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Objective To investigate the potential relationship between initial 131Ⅰ uptake by lung metastases from differentiated thyroid cancer (DTC) and treatment outcomes. Methods From 1997 to 2009, 41 patients with DTC lung metastases were treated in the authors' department. 131Ⅰ whole body scan (WBS), serum Tg levels and other imaging results were analyzed to evaluate the therapeutic effects. Complete response (CR) or partial response (PR) was considered to be effective. The x2 test and correlation analysis were performed using SPSS 11.5 software package. Results 131 Ⅰ treatment was effective in 63% (26/41) patients with DTC lung metastases, CR in 8 patients and PR in 18 patients. In other 37% ( 15/41 ) patients, 131Ⅰ treatment was ineffective, including one case died of distant metastases. Patients with initial presence of 131Ⅰ lung uptake had higher effective rate than those with 131Ⅰ lung uptake during the second or later 131Ⅰ treatment (76% (22/29)vs33% (4/12),x2 =4.911, P=0.027). Also, significantly higher effective rate was found in patients with lung metastases alone than those with extra-pulmonary metastases (75% (24/32) vs 22% (2/9), x2 = 6. 312, P =0.012). However, the effective rate in patients with diffuse metastases was not significantly different from that in patients with focal metastases (67% (12/18)vs 61% ( 14/23), x2 =0. 146, P=0.702). The positive rate of initial 131Ⅰ uptake by lung metastases was higher in patients with total thyroidectomy than those with partial thyroidectomy (83% (24/29) vs 42% (5/12) ). Those positive rates in patients with papilary DTC and patients with follicular DTC were 72% (23/32) and 6/9, respectively. The surgical mode was correlated with the initial 131Ⅰ uptake by lung metastases (r = 0.411, P ＜ 0.05), but no correlation was found between the histological type and the initial 131Ⅰ uptake by lung metastases ( r = 0. 047, P ＞ 0.05 ). Conclusion Initial uptake of 131 Ⅰ by lung metastases alone is a favorable prognostic factor for DTC patients treated by131Ⅰ, and total thyroidectomy may be beneficial for initial 131Ⅰ uptake by lung metastases.
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Objective 99Tcm-4,9-diaza-3,3,10,10-tetramethyldodecan-2,11-dione dioxime(HL91),a new type of hypoxic agents,accumulates in tumor hypoxic tissue specifically.The aim of this study was to evaluate the value of 99Tcm-HL91 imaging in the diagnosis of bone metastasis.Methods Nineteen cases with bone metastasis(without any treatment)and 8 cases with benign lesions underwent SPECT imaging at 4 h after injection of 740 MBq of 99Tcm-HL91 along with 99Tcm-methylene diphosphonic acid(MDP)imaging.Regions of interest(ROIs)were drawn in tumor tissue and contralateral normal tissue respectively,and the radioactivity ratios of tumor-to-normal(T/N)were calculated.The t-test was used for data analysis with SPSS 11.0.Results There were visible uptake of 99Tcm-HL91 in 79 out of 85 focuses in 19 patients of bone metastasis;however,there was no obvious uptake of 99Tcm-HL91 in 12 focuses of 8 patients of benign lesions.Significant difference existed between the T/N values of malignant(1.877±0.288)and benign lesions[(0.735±0.236);t=13.065,P＜0.05].However,the T/N value of bone metastasis from lung cancer did not differ with that from prostate cancer(1.915±0.344 and 1.825±0.175,respectively;t=1.378,P＞0.05).Conclusion The results indicated that 99Tcm-HL91 was useful in diagnosing the malignant and benign bone lesions.
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Objective To discuss the indication and complication of overhead traction of olecranon for displaced extension-type GartlandⅢ supracondylar fracture of the humerus in children.Methods Total of 87 patients(Gartland Ⅲ) proceeded with overhead skeletal traction of ulnar olecranon,including 68 cases of ulnar deviation and 19 cases of radial deviation.Eighteen cases had complicating revolve deviation.According portable X-ray results in the 2nd and 5th,three-dimension adjustment was performed within 1 week.Five patients were treated by open reduction because of symptoms nerves and blood vessel compression.When X-ray examination showed good callus formation and stable reduction,the patient was discharged after the elbow was stabilized in flexion position with plaster fixation,which was removed in 2 weeks.Results Sixty-seven of 87 patients were followed-up for 18 months.All of them had excellent results except one who had permanent ulnar nerve injury.No cubitus varus was observed.Conclusions The overhead olecranon skeletal traction is a simple,effective method,because it can increase joint motion,relieve elbow swell and pain rapidly,and improve upper limb line of traction.However,open reduction shall be done promptly if there is evidence of nerve,blood vessel or soft tissue between broken ends of fractured bone within 5 days.
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Objective To investigate the clinical epidemiologic features of transient synovitis(TS) of hip in children occurred in Shen-zhen district.Methods The medical files were reviewed and a standard questionnaire was filled according to the conditions of 705 cases such as pathogeny,clinical manifestation,therapy and prognosis.Results Transient synovitis occurred in a sporadic form all the year round.The peak age of patients with TS was 3-7 years old.The ratio of boys to girls was 2.9:1.About 19.3% patients were attacked an upper respiratory tract infection and 11.9% patients attributed the symptoms to trauma or severe activities before 1 week.A varying degree of painful limp and restriction of movement at the hip were found clinically.All of cases were cured by skin traction.The incidence of recurrence was 6.95%.Conclusions Male predominance is found in TS.It is characteristic of sporadic form in the 4 seasons and intently relation to an upper respiratory tract infection and trauma or severe activities.TS is recurrent and the prognosis is good by skin traction.
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Objective To evaluate the value of reconstruction of three-dimentional CT in development dislocation of hip(DDH)in children.Methods Twelve cases of DDH concluded 4 bilateral and 8 unilateral cases.To sum up,16 sick hips were operated and 8 normal hips were also obtained by three-dimensional CT(Hip speed Fi/x,GE Co).Results 3D reconstruction were used to show femoral head,(acetabulum) and relationship of acetabulum and femoral head respectively.The difference between FNA measurement of sick hips and those of normal hips were significant(P