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

Pellucid marginal degeneration is an uncommon, idiopathic, non-inflammatory, peripheral thinning disorder affecting the inferior cornea bilaterally. Protrusion of the cornea occurs above a band of thinning which is located 1 to 2mm from the limbus and measures 1 to 2mm in width. The disease is diagnosed usually between 20 and 50 years of age and its etiology remains obscure. We experienced two cases of pellucid marginal degeneration who had a histories of progressIve visual disturbance due to high irregular astigmatism. A 32 year old female(case.1) had the characteristic feature of pellucid marginal corneal degeneration with marked endothelial cell loss(OD. 624 +/- 32 cells/mm2, OS. 596 +/- 52 cells/mm2) in polymorphism. A 30 year old male(Case. 2) showed pellucid marginal corneal degeneration associated with rheumatoid athritis, but corneal endothelial cells appeared within normal ranges(OD. 2764 +/- 26, OS. 2812 +/- 34) with slight polymorphism. The Vision in these two cases improved to 20/20 with hard contact lens(Case. 1) and glasses(Case.2)
Adult ; Astigmatism ; Cornea ; Endothelial Cells ; Humans

Theophylline has been widely used in the treatment of asthma and chronic obstructive lung disease. To date, there have been very few reports on hepatotoxicity due to theophylline. We diagnosed, through biochemical testing and a liver biopsy, a case of acute cholestatic hepatitis developed after oral consumption of theophylline. A 43 year-old man was admitted to the department of internal medicine due to jaundice and pruritus which developed after ten days administration of oral theophylline (Etheophyl ). Liver function tests showed elevated serum bilirubin at 13.2 mg/dL with AST and ALT of 71 U/L and 194 U/L. Alkaline phosphatase and gamma-GTP were also elevated at 175 U/L and 301 U/L. There was no evidence of viral or autoimmune hepatitis in laboratory tests. The patient's symptoms and liver function tests were improved after conservative treatment. After 9 months oral theophylline was readministered for the control of relapsed asthma. Then, jaundice and pruritus again developed again. A liver biopsy showed a few lymphocytes and eosinophilic inflammatory cell infiltration in portal tract and cholestasis in the lobule. Drug-induced hepatitis was diagnosed with a typical clinical course; the exclusion of all possible causes of acute hepatic dysfunction; and a positive response to accidental readministration of drug. We report this case with a review of the literature.
Adult ; Alkaline Phosphatase ; Asthma ; Bilirubin ; Biopsy ; Cholestasis ; Drug-Induced Liver Injury ; Eosinophils ; Hepatitis* ; Hepatitis, Autoimmune ; Humans ; Internal Medicine ; Jaundice ; Liver ; Liver Function Tests ; Lymphocytes ; Pruritus ; Pulmonary Disease, Chronic Obstructive ; Theophylline