A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.
Blister ; Bronchi ; Lung ; Stents ; Thoracic Surgery

PURPOSE: We investigated the anti-inflammatory and anti-fibrotic effects of amniotic membrane(AM) ointment in filtering surgery of rabbits. METHODS: After filtering surgery was performed on both eyes of 10 rabbits, the AM ointment was applied over and under the scleral flap on one eye whereas base ointment excluding AM element was applied to the other as a control. The shapes of blebs were observed under slit-lamp biomicroscopy at postoperative 3 days, 1 week, 2 weeks and 4 weeks, and the tissues were excised for histologic studies. RESULTS: Serial changes of intraocular pressures had no significant difference. Slit-lamp biomicroscopy demonstrated that conjunctival blebs of AM ointment group were more elevated and cystic at 1 and 2 weeks. The heights of conjunctival blebs were significantly higher at 1, 2 and 4 weeks, and the width of scleral tracks was significantly wider at 1 and 2 weeks in AM ointment group. The number of inflammatory cells in the scleral track was significantly less at 3 days and 1 week, the number of fibroblasts in scleral track was significantly less at 2 and 3 weeks in AM ointment group. Masson s trichrome stain was less positive in AM ointment and the stain area of alpha-smooth muscle actin-positive fibroblasts was insignificant with image analysis system. Collagen type 3 appeared in scleral track from postoperative 1 week in control group, however, in AM ointment group, from 4 weeks. CONCLUSIONS: AM ointment is beneficial to suppress fibroblast differentiation, proliferation and inflam-matory reaction in filtering surgery and might be safe and effective adjunctive for enhancement of success in filtering surgery.
Amnion* ; Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Humans* ; Intraocular Pressure ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

In glaucoma filtering surgery, we conducted subconjunctival injection of Mitomycin-C(MMC) 12 hours before and after surgery, and examined histologic findings of the filtering bleb, and condition of the anterior chamber which ensued after the injection. We divided 15 full-grown rabbits into three groups, and for each group, administered subconjunctivally 0.1cc of 0.002%, 0.004%, and 0.008% MMC, respectively. The subconjunctival injection of MMC before surgery was given to the right eye and post-surgical injection to the left, and we examined the results 1, 2, 4, 7, and 14 days after the administration.In conclusion, subconjunctival injection of MMC 12 hours before glaucoma filtering surgery is shown to be more effective than the injection after the surgery.
Anterior Chamber ; Blister* ; Filtering Surgery* ; Glaucoma* ; Mitomycin* ; Rabbits

Endophthalmitis following the filtering surgery is rare and the visual prognosis is reported to be very poor. In many cases the infection starts in the bleb. Methods of treatment should be chosen according to the type and stage of infection, but the prompt use of appropriate antibiotic and corticosteroid is important. This report presents a case of endophthalmitis following trabeculectomy in a 61-year old female patient, which was successfully treated.
Blister ; Endophthalmitis* ; Female ; Filtering Surgery ; Humans ; Middle Aged ; Prognosis ; Trabeculectomy*

An overhanging, large bleb after filtering surgery leads to various complications ranging from foreign-body sensation to endophthalmitis. Herein we report two case of large painful blebs in nasal area. Argon laser was initially used for its shrinkage. However, this procedure was not successful, requiring surgical excision of bleb. The tissue was then examined to evaluate the cause of failure with the argon laser treatment. On examination, the bleb showed a pseudocyst, and hyaline degeneration in the inner membrane of the bleb. Shrinkage of the large bleb resulted in resolution of the pain.
Argon ; Blister* ; Endophthalmitis ; Filtering Surgery* ; Glaucoma* ; Hyalin ; Membranes ; Sensation

Endophthalmitis is a severe and unfortunate complication after glaucoma filtering surgery which may present months to years after the initial surgical intervention. Amniotic membrane is immunologically inert and has antiadhesive and wound-protectioning effects. Furthermore, it reduces pain and helps epithelization. So several reports disclosed the uses of amniotic membrane in transplantation for reconstruction of various ocular surface diseases recently. We report the usefulness of antibiotics-soaked amniotic membrane transplatation for endophthalmitis with bleb rupture 4 years after trabeculectomy.
Amnion* ; Blister ; Endophthalmitis* ; Filtering Surgery ; Glaucoma ; Rupture ; Trabeculectomy

During filtration surgery for glaucoma, the conjunctival incision site is sutured watertightly with a suture material like 10-0 nylon. However, this suture material may cause the infiltration of inflammatory cells, and the proliferation and migration of fibroblasts and collagen fibers at the junction of the conjunctiva and episclera. Subsequently, the arrangement of collagen fiber in episclera would be disrupted and the outflow of aqueous humor could be occluded. In the search for a more suitable suture material, the fibrin glue(Tisseel(R)) was introduced recently. It is claimed to be simple to use and safe, causes less damage and less inflammatory reaction than nylon. The authors used 10-0 nylon(control group) on the right eye and fibrin glue(Tisseel(R))(experimental group) on the left eye of a white rabbit's conjunctival suture. We compared and evaluated the clinical and histological effects of the suture material on the suture site as well as on the intraocular region. The results were as follows; 1. In the experimental group, conjunctival injection and chemosis were mild and disappeared rapidly. 2. The filtering bleb was macroscopically well formed and maintained from the third postoperative day in both groups, but, thereafter, it decreased in size in two cases of the control group. 3. There was no difference in the inflammatory reaction in anterior chamber in both groups postoperatively. 4. In the experimental group, there was loosening of the fibroblasts proliferation and lesser infiltration of inflammatory cells at the postoperative second and fourth week. And the arrangement of collagen fibers in episclera was intact. The above findings strongly suggest fibrin glue(Tisseel(R)) as a suture material in the filtration surgery of glaucoma is clinically promising.
Anterior Chamber ; Aqueous Humor ; Blister ; Collagen ; Conjunctiva ; Fibrin* ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma ; Nylons ; Rabbits* ; Sutures

A histologic study was performed if fibroblast proliferation could be inhibited in rab bits by deli very of bleomycin(1.35mg), an antineoplastic antibiotics, in a collagen sponge implant. Results showed that fibroblast proliferation was markedly inhibited and bleb longevity was prolonged when compared to controls. And inflammatory cell infiltration was noted around filtration wound.
Antibiotics, Antineoplastic ; Bleomycin* ; Blister ; Collagen* ; Fibroblasts ; Filtering Surgery* ; Filtration ; Glaucoma* ; Longevity ; Porifera* ; Wounds and Injuries