RESUMO
Basal ganglia germinomas (BGGs) are rare lesions. Because of the atypical features of early-stage clinical symptoms and imaging characteristics, BGGs are easily misdiagnosed with non-tumorous conditions. This article presented cases of 2 young male patients who came to the hospital due to right arm weakness. Brain Magnetic Resonance Imaging (MRI) images in the first case revealed a lobulated mixed component mass on the left basal ganglia. The solid part showed restricted diffusion on diffusion-weighted imaging, heterogeneous strong enhancement, and no signal of calcification or bleeding. The second case in the left putamen showed hypointensity on T2*, mild enhancement, and atrophy of the ipsilateral cerebral peduncle, increased choline, and decreased n-acetyl-aspartate (NAA) on spectroscopy. Follow-up MRI after 6 months showed a mass increase in size and hypointensity part on T2*. BGGs have been confirmed on biopsy in both cases. With isolated chemotherapy application, there is no sign of remission in the first patient. The second patient was treated with chemotherapy and radiotherapy, and MRI images after treatment showed a complete response.
RESUMO
Lead poisoning is a public health problem in many areas of the world. Children are at particularly high risk for adverse effects of lead exposure; even at low concentrations, lead can affect physical, mental, and behavioral development. Children living near lead-zinc mines are at high risk for environmental lead poisoning, especially the contaminated soil. We conducted a cross-sectional descriptive study in Ban Thi Commune, northern Vietnam. 195 children (92,9% participation) aged 3-14 years old (average: 7.69 ± 2.90) were randomly selected from a list of all children prepared by the village health collaborators. 109 (55.90%) were boys and 86 (44.10%) were girls. The research measures were the lead concentration in native soil and the children's total blood lead concentration determined by the inductively coupled plasma-mass spectrometry (ICP-MS) method. The results showed that lead content in soil was many times higher than American Environmental Protection Agency and Vietnam standards (average 2980.23 ± 6092.84 mg/kg dry weight of soil (range 80.05 - 33820.62)). Average blood lead levels for children were 15.42 ± 6.45 µg/dL (95% CI: 14.50 -16.33 µg/dL). The percentage of children with lead levels >10 µg/dL (value considered to be lead poisoning for children according to the Ministry of Health of Vietnam) was 79.49% of the total number of children. None of the children in this study had blood lead level (BLL) that required chelation treatment according to Vietnam MOH guideline (BLL ≥45 µg/dL). There is weakly evidence that lead exposure relates to the physical development of children. Children with low lead concentrations (less than 10 µg/dL) had height and weight of 1.47-3.51 cm and 1.19-2.81 kg, greater than those with BLL >10 µg/dL (p>0.05).