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Free nipple grafting has been performed for women with gigantomastia, severe hypertrophy, or systemic disease that could affect the vascularity of the skin aps. This technique was first described in 192245 and has been criticized for creating a attened breast as well as the obvious criticism of no nipple sensation, although later reports have established that a moderate number of patients have some sensation after 6 months or more. Another problem is depigmentation of the nipple graft in non-white patients. Tattooing has been performed as a salvage method with modest improvement. Some surgeons argue that patients with gigantomastia can be safely and effectively reduced using a pedicled technique and free nipple grafting need not be considered. The advantages of this technique include shorter operating time, reduced blood loss, and fewer wound-healing

FIGURE A2-1

It is worth mentioning that two of our younger Parkinson patients with recurrent syncope proved to have cardiac arrhythmias, which were cured by the insertion of a pacemaker, hence other causes of fainting are still to be considered At times, Parkinson disease is complicated by a dementia, a feature that had been commented upon by Charcot The reported frequency of this combination varies considerably, based on the selection of patients and type of testing An estimate of 10 to 15 percent (Mayeux et al) is the generally accepted gure and matches.

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neurologic syndrome; it appears to be identical to the one described by Strachan. The core disorder is an affection of the peripheral and optic nerves. The former consists mainly of sensory symptoms and signs, and the latter is characterized by the subacute evolution of failing vision, which, if untreated, may progress to complete blindness and pallor of the optic discs. Deafness and vertigo are generally uncommon, but in some outbreaks among prisoners of war these symptoms were frequent enough to earn the epithet camp dizziness. In all these respects the syndrome differs from beriberi. Along with the neurologic signs there may be varying degrees of stomatoglossitis, corneal degeneration, and genital dermatitis (the orogenital syndrome). These mucocutaneous lesions are unlike those of pellagra and ribo avin de ciency. There have been only a few neuropathologic studies of this syndrome. Aside from the changes in the papillomacular bundle of the optic nerve, which are similar to the de ciency amblyopia discussed above, the most consistent abnormality has been a loss of myelinated bers in each column of Goll adjacent to the midline. Fisher has interpreted this change to indicate a degeneration of the central processes of the bipolar sensory neurons of the dorsal root ganglia. The fact that the primary sensory neuron is the main site of the neuropathic disorder is consistent with the predominantly sensory symptomatology. The present authors nd it dif cult to draw a sharp dividing line between the nutritional peripheral (and optic) neuropathy described above and the Strachan syndrome.

DNS and WINS servers are both used to translate host names to IP addresses. DNS translates into domain names, and WINS translates into computer (NetBIOS) names. Windows Internet Naming Service (WINS) has a function similar to that of a DNS server but is used to resolve IP addresses to NetBIOS names rather than host names.

i f hh>h, h]-i = h; end while(1) i f ct+hh>tend, hh = tend-tt,'end : })' ; :),vararqin{ kl = dydt (tt.y1i, ymid = y(1,:) + kL.*hrh,./2; : ] )' ; k2 = dydt |.tt+hY\/2,ymid,varargini ymid = y(i,:) + k2*hrh/2; k3 - dydt (tt+hh,/2,ymid,vararqrin{ : } )' ; +k3*hh; Vei-rd=y(i,:) ; } )' ; k4 = dydL(tL+hh,yend,varargin{ phi = (k1+2*(k2+k3) +k4) /6; = y(i,:) y(i+l,:) + phi*hh;

We can easily nd y s that satisfy the inequalities on the right by simply making them large enough, for example (y1 , y2 , y3 ) = (5, 3, 6). But these particular multipliers would tell us that the optimum solution of the LP is at most 200 5 + 300 3 + 400 6 = 4300, a bound that is far too loose to be of interest. What we want is a bound that is as tight as possible, so we should minimize 200y1 + 300y2 + 400y3 subject to the preceding inequalities. And this is a new linear program! Therefore, nding the set of multipliers that gives the best upper bound on our original LP is tantamount to solving a new LP: min 200y1 + 300y2 + 400y3 y1 + y 3 1 y1 , y 2 , y 3 0 By design, any feasible value of this dual LP is an upper bound on the original primal LP. So if we somehow nd a pair of primal and dual feasible values that are equal, then they must both be optimal. Here is just such a pair: Primal : (x1 , x2 ) = (100, 300); Dual : (y1 , y2 , y3 ) = (0, 5, 1). y2 + y 3 6

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