• Archives of Plastic Surgery
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• v.36 no.3
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• pp.327-332
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• 2009

Purpose: Several methods of the nipple reduction have been reported. However, the methods described previously are difficult or have some demerits. This study proposes a simple technique for reduction of the nipple height as well as diameter. Methods: The purposed nipple height is marked. A pentahedral design of excision was marked around the nipple. Local anesthetic solution was infiltrated and a 4 - 0 Nylon traction suture was applied at the nipple apex. Excision of the nipple inside both two triangles and a rectangle was made. Remaining two flaps were approximated using 5 - 0 Nylon simple interrupted sutures. However, a part of wound closure was not done in the central area of the nipple. Results: 83 patients(166 nipples) underwent this procedure from December 1999 to December 2008. Follow up ranged from 6 months to 2 years with a mean of 10 months. 78 patients were female and 5 patients were male. No major complication occurred and remaining scars were very inconspicuous. Conclusion: This simple technique has the advantage of nipple reduction in both height and diameter, and provides good aesthetic outcomes.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.170-174
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• 1978

A case of mediastinal seminoma is presented. A male driver, 27 years old Korean, has been suffered from substernal pain, cough and moderate swallowing difficulty since 5 months prior to this admission. At the time of onset, he visited at a local clinic to find some mass in his anterior mediastinum on chest P-A and lateral X-ray check. Recently, intermittent hiccups with much aggravated dysphagia forced him to visit our hospital, and admitted for radical resection under the impression of anterior superior mediastinal tumor of thymus origin. Median sternotomy was done and total resection of the tumor of 8.0X11.0X3.5cm was done without any specific complication and biopsy of the tumor revealed as primary mediastinal seminoma of the mediastinum. Supplementary prophylactic irradiation therapy was done with a tumor dose of 4,000 rad in 4 weeks after operation. Postoperative hospital course was uneventful and patient was joyful with his occupation for 3 months after discharge.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.306-309
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• 1991

Esophageal perforation by a ingested coins is a rare but usually life threatening complication, particularly if there is a delay in their removal. We report a case of esophageal perforation which occurred in a 4-year-old child after ingestion of a coin. The coin was removed through a left cervical esophagostomy approach. A gastrograffin study of the esophagus, performed four days after surgery, revealed the fistula had reopened. The wound was reexplored and the fistula was closed again with some debridement. In spite of the procedure, there had been continuous drainage of the saliva through the cervical fistula of esophagus. However within three weeks of conservative management, aided by a local drainage and hyperalimentation, the fistula of the esophagus was closed spontaneously.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.140-145
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• 2001

Background and Objectives： Intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The purpose of this study was to review the authors’experience and Patient outcome with the laryngotracheal separation (LTS) procedure. Materials and Methods A retrospective review of 9 patients who underwent LTS between 1996 and 2001 was conducted. Ages ranged from 3 to 72 years. Results : Seven patients were expected to have morbid aspiration as a consequence of acquired neurologic injuries and two were congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care and minor procedure. Following LTS, aspiration was effectively controlled in all patients and four were able to tolerate a regular diet. Conclusion : LTS is a low-risk, successful. definitive procedure which decreases the potential for aspiration, pulmonary complication, hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and Poor speech potential.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.924-927
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• 1995

Main bronchial injury after blunt trauma is very rare in all bronchial injuries and the pathogenesis is variable and not well known in everycases. We report a case of complete transsection of right main bronchus by blunt trauma. This 24-year old patient was transferred from a local hospital with a chest tube. Because of the severe subcutaneous emphysema and tension pneumothorax, we inserted one more chest tube resulting no obvious interval change. With the impression of bronchial injury, we performed an exploratory thoracotomy. We couldn't proceed bronchoscopy in the operation room because of his unstable vital sign. After opening of the chest wall, we could identify completely transsected right main bronchus. We anastomosed the bronchus with 4~0 Vicryl interruptedly. After operation, the patient was recovered without any complication.

• Journal of applied mathematics & informatics
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• v.22 no.1_2
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• pp.193-208
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• 2006

A modified BFGS algorithm for solving the unconstrained optimization, whose Hessian matrix at the minimum point of the convex function is of rank defects, is presented in this paper. The main idea of the algorithm is first to add a modified term to the convex function for obtain an equivalent model, then simply the model to get the modified BFGS algorithm. The superlinear convergence property of the algorithm is proved in this paper. To compared with the Tensor algorithms presented by R. B. Schnabel (seing [4],[5]), this method is more efficient for solving singular unconstrained optimization in computing amount and complication.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.264-267
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• 1996

Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidural block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paralysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block which may affect responses of circulatory and ventilatory systems. Accordingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.374-377
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• 1995

Percutaneous neurolysis of upper thoracic sympathetic ganglion was performed by simultaneously injecting 3 ml of pure alcohol into the $T_2$ and $T_3$ levels after testng with same amount of local anesthetics on the same sites. We experienced poor sympatholytic effect or intercostal neuritis and Horner's Syndrome as the result of complication of thoracic sympathetic ganglion block. In Case 1, in spite of the good testing result, neurolytic block effect was poor. In Case 2, intercostal neuritis occurred, but neuralgia subsided within 3 weeks. In Case 3, Horner's Syndrome occurred for 1 day. To increase the success rate of block and decrease the incidence of complications, good radio-opaque dye appearance and good test block effect should be obtained.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.386-389
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• 1995

Combined infusion of local anesthetics and opioids has been a common method for providing postoperative analgesia. Complications that can occur with this method include pruritus, nausea and vomiting, urinary retention, hypotension, and both early and late respiratory depression. Late respiratory depression is a rare but feared complication to epidural opioid therapy. We experienced a case of respiratory arrest during epidural infusion of bupivacaine and morphine.

• The Korean Journal of Pain
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• v.8 no.2
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• pp.312-318
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• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.