The retraction of the upper eyelid is associated with thyroid dysfunction, facial palsy, trauma, and overcorrection of ptosis and also occurs iatrogenically after eyelid or orbital surgery. In this condition, corneal exposure leads to discomfort, epiphora, and corneal irritation. Moreover increased showing of sclera above corneal limbus is considered one of cosmetic defect. Treatment modalities may be either medical or surgical. The medical treatments consists of control of thyroid dysfunction, steroid, sympatholytics. Many authors described surgical correction; recession of levator palpebral muscle or M ller muscle and graft matrix. The difficulties in surgical treatment consist of unpredictability of levator-M ller muscle manipulation, and healing of grafted material. Two patients have been operated with using of septal cartilage-mucosa composite graft. nasal septal cartilage-mucosa composite graft is autologous, firm, thin and harvested easily. The result was satisfactory functionally and aesthetically.
Eyelids* ; Facial Paralysis ; Humans ; Lacrimal Apparatus Diseases ; Limbus Corneae ; Orbit ; Sclera ; Sympatholytics ; Thyroid Gland ; Transplants*

BACKGROUND: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. METHODS: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe (DT(pre), DT(post), degrees C), and the DTnet were calculated as follows. DT(net) = DT(post) - DT(pre). RESULTS: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the DT(post) (6.1 +/- 1.2degrees C, P = 0.021), and the DTnet (6.0 +/- 1.0degrees C, p = 0.023), as compared to group C. CONCLUSIONS: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.
Ganglia, Sympathetic ; Humans ; Skin ; Skin Temperature ; Spinal Stenosis ; Stress, Psychological ; Sympatholytics ; Toes ; Walking

A clinical observation was made on 75 cases of TURP from March 1984 to August 1987 had been studied in the Department of Urology, Eul Ji General Hospital. The results were summarized as follows. 1. TURP was performed in 65 cases of benign prostatic hyperplasia and 10 cases of the pro static cancer. Of the 75 cases, blood loss was calculated in 32 cases and change of serum electrolyte was in 42 cases. 2. Weight of resected tissue was 7.1+/-5.8 grams(Mean+/-S.D.). 3. Blood loss during TURP was 317+/-199.2ml. There was a correlation between the total loss and the weight of resected tissue, but the blood loss per gram of resected tissue decreased with the larger glands. 4. Serum sodium concentration was decreased in 24 of the 42 cases and increased in 10 cases and no change in 8 cases. And these change in serum sodium concentration showed no significant correlation with the weight of resected tissue, the amount of irrigating fluid and operation time. 5. Of the 75 patients who had performed TURP, 27(36%) experienced some types of non-fatal complication, the remaining 48(64%) recovered without event. 6. Hypotension during TURP was the most common complication(13.3%). It seemed to be temporary phenomenon due to sympatholytic effect in spinal anesthesia. 7. There was no fatal case in this series.
Anesthesia, Spinal ; Hospitals, General ; Humans ; Hypotension ; Prostate* ; Prostatic Hyperplasia ; Sodium ; Sympatholytics ; Transurethral Resection of Prostate ; Urology

Treatment of rabbits with thyroxine 1 mg/kg daily for three to six days produced a hyperthyroid state as evidenced by increase in the heart rate and PBI. The hyperthyroid animals exhibited a significant shortening of the atrial refractory period. Beta adrenergic receptor blocking agents, propranolol (l0(-6)M pronethalol (5 X 10(-5)M) or MJ-1999 (5 X 10(-4)M), completely blocked the shortening of the atrial refractory period produced by the treatment with thyroxin, and with norepinephrine. Consequently, the shortening of the atrial refractory period of rabbits treated with thyroxin appears to bs mediated through stimulation of the beta adrenergic receptor in the heart. From these results, it may be concluded that the stimulation of the beta adrenergic receptor plays an important role in the alteration of cardiac function found in hyperthyroidism, and that the beta adrenergic blocking agents may be useful in treatment of the cardiac complications of hyperthyroidism.
Adrenergic beta-Antagonists/pharmacology ; Animals ; Female ; Heart Atria/*drug effects/physiopathology ; Hyperthyroidism/chemically induced/*physiopathology ; Male ; Rabbits ; Sympatholytics/*pharmacology ; Thyroxine

We examined the expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) mRNAs upon isoproterenol (Iso)-induced cardiac hypertrophy in rats. Then, we tried to investigate the effects of sympatholytics to see if they can modulate the expression of ANP and BNP. In this study, RT-PCR technique was used to characterize the expression of ANP and BNP in right atrium (RA) and left ventricle (LV) of the hypertrophied rat heart. Histologic findings indicated that stimulation of beta-adrenoceptors with Iso for 5 days was sufficient to induce cardiac hypertrophy in rats. A continuous stimulation with Iso for 7 days resulted in an increase of the ANP and BNP expression in the LV and BNP expression in the RA. The increased expressions of ANP and BNP in the LV were slightly inhibited, and the increased expressions of BNP in the RA were markedly inhibited by a continuous treatment with propranolol, metoprolol, and clonidine for 7 days. Overall, our data present a differential expression of the natriuretic peptides in Iso-induced cardiac hypertrophy, and that the mechanisms involved in this differential ANP and BNP gene expression could be mediated via sympathetic nervous system.
Animals ; Atrial Natriuretic Factor ; Cardiomegaly* ; Clonidine ; Gene Expression ; Heart ; Heart Atria ; Heart Ventricles ; Isoproterenol ; Metoprolol ; Natriuretic Peptide, Brain ; Natriuretic Peptides ; Propranolol ; Rats* ; RNA, Messenger* ; Sympathetic Nervous System ; Sympatholytics

Dexmedetomidine is a potent, highly selective α-2 adrenoceptor agonist, with sedative, analgesic, anxiolytic, sympatholytic, and opioid-sparing properties. Dexmedetomidine induces a unique sedative response, which shows an easy transition from sleep to wakefulness, thus allowing a patient to be cooperative and communicative when stimulated. Dexmedetomidine may produce less delirium than other sedatives or even prevent delirium. The analgesic effect of dexmedetomidine is not strong; however, it can be administered as a useful analgesic adjuvant. As an anesthetic adjuvant, dexmedetomidine decreases the need for opioids, inhalational anesthetics, and intravenous anesthetics. The sympatholytic effect of dexmedetomidine may provide stable hemodynamics during the perioperative period. Dexmedetomidine-induced cooperative sedation with minimal respiratory depression provides safe and acceptable conditions during neurosurgical procedures in awake patients and awake fiberoptic intubation. Despite the lack of pediatric labelling, dexmedetomidine has been widely studied for pediatric use in various applications. Most adverse events associated with dexmedetomidine occur during or shortly after a loading infusion. There are some case reports of dexmedetomidine-related cardiac arrest following severe bradycardia. Some extended applications of dexmedetomidine discussed in this review are promising, but still limited, and further research is required. The pharmacological properties and possible adverse effects of dexmedetomidine should be well understood by the anesthesiologist prior to use. Moreover, it is necessary to select patients carefully and to determine the appropriate dosage of dexmedetomidine to ensure patient safety.
Adrenergic alpha-Agonists ; Analgesics ; Analgesics, Opioid ; Anesthetics ; Anesthetics, Intravenous ; Bradycardia ; Conscious Sedation ; Delirium ; Dexmedetomidine ; Heart Arrest ; Hemodynamics ; Humans ; Hypnotics and Sedatives ; Intubation ; Neurosurgical Procedures ; Patient Safety ; Perioperative Period ; Respiratory Insufficiency ; Sympatholytics ; Wakefulness