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PubMedDate not supplied

Contrast media induced pulmonary edema. Comparison of ionic and nonionic agents in an animal model.

High intravenous doses of diatrizoate are known to induce pulmonary edema in the rat. The newer generation of contrast media--nonionics and monovalent dimers--are considered less toxic than diatrizoate. In this study we evaluated the degree of pulmonary edema induced by a high dose (6 g I/kg) of these new agents and found that Ioxaglate produced higher lung weights than Renografin 60 and Iopamidol. Iohexol and Amipaque did not induce a significant degree of edema. The model used in this study demonstrates distinct differences in pulmonary toxicity among these new agents, when given in doses exceedingly higher than given in clinical practice.

Animals↗
PubMed1982

Diaphragmatic injury: a method for early diagnosis.

Traumatic diaphragmatic hernia, whether of blunt or penetrating etiology, is difficult to diagnose in the acute phase. The lesion is presently best diagnosed by chest X-ray, but only occasionally. Chest X-ray appears normal or nonspecific 25 to 50% of the time. For this reason, simple diagnostic technique using radiographic methodology available in emergency rooms was studied in animals in order to devise a way to diagnose this injury. Eight per cent diatrizoate meglumine and diatrizoate sodium (Renografin, Squibb) was placed into the chest or abdomen of animals with either 8-cm simulated blunt or 5-mm simulated penetrating injuries. The Renografin was infused by either a peritoneal lavage or thoracostomy catheter. Serial X-rays showed diagnostic rate of transdiaphragmatic leakage in 24 of 26 animals with blunt injury and seven of 16 animals with penetrating injury. There was no evidence of pleural, peritoneal, or pulmonary injury from the Renografin itself. It was concluded that the experimental technique may prove useful in screening or confirming traumatic diaphragmatic hernia during the acute or latent phases.

Animals↗
PubMed1980

Decrease in cardiotoxicity of contrast media in coronary angiography by addition of calcium ions: a combined experimental and clinical study.

The cardiotoxicity of commonly used contrast media such as sodium methylglucamine diatrizoate is related to nonphysiologic concentrations of ions and high osmolality. Following injection there is an excessive decrease in ambient calcium which disturbs the extracellular Na+/Ca2+ ratio and results in myocardial depression. In animal studies (anesthetized, intact mongrel dogs) this cardiodepressive effect could be fully compensated by adding 22.5 mEq/1 of ionic calcium to the contrast medium. In 16 patients studied for coronary artery disease (CAD) 72 injections of sodium methylglucamine diatrizoate, mainly in the left coronary artery, were thoroughly investigated. There was marked depression of left ventricular pressure (-22%) and (dP/dt)max (-27%), and marked heart rate slowing (-29%). Added calcium in the concentration cited reduced significantly (p < 0.001) the myocardial depression to -15% and -13%, respectively, but did not completely compensate it. The heart rate slowing was not altered significantly. It was concluded that the addition of calcium may be helpful when studying high-risk patients and using high injection volumes.

Angiography↗
PubMed1997

Measurements of oxygen tension in the rat kidney after contrast media using an oxygen microelectrode with a guard cathode.

The oxygen tension (PO2) in the rat kidney was studied by modified Clark microelectrodes. Changes in PO2 were measured in the renal cortex and outer medulla after intravenous injections of the X-ray contrast medium (CM) diatrizoate, 370 mg iodine/mg body weight. Injection of diatrizoate caused a slight fall in PO2 in the renal cortex (from 42 +/- 4 to 38 +/- 4 mm Hg). In the medulla PO2 decreased significantly (from 34 +/- 6 to 20 +/- 4 mm Hg). Ringer's solution did not induce any changes.

Animals↗
PubMed1982

The pharmacokinetics of amygdalin.

Amygdalin (D-mandelonitrile-beta-D-gentiobioside) is a cyanogenic glycoside claimed to show anti-cancer activity, sold under the incorrect name "Laetrile". For a sensible discussion of its alleged activity and its established toxicity it is necessary that its fate in the organism is known. The pharmacokinetics of amygdalin have been investigated in the Beagle dog after both intravenous and oral administration. The excretion of amygdalin has also been studied in the rat. Amygdalin concentrations were determined by high performance liquid chromatography in plasma ultrafiltrate and urine. The pharmacokinetics of amygdalin after intravenous administration were compared with those of diatrizoate, a model substance for extracellular volume and glomerular filtration. The amygdalin clearance is significantly larger than that of diatrizoate. The volumes of distribution of both substance are the same. After oral administration only a few percents of the amygdalin dose are systemically available. A part of the oral dose is recovered from the urine as prunasin (D-mandelonitrile-beta-D-glucoside).

Administration, Oral↗
PubMed1997

Variable effects of iodinated contrast media on different rabbit arteries in vitro.

Vasoconstriction caused by iodinated contrast media (CM) has been considered specific for the renal artery only. We examined the vascular effect of CM in rabbit carotid, aorta, renal, iliac, mesenteric and celiac arteries and found that other arteries also respond with a contraction to CM. Isolated arterial rings were exposed to diatrizoate (high osmolar CM), iohexol (low osmolar CM) or glucose solution, and the isometric contraction response was expressed as percentage of an initial KCl control contraction. Diatrizoate evoked contractions of 82% (carotid), 63% (aorta), 30% (renal), 24% (iliac), 28% (mesenteric) and 18% (celiac), respectively. Iohexol caused contractions of 31% (carotid), 24% (aorta), 15% (renal) and 14% (iliac), whereas the mesenteric and celiac arteries were relaxed by iohexol. A high osmolar glucose solution elicited contractions of 78%, 77%, 11%, 27%, 3% and 5%, respectively, in the arteries. CM have contraction potency in arterial vasculature other than the renal artery.

Animals↗
PubMed1981

The influence of contrast media additives upon ventricular fibrillation thresholds during coronary angiography in ischemic and normal canine hearts.

Contrast media additives that bind calcium lower the total dose necessary to induce fibrillation. The method of measuring ventricular fibrillation threshold during coronary arteriography is sensitive and allows dose comparison at volumes relevant to clinical use. We compared two commercial formulations of sodium/meglumine diatrizoate for their effects upon fibrillation threshold in normal and ischemic dog hearts. Even though the formulations differed only by their additives, Hypaque 76 was significantly less fibrillatory than Renografin 76. This was observed at two different doses and in both ischemic and non-ischemic hearts. We conclude that amounts of additives capable of binding calcium should be kept as low as possible in sodium/meglumine diatrizoate formulations that are used for coronary angiography.

Angiocardiography↗
PubMed1982

Iopamidol, a new nonionic contrast medium in peripheral angiography.

Iopamidol (B 15,000), a new nonionic contrast medium, was compared to diatrizoate (Urografin 60%) in a controlled clinical trial using aortofemoral runoff angiography in a consecutive series of 50 severely arteriosclerotic patients. Iopamidol was found to be superior to the conventionally used contrast medium, as it significantly reduced the pain and discomfort following injection. Only slight to moderate alterations of aortic blood pressure and pulse rate were observed following the injection of both media. The hemodynamic influence of iopamidol, however, was significantly less pronounced than that of diatrizoate.

Angiography↗
PubMed1997

Intrarenal oxygen tension measured by a modified clark electrode at normal and low blood pressure and after injection of x-ray contrast media.

The oxygen tension (pO2) in the rat kidney was studied using a Clark microelectrode with a guard cathode behind the sensing cathode. The mean (+/- SEM) outer tip diameter of the electrodes used was 5.5 +/- 1.9 microm. The zero-pO2 current amounted to 12.5 +/- 0.9 pA at 37 degrees C; at air saturation it was 252 +/- 22.9 pA. Rats with a systolic blood pressure (BP) above 80 mmHg (where 1 mmHg = 133 Pa) showed an average pO2 in the cortex of 45 +/- 2 mmHg and in the outer medulla of 31 +/-1 mmHg. In rats with a BP below 80 mmHg a paradoxically high outer medullary pO2 of 40 +/- 4 mmHg was found, while the pO2 in the cortex was 27 +/- 4 mmHg. Changes in pO2 were also noted in the renal cortex and outer medulla after intravenous injections of the x-ray contrast medium diatrizoate (370 mg iodine/ml). In rats with normal BP, injection of diatrizoate caused a slight fall in pO2 in the renal cortex, from 42 +/- 4 to 38 +/-4 mmHg. In the medulla pO2 decreased significantly from 34 +/- 6 to 20 +/-4 mmHg. Ringer's solution did not induce any changes.

Animals↗
PubMed2004

Rapid CT scan visualization of the appendix and early acute non-perforated appendicitis using an improved oral contrast method.

The purpose of this study was to optimize detection of the normal appendix in the clinical exclusion of acute nonperforated appendicitis using an improved and rapid method of bowel opacification in conjunction with the CT examination. A prospective evaluation of 100 consecutive patients, ranging from 13 to 50 years in age, was performed over a 4-month period using water-soluble oral contrast medium consisting of a fixed dose of diatrizoate salts administered as a prepared beverage in the emergency ward 50 min prior to performing a CT scan to evaluate clinical signs and symptoms of early acute appendicitis. The appendix was visualized in 84% (84 of 100) of patients, with a mean transit time of 50 min. The appendix filled with oral contrast medium in 89% (75 of 84) patients, and this sign was reliable in excluding appendicitis. In no instance did a contrast-filled appendix prove to represent appendicitis. The earliest signs of appendicitis were seen in 8% (8 of 100) patients. CT scan findings included absence of a contrast- or air-containing appendix with appendiceal thickening and infiltration of the periappendiceal mesenteric fat. CT scan utilizing a fixed dosage of orally administered water-soluble contrast containing diatrizoate salts, with a mean transit time of 50 min, provides a rapid and efficient means of visualizing the appendix in the clinical exclusion of appendicitis in the emergency setting.

Acute Disease↗
PubMed1992

The effects of ionic and nonionic radiographic contrast media on coronary hyperemia in patients during coronary angiography.

The purpose of this study was to compare the differential effects of ionic, high-osmolar meglumine diatrizoate; ionic, low-osmolar ioxaglate meglumine; and nonionic, low-osmolar iohexol (all radiographic contrast agents) on coronary blood flow velocity and hyperemic responses during diagnostic coronary angiography. Coronary flow velocity and arterial pressure were measured at baseline and during maximal hyperemia after contrast media were randomly injected (4 to 6 ml into left coronary artery) in 22 patients with the use of a Judkins-style 20 MHz Doppler-tipped angiographic catheter. Contrast media-induced hyperemic responses were compared to those induced with intracoronary nitroglycerin (200 micrograms) and papaverine (10 mg). There were no significant differences in systolic, diastolic, or mean arterial pressure measurements among the three contrast agents. The increase in mean coronary flow velocity during hyperemia was 118 +/- 93%, 133 +/- 73%, and 136 +/- 86% for iohexol, ioxaglate meglumine, and diatrizoate, respectively (p = NS among agents vs 264 +/- 109% for papaverine; p less than 0.05 for all). Coronary vasodilatory reserve (calculated as the ratio of hyperemic to basal mean flow velocity) was also similar among agents. It was comparable to the coronary vasodilatory reserve with nitroglycerin (2.1 +/- 1.0 to 2.2 +/- 1.1) and significantly less than that with papaverine (3.3 +/- 2.2, p less than 0.05). These data indicate that the clinical advantages of nonionic or low-osmolar contrast media are not mechanistically related to significant attenuation of the coronary hyperemic response.

Blood Flow Velocity↗
PubMed1978

Measurement of atrial septal defect during cardiac catheterization. Experimental and clinical results.

The size of experimental and clinical secundum atrial septal defects may be accurately measured during cardiac catheterization. The position of the defects in the septum and their distance from the aortic and mitral valves may also be ascertained. A balloon catheter inflated with radiopaque dye is used for the measurement. The volume of dye in the balloon has been correlated with its maximal diameter. Thus, a no. 8-10 French catheter filled with 10 ml of diatrizoate (50 percent) has a diameter of approximately 25 mm and a no. 8-22 French catheter filled with 40 ml of diatrizoate a diameter of approximately 43 mm. Persistent arrhythmias or other adverse effects of the procedure were not observed. There was a high correlation between balloon-measured atrial septal defects and those measured at necropsy in the animals or at operation in the patients. These measurements aid in determining whether an ostium secundum defect is of proper size and location to be closed transvenously and may also prove valuable in physiologic studies of atrial septal defects or other cardiac anomalies.

Adolescent↗
PubMed1989

Effects of contrast media on endothelial cell monolayers under controlled flow conditions.

To compare the biocompatibility of nonionic and ionic intravascular contrast media in a more physiologic in vitro system, key aspects of blood flow through a microvessel were simulated. Toward this end, monolayers of endothelial cells placed in a specially designed flow chamber, real-time imaging of the monolayers by brightfield and phase videomicroscopy, and real-time imaging and computer-aided quantitation at normal hematocrit levels of platelet adhesion/aggregation to sites of monolayer injury by means of epifluorescence videomicroscopy were used. At a concentration in culture medium of 20% by volume, it was found that monolayer morphology was least altered by iohexol when compared with diatrizoate and ioxaglate; monolayer production of prostacyclin was enhanced (p less than 0.001) by ioxaglate compared with saline controls; and at a concentration in citrated blood of 20% by non-red-cell volume, platelet adhesion/aggregation was reduced by all 3 contrast agents in the order diatrizoate greater than ioxaglate greater than iohexol.

Adult↗
PubMed1996

Variable influence of heparin and contrast agents on platelet function as assessed by the in vitro bleeding time.

Both heparin and contrast agents have anticoagulant effects which are well-documented but their effects on platelets are not well-characterized. The purpose of the present study was to evaluate the sequential effects of heparin and then a contrast agent on platelet function during an angiographic procedure. Blood samples from 54 patients were obtained at baseline, after a 5000 unit bolus of heparin and after administration of a contrast agent (iohexol, n = 30: diatrizoate, n = 24) during angiography. The in vitro bleeding time (IVBT) was determined on nonanticoagulated whole blood using a hollow fiber device under physiological flow conditions. Mean IVBT at baseline was 3.6 +/- 2.7 minutes and increased to 17.0 +/- 12.3 minutes after heparin (p < 0.01). After heparin, 44.5% of the patients still had a normal IVBT (< 9.0 minutes), 11% of the patients had a moderately increased IVBT and the remaining patients had a large increase in their IVBT. When contrast was given (167 +/- 52 mls) following heparin, mean IVBT was higher in those who received diatrizoate (23.3 +/- 9.4 minutes) compared with iohexol (15.0 +/- 10.9 minutes, p < 0.05). However, 15 patients (28%) continued to have a normal IVBT after contrast and of these 80% had received iohexol.

Aged↗
PubMedDate not supplied

Influence of radiographic contrast media on granulocyte enzymes and complement during uncomplicated urographies.

Four different radiographic contrast media (RCM) were used for i.v. urography in 40 patients, none of whom had complications. No rise in C3d was observed for any of the RCM, indicating that complement was not activated. However, significantly decreased values for CH50 were detected when the non-ionic RCM iopamidol and iohexol were used, and this may be due to interaction between the RCM and the complement molecules. Significantly increased numbers of neutrophils were observed in patients receiving ioxaglate, iohexol and diatrizoate, which may be due to inhibition of granulocyte adherence. No rise in the concentration of elastase and lactoferrin was observed. On the other hand, significantly decreased values of elastase were seen after injection of diatrizoate, which may be due to inhibition of the degranulation process by this media.

Complement Activation↗
PubMed1995

Impairment of fibrinolysis by streptokinase, urokinase and recombinant tissue-type plasminogen activator in the presence of radiographic contrast agents.

OBJECTIVES: The purpose of this study was to determine whether an adverse interaction exists between radiographic contrast agents and thrombolytic drugs. BACKGROUND: Coronary thrombosis may occur in the setting of unstable angina and after coronary angioplasty. However, the use of thrombolytic drugs in the setting of unstable angina has not been beneficial and, in one large trial of angioplasty in patients with unstable angina, was associated with an increased incidence of ischemic complications and abrupt closure. The reasons for these results are not clear. Coronary arteriography was performed in many of these trials, and it is known that fibrin structure and assembly are altered by radiographic contrast agents. METHODS: Blood samples were obtained from patients before (n = 25) and after (n = 20) angiography using iohexol. Blood samples obtained before angiography were tested for response to streptokinase (10 and 100 IU/ml), urokinase (100, 200 and 500 IU/ml) and recombinant tissue-type plasminogen activator (rt-PA) (100 and 1,000 IU/ml) and the results measured. Iohexol, diatrizoate or ioxaglate (4% by volume) was added to separate aliquots of the baseline sample, and the test was repeated. Blood samples obtained after angiography were tested in a similar manner. RESULTS: The onset of lysis at baseline by rt-PA at 1,000 IU/ml occurred at 72 +/- 8.2 s (mean +/- SD) and was markedly delayed in the presence of diatrizoate (527 +/- 181.7 s, p < 0.001) or iohexol (460 +/- 197.0 s, p < 0.001) but not ioxaglate. At 100 IU/ml, there was no lysis detected with rt-PA after the addition of any contrast agent. The addition of a contrast agent caused similar delays in the onset of lysis by urokinase and streptokinase; similar to rt-PA, the effect was smaller at higher concentrations of drug. In vivo blood samples obtained from the patient after angiography showed delays in the onset of lysis by rt-PA and urokinase but not streptokinase. CONCLUSIONS: These data demonstrate that radiographic contrast agents impede fibrinolysis. This previously undescribed interaction was demonstrated using an in vitro test system, but these findings may have clinical relevance when thrombolytic drugs are used at the time of angiography.

Contrast Media↗
PubMed1990

Contrast media in sialography: a comparison of Lipiodol Ultra Fluid and Urografin 290.

A prospective, randomized study of 60 patients undergoing sialography was conducted to compare Lipiodol Ultra Fluid (UF) (Ethyl diiodostearate, May & Baker Ltd), with Urografin 290 (meglumine diatrizoate 52.1% w/v and sodium diatrizoate 7.9% w/v, Schering). The quality of the images, the clinical tolerance and the side-effects of contrast were compared. Both agents produced adequate opacification of ducts but poor intra-gland duct filling was seen in two patients examined with Lipiodol UF. There were significantly more side-effects (which were also more severe) in the Lipiodol group. It is concluded that Urografin 290 is the better contrast agent for sialography because of better filling of intra-gland ducts and greater clinical tolerance.

Adolescent↗
PubMed1991

Increased urinary mucus production: a sequela of cystography following enterocystoplasty.

Early postoperative urinary mucus secretion was evaluated in 13 consecutive patients who underwent lower urinary tract reconstruction with incorporation of bowel segments, and the effect of intravesical infusion of sodium diatrizoate and meglumine diatrizoate in aqueous solution (Urografin 30%) was assessed. The mean volume of urinary mucus extracted before and immediately after cystography increased from 1.4 to 9.6 ml., respectively (p less than 0.0001). We conclude that mucus excretion increases significantly immediately following cystography during the early postoperative period. During that critical time cystography may cause potential hazards of mucus retention and catheter obstruction, which should be anticipated and treated promptly.

Adult↗