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At least 1,279 records · Page 71Linked to original sources
PubMed1995

111In-pentetreotide scintigraphy in the post-thyroidectomy follow-up of patients with medullary thyroid carcinoma.

Local and lymphnodal recurrences of medullary thyroid carcinoma (MTC) in thyroidectomy patients with elevated plasma levels of calcitonin and/or CEA can be detected using 111In-pentetreotide (Octreoscan: OCT) scintigraphy, although the sensitivity of this technique in localizing an intrathyroid recurrence of tumor is affected by the low target/non-target uptake ratio. The survival rate of patients with MTC, who have undergone thyroidectomy and who show evidence of a rise in plasma levels of calcitonin and/or CEA is closely linked to the number and localization of the metastases. However the role of conventional imaging techniques (X-rays, US, CT, and MR) in the follow-up after thyroidectomy is controversial. Numerous radiocompounds are currently being used to detect local and distant recurrences of MTC. The present study evaluated OCT and pentavalent 99mTc-dimercapto-succinic-acid (99mTc-DMSA-V) scintigraphy performed in 13 patients with a histologic diagnosis of MTC and in one with MEN 2A, all of whom had undergone thyroidectomy between 3 months and 15 years before. The patients also underwent 123I (NaCI) scintigraphy to evaluate the sites and extension of thyroidal remnants. 111In-pentetreotide scintigraphy was positive in 9/14 patients (64%); the 99mTc-DMSA-V was positive in 5/14 patients (35%). 111In-pentetreotide scintigraphy recognized 18 sites of abnormal uptake (12 in the neck); 9mmTc-DMSA-V detected 9 MTC recurrences in the same patients. In conclusion, 111In-OCT scintigraphy represents, in the authors' experience, a useful method, more sensitive than 9mmTc-DMSA-V, to detect MTC recurrences in patient follow-up post-thyroidectomy.

Adult↗
PubMed1995

111In-octreotide scintigraphy in metastatic medullary thyroid carcinoma before and after octreotide therapy: in vivo evidence of the possible down-regulation of somatostatin receptors.

We have investigated the presence of somatostatin receptors on the cell surface of metastatic medullary thyroid carcinoma in vivo using 111In-Octreotide scintigraphy. Five patients were studied before and three months after therapy with octreotide (300-600 micrograms/day). After each 111In-Octreotide scintigraphy the target/background (T/B) radioactivity ratio was calculated for each detectable metastases. A total of 14/18 metastases showed a reduction in the T/B ratio after therapy, suggesting saturation or down-regulation of the somatostatin receptors on metastases induced by octreotide therapy. Patients also showed a reduction in serum calcitonin levels after therapy. We conclude that 111In-Octreotide scintigraphy may be useful in medullary thyroid carcinoma to evaluate the rationale for somatostatin therapy and to monitor the effect of treatment.

Adult↗
PubMed1995

Radiolabeled somatostatin analog scintigraphy in medullary thyroid carcinoma and carcinoid tumor.

The aim of this study was to evaluate the effectiveness of a recently developed radiolabelled somatostatin analog (111In-pentetreotide) for the detection and localization of both medullary thyroid carcinoma (MTC) and carcinoid tumors, and to compare the results obtained with the results of 99mTc(V)-DMSA, and radioiodinated MIBG imaging. 111In-pentetreotide scintigraphy was performed in 9 patients with MTC and in 9 patients with carcinoid tumor. Whole body and SPECT studies were performed at 4 and 24 hours post-injection. SMS scintigraphy gave a positive result in 5 out of 7 patients with proven MTC lesions, and in 7 out of 9 patients with known lesions of carcinoid tumor. It gave a negative result in 2 MTC patients with high levels of calcitonin but with no evidence of disease at conventional diagnostic modalities. The scintigraphic results were comparable with those obtained with 99mTc(V)-DMSA in MTC and were superior to those of radioiodinated MIBG in both MTC and carcinoid tumors. When compared with the modifications of calcitonin levels brought about by the acute administration of octreotide ("Octeotride test"), these correlated well in 8 out of 9 patients studied.

3-Iodobenzylguanidine↗
PubMed1994

Solitary cold thyroid nodules -- a correlation of fine needle aspiration cytology with pentavalent technetium DMSA scanning and radionuclide perfusion scanning.

Twenty-five patients with solitary cold thyroid nodules (SCN) were studied by fine needle aspiration (FNA) cytology, radionuclide perfusion scanning (RPS) and pentavalent technetium dimercaptosuccinic acid (99m Tc DMSA) scanning, with an aim to distinguish neoplastic from non-neoplastic nodules. All the patients were operated upon and the nodules were subjected to histopathological examination. 13 of the 25 nodules (52%) were malignant (7 papillary carcinomas, 3 medullary thyroid carcinomas and 1 each of follicular carcinoma, insular carcinoma and clinically anaplastic thyroid tumour). The specificity of DMSA scanning and FNA cytology were 100% and that of RPS 60%. The sensitivity of RPS and DMSA scanning were 80% and 20% and that of FNA cytology (using a broad definition of test-positivity), 100%. Additionally, FNA cytology could morphologically type the majority of neoplasms.

Biopsy, Needle↗
PubMed1996

Effects of chelation therapy on hepatic glutathione, lipid peroxidation and phospholipid contents in lead-poisoned rats.

Hepatic lipid peroxidation, glutathione and phospholipid contents of homogenate prepared from the liver of lead-intoxicated male rats treated with 0.3 m mol/kg CaNa2EDTA and DMSA for 8 weeks, either alone or in combination, were investigated. A significant increase in hepatic malondialdehyde (MDA) and a reduction in glutathione levels was noticed. While a marginal decrease in phosphatidyl choline (PC) level was noticed, no effect on phospholipid contents was seen. Treatment with all the three chelating agents elicited decrease in PC level. DMSA alone was partially effective in restoring lead-induced altered hepatic glutathione and MDA levels. Combined treatment may have an adverse effects on hepatic tissue and does not seem to produce immediate recoveries in the lead-induced hepatic damage.

Animals↗
PubMedDate not supplied

Pentavalent 99mTc DMSA: uptake into a variety of human rhabdomyosarcoma xenografts.

BACKGROUND: Rhabdomyosarcoma is a common soft tissue sarcoma of childhood. While Ga is currently the most accurate modality for imaging residual or recurrent tumour its dosimetry is unfavourable. Pentavalent 99mTc DMSA [99mTc (V) DMSA] has been shown to accumulate in this tumour in a limited number of clinical cases. METHODS: Biodistribution of 99mTc (V) DMSA was determined in non-tumour bearing BALB-C mice. Operative specimens from four clinically 67Ga avid tumours were xenografted into nude mice and allowed to reach a significant size. Biodistribution studies were performed after the injection of 99mTc (V) DMSA in all animals and 125I HSA and 67Ga in a limited number of animals. RESULTS: None of the tumours investigated demonstrated significant 99mTc (V) DMSA accumulation. Biodistribution was identical in tumour and non-tumour bearing animals. CONCLUSIONS: Rhabdomyo-sarcoma xenografts do not demonstrate significant uptake of 99mTc (V) DMSA.

Albumins↗
PubMed1997

Followup study of renal function in children with reflux nephropathy after resolution of vesicoureteral reflux.

PURPOSE: We evaluated data collected for 10 years on children with reflux nephropathy to identify a means of predicting the prognosis. MATERIALS AND METHODS: A total of 15 boys and 13 girls were enrolled in this study at least 2 years after surgical and spontaneous resolution of vesicoureteral reflux in 25 and 3 patients, respectively. They were followed for more than 10 years and renal function was periodically evaluated. Urinary beta 2-microglobulin, alpha 1-microglobulin, N-acetyl-beta-D-glucosaminidase, microalbumin and 99mtechnetium dimercapto-succinic acid uptake were measured. RESULTS: Of the 28 patients 12 had high levels of urinary alpha 1-microglobulin during followup, including all 7 in whom renal function deteriorated. In 3 children with elevated alpha 1-microglobulin urinary microalbumin gradually increased after puberty. Although elevated levels of urinary beta 2-microglobulin, N-acetyl-beta-D-glucosaminidase and microalbumin were also observed, they were less predictive of renal function than alpha 1-microglobulin. CONCLUSIONS: These results suggest that elevated urinary levels of alpha 1-microglobulin may predict the risk of abnormal renal function in children with reflux nephropathy even before the appearance of significant proteinuria.

Acetylglucosaminidase↗
PubMed1997

Quantitative evaluation of renal parenchymal mass with 99mtechnetium dimercapto-succinic acid scintigraphy after nephrolithotomy.

PURPOSE: We detected renal parenchymal damage after nephrolithotomy. MATERIALS AND METHODS: We studied 12 patients with renal stones treated with nephrolithotomy. Renal function was determined with serum blood urea nitrogen (BUN) and creatinine values, and 99mtechnetium dimercapto-succinic acid scintigraphy of renal parenchymal tissue was performed before, and 7 days and 3 months after nephrolithotomy. Qualitative and quantitative analyses were done with the Wilcoxon signed rank test. RESULTS: There was no visual difference in size and appearance of the nephrotomy site between preoperative and postoperative visual scintigraphic evaluations. Quantitative data did not reveal any significant difference between kidneys with and without a nephrotomy incision (p > 0.05), as well as between nephrotomy regions and intact parenchyma within the same kidney (p > 0.05) 3 months after nephrolithotomy. There was no significant difference in serum BUN and creatinine levels between values preoperatively and 3 months postoperatively (p > 0.05). CONCLUSIONS: There was no significant change in renal cortical function and functioning renal parenchymal mass after nephrolithotomy as shown by serum BUN and creatinine levels, and 99mtechnetium dimercapto-succinic acid scintigraphy.

Adolescent↗
PubMed1997

Estimation of differential renal function in children with a prenatal diagnosis of unilateral pelvic dilatation.

PURPOSE: We compared the estimation of differential renal function by 99mtechnetium (Tc)-dimercapto-succinic acid (DMSA) and 99mTc-pentetic acid scintigraphic methods for followup of prenatally diagnosed unilateral renal pelvic dilatation. MATERIALS AND METHODS: We retrospectively analyzed differential renal function estimations calculated by static and dynamic methods in time matched test pairs that were included in the charts of 51 children monitored for prenatally diagnosed unilateral renal pelvic dilatation at our institution in a 5-year period. RESULTS: There were 96 test pairs with available archived raw data. Using the analytic method of assessment of agreement between the 2 tests, a 95% limit of agreement of +/-9% was calculated. Of the 96 pairs of tests the results of 94 revealed no significant difference. Subgroup analysis by patient age and operative intervention (13 postoperative pairs) also showed no difference in the results of the 2 tests. CONCLUSIONS: We established the 95% limits of agreement between 99mTc-DMSA and 99mTc-pentetic acid tests of differential renal function to be +/-9% discrepancy in 96 test pairs. During followup of prenatally diagnosed unilateral renal pelvic dilatation the assessment of differential renal function can be made by 99mTc-DMSA static or dynamic diuretic renography techniques. This interchangeability is consistent at all patient ages regardless of operative intervention. Since dynamic diuretic renography provides differential function and drainage data, using 99mTc-DMSA in this context is unnecessary and subjects patients to an unnecessary radiation burden.

Dilatation, Pathologic↗
PubMed1997

Urinary excretion of epidermal growth factor in children with reflux nephropathy.

PURPOSE: We determined urinary levels of epidermal growth factor in children with reflux nephropathy to evaluate the clinical significance of urinary epidermal growth factor. MATERIALS AND METHODS: We studied 59 boys and 41 girls 3 to 15 years old with reflux nephropathy, and 64 boys and 36 girls 3 to 15 years old who were healthy. Levels of urinary epidermal growth factor were determined by sandwich enzyme immunoassay using spot urine samples. We also determined the levels of serum creatinine, urinary alpha 1-microglobulin and urinary microalbumin. Absolute values of function of the left and right kidneys were assessed by 99mtechnetium dimercapto-succinic acid (DMSA) uptake. RESULTS: Levels of urinary epidermal growth factor gradually decreased with age in healthy children. There were low levels of urinary epidermal growth factor in 20 of the 44 patients (45%) with unilateral low DMSA uptake and 18 of the 19 (95%) with low total DMSA uptake (right and left uptakes). Urinary epidermal growth factor significantly correlated with serum creatinine (R = -0.702, p < 0.0001), urinary alpha 1-microglobulin (R = -0.606, p < 0.0001), urinary microalbumin (R = -0.708, p < 0.0001) and total DMSA uptake (R = 0.744, p < 0.0001). CONCLUSIONS: These results suggest that urinary epidermal growth factor may be a useful clinical tool to monitor functional nephron mass in children with reflux nephropathy.

Adolescent↗
PubMedDate not supplied

Comparison of In-111 pentetreotide, Tc-99m (V)DMSA and I-123 mlBG scintimaging in neural crest tumors.

Three radiolabelled substances, 111In-pentetreotide, 99mTc-(V)DMSA and 123I-MIBG with different kinetics but similar tumor seeking behavior, were i.v. injected to assess and correlate their clinical value in metastatic malignant pheochromocytomas (4 patients), stage III and IV neuroblastomas (7 patients) and medullary thyroid carcinomas (6 patients). All II pheochromocytoma/neuroblastoma patients received i.v. a dose of III MBq (3 mCi) of 123I-MIBG and 185 MBq (5 mCi) of 111In-pentetreotide, within approximately weeks each other. Furthermore, in 4 of these patients as well as in all medullary thyroid carcinoma patients 111 MBq (3 mCi) of 99mTc-(V)DMSA were applied i.v. I week prior to the pentetreotide/mlBG scans. Four patients (malignant pheochromocytoma) with a total of 7 foci showing MIBG accumulation had 3 sites with pentetreotide and 1 site with (V)DMSA uptake, while in 7 patients (neuroblastora) with 15 foci showing MIBG accumulation 10 sites had detectable pentetreotide and 3 sites detectable (V)DMSA. Of the three radiotracers, 111In-pentetreotide used for somatostatin receptor identification holds promise mainly in cases where foci imaged with 123I-MIBG are negative. 111In-pentetreotide is unlikely to replace 123I-MIBG as a first-line routine diagnostic scintigraphic modality; compared to pentetreotide or MIBG, (V)DMSA seems to be highly sensitive only in medullary thyroid carcinomas.

3-Iodobenzylguanidine↗
PubMedDate not supplied

Value of 99m-Tc MIBI and 99m-Tc(V) DMSA scintigraphy in evaluation of breast mass lesions.

Among several investigative methods currently undergoing evaluation for the differentiation of biological features of breast mass lesions, mammoscintigraphy with different radiopharmaceuticals appears promising. This study evaluated the efficacy of 99m-Tc MIBI and 99m-Tc(V) DMSA mammoscintigraphy in the detection of malignant focal breast lesions. Mammography, ultrasonography, 99m-Tc MIBI and 99m-Tc(V) DMSA mammoscintigraphy were performed in 51 women with palpable breast mass lesions. Following surgical removal of the abnormalities, histological examination revealed 40 malignant and 11 benign breast mass lesions. In mammoscintigraphy, early (5 minute p.i. of MIBI, 2 hours p.i. of DMSA) and late (2 hours p.i. of MIBI and 5 hours p.i. of DMSA) planar images of the breast and the axillary regions were evaluated visually and quantitatively. The efficacy of the methods was assessed via ROC curves and variance analysis. The visual scores and the quantitative T/NT values with MIBI demonstrated a significant difference between malignant and benign breast mass lesions. A significant difference was also found as concerns the grade of malignancy from the MIBI accumulation. The late MIBI images seemed optimal. The DMSA values indicated no relationship with the breast lesion malignancy. In the detection of metastatic lymph node involvement the sensitivity and specificity with mammography and ultrasonography were 57% and 85%, with MIBI 53% and 81%, and with DMSA 53% and 95%, respectively. It is concluded that MIBI (2 hours p.i.) mammoscintigraphy is a useful and simple method for differentiation of malignant breast abnormalities from benign lesions and for determination of the grade of malignancy. DMSA mammoscintigraphy appears superior to MIBI only in the detection of axillary lymph node metastases.

Adult↗
PubMedDate not supplied

Inhibitory effects of seven organosulphur compounds on clinical isolates of Candida species in vitro.

Thirty clinical isolates of Candida albicans and 10 other Candida species were tested for susceptibility to 6 substituted dithiocarbamates and one dimercaptosuccinate. Dimethyldithiocarbamate, sodium pyrrolidine dithiocarbamate, and sodium diethyldithiocarbamate showed dose-dependent antifungal activity which was partially reversed by the addition of zinc, copper, or iron sulfate with greatest reversal at 2:1 metal to dithiocarbamate molar ratio. Anaerobiosis also interfered with dithiocarbamate antifungal activity.

Anaerobiosis↗
PubMed1997

Full reversal of Pb++ block of L-type Ca++ channels requires treatment with heavy metal antidotes.

The mechanisms of Pb++ block and unblock of L-type Ca++ channel currents were measured using ventricular myocytes or the cloned channel. The cloned channel was expressed in either Xenopus laevis oocytes or human embryonic kidney cells (HEK 293, stable transfectants). The threshold for Pb++ block was 1 nM, and the apparent IC50 value was 152 nM in oocytes and 169 nM in HEK 293 cells. Pb++ block was dependent on the composition of the external recording solution but not dependent on the subunit composition of the channel. Pb++ block was voltage dependent, with little block observed at negative test potentials using low concentrations of Pb++. Strong depolarizations (>+100 mV) reversed Pb++ block, allowing measurement of reblock kinetics. Reblock was fast (tau = 11 msec), as measured during a +20-mV test pulse. Simple washout did not completely reverse Pb++ block, especially after exposure to concentrations of >100 nM. Full recovery could only be observed after treatment with heavy metal antidotes such as meso-2,3-dimercaptosuccinic acid, 2,3-dimercapto-1-propanesulfonic acid and EDTA. These results suggest that Pb++ blocks voltage-gated Ca++ channels by two mechanisms and that full reversal of lead block requires chelator treatment.

Animals↗
PubMed1997

New renal scars in children with urinary tract infections, vesicoureteral reflux and voiding dysfunction: a prospective evaluation.

PURPOSE: Established renal scarring represents areas of the kidney that imaging reveals to be damaged at presentation for medical management of urinary tract infection. New renal scarring represents new renal damage in parts of the kidney that imaging reveals to be normal at presentation. We attempted to characterize patients in whom new renal scars developed while they were under our care. MATERIALS AND METHODS: In 1988 a data base was started to identify patients with new renal scarring. All patients presenting with urinary tract infections were enrolled. Our data base has 250 possible fields per event with multiple events per patient. More than 2,100 patients have been enrolled to date. All patients with pyelonephritis, defined as a febrile urinary tract infection with flank pain and tenderness, and all with reflux underwent dimercapto-succinic acid (DMSA) scan at least 4 months after presenting with infection to assess established renal scars. New renal scars were identified when new renal defects were demonstrated on a second DMSA scan. RESULTS: In our data base there are 1,426 patients with urinary tract infections, 685 (46%) with pyelonephritis and 1,062 (74.5%) with vesicoureteral reflux, including 558 found to have bilateral vesicoureteral reflux and 504 diagnosed with unilateral reflux. A history of daytime urinary incontinence was noted in 538 patients (37.7%), 192 (13.5%) had established scars at initial presentation and in 31 (2.1%) new renal scars developed while they were under our care, including 30 with established scars as well. Of the 25 patients in whom new renal scars developed while on medical therapy 11 underwent surgery. In 6 patients with dysfunctional voiding who were receiving medical treatment renal scars developed postoperatively. Surgery was performed in 17 of the 31 patients and 24 (77%) with new renal scars had a history of dysfunctional voiding. CONCLUSIONS: Previous characterizations of patients with new renal scars have relied on excretory urography for assessing renal architecture and ignored voiding patterns of the children affected. Using the DMSA scan we identified 31 children with reflux, urinary tract infection and dysfunctional voiding in whom new renal scars developed while they were under our care.

Adolescent↗
PubMed1997

Plasma endothelin-1 level in patients with renovascular hypertension - does the kidney with stenosis of the renal artery upregulate production of endthelin-1?

PROBLEM: To examine the value of plasma endothelin-1 (ET-1), we measured the level of plasma ET-1 activity of peripheral venous blood and selective renal venous blood in renovascular hypertension patients, and compared that activity with corresponding renin activity and split renal function. METHODS: ET-1 level, renin activity in selective renal venous blood and peripheral venous blood, and 99mTc-dimercaptosuccinic acid renal uptake as a split renal function test were measured in 11 patients (mean 42.1 years old) with renovascular hypertension (RVH) and 6 patients with both renal cell cancer (RCC) and essential hypertension. RESULTS: 1. In patients with RVH, resting peripheral venous plasma ET-1 ranged from 0.6 to 8.1 (mean 4.07) pg/ml and was higher than the normal level (p <0.01). However, the renal vein ET-1 ratio was nor correlated with the renal vein renin ratio. 2. In patients with RCC, resting peripheral venous plasma ET-1 was not different from the normal level. There was no step-up of plasma ET-1, or renin among renal veins, or the proximal and distal parts of the interior vena cava. 3. Both renal vein renin ratio and renal vein ET-1 ratios were inversely correlated with t99mTC-dimercaptosuccinic acid renal uptake as a split renal function examination in patients with RVH. 4. The peripheral plasma ET-1 level was correlated with the degree of stenosis of the renal artery in patients with RVH of a unilateral lesion, but not bilateral lesions. CONCLUSION: These results suggest that ET-1 may take part in the hypertensive mechanisms of RVH in addition to the renin-angiotensin system, but its significance in RVH still remains to be examined.

Adolescent↗