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Sudesh Kumar Arya, Anubha Bhatti, Amit Raj, Ravi Kant Bamotra
The epithelial cells of cornea constantly undergo renewal and regeneration and the stem cells responsible for renewal resides within basal epithelium at the limbus in palisades of Vogt. Simple limbal epithelial transplantation (SLET) is a simplified technique for limbal stem cell deficiency and it combines the benefits of both conjunctival limbal autografting and cultivated limbal epithelial transplantation by being single-stage and utilizing minimal donor tissue. We will be discussing two cases of ocular surface disorder which were managed successfully by new technique simple limbal epithelial transplantation...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Vikas Mittal, Purvasha Narang, Vikas Menon, Ruchi Mittal, Santosh Honavar
PURPOSE: To describe the utility of simple limbal epithelial transplantation (SLET) along with tumor excision in the management of extensive ocular surface squamous neoplasia (OSSN) to avoid limbal stem cell deficiency (LSCD). METHODS: This case report describes the management of a 75-year-old man clinically diagnosed with OSSN involving more than 3 quadrants of limbus. The excisional biopsy of tumor along with 4-mm healthy margin led to a complete loss of the limbus, which was restored by limbal epithelial cell transplantation using the SLET technique in the same setting...
July 20, 2016: Cornea
Ana Gabriela Queiroz, Martina Maria Oiticica Barbosa, Myrna Serapião Santos, Telma Pereira Barreiro, José Álvaro Pereira Gomes
This study aimed to evaluate the effectiveness of the novel simple limbal epithelial transplantation (SLET) technique, which reduces the risk of iatrogenic limbal stem cell deficiency in the donor eye. Four patients with total unilateral limbal stem cell deficiency received a limbal graft, measuring 4 mm × 2 mm, from the contralateral healthy eye in a single surgical procedure. The graft was divided into 10-20 pieces and distributed on the corneal surface. At 6-month follow-up, a completely avascular corneal epithelial surface was obtained in two patients, and there was improvement in visual acuity in one patient...
April 2016: Arquivos Brasileiros de Oftalmologia
Lea Sletting Jakobsen, Kit Granby, Vibeke Kildegaard Knudsen, Maarten Nauta, Sara Monteiro Pires, Morten Poulsen
Acrylamide (AA) is a process-contaminant that potentially increases the risk of developing cancer in humans. AA is formed during heat treatment of starchy foods and detected in a wide range of commonly consumed products. Increased focus on risk ranking and prioritization of major causes of disease makes it relevant to estimate the impact that exposure to chemical contaminants and other hazards in food have on health. In this study, we estimated the burden of disease (BoD) caused by dietary exposure to AA, using disability adjusted life years (DALY) as health metric...
April 2016: Food and Chemical Toxicology
Jayesh Vazirani, Mohammed Hasnat Ali, Namrata Sharma, Nidhi Gupta, Vikas Mittal, Marwan Atallah, Guillermo Amescua, Tuhin Chowdhury, Alexandra Abdala-Figuerola, Arturo Ramirez-Miranda, Alejandro Navas, Enrique O Graue-Hernández, James Chodosh
PURPOSE: To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. METHODS: In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface...
October 2016: British Journal of Ophthalmology
Vikas Mittal, Rajat Jain, Ruchi Mittal, Urvish Vashist, Purvasha Narang
AIM: To study the outcomes of simple limbal epithelial transplantation (SLET) for unilateral total limbal stem cell deficiency (LSCD) secondary to severe ocular surface burns in children. METHODS: Retrospective interventional case series was performed at a private referral tertiary care centre. Children less than 15 years of age who underwent autologous SLET for total LSCD and had a minimum follow-up of 6 months were included in the study. Demographic and clinical data were recorded in a predesigned form...
August 2016: British Journal of Ophthalmology
Dhanyasree Nair, Ashik Mohamed, Virender S Sangwan
A 19-year-old woman presented to us after being diagnosed elsewhere with right eye total limbal stem cell deficiency resulting from a lime burn. She was advised to undergo limbal stem cell transplantation, but failed to immediately do so. Two years later, she underwent cultivated limbal epithelial transplantation (CLET). As she had severe loss of vision with persisting conjunctival nodule and symblepharon 2 years following surgery, an impression of failed CLET was formed. Subsequently, simple limbal epithelial transplantation (SLET) was performed...
2015: BMJ Case Reports
Motoi Inoue, Masato Nakasuji, Aki Kawasaki, Miwako Nagai, Taeko Miyata, Norie Imanaka, Masuji Tanaka
A 67-year-old woman underwent prone thoracoscopic esophagectomy with carbon dioxide (CO2) insufflation. After insertion of an epidural catheter, general anesthesia was induced with propofol, sevoflurane, remifentanil and rocuronium. The trachea was intubated with a single lumen endotracheal tube (SLET). CO2 insufflation at 5 mmHg with the SLET deflated the right lung and provided excellent visualization without respiratory instability. The left side pleura was injured during the inferior mediastinal lymphadenectomy and the patient went into sudden profound hypoventilation with an increase in end-tidal CO2 from 43 to 64 mmHg...
August 2015: Masui. the Japanese Journal of Anesthesiology
J Carlsen, C Ewertsen, S Sletting, I Vejborg, F K W Schäfer, D Cosgrove, M Bachmann Nielsen
Ultrasound elastography is an established method for characterization of focal lesions in the breast. Different techniques and analyses of the images may be used for the characterization. This article addresses the use of ultrasound elastography in breast cancer diagnosis. In the first part of the article the techniques behind both strain- and shear-wave-elastography are explained and followed by a section on how to obtain adequate elastography images and measurements. In the second part of the article the application of elastography as an adjunct to B-mode ultrasound in clinical practice is described, and the potential diagnostic gains and limitations of elastography are discussed...
December 2015: Ultraschall in der Medizin
Vikas Mittal, Rajat Jain, Ruchi Mittal
PURPOSE: To study the in vivo pattern of ocular surface epithelialization after simple limbal epithelial transplantation (SLET). METHODS: A retrospective interventional case series was performed at a cornea and anterior segment services of a referral tertiary care center between June 2012 and March 2015. Patients with unilateral limbal stem cell deficiency who underwent SLET and whose medical records had serial and detailed photographic documentation of ocular surface healing were reviewed...
October 2015: Cornea
Shilpa Das, Sayan Basu, Virender Sangwan
One day after molten aluminium had fallen into his right eye, a young man presented to our clinic with a vision of counting fingers at 1 m, conjunctival and corneal epithelial defects, and limbal involvement. He was diagnosed with grade 4 thermal burn and managed medically. Subsequently, the inflammation resolved, however, he developed pannus with conjunctivalisation and scarring of cornea suggestive of partial unilateral limbal stem cell deficiency. He was treated surgically with autologous simple limbal epithelial transplantation (SLET)...
2015: BMJ Case Reports
Erick Hernández-Bogantes, Guillermo Amescua, Alejandro Navas, Yonathan Garfias, Arturo Ramirez-Miranda, Alejandro Lichtinger, Enrique O Graue-Hernández
We describe a novel surgical technique for pterygium removal taking advantage of the properties of amniotic membrane and limbal epithelial stem cells. A total of 10 eyes underwent pterygium excision with amniotic membrane coverage of the bare sclera and placement of pieces of limbal epithelium in a linear fashion in the affected limbal area covered by a second amniotic membrane using fibrin glue. After up to 8 months of follow-up, there were no signs of early recurrence or sight-threatening complications...
December 2015: British Journal of Ophthalmology
Jayesh Vazirani, Ikeda Lal, Virender Sangwan
A 4-year-old boy developed unilateral, total limbal stem cell deficiency (LSCD) following an acid injury. A stable ocular surface was achieved with autologous simple limbal epithelial transplantation (SLET), performed 4 months after the injury. Focal areas of conjunctivalisation were noted in the postoperative period. These were addressed using a novel modification of SLET. A very small piece of limbus from the healthy eye was split into multiple pieces, and applied to the bare corneal stroma with fibrin glue after pannus resection...
2015: BMJ Case Reports
Ruixiang Zhang, Shilei Liu, Haibo Sun, Xianben Liu, Zongfei Wang, Jianjun Qin, Xionghuai Hua, Yin Li
Double-lumen endotracheal tube (DLET) anaesthesia is the commonly used method in minimally invasive oesophagectomy (MIE). However, DLET intubation does have its disadvantages. Firstly, the placement of the DLET needs a skilled anaesthetist with familiarity of the technique and subsequent ability to perform a fibre-optic bronchoscopy for confirmation. Secondly, DLET intubation and one-lung ventilation are associated with numerous complications, including hoarseness, tracheobronchial injury and vocal injury. In this report, a retrospective analysis was performed on 42 consecutive patients who underwent MIE using single-lumen endotracheal tube (SLET) anaesthesia with CO2 artificial pneumothorax compared with 81 patients who underwent the same procedure with DLET intubation...
August 2014: Interactive Cardiovascular and Thoracic Surgery
Ahmed M Harraz, Ahmed Mosbah, Mohamed Abdel-Latif, Ahmed El-Assmy, Hossam Gad, Atallah A Shaaban
OBJECTIVE: To determine the long-term effects of the direct refluxing-type ureteroileal anastomosis technique with those of an antireflux technique on individual renal units, using diuretic scintigraphy in a prospectively randomized study. PATIENTS AND METHODS: Between 2002 and 2006, a prospective randomized study was conducted on 102 patients undergoing radical cystectomy and urinary diversion. In every patient, both ureters were randomized to be implanted using a direct refluxing technique or an antireflux, serous-lined extramural tunnel (SLET) technique...
August 2014: BJU International
Swapnil Bhalekar, Virender S Sangwan, Sayan Basu
An 11-year-old boy underwent simple limbal epithelial transplantation (SLET) from the healthy right eye to his left eye for total limbal stem cell deficiency. One month later, corneal surface epithelialised and whitish plaques overlying the transplants were seen inferiorly. Those plaques were adherent to the surface of the contact lens and underlying corneal surface had smooth elevations. Similar findings were noted in a 23-year man following cyanoacrylate glue application for corneal perforation. On histological and immunohistochemical analysis, cells lining the contact lenses were identified as corneal epithelial cells...
2013: BMJ Case Reports
Manu S Sancheti, Brendan P Dewan, Allan Pickens, Felix G Fernandez, Daniel L Miller, Seth D Force
BACKGROUND: This study evaluated the feasibility of performing thoracoscopy without lung isolation employing single lumen endotracheal tube (SLET) intubation and carbon dioxide insufflation. METHODS: Eighty-two patients underwent a variety of thoracoscopic procedures without lung isolation using SLET intubation and carbon dioxide (CO2) insufflation between January and December 2012. Sixty-five of these patients underwent wedge resections and were isolated for analysis...
August 2013: Annals of Thoracic Surgery
Jayesh Vazirani, Sayan Basu, Virender Sangwan
A 9-year-old boy presented with unilateral, total limbal stem cell deficiency (LSCD) complicated by the presence of a large fibro-vascular ocular surface mass lesion secondary to accidental lime injury. The pathological tissue covering the cornea was excised and simple limbal epithelial transplantation (SLET) was performed using autologous limbal tissue from the fellow eye. Histopathology of the excised ocular surface tissue revealed exuberant granulation tissue interspersed with retained calcium particles...
2013: BMJ Case Reports
Ikeda Lal, Bhavik Uttam Panchal, Sayan Basu, Virender S Sangwan
A 20-year-old man from Bangladesh suffered accidental alkali injury to his right eye in May 2010 leading to total limbal stem cell deficiency. An amniotic membrane graft was performed 5 days after the accident and the patient presented to our institute 6 months later. On ocular examination, his best corrected visual acuity (BCVA) was 20/50 with a 360° pannus at the periphery and central area was spared but had stromal scarring. He underwent simple limbal epithelial transplantation (SLET) taking a limbal biopsy from his left eye and was prescribed steroid and antibiotic eye drops postoperatively as per the standard regimen...
2013: BMJ Case Reports
Swapnil Bhalekar, Sayan Basu, Ikeda Lal, Virender S Sangwan
A 3-year-old child sustained severe ocular surface burns in her left eye after accidental lime injury. Despite appropriate management in the acute stage, she developed limbal stem cell deficiency (LSCD) in that eye. This was initially treated with autologous ex vivo cultivated limbal epithelial transplantation (CLET), which unfortunately failed after 6 months resulting in recurrence of LSCD. One year following CLET, she underwent simple limbal epithelial transplantation (SLET) using autologous donor tissue from the healthy fellow eye...
2013: BMJ Case Reports
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