No abstract available.
Drug Therapy*

No abstract available.
Animals ; Mice* ; T-Lymphocytes*

PURPOSE: Male hypertrophic nipples can lead to psychological distress and physical discomfort. The authors present a new technique of male nipple reduction and describe its advantages. METHODS: The neonipple is designed to reduce diameter and height of nipple while preserving the subdermal plexus. After the central wedge excision, additional four triangular section of nipple skin is excised. One of the remaining two flaps is amputated partially and both flaps were approximated using 4-0 PDS and 6-0 Nylon sutures. RESULTS: From December 2007 to January 2009, 52 nipple reductions were performed in 30 male patients (mean = 29.5 years). Postoperative recovery was rapid and few complications were observed. The mean diameter of the hypertrophic nipple was 9.1 +/- 2.5 mm (range, 7 to 15 mm). The mean diameter of the neonipple was 5.0 +/- 0.7 mm (range, 4 to 6 mm), with an average reduction of 3.8 +/- 0.6 mm (range, 2 to 11 mm). In follow-up, the neonipple had a natural appearance, with less projection and an inconspicuous scar. CONCLUSION: The wedge and triangular skin excision and partial amputation are easy to perform and yields consistent results. This technique decreases both the diameter and height of any size nipple and can be modified to meet patients' preferences.
Amputation ; Follow-Up Studies ; Humans ; Male ; Nipples ; Nylons ; Skin

PURPOSE: Severe type of inverted nipple (cannot be pulled out above the areola plane by manipulation, grade III) usually cannot be corrected by a relatively simple pursestring suture technique. Most patients want to avoid visible scars. To treat the severe case and avoid visible stigma, we introduce this invisible dermal flap method. METHODS: This new surgical procedure makes bilateral incisions on the sidewall of nipple and dissections vertically to free the ducts from the contracted tissues. After dissection, the tunnel is formed. We insert "dermal flaps" into the tunnel underneath nipple base. Then through-and-through sutures are performed vertically (6 o'clock and 12 o'clock positions) and the purse-string suture is added with 4-0 nylon. RESULTS: We had treated 35 primary inverted nipples (grade III) in 27 patients and 13 recurrent nipples in 7 cases. The results were excellent in 45 nipples (93.7%). All but 3 recurred cases was fully or very satisfied with the results. CONCLUSION: This technique is effective for the correction of severe inverted nipples and recurrent cases. We can avoid the visible scars on the areola surface
Cicatrix ; Contracts ; Humans ; Nipples ; Nylons ; Skin ; Suture Techniques ; Sutures

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

Opioids are effective analgesics, but they are often difficult to use properly, due mainly to adverse events, such as constipation, respiratory depression, addiction, tolerance, and opioid induced hyperalgesia. In the past, the problem of opioids around the world was usually caused by drugs traded illegally, so there was no need for medical and social attention in Korea. On the other hand, with the dramatic increase in the therapeutic use of opioids, which commenced more than a decade ago, problems caused by legally prescribed drugs have emerged, and now a more serious opioid crisis is being experienced than in the days of illegal drugs. A growing number of patients are chronically prescribed opioids, and a growing number of health care providers and hospitals suffer from problems related to chronic prescription. Currently, in Korea, it is the time to pay serious attention to achieve the safe and effective use of prescribed opioids. This paper consists of the following parts. 1) A summary of the issues related to chronic pain, opioids, and problems associated with the use of opioids. 2) Some case examples the authors' experienced. 3) Simple guidelines on the use of opioids in the treatment of chronic non-cancer pain are proposed based on the author's experience and existing literature. These guidelines are by no means comprehensive, and hopefully in the future, related experts will join forces to develop better guidelines.
Analgesics ; Analgesics, Opioid ; Chronic Pain ; Constipation ; Hand ; Health Personnel ; Humans ; Hyperalgesia ; Korea ; Prescriptions ; Respiratory Insufficiency

No abstract available.

Elimination of the apocrine glands by a radical surgical procedure has been known to be the best solution for axillary osmidrosis; however, it is often accompanied with a marked scar. Ultrasonic tumescent liposuction is a safe procedure for removal of subcutaneous fat tissue. Herein, we describe our modification of the traditional osmidrosis operation(subdermal excision or superficial liposuction). The first, pre-suction "scrape" could require adequate plane of skin flap; the second, "ultrasound-assisted liposuction"; the third, post-suction "rasp" helped subdermal curettage; the last, "endoscopic approach" could visibly remove remaining apocrine glands. It is named SURE technique. From April 2007 to September 2008, 43 patients underwent our "SURE" method for axillary osmidrosis. All patients were followed up for 3 to 12 months with an average of 6 months. The total satisfaction rate was 91 percent(39/43). The complications(skin slough and subdermal band formation) rate was 14 percent(6 of 43). However these complications were temporary and complete recovery occurred without special cares. We emphasize four components of our SURE method procedures. In conclusion, "SURE" method can be one of alternatives for osmidrosis treatment.

The mean diameter of nipple-areolar complex(NAC) is 24.3 mm(range 21-29mm) in young Korean men, and patients usually, expect the decrease of NAC after gynecomastia correction. Therefore, the, authors studied the rate of decrease of NAC after ultrasound-assisted liposuction and fibroglandular excision via periareolar approach. Series of 121 cases(242 NAC) were reviewed from May to September 2007 with mean follow-up of 5 months. Inclusion criteria were the followings; 1) NAC diameter > 30 mm, 2) Bilateral cases within 3 mm difference between right and left NACs, and 3) Patients who agreed to take photographs longer than at least 3 month after operation. The decreased NAC ranged from 5.1% to 44.7%(mean 23.8%). The patient's satisfaction was high, and most of them were pleased with the decreased NAC diameter. Based on these results, we can provide the more informations about gynecomastia to patients.

Inverted nipples are histologically characterized by shortened lactiferous ducts and less connective tissue beneath the nipple. Some authors suggested that the major pathophysiologic basis in mild to moderated cases, is shortened ducts, but not lack of connective tissue at the base of the nipple. Under local or intravenous sedation, the nipple was everted. A small incision was made on lateral side at the nipple-areola junction. The lactiferous ducts and surrounding connective tissues were divided by sharp dissection only through vertical direction. Two purse-string sutures using Nylon 4-0 were performed for the maintenance of corrected nipple. The small incision was closed by the tissue adhesive. From May 2007 to January 2008, 137 nipples in 70 patients were treated. Twenty five nipples were graded as grade I and 112 nipples as II. There were no major complications except recurred inversion in 2 cases. Of these, one case had some inflammatory discharge. Almost patients(97.1%) were satisfied with their results. Advantages to using this technique include(1) no scars on the flat surface of the areola,(2) adequate blood and nerve supply to the nipple,(3) simple and easy to learn, and(4) no need of external stent or traction.