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Re: Prussian Blue



Forty six individuals, internally contaminated in the Goiania Accident, were

treated with Radiogardase-Cs (68% Fe4[Fe(CN)6]3) in dosages varying from 3

to 10 g/d for adults and adolescents, and from 1 to 3 g/d for children

One of the Conclusion - PB was shown to be an effective and safe drug for

Cesium decorporation treatment.



References:

 1) Dosimetric and Medical Aspects of the Radiological Accidente in Goiania,

IAEA TECDOC 1009, June 1998 -

Ten years follow-up contaminated patients - Chapter 5 Efficacy of Prussian

Blue Therapy for Decorporation on Cesium, Pages 37/46



2) Melo, D.R., Lipsztein, J. L., Oliveira, C.A.N. Bertelli, L, - Cs-137

Internal Contamination Involving a Brazilian Accident, and the Efficacy of

Prussian Blue Treatment, Health Phys. 66 (1994) 245-252;



3) Melo, D.R., Lundgren, D.L., Muggenburg, B.A., Guilmette, R.A., Prussian

Blue decorporation of Cs--137 in beagles of different ages, Health Phys. 71

No2. (1996) 190-197



4) R. Farina and C. E. Brandao-Mello: Medical aspects of 137Cs

decorporation: The Goiania radiologicalaccident. Health Phys. 60, 63-66

(1991).



Jose Julio Rozental

joseroze@netvision.net.il

Israel





----- Original Message -----

From: James Barnes <james.g.barnes@WORLDNET.ATT.NET>

To: Bjorn Cedervall <bcradsafers@HOTMAIL.COM>

Cc: <radsafe@list.vanderbilt.edu>

Sent: Sunday, August 11, 2002 8:59 AM

Subject: Re: Prussian Blue





Bjorn,



While I'm not a medical doctor, I have had interest in this area for some

time, and have done quite a bit of reading on the subject, and participated

in several studies related to this issue.



Cesium is an biologic analogue of potassium. It appears to tightly bind to

the transfer pores on the cell surface. (Surprisingly) in adults it is not

displaced by increased dietary intake of K or Na; there were several papers

published on this point in the 1960s. Further, there are other downsides

from oral supplementation with KCl and NaCl; other compounds may be

preferable.



There is some evidence that increased K supplementation may accelerate Cs

elimination in children, but it is not a profound acceleration. It doesn't

seem to have any effect in adults. This suggests that puberty may cause

certain physiological changes that alter the behavior of cesium.



The last I heard, Prussian Blue is still an experimental drug, and FDA has

not given permission for its widespread use for humans. I am not aware of

its specific pharmacology, but it appears to be relatively safe. [Perhaps

there are other listmembers who could amplify the current status and

behavior of the substance].  It is chemically specific for cesium; it binds

the cesium into an insoluble complex, which then passes through the gut into

the feces. This binding interferes with the bilatory recycling of the

cesium, which drops the body burden over a few days. Given the fact that

Cs-137 is not a particularly "dangerous" isotope, the use of PB would

probably not be justified unless the Cs-137 burden was quite high.



Bentonite has been used for reduction of toxic effects in the GI tract. I

don't know if it is effective for cesium due to the fact that I'm not sure

it interferes with the bilatory recycling. If you don't bind cesium to

something, it gets reabsorbed and recycled fairly readily.



Similarly, just increasing water intake doesn't appear to have much effect

either (recall the cesium becomes tightly bound to the cell walls).



I believe there was a very good discussion of these types of substances in

the first HPS Summer School on Internal Dosimetry. Check the textbook that

was published from that session.



Jim Barnes, CHP

james.g.barnes@att.net



----- Original Message -----

From: "Bjorn Cedervall" <bcradsafers@HOTMAIL.COM>

To: <radsafe@list.vanderbilt.edu>

Sent: Saturday, August 10, 2002 10:18 PM

Subject: Prussian Blue





> >who may become inadvertently internally contaminated, were KI (which we

can

> >buy), Prussian Blue (an oral drug that binds Cs-137 and promotes fecal

> >excretion), <snip>

> ---

> A question for reason of clarification:

>

> I understand that Prussian Blue, KFe(III)[Fe(II)(CN)6], is very stable and

> guess that the mechanism is replacing the K with Cs.

>

> The hexacyanide complex is, however, possible to break up with strong warm

> acid - potentially releasing HCN. As decontamination experiments have been

> made with mammalians Prussian Blue obviously passes through the stomach

> without any problems. In order to understand this from a chemistry point -

> can anyone shed light on the stability as a function of pH and

temperature?

> (37 C, 1 M HCl does not seem to be enough)

>

> I guess that some HCN is released - depending on the quantity taken in -

so

> for a low level of say a Cs-137 contamination I might prefer to keep the

> Cs-137 and just try to wash it out faster with a combination of heavy

> drinking (not exactly whiskey) and increased intake of potassium/sodium

> chloride. An alternative to Prussian Blue is bentonite which I think

> (=probably something my professor in nuclear chemistry told me 20 years

ago)

> has been tried on sheep or some other larger mammal (?).

>

> Please comment, add or correct whatever is necessary.

>

>

> My personal reflections only,

>

> Bjorn Cedervall    bcradsafers@hotmail.com

> http://www.geocities.com/bjorn_cedervall/

>

>

> _________________________________________________________________

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