Kombinierte Ventilations- und Inhalationsszintigraphie Während konventionelle Lungenfunktionsparameter zur Bestimmung ventilatorisch und atemmechanisch bedingten Verteilungsstörungen nur eine funktionelle Beurteilung erlauben, ermöglichen die Methoden der Ventilations- und Inhalationsszintigraphie eine regional funktionelle Zuordnung. Bei obstruktiven Lungenerkrankungen kann durch den Einsatz von Aerosolen gezielt eine Verteilungsstörung nachgewiesen werden, die um so ausgeprägter ist, je weniger sich im Szintigramm (regional) die Lungenperipherie darstellen läßt. Mit einer gleichzeitig durchgeführten Xenon-133-Ventilation kann differenziert werden, ob es sich um eine obstruktionsbedingte Minderbelüftung handelt ( Ventilations-Inhalations-Mismatch), oder ob die Belüftung bestimmter Lungenareale funktionell ausgefallen ist ( Ventilations-Inhalations-Match). Ziel unserer Untersuchung war es herauszufinden, in welcher Beziehung die regionale Darstellung der Ventilations-Inhalations-Konstellationen zu konventionellen Inhomogenitätsparametern der Lungenfunktion bei Patienten mit COPD steht und inwieweit Informationen über die Lungenfunktion hinaus erlangt werden können. Patienten: Wir untersuchten 32 Patienten mit chronisch obstruktiver Lungenkrankheit (COPD) im Alter zwischen 17 und 68 Jahren. Die Untersuchung der Patienten wurde in einem möglichst beschwerdefreien Intervall unter klinischer Fragestellung durchgeführt. Methodik: Die Patienten wurden mittels folgender Methoden untersucht:1. Lungenfunktionsdiagnostik: Fluß-Volumen-Kurve, Bodyplethysmographie, FRC-Rebreathing, Diffusionsmessung und Impulsoszillometrie. 2. Szintigraphische Untersuchung: Alle Patienten wurden zur Darstellung der belüfteten Lungenabschnitte einer Xenon-133-Ventilationsszintigraphie und im Anschluß daran einer Technetium-99m-DTPA-Inhalationsszintigraphie unterzogen. Xenon-133 wurde im single-breath Verfahren mit 10 Sekunden Atemanhaltezeit verabreicht. Die Inhalation von Technetium markierten Aerosolpartikeln erfolgte mittels eines Verneblersystems. Die Patienten atmeten das Aerosol 7 Minuten langsam und ruhig ein. Die quantitative Auswertung erfolgte mittels interessierender Regionen (ROI) und eines Scores. Statische Szintigramme wurden nach einem Score in 4 Gruppen entsprechen verschiedener Ventilations-Inhalations-Konstellationstypen ( Mismatch, Match) eingeteilt. Ergebnisse: Bei Patienten mit COPD wurden nuklearmedizinisch 3 Schweregrade von Ventilationsstörungen unterschieden: geringgradiges Ventilations-Inhalations-Mismatch, ausgeprägtes Ventilations-Inhalations-Match, pathologisches Ventilations-Inhalations-Match. Im Vergleich der Schweregradeinteilung der Verteilungsstörungen durch Methoden der konventionellen Lungenfunktionsdiagnostik und der Nuklearmedizin ergibt sich eine hochsignifikante Korrelation. Von den 22 Patienten, die pathologische Lungenfunktionswerte aufwiesen, ergaben sich auch zu 95 % Veränderungen in der Szintigraphie, währenddessen zeigten von den 28 Patienten mit pathologischer nuklearmedizinischer Bewertung nur 75% pathologische Inhomogenitätsparameter. Die Methode der Ventilations- und Inhalationsszintigraphie erwies sich somit als sensitiver. / Combination of ventilation and inhalation scintigraphy While conventional parameters to determine the ventilatory and respiratory-mechanical distribution disturbances allow a functional assessment only, the methods of ventilation and inhalation scintigraphy enable a regional functional categorization. With obstructive pulmonary diseases, a disturbance of distribution can be traced with the help of aerosols, the disturbance of distribution being the more severe the less the regional periphery of the lung can be imaged in the scintigram. A simultaneous xenon-133-ventiation, which is performed in selected cases, allows to differentiate between an obstructive underventilation (ventilation-inhalation mismatch) and the functional failure of ventilation of definite areas of the lung (ventilation-inhalation match). It was the aim of our investigation to find out the relation between the regional demonstration of the different ventilation-inhalation patterns and conventional parameters of inhomogeneity in patients with COPD. Is it possible to get more informations by scitigraphic methods and is there perhaps a parameter in conventional pulmonary function that reflects the degree of the disturbance of nuclear medical measures best? Patients: We examined 32 patients with chronic obstructive pulmonary disease (COPD) between 17 and 68 years of age. The patients were examined during a complaint-free period, so it was possible. Methodology: The following methods were applied to examine the patients: 1. Pulmonary function: flow-volume curves, bodyplethysmography, FRC-rebreathing, diffusion measuring and impulse oscillometry. 2. Scintigraphic examination: For imaging the ventilated parts of the lung, all patients underwent a xenon-133-ventilation scintigraphy followed by a technetium-99m-DTPA-inhalation scitigraphy with 10 seconds of breath-holding. The inhalation of technetium-marked particles of aerosol was enabled by mechanical atomising system. The patients inhale the aerosol for 7 minutes slowly and calmly. Quantitative evaluation was based on the regions of interest (ROI) and score. Static scitigrams were devided into 4 groups according to a score and to the different types of ventilation-inhalation patterns (match, mismatch). Results: In patients with COPD three degrees of severity of ventilation disturbances are defined by nuclear medical examinations: low-grade ventilation-inhalation mismatch, moderate ventilation-inhalation mismatch, pathological ventilation-inhalation match. A comparison of the classification of severity of distribution disturbances according to conventional pulmonary function diagnosis and nuclear medicine results in a highly significant correlation. Of the 22 patients with pathological values of pulmonary function, 95% showed pathological changes in the scintigram, whereas in the 28 patients who underwent nuclear medical examinations pathological inhomogeneity parameters were found in only 75%. Hence it follows that the method of ventilation and inhalation scintigraphy is the more sensitive one.

Análogos da timidina têm sido marcados com diferentes radioisótopos devido ao seu potencial em monitorar a proliferação incontrolável de células. Considerando que o radioisótopo tecnécio-99m mantém ainda uma posição privilegiada devido às suas propriedades químicas e nucleares, este trabalho constituiu-se do desenvolvimento de uma nova técnica de marcação da timidina com o 99mTc, mediante o emprego de complexos organometálicos. Os objetivos do trabalho foram: a síntese do complexo organometálico carbonil-tecnécio-99m; marcação da timidina com este complexo precursor; avaliação da estabilidade; e avaliações radioquímicas e biológicas com animais sadios e portadores de tumor. A preparação do complexo precursor, utilizando o gás CO foi de fácil execução, assim como a marcação da timidina com este precursor, obtendo-se uma pureza radioquímica ≥ 97% e ≥ 94%, respectivamente. Sistemas cromatográficos com bons níveis de confiabilidade foram utilizados, podendo qualificar e quantificar as espécies radioquímicas. O resultado do estudo in vitro da lipofilicidade revelou que o a timidina radiomarcada é hidrofílica, com um coeficiente de partição (log P) de -1,48. O complexo precursor e a timidina radiomarcada apresentaram boa estabilidade radioquímica em até 6 h em temperatura ambiente. A estabilidade com soluções de cisteína e histidina apresentaram perdas entre oito e onze pontos percentuais para concentrações de até 300 mM. Os ensaios de biodistribuição em camundongos sadios indicaram que a timidina radiomarcada apresentou uma rápida depuração sangüínea e baixa captação nos demais órgãos, com predominância de excreção da droga pelo sistema urinário e hepatobiliar. A captação tumoral foi baixa, apresentando valores de 0,28 e 0,18 %DI/g para tumor de pulmão e mama, respectivamente. Os resultados obtidos sugerem mais investigações em outros modelos tumorais ou a modificação da estrutura da molécula orgânica que atua como ligante. / Thymidine analogs have been labeled with different radioisotopes due to their potential in monitoring the uncontrollable cell proliferation. Considering that the radioisotopes technetium-99m still keep a privileged position as a marker due to its chemical and nuclear properties, this dissertation was constituted by the developed of a new technique of labeling of thymidine analog with 99mTc, by means of the organometallic complex. The aims of this research were: synthesis of the organometallic complex technetium-99m-carbonyl, thymidine labeling with this precursor, evaluation of stability, and radiochemical e biological evaluation with healthy and tumor-bearing animals. The preparation of the organometallic precursor, using the CO gas, was easily achieved, as well as the labeling of thymidine with this precursor, resulting itself a radiochemical pureness of ≥ 97% and ≥ 94%, respectively. Chromatography systems with good levels of trustworthiness were used, ensuring the qualification and quantification of the radiochemical samples. The result of in vitro testing of lipophilicity disclosed that the radiolabeled complex is hydrophilic, with a partition coefficient (log P) of -1.48. The precursor complex and the radiolabeled have good radiochemical stability up to 6 h in room temperature. The cysteine and histidine challenge indicated losses between 8 and 11% for concentrations until 300 mM. The biodistribution assay in healthy mice revealed rapid blood clearance and low uptake by general organs with renal and hepatobiliary excretion. The tumor concentration was low with values of 0.28 and 0.18 %ID/g for lung and breast cancer, respectively. The results imply more studies in other tumor models or the modification of the structure of the organic molecule that act like ligand.

Diagnóstico precoce e tratamento de melanoma, um tumor cutâneo com o pior prognóstico, é extremamente importante para um resultado clínico favorável. A biblioteca de peptídeos phage display é um recurso útil de triagem para identificar peptídeos bioativos que interagem com alvos em cânceres. O objetivo desse estudo foi a avaliação de dois traçadores de tecnécio-99m com sequências peptídicas RGD e NGR, conjugados com o quelante bifuncional MAG3. Os conjugados peptídicos (10 μL de uma solução μg/μL) foram marcados com tecnécio-99m usando tampão de tartarato de sódio. A avaliação radioquímica foi feita por ITLC e confirmada por CLAE. O coeficiente de partição foi determinado e ensaios de internalização foram realizados em duas linhagens celulares de melanoma (B16F10 e SKMEL28). A avaliação da biodistribuição dos traçadores foi realizada em animais sadios em diferentes tempos e também em camundongos portadores de células tumorais aos 120 min após a sua administração. Estudos de bloqueamento também foram conduzidos pela co-injeção de peptídeo frio. O desempenho dos conjugados peptídicos mostraram-se bastante parecidos em diversas avaliações. Eles foram radiomarcados com alta pureza radioquímica (>97%). Ambos são hidrofílicos, com excreção renal preferencial. A captação tumoral foi maior para células SKMEL28 do que para as células B16F10, especialmente para o 99mTc-MAG3-PEG8-c(RGDyK) (7,85±2,34 %DI/g) aos 120 min pós-injeção. O desempenho do 99mTc-MAG3-PEG8-c(RGDyk) foi superior que o do traçador com NGR, quanto à captação no melanoma humano podendo ser considerado como um promissor radiofármaco para diagnóstico de melanoma. / Early diagnosis and treatment of melanoma, a cutaneous tumor with a serious prognosis, is extremely important for optimal clinical outcome. Phage display peptide libraries are a useful screening resource for identifying bioactive peptides that interact with cancer targets. The aim of this study was the evaluation of two technetium-99m tracers for angiogenesis detection in melanoma model, using cyclic peguilated pentapeptide with RGD and NGR motifs conjugated with bifunctional chelator MAG3. The conjugated peptides (10 μL of a μg/μL solution) were labeled with technetium-99m using a sodium tartrate buffer. Radiochemical evaluation was done by ITLC and confirmed by HPLC. Partition coefficient was determined and internalization assays were performed in two melanoma cells (B16F10 and SKMEL28). Biodistribution evaluation of the tracers was done in healthy animals at different times and also in mice bearing the tumor cells at 120 min post injection. Blocking studies were also conducted by co-injection of cold peptides. The conjugated showed the same profile in many evaluations. They were radiolabeled with high radiochemical purity (>97%). Both were hydrophilic, with preferential renal excretion. Tumor uptake was higher for human melanoma cells than for murinic melanoma cells, specially for 99mTc-MAG3-PEG8-c(RGDyK) (7.85±2.34 %ID/g) at 120 min post injection. The performance of 99mTc-MAG3-PEG8-c(RGDyk) was much better than NGR tracer concerning human melanoma uptake and might be considered in future investigations focusing radiotracers for melanoma diagnosis.

O crescimento anual no número de procedimentos realizados em Medicina Nuclear se deve em primeiro lugar à vantagem de não serem invasivos. Cerca de 80% dos diagnósticos realizados em Medicina Nuclear utilizam radiofármacos preparados com tecnécio-99m devido a suas características físicas ideais, disponibilidade e baixo custo. Dentre os radiofármacos utilizados para identificar processos de infecção e inflamação estão os leucócitos marcados com tecnécio-99m, considerado o padrão ouro e o citrato de gálio (67 Ga), atualmente comercializado no Brasi. Os leucócitos marcados possuem a desvantagem da técnica laboriosa de marcação nem sempre disponível nos centros de Medicina Nuclear, enquanto o citrato de gálio (67 Ga) não é específico e possui energias desfavoráveis para a dosimetria do paciente e para a aquisição de imagens. Neste cenário, novas moléculas para diagnóstico de focos de infecção têm sido pesquisadas, particularmente envolvendo biomoléculas, como os peptídeos antimicrobianos. Nesta categoria, a Ubiquicidina na forma de um fragmento sintético (UBI 29-41) despertou o interesse de pesquisadores que estudaram a marcação com tecnécio-99m utilizando métodos direto e indireto. Um reagente liofilizado de UBI 29-41descrito na literatura demonstrou eficácia no diagnóstico de focos de infecção utilizando-se imagens cintilográficas, porém o produto não está disponível no Brasil. O objetivo deste trabalho foi estudar a marcação do fragmento de UBI 29-41 com tecnécio-99m por método direto e avaliar a utilização de soluções tampão no procedimento de marcação, de modo a flexibilizar o volume da solução de pertecnetato de sódio a ser utilizado, o que constitui aspecto de ineditismo deste trabalho. O fragmento foi radiomarcado com diferentes volumes de soluções tampão alcalinas (carbonato e fosfato) e a utilização dos tampões em substituição à solução de hidróxido de sódio possibilitou realizar a marcação com diferentes volumes da solução de pertecnetato de sódio, sem comprometimento do rendimento de marcação. Uma formulação liofilizada foi avaliada, demonstrando estabilidade por período de 12 meses, viabilizando a produção rotineira do agente de marcação. Os estudos de biodistribuição das preparações efetuadas com os diferentes tampões demonstraram que os complexos formados apresentam características gerais de biodistribuição semelhantes ao composto padrão descrito na literatura, incluindo rápido clareamento sanguíneo e alta captação renal, condizente com a eliminação do produto por esta via. Entretanto, as preparações estudadas apresentaram captação hepática maior e captação renal menor que o composto padrão. As preparações estudadas captaram no foco de infecção provocado por S.aureus e demonstraram potencial para aplicação clínica no diagnóstico em Medicina Nuclear. Como pré-requisito para a realização de estudos clínicos de um novo composto foi realizado estudo de cito e genotoxicidade, cujos resultados demonstraram a segurança das preparações estudadas. / The annual growth in the number of Nuclear Medicine procedures is directly related to the fact that they are non invasive techniques. About 80% of diagnostic procedures in Nuclear Medicine use technetium-labelled radiopharmaceuticals, because of ideal physics characteristics of this radionuclide, disponibility and low cost. Some radiopharmaceuticas employed in the diagnostic of infection and inflammation is technetium labeled leukocytes, considered the gold standard, and gallium citrate (67 Ga) that are commercialized in Brazil. The procedures for labeling leukocytes are laborious and not always aviable in the Nuclear Medicine Centers, that constitutes a disadvantage of this radiopharmaceutical. On the other hand, galium citrate (67 Ga) is not specific and its energies are not favourable for patient dosimetry and image. In this context, new molecules for diagnostic of infection have been studied, particularly biomolecules, as the antimicrobians peptides. In this category, the Ubiquicidine, as a synthetic fragment (UBI 29-41), was particularly investigated by many researchers for labeling with technetium-99m by direct and indirect methods. A liophylized kit described in the literature showed good results in the diagnostic of infection focous by scintilographic images, but this product is not aviable in Brazil. The objective of this work was to study the labeling of the UBI 29-41 fragment with technetium-99m by direct method using buffer solutions on labeling procedure, that results in a less restrictive labeling technique concerning the volume of sodium pertechnetate solution employed, that constitutes in the originality of this work. UBI fragment was labeled with different volumes of alkaline buffers (carbonate and phosphate) and the use of buffers instead sodium hydroxide solution resulted in labeling procedures that employed different volumes of sodium pertechnetate solution without loss in the labeling yield. A liophylized kit was prepared, showing stability for 12 months, that supports a rotine production of this labeling agent. The biodistribution studies using the radiopharmaceutical prepared with different buffers showed that the resulted complexes presented biodistribution characteristics similar to the standard preparation described in the literature, including fast blood clearance and renal excretion. However, the studied preparations showed higher liver uptake and lower renal uptake when compared to the standard preparation. The studied preparations presented good uptake on infection focus produced by inoculation of S.aureus and showed potential for application in clinical procedures in Nuclear Medicine. Citotoxicity and genotoxicity studies were conducted with the peptide fragment as prerequisit for future clinical studies and the results showed the security of the compound for clinical application.

O objetivo deste experimento foi avaliar as variações da permeabilidade dentinária do sistema endodôntico produzidas pelo protocolo de irrigação intracanal: ácido cítrico a 15%, EDTA-T a 17%, MTAD, Smear Clear e NaCl 0,9% e a influência de diferentes lasers: Diodo, Er:YAG, Nd:YAG, utilizando para isso o radioisótopo Tecnécio-99m (99m Tc) (PARTE a) e o polietilenoglicol 400 (PEG 400) marcado 99m Tc (PARTE b). Foram selecionadas 150 raízes palatinas de molares superiores, divididas em 5 grupos, com 10mL/amostra para realizar a irrigação. Inicialmente analisou-se 10 raízes de cada grupo, introduzindo-se 5?L de 99m Tc no canal radicular, sendo então imersos em NaCl 0,9%, com exceção da superfície da entrada do canal para realizar a contagem da quantidade de radioisótopo dissociado para o meio externo (salina), sendo que se realizou os mesmos procedimentos com a introdução de PEG marcado (5?ci) no canal radicular. Posteriormente, cada um dos grupos experimentais foram subdivididos em outros 3 para irradiação com os diferentes lasers: Diodo (1,5W, modo contínuo, fibra de 300?m de diâmetro); Er:YAG [100mJ (42mJ output),1W, 10Hz, fibra com 0,375?m]; Nd:YAG (100mJ, 1,5Hz, 15W, fibra com 300?m). Repetindo-se os mesmos procedimentos primeiramente com 99m Tc livre e posteriormente o PEG400 marcado com 99m Tc para a realização para a contagem do radioisótopo dissociado na solução salina. Os dados obtidos foram tabulados e a analisados estatisticamente pelo teste Tukey com 95% de confiança. Pôde-se concluir que a irradiação com laser Nd:YAG + irrigação com ácido cítrico, ou com EDTA-T apresentaram os melhores índices de permeabilidade, enquanto que a irrigação com NaCl 0,9% e o MTAD apresentaram os piores índices pe permeabilidade independente da aplicação do laser. O ácido cítrico e o EDTA-T apresentaram os melhores resultados na ausência de irradiação e também no grupo irradiado pelo Er:YAG. E ao irradiar com Diodo a irrigação com EDTA-T apresentou maior permeabilidade. / Assess the variation of root canal dentin permeability produced by intracanal irrigation protocol: 15% citric acid, 17% EDTA-T, MTAD,Smear Clear and 0,9% NaCl and irradiation with different lasers: Diodo, Er:YAG, Nd:YAG using radioisotope technetium-99m (99mTc ) (PART a) and polietileneglycol 400 (PEG) marked with 99mTc (PART b) was the aim of this study. Hundred fifty palatin roots of molar were selected and divided in 5 groups to carry out the irrigation with 10 mL/sample of the solutions. Ten roots of each group were analyzed, introducing 5?L of the 99mTc dissolved in distilled water, with aproximatly 5?L in the root canal and imersed in 0,9% NaCl to carry out the count of amount of 99mTc dissociated to the external enviroment and after introducing 5?L of PEG marked with 99m Tc (5mci). Later, the groups were (PART b) divided to other 3 to irradiate with the folowing parameters: Diodo (1,5W, continuous, 300?m filament); Er:YAG [100mJ (42mJ output),1W, 10Hz, 0,375?m fiber]; Nd:YAG (100mJ, 1,5Hz, 15W, 300?m fiber). The same procedures were repeted to count and the obteined datas were analyzed statistically by the tukey test with 95% reliance. It was concluded that Nd:YAG laser + irrigation with citric acid or EDTA-T have presented the best scores of permeability, while the NaCl and the MTAD presented the worst scores independent of the laser irradiation. The citric acid and the EDTA-T have presented the best results in absence of laser and also, in the group irradiated by Er:YAG laser. Additionaly, if we irradiate with Diode, the EDTA-T group presented higher permeability.

Wong Wai Lun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 119-125). / Abstract also in Chinese. / Acknowledgments --- p.i / Legend for Figures --- p.ii / Legend for Tables --- p.iv / Abstract --- p.v / Abstract in Chinese --- p.ix / Chapter Chapter I --- Introduction --- p.1 / Objective --- p.5 / Chapter Chapter II --- Literature Review / Chapter II.1. --- Anatomy of the urinary system --- p.6 / Chapter II.2. --- Physiology of the urinary system --- p.10 / Chapter II.3. --- Methods for investigating the urinary system --- p.12 / Chapter II.3.1. --- Plain film radiography --- p.12 / Chapter II.3.2. --- Excretory Urogram --- p.12 / Chapter II.3.3. --- Ultrasound --- p.13 / Chapter II.3.4. --- Computed Tomography --- p.15 / Chapter II.3.5. --- Renal Angiography --- p.16 / Chapter II.3.6. --- Magnetic Resonance Imaging (MRI) --- p.16 / Chapter II.3.7. --- Radionuclide Imaging --- p.17 / Chapter II.4. --- Radiopharmaceuticals for renal parenchyma imaging --- p.17 / Chapter II.4.1. --- Tc-99m GHA --- p.18 / Chapter II.4.1.1. --- Chemistry of Tc-99m GHA --- p.18 / Chapter II.4.1.2. --- Preparation --- p.18 / Chapter II.4.1.3. --- Doses --- p.18 / Chapter II.4.1.4. --- Biological behavior --- p.19 / Chapter II.4.2. --- Tc-99m DMSA / Chapter II.4.2.1. --- Chemistry of Technetium-99m Dimercaptosuccinic Acid (Tc-99m DMSA) --- p.20 / Chapter II.4.2.2. --- Chemical property of Tc-99m DMSA --- p.21 / Chapter II.4.2.3. --- Preparation --- p.22 / Chapter II.4.2.4. --- Radiochemical purity measurement --- p.22 / Chapter II.4.2.5. --- Doses --- p.23 / Chapter II.4.2.6. --- Pharmacokinetic of Tc-99m DMSA --- p.23 / Chapter II.4.2.7. --- Renal handling of injected Tc-99m DMSA --- p.25 / Chapter II.5. --- General consideration for quantitative uptake measurement in organs --- p.26 / Chapter II.5.1. --- Clinical significance of renal Tc-99m DMSA uptake --- p.28 / Chapter II.5.2. --- Special consideration and problems for quantitative renal Tc-99m uptake measurement --- p.29 / Chapter II.5.3. --- Suggestions and solutions for quantitative renal Tc-99m uptake measurement --- p.29 / Chapter II.5.3.1. --- Planar images Vs SPECT images for quantification --- p.29 / Chapter II.5.3.2. --- Background subtraction --- p.31 / Chapter II.5.3.3. --- Choice of location for background ROI --- p.32 / Chapter II.5.3.4. --- Attenuation --- p.35 / Chapter II.5.3.5. --- Principle of the conjugate view method --- p.36 / Chapter II.5.3.6. --- Body thickness and kidney depth measurement --- p.37 / Chapter II.6. --- Glomerular Filtration / Chapter II.6.1. --- Introduction --- p.39 / Chapter II.6.2. --- Gold standard for GFR measurement --- p.40 / Chapter II.6.3. --- Laboratory studies for the measurement of glomerular filtration : Serum Creatinine and Blood Urea Nitrogen (BUN) levels --- p.41 / Chapter II.6.3.1. --- Calculation of Creatinine Clearance Rate --- p.43 / Chapter II.6.3.2. --- Critique for using creatinine clearance as a measurement of renal function --- p.44 / Chapter II.6.3.3. --- Limitation of the serum creatinine concentration used alone as a measurement of renal function --- p.46 / Chapter II.6.4. --- Radionuclide technique for the assessment of the glomerular function --- p.48 / Chapter II.6.4.1. --- Diethylene Triamine Penta Acetic acid (DTPA) --- p.49 / Chapter II.6.4.2. --- Methods / Chapter II.6.4.2.1. --- Measurement of Glomerular Filtration Rate using Tc-99m DTPA with single injection techniques --- p.51 / Chapter II.6.4.2.2. --- Compartment model --- p.52 / Chapter II.6.4.2.2a. --- Two-compartment model --- p.52 / Chapter II.6.4.2.2b. --- Single-compartment model --- p.54 / Chapter II.6.4.2.3. --- Single blood sample technique: a modification of Tauxe's OIH method in which counts in a single plasma sample correlated with a GFR nomogram --- p.56 / Chapter II.6.4.2.4. --- Gamma camera based method --- p.58 / Chapter II.6.4.2.4a. --- Gates-modification of Schlegel's OIH technique --- p.58 / Chapter II.6.4.2.4b. --- Critique for the Gamma camera technique for measuring GFR --- p.62 / Chapter II.7. --- The relationship between the Tc-99m DMSA uptake and GFR --- p.67 / Chapter Chapter III --- Material and Methods --- p.69 / Chapter III.1. --- Subjects and Sampling Methods --- p.69 / Chapter III.2. --- Quantitation of Absolute DMSA uptake --- p.70 / Chapter III.2.1. --- Parameters for Tc-99m DMSA uptake study --- p.70 / Chapter III.2.1.1. --- Materials and methods --- p.70 / Chapter III.2.1.1.1. --- Instrumentation --- p.70 / Chapter III.2.1.1.2. --- Dosage --- p.70 / Chapter III.2.1.1.3. --- Optimum acquisition start time --- p.70 / Chapter III.2.1.1.4. --- Length of acquisition time --- p.71 / Chapter III.2.1.1.5. --- Acquisition parameter --- p.71 / Chapter III.3. --- Calculation of absolute renal DMSA uptake --- p.72 / Chapter III.3.1. --- Attenuation Coefficient factor(μ) --- p.73 / Chapter III.3.2. --- Table attenuation --- p.75 / Chapter III.3.3. --- Body thickness measurement --- p.77 / Chapter III.3.4. --- Decay correction --- p.78 / Chapter III.3.5. --- Calculation of DMSA uptake --- p.78 / Chapter III.3.6. --- Counting dose injected --- p.80 / Chapter III.3.7. --- Calculation of absolute quantitation of Tc-99m DMSA uptake --- p.80 / Chapter III.3.8. --- Dose infiltration --- p.81 / Chapter III.4. --- GFR measurement --- p.82 / Chapter III.4.1. --- Instrumentation --- p.82 / Chapter III.4.2. --- Methods --- p.82 / Chapter III.5. --- Statistical and analytical methods --- p.84 / Chapter Chapter IV --- Results --- p.87 / Chapter IV. 1. --- Characteristics of experimental subjects and their serum creatinine profile --- p.88 / Chapter IV.2. --- Absolute Tc-99m DMSA uptake / Chapter IV.2.1. --- The change of absolute Tc-99m uptake with time --- p.89 / Chapter IV.2.2. --- Absolute Tc-99m DMSA uptake measurement at 6 and 24 hours --- p.90 / Chapter IV.2.3. --- Gender difference in absolute Tc-99m uptake measurement at 6 hour --- p.92 / Chapter IV.3. --- GFR measurement --- p.93 / Chapter IV.3.1. --- GFR measurement by single (3hr) and double (1&3 hrs) plasma sampling --- p.93 / Chapter IV.3.2. --- Gender difference in GFR measurement using single plasma sampling --- p.96 / Chapter IV.4. --- Univariate Correlation --- p.97 / Chapter IV.4.1. --- Correlation between GFR using single plasma sampling and absolute Tc-99m uptake --- p.97 / Chapter IV.4.2. --- Correlation between GFR using single plasma sampling and plasma creatinine levels --- p.98 / Chapter IV.4.3. --- Correlation between anthropometric variables on GFR(3 hr) --- p.99 / Chapter IV.4.4. --- Correlation between anthropometric variables and serum creatinine plasma level on absolute Tc-99m DMSA uptake measurement at 6 hour --- p.101 / Chapter IV.4.5. --- Multiple linear stepwise regression --- p.103 / Chapter Chapter V. --- Discussion / Chapter V. 1 --- . Review of the study --- p.104 / Chapter V.1.1. --- Experimental subjects and their absolute Tc-99m DMSA uptake (%) at 6 hr --- p.104 / Chapter V.1.2. --- Experimental subjects and their GFR(3 hr) --- p.105 / Chapter V.2. --- Discussion on subject --- p.105 / Chapter V.2.1. --- Subject preparation --- p.106 / Chapter V.3. --- Discussion of method --- p.106 / Chapter V.3.1. --- Equipment --- p.106 / Chapter (a) --- Dose calibrator --- p.106 / Chapter (b) --- The sensitivity of the head 1 and 2 of the gamma camera --- p.106 / Chapter (c) --- Validation of quantification of injected activity by gamma camera method--------constancy of performance for gamma camera --- p.110 / Chapter (d) --- LEHR Collimator --- p.112 / Chapter (f) --- Dead time loss --- p.112 / Chapter V.4. --- Discussion on measurement --- p.113 / Chapter (a) --- Length of acquisition time --- p.113 / Chapter (b) --- Attenuation Coefficient factor (\x) --- p.113 / Chapter (c) --- "Body thickness, L, measurement" --- p.113 / Chapter (d) --- Optimum acquisition time for data collection --- p.115 / Chapter v.5. --- Discussion on overall error estimation --- p.115 / Chapter (a) --- Tc-99m DMSA uptake measurement at 6 hr --- p.115 / Chapter (b) --- GFR measurement by single (3 hr) sample --- p.116 / Chapter Chapter VI --- Conclusion --- p.117 / Reference --- p.119 / Appendix I --- p.126 / Appendix II --- p.128 / Appendix III --- p.134

O crescimento anual no número de procedimentos realizados em Medicina Nuclear se deve em primeiro lugar à vantagem de não serem invasivos. Cerca de 80% dos diagnósticos realizados em Medicina Nuclear utilizam radiofármacos preparados com tecnécio-99m devido a suas características físicas ideais, disponibilidade e baixo custo. Dentre os radiofármacos utilizados para identificar processos de infecção e inflamação estão os leucócitos marcados com tecnécio-99m, considerado o padrão ouro e o citrato de gálio (67 Ga), atualmente comercializado no Brasi. Os leucócitos marcados possuem a desvantagem da técnica laboriosa de marcação nem sempre disponível nos centros de Medicina Nuclear, enquanto o citrato de gálio (67 Ga) não é específico e possui energias desfavoráveis para a dosimetria do paciente e para a aquisição de imagens. Neste cenário, novas moléculas para diagnóstico de focos de infecção têm sido pesquisadas, particularmente envolvendo biomoléculas, como os peptídeos antimicrobianos. Nesta categoria, a Ubiquicidina na forma de um fragmento sintético (UBI 29-41) despertou o interesse de pesquisadores que estudaram a marcação com tecnécio-99m utilizando métodos direto e indireto. Um reagente liofilizado de UBI 29-41descrito na literatura demonstrou eficácia no diagnóstico de focos de infecção utilizando-se imagens cintilográficas, porém o produto não está disponível no Brasil. O objetivo deste trabalho foi estudar a marcação do fragmento de UBI 29-41 com tecnécio-99m por método direto e avaliar a utilização de soluções tampão no procedimento de marcação, de modo a flexibilizar o volume da solução de pertecnetato de sódio a ser utilizado, o que constitui aspecto de ineditismo deste trabalho. O fragmento foi radiomarcado com diferentes volumes de soluções tampão alcalinas (carbonato e fosfato) e a utilização dos tampões em substituição à solução de hidróxido de sódio possibilitou realizar a marcação com diferentes volumes da solução de pertecnetato de sódio, sem comprometimento do rendimento de marcação. Uma formulação liofilizada foi avaliada, demonstrando estabilidade por período de 12 meses, viabilizando a produção rotineira do agente de marcação. Os estudos de biodistribuição das preparações efetuadas com os diferentes tampões demonstraram que os complexos formados apresentam características gerais de biodistribuição semelhantes ao composto padrão descrito na literatura, incluindo rápido clareamento sanguíneo e alta captação renal, condizente com a eliminação do produto por esta via. Entretanto, as preparações estudadas apresentaram captação hepática maior e captação renal menor que o composto padrão. As preparações estudadas captaram no foco de infecção provocado por S.aureus e demonstraram potencial para aplicação clínica no diagnóstico em Medicina Nuclear. Como pré-requisito para a realização de estudos clínicos de um novo composto foi realizado estudo de cito e genotoxicidade, cujos resultados demonstraram a segurança das preparações estudadas. / The annual growth in the number of Nuclear Medicine procedures is directly related to the fact that they are non invasive techniques. About 80% of diagnostic procedures in Nuclear Medicine use technetium-labelled radiopharmaceuticals, because of ideal physics characteristics of this radionuclide, disponibility and low cost. Some radiopharmaceuticas employed in the diagnostic of infection and inflammation is technetium labeled leukocytes, considered the gold standard, and gallium citrate (67 Ga) that are commercialized in Brazil. The procedures for labeling leukocytes are laborious and not always aviable in the Nuclear Medicine Centers, that constitutes a disadvantage of this radiopharmaceutical. On the other hand, galium citrate (67 Ga) is not specific and its energies are not favourable for patient dosimetry and image. In this context, new molecules for diagnostic of infection have been studied, particularly biomolecules, as the antimicrobians peptides. In this category, the Ubiquicidine, as a synthetic fragment (UBI 29-41), was particularly investigated by many researchers for labeling with technetium-99m by direct and indirect methods. A liophylized kit described in the literature showed good results in the diagnostic of infection focous by scintilographic images, but this product is not aviable in Brazil. The objective of this work was to study the labeling of the UBI 29-41 fragment with technetium-99m by direct method using buffer solutions on labeling procedure, that results in a less restrictive labeling technique concerning the volume of sodium pertechnetate solution employed, that constitutes in the originality of this work. UBI fragment was labeled with different volumes of alkaline buffers (carbonate and phosphate) and the use of buffers instead sodium hydroxide solution resulted in labeling procedures that employed different volumes of sodium pertechnetate solution without loss in the labeling yield. A liophylized kit was prepared, showing stability for 12 months, that supports a rotine production of this labeling agent. The biodistribution studies using the radiopharmaceutical prepared with different buffers showed that the resulted complexes presented biodistribution characteristics similar to the standard preparation described in the literature, including fast blood clearance and renal excretion. However, the studied preparations showed higher liver uptake and lower renal uptake when compared to the standard preparation. The studied preparations presented good uptake on infection focus produced by inoculation of S.aureus and showed potential for application in clinical procedures in Nuclear Medicine. Citotoxicity and genotoxicity studies were conducted with the peptide fragment as prerequisit for future clinical studies and the results showed the security of the compound for clinical application.

Esta tese apresenta a síntese e a caracterização de novos complexos de rênio e tecnécio utilizando como agentes complexantes ligantes assimétricos do tipo base de Schiff e ligantes triaminas derivadas da dietilenotriamina. Os ligantes assimétricos foram sintetizados através de reações de condensação entre 2,2\'-dihidroxibenzofenona e as aminas alifáticas etilenodiamina e dietilenotriamina, formando, respectivamente, os ligantes 2,2\'-(((2-aminoetill)imino)metileno)difenol(HL1) e 2,2\'-(((2-((2-aminoetil)amino)etil)imino) metileno)difenol (HL2). Os ligantes simétricos foram sintetizados através de reações de condensação entre benzaldeído, 4-hidroxibenzofenona e 3- e 4-metoxibenzaldeído com a amina alifática dietilenotriamina, formando, respectivamente, os ligantes simétricos tridentados tricloridrato de N1-benzil-N2-(2-(benzilamino)etil)etano-1,2-diamina (HL3), 4,4\'-(((azanodiilbis(etano-2,1-diil))bis- (azanediil))bis(phenilmetileno))difenol (HL4), tricloridrato de N1-(4-metoxibenzil)-N2-(2-((4-metoxibenzil)amino)etil) etano-1,2-diamina (HL5) e tricloridrato de N1-(3-metoxibenzil)-N2-(2-((3-metoxibenzil)amino)etil)etano-1,2-diamina (HL6). Reações de complexação foram conduzidas com os precursores metálicos de ReI eTcI. O complexo [Re(CO)5Br] foi utilizado como precursor de ReI. Foi obtido o complexo neutro do tipo fac-[Re(CO)3(L1)] e complexos catiônicos do tipo fac-[Re(CO)3(HL2,3,4,5,6)]Br. Os ligantes e complexos foram caracterizados por ponto de fusão, análise elementar (CHN), espectroscopia de absorção na região do infravermelho, espectroscopia de absorção na região do ultravioleta visível, espectroscopia de ressonância magnética nuclear de 1H e 13C, espectrometria de massas (MS-ESI) e, no caso dos complexos com os ligantes HL1,2,5,6, difração de raios X pelo método do monocristal. Foi realizada a marcação do ligante HL3 com o complexo fac-[[99mTc](H2O)(CO)3]+, formando o complexo fac-[[99mTc](CO)3(HL3)]Br e outras espécies em solução, que foram separadas por HPLC. Adicionalmente, realizou-se um estudo comparativo entre o método convencional de síntese (aquecimento) com o método de síntese no qual microondas são utilizadas. O complexo de tecnécio foi caracterizado por HPLC e eletroforese em papel. Foram realizados testes de estabilidade em cisteína, histidina e tampão PBS. Os testes de estabilidade mostraram que o complexo apresenta boa estabilidade por período de 3 horas. Foi determinado o coeficiente de partição desse complexo, tendo sido observado o caráter lipofílico do mesmo. Foram também realizados testes biológicos in vitro de captação e extrusão com células B16F10 (melanoma murino), onde as células captaram o complexo fac-[[99mTc](CO)3(HL3)]Br,em torno de 4,2%, e mantiveram retidas em seu interior cerca de 20% do complexo, após 60 minutos de incubação. O teste de viabilidade celular por azul de Tripan, mostrou estabilidade das células, durante os experimentos de captação e extrusão, frente às espécies radioativas, apresentando uma viabilidade celular superior a 90% em todos os casos. / This thesis presents the synthesis and characterization of novel rhenium and technetium complexes using as complexing agents asymmetric ligands (Schiff\'s bases type ligands) and triamines ligands derived from diethylenetriamine. The asymmetric ligands were synthesized by condensation reactions between 2,2\'-dihydroxybenzophenone and the aliphatic amines ethylenediamine and diethylenetriamine, giving rise, respectively, to the ligands 2,2\'-(((2-aminoetill)imino) methylene)diphenol (HL1) and 2,2\'-(((2-((2-aminoethyl)amino)ethyl)imino) methylene) diphenol (HL2). The symmetrical ligands were synthesized by condensation reactions between benzaldehyde, 4-hydroxybenzophenone and 3- and 4-methoxybenzaldehyde with the aliphatic amine diethylenetriamine, resulting in the formation, respectively, of the symmetrical tridentated ligands trihydrochloride N1-benzyl-N2-(2-(benzylamino)ethyl)ethane-1,2-diamine (HL3), 4,4\'-(((azanodiilbis(ethane-2,1-diyl))bis(azanediil))bis(phenilmetileno))diphenol (HL4), trihydrochloride N1-(4-methoxybenzyl)-N2-(2-((4-methoxybenzyl)amino)ethyl)ethane-1,2-diamine (HL5) and trihydrochloride N1-(3-methoxybenzyl)-N2-(2-((3-methoxybenzyl)amino)ethyl)ethane-1,2-diamine (HL6). Complexation reactions were carried out using ReI and TcI as metal precursors. The complex [Re(CO)5Br] was used as ReI precursor. Neutral complexe of the type fac-[Re(CO)3(L1)] and cationic complexes of the type fac-[Re(CO)3(HL2,3,4,5,6)]Br were obtained. The ligands and complexes were characterized by melting point, elemental analysis (CHN), infrared absorption spectroscopy, UV-visible absorption spectroscopy, 1H and 13C nuclear magnetic resonance spectroscopy, mass spectrometry (MS-ESI) and for the complexes with the ligands HL1,2,5,6, single crystal X ray diffraction method. Labeling studies were carried out for the HL3 ligand with the complex fac-[[99mTc](H2O)(CO)3]+, forming the complex fac-[[99mTc](CO)3(HL3)]Br and other species in solution, which were separated by high performance liquid chromatography (HPLC). Additionally, a comparative study was done between the conventional (heating) and the synthesis method using microwaves. The technetium complex was characterized by HPLC and electrophoresis on paper. Stability tests were conducted on cysteine, histidine and PBS buffer. The stability tests showed that the compound presents good stability over a 3 hour period. The lipophilic character of the complex was confirmed by the determination of the partition coefficient. In addition, In vitro biolgical tests of captation and influx were performed on B16F10 cells (murine melanoma). The cells captured around 4.2% of the complex fac-[[99mTc](CO)3(HL3)]Br and retained 20% of the amount inside after 60 minutes of incubation. The Trypan blue exclusion test of cell viability showed stability of the cells during the influx and captation experiments, front of the radioactive species, showing cell viability greater than 90% in all cases.

Many histidine-rich sites in proteins bind transition metal ions such as Zn2+, natively. Such sites can encourage proper protein folding or allow access to enzymatic capabilities such as hydrolysis. Ru(II) and Tc(I) also bind to aromatic amines providing access to unique chemistries not observed in biology. Ru(II) complexes have shown efficacy in fighting cancer and catalysis, while 99mTc complexes are used in radio-imaging. To incorporate such metal-ions' activities into proteins, several mutants have been designed to bind Zn2+, Ru2+, and Tc1+ by introducing three histidines onto their surfaces. The first design, Z0, utilized a chimeric approach by substituting a turn in engrailed homeodomain for the superimposable Zn2+-binding loop of astacin. In the second design, 3HT-C, three histidine residues were incorporated into the N-terminus of the Trp-cage. The final scaffold, ubiquitin, was used to make two mutants: 3HIU with a 3-histidine containing loop inserted between residues 9 and 10, and 3HPU with 3-histidine point mutations near residues 35-38. Z0 proved unstable due to incorporation of a hydrophobic patch onto its surface and was not able to be isolated in sufficient quantities for study. However, the other proteins were stable and soluble. Zn2+-binding by 3HT-C was investigated by intrinsic tryptophan fluorescence quenching, circular dichroism, and RP-HPLC. Binding by 3HIU and 3HPU was studied by CD. All designed proteins bind to Zn2+ with Kd values in the micromolar range. 3HIU and 3HPU were further studied for their ability to bind Ru(tacn)2+ complexes. While addition of Ru-complexes caused oligomerization to various extents depending upon reaction conditions, homogeneous Ru-protein monomers were purified by a combination of size-exclusion, cation-exchange and immobilized-metal affinity chromatographies. Ru-binding was confirmed by ESI-MS, and structural integrity was investigated by CD. Results indicate that Ru(tacn)2+ complexes can be bound to surface binding sites in proteins without disruption of structure, opening the door for the study of catalysis in a protein context. 99mTc(CO)3+-binding studies were performed with 3HIU by RP-HPLC. This protein binds Tc+ and resists substitution by free L-histidine, suggesting that peptidic Tc-binding tags could be designed with this approach to readily incorporate the radionuclide into any protein expression system.

Thesis (Ph.D.)--McMaster University, 2005. / Supervisor: John Fitzmaurice Valliant. Includes bibliographical references. Also available online.