RESUMO
This report describes a rare case of multiple intracranial, extradural chloromas. A five year old African American male presented with headache, fever, and vomiting. The peripheral blood smear showed myeloblasts with Auer rods. The CTscan of the brain showed three intracranial, epidural lesions as well as soft tissue masses in the retroorbital region and sphenoid sinuses. CTscan of the chest showed two paraspinal epidural thoracic masses. Pathology of the epidural intracranial mass revealed a granulocytic sarcoma. Cytogenetic analysis showed simultaneous occurrence of t(8;21) and trisomy 8. Following induction therapy, he is now in complete remission.
Assuntos
Aberrações Cromossômicas , Leucemia Mieloide Aguda/diagnóstico , Sarcoma Mieloide/diagnóstico , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Pré-Escolar , Cromossomos Humanos Par 21 , Cromossomos Humanos Par 8 , Análise Citogenética , Neoplasias Epidurais/diagnóstico , Neoplasias Epidurais/diagnóstico por imagem , Neoplasias Epidurais/genética , Humanos , Leucemia Mieloide Aguda/genética , Masculino , Radiografia , Indução de Remissão , Sarcoma Mieloide/diagnóstico por imagem , Sarcoma Mieloide/genética , Translocação Genética , TrissomiaRESUMO
Ovarian metastasis of childhood tumors is rare despite their aggressive nature. The childhood tumor that spreads to the ovary most frequently is the neuroblastoma. The clinical features and frequent bilaterality of ovarian metastatic tumors are helpful diagnostic features in many cases, but when the ovarian tumor is the presenting manifestation of the disease, differentiation from various primary ovarian tumors may be difficult. In this paper, a rare case of metastatic ovarian neuroblastoma is reported.
Assuntos
Neuroblastoma/secundário , Neoplasias Ovarianas/secundário , Adolescente , Feminino , HumanosRESUMO
In an earlier study only 10.5% of 162 patients developed protective levels of antibody (anti-Hbs) to a series of three double dose immunization with Hepatitis B virus (HBV) vaccine (Engerix B, Smith Kline Beecham). A second study was conducted giving five primary doses at monthly intervals followed by a booster 1 year after the first dose. Serum antibodies were detected in 30% of patients who received all six doses of vaccine, and in only 19% were antibody levels protective. Infection with HBV occurred in 43% of patients.
Assuntos
Vacinas contra Hepatite B/administração & dosagem , Esquemas de Imunização , Leucemia-Linfoma Linfoblástico de Células Precursoras/imunologia , Criança , Pré-Escolar , Feminino , Anticorpos Anti-Hepatite B/biossíntese , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/sangue , Humanos , Imunização Secundária , Lactente , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangueRESUMO
OBJECTIVE: To study the outcome of oral busulfan and intravenous cyclophosphamide (BuCY 2 regimen) followed by allogeneic bone marrow transplant (BMT) in a cohort of patients with Philadelphia chromosome (Ph+) chronic myeloid leukaemia (CML) in a single centre. METHODS: From 1991 to March 1998, a total of 27 consecutive Ph+ CML patients received busulfan 4 mg/kg/day over 4 days and cyclophosphamide 60 mg/kg/day over 2 days followed by infusion of HLA-identical sibling haematopoietic stem cells. All except one (who received peripheral blood stem cells) were given donor bone marrow cells. Post-transplant graft versus host disease (GVHD) prophylaxis included a short course of methotrexate (on days +1, +3, +6 and +11) and cyclosporine till day +180. RESULTS: With a median follow-up of 30.5 months (1-55+ months), 14 patients (52%) are alive free from relapse. Early mortality was relatively high with 10 patients (37%) dying within first 100 days post-transplant. Acute GVHD developed in 14 patients (52%) inspite of GVHD prophylaxis with methotrexate and cyclosporine; six had grade I/II and eight grade III/IV. Chronic GVHD developed in five of 15 patients who lived beyond 70 days. CONCLUSION: Allogeneic BMT appears to result in eradication of CML and ensure disease free survival in about half of the young patients. However, efforts should be on to minimise early mortality.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Purging da Medula Óssea/métodos , Transplante de Medula Óssea/métodos , Bussulfano , Ciclofosfamida , Leucemia Mielogênica Crônica BCR-ABL Positiva/terapia , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Masculino , Taxa de SobrevidaRESUMO
A new device is introduced for holding temporal bones during dissection. It is structurally very different, more practical and effective for securing the bone than the temporal bone holding bowl which has been in use so far.
Assuntos
Dissecação/instrumentação , Educação de Graduação em Medicina , Otolaringologia/educação , Osso Temporal/cirurgia , Desenho de Equipamento , HumanosRESUMO
The impaction of a cannabis-filled condom in the upper oesophagus of a 28-year-old prisoner is reported. The history was deceptive and smoking and drug abuse denied. The ENT surgeon being unaware of the identity of the drug faced tackling a possibly lethal foreign body, technically difficult to remove by the usual forceps method. (The Dormier basket is recommended for this task but we were unable to try it). Passage of the condom into the stomach occurred during attempted removal and its further progress was uneventful, indicating that gastroscopic removal of cannabis is unnecessary unless obstructive symptoms occur.
