Keratoacanthoma formation after skin grafting: A brief report and pathophysiological hypothesis

Keratoacanthoma formation after skin grafting is rare. We report the third case in the literature of multiple keratoacanthomas developed at both split‐thickness skin graft donor and recipient sites. We provide possible explanations for this poorly understood phenomenon and highlight its implications on treatment options.     

Review of current indications for combined very high fluence collagen cross-linking and laser in situ keratomileusis surgery

In this brief review we will discuss the reasoning and evolution of our current use of combined very high-fluence collagen crosslinking and laser in situ keratomileusis. Several presentations and pertinent publications are reviewed, along with the key steps of the enhanced LASIK procedure. Long term outcome data support the safety and efficacy of LASIK Xtra in stabilizing myopic but also hyperopic LASIK results. In conclusion, we have compelling evidence that LASIK Xtra is a safe and effective adjunct.     

RBC-derived vesicles during storage: ultrastructure, protein composition, oxidation, and signaling components

BACKGROUND: Red cells (RBCs) lose membrane in vivo, under certain conditions in vitro, and during the ex vivo storage of whole blood, by releasing vesicles. The vesiculation of the RBCs is a part of the storage lesion. The protein composition of the vesicles generated during storage of banked RBCs has not been studied in detail. STUDY DESIGN AND METHODS: Vesicles were isolated from the plasma of nonleukoreduced RBC units in citrate‐phosphate‐dextrose‐adenine, at eight time points of the storage period and shortly afterward. The degree of vesiculation, ultrastructure, oxidation status, and protein composition of the vesicles were evaluated by means of electron microscopy and immunoblotting. RBCs and ghost membranes were investigated as controls. RESULTS: The total protein content of the vesicle fraction and the size of the vesicles increased but their structural integrity decreased over time. The oxidation index of the vesicles released up to Day 21 of storage was greater than that of the membrane ghosts of the corresponding intact RBCs. The vesicles contain aggregated hemoglobin, band 3, and lipid raft proteins, including flotillins. They also contain Fas, FADD, procaspases 3 and 8, caspase 8 and caspase 3 cleavage products (after the 10th day), CD47 (after the 17th day), and immunoglobulin G. CONCLUSION: These data indicate that the vesicles released during storage of RBCs contain lipid raft proteins and oxidized or reactive signaling components commonly associated with the senescent RBCs. Vesiculation during storage of RBCs may enable the RBC to shed altered or harmful material.     

Tumor extending through inferior vena cava into the right atrium. A late recurrence of renal cell carcinoma

Renal cell carcinoma is a tumor with a distinct feature; it can invade through renal vein to the inferior vena cava (IVC) and growths intravascularly extending sometimes into the right cardiac chambers. Previous reports of renal cancer with extension to the right atrium at the time of diagnosis have been published. We present the case of a patient with a right atrial mass arising from the IVC found by echocardiography, which was subsequently proved to be a recurrence of renal cell carcinoma 5 years after radical nephrectomy.