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At least 649 records · Page 36Linked to original sources
PubMed1997

Kidney swelling. Findings on DMSA scintigraphy.

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.

Acute Disease↗
PubMedDate not supplied

Radionuclide measurement of differential glomerular filtration rate.

The authors sought to determine whether radionuclides could provide a reasonable estimate of differential renal function in five normal dogs and six dogs with unilateral segmental renal infarction. Glomerular filtration rate (GFR) of each kidney was measured by the standard technique using constant infusions of 99mTc-DTPA, iothalamate, and creatinine following ureteral catheterization. These results were correlated with total GFR estimated by bolus injection of 99mTc-DTPA and analysis of the plasma 99mTc-DTPA disappearance curve obtained by blood sampling. Differential GFR was then calculated by multiplying the total GFR from double exponential analysis of this curve (DTPA2) by each of three measures of differential function. These include the percent differential uptake of 99mTc-DTPA and 99mTc-DMSA in the posterior projection as well as the geometric mean of 99mTc-DMSA uptake. There were good correlations between differential GFR calculated from iothalamate clearances obtained at ureteral catheterization and all noninvasive methods involving radionuclides and DTPA2 (r = 0.85 - 0.99). Single exponential analysis of the 99mTc-DTPA plasma disappearance curve was less satisfactory. The authors suggest that measurement of total and differential GFR calculated from plasma clearance of 99mTc-DTPA and external counting may be a useful method with potential clinical applications.

Animals↗
PubMedDate not supplied

Radionuclide measurement of differential glomerular filtration rate in urinary tract obstruction.

In a previous study using dogs whose renal function was rendered asymmetric by unilateral infarction, the efficacy of technetium-99m (99mTc) DTPA and DMSA in measuring differential glomerular filtration rate (GFR) was demonstrated. The present study was undertaken to determine whether the same techniques were applicable to unilateral ureteral obstruction. Five normal dogs and nine dogs with partial unilateral ureteral obstruction had determination of glomerular filtration rate by standard techniques using constant infusions of iothalamate and creatinine after ureteral catheterization. These results were compared with total GFR as measured by single injection of 99mTc DTPA and analysis of the plasma disappearance curve. Calculated differential GFR was obtained by multiplying total GFR from double exponential analysis of this curve (DTPA2) by each of three measures of differential function. These included the percent differential uptake of 99mTc DTPA and 99mTC DMSA in the posterior projection as well as the geometric mean of 99mTc DMSA uptake. There were good correlations between differential GFR determined by iothalamate clearances at ureteral catheterization and all noninvasive methods involving radionuclides and DTPA2 ( r = 0.93-0.99). Single exponential analysis of the 99mTc DTPA plasma disappearance curve was less satisfactory than double exponential analysis. These results and those reported previously support the use of radionuclides in the determination of differential GFR in a variety of clinical situations.

Animals↗
PubMed1989

Noncontrast and contrast enhanced MR imaging in the evaluation of partial ureteral obstruction: an experimental study in the micropig.

Twelve Yucatan micropigs (3 controls; 3 sham-operated; 6 with unilateral obstruction) were studied to assess the value of noncontrast and contrast-enhanced (Gadolinium-DTPA) magnetic resonance (MR) imaging in the evaluation of partial ureteral obstruction. MR findings were correlated with findings of quantitative (Tc-99m-DMSA) scintigraphy, and histology. On noncontrast T1-weighted images, the normal porcine kidney demonstrated good corticomedullary contrast (CMC = 16.8% +/- 5.0). Five minutes after administration of Gd-DTPA, there was enhancement of the renal cortex (+24.4% and medulla (+46.2%), and CMC was no longer discernible. Enhancement of the urine within the collecting system (+119.1%) was also observed. The obstructed kidneys demonstrated marked thinning of the renal parenchyma and decreased signal intensity on noncontrast T1- and T2-weighted images (P less than 0.01). Urine in the dilated collecting system did not differ significantly from urine in controls except in the three animals with urinary tract infection (P less than 0.05). Five minutes following injection of Gd-DTPA, there was enhancement of the renal parenchyma in all kidneys. Excretion was seen in three pigs and no excretion in two. Thus, useful information can be obtained in partial ureteral obstruction from both pre-contrast and Gd-DTPA-enhanced MR images of the kidney.

Animals↗
PubMed1987

Oxygen-derived free radical inhibition in the healing of experimental zone-of-stasis burns.

When dehydration, infection, and mechanical trauma are prevented, procedures (such as cooling and/or oral antithromboxane) designed to diminish ischemia in experimental zone-of-stasis burns have been associated with no or only minor improvement in wound healing. To test the hypothesis that ongoing skin damage occurring postburn (PB) may in part be due to release of oxygen-derived free radicals during the 16-hour through 4-day PB period of reperfusion in such burns, beginning immediately and for a period of 5 days PB, equal numbers of guinea pigs received: allopurinol 150 mg/kg PO q 6 h vs. placebo, dimethylsulfoxide (DMSO) 75% applied topically q 12 h vs. placebo, or yeast-derived superoxide dismutase coupled with polyethylene glycol (PEG-SOD, Pharmacia) 10,000 U (Fridovich) given IV q 8 h producing a concentration of 16 U/cc of plasma 8 hr after injection vs. placebo. Gross and histologic examination of wounds by a 'blinded' investigator at 1 week and 3 weeks PB revealed no difference between treatment and control groups when rates of re-epithelialization and frequencies of hair-follicle retention were compared. Using the dosages, routes, and model described, treatment of a zone-of-stasis burn with PO allopurinol (a xanthine oxidase inhibitor), topical DMSO (a scavenger of the hydroxyl radical), or IV PEG-SOD (a scavenger of the superoxide radical) during the first 5 days PB was associated with no increase in the rate of re-epithelialization or frequency of hair follicle retention at 1 and 3 weeks PB when compared with controls.

Allopurinol↗
PubMed1995

Contradictory supranormal nuclear renographic differential renal function: fact or artifact?

We previously reported contradictory supranormal nuclear renographic differential renal function in cases of unilateral hydroureteronephrosis, in which the kidneys with hydroureteronephrosis paradoxically had a greater differential function than the contralateral normal mate, based on diethylenetriaminepentaacetic acid (DTPA) nuclear renography. To evaluate whether DTPA supranormal differential function represented true hyperfunction, patients with DTPA supranormal differential function were evaluated with dimercaptosuccinic acid (DMSA) nuclear renography and the results were compared. A total of 16 patients with unilateral hydronephrosis was identified to have DTPA differential function of 53% or more. They were younger than age 1 year and had never undergone any urological surgery. In all 16 patients the DMSA differential function (mean 51.1%, range 42 to 57%) was lower than their own corresponding DTPA differential function (mean 58.3%, range 53 to 66%, p < 0.0001). In addition, the DMSA differential function was not significantly different from the intuitively anticipated mean of 50% (p = 0.48). The DTPA supranormal differential function identified in our patients was not corroborated by the DMSA differential function. With recent evidence that DMSA differential function may be a better predictor of outcome following relief of unilateral ureteral obstruction consideration should be given to using DMSA as a potentially more relevant method for differential function measurement in the setting of unilateral hydronephrosis. Conversely, until the potential deficiencies of DTPA are fully understood caution should be exercised in the interpretation of DTPA differential function in the setting of hydronephrosis.

Artifacts↗
PubMed1985

The relationship between renal parenchymal mass and absolute quantitation of 99Tcm-DMSA uptake. An experimental study in the growing pig.

Five Gottingen minipigs from the same litter aged 1 month entered the study and right nephrectomies were performed at staggered intervals between weeks 1 and 5. Absolute renal uptake of 99Tcm-DMSA, expressed as a percentage of the administered dose, was recorded in each animal weekly before right nephrectomy and at weekly intervals for 5 weeks post-nephrectomy. Before nephrectomy absolute renal uptake of 99Tcm-DMSA ranged between 16.8 and 21.5% (mean 18.6%) per kidney with no difference between right and left kidneys. After right nephrectomy, uptake in the left kidney approximately doubled within 1 week. No correlation was shown between renal parenchymal mass and absolute 99Tcm-DMSA uptake in paired or solitary normal kidneys undergoing growth or compensatory growth.

Animals↗
PubMed1985

Quantitation of renal function with 99Tcm-DMSA. A comparison with creatinine clearance in children with single kidney.

To study the accuracy of renal function quantification with 99Tcm-DMSA we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two months to fourteen years. Creatinine clearance was normalized to 1.73 m2. DMSA uptake was measured 7 h after intravenous injection. Background subtraction was used and soft tissue attenuation was taken into account. The uptake was normalized in percentage of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (rt = 0.866, p less than 0.01). Normal creatinine clearance range in children (80 to 120 ml min-1/1.73 m2) allowed determination of normal uptake range (36 to 60%). This study indicates that in case of asymmetrical renal impairment renal uptake will reflect split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

Adolescent↗
PubMed1986

Formation of labelled colloid in 99Tcm-DMSA due to the presence of bactericidal fluid.

The possibility that traces of bactericidal fluid in 99Tcm-DMSA could lead to the formation of labelled colloid, was explored. In vitro investigations were undertaken using ultracentrifugation techniques and photon correlation spectroscopy. The latter showed that both contaminated and uncontaminated DMSA contained colloidal (or particulate) material. However the presence of 10 microliters bactericidal fluid as contaminant was shown by ultracentrifugation to result in labelling of this colloidal material when 99Tcm was added to DMSA. Studies in a normal volunteer confirmed the results of the in vitro studies, in that significant liver and spleen uptake was observed after the administration of contaminated 99Tcm-DMSA.

Anti-Infective Agents, Local↗