ABSTRACT
BACKGROUND/AIMS: Retinoblastoma is a highly malignant eye tumour in children with different survival rates across the world. The aims of this study are to determine the globe and patient survival in children with retinoblastoma in a major referral centre in Iran. METHODS: 156 eyes of 105 consecutive patients with retinoblastoma were enrolled from 2001 to 2007. All demographic data, family history, presenting symptoms, duration of symptoms, ocular findings and treatment modalities that were used for the patients were collected. For patient survival, event was defined as death and for globe survival as enucleation. RESULTS: The mean age at diagnosis was 28.5 months (unilateral 27.4 months; bilateral 30 months). Five patients had a positive family history. Fifty-two per cent of the cases were unilateral, and 48% were bilateral. The most common presenting sign was leucocoria (64.8%) followed by strabismus (28.2%). Enucleation was done primarily for 75.9% of unilateral cases and 34.3% of bilateral cases. Secondary enucleation was necessary in 5.6% and 7.8% of unilateral and bilaterally involved eyes respectively. Sixty-nine (44.2%) of 156 eyes were salvaged by different globe preserving modalities (unilateral 18.5%; bilateral 57.9%). The Kaplan-Meier survival estimate for globe preservation according to International Classification of Retinoblastoma (ICRB) was 100% for group A eyes, 93.5% for group B, 86.7% for group C, 57.1% for group D and 0% for group E eyes. Kaplan-Meier estimates for patients survival were 100% at 1 year, 94.8% at 3 years and 83.1% at 5 years. CONCLUSION: Progress in methods of treatment, early detection of the disease and prompt referral to specialised centres have led to improved outcomes for patients with retinoblastoma in terms of globe and patients' survival rates even in developing countries.
Subject(s)
Eye Enucleation , Retinal Neoplasms/mortality , Retinoblastoma/mortality , Child, Preschool , Eye Enucleation/statistics & numerical data , Eye Enucleation/trends , Female , Humans , Infant , Iran/epidemiology , Male , Patient Acceptance of Health Care/statistics & numerical data , Retinal Neoplasms/diagnosis , Retinal Neoplasms/therapy , Retinoblastoma/diagnosis , Retinoblastoma/therapy , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
Differentiation between rejection (the most common cause) and many other possibilities for detrimental effects on graft function represents a difficult issue to diagnose the cause of renal allograft dysfunction. This study was designed to determine whether technetium-99m sulfur colloid (TSC) accumulation predicted graft rejection. We prospectively studied 54 episodes of allograft dysfunction in 53 kidney transplant recipients who underwent TSC scintiscanning and graft biopsy. Visual analysis of TSC uptake compared uptake, in the allograft with that in the marrow of the fifth lumbar vertebra (L5). A 3+ result meant that allograft uptake was greater than L5 marrow uptake; 2+, the same; 1+, less and finally 0, no allograft uptake. Transplant accumulation of 2+ or more was considered consistent with rejection (P = .01). Allograft biopsies interpreted based on the Banff Working Classification showed rejection in 45 of 54 renal biopsies with 42 the biopsy-proven rejection episodes showing at least 2+ graft uptake. Furthermore, this nuclear medicine technique had a sensitivity of 93.3%, a specificity of 44.4%, a positive predictive value of 89.3%, a negative value of 57.1% and an efficiency of 83.3% for the diagnosis of renal allograft rejection.
Subject(s)
Graft Rejection/diagnostic imaging , Kidney Transplantation/pathology , Technetium Tc 99m Sulfur Colloid/pharmacokinetics , Adult , Biological Transport , Bone Marrow/diagnostic imaging , Female , Graft Rejection/epidemiology , Humans , Lumbar Vertebrae/diagnostic imaging , Male , Predictive Value of Tests , Radionuclide Imaging , Radiopharmaceuticals/pharmacokinetics , Tissue DistributionABSTRACT
A case of fatal cytomegalovirus pneumonia in a non-immunocompromised 65-year old man is reported. The patient presented with symptoms of a lower respiratory tract infection. The diagnosis of cytomegalovirus pneumonia was made after histopathological examination of the open lung biopsy. Confirmation of cytomegalovirus infection was made with in situ DNA Hybridization. The outcome was rapidly fatal. This case demonstrates the value of DNA probe analysis for diagnosis. This case is also unusual in that a non-immunocompromised adult had severe evolution of cytomegalovirus infection.
