A 62-year-old man with stage IV follicular lymphoma presented with acute left-sided abdominal pain, acute-on-chronic anaemia and thrombocytopenia. An urgent contrast-enhanced CT scan of the abdomen demonstrated the presence of haemoperitoneum. Irregular linear-branching hypodensities distorting the
Summary Measurement of the Haemoglobin F in red cell haemolysates is important in the diagnosis of δβ thalassaemia, hereditary persistence of fetal haemoglobin (HPFH) and in the diagnosis and management of sickle cell disease. The distribution of Hb F in red cells is useful in the diagnosis of HPFH and in the assessment of feto‐maternal haemorrhage. The methods of quantifying Hb F are described together with pitfalls in undertaking these laboratory tests with particular emphasis on automated high‐performance liquid chromatography and capillary electrophoresis.
Topoisomerase I inhibitors have shown positive effects in combination with radiation therapy in some studies. Normally oxygenated and hypoxic human MCF-7 breast carcinoma-cells were exposed to irinotecan (100 mu M or 250 mu M) or to SN-38 (10 mu M or 25 mu M) for 1 h prior to, during and for 3 h after radiation. Irinotecan and SN-38 showed little or no radiation sensitization of normally oxygenated MCF-7 cells but were effective radiation sensitizers of hypoxic cells. Both irinotecan and SN-38 diminished or eliminated the shoulder of the radiation survival curves of both the normally oxygenated and hypoxic cells indicating inhibition of the repair of sublethal radiation damage to DNA. Irinotecan (20 mg/kg or 30 mg/kg) was administered to mice bearing the EMT-6 mammary carcinoma on days 7 through 11 just prior to fractionated radiation (5x3 Gray). The tumor growth delays obtained with the combination regimens were greater than expected for simple additivity of the two treatments. Treatment with irinotecan resulted in decreased expression of topoisomerase I mRNA and increased expression of topoisomerase II mRNA in EMT-6 tumor tissue. Irinotecan treatment did not alter the protein levels for topoisomerase I or II in the tumor tissue; however, the combination of radiation therapy and irinotecan administration resulted in decreased topisomerase I and increased topoisomerase II protein in the tumor tissue. These results suggest that with appropriate scheduling of a topoisomerase I inhibitor and a topoisomerase II inhibitor with fractionated radiation therapy maximal cyto-reduction can be achieved.
Summary Although DNA analysis is needed for characterization of the mutations that cause β‐thalassaemia, measurement of the Hb A 2 is essential for the routine identification of people who are carriers of β‐thalassaemia. The methods of quantitating Hb A 2 are described together with pitfalls in undertaking these laboratory tests with particular emphasis on automated high‐performance liquid chromatography and capillary electrophoresis.
Pheochromocytoma is an uncommon neuroendocrine tumour arising from the chromaffin cells associated with increased catecholamine production. More than 85% of the tumours are infradiaphragmatic in location, with para-aortic region being the most common site.[1][1] Extra-adrenal pheochromocytoma (EAP
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