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At least 1,009 records · Page 56Linked to original sources
PubMed1991

Renal function and technetium-99m-dimercaptosuccinic acid uptake in single kidneys: the value of in vivo SPECT quantitation.

The ability to evaluate kidney function in each kidney separately by quantitative SPECT was tested in 20 patients with a single kidney and varying degrees of renal disease. Technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) uptake was compared with renal function measured by creatinine clearance and serum creatinine. There was a good correlation for both serum creatinine (r = 0.89, y = 24.6 *X -1.15, error = 5.6, p less than 0.001) and creatinine clearance (r = 0.76, y = 0.6 *X 0.84, error = 8.0, p less than 0.001). The results indicate that SPECT quantitation of 99mTc-DMSA uptake can be used as an indicator of the function of each kidney individually.

Adult↗
PubMed1991

The chemical identity of pentavalent technetium-99m-dimercaptosuccinic acid.

The tumor-targeting radiopharmaceutical known as pentavalent technetium-99m-meso dimercaptosuccinic acid (DMSA) has been studied by a variety of techniques in order to elucidate its structure and chemical behavior. The radiopharmaceutical is identical with a chemically characterized sample of [99TcO(DMSA)2]- when studied by mobility methods including thin-layer chromatography, reversed-phase high-performance liquid chromatography, gel filtration, and electrophoresis. The technetium is pentavalent and coordinated by an oxo-ligand and four thiolate sulfurs of two DMSA ligands. No-carrier-added preparations consist of mixtures of three stereoisomers of the square pyramidal, mononuclear complex. The isomers arise from differing orientations of the carboxylate groups in the DMSA ligands and may be designated syn-endo, syn-exo, and anti. All three isomers are significant components of the radiopharmaceutical, raising the question of which are tumor-specific. The carboxylate groups in the complex are almost completely ionized at pH 7, thus the average charge on the complex at this pH approaches -5.

Chromatography, High Pressure Liquid↗
PubMed1991

Iodine 131 metaiodobenzylguanidine scintigraphy of medullary carcinoma of the thyroid.

We have presented a case of sporadic medullary carcinoma of the thyroid with documentation of localization of tracer 131I-MIBG within the primary neoplasm. A review of the nuclear medicine literature of localization techniques for MCT demonstrates that 131I-MIBG, while an excellent choice for diagnosis of pheochromocytoma and neuroblastoma, produces low yield and unpredictable concentration in other neural crest apudomas, including MCT. A low incidence of true-positive results with 131I-MIBG uptake and a high incidence of false-negative results make this radiopharmaceutical a suboptimal choice for diagnostic studies, but a potentially promising one as a therapeutic agent.

3-Iodobenzylguanidine↗
PubMed1990

Pentavalent technetium-99m (V)-DMSA uptake in a pheochromocytoma in a patient with Sipple's syndrome.

This case report describes 99mTc(V)-dimercaptosuccinic acid (DMSA) accumulation in a pheochromocytoma in a patient with Sipple's syndrome. Scintigraphy with 99mTc(V)-DMSA demonstrated uptake in medullary carcinoma of the thyroid gland (MCT). Iodine-131 metaiodobenzylguanidine (MIBG) scintigraphy showed the bilateral pheochromocytomas but did not demonstrate uptake in the MCT.

3-Iodobenzylguanidine↗
PubMed1978

2,3-Dimercaptosuccinic acid: a new agent for the treatment of lead poisoning.

Using minimally lead-poisoned rats, we have measured urinary and fecal lead excretion in response to 2,3-dimercaptosuccinic acid (DMS) administered i.p. or p.o. and compared it to that induced by dimercaptopropanol (BAL) (i.p.), EDTA (i.p.), D-penicillamine (p.o. and i.p.) and the combination of BAL and EDTA (i.p.). At doses of 30 mg/kg, parenterally administered DMS was as effective as i.p. BAL and these two drugs were more effective than the other treatment groups. However, p.o. DMS was only 20% less effective and was as effective as i.p. EDTA and the combination of EDTA + BAL i.p. and significantly more effective than D-penicillamine p.o. or i.p. Unlike BAL, most lead excretion in response to DMS was via the urine, undoubtedly reflecting the greater water solubility of DMS. When mice were fed a diet containing both lead and DMS, the drug prevented the accumulation of porphyrins in erythrocytes. Studies with 210Pb indicate that this prophylactic effect is not due to an inhibition of lead absorption but rather to enhanced excretion of lead. The residual tissue distribution of 210 Pb administered simultaneously with DMS was not different form that of 210Pb alone. Since DMS is orally effective and its LD50 is 30 times greater than that of BAL, we expect this compound to be clinically useful in the treatment of lead poisoning.

Animals↗
PubMed1978

The pharmacology of 2,3-dimercaptosuccinic acid and its potential use in arsenic poisoning.

Arsenic (As2O3)-poisoned rats were treated with either 2,3-dimercaptosuccinic acid (DMS) or dimercaptopropanol (BAL) at doses of 30 mg/kg/day. A control group received no treatment. The total quantity of arsenic excreted was not significantly different in response to 4 days of treatment with either DMS or BAL. In addition, there was no difference between the two drug treatment groups in the residual arsenic content of brain, liver, kidney and spleen after treatment. Both drugs reduced the arsenic content of each tissue to approximately 40% of that of untreated controls. Previous studies have shown that DMS is orally effective for the treatment of lead poisoning. The LD50 of DMS was determined to be in excess of 3 g/kg in rats and mice, approximately 30 times the LD50 of BAL. No gross, histopathological or biochemical evidence of toxicity was observed in mice, rats or dogs which received DMS 5 days per week for 6 months. DMS did not affect the excretion of zinc, iron, calcium or magnesium. Urinary copper excretion was significantly elevated in response to 30 mg/kg of DMS, suggesting that the drug might also be useful for the treatment of Wilson's disease.

Animals↗
PubMed1990

Enalaprilat-enhanced renography in a rat model of renovascular hypertension.

The effect of rapid converting enzyme inhibition (CEI) with intravenous enalaprilat on technetium-99m-(99mTc) diethylenetriaminepentaacetic acid (DTPA) and 99mTc-dimercaptosuccinic acid (DMSA) renograms was evaluated in rats with two-kidney, one-clip renovascular hypertension. Rapid sequential DTPA renograms, performed immediately before and five minutes after enalaprilat injection (30 micrograms/kg), demonstrated a selective decrease in clipped kidney DTPA plasma clearance following CEI and no significant effect on unclipped kidney function. Pre- and post-CEI data were obtained with a single injection of DMSA by administering enalaprilat five minutes after the radiopharmaceutical. Enalaprilat slowed the rate of DMSA accumulation in clipped relative to unclipped kidneys, and reduced the clipped/unclipped kidney ratio of absolute DMSA uptake at 10 and 30 min. DTPA and DMSA were equally effective in demonstrating the CEI effect. Enalaprilat was also compared with captopril (3 mg/kg, intraperitoneally), using sequential DTPA renograms. Clipped kidney DTPA plasma clearance was reduced to an identical degree (40%) by both converting enzyme inhibitors. Clinical renographic protocols can probably be devised to take advantage of the rapid, reliable CEI of enalaprilat, thereby shortening total procedure time.

Animals↗
PubMed1978

Reduction of methylmercury concentration in neonatal rat brains after administration of dimercaptosuccinic acid to dams while pregnant.

Sprague-Dawley rats were gavaged on day 7 of gestation with 1.62, 3.23 or 10 mg methylmercury/kg. Beginning one day later, the dams were administered 0, 20 or 40 mg 2,3-dimercaptosuccinic acid/kg/day until they delivered their pups. Concentrations of methylmercury in the brains of pups whose dams were treated with 20 mg DMSA/kg/day were reduced 50% compared with control pups. 40 mg DMSA/kg/day decreased brain concentrations 70% compared to non-chelated controls. The data indicate that DMSA might be effective in protecting the developing organism against morphological and/or behavioral teratological consequences of methylmercury poisoning in utero.

Animals↗
PubMed1978

The relative effectiveness of some chelating agents as antidotes in acute cadmium poisoning.

An examination has been made of the relative effectiveness of three chelating agents in reducing lethality in acute cadmium poisoning. The chelating agents used were sodium 2,3 dimercaptosulfonate (DMPS), N-Acetyl d,1 penicillamine (NAPA), and 2,3 dimercaptosuccinic acid (DMSA). For cadmium acetate administered ip at a level of 16.9 mg/kg, the oral administration of the chelating agents at a 20:1 mole ratio in three doses subsequent to the cadmium acetate at 20 minutes, 90 minutes, and 210 minutes resulted in a significant enhancement of the survival rate for all three compounds. At this level none of the control animals survived beyond 2 days. On the basis of the experiments carried out here the survival rates decreased in the order sodium 2,3 dimercaptopropane-sulfonate greater than 2,3 dimercaptosuccinic acid greater than N-Acetyl d,l penicillamine. In a study of the effect of the mole ratio of the chelating agent sodium 2,3 dimercaptopropanesulfonate to cadmium acetate on the survival rate, it was found that the survival rate attained a maximum for values between 20 and 60 and dropped off at both higher and lower values. It was also found that for at least one set of conditions, younger animals were better able to survive the administration of cadmium acetate and the antidote than older animals.

Animals↗
PubMed1990

[A study of renal leak of 99mTc-DMSA in maleate-treated rats by factor analysis].

To elucidate renal leak of 99mTc-dimercaptosuccinic acid (99mTc-DMSA) in maleate-treated rats, plasma amino acid levels and urinary excreted % doses of 99mTc-DMSA and 131I-ortho-iodohippurate (131I-OIH) were studied by factor analysis. 0.4 m mol of Na-maleate dissolved in 2 ml of saline was intraperitoneally injected twice at an interval of 20 hours. Four hours later after second injection, mixture of 99mTc-DMSA and 131I-OIH was injected from tail vein. Urine was collected 15 minutes later to calculate the excretion ratios. Then rats were sacrificed by decapitation and blood samples were taken by cardiac puncture to determine plasma levels of amino acids and their metabolites. Urinary excreted % doses of 99mTc-DMSA were 10.1 +/- 1.3% in control group (n = 5) and 10.6 +/- 4.9% in maleate-treated group (n = 10). Of the 10 treated rats, only 2 rats showed clearly increased excretion of 99mTc-DMSA (19.1% and 19.4% respectively and others ranged from 6.2% to 12.0%). Fifteen variables used for factor analysis consisted of the % doses of two kinds of radiopharmaceuticals and 13 kinds of the data of amino acids analysis. Statistical procedures were as follows. Varimax rotation was performed, two factors were extracted and factor scores for each rat were plotted to obtain scattergram. Interpretation of the results led to a hypothesis that renal leak of 99mTc-DMSA might be relevant to decreased glutamine metabolism.

Animals↗
PubMed1990

[Quantitation of absolute and relative renal uptake using 99mTc-DMSA: sequential change in time and correlation with 99mTc-DTPA uptake].

A renal uptake of 99mTc-DMSA as a function of time and correlation between 99mTc-DMSA and 99mTc-DTPA in renal uptake were discussed. The absolute renal uptake of 99mTc-DMSA calculated by complete correction of tissue attenuation and physical decay showed increase by 5 hours after the administration, except one case with congestive heart failure. The net renal counts attained a maximum between 2 to 3 hours after the administration. There was a good correlation (r -0.992, p less than 0.001) between the relative renal uptake of 99mTc-DMSA (2 hour) and that of 99mTc-DTPA (2-3 min). On the contrary, the absolute renal uptake of 99mTc-DMSA as a indicator of total renal function showed a poor correlation (r = 0.419) to GFR calculated from 99mTc-DTPA. The results indicate that the relative renal uptake of 99mTc-DMSA is a reliable quantitative parameter for split renal function. However, the absolute renal uptake of 99mTc-DMSA may be suggested to be a different renal functioning indicator from GFR calculated from 99mTc-DTPA.

Adolescent↗
PubMed1990

99Tcm (v) DMSA: a clinical, planar and SPECT study to evaluate patients with head and neck squamous carcinoma.

Technetium-99m (99Tcm) (v) dimercaptosuccinic acid (DMSA) is a new tumour imaging agent which has been used to image squamous cell carcinoma (SCC) of the head and neck. This study was undertaken to compare planar versus SPECT 99Tcm (v) DMSA scintigraphy in patients with head and neck SCC. Thirty-four patients were studied. Twenty-eight had SCC, and of these, four had received previous treatment with surgery or irradiation. SPECT was as sensitive and as accurate as clinical examination (but more sensitive and accurate than planar scintigraphy) in detecting which patients had cancer and which patients had primary tumours. SPECT was more sensitive and more accurate than planar scintigraphy (but less sensitive and accurate than clinical examination) in detecting lateral neck compartments with metastatic carcinoma. SPECT correctly upstaged 6% of clinically N0 necks. Although SPECT 99Tcm (v) DMSA scintigraphy improved the image quality, sensitivity and spatial resolution of the investigation, it has no role to play in the routine evaluation of patients with head and neck SCC (to include the clinically N0 neck).

Adult↗
PubMed1990

[Clinical analysis of 418 patients with Wilson's disease in traditional Chinese medicine and Western medicine therapy].

From 1974 to 1988, 418 cases of Wilson's disease were treated with TCM-WM in our hospital. 147 cases were of Wilson's type; 149 cases were of pseudosclerosis type; 40 cases were of abdominal and hepatocerebral type; 21 cases were of choreoathetosis type and 21 cases of other types. After a course of treatment for 3 to 6 months, 103 patients showed marked improvement and 286 made some improvement, but no effect was found in 22 patients and 7 deaths were observed. The results were as follows: (1) The mortality in the severe and moderate groups were significantly higher than the mild (P less than 0.05) and the marked effective rate was less than the latter (P less than 0.01). (2) The marked effective rate was lower in abdominal and hepatocerebral type, and no significant difference was found in recovery rate between Wilson's type and pseudosclerosis type.

Adolescent↗
PubMed1990

Determination and metabolism of dithiol chelating agents: X. In humans, meso-2,3-dimercaptosuccinic acid is bound to plasma proteins via mixed disulfide formation.

meso-2,3-Dimercaptosuccinic acid (DMSA) is orally effective for the treatment of chronic lead intoxication in humans. Earlier studies have shown that the majority of DMSA, given p.o. to normal humans, is excreted in the urine as mixed disulfides with L-cysteine. We have developed an assay for the determination of DMSA that has made possible the determination of the form of DMSA in blood and plasma. After p.o. administration of 10 mg DMSA/kg to four normal young men, no unaltered DMSA (unaltered DMSA is the unbound, parent compound; total DMSA consists of unaltered DMSA plus oxidized (disulfide) DMSA and is determined after reduction with dithiothreitol) was found in the blood over an 8-hr period. Only after treatment of blood or plasma with the disulfide-reducing agent, dithiothreitol, was DMSA detected. This indicates that DMSA is in disulfide linkage with plasma proteins and/or non-protein sulfhydryl compounds. Most of the DMSA in the plasma (92-95%) was found to be bound to plasma proteins, mainly albumin. The remaining DMSA may be bound to small molecular weight (less than 10,000 MW) nonprotein sulfhydryl compounds such as cysteine. Plasma protein appears to serve as a depot and reservoir of DMSA, which can exchange for cysteine. The urinary excretion of unaltered DMSA and DMSA mixed disulfides with L-cysteine suggests that this exchange takes place at the kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1990

Scintigraphic evaluation of aggressive fibromatosis.

Despite its benign microscopic appearance, aggressive fibromatosis has potential to recur and infiltrate neighboring tissues. Therefore, it is necessary to determine the exact extent before therapy. In the present study, 11 cases of aggressive fibromatosis were examined scintigraphically using [99mTc(V)]dimercaptosuccinic acid (11 cases) and 67Ga-citrate (7 cases). Technetium-99m-(V)-dimercaptosuccinic acid demonstrated all lesions, while 67Ga-citrate detected 57% of the cases.

Adult↗
PubMed1990

[Quantitative renal DMSA scintigraphy after extracorporeal lithotripsy].

This study reports the results of renal DMSA isotope scan before and after EDAP extracorporeal lithotripsy in 106 patients. An isotope scan was performed before lithotripsy and on the fourth day after lithotripsy and again on the 90th day when alterations were observed on the first post-lithotripsy scan. The assessment of any sequelae was based on the scale of colours of the spectrum, which revealed three types of modifications. The analysis of the results is divided into three periods according to the development in our lithotripsy technique: high firing rates had a success rate of only 40%, with renal scars on isotope scans in 2/3 of cases; low frequency firing rates had a 55% success rate and induced minor changes which were virtually always reversible; in contrast, low frequency firing rates during the 3rd period had a 60% success rate with scars on isotope scans in 1/3 of cases. These isotope scan modifications also depended on the site of the stone. In conclusion, lithotripsy definitely induces renal modifications. The renal parenchyma cannot remain indifferent to lithotripsy beyond a certain threshold. A homogeneous multicentre study with a common protocol is necessary to compare the various lithotriptors and to define cautious and coherent indications for each lithotriptor in the treatment of renal stones.

Humans↗