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Succimer (DMSA) For Removing Lead

Studies On Succimer (DMSA) Used To Remove Toxic Lead From Human Bodies



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Published in 1997 through 1999
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Documents: 1 to 50 of 64

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1 Mückter H, et al; Are we ready to replace dimercaprol (BAL) as an arsenic antidote? (Hum Exp Toxicol, 1997 Aug, Abstract available) [MEDLINE]
2 Sigg T, et al; A report of pediatric SUCCIMER overdose. (Vet Hum Toxicol, 1998 Apr, Abstract available) [MEDLINE]
3 Bhatnagar A, et al; Renal imaging with 99Tc(m)-dextran. (Nucl Med Commun, 1997 Jun, Abstract available) [MEDLINE]
4 Bowden CA, et al; Clinical applications of commonly used contemporary antidotes. A US perspective. (Drug Saf, 1997 Jan, Abstract available) [MEDLINE]
5 Gordon RA, et al; Aggressive approach in the treatment of acute lead encephalopathy with an extraordinarily high concentration of lead. (Arch Pediatr Adolesc Med, 1998 Nov, Abstract available) [MEDLINE]
6 Blower PJ, et al; Pentavalent rhenium-188 dimercaptosuccinic acid for targeted radiotherapy: synthesis and preliminary animal and human studies. (Eur J Nucl Med, 1998 Jun, Abstract available) [MEDLINE]
7 Aaseth J, et al; Hemolytic activity of copper sulfate as influenced by epinephrine and chelating thiols. (Chung Kuo Yao Li Hsueh Pao, 1998 May, Abstract available) [MEDLINE]
8 Gerhardsson L, et al; Chelated lead in relation to lead in bone and ALAD genotype. (Environ Res, 1999 May, Abstract available) [MEDLINE]
9 Pigman EA, et al; Use of the Caco-2 cell model to assess the relative lead-chelating ability of diasterioisomers of 2,3-dimercaptosuccinic acid. (Environ Health Perspect, 1999 Feb, Abstract available) [MEDLINE]
10 Restek-Samarzija N, et al; Meso-2,3-dimercaptosuccinic acid in the treatment of occupationally exposed lead workers. (Arh Hig Rada Toksikol, 1998 Jun, Abstract available) [MEDLINE]

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11 Miller AL; Dimercaptosuccinic acid (DMSA), a non-toxic, water-soluble treatment for heavy metal toxicity. (Altern Med Rev, 1998 Jun, Abstract available) [MEDLINE]
12 Rodriguez JL, et al; Renal 99Tc(m)-DMSA SPET and planar imaging: are they really the same? (Nucl Med Commun, 1997 Jun, Abstract available) [MEDLINE]
13 Besunder JB, et al; Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning. (J Pediatr, 1997 Jun, Abstract available) [MEDLINE]
14 Wallin L, et al; Kidney swelling. Findings on DMSA scintigraphy. (Clin Nucl Med, 1997 May, Abstract available) [MEDLINE]
15 Balbay MD, et al; Quantitative evaluation of renal parenchymal mass with 99mtechnetium dimercapto-succinic acid scintigraphy after nephrolithotomy. (J Urol, 1997 Apr, Abstract available) [MEDLINE]
16 Van der Wall H, et al; Pentavalent 99mTc DMSA: uptake into a variety of human rhabdomyosarcoma xenografts. (In Vivo, 1997 Jan, Abstract available) [MEDLINE]
17 Hirano T, et al; Differentiating histologic malignancy of primary brain tumors: pentavalent technetium-99m-DMSA. (J Nucl Med, 1997 Jan, Abstract available) [MEDLINE]
18 Lifshitz M, et al; The effect of 2,3 dimercaptosuccinic acid in the treatment of lead poisoning in adults. (Ann Med, 1997 Feb, Abstract available) [MEDLINE]
19 Liu C, et al; Contralateral reflux after unilateral ureteral reimplantation--preexistent rather than new-onset reflux. (J Pediatr Surg, 1999 Nov, Abstract available) [MEDLINE]
20 Lynn S, et al; Vicinal-thiol-containing molecules enhance but mono-thiol-containing molecules reduce nickel-induced DNA strand breaks. (Toxicol Appl Pharmacol, 1999 Oct, Abstract available) [MEDLINE]

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21 Petit T, et al; Does the endoscopic incision of ureteroceles reduce the indications for partial nephrectomy? (BJU Int, 1999 Apr, Abstract available) [MEDLINE]
22 Schwartz BS, et al; Predictors of dimercaptosuccinic acid chelatable lead and tibial lead in former organolead manufacturing workers. (Occup Environ Med, 1999 Jan, Abstract available) [MEDLINE]
23 Reymond JM, et al; Sodium stibogluconate (pentostan) overdose in a patient with acquired immunodeficiency syndrome. (Ther Drug Monit, 1998 Dec, Abstract available) [MEDLINE]
24 Barry BP, et al; Improved ultrasound detection of renal scarring in children following urinary tract infection. (Clin Radiol, 1998 Oct, Abstract available) [MEDLINE]
25 Sixt R, et al; Assessment of infective urinary tract disorders. (Q J Nucl Med, 1998 Jun, Abstract available) [MEDLINE]
26 Konda R, et al; Soluble interleukin-2 receptor in children with reflux nephropathy. (J Urol, 1998 Feb, Abstract available) [MEDLINE]
27 Jéquier S, et al; Acute childhood pyelonephritis: predictive value of positive sonographic findings in regard to later parenchymal scarring. (Acad Radiol, 1998 May, Abstract available) [MEDLINE]
28 Choi Y, et al; Renovascular hypertension in children with moyamoya disease. (J Pediatr, 1997 Aug, Abstract available) [MEDLINE]
29 Kiratli PO, et al; Laurence-Moon-Biedl syndrome: scintigraphic appearance of kidneys. (Ann Nucl Med, 1997 May, Abstract available) [MEDLINE]
30 Arbab AS, et al; Scan findings of various myocardial SPECT agents in a case of amyloid polyneuropathy with suspected myocardial involvement. (Ann Nucl Med, 1997 May, Abstract available) [MEDLINE]

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31 Lavocat MP, et al; Imaging of pyelonephritis. (Pediatr Radiol, 1997 Feb, Abstract available) [MEDLINE]
32 Kobayashi H, et al; MRI and scintigraphic features of extraabdominal desmoid tumors. (Clin Imaging, 1997 Jan, Abstract available) [MEDLINE]
33 Benador D, et al; Are younger children at highest risk of renal sequelae after pyelonephritis? [see comments] (Lancet, 1997 Jan, Abstract available) [MEDLINE]
34 Hiraoka M, et al; Congenitally small kidneys with reflux as a common cause of nephropathy in boys. (Kidney Int, 1997 Sep, Abstract available) [MEDLINE]
35 Yeung CK, et al; The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis. (Br J Urol, 1997 Aug, Abstract available) [MEDLINE]
36 Naseer SR, et al; New renal scars in children with urinary tract infections, vesicoureteral reflux and voiding dysfunction: a prospective evaluation. (J Urol, 1997 Aug, Abstract available) [MEDLINE]
37 Berlin CM Jr; Lead poisoning in children. (Curr Opin Pediatr, 1997 Apr, Abstract available) [MEDLINE]
38 Bernal J, et al; Full reversal of Pb++ block of L-type Ca++ channels requires treatment with heavy metal antidotes. (J Pharmacol Exp Ther, 1997 Jul, Abstract available) [MEDLINE]
39 Konda R, et al; Urinary excretion of epidermal growth factor in children with reflux nephropathy. (J Urol, 1997 Jun, Abstract available) [MEDLINE]
40 Konda R, et al; Followup study of renal function in children with reflux nephropathy after resolution of vesicoureteral reflux. (J Urol, 1997 Mar, Abstract available) [MEDLINE]

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41 The Treatment of Lead-exposed Children (TLC) trial: design and recruitment for a study of the effect of oral chelation on growth and development in toddlers. (Paediatr Perinat Epidemiol, 1998 Jul, Abstract available) [MEDLINE]
42 Bhattacharya A, et al; The effect of succimer therapy in lead intoxication using postural balance as a measure: a case study in a nine year old child. (Neurotoxicology, 1998 Feb, Abstract available) [MEDLINE]
43 Grandjean P, et al; Placebo response in environmental disease. Chelation therapy of patients with symptoms attributed to amalgam fillings. (J Occup Environ Med, 1997 Aug, Abstract available) [MEDLINE]
44 Fleming JS, et al; UK audit of relative renal function measurement using DMSA scintigraphy. (Nucl Med Commun, 1998 Oct, Abstract available) [MEDLINE]
45 OConnor ME, et al; Children with moderately elevated lead levels: is chelation with DMSA helpful? (Clin Pediatr (Phila), 1999 Jun, Abstract available) [MEDLINE]
46 Merguerian PA, et al; Utility of SPECT DMSA renal scanning in the evaluation of children with primary vesicoureteral reflux. (Urology, 1999 May, Abstract available) [MEDLINE]
47 Ditchfield MR, et al; The DMSA scan in paediatric urinary tract infection. (Australas Radiol, 1998 Nov, Abstract available) [MEDLINE]
48 Guha Mazumder DN, et al; Randomized placebo-controlled trial of 2,3-dimercaptosuccinic acid in therapy of chronic arsenicosis due to drinking arsenic-contaminated subsoil water. (J Toxicol Clin Toxicol, 1998, Abstract available) [MEDLINE]
49 Piepsz A, et al; Five-year study of medical of surgical treatment in children with severe vesico-ureteral reflux dimercaptosuccinic acid findings. International Reflux Study Group in Europe. (Eur J Pediatr, 1998 Sep, Abstract available) [MEDLINE]
50 Nathan I, et al; Alterations in membrane lipid dynamics of leukemic cells undergoing growth arrest and differentiation: dependency on the inducing agent. (Exp Cell Res, 1998 Mar, Abstract available) [MEDLINE]

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NLM database Documents

Record 1 from database: MEDLINE
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Title
Are we ready to replace dimercaprol (BAL) as an arsenic antidote?
Author
Mückter H; Liebl B; Reichl FX; Hunder G; Walther U; Fichtl B
Address
Walther-Straub-Institut fÂur Pharmakologie und Toxikologie, MÂunchen, Germany.
Source
Hum Exp Toxicol, 1997 Aug, 16:8, 460-5
Abstract
1 Dimercaprol (BAL), 2,3-dimercaptopropanesulphonate sodium (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) are effective arsenic antidotes, but the question which one is preferable for optimal therapy of arsenic poisoning is still open to discussion. Major drawbacks of BAL include (a) its low therapeutic index, (b) its tendency to redistribute arsenic to brain and testes, for example, (c) the need for (painful) intramuscular injection and (d) its unpleasant odour. 2 The newer antidotes DMPS and DMSA feature low toxicity and high therapeutic index. They can be given orally or intravenously due to their high water solubility. While these advantages make it likely that DMPS and DMSA will replace BAL for the treatment of chronic arsenic poisoning, acute intoxication-especially with lipophilic organoarsenicals-may pose a problem for the hydrophilic antidotes, because their ionic nature can adversely affect intracellular availability. 3 This article focuses on aspects dealing with the power of BAL, DMPS, and DMSA to mobilize tissue-bound arsenic in various experimental models, such as monolayers of MDCK (= Madin-Darby canine kidney) cells from dog kidney, isolated perfused liver from guinea-pigs, and perfused jejunal segments from rat small intestine. 4 The results show that hydrophilic DMPS and DMSA may fail to rapidly and completely remove arsenic that has escaped from the extracellular space across tight epithelial barriers. However, owing to their low toxicity, which allows larger doses to be applied, and the potential modification of their pharmacokinetics by means of inert oral anion-exchange resins, DMPS and DMSA may advantageously replace BAL whenever intervention time is not critical. With severe intoxication by organic arsenicals, when the point-of-no-return is a limiting factor, BAL may still have a place as an arsenic antidote.
Language of Publication
English
Unique Identifier
97437753

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MeSH Heading (Major)
Antidotes|PK/TO/*TU; Arsenic|*PO; Dimercaprol|PK/TO/*TU; Poisoning|*DT
MeSH Heading
Animal; Dogs; Guinea Pigs; Human; Mice; Rats; Succimer|PK/TO/TU; Unithiol|PK/TO/TU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0960-3271
Country of Publication
ENGLAND

Record 2 from database: MEDLINE
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Title
A report of pediatric SUCCIMER overdose.
Author
Sigg T; Burda A; Leikin JB; Gossman W; Umanos J
Address
Illinois Poison Center, Chicago 60661, USA.
Source
Vet Hum Toxicol, 1998 Apr, 40:2, 90-1
Abstract
A 3-y-old child ingested SUCCIMER capsules to receive a dose of 185 mg dimercaptosuccinic acid/kg body weight. No adverse effects occurred.
Language of Publication
English
Unique Identifier
98214679

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MeSH Heading (Major)
Antidotes|AD/*AE; Chelating Agents|AD/*AE; Lead Poisoning|*DT; Succimer|AD/*AE
MeSH Heading
Case Report; Cathartics|TU; Charcoal|TU; Child, Preschool; Female; Human; Lead|BL; Sorbitol|TU

Publication Type
JOURNAL ARTICLE
ISSN
0145-6296
Country of Publication
UNITED STATES

Record 3 from database: MEDLINE
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Title
Renal imaging with 99Tc(m)-dextran.
Author
Bhatnagar A; Singh AK; Babbar A; Soni NL; Singh T
Address
Department of Nuclear Medicine, Institute of Nuclear Medicine and Allied Sciences, Lucknow Marg, Delhi, India.
Source
Nucl Med Commun, 1997 Jun, 18:6, 562-6
Abstract
Significant uptake and retention of 99Tc(m)-dextran (molecular weight: 81,000) in renal parenchyma was discovered during evaluation of its intravascular use. Renal SPET images confirmed this. This study was designed to evaluate 99Tc(m)-dextran as a renal cortex imaging agent. Stability of parenchymal retention was shown by insignificant outflow at 24 h and by frusemide intervention. Evaluation of the renal parameters of intravenous 99Tc(m)-dextran (n = 71 normal kidneys) and its comparison with 99Tc(m)-DTPA n = 10) and 99Tc(m)-DMSA(III) (n = 23) was undertaken. The early glomerular extraction phase of the renograms of 99Tc(m)-DTPA and 99Tc(m)-dextran appeared identical; parenchymal uptake of 99Tc(m)-dextran continued to increase and reached a near-plateau by 40-60 min. The mean cortex-to-background and cortex-to-liver ratios at 2 h with 99Tc(m)-dextran and 99Tc(m)-DMSA(III) were 14.9 and 9.2, and 16.0 and 8.9, respectively. The target-to-nontarget ratios were similar despite different absolute renal uptake values (12 vs 20% at 2 h) because of faster background clearance of 99Tc(m)-dextran. The mechanism of parenchymal retention of 99Tc(m)-dextran appears to be trapping at the endothelial-epithelial interphase of the glomerulus. Our initial experience suggests 99Tc(m)-dextran is a viable renal parenchyma imaging agent.
Language of Publication
English
Unique Identifier
97402465

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MeSH Heading (Major)
Dextrans|*DU/*PK; Kidney Cortex|DE/ME/*RI; Kidney Diseases|*RI; Organotechnetium Compounds|*DU/*PK; Radiopharmaceuticals|*DU/PK
MeSH Heading
Adolescence; Adult; Aged; Child; Child, Preschool; Comparative Study; Female; Furosemide|DU; Human; Injections, Intravenous; Male; Metabolic Clearance Rate; Middle Age; Reagent Kits, Diagnostic; Reference Values; Succimer|DU/PK; Technetium Tc 99m Pentetate|DU/PK; Tissue Distribution; Tomography, Emission-Computed, Single-Photon

Publication Type
JOURNAL ARTICLE
ISSN
0143-3636
Country of Publication
ENGLAND

Record 4 from database: MEDLINE
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Title
Clinical applications of commonly used contemporary antidotes. A US perspective.
Author
Bowden CA; Krenzelok EP
Address
Pharmacy Department, Methodist Hospital, Houston, Texas, USA.
Source
Drug Saf, 1997 Jan, 16:1, 9-47
Abstract
Poisonings are a common problem. In 1995, over 2 million exposures were reported to American poison information centres alone. The majority of poisoning exposures can be treated without major therapeutic intervention. If therapy is indicated, it is usually in the form of gastrointestinal decontamination with activated charcoal, to prevent absorption of the toxin and the subsequent toxicity that may occur. In a limited number of cases, more aggressive life-support measures may be necessary to treat the adverse effects of poisons. Occasionally, that intervention may include the use of pharmacological antagonists, more commonly referred to as antidotes. According to the American Association of Poison Control Centers, the most commonly used antidotes are acetylcysteine, naloxone, atropine, deferoxamine (desferrioxamine) and antivenins. Overall, 17 antidotes account for 99% of all antidote use and those agents are reviewed in this article. With the exception of naloxone, most antidotes have pharmacological effects that are independent of their inherent antidotal properties. Therefore, antidotes should be used judiciously because their pharmacological properties may exacerbate pre-existing toxicity and only in rare circumstances are they used prophylactically. Some antidotes, such as digoxin-specific antigen binding fragments (digoxin immune Fab), are very expensive, and both the risk: benefit ratio and the associated cost should be considered before the antidote is administered. The principle aims are to "treat the patient, not the poison' and to do no harm to the patient. Antidotes should be used only when they are indicated and may help a patient.
Language of Publication
English
Unique Identifier
97163886

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MeSH Heading (Major)
Antidotes|*TU; Poisoning|*DT
MeSH Heading
Acetylcysteine|AE/TU; Antivenins|AE/TU; Atropine|AE/TU; Deferoxamine|AE/TU; Flumazenil|AE/TU; Human; Hydroxocobalamin|AE/TU; Naloxone|AE/TU; Physostigmine|AE/TU; Succimer|AE/TU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
0114-5916
Country of Publication
NEW ZEALAND

Record 5 from database: MEDLINE
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Title
Aggressive approach in the treatment of acute lead encephalopathy with an extraordinarily high concentration of lead.
Author
Gordon RA; Roberts G; Amin Z; Williams RH; Paloucek FP
Address
Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago 60612, USA.
Source
Arch Pediatr Adolesc Med, 1998 Nov, 152:11, 1100-4
Abstract
OBJECTIVE: To report a case of a 3-year-old child with an extraordinarily massive lead concentration, 26.4 micromol/L (550 microg/dL), following environmental exposure to lead paint in the home. LITERATURE REVIEW: The relevant literature concerning the treatment of lead encephalopathy was reviewed during the treatment of this child and preparation of the manuscript. To our knowledge, the landmark article written by Julian Chisolm in 1968 is the only recent article that reported similarly high levels of lead concentration. This case, however, is the first in which 3 chelating agents were used for the treatment of lead encephalopathy. We also reviewed the literature on the use of whole bowel irrigation in heavy metal intoxications. CONCLUSIONS: In this case, aggressive gut decontamination with whole bowel irrigation and triple chelation therapy with British anti-Lewisite, EDTA, and oral succimer was well tolerated and seemed effective for rapidly deleading the child. The extent to which her lead concentration increased while being treated with oral succimer alone necessitated further chelation with EDTA. Further evaluation is necessary to determine if triple chelation therapy is an appropriate method for severe lead intoxication, and if the use of whole bowel irrigation should be considered in heavy metal intoxication.
Language of Publication
English
Unique Identifier
99027427

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MeSH Heading (Major)
Brain Diseases|*ET/TH; Iron Chelating Agents|*TU; Lead|*BL; Lead Poisoning|BL/*TH
MeSH Heading
Case Report; Child, Preschool; Dimercaprol|TU; Edetic Acid|TU; Environmental Exposure; Female; Human; Irrigation; Paint|PO; Polyethylene Glycols|AD; Succimer|TU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW OF REPORTED CASES
ISSN
1072-4710
Country of Publication
UNITED STATES

Record 6 from database: MEDLINE
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Title
Pentavalent rhenium-188 dimercaptosuccinic acid for targeted radiotherapy: synthesis and preliminary animal and human studies.
Author
Blower PJ; Lam ASK; ODoherty MJ; Kettle AG; Coakley AJ; Knapp FF Jr
Address
Nuclear Medicine Department, Kent and Canterbury Hospital, Canterbury, UK.
Source
Eur J Nucl Med, 1998 Jun, 25:6, 613-21
Abstract
Pentavalent rhenium-188 dimercaptosuccinic acid [188Re(V)DMSA] is a beta-emitting analogue of 99mTc(V)DMSA, a tracer that is taken up in a variety of tumours and bone metastases. The aim of this study was to develop the kit-based synthesis of the agent on a therapeutic scale, to assess its stability in vivo, and to obtain preliminary biodistribution and dosimetry estimates, prior to evaluation of its potential as a targeted radiotherapy agent. The organ distribution of 188Re in mice was determined 2 h after injection of 3 MBq 188Re(V)DMSA prepared from eluate from a 188W/188Re generator. Three patients with cancer of the prostate and three with cancer of the bronchus, all with bone metastases confirmed with a standard 99mTc-hydroxymethylene diphosphonate (99mTc-HDP) scan, were given 370 MBq 188Re(V)DMSA and imaged at 3 h and 24 h using the 155-keV gamma-photon (15%). Blood and urine samples were collected to determine clearance and to analyse the speciation of 188Re. Organ residence times were estimated from the scans, and used to estimate radiation doses using MIRDOSE 3. In mice, 188Re(V)DMSA was selective for bone and kidney. In patients, it showed selectivity for bone metastases (particularly those from prostate carcinoma) and kidney, but uptake in normal bone was not significantly greater than in surrounding soft tissues. Of the normal tissues the kidneys received the highest radiation dose (0.5-1.3 mGy/MBq). The images were strongly reminiscent of 99mTc(V)DMSA scans in similar patients. High-performance liquid chromatography analysis of blood and urine showed no evidence of 188Re in any chemical form other than 188Re(V)DMSA up to 24 h. In conclusion, 188Re(V)DMSA and its 186Re analogue warrant further clinical assessment as generator/kit-derived agents for treatment of painful bone metastases. These agents should also be assessed in medullary thyroid carcinoma and other soft tissue tumours which have been shown to accumulate 99mTc(V)DMSA.
Language of Publication
English
Unique Identifier
98283900

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MeSH Heading (Major)
Organometallic Compounds|*CS/PK/*TU; Radiopharmaceuticals|*CS/PK/*TU; Rhenium|PK/*TU; Succimer|*CS/PK/*TU
MeSH Heading
Aged; Aged, 80 and over; Animal; Bone Neoplasms|RI/SC; Case Report; Female; Human; Lung Neoplasms|RI; Male; Mice; Mice, Inbred BALB C; Middle Age; Prostatic Neoplasms|RI; Radiation Dosage; Radioisotopes|PK/TU; Support, U.S. Gov't, Non-P.H.S.; Tissue Distribution

Publication Type
JOURNAL ARTICLE
ISSN
0340-6997
Country of Publication
GERMANY

Record 7 from database: MEDLINE
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Title
Hemolytic activity of copper sulfate as influenced by epinephrine and chelating thiols.
Author
Aaseth J; Korkina LG; Afanasev IB
Address
Department of Medicine, Kongsvinger Hospital, Norway. joaaseth@hotmail.com
Source
Chung Kuo Yao Li Hsueh Pao, 1998 May, 19:3, 203-6
Abstract
AIM: To study the effects of epinephrine, homocysteine, and other complexing agents on the cytotoxicity of copper sulfate. METHODS: In vitro suspensions of human red cells incubated with cupric sulfate were used, and hemolysis was determined by extracellular hemoglobin. RESULTS: The hemolytic activity of CuSO4 (0.3 mmol.L-1) was enhanced by the presence of epinephrine and to a lesser extent by homocysteine, whereas D-penicillamine, succimer, and mercaptodextran reduced the copper-induced hemolysis. The latter 3 chelating thiols also reduced the copper-epinephrine-induced hemolysis. The plasma protein ceruloplasmin reduced markedly the copper-epinephrine-induced hemolysis, even upon concentrations < 20% of that of copper. Chromic chloride, as well, acted anti-hemolytically. CONCLUSION: The latter protectors may interact with the production or activity of toxic oxygen, while classical copper chelators sequester cupric ions from interaction with epinephrine or homocysteine.
Language of Publication
English
Unique Identifier
99304014

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MeSH Heading (Major)
Antidotes|*TO; Chelating Agents|*PD; Copper Sulfate|*TO; Epinephrine|*PD; Hemolysis|*DE
MeSH Heading
Adult; Ceruloplasmin|PD; Drug Synergism; Homocysteine|PD; Human; Penicillamine|PD; Succimer|PD

Publication Type
JOURNAL ARTICLE
ISSN
0253-9756
Country of Publication
CHINA

Record 8 from database: MEDLINE
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Title
Chelated lead in relation to lead in bone and ALAD genotype.
Author
Gerhardsson L; Börjesson J; Mattsson S; Schütz A; Skerfving S
Address
Department of Occupational and Environmental Medicine, University Hospital, Lund, SE-221 85, Sweden.
Source
Environ Res, 1999 May, 80:4, 389-98
Abstract
In order to assess whether lead in bone is available for chelation by 2,3 meso-dimercaptosuccinic acid (DMSA), 21 workers (10 active and 11 retired) from a secondary lead smeltery were studied. A morning urine sample was obtained from all participants, followed by ingestion of 10 mg per kg body weight of the chelating agent DMSA. All urine produced during the following 24 h was collected in consecutive 6- and 18-h portions. Concentrations of lead in blood (B-Pb) and urine were determined by flameless atomic absorption spectrometry (AAS), in plasma (P-Pb) by inductively coupled plasma mass spectrometry (ICP-MS), and in finger bone (Bone-Pb) by K X-ray fluorescence technique (XRF). DMSA-chelatable lead excreted in the 24-h portion correlated well with the excretion in the 6-h portion (U-Pb6h; rs=0.95; P<0.001). U-Pb6h showed a non-linear relationship to B-Pb (rs=0.84; P<0.001) and linear relationships to P-Pb (rs=0. 91; P<0.001) and lead in morning urine (rs=0.95; P<0.001). In active workers, but not in retired ones, P-Pb and U-Pb6h showed some relationship to Bone-Pb. In alternative multiple regression models B-Pb or P-Pb were both significant predictors of U-Pb6h, while Bone-Pb did not significantly improve the models. It can, thus, be concluded that DMSA-chelatable lead mainly reflects lead concentrations in blood, soft tissues, and possibly also trabecular bone. It is not a good index of total body burden and long-term exposure. For such estimations cortical Bone-Pb is more valid, as it contains the major fraction of long-term accumulated lead in the body. Further, the mobilization test did not give better information than measurements of lead levels in blood, plasma, or urine without chelation. Copyright 1999 Academic Press.
Language of Publication
English
Unique Identifier
99264504

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MeSH Heading (Major)
Bone and Bones|*DE/ME; Chelating Agents|*PD/TU; Lead|BL/*ME/UR; Porphobilinogen Synthase|BL/*GE; Succimer|*PD/TU
MeSH Heading
Age Factors; Body Burden; Dose-Response Relationship, Drug; Fingers; Genotype; Human; Metallurgy; Occupational Exposure; Regression Analysis; Retirement; Spectrometry, X-Ray Emission; Spectrophotometry, Atomic Absorption; Spectrum Analysis, Mass; Support, Non-U.S. Gov't; Time Factors

Publication Type
JOURNAL ARTICLE
ISSN
0013-9351
Country of Publication
UNITED STATES

Record 9 from database: MEDLINE
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Title
Use of the Caco-2 cell model to assess the relative lead-chelating ability of diasterioisomers of 2,3-dimercaptosuccinic acid.
Author
Pigman EA; Lott JR; Fernando Q; Blanchard J
Address
Department of Pharmaceutical Sciences, University of Arizona, College of Pharmacy, Tucson, AZ 85721 USA.
Source
Environ Health Perspect, 1999 Feb, 107:2, 111-5
Abstract
The purpose of this study was to examine the mechanisms of lead (Pb) uptake by human intestinal cells and to compare the intestinal transport and relative lead-chelating ability of two diastereoisomeric forms (i.e., meso and racemic) of 2, 3-dimercaptosuccinic acid (DMSA). The model used was the human adenocarcinoma (Caco-2) cell monolayer. The Caco-2 cells were cultured in flasks for examination of cellular uptake of lead and subsequent chelation of the lead by the DMSA isomers. For assessment of the comparative intestinal transport of the diastereoisomers, the Caco-2 cells were cultured on semipermeable supports. The effects of N-ethylmaleimide and 1,25-dihydroxyvitamin D3 (vitamin D3) on the uptake of lead by the Caco-2 monolayer were examined to determine the contributions of sulfhydryl-binding and calcium-binding protein, respectively, to the lead uptake process. Analysis of lead was performed using both macro- and micro-proton-induced X-ray emission (PIXE), and DMSA was measured spectrophotometrically following derivatization with 5,5'-dithiobis-2-nitrobenzoic acid. Results from micro-PIXE imaging suggest that lead is bound on the surface of the cell, and that sulfhydryl binding may be an important step in the uptake of lead by the Caco-2 cells. Macro-PIXE results indicate that the racemic form of DMSA may be more effective in chelating lead from within the cell. Comparison of the transport of the two DMSA diastereoisomers indicates that the racemic form is transported across the Caco-2 monolayer more readily than the meso form.
Language of Publication
English
Unique Identifier
99122932

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MeSH Heading (Major)
Chelating Agents|CH/*PD; Lead|*ME/TO; Succimer|CH/*PD
MeSH Heading
Caco-2 Cells; Cell Membrane|ME; Cell Survival|DE; Human; Spectrometry, X-Ray Emission; Stereoisomerism; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.

Publication Type
JOURNAL ARTICLE
ISSN
0091-6765
Country of Publication
UNITED STATES

Record 10 from database: MEDLINE
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Title
Meso-2,3-dimercaptosuccinic acid in the treatment of occupationally exposed lead workers.
Author
Restek-Samarzija N; Blanusa M; Pizent A; Samarzija M; Turk R; Corovic N; Jurasovic J
Address
Institute for Medical Research and Occupational Health, Zagreb, Croatia.
Source
Arh Hig Rada Toksikol, 1998 Jun, 49:2, 137-45
Abstract
The aim of this study was to evaluate the efficacy of meso-2,3-dimercaptosuccinic acid (DMSA) treatment in workers with increased lead absorption and no overt symptoms of lead poisoning. Seven occupationally lead exposed male workers with blood lead concentrations (PbB) exceeding 50 micrograms/100 ml and a positive calcium disodium ethylenediaminetetraacetate (EDTA) lead mobilization test were treated with DMSA for 19 days. Individual doses were 700 mg DMSA, three times a day from day one to five, and twice a day from day six to 19. The treatment intensified urinary lead excretion, most rapidly during the first five days. The increased elimination was followed by a decline of mean PbB to 15% of the pretreatment values. However, 15 days after the treatment, the PbB concentrations rebounded, yet kept below the baseline values and did not exceed 40 micrograms/100 ml. After repeated EDTA lead mobilization test, urine lead was 23-68% of that before DMSA treatment. It can be concluded that DMSA can effectively reduce chelatable lead in occupationally exposed workers.
Language of Publication
English
Unique Identifier
99118372

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MeSH Heading (Major)
Chelating Agents|*TU; Lead|*BL/UR; Occupational Exposure|*; Succimer|*TU
MeSH Heading
Adult; Human; Lead Poisoning|TH; Male; Middle Age; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0004-1254
Country of Publication
CROATIA
CAS Registry/EC Number
0 (Chelating Agents); 304-55-2 (Succimer); 7439-92-1 (Lead)

 


Record 11 from database: MEDLINE
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Title
Dimercaptosuccinic acid (DMSA), a non-toxic, water-soluble treatment for heavy metal toxicity.
Author
Miller AL
Address
Alternative Medicine Review. P.O. Box 25, Dover, ID 83825, USA. alan@thorne.com
Source
Altern Med Rev, 1998 Jun, 3:3, 199-207
Abstract
Heavy metals are, unfortunately, present in the air, water, and food supply. Cases of severe acute lead, mercury, arsenic, and cadmium poisoning are rare; however, when they do occur an effective, non-toxic treatment is essential. In addition, chronic, low-level exposure to lead in the soil and in residues of lead-based paint, to mercury in the atmosphere, in dental amalgams and in seafood, and to cadmium and arsenic in the environment and in cigarette smoke is much more common than acute exposure. Meso-2,3-dimercaptosuccinic acid (DMSA) is a sulfhydryl-containing, water-soluble, non-toxic, orally-administered metal chelator which has been in use as an antidote to heavy metal toxicity since the 1950s. More recent clinical use and research substantiates this compound s efficacy and safety, and establishes it as the premier metal chelation compound, based on oral dosing, urinary excretion, and its safety characteristics compared to other chelating substances.
Language of Publication
English
Unique Identifier
98331854

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MeSH Heading (Major)
Chelating Agents|PK/*TU; Metals, Heavy|*PO; Succimer|PK/*TU
MeSH Heading
Arsenic|PO; Cadmium Poisoning|DT; Human; Lead Poisoning|DT; Mercury Poisoning|DT; Poisoning|DT

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
1089-5159
Country of Publication
UNITED STATES

Record 12 from database: MEDLINE
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Title
Renal 99Tc(m)-DMSA SPET and planar imaging: are they really the same?
Author
Rodriguez JL; Perera A; Fraxedas R; Reyes L; Hernandez A; Solano ME
Address
Centre for Clinical Research, Playa, Havana, Cuba.
Source
Nucl Med Commun, 1997 Jun, 18:6, 556-61
Abstract
Previous studies have suggested that more defects are detected on SPET than on planar DMSA images. The aim of this study was to evaluate differences between planar and SPET imaging. Sixty-four kidneys from pyelonephritic patients were studied using both techniques. An automated algorithm for reorientation and centring of the SPET images was used to minimize inter-observer variability. Reduced uptake and contour defects showed different localization on planar and SPET imaging. Coincidence of defects on both types of image was low. We also noted a dependence on defect frequency content for detectability. Image contrast played a noticeable role in the detection of defects. Differences in contrast between SPET and planar images may be responsible for the variable success in the detection of defects. Contour defects are seen more frequently on tomographic slices, whereas reduced uptake defects are seen more frequently on planar images. A difference is also noted between the cortical and calyceal zones for differently contrasted lesions. SPET and planar DMSA images can potentially provide a different diagnosis of renal lesions.
Language of Publication
English
Unique Identifier
97402464

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MeSH Heading (Major)
Kidney|*RI; Organotechnetium Compounds|*DU/PK; Pyelonephritis|*RI; Succimer|*DU/PK; Tomography, Emission-Computed|*; Tomography, Emission-Computed, Single-Photon|*
MeSH Heading
Adult; Algorithms; Comparative Study; Human; Models, Theoretical; Reproducibility of Results; Tissue Distribution

Publication Type
JOURNAL ARTICLE
ISSN
0143-3636
Country of Publication
ENGLAND

Record 13 from database: MEDLINE
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Title
Comparison of dimercaptosuccinic acid and calcium disodium ethylenediaminetetraacetic acid versus dimercaptopropanol and ethylenediaminetetraacetic acid in children with lead poisoning.
Author
Besunder JB; Super DM; Anderson RL
Address
Department of Pediatrics, MetroHealth Medical Center, Cleveland, OH 44109-1998, USA.
Source
J Pediatr, 1997 Jun, 130:6, 966-71
Abstract
OBJECTIVES: To compare the response to dimercaptopropanol (BAL) and calcium disodium ethylenediaminetetraacetic acid (EDTA) versus orally administered meso-2,3-dimercaptosuccinic acid (DMSA) and EDTA in children with lead poisoning. METHODS: Retrospective review of medical records of children admitted to MetroHealth Medical Center with a whole blood lead (BPb) concentration of 2.17 mumol/L (45 micrograms/dl) or more (or less than 2.17 mumol/L and not a candidate for outpatient oral chelation) and treated with BAL + EDTA or DMSA + EDTA. In each group, the mean BPb values at the end of therapy and at 14 and 33 days after chelation were compared with pretreatment BPb by the Wilcoxon signed-rank test, whereas the Mann-Whitney U test was used to compare percentage change from pretreatment at each follow-up day between the two groups. RESULTS: Twenty-three children received BAL + EDTA and 22 received DMSA + EDTA. The BPb values (mean +/- SD) at the end of therapy and at 14 and 33 days after chelation were significantly lower than pretreatment in both groups (BAL + EDTA: 17 +/- 10, 34 +/- 7, 36 +/- 11 vs 58 +/- 14 micrograms/dl, p < 0.02, 0.01, 0.001, respectively; DMSA + EDTA: 10 +/- 4, 30 +/- 10, 30 +/- 14 vs 50 +/- 10 micrograms/dl, p < 0.01, 0.001, 0.01, respectively). The percentage reduction (mean +/- SD) in BPb from pretreatment at the end of therapy and on days 14 and 33 after chelation did not differ between the groups (BAL + EDTA: -71.2% +/- 19.8%, -40.2% +/- 13.8%, -37.1% +/- 17%; DMSA + EDTA: -79.9% +/- 8.7%, -38.3% +/- 21.6%, -37% +/- 32%; p > 0.20). Elevation of alanine aminotransferase and vomiting during therapy were observed more frequently in the BAL + EDTA group compared with the DMSA + EDTA group. CONCLUSIONS: Treatment with DMSA or BAL combined with EDTA results in a comparable reduction in BPb.
Language of Publication
English
Unique Identifier
97346201

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MeSH Heading (Major)
Edetic Acid|AE/*TU; Lead Poisoning|BL/*DT; Succimer|AE/*TU
MeSH Heading
Alanine Transaminase|BL; Blood Urea Nitrogen; Child; Child, Preschool; Comparative Study; Creatinine|BL; Female; Hemoglobins; Human; Male; Retrospective Studies; Vomiting|ET

Publication Type
JOURNAL ARTICLE
ISSN
0022-3476
Country of Publication
UNITED STATES

Record 14 from database: MEDLINE
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Title
Kidney swelling. Findings on DMSA scintigraphy.
Author
Wallin L; Helin I; Bajc M
Address
Department of Clinical Physiology, Lund University Hospital, Sweden.
Source
Clin Nucl Med, 1997 May, 22:5, 292-9
Abstract
OBJECTIVE: To develop criteria identifying swollen kidneys on dimercaptosuccinic acid (DMSA) renal scintigraphy in acute pyelonephritis with regard to the DMSA distribution pattern, kidney functional size, and radioactive uptake. SUBJECTS AND METHODS: Thirty-eight children aged 15 days to 7 years with known pyelonephritis were examined with DMSA renal scintigraphy. All children were observed 2 or 3 times. In total, 94 scintigrams were evaluated. Qualitative and quantitative criteria for swelling were defined. RESULTS: Thirty-one observed kidneys satisfied the criteria of swelling. Quantitatively, kidney length and width/length were greater in swollen kidneys. Kidney uptake in percent of injected dose and kidney uptake/background were lower in swollen kidneys. Qualitatively, focal radioactive uptake defects known from a previous examination were sometimes obscured by swelling, and reappeared at follow-up. In 5 children with signs of swelling on repeat imaging, scintigraphy reinfection at the time of swelling was verified. CONCLUSIONS: Swollen kidneys may be the only sign of acute pyelonephritis on DMSA scintigraphy and swelling may obscure focal radioactive uptake defects. Measurement of kidney size and radioactive uptake can help identify swollen kidneys at DMSA scintigraphy and disclose acute pyelonephritis in the absence of overt clinical symptoms.
Language of Publication
English
Unique Identifier
97297057

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MeSH Heading (Major)
Kidney|ME/PA/PP/*RI; Organotechnetium Compounds|*DU/PK; Pyelonephritis|ME/PA/PP/*RI; Radiopharmaceuticals|*DU/PK; Succimer|*DU/PK
MeSH Heading
Acute Disease; Child; Child, Preschool; Edema|ME/PA/PP/RI; Follow-Up Studies; Human; Infant; Infant, Newborn; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0363-9762
Country of Publication
UNITED STATES

Record 15 from database: MEDLINE
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Title
Quantitative evaluation of renal parenchymal mass with 99mtechnetium dimercapto-succinic acid scintigraphy after nephrolithotomy.
Author
Balbay MD; Varoglu E; Devrim H; Sahin A; Atan A; Ergen A; Remzi D
Address
Department of Urology, Hacettepe University, School of Medicine, Ankara, Turkey.
Source
J Urol, 1997 Apr, 157:4, 1226-8
Abstract
PURPOSE: We detected renal parenchymal damage after nephrolithotomy. MATERIALS AND METHODS: We studied 12 patients with renal stones treated with nephrolithotomy. Renal function was determined with serum blood urea nitrogen (BUN) and creatinine values, and 99mtechnetium dimercapto-succinic acid scintigraphy of renal parenchymal tissue was performed before, and 7 days and 3 months after nephrolithotomy. Qualitative and quantitative analyses were done with the Wilcoxon signed rank test. RESULTS: There was no visual difference in size and appearance of the nephrotomy site between preoperative and postoperative visual scintigraphic evaluations. Quantitative data did not reveal any significant difference between kidneys with and without a nephrotomy incision (p > 0.05), as well as between nephrotomy regions and intact parenchyma within the same kidney (p > 0.05) 3 months after nephrolithotomy. There was no significant difference in serum BUN and creatinine levels between values preoperatively and 3 months postoperatively (p > 0.05). CONCLUSIONS: There was no significant change in renal cortical function and functioning renal parenchymal mass after nephrolithotomy as shown by serum BUN and creatinine levels, and 99mtechnetium dimercapto-succinic acid scintigraphy.
Language of Publication
English
Unique Identifier
97223153

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MeSH Heading (Major)
Kidney|*RI; Kidney Calculi|*SU; Nephrostomy, Percutaneous|*AE; Organotechnetium Compounds|*DU/PK; Succimer|*DU/PK
MeSH Heading
Adolescence; Adult; Aged; Child; Female; Human; Male; Middle Age; Prospective Studies

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 16 from database: MEDLINE
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Title
Pentavalent 99mTc DMSA: uptake into a variety of human rhabdomyosarcoma xografts.
Author
Van der Wall H; Henderson D; Baker R; Murray IP
Address
Department of Nuclear Medicine, Prince of Wales Hospital, Sydney, Australia.
Source
In Vivo, 1997 Jan, 11:1, 45-50
Abstract
BACKGROUND: Rhabdomyosarcoma is a common soft tissue sarcoma of childhood. While Ga is currently the most accurate modality for imaging residual or recurrent tumour its dosimetry is unfavourable. Pentavalent 99mTc DMSA [99mTc (V) DMSA] has been shown to accumulate in this tumour in a limited number of clinical cases. METHODS: Biodistribution of 99mTc (V) DMSA was determined in non-tumour bearing BALB-C mice. Operative specimens from four clinically 67Ga avid tumours were xenografted into nude mice and allowed to reach a significant size. Biodistribution studies were performed after the injection of 99mTc (V) DMSA in all animals and 125I HSA and 67Ga in a limited number of animals. RESULTS: None of the tumours investigated demonstrated significant 99mTc (V) DMSA accumulation. Biodistribution was identical in tumour and non-tumour bearing animals. CONCLUSIONS: Rhabdomyo-sarcoma xenografts do not demonstrate significant uptake of 99mTc (V) DMSA.
Language of Publication
English
Unique Identifier
97220610

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MeSH Heading (Major)
Organotechnetium Compounds|*DU/PK; Rhabdomyosarcoma|*RI; Succimer|*DU/PK
MeSH Heading
Albumins|PK; Animal; Child; Comparative Study; Gallium Radioisotopes|DU/PK; Human; Iodine Radioisotopes|DU/PK; Kinetics; Mice; Mice, Inbred BALB C; Mice, Nude; Neoplasm Transplantation; Tissue Distribution; Transplantation, Heterologous

Publication Type
JOURNAL ARTICLE
ISSN
0258-851X
Country of Publication
GREECE

Record 17 from database: MEDLINE
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Title
Differentiating histologic malignancy of primary brain tumors: pentavalent technetium-99m-DMSA.
Author
Hirano T; Otake H; Shibasaki T; Tamura M; Endo K
Address
Department of Nuclear Medicine, Gunma University, School of Medicine, Japan.
Source
J Nucl Med, 1997 Jan, 38:1, 20-6
Abstract
This study assessed pentavalent 99mTc-DMSA uptake in primary brain tumors and evaluated the relationship between retention and histologic malignancy. METHODS: SPECT images of the brain were obtained at 30 min and 3 hr after intravenous administration of approximately 555 MBq 99mTc(V)-DMSA in patients with brain tumors. Sixty studies were performed in 57 patients and 63 lesions were demonstrated: 11 glioblastomas, 13 anaplastic astrocytomas (Grade 3), 11 astrocytomas (Grade 2), 18 meningiomas and 10 schwannomas. Uptake ratios, retention ratio and retention index were calculated and compared with tumor histology and malignancy grade. RESULTS: Approximately 95% of both benign and malignant primary brain tumors were demonstrated by 99mTc(V)-DMSA SPECT images. False negative was noted in three cases. The early uptake ratios were closely related to the tumor vascularity but had no statistically significant difference in the tumor histology or histologic malignancy. The delayed uptake ratio, retention ratio and retention index were higher in the malignant tumors than the benign tumors. CONCLUSION: Technetium-99m(V)-DMSA washout from the tumor was highly dependent upon its histology and histologic malignancy. The delayed uptake ratio considerably reflected tumor histology and differentiated benign tumors from malignant tumors. The retention ratio and retention index significantly reflected tumor histology and histologic grade of primary brain tumors and clearly distinguished between benign and malignant tumors with statistically significant difference (p < 0.05). These results could suggest the clinical utility of 99mTc(V)-DMSA in imaging primary brain tumors and differentiating their histological malignancy grade noninvasively.
Language of Publication
English
Unique Identifier
97152211

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MeSH Heading (Major)
Brain Neoplasms|ME/*RI; Organotechnetium Compounds|*DU/PK; Succimer|*DU/PK
MeSH Heading
Adolescence; Adult; Aged; Astrocytoma|ME/RI; Child; Female; Glioblastoma|ME/RI; Glioma|ME/RI; Human; Male; Meningeal Neoplasms|ME/RI; Meningioma|ME/RI; Middle Age; Neurilemmoma|ME/RI; Oligodendroglioma|ME/RI

Publication Type
JOURNAL ARTICLE
ISSN
0161-5505
Country of Publication
UNITED STATES

Record 18 from database: MEDLINE
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Title
The effect of 2,3 dimercaptosuccinic acid in the treatment of lead poisoning in adults.
Author
Lifshitz M; Hashkanazi R; Phillip M
Address
Division of Clinical Toxicology, Soroka Medical Center, Beer-Sheva, Israel.
Source
Ann Med, 1997 Feb, 29:1, 83-5
Abstract
Four patients, aged 22-60, belonging to a single family that had been exposed to lead-contaminated food for an unknown period, and nine workers, aged 20-65, who had been exposed to air-borne lead for 6-8 years, were evaluated for lead poisoning in our centres. Blood lead levels were 3.57 +/- 0.39 micromol/L (mean +/- SD) in the family members and 3.46 +/- 0.43 micromol/L (mean +/- SD) in the group of workers. 2,3 dimercaptosuccinic acid (DMSA) therapy was instituted in the four family members while the nine workers were closely monitored after being removed from the contaminated environment without receiving any chelation therapy. DMSA therapy given for the duration of 19 days reduced the blood lead levels to 0.63 +/- 0.44 micromol/L (mean +/- SD), P<0.01, in the four family members. No significant change was observed in the untreated group. The exposure time in the untreated group was probably longer than that in the treated group. Following long-term exposure most of the lead in the body is found in the bones and therefore not easily removed by chelation therapy. No side-effects were reported in the treated group and no rebound elevation of blood lead levels was observed during the therapy period or during the 12-week follow-up period following cessation of therapy. We conclude that 19 days of chelation therapy with DMSA in adults with moderate to severe lead poisoning is effective and safe.
Language of Publication
English
Unique Identifier
97226058

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MeSH Heading (Major)
Lead Poisoning|BL/*DT; Succimer|PD/*TU
MeSH Heading
Administration, Oral; Adult; Aged; Case Report; Human; Lead|BL; Middle Age

Publication Type
JOURNAL ARTICLE
ISSN
0785-3890
Country of Publication
ENGLAND

Record 19 from database: MEDLINE
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Title
Contralateral reflux after unilateral ureteral reimplantation--preexistent rather than new-onset reflux.
Author
Liu C; Chin T; Wei C
Address
Department of Surgery, Veterans General Hospital-Taipei, Taipei, Taiwan, Republic of China.
Source
J Pediatr Surg, 1999 Nov, 34:11, 1661-4
Abstract
PURPOSE: The authors studied the preoperative Technetium 99m-dimercaptosuccinic acid renal scan (DMSA) of patients undergoing unilateral vesicoureteral antireflux surgery to compare the amount of renal scarring between the refluxing and the contralateral renal units. They sought to determine whether postoperative contralateral vesicoureteral reflux was preexistent or new onset. METHODS: Sixty-eight patients who underwent unilateral vesicoureteral antireflux surgery and had preoperative DMSA and postoperative voiding cystourethrography (VCUG) examinations were studied. Preoperative DMSA results were analyzed to determine the amount of renal scarring in each kidney. RESULTS: Sixty-four (94.1%) ipsilateral refluxing renal units had renal scars. Of the 68 contralateral renal units, scars were noted in 28 (41.2%). The rate of nonscar was 4 of 68 (5.9%) in reflux kidneys, which was significantly lower than 40 of 64 (62.5%, excluding 4 with a history of resolved reflux) in nonreflux kidneys (P<.001). Of 40 contralateral nonscarred kidneys, 1 of 40 (2.5%) had subsequent reflux, which was significantly lower than 5 of 28 (17.9%) of scarred kidneys (P<.005). Six patients (8.8%) had contralateral reflux, and 1 of them had a history of resolved reflux. Of the 6 contralateral kidneys with severe scarring involving 3 poles or contracted, 4 of 6 (66.7%) had subsequent reflux. CONCLUSIONS: Scar in the contralateral kidney seen on DMSA scan seems to predict contralateral reflux after unilateral antireflux surgery. The contralateral reflux may be preexistent. Postoperative VCUG should be performed routinely for patients who have contralateral renal scars. In patients with a history of contralateral reflux or severe contralateral renal scar, simultaneous contralateral ureteral reimplantation should be considered.
Language of Publication
English
Unique Identifier
20057565

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MeSH Heading (Major)
Kidney|*PA/RI; Ureter|AB/*SU; Urologic Surgical Procedures|*AE/MT; Vesico-Ureteral Reflux|EP/*ET/*RI
MeSH Heading
Adolescence; Child; Child, Preschool; Female; Follow-Up Studies; Human; Infant; Male; Retrospective Studies; Risk Assessment; Sensitivity and Specificity; Succimer|DU; Tomography, Emission-Computed, Single-Photon|MT

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE
ISSN
0022-3468
Country of Publication
UNITED STATES

Record 20 from database: MEDLINE
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Title
Vicinal-thiol-containing molecules enhance but mono-thiol-containing molecules reduce nickel-induced DNA strand breaks.
Author
Lynn S; Yu GL; Yan K
Address
Institute of Zoology, Academia Sinica, Taipei, Taiwan, 11529, Republic of China.
Source
Toxicol Appl Pharmacol, 1999 Oct, 160:2, 198-205
Abstract
Several thiol-containing molecules (TCM) are currently used as antidotes for nickel, and vicinal TCM seem to be more effective in mobilizing tissue nickel than are mono TCM. Using single cell alkaline electrophoresis, we have shown that the vicinal TCM, meso-2, 3-dimercaptosuccinic acid (DMSA), 2,3-dimercaptopropane-1-sulfonate, and 2,3-dimercaptopropanol markedly enhanced, whereas the mono TCM, D-penicillamide, glutathione, beta-mercaptoethanol, and diethyl dithiocarbomate, reduced nickel chloride (Ni)-induced DNA breaks in a human leukemia cell line, NB4 cells. Ni or TCM alone did not induce plasmid DNA breaks in test tubes and neither did Ni plus mono TCM; however, Ni plus vicinal TCM did. Vicinal TCM did, but mono TCM did not generate H(2)O(2) in solution. H(2)O(2) alone did not, but H(2)O(2) plus Ni induced plasmid DNA breaks. Although Ni plus glutathione did not break DNA, Ni plus glutathione plus H(2)O(2) did. The Ni-DMSA-induced DNA breaks in NB4 cells, as well as in plasmids, were completely prevented by d-mannitol or partially prevented by several antioxidants. Therefore, the DNA breaks induced by Ni plus vicinal TCM seem to be due to the complex of Ni with TCM in concert with the H(2)O(2) produced by the vicinal TCM. The results that DMSA at a concentration as low as 5 microM enhanced the Ni-induced DNA breaks suggest a further evaluation of the TCM as nickel chelators is needed. Copyright 1999 Academic Press.
Language of Publication
English
Unique Identifier
99459086

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MeSH Heading (Major)
DNA Damage|*; Nickel|AI/CH/PD/*TO; Sulfhydryl Compounds|CH/*PD
MeSH Heading
Cell Line|DE; Comet Assay; Comparative Study; Dimercaprol|PD; Ditiocarb|PD; Dose-Response Relationship, Drug; Drug Synergism; Glutathione|PD; Human; Mercaptoethanol|PD; Oxidation-Reduction; Penicillic Acid|AA/PD; Plasmids|DE; Succimer|PD; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0041-008X
Country of Publication
UNITED STATES

Record 21 from database: MEDLINE
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Title
Does the endoscopic incision of ureteroceles reduce the indications for partial nephrectomy?
Author
Petit T; Ravasse P; Delmas P
Address
Department of Paediatric Surgery, Caen University Hospital, Caen, France.
Source
BJU Int, 1999 Apr, 83:6, 675-8
Abstract
OBJECTIVE: To determine whether the endoscopic incision of ureteroceles reduces the indications for partial nephrectomy. PATIENTS AND METHODS: Between 1987 and 1996, endoscopic incision was used as the first-line treatment of 18 children (13 boys, five girls, aged 8 days to 6 months) with a duplex-system ureterocele diagnosed antenatally (15) or in the first weeks of life during the course of a urinary infection (three). Of the 19 ureteroceles (one bilateral), four were intravesical and 15 ectopic, according to the American Academy of Paediatrics classification. Vesico-ureteric reflux into the inferior pole of the kidney was present in 10 children, seven of whom had an ectopic ureterocele. A functioning upper pole was detected by intravenous pyelography (IVP) in half the intravesical and in a third of the ectopic ureteroceles. RESULTS: Endoscopic incision resulted in decompression and reduction of dilatation in 16 cases; three with inferior pole reflux resolved on control cystography, whilst in seven with an ectopic ureterocele, reflux into the upper urinary tract was induced by endoscopic incision. In three children with an ectopic ureterocele, renal function had improved at 3 months, as assessed by IVP. Endoscopic incision was the only treatment for half the intravesical and six of 15 ectopic ureteroceles. Overall, nephrectomy was required in four of 18 patients (three partial nephrectomies for persistent dilatation and one total nephrectomy). Five nonfunctioning, undilated upper poles with no reflux were left in place. Nine vesico-ureteric reimplantations for persistent or induced reflux were carried out using the Cohen technique. CONCLUSION: Endoscopic incision can allow the deferral of nephrectomy, facilitate lower urinary tract reconstruction and reduce the indications for partial nephrectomy, if it is accepted that a nonfunctioning, undilated renal pole with no reflux can safely be left in place.
Language of Publication
English
Unique Identifier
99252518

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MeSH Heading (Major)
Nephrectomy|*MT; Surgical Procedures, Endoscopic|*MT; Ureterocele|RI/*SU
MeSH Heading
Electrocoagulation|MT; Female; Human; Infant; Infant, Newborn; Male; Retrospective Studies; Succimer|DU; Urinary Catheterization

Publication Type
JOURNAL ARTICLE
ISSN
1464-4096
Country of Publication
ENGLAND

Record 22 from database: MEDLINE
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Title
Predictors of dimercaptosuccinic acid chelatable lead and tibial lead in former organolead manufacturing workers.
Author
Schwartz BS; Stewart WF; Todd AC; Links JM
Address
Department of Environmental Health Sciences, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA.
Source
Occup Environ Med, 1999 Jan, 56:1, 22-9
Abstract
OBJECTIVES: To identify predictors of tibial and dimercaptosuccinic acid (DMSA) chelatable lead in 543 organolead manufacturing workers with past exposure to organic and inorganic lead. METHODS: In this cross sectional study, tibial lead (by 109Cd K-shell x ray fluorescence), DMSA chelatable lead (4 hour urinary lead excretion after oral administration of 10 mg/kg), and several exposure measures were obtained on study participants, mean (SD) age 57.6 (7.6) years. RESULTS: Tibial lead concentrations ranged from -1.6 to 52.0 micrograms lead/g bone mineral, with a mean (SD) of 14.4 (9.3) micrograms/g. DMSA chelatable lead ranged from 1.2 to 136 micrograms, with a mean (SD) of 19.3 (17.2) micrograms. In a multiple linear regression model of tibial lead, age (p < 0.01), duration of exposure (p < 0.01), current (p < 0.01) and past (p = 0.05) cigarette smoking, and diabetes (p = 0.01) were all independent positive predictors, whereas height (p = 0.03), and exercise inducing sweating (p = 0.04) were both negative predictors. The final regression model accounted for 31% of the variance in tibial lead concentrations; 27% was explained by age and duration of exposure alone. DMSA chelatable lead was directly associated with tibial lead (p = 0.01), cumulative exposure to inorganic lead (y.microgram/m3, p = 0.01), current smoking (p < 0.01), and weight (p < 0.01), and negatively associated with diabetes (p = 0.02). The final model accounted for 11% of the variance in chelatable lead. When blood lead was added to this model of DMSA chelatable lead, tibial lead, cumulative exposure to inorganic lead, and diabetes were no longer significant; blood lead accounted for the largest proportion of variance (p < 0.001); and the total model r2 increased to 19%. CONCLUSIONS: The low proportions of variance explained in models of both tibial and chelatable lead suggest that other factors are involved in the deposition of lead in bone and soft tissue. In epidemiological studies of the health effects of lead, evaluation of associations with both these measures may allow inferences to be made about whether health effects are likely to be recent, and thus potentially reversible, or chronic, and thus possibly irreversible. The data also provide direct evidence that in men the total amount of lead in the body that is bioavailable declines with age.
Language of Publication
English
Unique Identifier
99273288

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MeSH Heading (Major)
Chemical Industry|*; Environmental Monitoring|*MT; Lead|AN/*ME; Occupational Exposure|*; Tibia|CH/*ME
MeSH Heading
Adult; Aged; Aging|ME; Chelating Agents|DU; Cross-Sectional Studies; Human; Linear Models; Middle Age; Risk Factors; Succimer|DU; Support, U.S. Gov't, P.H.S.

Publication Type
JOURNAL ARTICLE
ISSN
1351-0711
Country of Publication
ENGLAND

Record 23 from database: MEDLINE
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Title
Sodium stibogluconate (pentostan) overdose in a patient with acquired immunodeficiency syndrome.
Author
Reymond JM; Desmeules J
Address
Medical Clinic 1, Department of Internal Medicine, Geneva University Hospital, Switzerland.
Source
Ther Drug Monit, 1998 Dec, 20:6, 714-6
Abstract
A 32-year-old man with acquired immunodeficiency syndrome (AIDS) admitted to the hospital for treatment of visceral leishmaniasis was inadvertently given 10 times the prescribed first dose of sodium stibogluconate ([Sb] 6.5 g instead of 0.65 g). He experienced no immediate major toxicity during the first 48 hours, but a significant rise of pancreatic enzyme activities was observed (amylase at 10 times the upper limit of normal, lipase at 50 times the upper limit of normal) without clinical signs or indications on computed tomography (CT) of pancreatitis. The third day after the overdose, he developed appendicitis, which appeared coincidental; he recovered uneventfully from surgery. Most of the overdose of Sb was eliminated within the first few hours. Pharmacokinetics remained linear; the rapid, long elimination half-lives (2.7 hours and 54 hours, respectively) were similar to those in previously published results. The administration of a chelating agent, dimercaptosuccinic acid (DMSA), 72 hours after the Sb overdose did not modify the pharmacokinetics of the medication.
Language of Publication
English
Unique Identifier
99068882

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MeSH Heading (Major)
Acquired Immunodeficiency Syndrome|*CO; Amylases|BL/*DE; Antimony Sodium Gluconate|PK/*PO; Antiprotozoal Agents|*PO; Lipase|BL/*DE; Medication Errors|*
MeSH Heading
Adult; Case Report; Half-Life; Human; Leishmaniasis, Visceral|DT; Male; Succimer|PD; Time Factors; Tomography Scanners, X-Ray Computed

Publication Type
JOURNAL ARTICLE
ISSN
0163-4356
Country of Publication
UNITED STATES

Record 24 from database: MEDLINE
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Title
Improved ultrasound detection of renal scarring in children following urinary tract infection.
Author
Barry BP; Hall N; Cornford E; Broderick NJ; Somers JM; Rose DH
Address
Department of Radiology, Nottingham City Hospital, UK.
Source
Clin Radiol, 1998 Oct, 53:10, 747-51
Abstract
A system for defining renal scarring on ultrasound is proposed and compared with DMSA scintigraphy. Renal scarring was assessed with ultrasound in children following urinary tract infection (UTI) using the following criteria: (1) proximity of sinus echoes to cortical surface; (2) loss of pyramids; (3) irregularity of outline; (4) loss of definition of capsular echo; and (5) calyceal dilatation. Three hundred and thirty-nine consecutive ultrasound scans (US) and DMSA scintigrams, comprising 648 kidneys, were performed and reported blindly and the results were compared. Using DMSA scintigraphy as the gold standard, ultrasound had a positive predictive value of 93% and a negative predictive value of 95%. Ultrasound disagreed with DMSA scintigraphy in 5.2% of kidneys. On review of the cases of disagreement where arbitration was possible by comparison with other imaging, ultrasound was incorrect in 10 kidneys and DMSA was incorrect in 13. We conclude that the sensitivity in the ultrasound detection of renal scarring can be greatly improved using this method. If no scars were detected at ultrasound an alternative explanation for an abnormal DMSA scintigram should be sought.
Language of Publication
English
Unique Identifier
99031982

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MeSH Heading (Major)
Cicatrix|CO/RI/*US; Kidney Diseases|CO/RI/*US; Urinary Tract Infections|*ET
MeSH Heading
Adolescence; Age Factors; Child; Child, Preschool; Comparative Study; False Negative Reactions; False Positive Reactions; Female; Human; Infant; Infant, Newborn; Male; Predictive Value of Tests; Sensitivity and Specificity; Succimer|DU

Publication Type
CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; JOURNAL ARTICLE
ISSN
0009-9260
Country of Publication
ENGLAND

Record 25 from database: MEDLINE
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Title
Assessment of infective urinary tract disorders.
Author
Sixt R; Stokland E
Address
Department of Pediatric Clinical Physiology, Sahlgrenska University Hospital/Ostra, GÂoteborg, Sweden.
Source
Q J Nucl Med, 1998 Jun, 42:2, 119-25
Abstract
Urinary tract infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigraphic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The 99mTc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted. An early treatment is more important than an early scan!
Language of Publication
English
Unique Identifier
98360777

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MeSH Heading (Major)
Diagnostic Imaging|*; Urinary Tract Infections|*DI/RI/US
MeSH Heading
Child; Female; Human; Male; Radioisotope Renography; Radiopharmaceuticals|DU; Sensitivity and Specificity; Succimer|DU; Technetium Tc 99m Mertiatide|DU; Tomography, Emission-Computed, Single-Photon

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW, TUTORIAL
ISSN
1124-3937
Country of Publication
ITALY

Record 26 from database: MEDLINE
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Title
Soluble interleukin-2 receptor in children with reflux nephropathy.
Author
Konda R; Sakai K; Ota S; Takeda A; Chida N; Sato H; Orikasa S
Address
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Source
J Urol, 1998 Feb, 159:2, 535-9
Abstract
PURPOSE: Serum soluble interleukin-2 receptor level is a sensitive and quantitative marker of lymphocyte activation. We determined levels of serum soluble interleukin-2 receptor in children with reflux nephropathy to evaluate its clinical significance in the prediction for the progression of renal injuries. MATERIALS AND METHODS: Serum soluble interleukin-2 receptor values were determined in 63 children with reflux nephropathy. The group consisted of 37 boys and 26 girls 10 to 18 years old. T cells (naive and memory), B cells and macrophages were evaluated immunohistochemically in the scarred kidneys of 4 other patients (3 boys and 1 girl 5 to 16 years old) who underwent nephrectomy due to severe reflux nephropathy with little function seen on (99m)technetium-dimercapto-succinic acid (DMSA) renal scan. Levels of serum soluble interleukin-2 receptor were measured by an enzyme-linked immunosorbent assay. We simultaneously determined serum levels of creatinine and beta2-microglobulin, and urinary levels of alpha1-microglobulin and microalbumin. Individual functions of the right and left kidneys were estimated by renal dimercaptosuccinic acid uptake. RESULTS: Levels of serum soluble interleukin-2 receptor in the patients who had low total uptake of DMSA (right uptake plus left uptake) were significantly higher than those from patients with normal total uptake. Levels of serum soluble interleukin-2 receptor correlated significantly with levels of creatinine (r=0.616, p <0.0001) and beta2-microglobulin (r=0.803, p <0.0001), and levels of urinary alpha1-microglobulin (r=0.753, p <0.0001) and microalbumin (r=0.673, p <0.0001). A significant negative correlation was observed between levels of serum soluble interleukin-2 receptor and total DMSA uptake values (right uptake plus left uptake r=-0.678, p <0.0001). In the scarred kidneys leukocyte infiltrates were markedly increased in fibrosed spaces. The predominant cell type in these lesions was memory T cells. CONCLUSIONS: These results suggest that elevated levels of serum soluble interleukin-2 receptor are likely to reflect activated T cells in the kidneys of patients with reflux nephropathy and may be a useful predictor of progression of renal injury in these children.
Language of Publication
English
Unique Identifier
98311621

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MeSH Heading (Major)
Receptors, Interleukin-2|*BL; Vesico-Ureteral Reflux|*BL/ME
MeSH Heading
Adolescence; Biological Markers|BL; Child; Disease Progression; Female; Human; Kidney|PA; Leukocytes; Male; Predictive Value of Tests; Succimer|PK

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 27 from database: MEDLINE
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Title
Acute childhood pyelonephritis: predictive value of positive sonographic findings in regard to later parenchymal scarring.
Author
Jéquier S; Jéquier JC; Hanquinet S
Address
Department of Radiology, University Hospital of Geneva, Children's Hospital, Switzerland.
Source
Acad Radiol, 1998 May, 5:5, 344-53
Abstract
RATIONALE AND OBJECTIVES: The authors evaluated the importance of positive sonographic findings in acute childhood pyelonephritis. MATERIALS AND METHODS: A total of 290 children (91 boys, 199 girls, aged 4 days to 15 years [median, 394 days]) with clinically suspected acute pyelonephritis underwent initial renal gray-scale ultrasound (US) and dimercaptosuccinate scintigraphic examination within 3 days of onset. A total of 173 patients underwent color or energy US examination. One hundred fifteen children with normal scintigraphic or pathologic findings (other than acute pyelonephritis) were excluded from further study; 170 patients with abnormal scintigraphic findings underwent follow-up scintigraphic scanning 60-90 days later. RESULTS: When pathologic structures other than acute pyelonephritis were not considered, the diagnostic value of gray-scale US was poor, with a sensitivity of 45.5%, a specificity of 86.6%, a positive predictive value of 88.8%, and a negative predictive value of only 40.6%. In regard to future renal scarring, gray-scale US had a positive predictive value of 67.7%, a negative predictive value of 40%, and a likelihood ratio of 1.16. Abnormal Doppler findings helped predict future scarring with a positive predictive value of 85.7%, a negative predictive value of 37.2%, a very low sensitivity of 26.9%, a high specificity of 90.6%, and a likelihood ratio of 2.87. CONCLUSION: Positive US Doppler findings in children with clinically suspected acute pyelonephritis indicate the need for immediate treatment. A positive initial gray-scale US examination does not predict future renal scarring, but a positive Doppler examination indicates a high probability of scarring. Negative gray-scale or Doppler US does not exclude a diagnosis of acute pyelonephritis and it cannot predict an absence of future scarring.
Language of Publication
English
Unique Identifier
98259390

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MeSH Heading (Major)
Cicatrix|*ET; Kidney Diseases|*ET; Pyelonephritis|RI/*US
MeSH Heading
Acute Disease; Adolescence; Chelating Agents|DU; Chi-Square Distribution; Child; Child, Preschool; False Positive Reactions; Female; Follow-Up Studies; Human; Infant; Infant, Newborn; Likelihood Functions; Male; Predictive Value of Tests; Sensitivity and Specificity; Succimer|DU; Ultrasonography, Doppler; Ultrasonography, Doppler, Color

Publication Type
JOURNAL ARTICLE
ISSN
1076-6332
Country of Publication
UNITED STATES

Record 28 from database: MEDLINE
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Title
Renovascular hypertension in children with moyamoya disease.
Author
Choi Y; Kang BC; Kim KJ; Cheong HI; Hwang YS; Wang KC; Kim IO
Address
Department of Pediatrics, College of Medicine, Seoul National University, Korea.
Source
J Pediatr, 1997 Aug, 131:2, 258-63
Abstract
OBJECTIVES: To examine the incidence, clinical and radiologic findings, and response to treatment of renovascular hypertension (RVHT) in moyamoya disease (MMD). METHODS: A retrospective analysis of medical records in six RVHT cases (8.3%) among 72 MMD patients observed from November 1987 to December 1995. RESULTS: The age at onset of MMD ranged from 9 months to 7 years 1 month (mean, 3.3 years). The most common initial manifestation of MMD was transient ischemic attack. Hypertension was detected between 4 years 4 months and 12 years 3 months (mean, 7.87 years). Unstimulated plasma renin activity was elevated in all six cases. Renal ultrasonography and captopril technetium 99m-labeled dimercaptosuccinic acid scan showed abnormal findings in four of five and in three of four available studies, respectively. However, both imaging studies showed abnormal findings only in the most severely affected kidneys even with bilateral renal artery stenosis. Renal arteriography revealed bilateral lesions in three of the patients and unilateral lesions in the others. Renal angioplasty was performed in four cases but was successful in only one and partially successful in another. A renal artery specimen obtained during renal autotransplantation showed intimal fibroplasia. At the last follow-up, one patient had normal blood pressure without the use of antihypertensive agents, but the other five patients needed this medication to control blood pressure. CONCLUSION: Because RVHT may be more commonly associated with MMD than has hitherto been appreciated, it is recommended that blood pressure be carefully followed and that diagnostic procedures for RVHT be carried out in hypertensive patients with MMD.
Language of Publication
English
Unique Identifier
97435946

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MeSH Heading (Major)
Hypertension, Renovascular|*ET/PA/RA/TH; Moyamoya Disease|*CO
MeSH Heading
Adolescence; Angiography; Angiotensin-Converting Enzyme Inhibitors|DU; Antihypertensive Agents|DU; Biopsy; Blood Pressure; Captopril|DU; Cerebral Ischemia, Transient|ET; Child; Child, Preschool; Female; Fibromuscular Dysplasia|PA; Follow-Up Studies; Human; Incidence; Infant; Kidney|RA/RI/US; Kidney Transplantation; Male; Organotechnetium Compounds|DU; Radiopharmaceuticals|DU; Renal Artery Obstruction|RA/RI/US; Renin|BL; Retrospective Studies; Seizures|ET; Succimer|DU; Support, Non-U.S. Gov't; Tunica Intima|PA

Publication Type
JOURNAL ARTICLE
ISSN
0022-3476
Country of Publication
UNITED STATES

Record 29 from database: MEDLINE
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Title
Laurence-Moon-Biedl syndrome: scintigraphic appearance of kidneys.
Author
Kiratli PO; Erbas B; Bekdik FC
Address
Department of Nuclear Medicine, Hacettepe University Medical School, Ankara, Turkey.
Source
Ann Nucl Med, 1997 May, 11:2, 159-61
Abstract
We report a 7-year-old child with Laurence-Moon-Biedl syndrome, an autosomal recessive syndrome, with impaired renal function detected by means of technetium-99m diethylenetriamine-pentaacetic acid (Tc-99m DTPA), technetium-99m dimercaptosuccinic acid (Tc-99m DMSA) scintigraphy, and ultrasonography. The altered renal morphology and decreased renal functions are documented.
Language of Publication
English
Unique Identifier
97356463

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MeSH Heading (Major)
Kidney|AB/PP/*RI; Laurence-Moon-Biedl Syndrome|CO/PP/*RI
MeSH Heading
Case Report; Child; Female; Human; Hydronephrosis|CO/PP/RI; Organotechnetium Compounds|DU; Succimer|DU; Technetium Tc 99m Pentetate|DU

Publication Type
JOURNAL ARTICLE
ISSN
0914-7187
Country of Publication
JAPAN

Record 30 from database: MEDLINE
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Title
Scan findings of various myocardial SPECT agents in a case of amyloid polyneuropathy with suspected myocardial involvement.
Author
Arbab AS; Koizumi K; Toyama K; Arai T; Yoshitomi T; Araki T
Address
Department of Radiology, Yamanashi Medical University, Japan. saali@res.yamanashi-med.ac.jp
Source
Ann Nucl Med, 1997 May, 11:2, 139-41
Abstract
A 31-year-old male having familial amyloid polyneuropathy underwent a Tc-99m(V)-DMSA study to evaluate the myocardial involvement. The patient also underwent T1-201, I-123-BMIPP and I-123-MIBG myocardial SPECT studies to evaluate blood perfusion, fatty acid metabolism and sympathetic function of the heart, respectively. Tc-99m(V)-DMSA SPECT showed uptake to the myocardium indicating myocardial involvement of amyloidosis. Both T1-201 and I-123-BMIPP studies showed normal uptake indicating normal blood perfusion and fatty acid metabolism but I-123-MIBG SPECT showed no uptake to the heart, indicating severe impairment of sympathetic function.
Language of Publication
English
Unique Identifier
97356458

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MeSH Heading (Major)
Amyloid Neuropathies|*RI; Amyloidosis|ME/PP/*RI; Myocardial Diseases|ME/PP/*RI; Tomography, Emission-Computed, Single-Photon|*MT
MeSH Heading
Adult; Case Report; Coronary Circulation; Fatty Acids|DU/ME; Human; Iodine Radioisotopes|DU; Iodobenzenes|DU; Male; Organotechnetium Compounds|DU; Succimer|DU; Thallium Radioisotopes|DU

Publication Type
JOURNAL ARTICLE
ISSN
0914-7187
Country of Publication
JAPAN

Record 31 from database: MEDLINE
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Title
Imaging of pyelonephritis.
Author
Lavocat MP; Granjon D; Allard D; Gay C; Freycon MT; Dubois F
Address
Department of Pediatrics, CHU de Saint Etienne, HÈopital Nord, F-42055 Saint Etienne Cedex, France.
Source
Pediatr Radiol, 1997 Feb, 27:2, 159-65
Abstract
OBJECTIVE: Accurate diagnosis of pyelonephritis using clinical and laboratory parameters is often difficult, especially in children. The main aims of this prospective study were to compare the value of different imaging techniques [renal sonography, cortical scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc DMSA) and computed tomography (CT)] in detecting renal involvement in acute urinary tract infections and to determine the sensitivity of DMSA scans for permanent renal scars 6 months later. MATERIALS AND METHODS: Between February 1992 and January 1993, 55 children admitted to our pediatric unit with febrile symptomatic urinary tract infections were eligible for analysis. Ultrasonography (US), DMSA scanning and micturating cystourethrography were performed in every case. Only 18 children underwent CT. A second DMSA scan was performed in 48 children a mean of 7.5 months after the first. RESULTS: US abnormalities were found in 25 children (45 %). The first DMSA scan showed a parenchymal aspect suggestive of pyelonephritis in 51 patients (93 %). Among the 18 patients studied by CT, 14 had abnormalities. Normal US findings did not rule out renal parenchymal involvement. Scintigraphy appeared to be more sensitive than CT for renal involvement. The frequency and degree of initial renal parenchymal damage seemed to correlate with vesicoureteral reflux, but the most severe initial parenchymal defects were not associated with marked clinical or laboratory manifestations. Repeat DMSA scans, performed on 45 kidneys with abnormalities at the first examination, showed resolution in 19, improvement in 16, persistence in 8 and deterioration in 2. The prevalence of vesicoureteral reflux was not higher in patients with renal scarring on the second DMSA scan than in patients whose scans showed an improvement. CONCLUSION: DMSA scans should be considered as a reference in the detection and follow-up of renal scarring associated with acute urinary tract infection as this technique is more sensitive than US and CT, the latter being unsuitable because it entails radiation exposure and sedation of patients.
Language of Publication
English
Unique Identifier
97181002

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MeSH Heading (Major)
Diagnostic Imaging|*; Pyelonephritis|*DI/RA/RI/US
MeSH Heading
Acute Disease; Adolescence; Bladder|RA; Child; Child, Preschool; Cicatrix|DI; Comparative Study; Disease Progression; Female; Follow-Up Studies; Human; Infant; Infant, Newborn; Kidney|US; Kidney Diseases|DI; Male; Organotechnetium Compounds|DU; Prevalence; Prospective Studies; Radiopharmaceuticals|DU; Sensitivity and Specificity; Succimer|DU; Tomography, X-Ray Computed; Urethra|RA; Urinary Tract Infections|DI; Urination; Vesico-Ureteral Reflux|DI

Publication Type
JOURNAL ARTICLE
ISSN
0301-0449
Country of Publication
GERMANY

Record 32 from database: MEDLINE
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Title
MRI and scintigraphic features of extraabdominal desmoid tumors.
Author
Kobayashi H; Kotoura Y; Hosono M; Tsuboyama T; Sakahara H; Endo K; Konishi J
Address
Department of Radiology and Nuclear Medicine, Kyoto University, Japan. KOBAYASHI@NMDPET.CC.NIH.GOV
Source
Clin Imaging, 1997 Jan, 21:1, 35-9
Abstract
To determine whether extraabdominal desmoid can be correctly diagnosed using both magnetic resonance imaging (MRI) and scintigraphy with pentavalent technetium-99m dimercaptosuccinic acid and gallium-67 citrate, MRI (T1- and T2-weighted images) and scintigraphy were performed in 18 patients with 27 histologically proved extraabdominal desmoid tumors. The extraabdominal desmoid tumors were characterized by positive uptake of pentavalent technetium-99m dimercaptosuccinic acid and lack of uptake of gallium-67 citrate on scintigraphy. These tumors were isointense to skeletal muscle on T1-weighted MRIs and hyperintense on T2-weighted images. They also displayed septum-like internal inhomogeneity and surrounding hypointense capsular band. The combination of scintigraphy and MRI is of value in correctly diagnosing extraabdominal desmoid tumors except in the rare case of fibrotic verylow-grade sarcoma.
Language of Publication
English
Unique Identifier
97180478

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MeSH Heading (Major)
Fibromatosis, Aggressive|*PA/*RI; Magnetic Resonance Imaging|*; Soft Tissue Neoplasms|*DI
MeSH Heading
Comparative Study; Human; Organotechnetium Compounds|DU; Retrospective Studies; Succimer|DU

Publication Type
JOURNAL ARTICLE
ISSN
0899-7071
Country of Publication
UNITED STATES

Record 33 from database: MEDLINE
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Title
Are younger children at highest risk of renal sequelae after pyelonephritis? [see comments]
Author
Benador D; Benador N; Slosman D; Mermillod B; Girardin E
Address
Department of Paediatrics, Cantonal University Hospital, Geneva, Switzerland.
Source
Lancet, 1997 Jan, 349:9044, 17-9
Abstract
BACKGROUND: The general belief about the relation between risk of renal sequelae after pyelonephritis and age is that infants are at highest risk and children older than 5 years at lower risk. This assumption has led to differences in treatment based on age. The aim of this prospective study was to investigate the occurrence of renal lesions in children aged 0-16 years. METHODS: Between May, 1994, and January, 1996, all children aged 0-16 years who were admitted to our department with a diagnosis of probable pyelonephritis and a positive urine culture were included in this prospective study. All patients received antibiotics for 7-21 days. During the acute phase of urinary-tract infection, scintigraphy with technetium-99m-dimercaptosuccinic acid (DMSA) and ultrasonography were done. Voiding cystourethrography was undertaken at least 6 weeks after the end of antibiotic treatment. When scintigraphy showed renal parenchymal lesions, repeat scintigraphy was done after at least 2 months to assess the progression of renal lesions. For the analysis, children were grouped by age according to presumed risk of renal sequelae after pyelonephritis: high risk (< 1 year), moderate risk (1-5 years), low risk (> 5 years). FINDINGS: 201 patients were enrolled in the study (119 < 1 year, 47 aged 1-5 years, 35 > 5 years). During the acute phase of urinary-tract infection, renal lesions were found in 66 (55%) infants under 1 year, in 37 (79%) children aged 1-5 years, and in 24 (69%) children older than 5 years. Of these 127 children, 108 underwent repeat scintigraphy after an average of 3 months (50 < 1 year, 36 aged 1-5 years, 22 > 5 years). Overall, renal scars were found on repeat scintigraphy in 20 (40%) infants under 1 year, in 31 (86%) children aged 1-5 years, and in 14 (64%) children older than 5 years. 38 (36%) of these 65 patients had vesicoureteric reflux. Among 88 children who had a first documented urinary-tract infection and underwent repeat scintigraphy, renal scars were found in 20 (43%) under 1 year, in 26 (84%) aged 1-5 years, and in eight (80%) older than 5 years. INTERPRETATION: This study did not confirm the conventional view that the risk of renal scars after pyelonephritis diminishes with age. We believe that all children, irrespective of age, will benefit from any measure that prevents the development of renal sequelae.
Language of Publication
English
Unique Identifier
97141867

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MeSH Heading (Major)
Cicatrix|*ET; Kidney Diseases|*ET/US; Pyelonephritis|*CO/DT/MI/US
MeSH Heading
Adolescence; Age Factors; Anti-Infective Agents, Urinary|AD/TU; Antibiotics|AD/TU; Bacterial Infections|DT; Child; Child, Preschool; Disease Susceptibility; Human; Infant; Infant, Newborn; Organotechnetium Compounds|DU; Prospective Studies; Recurrence; Risk; Succimer|DU; Vesico-Ureteral Reflux|CO

Publication Type
JOURNAL ARTICLE
ISSN
0140-6736
Country of Publication
ENGLAND

Record 34 from database: MEDLINE
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Title
Congenitally small kidneys with reflux as a common cause of nephropathy in boys.
Author
Hiraoka M; Hori C; Tsukahara H; Kasuga K; Ishihara Y; Sudo M
Address
Department of Pediatrics, Fukui Medical School, Kasuga Ladies' Clinic, and Aiiku Hospital, Japan.
Source
Kidney Int, 1997 Sep, 52:3, 811-6
Abstract
Congenital maldevelopment is sometimes found in small kidneys with ureteral reflux. However, the incidence of congenitally small kidneys and the frequency of its association with ureteral reflux remains unknown. Ultrasound scanning, performed in 4,000 apparently healthy neonates or young infants (males 2,129, females 1,871), detected 51 children suspected of having small kidneys. A careful ultrasound re-examination performed one month later in 45 of the 51 children confirmed small kidneys in eight children, one bilateral and seven unilateral. Dimercaptosuccinate (DMSA) renoscintigraphy revealed small kidneys with generally diminished uptake in six infants and no uptake unilaterally in the other two infants. One of the 12 children, who had normal findings on the initial scanning and subsequently developed urinary infection, was later diagnosed having unilateral small kidney with generally reduced DMSA uptake. All seven infants having small kidneys with reduced tracer uptake were male (incidence, 1:300 boys). All eight small kidneys in the seven boys and four of the six contralateral non-small kidneys were associated with ureteral reflux, while neither of the two infants with a non-functioning kidney had ureteral reflux. Serial ultrasounds documented the poor growth of all small kidneys. Thus, congenitally small kidneys with generally diminished DMSA uptake were highly associated with ureteral reflux and especially observed in boys.
Language of Publication
English
Unique Identifier
97434980

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MeSH Heading (Major)
Kidney|*AB/RI/US; Kidney Diseases|*ET; Vesico-Ureteral Reflux|*CO/DI/RA
MeSH Heading
Female; Follow-Up Studies; Human; Incidence; Infant; Infant, Newborn; Male; Succimer|DU; Support, Non-U.S. Gov't; Urinary Tract Infections|CO

Publication Type
JOURNAL ARTICLE
ISSN
0085-2538
Country of Publication
UNITED STATES

Record 35 from database: MEDLINE
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Title
The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis.
Author
Yeung CK; Godley ML; Dhillon HK; Gordon I; Duffy PG; Ransley PG
Address
The Great Ormond Street Hospital for Children NHS Trust and the Institute of Child Health, London, UK.
Source
Br J Urol, 1997 Aug, 80:2, 319-27
Abstract
OBJECTIVE: To examine the characteristics of primary vesico-ureteric reflux (VUR) in young infants following prenatal hydronephrosis. PATIENTS AND METHODS: The study comprised 155 consecutive infants with VUR detected at a mean age of 8.7 weeks (SD 6.3). Reflux units (n = 236) were analysed for relationships between gender, severity of reflux, exposure to urinary tract infection (UTI) and the presence of focal and generalized types of kidney damage on imaging. Bladder wall thickness (from ultrasonography) was examined in comparison with a further group of 29 males without VUR. RESULTS: Male infants predominated (117 of 155, 75%); bilateral VUR affected the same proportion (52%) of males and females. Most kidneys exposed to VUR (158 of 236. 67%) were normal and of the 78 abnormal kidneys (57 without UTI), 53 showed generalized damage (only eight exposed to UTI) and 71 (91%) were associated with severe (grades IV and V) reflux that predominantly affected males (P < 0.001). Grade V reflux was almost exclusively a male disorder. Most female units (45 of 58, 78%) compared with 46% (82/178) of male units had mild (grades I to III) reflux that was independently associated with normal kidneys. The mean bladder wall thickness was significantly greater for males with VUR than for females with VUR and for males without VUR. CONCLUSIONS: Two distinct but not exclusive patterns of VUR were identified: (i) mild reflux associated with normal kidneys that affected most females and a proportion of males; (ii) severe reflux combined with kidney damage, most likely fetal in origin, that is almost exclusively a male disorder.
Language of Publication
English
Unique Identifier
97428021

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MeSH Heading (Major)
Hydronephrosis|DI/*EM; Vesico-Ureteral Reflux|*ET/RI
MeSH Heading
Bladder Diseases|PA; Female; Fetal Diseases|DI; Follow-Up Studies; Gestational Age; Human; Infant; Kidney|AB; Male; Prenatal Diagnosis; Prospective Studies; Radioisotope Renography; Sex Factors; Succimer|DU; Support, Non-U.S. Gov't

Publication Type
JOURNAL ARTICLE
ISSN
0007-1331
Country of Publication
ENGLAND

Record 36 from database: MEDLINE
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Title
New renal scars in children with urinary tract infections, vesicoureteral reflux and voiding dysfunction: a prospective evaluation.
Author
Naseer SR; Steinhardt GF
Address
Department of Pediatrics, St. Louis University Medical Center, Missouri, USA.
Source
J Urol, 1997 Aug, 158:2, 566-8
Abstract
PURPOSE: Established renal scarring represents areas of the kidney that imaging reveals to be damaged at presentation for medical management of urinary tract infection. New renal scarring represents new renal damage in parts of the kidney that imaging reveals to be normal at presentation. We attempted to characterize patients in whom new renal scars developed while they were under our care. MATERIALS AND METHODS: In 1988 a data base was started to identify patients with new renal scarring. All patients presenting with urinary tract infections were enrolled. Our data base has 250 possible fields per event with multiple events per patient. More than 2,100 patients have been enrolled to date. All patients with pyelonephritis, defined as a febrile urinary tract infection with flank pain and tenderness, and all with reflux underwent dimercapto-succinic acid (DMSA) scan at least 4 months after presenting with infection to assess established renal scars. New renal scars were identified when new renal defects were demonstrated on a second DMSA scan. RESULTS: In our data base there are 1,426 patients with urinary tract infections, 685 (46%) with pyelonephritis and 1,062 (74.5%) with vesicoureteral reflux, including 558 found to have bilateral vesicoureteral reflux and 504 diagnosed with unilateral reflux. A history of daytime urinary incontinence was noted in 538 patients (37.7%), 192 (13.5%) had established scars at initial presentation and in 31 (2.1%) new renal scars developed while they were under our care, including 30 with established scars as well. Of the 25 patients in whom new renal scars developed while on medical therapy 11 underwent surgery. In 6 patients with dysfunctional voiding who were receiving medical treatment renal scars developed postoperatively. Surgery was performed in 17 of the 31 patients and 24 (77%) with new renal scars had a history of dysfunctional voiding. CONCLUSIONS: Previous characterizations of patients with new renal scars have relied on excretory urography for assessing renal architecture and ignored voiding patterns of the children affected. Using the DMSA scan we identified 31 children with reflux, urinary tract infection and dysfunctional voiding in whom new renal scars developed while they were under our care.
Language of Publication
English
Unique Identifier
97367658

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MeSH Heading (Major)
Cicatrix|*ET/RA; Kidney Diseases|*ET; Pyelonephritis|*CO; Urinary Incontinence|*CO; Urinary Tract Infections|*CO; Vesico-Ureteral Reflux|*CO
MeSH Heading
Adolescence; Child; Child, Preschool; Female; Human; Infant; Male; Prospective Studies; Succimer|DU

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 37 from database: MEDLINE
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Title
Lead poisoning in children.
Author
Berlin CM Jr
Address
Department of Pediatrics, Milton S. Hershey Medical Center, Pannsylvania State University College of Medicine, Harshey 17033-0850, USA.
Source
Curr Opin Pediatr, 1997 Apr, 9:2, 173-7
Abstract
Increased lead exposure and increased body burden of lead remains a significant problem for children in the United States. With the increased use of blood level screening methods, a large percentage of children in many industrialized countries are being tested as a being at risk. A controversy continues over the definition of what population to screen and at what age to screen. There are parts of the United States, especially rural areas and health maintenance organization populations, where screening for lead exposure has not been productive. A new drug, DMSA (meso 2,3-dimercaptosuccinic acid) has been approved for oral chelation of children with increased body burden of lead. At the present time it is labeled for use in children with blood lead concentrations in excess of 45 micrograms/dL. Evidence exists that DMSA is effective in lowering the blood lead concentrations in children with levels between 25 and 45 micrograms/dL. The long-term effectiveness of chelation at lower levels is at present uncertain. There remains no substitution for strict environmental decontamination in the home environment of children and the workplace environment of their parents.
Language of Publication
English
Unique Identifier
97348195

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MeSH Heading (Major)
Lead Poisoning|*DI/DT
MeSH Heading
Chelating Agents|TU; Child; Human; Succimer|TU

Publication Type
JOURNAL ARTICLE; REVIEW; REVIEW LITERATURE
ISSN
1040-8703
Country of Publication
UNITED STATES

Record 38 from database: MEDLINE
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Title
Full reversal of Pb++ block of L-type Ca++ channels requires treatment with heavy metal antidotes.
Author
Bernal J; Lee JH; Cribbs LL; Perez Reyes E
Address
Department of Physiology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Source
J Pharmacol Exp Ther, 1997 Jul, 282:1, 172-80
Abstract
The mechanisms of Pb++ block and unblock of L-type Ca++ channel currents were measured using ventricular myocytes or the cloned channel. The cloned channel was expressed in either Xenopus laevis oocytes or human embryonic kidney cells (HEK 293, stable transfectants). The threshold for Pb++ block was 1 nM, and the apparent IC50 value was 152 nM in oocytes and 169 nM in HEK 293 cells. Pb++ block was dependent on the composition of the external recording solution but not dependent on the subunit composition of the channel. Pb++ block was voltage dependent, with little block observed at negative test potentials using low concentrations of Pb++. Strong depolarizations (>+100 mV) reversed Pb++ block, allowing measurement of reblock kinetics. Reblock was fast (tau = 11 msec), as measured during a +20-mV test pulse. Simple washout did not completely reverse Pb++ block, especially after exposure to concentrations of >100 nM. Full recovery could only be observed after treatment with heavy metal antidotes such as meso-2,3-dimercaptosuccinic acid, 2,3-dimercapto-1-propanesulfonic acid and EDTA. These results suggest that Pb++ blocks voltage-gated Ca++ channels by two mechanisms and that full reversal of lead block requires chelator treatment.
Language of Publication
English
Unique Identifier
97366722

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MeSH Heading (Major)
Antidotes|*PD; Calcium Channel Blockers|*PD; Lead|*PD
MeSH Heading
Animal; Dose-Response Relationship, Drug; Edetic Acid|PD; Human; Rabbits; Succimer|PD; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.; Xenopus laevis

Publication Type
JOURNAL ARTICLE
ISSN
0022-3565
Country of Publication
UNITED STATES

Record 39 from database: MEDLINE
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Title
Urinary excretion of epidermal growth factor in children with reflux nephropathy.
Author
Konda R; Sakai K; Ota S; Takeda A; Chida N; Orikasa S
Address
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Source
J Urol, 1997 Jun, 157:6, 2282-6
Abstract
PURPOSE: We determined urinary levels of epidermal growth factor in children with reflux nephropathy to evaluate the clinical significance of urinary epidermal growth factor. MATERIALS AND METHODS: We studied 59 boys and 41 girls 3 to 15 years old with reflux nephropathy, and 64 boys and 36 girls 3 to 15 years old who were healthy. Levels of urinary epidermal growth factor were determined by sandwich enzyme immunoassay using spot urine samples. We also determined the levels of serum creatinine, urinary alpha 1-microglobulin and urinary microalbumin. Absolute values of function of the left and right kidneys were assessed by 99mtechnetium dimercapto-succinic acid (DMSA) uptake. RESULTS: Levels of urinary epidermal growth factor gradually decreased with age in healthy children. There were low levels of urinary epidermal growth factor in 20 of the 44 patients (45%) with unilateral low DMSA uptake and 18 of the 19 (95%) with low total DMSA uptake (right and left uptakes). Urinary epidermal growth factor significantly correlated with serum creatinine (R = -0.702, p < 0.0001), urinary alpha 1-microglobulin (R = -0.606, p < 0.0001), urinary microalbumin (R = -0.708, p < 0.0001) and total DMSA uptake (R = 0.744, p < 0.0001). CONCLUSIONS: These results suggest that urinary epidermal growth factor may be a useful clinical tool to monitor functional nephron mass in children with reflux nephropathy.
Language of Publication
English
Unique Identifier
97292113

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MeSH Heading (Major)
Epidermal Growth Factor-Urogastrone|*UR; Vesico-Ureteral Reflux|*UR
MeSH Heading
Adolescence; Child; Child, Preschool; Female; Human; Infant; Male; Succimer|PK

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 40 from database: MEDLINE
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Title
Followup study of renal function in children with reflux nephropathy after resolution of vesicoureteral reflux.
Author
Konda R; Sakai K; Ota S; Takeda A; Orikasa S
Address
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Source
J Urol, 1997 Mar, 157:3, 975-9
Abstract
PURPOSE: We evaluated data collected for 10 years on children with reflux nephropathy to identify a means of predicting the prognosis. MATERIALS AND METHODS: A total of 15 boys and 13 girls were enrolled in this study at least 2 years after surgical and spontaneous resolution of vesicoureteral reflux in 25 and 3 patients, respectively. They were followed for more than 10 years and renal function was periodically evaluated. Urinary beta 2-microglobulin, alpha 1-microglobulin, N-acetyl-beta-D-glucosaminidase, microalbumin and 99mtechnetium dimercapto-succinic acid uptake were measured. RESULTS: Of the 28 patients 12 had high levels of urinary alpha 1-microglobulin during followup, including all 7 in whom renal function deteriorated. In 3 children with elevated alpha 1-microglobulin urinary microalbumin gradually increased after puberty. Although elevated levels of urinary beta 2-microglobulin, N-acetyl-beta-D-glucosaminidase and microalbumin were also observed, they were less predictive of renal function than alpha 1-microglobulin. CONCLUSIONS: These results suggest that elevated urinary levels of alpha 1-microglobulin may predict the risk of abnormal renal function in children with reflux nephropathy even before the appearance of significant proteinuria.
Language of Publication
English
Unique Identifier
97188856

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MeSH Heading (Major)
Kidney|*PP; Vesico-Ureteral Reflux|*CO/TH
MeSH Heading
beta 2-Microglobulin|UR; Acetylglucosaminidase|UR; Adolescence; Albuminuria; Alpha-Globulins|UR; Child; Child, Preschool; Cicatrix|ET/PP; Female; Follow-Up Studies; Human; Kidney Diseases|ET/PP; Kidney Function Tests; Male; Predictive Value of Tests; Prognosis; Sensitivity and Specificity; Succimer|ME

Publication Type
JOURNAL ARTICLE
ISSN
0022-5347
Country of Publication
UNITED STATES

Record 41 from database: MEDLINE
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Title
The Treatment of Lead-exposed Children (TLC) trial: design and recruitment for a study of the effect of oral chelation on growth and development in toddlers.
Address
 
Source
Paediatr Perinat Epidemiol, 1998 Jul, 12:3, 313-33
Abstract
Exposure to lead impairs cognitive development in young children, but the benefits of lowering blood lead pharmacologically are not clear. This report describes the design, recruitment, enrolment and baseline results of the Treatment of Lead-Exposed Children (TLC) trial, a randomised, multicentre, placebo-controlled, double-blind clinical trial of the effects of treating lead-exposed children with succimer, a drug that enhances urinary excretion of lead, on cognitive, behavioural and physical development. TLC clinical sites were in Baltimore, Cincinnati and Columbus, Newark and Philadelphia. Children were eligible for TLC if they were between 12 and 33 months of age, had a confirmed blood lead concentration between 20 and 44 micrograms/dL and lived in a residence suitable for lead dust reduction. Randomised children received up to three 26-day courses of succimer or placebo, and were then followed for 3 years. The study can detect a three-point difference in full-scale IQ at 3-year follow-up. Statistical power for the other end points is more difficult to estimate. A total of 1854 children were evaluated and 780 children were randomised between August 1994 and January 1997. The mean age of randomised children was 24 months and mean blood lead level 26 micrograms/dL. Three-quarters were African-American. Most children had poor, single mothers who had completed 12 or fewer years of school and who lived in older, poorly maintained residences.
Language of Publication
English
Unique Identifier
98354723

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MeSH Heading (Major)
Chelating Agents|*TU; Chelation Therapy|*; Lead Poisoning|*DT; Succimer|*TU
MeSH Heading
Child Development|DE; Child, Preschool; Double-Blind Method; Housing; Human; Infant; Lead|BL; Support, U.S. Gov't, P.H.S.; United States

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
ISSN
0269-5022
Country of Publication
ENGLAND

Record 42 from database: MEDLINE
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Title
The effect of succimer therapy in lead intoxication using postural balance as a measure: a case study in a nine year old child.
Author
Bhattacharya A; Smelser DT; Berger O; Shukla R; Medvedovic M
Address
Biomechanics-Ergonomics Research Laboratory, University of Cincinnati Medical School, OH, USA.
Source
Neurotoxicology, 1998 Feb, 19:1, 57-64
Abstract
Postural balance testing was used as a measure of the effect of therapy on a 9 year old boy with high lead levels. Following therapy with CaEDTA and succimer, the patient's postural sway responses were comparable to a low-lead (< 10 micrograms/dL) comparison group for 3 out of 4 tests which rely relatively less on the higher centers for balance. This improvement in postural balance may be attributable to the combined influence of pharmacologic and age associated maturational effects. This case study provides suggestive evidence that while chelation therapy can reduce PbB levels quickly, it can also modify gross neuromotor function manifested by postural balance characteristics.
Language of Publication
English
Unique Identifier
98159656

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MeSH Heading (Major)
Equilibrium|*DE; Lead Poisoning|*DT/*PP; Succimer|*TU
MeSH Heading
Administration, Oral; Case Report; Child; Dimercaprol|TU; Drug Administration Schedule; Edetic Acid|TU; Human; Male; Patient Compliance; Support, U.S. Gov't, P.H.S.

Publication Type
JOURNAL ARTICLE
ISSN
0161-813X
Country of Publication
UNITED STATES

Record 43 from database: MEDLINE
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Title
Placebo response in environmental disease. Chelation therapy of patients with symptoms attributed to amalgam fillings.
Author
Grandjean P; Guldager B; Larsen IB; J‡rgensen PJ; Holmstrup P
Address
Department of Environmental Medicine, Odense University, Denmark.
Source
J Occup Environ Med, 1997 Aug, 39:8, 707-14
Abstract
Treatment of patients who attribute their environmental illness to mercury from amalgam fillings is largely experimental. On the Symptom Check List, overall distress, and somatization, obsessive-compulsive, depression, and anxiety symptom dimensions, were increased in 50 consecutive patients examined, and Eysenck Personality Questionnaire scores suggested less extroversion and increased degree of emotional liability. Succimer (meso-2, 3-dimercaptosuccinic acid) was given at a daily dose of 30 mg/kg for five days in a double-blind, randomized placebo-controlled trial. Urinary excretion of mercury and lead was considerably increased in the patients who received the chelator. Immediately after the treatment and 5 to 6 weeks later, most distress dimensions had improved considerably, but there was no difference between the succimer and placebo groups. These findings suggest that some patients with environmental illness may substantially benefit from placebo.
Language of Publication
English
Unique Identifier
97419307

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MeSH Heading (Major)
Chelating Agents|*TU; Dental Amalgam|*AE; Environmental Illness|*DT/PX; Mercury|*AE/BL/UR; Succimer|*TU
MeSH Heading
Adult; Aged; Comparative Study; Denmark; Double-Blind Method; Female; Human; Lead|BL/UR; Male; Middle Age; Placebo Effect; Support, Non-U.S. Gov't

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
ISSN
1076-2752
Country of Publication
UNITED STATES

Record 44 from database: MEDLINE
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Title
UK audit of relative renal function measurement using DMSA scintigraphy.
Author
Fleming JS; Cosgriff PS; Houston AS; Jarritt PH; Skrypniuk JV; Whalley DR
Address
Nuclear Medicine Software Working Party, Institute of Physics and Engineering in Medicine, York, UK.
Source
Nucl Med Commun, 1998 Oct, 19:10, 989-97
Abstract
A variety of software is used to determine quantitative parameters from radionuclide imaging procedures. Knowledge of the variability of parameter values found in different hospitals is an important aspect of clinical audit of these techniques. This study investigated the variation in relative renal function measurement from static DMSA scintigraphy in the UK. Ten studies representing a range of ages and relative function values were distributed in digital form to 100 hospitals with the assistance of the gamma camera computer suppliers and regional audit coordinators. The studies were analysed at each participating hospital and details of the different techniques and computer systems used were documented. The median value of relative percentage function was assessed for each of the studies. Methods varied in terms of the view used for analysis (54% geometric mean, 46% posterior), the type of background subtraction (single region 32%, separate regions 60%, none 8%) and the definition of the renal regions of interest (73% manual, 27% semi-automatic). Eighty-eight percent of results were within two percentage points of the study median and 98% within five percentage points. There were statistically significant differences observed in the results arising from the view used for the analysis and the background subtraction protocol. The results indicate that relative renal function assessment from static DMSA scintigraphy in the UK is essentially a reliable procedure, although improvements could be made by standardizing the technique used.
Language of Publication
English
Unique Identifier
99250987

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MeSH Heading (Major)
Kidney|*RI; Radionuclide Imaging|*ST; Succimer|*DU/*PK
MeSH Heading
Adult; Child; Gamma Cameras; Great Britain; Human; Kidney Function Tests; Quality Control; Software

Publication Type
JOURNAL ARTICLE
ISSN
0143-3636
Country of Publication
ENGLAND

Record 45 from database: MEDLINE
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Title
Children with moderately elevated lead levels: is chelation with DMSA helpful?
Author
OConnor ME; Rich D
Address
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
Source
Clin Pediatr (Phila), 1999 Jun, 38:6, 325-31
Abstract
This study evaluates the effectiveness (use under routine circumstances) of DMSA (2,3 dimercaptosuccinic acid) and environmental remediation as compared with placebo and environmental remediation on children with blood lead (BPb) levels of 30-45 micrograms/dL (1.45-2.17 mumol/L). The endpoints were BPb at 1 month and 6 months after study entry. This double-blind placebo-controlled trial involved 39 children aged 2-5 years, who were randomized to one course of DMSA or placebo. The mean BPb levels of the two groups at study entry were similar, placebo group 33.0 micrograms/dL (1.59 mumol/L) and the DMSA group 34.9 micrograms/dL (1.68 mumol/L). At 1 month (the end of treatment) the mean BPb levels of the two groups were: placebo group 33.2 micrograms/dL (1.60 mumol/L) and the DMSA group 27.4 micrograms/dL (1.32 mumol/L), p = 0.16. At 6 months, the mean BPb levels were 25.1 micrograms/dL (1.21 mumol/L) for the placebo group and 28.8 micrograms/dL (1.39 mumol/L) for the DMSA-treated group, p = 0.06. Neither of these differences is statistically significant. All children with BPb, in the range studied here, should receive environmental evaluation and remediation; DMSA does not improve long-term blood lead levels.
Language of Publication
English
Unique Identifier
99305852

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MeSH Heading (Major)
Chelating Agents|*TU; Lead|*BL; Lead Poisoning|*/*DI/TH; Succimer|*TU
MeSH Heading
Follow-Up Studies; Human; Support, Non-U.S. Gov't; Support, U.S. Gov't, P.H.S.

Publication Type
JOURNAL ARTICLE
ISSN
0009-9228
Country of Publication
UNITED STATES

Record 46 from database: MEDLINE
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Title
Utility of SPECT DMSA renal scanning in the evaluation of children with primary vesicoureteral reflux.
Author
Merguerian PA; Jamal MA; Agarwal SK; McLorie GA; Bägli DJ; Shuckett B; Gilday DL; Khoury AE
Address
Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Source
Urology, 1999 May, 53:5, 1024-8
Abstract
OBJECTIVES: DMSA renal scanning is more sensitive than ultrasound in detecting renal parenchymal scars. We proposed to determine the utility of single-photon emission computed tomography (SPECT) dimercaptosuccinic acid (DMSA) renal scanning in children with primary vesicoureteral reflux (VUR). METHODS: During a 24-month period, we evaluated the charts of 368 patients who had undergone SPECT DMSA renal scanning for primary VUR. Patients were divided into three age groups: (a) less than 1 year, (b) between 1 and 5 years, and (c) older than 6 years. Renal scars were deemed severe or focal. The data were analyzed to evaluate the utility of SPECT DMSA scanning in children with primary VUR and to determine the indications for performing SPECT DMSA. We also evaluated the sensitivity of recent renal ultrasound technology in detecting focal and diffuse scars. RESULTS: One hundred twenty-eight patients were younger than 1 year at presentation. These included 24 cases that were detected prenatally. One hundred eighty-five were between the ages of 1 and 5 years, and 55 were 6 years or older. Reflux nephropathy at presentation was found in 99 (26.9%) of 368 patients. DMSA scanning changed the treatment in only 13 patients (3.5%). When scarring was diffuse, ultrasound examination correlated 100% with DMSA scanning; when focal scarring was present, the correlation was poor. CONCLUSIONS: Our results suggest that DMSA scans should be tailored to children who have ultrasound abnormalities, high-grade reflux, or recurrent breakthrough urinary tract infections. These guidelines will result in a substantial cost savings and a significant decrease in radiation exposure.
Language of Publication
English
Unique Identifier
99238011

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MeSH Heading (Major)
Radioisotope Renography|*; Succimer|*DU; Tomography, Emission-Computed, Single-Photon|*; Vesico-Ureteral Reflux|*RI
MeSH Heading
Child; Child, Preschool; Evaluation Studies; Female; Human; Infant; Male; Retrospective Studies

Publication Type
JOURNAL ARTICLE
ISSN
0090-4295
Country of Publication
UNITED STATES

Record 47 from database: MEDLINE
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Title
The DMSA scan in paediatric urinary tract infection.
Author
Ditchfield MR; Nadel HR
Address
British Columbia's Children's Hospital, Vancouver, Canada.
Source
Australas Radiol, 1998 Nov, 42:4, 318-20
Abstract
The objective of the present paper was to review the use of the dimercaptosuccinic acid (DMSA) scan in urinary tract infection at British Columbia's Children's Hospital to determine the frequency of cortical defects and the association between vesico-ureteric reflux and the presence of cortical defects in children with urinary tract infection. A total of 129 consecutive children with a urinary tract infection referred for a DMSA scan in a 2-year period (January 1992-January 1994) were retrospectively studied. The results were analysed in terms of kidneys, and the incidence of cortical defects was determined. Eighty-eight patients (68%) had a radiographic micturating cysto-urethrogram within 6 months of the DMSA scan, and in this group the relationship of defects with vesico-ureteric reflux was determined. Overall, 81/258 (31%) of kidneys had a cortical defect on a DMSA scan. Of those who had a micturating cysto-urethrogram, 53/176 (30%) kidneys had vesico-ureteric reflux, and of those that had reflux, 21/53 (40%) had a cortical defect on a DMSA scan. In the group of children without reflux, 38/123 (31%) had a cortical defect. Renal cortical scan defects are common findings in paediatric urinary infection, and frequently occur in the absence of vesico-ureteric reflux. These defects represent either established scars or acute pyelonephritis that can proceed to scarring. The micturating cysto-urethrogram alone is insufficient as a screening modality to identify those kidneys at risk of renal scarring.
Language of Publication
English
Unique Identifier
99050562

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MeSH Heading (Major)
Organotechnetium Compounds|*DU; Succimer|*DU; Tomography, Emission-Computed, Single-Photon|*; Urinary Tract Infections|*RI
MeSH Heading
Acute Disease; Adolescence; Chi-Square Distribution; Child; Child, Preschool; Cicatrix|RI; Female; Human; Infant; Kidney Cortex|RI; Male; Pyelonephritis|RI; Retrospective Studies; Vesico-Ureteral Reflux|RI

Publication Type
JOURNAL ARTICLE
ISSN
0004-8461
Country of Publication
AUSTRALIA

Record 48 from database: MEDLINE
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Title
Randomized placebo-controlled trial of 2,3-dimercaptosuccinic acid in therapy of chronic arsenicosis due to drinking arsenic-contaminated subsoil water.
Author
Guha Mazumder DN; Ghoshal UC; Saha J; Santra A; De BK; Chatterjee A; Dutta S; Angle CR; Centeno JA
Address
Department of Gastroenterology, Institute of Postgraduate Medical Education and Research, Calcutta.
Source
J Toxicol Clin Toxicol, 1998, 36:7, 683-90
Abstract
INTRODUCTION: Chronic arsenic toxicity producing various clinical manifestations is currently epidemic in West Bengal, India, Bangladesh, and other regions of the world. Animal studies have indicated that 2,3-dimercaptosuccinic acid can be used as an oral chelating agent. A prospective, double-blind, randomized controlled trial was carried out to evaluate the efficacy and safety of 2,3-dimercaptosuccinic acid for chronic arsenicosis due to drinking arsenic-contaminated (> or = 50 micrograms/L) subsoil water in West Bengal. METHOD: Twenty-one consecutive patients with chronic arsenicosis were individually randomized (random number; assignment made by individual not evaluating patients) into 2 groups: 11 patients (10 male, age 25.5 +/- 8 years) received 2,3-dimercaptosuccinic acid 1400 mg/d (1000 mg/m2) in the first week and 1050 mg/d (750 mg/m2) during the next 2 weeks with a repeat course 3 weeks later. The other 10 patients (all male, age 32.2 +/- 9.7 years) were given placebo capsules for the same schedule. The clinical features were evaluated by an objective scoring system before and after treatment. Routine investigations including liver function tests, arsenic concentrations in urine, hair, and nails, and skin biopsy evaluations were also completed. RESULTS: Though there was improvement in the clinical score of 2,3-dimercaptosuccinic acid-treated patients, similar improvement was observed in the placebo-treated group. There were no statistical differences in the clinical scores between the 2 groups at the beginning and at the end of treatment. Similarly, no differences were found for the other investigated parameters. CONCLUSION: Under the conditions of this study, 2,3-dimercaptosuccinic acid was not effective in producing any clinical or biochemical benefit or any histopathological improvement of skin lesions in patients with chronic arsenicosis.
Language of Publication
English
Unique Identifier
99082755

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MeSH Heading (Major)
Antidotes|*TU; Arsenic|AN/*PO; Succimer|*TU; Water Pollutants, Chemical|AN/*PO
MeSH Heading
Adolescence; Adult; Chronic Disease; Double-Blind Method; Human; India; Liver Function Tests; Male; Poisoning|DT/PA; Prospective Studies; Skin|PA

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
ISSN
0731-3810
Country of Publication
UNITED STATES

Record 49 from database: MEDLINE
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Title
Five-year study of medical of surgical treatment in children with severe vesico-ureteral reflux dimercaptosuccinic acid findings. International Reflux Study Group in Europe.
Author
Piepsz A; Tamminen Möbius T; Reiners C; Heikkilä J; Kivisaari A; Nilsson NJ; Sixt R; Risdon RA; Smellie JM; Söderborg B
Address
Department of Nuclear Medicine, C.H.U.Saint-Pierre, Brussels, Belgium.
Source
Eur J Pediatr, 1998 Sep, 157:9, 753-8
Abstract
The results of serial dimercaptosuccinic acid (DMSA) imaging over 5 years are reported in 287 children with severe vesico-ureteral reflux entered into the European Branch of the International Reflux Study in Children. The children were randomly allocated to medical (n=147) or surgical (n=140) management and DMSA studies were performed during the follow up period at least 6 months after any urinary tract infection. Abnormal images were classified into four types: (1) large polar hypodensity with normal renal outline; (2) peripheral photon deficient defect(s) in a non-deformed kidney; (3) small renal image with normal contour; and (4) peripheral defect(s) with resultant irregularity of the renal outline. The DMSA findings were abnormal at entry in 235 (82%) with no difference in incidence or severity between the two treatment groups. During follow up, deterioration was observed in 25 medically and 23 surgically treated patients and comprised image deterioration alone in 17, image deterioration with corresponding reduction in differential function in 16 and reduction in relative function without image change in 15, with similar distribution between the two treatment groups. Deterioration was more frequent in children entering the study under the age of 2 years and in those with grade IV rather than grade III reflux. These findings, showing no difference in outcome between children managed surgically or medically, are consistent with the radiological results already published. CONCLUSION: In the International Reflux Study the DMSA scintigraphic data showed no difference in outcome between children managed surgically or medically.
Language of Publication
English
Unique Identifier
98447431

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MeSH Heading (Major)
Succimer|*DU; Vesico-Ureteral Reflux|*RI/SU/*TH
MeSH Heading
Child; Child, Preschool; Comparative Study; Female; Human; Kidney|RI; Male; Recurrence; Support, Non-U.S. Gov't; Urinary Tract Infections|RI

Publication Type
CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
ISSN
0340-6199
Country of Publication
GERMANY

 

Record 50 from database: MEDLINE
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Title
Alterations in membrane lipid dynamics of leukemic cells undergoing growth arrest and differentiation: dependency on the inducing agent.
Author
Nathan I; Ben Valid I; Henzel R; Masalha H; Baram SN; Dvilansky A; Parola AH
Address
Unit of Hematology, Faculty of Medical Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Source
Exp Cell Res, 1998 Mar, 239:2, 442-6
Abstract
The effect of various differentiation inducers on membrane cell dynamics was studied using HL-60 and K562 leukemic cell lines. Membrane lipid dynamics was measured by the steady-state fluorescence polarization (P) method utilizing either 1,6-diphenyl-1,3,5-hexatriene (DPH) or the trimethyl ammonium derivative of DPH (TMA-DPH), which ascertains anchorage of the label to the membrane-water-lipid interface. Decrease in membrane microfluidity was observed in HL-60 cells undergoing differentiation into macrophages by 1,25-dihydroxyvitamin D3 and by K562 cells induced to differentiate by DMSO. Sodium butyrate caused an increase in membrane fluidity in K562 cells undergoing differentiation into erythroid-like cells while in HL-60 cells a dual effect was observed. At 0.4 mM concentration, in which the cells were induced to differentiate along the monocyte pathway, a decrease in membrane fluidity was observed, while at 1 mM concentration an increase in membrane fluidity occurred. Interferon-gamma (IFN-gamma) induced an increase in membrane fluidity in both cell lines. Using HL-60 cells fluorescently labeled by TMA-DPH, similar results indicating fluidization of the membrane following IFN-gamma treatment were obtained. Advanced fluorescence lifetime measurements, evaluated either by phase modulation spectrofluorometry or by single photon correlation fluorometry confirmed that the decrease in fluorescence polarization by IFN-gamma resulted from membrane fluidization and not from elongation of the probe's excited state lifetime. It is suggested that the inducer mode of action, and not the differentiation route, determine the outcome of changes in membrane microviscosity.
Language of Publication
English
Unique Identifier
98189156

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MeSH Heading (Major)
Butyric Acids|*PD; Calcitriol|*PD; HL-60 Cells|*DE/ME; Interferon-gamma, Recombinant|*PD; Leukemia, Erythroblastic, Acute|ME/*PA; Leukemia, Myeloid, Philadelphia-Positive|ME/*PA; Membrane Lipids|*ME; Succimer|*PD
MeSH Heading
Cell Differentiation|DE; Cell Division|DE; Comparative Study; Diphenylhexatriene|AA; Fluorescence Polarization; Fluorescent Dyes; Human; Membrane Fluidity|DE; Tumor Cells, Cultured|DE

Publication Type
JOURNAL ARTICLE
ISSN
0014-4827
Country of Publication
UNITED STATES

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