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Computed tomography findings of retinoblastoma patients at Cipto Mangunkusumo Hospital Jakarta Asih, Dewi; Gatot, Djayadiman; Sitorus, Rita S.
Medical Journal of Indonesia Vol 18, No 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (199.806 KB) | DOI: 10.13181/mji.v18i4.366

Abstract

Aim: As data of CT findings for retinoblatoma in Indonesia is not yet available, this study aimed to determine patient distribution and to describe CT findings of RB patients at Cipto Mangunkusumo Hospital.Methods: From April 2004 to August 2007, CT scans were performed on 64 new patients of RB with clinical findings: leukocoria (19 patients), leukocoria with proptosis (41 patients), buphthalmus (2 patients) and red eyes (2 patients). The CT can was performed using single slice CT scan and multislice CT scan with axial and coronal section. The cases were categorized into 3 groups: grade I: tumor confined to the globe, grade II: tumor extended to orbital soft tissue or involved the optic nerve, and grade III: tumor extended beyond the orbit or intracranial space. The CT features were evaluated in each group for the presence of calcifi cation, contrast enhancement and lateralization.Results: Sixty four patients (30 females and 34 males) were evaluated. Age range: 3 months up to 9 years old; bilateral 20 patients, unilateral 44 patients. Six patients of 19 patients with clinical finding leukocoria were included in group I, and the remaining were included in group II. Twenty seven patients of 41 patients with proptotic eyes were included in group II, and the remaining were included in group III. Patients with clinical finding buphthalmus and red eyes were included in group II. All of the group I tumors (6 patients) showed calcification and enhancement. In group II (44 patients), calcification was detected in 41 patients, and there was no evidence of contrast enhancement in 6 patients. Group III (14 patients): no calcification in 2 patients, all of the tumors showed enhancement.Conclusion: Our study showed calcification in 92% of RB. Calcifi cation was not a favorable prognostic sign,because calcification was detected in almost all of the extraocular and intracranial tumors. Tumor enhancement was not correlated with extra ocular tumor extension. The finding of leukocoria without proptosis could not exclude the presence of extraocular tumor extension. Suspicious intracranial invasion should be considered in proptotic RB patient. Most retinoblastoma cases in Indonesia are diagnosed at advanced stage, so that the objective of the therapy is life saving rather than visual salvation. (Med J Indones 2009; 18: 239-43)Keywords: leukocoria, enhancement, calcification
The Role Of Coagulation Testing Prior To Surgery Cozie, Novie Amelia; Windiastuti, Endang; Gatot, Djayadiman
Jurnal Plastik Rekonstruksi Vol. 1 No. 6 (2012): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.389 KB) | DOI: 10.14228/jpr.v1i6.131

Abstract

Preoperative coagulation screening has been among the most debated of all laboratory tests, especially in children. Although an undiagnosed coagulopathy could result in serious surgical morbidity, commonly used screening tests such as bleeding time, prothrombin time, activated partial thromboplastin time, and platelet count, do not reliably predict abnormal perioperative bleeding. Laboratory testing should be considered in patients either the history or medical condition suggests a possible hemostatic defect, in patients undergoing surgical procedures that might induce hemostatic disturbances (eg, cardiopulmonary bypass), when the coagulation system is particularly needed for adequate hemostasis (eg, tonsillectomy), and in patients for whom even minimal postoperative bleeding could be critical (eg, neurosurgery). In the case of minor surgery and a negative history of clotting disorders, no tests are suggested.