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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
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