Background: Many Korean women with single eyelids wish to have their eyes enlarged through double eyelidplasty, and many of them also want to have additional procedures in order to have a larger perceived size of their eyes, with the desire for their eyes to resemble those with inborn double eyelids. Thus, in this study, we performed eye measurements and evaluated the usefulness of the eyeball exposure area to differentiate the overall eye size according to the nature of double eyelids (inborn or operated). Methods: This study involved 92 eyes with natural double eyelids (group A) and 76 eyes with only double eyelidplasty (group B). The two groups were compared through measurements of the exposed eyeball area (EEA) and palpebral fissure height (PFH). To compare the usefulness of the EEA for the perceived eye size, the PFH value was also measured by adjusting it to a percentage value. Results: The mean value of the PFH was 9.95±0.67 mm in group A and 8.48±1.04 mm in group B. The adjusted percentage value of the PFH relative to the corneal diameter (11.3 mm) was 88.05% in group A and 75.04% in group B. The EEA was 85.59%±3.25% in group A and 82.89%±6.36% in group B. The difference between the two groups was 13.01% in terms of PFH and only 2.7% in terms of EEA. Conclusions The values of PFH and EEA were higher in group A, but EEA was more useful for evaluating the perceived eye size between the two groups.

PURPOSE: Refractory small-cell lung cancer (SCLC) has a poor prognosis, and current salvage chemotherapy for refractory SCLC, such as CAV (cyclophosphamide, adriamycin, vincristine) or topotecan, has an unsatisfactory outcome, with a response rate and overall survival of less than 10% and 6 months, respectively. This phase II study evaluated the role of topotecan combined with etoposide in SCLC patients that have progressed, or relapsed, within 3 months following completion of the initial chemotherapy. MATERIALS AND METHODS: Twenty-seven patients were entered into this study. Eligible patients had an ECOG performance status of less than, or equal to, 2, at least one bidimensionally measurable lesion and adequate end organ function. IV topotecan, 1.0 mg/m2/d for 5 consecutive days, and etoposide, 100 mg/m2/d through days 1 to 3, were administered every 3 weeks until disease progression or undue toxicity. RESULTS: The major toxicity was myelosuppression. Grade 3/4 anemia, granulocytopenia, and thrombocy-topenia occurred in 14.2, 34.8, and 27.3% of cycles, respectively. There was no treatment-related death, and other non-hematologic toxicities were generally mild. Four patients achieved partial responses, with a response rate RR of 14.8%. The progression-free survival PFS ranged from 1 to 7 months, with a median of 2.0 months (95% confidence interval 1.22~2.78 months). Twenty-five patients died, with a median overall survival of 5.5 months (ranging from 1 to 21 months, 95% CI 4.32~6.68 months), and the 6-month survival rate was 32.1% (95% confidence interval 14.4~49.8%). CONCLUSION: The combination of topotecan and etoposide chemotherapy showed a modest response rate, but failed to prolong survival of refractory SCLC patients compared to topotecan monotherapy.
Agranulocytosis ; Anemia ; Carcinoma, Small Cell ; Disease Progression ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Etoposide* ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis ; Survival Rate ; Topotecan*

BACKGROUND: Patients with non-Q wave myocardial infarction tend to have smaller infarcts and less degree of ventricular function impairment initially, however, uncomplicated non-Q wave infarctions are known to be as serious as Q wave myocardal infarction due to residual myocardal ischemia and higher reinfarction rate. METHODS: Inorder to compare the clinical and coronary angiographic findings of Q wave infarction with those of non-Q wave infarction. 58 partients with acute myocardial infarction were reviewed retrospectively. Patients were classified into Q wave(n=45) and non-Q wave infarction(n=13) according to electrocardiographic findings. RESULTS: 1) There were no significant differences between the two groups in risk factors of coronary artery disease such as hypertension, hypercholesterolemia, smoking and diabets mellitus. 2) The peak myocardial enzyme levels of CPK, CPK-MB were significantly higher in the Q wave MI group, and the percentage of wall motion abnormality on two-dimensional echocardiography was significantly higher in Q wave MI than in the non-Q wave MI group. 3) The number of involved vessel, degree of stenosis and collateral circulation were not different but high degree of stenosis of infarct-related artery was more frequent in Q wave MI group. 4) There were no significant differences between the two groups in the incidence of arrhythmia and in-hospital mortality. CONCLUSION: There were some differences in clinical and angiographic findings, but in-hospital mortality was not significant different between two groups. Futher prospective studies should be performed to clarify the long term prognosis.
Arrhythmias, Cardiac ; Arteries ; Collateral Circulation ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Echocardiography ; Electrocardiography ; Hospital Mortality ; Humans ; Hypercholesterolemia ; Hypertension ; Incidence ; Infarction ; Ischemia ; Myocardial Infarction* ; Prognosis ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Ventricular Function

Five cases of traumatic intracranial aneurysm were presented. All of them were located at the cavernous segment of the internal carotid artery. These lesions were associated with basal skull fracture. Four cases were presented with massive epistaxis, and two of them required transfusion. All cases were treated successfully:four by detachable balloon occlusion of the proximal internal carotid artery and one by trapping of the lesion at the internal carotid artery. Because the mortality rate of ruptured traumatic aneurysm if high, clinical suspicion must be focused on prompt diagnostic work-up and early treatment.
Aneurysm ; Aneurysm, False ; Balloon Occlusion ; Carotid Artery, Internal ; Epistaxis ; Intracranial Aneurysm* ; Mortality ; Skull Fractures

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

No abstract available.
Postural Orthostatic Tachycardia Syndrome* ; Syncope

Continuous venovenous hemodiafiltration (CVVHDF) was used to eliminate pentobarbital from the blood of a 30-year-old potentially brain dead male patient with traumatic intracranial hemorrhage after a motorcycle accident. The Acute Physiology and Chronic Health Evaluation (APACHE) II score of hospital day 1 was 24, but by day 8 it was 36, when the patient was considered to be brain dead. To control seizures and reduce intracranial pressure, pentobarbital had been administered in a continuous flow (2,880 mg/day for 5 days). Coma can be induced by pentobarbital at a serum level of 1~5 mg/dL. However, drug intoxication should be excluded from a brain death evaluation; therefore, the patient was not given any drug for approximately 88 hrs after ceasing pentobarbital in order for serum level to dip below 0.5 mg/dL (which is the hypnotic level). At 48 hours from CVVHDF, the pentobarbital level was close to the hypnotic level (0.1~0.5 mg/dL). Before stopping, the serum level of pentobarbital was 3.89 mg/dL and between 48 and 72 hours from CVVHDF, 4 cycles of pentobarbital half-life elimination (0.24 mg/dL) could be measured. Therefore, we suggest that in case of potential brain dead patients who have been administered pentobarbital, CVVHDF can enhance the elimination of pentobarbital from the circulatory system and shorten the waiting time for a brain death evaluation.
Adult ; APACHE ; Brain ; Brain Death ; Coma ; Half-Life ; Hemodiafiltration ; Humans ; Intracranial Hemorrhage, Traumatic ; Intracranial Pressure ; Male ; Motorcycles ; Pentobarbital ; Seizures

The content of meconium in amniotic fluid(AF) is important for assessing the risk of several perinatal problems such as asphyxia, meconium aspiration syndrome and various perinatal infections. This estimate is usually performed subjectively by visual inspection. The purpose of this study is to develop the objective method for quantitative measurement of meconium content in AF. Absorption spectra and meconium-crit of the solutions with various concentrations of meconium were measured. EfFects of filtration and blood contamination on the measurement of meconium content were also estimated by the same methods. Optical densities(OD) were correlated with concentrations of meconium in the whole range of scanned wavelengths. A specific peak of meconium was not available but the highest OD around 410 nm was shown. OD were linearly related to the concentrations of meconium. Meconium-crits were also well-correlated with the concentrations of meconium. Filtration of AF as well as blood contamination in AF severely affected the measurement of meconium content in AF. From the results of this study, both the spectrophotometric method and meconium-crit couid be objective methods for measuring meconium content. Both methods had merits and shortcomings. Filtration and blood contamination should be avoided for the measurement of meconium content in AF. We hope that both or either one of the two methods will be clinically used.
Absorption ; Amniotic Fluid* ; Asphyxia ; Female ; Filtration ; Hope ; Infant, Newborn ; Meconium Aspiration Syndrome ; Meconium*