Does the use of recombinant TSH in preparation for I-131 scintigraphy scan affect hearing function?

Objective: The objective of this study was to examine the effect of hypothyroidism on hearing function in patients surgically treated for differentiated thyroid cancer and subsequently experienced hypothyroidism during preparation for follow up I-131 scintigraphy scan by either recombinant human thyroid stimulating hormone(rhTSH) treatment or thyroid hormone withdrawal(THW).Methods: A total of 55 patients undergoing I-131 scintigraphy scan following surgeries for differentiated thyroid cancer were included in the study, including 25 patients prepared by administration of recombinant TSH(rhTSH Group) and 30 patients by thyroid hormone withdrawal(THW Group).Results: Air conduction thresholds at 1, 2 and 4 kHz for both ears were higher during hypothyroid period than during euthyroid period for patients in the THW group(p < 0.05) but not for patients in the rhTSH group.Conclusion: Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss.

Intraoperative permanent implantation of radioactive I-125 seed for local advanced non small lung cancer

Objective： To study the clinical efficacy and methods of permanent implantation of radioactive I-125 seed in surgery for local advanced non small lung cancer （LANSCLC）. Methods： From Apr. 2004 to Apr. 2006, the I-125 seeds were implanted into 30 patients with LANSCLC in surgery. The numbers of seeds were 10-40. The chemotherapy was performed in 10 to 14 days after operation. Results： There was no operative death, and the distribution of seeds and complications were reviewed by CT and X-ray after treatment. The distribution of seeds was satisfactory in all patients. The complete response rate （CR） was 56.6% and the part response （PR） was 26.6%. The overall response rate was 83.3% after 4-24 months of surgery. There was no one occurred radiation pneumonia. Prospective efficacy await further follow-up. Conclusion： Permanent implantation of 1-125 seed in surgery for LANSCLC, is a safe and effective method with mild complications.

^(99m)Tc-MIBI/^(99m)TcO_4^-核素显像定位诊断甲状旁腺功能亢进症

目的 观察比较99mTc MIBI/99mTcO4-双时相减影法与单纯双时相99mTc MIBI甲状旁腺显像定位诊断甲状旁腺功能亢进症 (hyperparathyroidism ,HPT)。 方法 18例经临床确诊HPT患者 ,行双时相99mTc MIBI甲状旁腺显像 (方法一 ) :静脉注射显像剂99mTc MIBI 74 0MBq后 ,分别于 2 0min(或 30min)和 12 0min时行颈前平面显像。99mTc MIBI/99mTcO4-双时相减影法 (方法二 ) :99mTc MIBI显像后次日 ,静脉注射99mTcO4-370MBq ,10min～ 2 0min后行颈前甲状腺平面显像。与99mTc MIBI影像进行比较分析。结果 18例HPT患者中 ,经手术证实有 2 3个病灶 ,其中 19个为腺瘤 ,4个为增生 ,未发现癌变病灶。 4例肾功能衰竭患者有 7个病灶 ,2例原发HPT患者各有 2个腺瘤。方法一发现 15个阳性病灶 (15 /2 3,6 5 .2 % ) ,均为腺瘤 ,另有 2个腺瘤和 1个增生病灶诊断可疑阳性 (3/2 3,13.0 % )。方法二发现 18个阳性病灶 (18/2 3,78.3% ) ,其中 17个腺瘤 ,1个增生。方法二将方法一中的 3个可疑病灶明确为阳性。结论 99mTc MIBI/99mTcO4-双时相减影法具有很好的临床应用价值 ,可作为99mTc MIBI双时相甲状旁腺显像的有力补充或替代方法。