Sulfur

Absorption

When administered subcutaneously, Technetium Tc 99m Sulfur Colloid enters the lymphatic capillaries and is transported with lymph to lymph nodes where it can be used to detect drainage of primary tumours. When administered by intraperitoneal injection, Technetium Tc 99m Sulfur Colloid mixes with the peritoneal fluid where the rate of clearance from the cavity allows assessment of shunt patency. When administered by intravenous injection, Technetium Tc 99m Sulfur Colloid is taken up by the reticuloendothelial system (RES), allowing RES rich structures to be imaged. Uptake of the radioactive colloid by organs of the RES is dependent upon both their relative blood flow rates and the functional capacity of the phagocytic cells. When administered orally, Technetium Tc 99m sulfur colloid can be used in esophageal transit studies, gastroesophageal reflux scintigraphy, and for the detection of pulmonary aspiration of gastric contents. This is possible as the active substance is not absorbed from the GI tract.

Toxicity

The most frequently reported adverse reactions, across all categories of use and routes of administration, include rash, allergic reaction, urticaria, anaphylaxis/anaphylactic shock, and hypotension. Less frequently reported adverse reactions are fatal cardiopulmonary arrest, seizures, dyspnea, bronchospasm, abdominal pain, flushing, nausea, vomiting, itching, fever, chills, perspiration, numbness, and dizziness. Local injection site reactions, including burning, blanching, erythema, sclerosis, swelling, eschar, and scarring, have also been reported. Anaphylactic reactions including rare fatalities have occurred following intravenously administered Technetium Tc 99m Sulfur Colloid. Radiation-emitting products, including Technetium Tc 99m Sulfur Colloid Injection, may increase the risk for cancer, especially in pediatric patients. Use the smallest dose necessary for imaging and ensure safe handling to protect the patient and health care worker.

Description

Sulfur belongs to a nonmetallic chemical element (pure product: yellow crystalline solid) under the symbol S. It can actively react with many other elements. It exists in various kinds of forms and compound such as sulfide and sulfate minerals which can be found everywhere around the universe and earth. It is also a key element for all life as the major component of amino acids, vitamins and many other cofactors. Sulfur has applications in various kinds of fields. For example, one of its biggest applications is for the production of sulfuric acid for sulfate and phosphate fertilizers. It is also used for the manufacturing of insecticides, fungicides, and bactericides. In pharmaceutical, it can be used for the manufacturing of many kinds of sulfur-containing antibiotics.

The Uses of Sulfur

Elemental sulfur is used for vulcanizing rubber; making black gunpowder; as a soil conditioner; as a fungicide; preparing a number of metal sulfides; and producing carbon disulfide. It also is used in matches; bleaching wood pulp, straw, silk, and wool; and in synthesis of many dyes. Pharmaceutical grade precipitated and sublimed sulfurs are used as scabicides and as antiseptics in lotions and ointments.
Important sulfur compounds include sulfuric acid, sulfur dioxide, hydrogen 890 SULFUR sulfide, sulfur trioxide, and a number of metal sulfides and metal oxo- salts such as sulfates, bisulfates, and sulfites. Numerous organic compounds contain sulfur, such as mercaptans, thiophenes, thiophenols, sulfate esters, sulfones, and carbon disulfide.

Indications

Technetium 99m sulfur colloid is indicated as a diagnostic agent in adults for the following tests: localization of lymph nodes draining a primary tumor in patients with breast cancer or malignant melanoma; and evaluation of peritoneo-venous (LeVeen) shunt patency. It is indicated in both adult and pediatric patients for: imaging areas of functioning reticuloendothelial cells in the liver, spleen and bone marrow; and studies of esophageal transit and gastroesophageal reflux, and detection of pulmonary aspiration of gastric contents.

Background

Technetium 99m sulfur colloid is a radiopharmaceutical diagnostic agent used in the evaluation of various conditions including lymph node metastases in breast cancer, detection of shunt patency, imaging of reticuloendothelial cells for assessment of liver function, and studies of esophageal transit and gastroesophageal reflux. Following injection or oral administration, single photon emission computer tomography (SPECT) imaging is performed using a gamma camera to detect technetium-99m decay. This is possible as Technetium-99m decays by isomeric transition to technetium-99 through the release of a gamma ray. Depending on site of administration and intended usage, Technetium 99m sulfur colloid enters the capillaries and is transported to the lymph nodes (subcutaneous injection), mixes with peritoneal fluid (intraperitoneal injection), is taken up by reticulocytes (intravenous injection), or enters the gastroesphageal tract (oral administration).

Metabolism

In the average patient 80 to 90% of the injected collodial particles are phagocytized by the Kupffer cells of the liver, 5 to 10% by the spleen and the balance by the bone marrow.