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Biomedical subjects

R L Siegle

Publications and source records attributed to R L Siegle.

14 recordsLinked to original sources
PubMed1992

Iodixanol in excretory urography: initial clinical experience with a nonionic, dimeric (ratio 6:1) contrast medium. Work in progress.

The authors report the first clinical experience in the United States with the highly water soluble, nonionic dimer (6:1 ratio) contrast medium iodixanol (5,5'-[(2-hydroxyl-1,3-propanediyl)bis(acetylimino)]bis[N,N' - bis(2,3dihydroxypropyl)-2,4,6-triodo1,3-benzenedicarbooxa mide]). Iodixanol has an osmolality less than half that of monomeric, nonionic equivalent contrast media. Sodium, calcium, and magnesium ions were added to iodixanol to make the injected solution isosmotic to blood (290 mosm/kg H2O), with levels of free calcium and magnesium equivalent to levels found in the blood. Forty patients undergoing elective excretory urography were studied after bolus injection of doses of iodixanol with either 27 or 32 g of iodine. No adverse event or idiosyncratic reaction occurred. Seven patients felt coolness at the site of injection. Diagnostically adequate urographic examinations were routinely obtained with both doses. Further clinical investigation with iodixanol is warranted to determine if its beneficial chemical properties minimize both the chemotoxic and osmotoxic side effects and the disruption of physiologic functions that are seen with use of other ionic and nonionic contrast media.

Adult↗
PubMed1979

Complement activation following intravenous contrast material administration.

Untoward reactions to iodinated contrast material (ICM) continue to be a significant medical problem. Complement components were assayed in patients having reactions to evaluate the possibility of complement activation in these reactions. Reactor group samples were drawn from patients during the contrast reactions and then 2 weeks later to provide the equivalent of preinjection baseline samples, Control patient values were determined from blood samples drawn from patients before and 20 minutes after ICM injections without reaction. There were consistent falls in total hemolytic complement (CH50) as well as C3, C4, and C5 in both the control group and the reactor group. These falls in the complement reached statistical significance only for CH50 in the reactor group. The results indicate that complement activation occurs after ICM injection. This activation can occur independent of clinical reactions; however, falls in total hemolytic complement and low hemolytic complement titers prior to ICM infusion may be related to the presence of anaphylactoid symptoms.

Adolescent↗
PubMed1979

Rectal thiopental for sedation of children for computed tomography.

Rectally administered thiopental was evaluated for sedation in pediatric computed tomography and compared with "cardiac cocktail" sedation. The drug produced sedation as effective as the "cocktail" with easier administration, more rapid onset, and shorter duration of sedation. Although no complications were observed, careful observation for respiratory depression is suggested.

Anesthesia, General↗
PubMed1978

Anaphylactoid reactions to iodinated contrast material.

A review of the literature involving anaphylactoid reactions to iodinated contrast material (ICM) suggests that the reactions are nonantibody-mediated but that a complex activation of inflammatory mediators occurs. Histamine release and/or complement activation has been demonstrated in both in vitro and in vivo experimental systems. It appears that pretreatment of selected cases (those patients previously exhibiting an anaphylactoid reaction) is effective in reducing the frequency and severity of subsequent reactions when readministration is necessary.

Adrenal Cortex Hormones↗
PubMed1976

Chronic urticaria and intermittent anaphylaxis. Reactions to lophendylate.

In a case of chronic, severe urticaria and intermittent episodes of anaphylaxis due to an iophendylate injection (Pantopaque) given in the course of myelography, almost complete relief was obtained from the removal of approximately 8 ml of residual iophendylate from the spinal canal. Data obtained from direct skin testing, Prausnitz-Küstner testing, peptide inhibition of Prausnitz-Küstner testing, and IgE levels quantitated before and after removal of iophendylate indicate that these symptoms were mediated via an IgE anti-iophendylate reaction.

Anaphylaxis↗
PubMed1976

Air embolus following pulmonary interstitial emphysema in hyaline membrane disease.

Two cases of hyaline membrane disease are presented complicated by severe, interstitial emphysema and resulting in death from air embolus. This is consistent with the experimental evidence of other investigators that shows that such an air embolus may be more common complication of hyaline membrane disease than previously expected.

Embolism, Air↗
PubMed1976

Changing clinical and roentgenographic patterns of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) occasionally deviates from the classical presentation of the disease. Small bowel dilatation and pneumatosis are frequently present prior to the actual onset of the clinical presentation. Pneumatosis intestinalis, an important diagnostic sign of NEC, is quite variable; it may be present, persist, worsen, or disappear; or at times it may not be present at all. A severe complication of necrotizing enterocolitis is perforation which in 50 percent of the cases presented without obvious free intra-abdominal air. Accumulation of fluid in the abdomen is stressed as strong evidence for perforation and a strong indication for surgery. The varying features indicate that NEC has a clinical spectrum that extends from benign to severe, and recognition of all these variations will lead to better diagnosis and to a better understanding of the disease. The clinical and roentgenologic variations make classification difficult but the variety most likely represents the combination of a great number of susceptible children and a greater recognition of the disease.

Air↗
PubMed1976

Intestinal perforations secondary to nasojejunal feeding tubes.

Infant alimentation by nasojejunal tube feeding has been successfully used since 1973. A significant complication is small bowel perforation by the tube; three cases are presented. The differential diagnosis includes spontaneous gastric perforation and necrotizing enterocolitis. Nasojejunal tube perforation almost always occurs in the distal duodenum. It is likely the result of peristaltic activity which propels the tube along the relatively rigid duodenal loop. Thus it is preferable to position the tube end distal to the ligament of Treitz.

Duodenal Diseases↗
PubMed1976

Early diagnosis of necrotizing enterocolitis.

This study demonstrates that the diagnosis of necrotizing enterocolitis can sometimes be made before the full-blown clinical and radiographic findings are manifest. Of 12 infants with films available prior to diagnosis of the disease, nine had early selective dilatation of small bowel and little or no air in the colon. Necrotizing enterocolitis should be foremost in the differential diagnosis when this finding is coupled with signs such as abdominal distention, acidosis, and diarrhea.

Enterocolitis, Pseudomembranous↗
PubMedDate not supplied

Measurement of histamine, complement components and immune complexes during patient reactions to iodinated contrast material.

Studies were performed on nine patients who had just suffered urticarial or bronchospastic reactions following injection of iodinated contrast material (ICM). The parameters studied were white cell histamine, serum complement components C'3 and C'4 and circulating immune complexes. The white cells of the nine patients demonstrated an average increase of 125% in intracellular histamine over the 3-4 week period following the ICM reaction. Control volunteers averaged only a 10% change. The data implies that there was a loss of white cell histamine during the ICM reaction with replenishment during the following 3-4 week period. Complement components C'3 and C'4 were normal. Circulating antigen-antibody complexes were sought via precipitin bands in agar gel using Clq. None could be isolated following seven ICM reactions. Thus these ICM reactions appeared to release histamine without detection of circulating immune complexes and with normal levels of two major complement components.

Antigen-Antibody Complex↗