Thyroid uptake neck phantoms are not created equal.

The main purpose of this communication is to alert nuclear medicine departments to the fact that the earlier version of the water phantom grossly overestimates soft-tissue attenuation in the neck, resulting in calculated thyroid uptake values which are significantly overestimated (in hyperthyroid patients we noted uptake values approaching or exceeding 100%). We believe that the solid Lucite phantom (which is the one recommended by IAEA) better approximates the human neck soft tissue overlying the thyroid. Institutions that continue to use the water phantom should be aware that their thyroid uptakes will be relatively elevated and the normal range must be shifted accordingly. Our normal range is 10%-30% uptake of 123I at 24 hr for the Lucite phantom. For the water phantom, the estimated normal range would be 15%-45%. In addition, the phantom type should be considered when comparing uptake results with those from another institution for a particular patient. Also, treatment doses for Grave's disease could be significantly affected, if such doses are calculated by a formula that depends on uptake.     

A leg ulcer as manifestation of metastatic squamous cell vaginal carcinoma

Cutaneous metastasis of vaginal carcinoma is extremely rare. So far, the total number of reported skin metastasis of vaginal carcinoma is only one. We present another case with an unusual manifestation of vagina carcinoma metastasis: skin metastasis presenting as a leg ulcer on the lower leg.     

Localization of a gene for otosclerosis to chromosome 15q25-q26

Among white adults otosclerosis is the single most common cause of hearing impairment. Although the genetics of this disease are controversial, the majority of studies indicate autosomal dominant inheritance with reduced penetrance. We studied a large multi- generational family in which otosclerosis has been inherited in an autosomal dominant pattern. Five of16 affected persons have surgically confirmed otosclerosis; the remaining nine have a conductive hearing loss but have not undergone corrective surgery. To locate the disease- causing gene we completed genetic linkage analysis using short tandem repeat polymorphisms (STRPs) distributed over the entire genome. Multipoint linkage analysis showed that only one genomic region, on chromosome 15q, generated a lod score >2.0. Additional STRPs were typed in this area, resulting in a lod score of 3.4. STRPs FES (centromeric) and D15S657 (telomeric) flank the 14. 5 cM region that contains an otosclerosis gene.