Biological behavior and metabolic fate of the BAL analogues DMSA and DMPS.
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A total of 127 patients were examined to determine the efficacy of the use of sonography, angionephroscintigraphy and roentgenocontrast angiography in renal tumors and the importance of these methods in diagnostic studies with suspicion for a renal tumor. All the patients were given ultrasound and radionuclide examination, 86 roentgenocontrast angiography. The study has shown a high sensitivity of all three methods in the diagnosis of sizable renal lesions though each one has a different diagnostic tendency. In vascularized tumors the combined use of sonography and angionephroscintigraphy practically ensures 100% diagnosis in a patient even at the out-patient stage of examination. The main difficulties occur in the differential diagnosis of hypovascular sizable tumors when the comparison of the results of all three methods makes it possible to establish correct diagnosis. The advantage of sonography is the absence of traumatism, that of angiography a possibility to determine the functional activity of both involved and intact kidneys. Roentgenocontrast angiography plays the leading role in defining the involvement of the renal and cava inferior veins by a tumor thrombus.
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It is common practice to dispense radiopharmaceuticals into empty sterile vials for dispatch to the departments where they are to be administered. It has been noted that on withdrawal of technetium-99m dimercaptosuccinic acid injections (99Tcm-DMSA) which have been dispensed into such vials, the activities obtained are lower than expected. To explain this phenomenon, the adsorption of 99Tcm-DMSA onto commercially available, empty, sterile vials has been investigated. The 99Tcm-DMSA solutions were prepared using kits from two manufacturers and were tested in vials from two manufacturers and the original kit vials. Adsorption of 99Tcm in one DMSA/vial combination after storage for 4 h was 49.6% (+/- 4.5% S.E.M.), but typically, adsorption was approximately 12% after 4 h. Although rate of adsorption was found to vary with storage conditions, no conditions satisfactorily overcame the effect. In vials from one manufacturer, the 99Tcm adsorption was predominantly on the glass, while in vials from the other, it was predominantly on the rubber stopper. It is concluded that the compatibility between vials and radiopharmaceuticals must be investigated in the hospital radiopharmacy.
Acute myocardial infarctions were produced by ligature of the left frontal descending coronary artery in 9 dogs. The possibility of scintigraphic imaging with 99mTc-DMSA 4 hrs after intravenous administration was studied. The infarctions were 4, 24 and 48 hrs old. The in vivo scan was positive in only one dog with a 4-hr old infarction. The in vivo scans were confirmed by the analysis of the radioactivity in tissue samples. The accumulation of the radiopharmaceutical increased slightly in 48-hr old lesions; however, this increase was not sufficient for a positive scintigraphic finding. Thus, we do not recommend 99mTc-DMSA for clinical use in acute lesions.
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Experiences are reported on renal imaging with 99mTc-dimercaptosuccinic acid (DMSA) in pediatric nephrology. Because of its low radiation dose, the use of 99mTc-DMSA has advantages in infancy and childhood, while the considerable accumulation of this compound in the renal cortex results in more informative imaging than with other 99mTc-complexes. Not only can the shape, size and position of the kidneys, and the location and extent of renal tumors, cysts and abscesses be visualized, but as a complement to excretory urography this technique contributes even in pyelonephritis to the precise determination of parenchymal damage.
Lead ions have potent neurotoxic activities. At the neuromuscular junction, they depress the neurally evoked release, but strongly facilitate the spontaneous release of transmitter quanta from motor nerve terminals. The mechanisms underlying the latter action of lead were studied in the isolated frog neuromuscular preparation. The evidence presented in this article is consistent with the hypothesis that lead ions inhibit some membranal and intracellular calcium regulatory mechanisms, consequently producing an increase in the intraterminal concentration of ionized calcium, and hence, in spontaneous transmitter release.
Aprotinin (A) and DMSA labelled with 99mTc were compared in patients with normal (NK, n = 12) and diseased kidneys (CRF, n = 13) by means of quantitative serial scans and measurements of blood clearance and urinary excretion. Serial scans only were obtained in additional 13 patients. Scan quality in the NK patients was essentially equal: faster blood clearances, reduced urinary excretions and higher fixations of A in the target compensated for the increased liver uptake. On the other hand, the scan quality in the CRF patients was definitely superior with A, allowing detection of residual functioning parenchyma also in severe kidney failure. Correlation between the net kidney uptake 6 hrs p.i. and the separate hippuran clearance rate was better with A than with DMSA, indicating the feasibility of A in evaluating relative renal function.
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