ABSTRACT
A prospective study was conducted to study the splenic function among sickle cell anemia (SCA) patients in Qatif (Eastern Province of Saudi Arabia). Seventy-seven patients (30 children and 47 adults aged 2-57 years) were included. (99m)Tc stannous colloid liver-spleen scan was done for each patient during steady state. The splenic function was graded from 0 to 4 in relation to liver uptake. Seventy percent of our patients showed evidence of splenic hypofunction, and most of them (83%) had severe hyposplenism. Up to the age of 4 years, only 17% of the children showed evidence of functional hyposplenism, but by the age of 10 years >50% were hyposplenic. Most of the hyposplenic children had functional hyposplenism, whereas only one-third of hyposplenic adults had autosplenectomy. There was no effect of level of HbF on the frequency of hyposplenism, but on the other hand low MCV seems to be protective against hyposplenism. A significant number of adult SCA patients have clinically enlarged spleens, and almost a third have normally functioning spleens. Because of the low prevalence of hyposplenism in children younger than 4 years of age, routine penicillin prophylaxis is probably not indicated in this population, an issue which needs further evaluation.
Subject(s)
Anemia, Sickle Cell/epidemiology , Splenic Diseases/diagnostic imaging , Splenic Diseases/epidemiology , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Clinical Trials as Topic , Comorbidity , Erythrocyte Indices , Female , Fetal Hemoglobin/metabolism , Hepatomegaly/diagnosis , Humans , Liver/diagnostic imaging , Male , Middle Aged , Mononuclear Phagocyte System/diagnostic imaging , Prevalence , Prospective Studies , Radionuclide Imaging , Saudi Arabia/epidemiology , Sex Distribution , Spleen/diagnostic imaging , Splenic Diseases/diagnosis , Splenomegaly/diagnosis , Technetium Compounds , Tin FluoridesABSTRACT
We present two cases of medulloblastoma in adults patients showing extensive astrocytic differentiation. In one case, there was synchronous oligodendroglial differentiation, both changes appearing after treatment with radiotherapy. The possible role of radiotherapy in the differentiation is discussed.
Subject(s)
Astrocytoma/pathology , Brain Neoplasms/pathology , Medulloblastoma/pathology , Neoplasm Recurrence, Local/pathology , Oligodendroglioma/pathology , Adult , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/therapy , Cell Transformation, Neoplastic , Combined Modality Therapy , Humans , Male , Medulloblastoma/diagnostic imaging , Medulloblastoma/therapy , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/etiology , Tomography, X-Ray ComputedSubject(s)
Brain Neoplasms/surgery , Dysgerminoma/surgery , Brain Neoplasms/pathology , Brain Stem/pathology , Cerebellum/pathology , Cranial Fossa, Posterior , Dysgerminoma/pathology , Humans , Infant , Male , Microscopy, Electron , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Tomography, X-Ray ComputedABSTRACT
A quantitative analysis of the results obtained by sequential 99mTc methylene diphosphonate (MDP) and 67Ga-citrate (Ga) imaging to disclose and distinguish infections in bone, synovium and adjacent soft tissue is reported. There were 129 patients with proved or probable osteomyelitis, septic arthritis and cellulitis, and 94 patients who were eventually shown to be free of sepsis, but not necessarily free of some other nonseptic affliction. Of the 159 patients referred with a presumptive clinical diagnosis of osteomyelitis 94 were eventually shown to be free of infection. The results of this group by sequential imaging were true positive 0.72, true negative 0.86 and accuracy 0.80 when low-grade Ga uptakes, which were similar in distribution to MDP, were excluded. In 26 patients with septic arthritis, the true-positive fraction for combined MDP and Ga was 0.84. The true-positive fraction for Ga in 38 patients with cellulitis was 0.79.
