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Using Percutaneous Ventricular Support Gadgets in Intense Myocardial Infarction Complicated through Cardiogenic Distress.
CONCLUSIONS The propagation of light within SS primarily does not occur by TIR off the posterior cornea but rather the direct transcameral propagation of light. SS also represents an inefficient usage of light, with approximately half of the light creating a potential glare source for clinicians. We have formulated a recommended set of parameters for the slit-lamp setup to maximize clinical visualization. We also describe the transcameral pathways involved in SS that create a corneal "backlighting" effect. Almost a century after Graves original description, the optics of this phenomenon are described here.PURPOSE To describe a case of a patient with bilateral proliferation of chondrocytes of the lower palpebral conjunctiva. METHODS Observational case report and review of relevant literature. RESULTS Conjunctival biopsy from an 83-year-old man with bilateral acquired lower conjunctival nodules revealed a benign proliferation of chondrocytes. A general medical evaluation revealed serum monoclonal gammopathy with light-chain proteinuria. CONCLUSIONS Bilateral-acquired benign chondrocyte tumefactions of the palpebral conjunctiva have not been previously reported. This initiated a search for a biologically plausible explanation. The findings in this report support that these proliferations represent chondroid metaplasia related to light-chain deposition. The diagnosis requires exclusion of other forms of chondrocyte proliferation including well-differentiated chondrosarcoma.PURPOSE To highlight the novel application of anterior segment optical coherence tomography (AS-OCT) to detect corneal silver deposition in a case of ocular argyrosis. METHODS This is a case report and review of the literature. RESULTS A 67-year-old man with a 30-year history of chronic occupational exposure to silver-halides secondary to photographic film manufacturing presented with significant ocular argyrosis. His ophthalmic examination was notable for bilateral, widespread pinpoint gray deposits throughout his conjunctiva and cornea at the level of Descemet membrane. Further evaluation with AS-OCT showed deposition in 2 distinct, diffusely hyperreflective bands, corresponding to Bowman layer and Descemet membrane. CONCLUSIONS AS-OCT provides a useful imaging modality in evaluating corneal deposition diseases. In this case of ocular argyrosis, AS-OCT led to the detection of a hyperreflective Bowman layer and Descemet membrane, representing silver deposition in both these anatomic locations.PURPOSE To present successful management of bilateral limbal stem cell deficiency (LSCD) by using an allogeneic limbal epithelial stem cell transplantation together with solid activated platelet-rich plasma (PRP). METHODS A 59-year-old man with a history of bilateral LSCD due to penicillin-induced Stevens-Johnson Syndrome suffered from a lime corneal burn in his right eye, leading to a total LSCD with severely reduced visual acuity. After stabilizing the ocular surface, we performed an allogeneic limbal epithelial transplantation from a cadaveric donor using an autologous clot of PRP to cover the limbal grafts to nourish the ocular surface microenvironment. RESULTS At the first week after the procedure, the corneal epithelium had fully reepithelized. At month 3, visual acuity improved from hand motion to 20/70. CONCLUSIONS In this case, this new modified procedure was a promising, easy-to-perform, apparently safe, and effective treatment option to enhanced epithelial wound healing in ocular surface diseases. To our knowledge, this is the first report describing the incorporation of solid PRP in limbal transplantation procedures.RATIONALE Very severe aplastic anemia (vSAA) with active infections is always fatal. Adequate infection control before hematopoietic stem cell transplantation is recommended. PATIENT CONCERNS A 38-year-old woman with vSAA suffered from acute perforated appendicitis and invasive pulmonary fungal infection, and she failed to respond to intense antimicrobial therapies. DIAGNOSIS She was diagnosed with refractory vSAA with stubborn acute perforated appendicitis and invasive pulmonary fungal infection. INTERVENTIONS We successfully completed an emergent reduced intensity conditioning-matched unrelated donor (MUD)-peripheral blood stem cell transplantation (PBSCT) as a salvage therapy in the presence of active infections. The conditioning regimens consisted of reduced cyclophosphamide 30 mg/kg/day from day-5 to day-3, fludarabine 30 mg/m/day from day-5 to day-3 and porcine-antilymphocyte immunoglobulin 15 mg/kg/day from day-4 to day-2 without total body irradiation. Cyclosporin A, mycophenolate mofetil and short-term methotrexate were administered as graft-versus-host disease (GVHD) prophylaxis. Selleckchem Curaxin 137 Neutrophils and platelets were engrafted on day+15 and day+21. Appendiceal abscess and severe pneumonia developed after neutrophil engraftment, which were successfully managed with intense antimicrobial therapy and surgical intervention. OUTCOMES Only limited cutaneous chronic GVHD was observed 5 months after transplantation. The patient still lives in a good quality of life 2 years after transplantation. LESSONS Active infections may be no longer a contraindication to hematopoietic stem cell transplantation for some patients with vSAA.RATIONALE Surgical treatment of hidradenitis suppurativa (HS) is challenging. Wide excision of affected lesions followed by skin graft or flap coverage has been recommended to achieve remission and prevent recurrence. Herein, we present our experience of bilateral inferomedial gluteal defects coverage using symmetrical keystone flaps (KFs) designed parallel to relaxed skin-tension lines (RSTLs). PATIENT CONCERNS An 18-year-old man was admitted for chronic inflammatory lesions in both inferomedial gluteal areas. DIAGNOSES Physical examination revealed multiple sinuses with broad surrounding scars in both inferomedial gluteal areas, which led to a diagnosis of HS. INTERVENTIONS We performed wide excision on all affected lesions. The size of the final defects was 6 × 10 cm on the right side, and 5 × 9 cm on the left side. We covered the defects with KFs 9 × 15 cm (right) and 8 × 12 cm (left), which were based on the hotspots of the interior gluteal artery and internal pudendal artery perforators, and parallel to RSTLs.
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