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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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