Epicanthus as a Cause of Pruritis

According to the ophthalmic literature, the lack of epicanthus and termi-nal hairs at the medial side of punctum are unique features in most non-Asian eyelids.We wanted to examine the presence of terminal hairs at the medial side of punctum in Asian.A study was designed to examine 416 eyes of 208 patients who had visited our hospital between March 1999 and Sep-tember 1999.Physical examination included the presence of epicanthus, terminal hairs at the medial side of punctum, upper eyelid crease and pruritus in medial canthal area.The mean age of the patients was 56.5 years.Epi-canthus was seen in 256 eyes of 416 eyes (61.5%).The upper lid creases were detected in 242 eyes of 416 eyes (58.2%)and classified mostly as the medial tapering and lateral flaring type (83.5%).There were 250 eyes of 416 eyes (60.1%)who had terminal hairs at the medial side of punctum.Sixty eyes of 416 eyes (14.4%)complained of itching sensation in medial canthal area and had experienced once or two times per week (70.0%).They com-posed of 44 eyes of 60 eyes (73.3%)with epicanthus and terminal hairs, 10eyes of 60 eyes (16.7%)with only terminal hairs, and 6 eyes of 60eyes (10.0%)with only epicanthus.In our study, we found many patients had terminal hairs at the medial side of punctum in Asian and the presence of epicanthus and terminal hairs caused itching sensation at medial canthal area.

Clinical Evaluation of Supraclavicular Block ; Influence of Injected Volume of Bupivacaine on Neural Blockade / 대한마취과학회지

Brachial plexus block is frequently used for surgery on the upper extremity. Unsuccessful brachial plexus block is usually caused either by injection outside the neurovascular sheath or by incomplete blockade inspite of injection within the neurovascular sheath. Studied by Winnie and Collines suggested that the extent of blockade following injection in the sheath surrounding the brachial plexus also should be directly proportional to the volume of local anesthetic injected. We therefore investigated the extent of blockade using different volume of bupivacaine with supraclavicular approach. The results were as follows. 1) Complete analgesia was observed between the group of 15 ml and 30 ml. 2) The interval of complaint of pain after a single injection ranged from 14.3 to 16.4 hours. Insignifi-cant difference was found between the group of 15 ml and 30 ml (p> 0.1) 3) There was no hematoma, shivering, but there was Horner's syndrome in 13, phrenic N.paralysis in 2, pneumothorax in 1 cases. No general seizure or other side effects were observed. Therefore we come to the conclusion that above the volume of 15 ml is sufficient to brachial plexus block with supraclavicular approach.