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At least 541 records · Page 30Linked to original sources
PubMed1997

The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis.

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.

Female↗
PubMed1999

Does the endoscopic incision of ureteroceles reduce the indications for partial nephrectomy?

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.

Electrocoagulation↗
PubMed2000

The efficacy and parenchymal consequences of extracorporeal shock wave lithotripsy in infants.

OBJECTIVES: To determine the efficacy of extracorporeal shock-wave lithotripsy (ESWL) in young children and to evaluate, using renal scintigraphy, any possible adverse effects on renal parenchyma. PATIENTS AND METHODS: From January 1991 to October 1998, 19 infants (aged 5-24 months) underwent ESWL for kidney urolithiasis using a Sonolith 3000 (14 kV, Technomed Corp, Lyon, France) or a Nova (14-20 kV, Direx Medical Systems, Paris, France) lithotripter. The treatment and its effects were evaluated using a physical examination, conventional imaging (plain abdominal X-ray and ultrasonography) and renal scintigraphy 24 h before ESWL and again at least 6 months after the last session of treatment. RESULTS: Ten children were rendered stone-free by ESWL after one session and 18 after two sessions. At the follow-up (8 months to 8 years, mean 36 months) no hypertension was recorded and no acquired parenchymal damage was detected with conventional imaging. No scars or significant variation of differential function attributable to ESWL were identified on renal scintigraphy. CONCLUSION: ESWL is clearly effective for treating infant urolithiasis. There were no renal parenchymal lesions associated with ESWL, even in previously damaged kidneys or after the treatment of staghorn calculi. A long-term follow-up (assessing blood pressure) is mandatory and renal scintigraphy before and 6 months after ESWL in infants is recommended to confirm these results in a larger series.

Child, Preschool↗
PubMed1996

Assessment of the role of the glutathione and pentose phosphate pathways in the protection of primary cerebrocortical cultures from oxidative stress.

Reactive oxygen species have been implicated in neuronal injury associated with various neuropathological disorders. However, little is known regarding the relationship between antioxidant enzyme capacity and resultant toxicity. The antioxidant pathways of primary cerebrocortical cultures were directly examined using a novel technique that measures pentose phosphate pathway (PPP) activity, which is enzymatically coupled to glutathione peroxidase (GPx) detoxification of hydrogen peroxide (H2O2). PPP activity was quantified from data obtained by gas chromatography/mass spectrometry analysis of released labeled lactate following metabolic degradation of [1,6-(13)C2, 6,6-(2)H2] glucose by cerebrocortical cultures. The antioxidant capacity of these cultures was systematically evaluated using H2O2, and the resultant toxicity was quantified by lactate dehydrogenase release. Exposure of primary mixed and purified astrocytic cultures to H2O2 caused stimulation of PPP activity in a concentration-dependent fashion from 0.25 to 22.2% and from 6.9 to 66.7% of glucose metabolized to lactate through the PPP, respectively. In the mixed cultures, chelation of iron before H2O2 exposure was protective and resulted in a correlation between PPP saturation and toxicity. Conversely, addition of iron, inhibition of GPx, or depletion of glutathione decreased H2O2-induced PPP stimulation and increased toxicity. These results implicate the Fenton reaction, reflect the pivotal role of GPx in H2O2 detoxification, and contribute to our understanding of the etiological role of free radicals in neuropathological conditions.

Amitrole↗
PubMed1990

[Medullary carcinoma of the thyroid and 99mTc(V)-DMSA scintigraphy. Clinical results with a new radiopharmaceutical].

99mTc(V)-DMSA scintigraphy is a non-invasive diagnostic tool for diagnostic differentiation and localisation of medullary carcinoma of the thyroid. For primary tumours its sensitivity is 77%. This diagnostic means is not only helpful for the diagnosis of primary tumours, but is especially informative for recidives and metastases of the medullary carcinoma of the thyroid. Its sensitivity for recidives and metastases is 66%. The sensitivity obtained in our study, which included four patients, corresponded to that reported in the literature.

Aged↗
PubMed1993

DMSA scintigraphy in renal duplex system.

During a 4-year period 40 children (13 boys and 27 girls) with renal duplex system were examined with DMSA scintigraphy. The age at the investigation varied from 18 days to 9 years, mean 2.5 years. Duplicated system existed in 52 kidneys, bilaterally in 12 cases, right-sided in 10 and left-sided in 18 cases. The renal DMSA scintigraphy of the 52 duplicated kidneys revealed insignificant parenchymal damage in 19 kidneys. Moderate parenchymal damage existed in 10 kidneys. In the remaining 23 kidneys, severely deteriorated function of the upper moiety was found in 15 cases and of the lower pole in 9 cases, as both moieties were affected in one kidney. The function of the severely deteriorated moiety varied between 0% and 14%, mean 5.7% of the total renal function. All the 23 cases with severely deteriorated function were operated upon, 22 with heminephrectomy and one with nephrectomy. The assessment of parenchymal function of the separate parts of the kidney with duplex system by DMSA scintigraphy is of great value in the decision of management and surgical procedure.

Child↗
PubMed2000

Mercury poisoning.

Explore the source record for details and available documents.

Acute Disease↗
PubMed1996

Low lead levels stunt neuronal growth in a reversible manner.

The developing brain is particularly susceptible to lead toxicity; however, the cellular effects of lead on neuronal development are not well understood. The effect of exposure to nanomolar concentrations of lead on several parameters of the developing retinotectal system of frog tadpoles was tested. Lead severely reduced the area and branchtip number of retinal ganglion cell axon arborizations within the optic tectum at submicromolar concentrations. These effects of lead on neuronal growth are more dramatic and occur at lower exposure levels than previously reported. Lead exposure did not interfere with the development of retinotectal topography. The deficient neuronal growth does not appear to be secondary to impaired synaptic transmission, because concentrations of lead that stunted neuronal growth were lower than those required to block synaptic transmission. Subsequent treatment of lead-exposed animals with the chelating agent 2,3-dimercaptosuccinic acid completely reversed the effect of lead on neuronal growth. These studies indicate that impaired neuronal growth may be responsible in part for lead-induced cognitive deficits and that chelator treatment counteracts this effect.

Animals↗
PubMedDate not supplied

Different associations of blood lead, meso 2,3-dimercaptosuccinic acid (DMSA)-chelatable lead, and tibial lead levels with blood pressure in 543 former organolead manufacturing workers.

In this study, the authors' objective was to determine the influence of blood lead, meso 2,3-dimercaptosuccinic acid (DMSA)-chelatable lead, and tibial lead on systolic and diastolic blood pressures and on hypertension in 543 former organolead manufacturing workers. All workers had past exposure to inorganic and organic lead. The authors used linear regression to model systolic and diastolic blood pressure separately, and logistic regression was used for the modeling of hypertension status (i.e., systolic blood pressure > 160 mm Hg, diastolic blood pressure > or =96 mm Hg, or current use of antihypertensive medications). Blood lead, DMSA-chelatable lead, and tibial lead levels had means (standard deviations appear within parentheses) of 4.6 microg/dl (2.6 microg/dl), 19.3 microg (17.2 microg), and 14.4 microg/g (9.3 microg/g), respectively. The authors adjusted for covariates, and they found that blood lead was a predictor of (1) both systolic and diastolic blood pressures and (2) hypertension status in men < 58 y of age. DMSA-chelatable lead and tibial lead were not associated with any of the blood pressure measures. Systolic blood pressure was elevated by blood lead levels as low as 5 microg/dl. We speculate that lead may have a transient influence on blood pressure that is related to target dose levels obtained once release of lead from body stores has occurred.

Adult↗
PubMedDate not supplied

Associations of subtypes of hemoglobin with delta-aminolevulinic acid dehydratase genotype and dimercaptosuccinic acid-chelatable lead levels.

Hemoglobin in erythrocytes may be an important intravascular site of lead binding. We examined associations of hemoglobin subtypes A1 and A2 with delta-aminolevulinic acid dehydratase (ALAD) genotype, a protein that is another important site of erythrocyte lead binding. After oral administration of dimercaptosuccinic acid (DMSA-chelatable lead), we also examined 4-h lead excretion, which provides an estimate of bioavailable lead stores. We randomly selected 57 South Korean current lead battery manufacturing workers from two plants (N = 290 employees) and from two ALAD genotype strata (ALAD1-1 and ALAD1-2). These workers voluntarily administered 5 mg/kg oral DMSA. We frequency-matched subjects with ALAD1-1 (n = 38) to subjects with ALAD1-2 (n = 19) with respect to duration of employment in the lead industry. Blood lead levels ranged from 11 to 53 microg/dl (mean +/- standard deviation, 25.4 +/- 10.2 microg/dl). After administration of oral DMSA, workers excreted a mean lead level of 85.4 (standard deviation, 45.0 microg; range, 16.5-184.1 microg). Hemoglobin A1 and A2 ranged from 3.7% to 9.9% and 1.6% to 5.9%, respectively (mean +/- standard deviation, 6.2 +/- 1.0% and 2.7 +/- 0.8%, respectively). Subjects with ALAD1-1 had elevated mean hemoglobin A1 levels (adjusted p = .05). In addition, higher hemoglobin A1 levels were associated with higher DMSA-chelatable lead levels (adjusted p = .03). This, as well as the results of prior research, suggest that both ALAD and hemoglobin A1 may be important lead-binding sites that influence urinary lead excretion after administration of DMSA.

Administration, Oral↗
PubMed1996

Comparative evaluation of chelating agents on the mobilization of cadmium: a mechanistic approach.

A comparative evaluation of chelating agents, namely, diethyl dithiocarbamate (DDC), dimethyl dithiocarbamate (DMDC), 1,4,8,11-tetraazacyclotetradecane (CYCLAM), 1,4,8,12-tetraazacyclopentadecane (TACPD), 2,3-dimercaptosuccinic acid (DMSA), and 2,3-dimercapto-1-propane sulfonate (DMPS) was conducted to assess their efficacy against acute cadmium (Cd) toxicity. DMSA and DMPS appeared to be most effective in reducing mortality as well as Cd burden of liver, kidneys, and brain in cadmium intoxicated mice. DMDC reduced Cd levels only in liver and kidneys, while DDC significantly enhanced its level in brain. CYCLAM and TACPD significantly increased the Cd level in liver and kidneys and were ineffective in brain. The therapeutic index as well as therapeutic efficacy was highest for DMSA followed by DMPS and DMDC. A fair degree of correlation was found to exist between (1) stability constant of Cd chelates and percent survival (r = .438, (2) stability constant and percent transport (r = .479), and (3) percent survival and percent transport (r =.447). However, the lipophilicity did not show any appreciable correlation with percent survival and stability constant of Cd chelates.

Animals↗