg, and(in decreasing order of frequency) the scalp, abdomen, and face. 4) The positivity of upper epidermal cytoplhsmic antibodies in normal human sera (40.7%) was significa.ntly higher than that in untreated psoriasis sera(21.3%). 5) Ir.. the majority of cases, upper epidermal cytoplasmic antibodies coexisted with straturn corneum antibodies in the sera of patients with psoriasis and in the sera of normal humans.
Abdomen ; Antibodies* ; Arm ; Cytoplasm* ; Fluorescent Antibody Technique, Indirect ; Humans ; Humans* ; Incidence* ; Leg ; Psoriasis* ; Scalp ; Skin

Magnetic resonance (MR) imaging has been widely used in the clinic because of the benefit of high spatial and temporal resolution, and the excellent anatomical tissue contrast. Cancer-targeted MR molecular imaging comprises 3 major components: a relevant molecular target which is specifically highly expressed on the membrane of the cancer cell; a target specific imaging probe which is composed of superparamagnetic iron oxide nanoparticle coreconjugated target specific ligand such as antibody, peptide, and molecules; MR imaging hardware and software which are sensitive to the imaging probe. Among the various molecular targets, HER2/neu receptor antibody, folic acid, and arginine-glycine-aspartic acid (RGD) are well known targeting ligands. The sensitivity of the cancer-targeted MR imaging is affected by the magnetic susceptibility of the T2 contrast agent, resolution of the image, targeting efficiency of the imaging probe, and image acquisition pulse sequence. Recently, successful cancer-targeted MR imaging with T1 contrast agent and cancer-specific molecular MR imaging using innate contrast of the cancer cell by chemical exchange phenomenon without using the imaging probe has been introduced. Cancer-targeted MR molecuar imaging is a robust diagnostic method to detect cancer at the cellular stage of the cancer development and it would help improve early detection rate of the cancer.
Ferric Compounds ; Folic Acid ; Iron ; Ligands ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Membranes ; Molecular Imaging ; Nanoparticles

After the stabilization using unreamed intramedullary interlocking nails for the management of fractures of the tibial shaft, a large percentage of patients whose fractures would proceed to delayed bony union may be subject to secondary surgical procedure. The purpose of this study is to determine whether ultrasound, through its potential early assessment of the presence or absence of callus at the fracture site, can be used to predict the need for secondary surgical procedure. Fourteen tibial fractures (5 open, 9 closed) were treated with unreamed interlocking intramedullary nailing. Radiographs were obtained to monitor the maintenance of reduction and fracture healing. The results of ultrasound studies were obtained at two-week intervals for 10 weeks postoperatively and read by a radiologist. In prospective study of 14 patients, tibial fractures treated with unreamed interlocking intramedullary nailing were analyzed from June 1995 to February 1997 and following results were obtained. 1. Ultrasound correctly predicted fracture healing in all 10 fractures that subsequently progressed to fracture union. 2. Of the 4 fractures that did not heal, ultrasound was able to predict delayed union before it was radiographically evident. 3. Ultrasound predicted fracture healing at an average of 42 days (range, 22-70 days). In comparison, the plain radiographs showed fracture healing at an average of 126 days (range, 70 - 180 days). In conclusion, the tibia was ideal for ultrasound study because of the thin overlying soft tissue. Furthermore, the presence of the intramedullary nail facilitated evaluation of the intervening tissue. And there were several advantages of ultrasound over other imaging modalities. It was noninvasive, easy to use, and painless method of evaluation that does not use ionizing radiation.
Bony Callus ; Fracture Fixation, Intramedullary ; Fracture Healing* ; Humans ; Prospective Studies ; Radiation, Ionizing ; Tibia* ; Tibial Fractures ; Ultrasonography*

No abstract available.
Humans ; Subcutaneous Tissue* ; Tissue Donors* ; Ultrasonography*

Atrophie blanche is a rare vasculitis reported by Milian in 1929, that is characterizel by small erythematous, telangiectatic purpura which developes central hemorragic curst or painful ulceration and heals with atrophic white scar several months later. It is seen more commonly in middle-aged women and become worse in summer. It manifests primarly on the lower legs, ankles and dorsa of the feet, rarely on the elbows and dorse of the hands, where are the areas of the poor blood circulation. This case was 45 year-old woman who had suffered from periodic painful ulceration on the legs, ankles, dorsa of feet k hands and. elbows for about 18 years. Histopathologic findings showed fibrinoid degeneration R partial occlusion in the capillaries and mild perivascular chronic inflammatory cells infiltration in the upper corium. The lesion was not so improved by systemic k local corticosteroid therapy for about 3 months,
Ankle ; Blood Circulation ; Capillaries ; Cicatrix ; Dermis ; Elbow ; Female ; Foot ; Hand ; Humans ; Leg ; Middle Aged ; Purpura ; Ulcer ; Vasculitis

BACKGROUND: CD44 is a family of glycoproteins involved in cell to cell and cell to matrix interactions. Overexpression of CD44v6(variant exon 6) form has been reported in several malignant tumors such as stomach cancer, uterine cervical cancer, colorectal cancer, breast cancer and keratinocytic skin tumors, such as, basal cell carcinoma and squamous cell carcinoma. However, CD44 expression in cutaneous T cell lymphoma has not been investigated thoroughly. OBJECTIVE: The purpose of this study is to examine whether there is any difference in the expression of CD44s & CD44v6 between mycosis fungoides(MF), angiocentric T cell lymphoma, subcutaneous panniculitic T cell lymphoma, Ki lymphoma and unspecified peripheral T cell lymphoma. We also evaluated the statistical significance between the expression of CD44v6 and systemic involvement of the diseases. METHODS: Routine paraffin sections of formalin-fixed 33 tissues (11 MF, 8 angiocentric T cell lymphoma, 5 subcutaneous panniculitic T cell lymphoma, 2 Ki lymphoma, 1 unspecified peripheral T cell lymphoma, 2 psoriasis, 2 lichen planus, 2 erythema nodosum) were labeled with anti-CD44 monoclonal antibody using a avidin-biotin-peroxidase complex. Normal skin served as the negative control. RESULTS: 1. Eccrine glands, hair follicles and the epidermis, except the cornified layer, showed positive staining for CD44s. In inflammatory skin diseases, it showed positive staining for CD44s, however CD44v4/5 and CD44v6 stainings were negative. 2. All(4 out of 4) of the tumor stages of MF showed positive CD44s staining, and 3 out of 4 showed positive CD44v6 staining(p=0.024). However, none of them expressed CD44v4/5. 3. All 8 cases of angiocentric T cell lymphoma were positively stained for CD44s, but not for CD44v4/5. In contrast to other peripheral T cell lymphoma, CD44v6 was expressed in 3 out of 8 cases of angiocentric T cell lymphoma. In subcutaneous T cell lymphoma, only the CD44s was expressed, and Ki lymphoma was positively stained for CD44s and negatively stained for CD44v4/5 and CD44v6. 4. In CD44v6 positive angiocentric T cell lymphoma (3 out of 8) and CD44v6 positive tumor stages of MF (3 out of 4), 5 out of 6 patients had systemic involvement suggesting a statistical significance between CD44v6 expression and patient's systemic involvement(p=0.015). CONCLUSION: These results suggest that CD44v6 may serve as a useful prognostic marker in the tumor stage of mycosis fungoides and angiocentric T cell lymphomas.
Breast Neoplasms ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Colorectal Neoplasms ; Eccrine Glands ; Epidermis ; Erythema ; Exons ; Glycoproteins ; Hair Follicle ; Humans ; Lichen Planus ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous* ; Lymphoma, T-Cell, Peripheral ; Mycosis Fungoides ; Paraffin ; Psoriasis ; Skin ; Skin Diseases ; Stomach Neoplasms ; Uterine Cervical Neoplasms

The mechanism responsible for the formation of sunburn cells in mammalian skin is unknown. However it is suggested that the reactive free radicals and oxygen species generated by UV radiation are causing oxidative reactions in certain keratinocytes that are manifestated in the form of dyskeratotic cells and free radical scavengers such as a-tocopherol acetate or p-carotene were thought to be photoprotective against sunburn radiation. In the present study, we evaluated the effect of single and multiple applications of n-tocopherol acetate(a-TCA) and p-carotene on the formation of sunburn cells. We also determined the effect of these two antioxidants on the sunburn reartion by UVB irradiation. The results were as follows : 1. Both a-tocopheroJ acetate and p-carotene were photoprotective and prevented the formation of sunburn cells and sunburn reaction. 2. Topical p-carotene was less photoprotective than u-tocopherol acetate. 3. Topical use of a-tocopherol acetate and p-carotene in dose range exceeding 1,000 pgcm could provide photoprotective effect if the UVB exposure doses were less than 300 mJ/cm'( 3 MED)
Animals ; Antioxidants ; Carotenoids* ; Free Radical Scavengers ; Free Radicals ; Guinea Pigs* ; Guinea* ; Keratinocytes ; Oxygen ; Skin ; Sunburn ; Tocopherols*