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PubMedDate not supplied

Clinical response to therapeutic agents in poisoning from mercury vapor.

Exposure to mercury vapors for an hour per working day over a period of 13 years produced in a thermometer manufacturer severe signs and symptoms of mercury poisoning. Complete disability developed insidiously over the last six months of employment. During the first two months of observation, the patient was treated in succession with three chelating agents: 2,3-dimercapto-l-propanol (BAL), D-penicillamine and sodium diethyldithiocarbamate (Dithiocarb). Each agent was administered initially for a period of approximately two weeks. A second course of therapy with BAL was administered for three days. Of the three complexing agents used, BAL gave the most dramatically favorable clinical response and yielded the highest urinary excretions of mercury. Dithiocarb was partially effective; d-pencillamine proved to be essentially ineffective. Analyses of the patient's sweat indicated that appreciable amounts of mercury were excreted by this route. Following the alleviation of the severe symptoms by BAL, the patient was placed on a regimen of daily sweats and physio-therapy for a protracted period of several months. On this latter regimen, the mercury levels in the urine, blood serum and sweat were decreased to within the normal ranges of values. The patient made a complete and uneventful recovery. In patients encountering psychotic and neurological disorders of undetermined etiology, consideration should be given to unsuspected or masked chronic exposure to mercury vapors as a possible cause.

Adult↗
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↗
PubMed1979

Restrictions on the applicability of mixed ligand chelate therapy (MLC) in acute cadmium intoxication.

An experimental study of the comparative effectiveness of single and mixed ligand chelates as antidotes for acute cadmium poisoning reveals few appreciable differences when the cadmium (as cadmium chloride or acetate) is administered ip. In each case the mixed ligand chelate system showed little or no improvement over the results obtained with the most effective of the individual components. This procedure, using mixed ligand chelate systems, may well be one which is limited to conditions more narrowly similar to those reported by Schubert and Derr (1978). It does not appear to possess the broad range of applicability which might be expected from the equilibrium principles on which it is based. By comparing our data with previous studies it can be seen that Na2CaEDTA is capable of offsetting the lethality of ip cadmium chloride when the latter is administered at rather higher levels that have previously been counteracted by any of the sulfur containing chelating agents tested to date.

Acute Disease↗
PubMed1990

Short-term smoking reduction is associated with reduction in measures of lower respiratory tract inflammation in heavy smokers.

The beneficial effect of short-term smoking reduction in reducing lower respiratory tract inflammation was assessed in 15 healthy heavy smokers. All underwent fibreoptic bronchoscopy and bronchoalveolar lavage and were then treated with at least 20 mg of nicotine gum daily. Self-reported cigarette consumption decreased from 50.7 +/- 2.3 to 18.8 +/- 1.5 (p less than 0.001) cigarettes daily, and expired CO decreased from 48.5 +/- 2.5 to 27.3 +/- 2.5 ppm (p less than 0.001). After two months, repeat bronchoscopy and bronchoalveolar lavage revealed that bronchial inflammation, as assessed by direct inspection, neutrophilia of bronchial lavage fluid, and the number of alveolar macrophages, the number of alveolar neutrophils and the concentration of neutrophil elastase alpha 1-antiprotease complex in alveolar lavage fluid, had improved significantly. The present study suggests that smoking reduction may be associated with an improvement in lower respiratory tract inflammation in heavy smokers and may, if persistent, be an alternative for smokers who cannot, or do not wish, to quit.

Adult↗
PubMed1990

[Treatment of mercury-induced organ damage].

At the instance of a case of severe Hg-induced proteinuria the efficiency of a complex former therapy with sulfactin (BAL) is demonstrated, which led to the complete elimination of the protein excretion in the urine. For this other possibilities of a complex-forming therapy for hydrargyrism are discussed and consequences for the occupational-medical and clinical treatment are shown.

Acute Kidney Injury↗
PubMed1990

Influence of Rhodococcus equi on the respiratory burst of resident alveolar macrophages from adult horses.

Opsonized Rhodococcus equi activated the respiratory burst of resident alveolar macrophages (AM) from adult horses in a logarithmic-linear, mass-related manner. The effect of R equi was not significantly different from that of equal masses of opsonized zymosan A. Therefore, R equi does not appear to attenuate the respiratory burst of equine AM. The stimulatory effect of R equi was not reflected by increased production of superoxide anion (O2-), but increased activity of the hexose monophosphate shunt was observed. These results suggest a similarity between the respiratory burst of AM from horses and that of AM from rabbits. We concluded that resident AM from adult horses do not produce O2- concurrently with an increase in activity of the hexose monophosphate shunt when stimulated with either opsonized zymosan A or opsonized R equi. This suggests that O2- is not an important component of the antibacterial defenses of equine AM. Whether equine AM are incapable of producing O2- or require different stimuli to produce it was not determined.

Animals↗
PubMed1989

Acute mercury vapour intoxication: report of six cases.

In a group of six workers acutely exposed to metallic mercury vapour in a confined space, one patient had acute renal and respiratory failure which required daily haemodialysis and mechanical ventilation, another had acute bilateral pneumonitis with respiratory insufficiency, and the other four had corrosive oropharyngeal mucositis with a 'flu-like syndrome. Serum and urinary mercury showed an obvious correlation with the clinical picture. After removal from the source of exposure and the institution support measures (including chelant therapy in the first two patients), all recovered without evidence of residual damage.

Acute Disease↗
PubMed1989

[Synthesis and study of the convulsant action of polycyclic amino-gamma-lactone and of its tetrahydrofuran analogue].

In this paper, the synthesis of the gamma-benzyl-amino-gamma-lactone 6 and its tetrahydrofuran analogue 8 is described. Their convulsant action was studied in mice. They display a weak convulsant activity coming with sedation and myorelaxation. The introduction of the benzyl group abolishes the strong convulsant and lethal action characteristic of the already studied non benzylated aminolactones but leaves intact the aminoethers activity. These results could indicate that the activity of these amino-gamma-lactones is essentially antiglycinergic and those of the corresponding aminoethers is anti-GABAergic lined with a partial agonist action.

Animals↗
PubMedDate not supplied

Atypical Wilson disease--a case report with CT scan.

A case of atypical Wilson disease is being reported. Possible mechanism of the process, diagnostic features and CT appearance of brain is described. Early detection and therapy with copper chelating agents result in neurologic and performance improvement of patients.

Child↗
PubMed1989

Comparative effects of chelating agents on distribution, excretion, and renal toxicity of inorganic mercury in rats.

The effects of three chelating agents, sodium N-benzyl-D-glucamine dithiocarbamate(NBG-DTC), 2,3-dimercaptopropanol(BAL), and D-penicillamine(D-PEN), on the distribution, excretion, and renal toxicity of inorganic mercury were compared in rats exposed to HgCl2. Rats were injected i.p. with 203HgCl2 (300 micrograms of Hg and 2 microCi of 203Hg/kg) and 30 min or 24 h later they were injected with a chelating agent (a quarter of an LD50). The injection of the chelating agents significantly enhanced the biliary and urinary excretions of mercury. BAL was the most effective for removal of mercury from the body at 30 min after mercury treatment. The extent of enhancing effect of the chelating agents for removal of mercury at 24 h after mercury was in the order NBG-DTC = BAL greater than D-PEN. The injection of BAL at 24 h after mercury treatment caused the redistribution of mercury to the heart and lung. NBG-DTC did not result in the redistribution of mercury to the heart, lung, and brain. Urinary excretion of protein and AST significantly increased 24-48 h after mercury treatment and decreased to the control values 72 h after mercury. The injection of the chelating agents at 30 min after mercury treatment significantly decreased the urinary excretion of protein and AST. In rats pretreated with mercury 24 h earlier, the chelating agents significantly decreased the urinary protein at 48 h after mercury treatment, but did not decrease the urinary AST. The results of this study indicate that the chelating agents are effective in removing mercury from the body, resulting in the protective effect against the mercury-induced renal damage.

Animals↗