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

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*

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

A 47-year-old male patient presented us with erythematous, telangiectatic, purpuric or hyperpigmented patqhes, recurrent painful ulceration and ivory white atrophic scars on the lower portions of his legs, ankles and dorsal surfaces of both feet exacerbating on every summer for 5 years. The histopathalogical findings of an atrophic patch showed endothelial proliforetiion, partial occlusion of the dermal capillaries and fibrinoid material) on the superficial blood vessels, This patient was treated with aspirin and dipyriclamole for 4 months, and the skin lesions were improved significantly.
Ankle ; Aspirin ; Blood Vessels ; Capillaries ; Cicatrix ; Foot ; Humans ; Leg ; Male ; Middle Aged ; Skin ; Ulcer ; Vasculitis*

The clinical and histopathologic study of 26 cases with tsutsugamushi disease seen at the Department of Derrnatology, Kosin Medical Center, Pusan, Korea from October 1986 to December 1988 was performed. The results were summarized as follows : 1. Age distribution was from 12 to 73 years and male to female ratio was 1: 1.2 (1P, males 14 females). 2. The disease occurred from September to December in a year. The peak incidence was in October (61.5%). 3. Major clinical manifestations were as follows : Chill, fever and headache (100 %), maculopapular eruption (90.2%), eschar (88.5%) and myalgia (84.6%). 4. Eschars were distributed on the abdomen (34.8%), chest (30.4%), leg (7.4%) and ot.her sites. 5. Histopathologic findings of the erythernatous macules in 24 patients showed epiderrnal changes including exocytosis of rnononuclear cells (66.7%), liquefaction degeneration of basal cells (54.2%), spongiosis (33.3%) and epidermal cell necrosis (29.2%). Dermal changes revealed vascular dilatation and perivascular infiltration of rnononuclear cells (100%), extravasated RBC (50%), and edema of papillary dermis (45.8%). Epidermal changes around the eschar were liquefaction degeneration of basal cells (52.2%), spongiosis (43.5%) and exocytosis of mononuclear cells (30.4%). Dermal changes included vascular dilatation and perivascular mononuclear cell infiltration (100%), vessel wall necrosis (73.9%), ederna of papillary dermis (65.2%) and endothelial cell swelling (65.2%).
Abdomen ; Age Distribution ; Busan ; Dermis ; Dilatation ; Edema ; Endothelial Cells ; Exocytosis ; Female ; Fever ; Headache ; Humans ; Incidence ; Korea ; Leg ; Male ; Myalgia ; Necrosis ; Scrub Typhus* ; Thorax

We report a case of Wells' syndrome consisting chiefly of papular, vesicular, pustular and vegetative lesions on the trunk, lower extremities and palms in a 48-year-old female, though characteristic lesions of this syndrome are known to be cellulitis or urticaria like plaques. Only a few cases with such lesions as ours have been reported until now. Histologic finding showed spongiotic vesicles in the epidermis and diffuse dense infiltration of eosinophils with characteristic flame figures in the dermis. In addition, marked blood eosinophilia was noted. We tried oral prednisolone for 3 weeks, and the skin lesions improved almost completely.
Cellulitis ; Dermis ; Eosinophilia ; Eosinophils ; Epidermis ; Female ; Humans ; Lower Extremity ; Middle Aged ; Prednisolone ; Skin ; Urticaria

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

We report a case of paraneoplastic acrokeratosis(Bazex syndrome) occurring in a 70 year old man with small cell carcinoma of the lung. The skin lesions showed violaceous erythema and psoriasiform scaling of the face, aural helices, scalp, and palmoplantar regions with severe nail dystrophy, Histcipathological findings revealed hyperkeratosis, acanthosis and spongiosis in the epiderrnis, and lyrnphocytic infiltration in the upper dermis. He was treated with cis-diamine dichloroplanum(Cisplan), 4 o-demethy-l-o-epipodo- phyllotoxin (Etoposide ) and steroid onitrnent. But eight months later, he died of lung carcinoma.
Aged ; Carcinoma, Small Cell ; Dermis ; Erythema ; Humans ; Lung ; Scalp ; Skin

We report a case of eosinophilic fasciitis occurring in a 48-year-old man who showed tender, edemstous, indurated, and tight skin on the left forearm and elbow joint. Laboratory findings showed peripheral blood eosinophilia and hypergammaglobulinemia. Other laboratory tests were negative or within normal limits including ANA and anti-DNA. Histopathological findings revealed sclerosis of dermis and thickening of fat and fascia with intense infiltrations of lymphocytes, histiocytes and eosinophils. He was treated successfully with oral prednisolone for 2 weeks.
Dermis ; Elbow Joint ; Eosinophilia ; Eosinophils* ; Fascia ; Fasciitis* ; Forearm ; Histiocytes ; Humans ; Hypergammaglobulinemia ; Lymphocytes ; Middle Aged ; Prednisolone ; Sclerosis ; Skin

No abstract available.