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At least 811 records · Page 45Linked to original sources
PubMed1993

Renal streak artifact during contrast-enhanced CT: comparison of low versus high osmolality contrast media.

Two hundred abdominal computed tomographic (CT) scans in 200 patients, 100 performed with low osmolality contrast (ioversol 68%, 100 ml) and 100 performed with high osmolality contrast (diatrizoate meglumine 60%, 150 ml), were retrospectively evaluated for the presence of renal streak artifact. Contrast was administered by hand injection at a rate of approximately 1-2 ml/s and sequential scanning was employed. Of the scans performed with high osmolality contrast, 70% had no artifact, 28% had minimal artifact, and only 2% had marked artifact. Only 26% of the exams performed with low osmolality contrast were artifact-free, whereas 53% demonstrated minimal artifact and 21% demonstrated marked artifact. The likelihood of encountering renal streak artifact when using low osmolality contrast agents is almost seven times greater than when high osmolality contrast agents are used.

Adult↗
PubMed1988

Improvement of IVDSA of the brachiocephalic arteries using a non-ionic contrast medium.

The introduction of IVDSA provides a safer method of angiographic investigation of the aortic arch and brachiocephalic arteries than conventional angiography in patients with cerebro-vascular disease. The quality of visualization however decreases. Instead of changing over to IADSA we find it worthwile to try to improve IVDSA in different ways. One of them is represented in this prospective double blind cross-over study in which we have investigated the effects of using an isotonic non-ionic contrast medium, iohexol (omnipaque), in comparison to meglumin-sodium-diatrizoate (urografin) which is widely used. Iohexol causes less severe side-effects, less severe artifacts and a better image quality. A statistical relation between parameters could not be established. A lag-effect exists for side-effects. The necessity of using low osmolar contrast media is discussed.

Angiography↗
PubMed1992

Evaluation of hepatic density change by dynamic CT in healthy humans and in patients with chronic liver diseases.

Dynamic computed tomography using 0.4 ml/kg of 65% meglumine diatrizoate was performed to estimate pharmacokinetics of contrast media in the liver in healthy controls (N = 11), in patients with chronic viral hepatitis (N = 17), posthepatic liver cirrhosis (N = 21), and alcoholic liver cirrhosis (N = 23). The time of peak enhancement (the time interval between peak aortic and liver enhancement) was significantly different between each group. Alcoholic liver cirrhosis was the most prolonged, followed by posthepatic liver cirrhosis, chronic viral hepatitis, and finally controls. A peak enhancement time of 28 sec had a diagnostic accuracy of 97% for chronic liver diseases. A time greater than 44 sec had a diagnostic accuracy for cirrhosis of 96%. The decay time (the time from peak enhancement of the liver to the curve's center of gravity) was also significantly different between each group. Again, alcoholic liver cirrhosis was the longest, followed by posthepatic liver cirrhosis, chronic viral hepatitis, and then the controls. Dynamic computed tomography has many potential applications in studying intrahepatic physiologic events and may contain diagnostic information for chronic liver diseases.

Adult↗
PubMedDate not supplied

Contemporary management of meconium ileus.

Meconium ileus was noted as an early manifestation of cystic fibrosis in 60 neonates between 1972 and 1991. There were 20 girls and 40 boys. A family history of cystic fibrosis was present in six children. Twenty-five neonates had uncomplicated meconium ileus due to inspissated meconium within the terminal ileum. Thirty-five neonates presented with 56 complications of meconium ileus, including volvulus (n = 22), atresia (n = 20), perforation (n = 6), and giant cystic meconium peritonitis (n = 8). Clinical presentation included abdominal distension, bilious vomiting, and failure to pass meconium. In two recent cases, prenatal ultrasonography detected a mass with proximal bowel distension indicative of cystic meconium peritonitis. Mechanical bowel obstruction in the other neonates was diagnosed from plain abdominal radiographs and barium enema. Ten patients with uncomplicated meconium ileus were successfully treated with a diatrizoate meglumine (Gastrografin) enema. The remaining 15 patients required a laparotomy, with 9 treated by bowel resection and enterostomy and 6 recent cases managed with enterotomy and irrigation. Complicated cases were managed by bowel resection and anastomosis (n = 15) or enterostomy (n = 20). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 89% for those with complicated meconium ileus. The therapy of choice for uncomplicated meconium ileus is nonoperative Gastrografin enema, with enterotomy and irrigation reserved for enema failures. Complicated cases require exploration and, in the absence of giant cystic meconium peritonitis, are usually amenable to bowel resection and primary anastomosis.

Anastomosis, Surgical↗
PubMed1991

Comparative examination of various rectal tubes and contrast media for the reduction of intussusceptions.

The hydrodynamic influence of different rectal tube sizes, contrast media, and heights of the fluid column on hydrostatic reduction of intussusception was analyzed in vitro. Enemas were performed in dead rabbits to compare the filling speed of bowel with a liquid and a gaseous contrast medium. For hydrostatic reduction, tubing and rectal tube with a large caliber and a low viscosity contrast medium achieved a higher filling speed of colon and are expected to provide a higher force of reduction on the intussusceptum. A rectal tube with a large caliber can be more useful than an increase of the column height. Filling bowel with carbon dioxide was approximately 7 times faster than with meglumine sodium diatrizoate. Theoretical considerations allow the hypothesis that a gaseous medium provides a faster and steadier reduction than a liquid.

Animals↗
PubMed1992

Pouchogram: predictor of clinical outcome following ileal pouch-anal anastomosis.

UNLABELLED: Among 914 patients undergoing ileal pouch-anal anastomosis (IPAA) between January 1981 and June 1989, 463 (51 percent) had a pouchogram (meglumine diatrizoate [Gastrografin; E.R. Squibb & Sons, Inc., Princeton, NJ] enema) to assess anastomosis and ileal pouch integrity before closure of the ileostomy. The aim was to determine whether a pouchogram was useful in predicting clinical outcome. RESULTS: Abnormal findings were present in 74 patients (16 percent). These included anastomotic and pouch leaks and anstomotic strictures. Pouchograms were normal in the remaining 389 patients (84 percent). The incidence of significant anastomotic stricturing requiring dilatation under anesthesia was much higher in the abnormal than in the normal pouchogram group (33 percent vs. 4 percent, respectively; P less than 0.001). More significantly, an abnormal pouchogram was associated with an overall long-term failure rate of 23 percent, compared with 6 percent for a normal pouchogram (P less than 0.001). CONCLUSION: Abnormal findings in a pouchogram prior to ileostomy closure indicated those patients at high risk of long-term complications following IPAA.

Adolescent↗
PubMed1999

Enema-induced perforation of the rectum in chronically constipated patients.

INTRODUCTION: The use of retrograde irrigation enemas is common in the treatment of chronic constipation, especially in the elderly. Perforation of the rectum and sigmoid colon caused by cleansing enemas, used by chronically constipated patients, has not been previously described. METHODS: We reviewed all patients with colorectal perforations caused by irrigation enemas admitted to our service in the three-year period between January 1995 and December 1997. RESULTS: Thirteen patients were treated by our surgical service because of perforations of the rectum and sigmoid colon related to a previous retrograde irrigation enema. Ten of these patients came from nursing homes, and the other three lived at home. The relevant information relating the enema administration to the patient's condition was given in only two of the ten patients referred to the emergency room by the institution's nursing or medical staff. In the other eight the information was vague and sometimes misleading. The diagnosis of colorectal perforation was made by history, plain abdominal x-rays, and CT scan with or without meglumine diatrizoate enemas. Ten patients survived, regardless of age, previous diseases, or operative findings. In all of them, diagnosis was made within 36 hours from the perforation. The three deaths occurred in patients in whom the diagnosis was made late. CONCLUSIONS: Awareness of the possible injury from enemas administered to chronically constipated patients should be stressed. A high degree of suspicion by the attending physician is extremely important, because prompt diagnosis and early surgical treatment carries a relatively good prognosis.

Adult↗
PubMed1982

Experimental myocardial ischemia II: radiographic contrast media toxicity.

The comparative effects of meglumine sodium diatrizoate (MSD), sodium meglumine calcium metrizoate (SMCM), and metrizamide (M) were studied in an isolated canine heart preparation. The parameters observed were coronary blood flow (CBF), myocardial contractile force (MCF), positive and negative dF/dt, and perfusion pressure during normal and ischemic perfusion conditions. MSD had an initial negative inotropic effect but baseline MCF returned in 1 min during normal perfusion and 2 min under ischemic conditions. SMCM and M had only a positive inotropic effect under normal perfusion. However, during ischemia, the positive effect of SMCM was followed by a decrease in contractile force. M showed only a positive effect on force during ischemia. Our results indicate that calcium additive may increase the risk of coronary arteriography in patients with severe coronary artery disease.

Animals↗
PubMed1981

Effects of intracoronary administration of contrast materials on left ventricular function in the presence of severe coronary artery stenosis.

The effects of intracoronary administration of contrast materials on regional and global left ventricular (LV) function were assessed in anesthetized dogs with segmental myocardial ischemia produced by critical stenosis of the circumflex coronary artery. Effects caused by sodium meglumine diatrizoate (R76), sodium meglumine calcium metrizoate (ISO), and metrizamide were evaluated. In the nonischemic state R76 produced an early (0-10 seconds) decrease in LV contractility followed by a late (10-20 seconds) positive inotropic effect. In the presence of regional ischemia there was prolongation of the negative inotropic effect. ISO produced only positive inotropic effects without significant differences between responses in the nonischemic and ischemic states. Metrizamide produced almost no alterations in LV function.

Animals↗
PubMed1982

Iopamidol in urography. A comparison between ionic and nonionic contrast media in patients with normal and impaired renal function.

The radiographic results obtained in urography with iopamidol, a new low osmolality contrast medium, given to 50 patients with normal renal function and 42 patients with impaired renal function, have been evaluated and compared with those obtained with ionic media of current use (meglumine sodium diatrizoate and sodium iothalamate). Based on this comparison, the authors believe there are no significant radiographic advantages to iopamidol.

Contrast Media↗
PubMed1991

Angiographic contrast media interference with laser-induced fluorescence excitation and detection in atherosclerotic human coronary arteries.

Laser-induced fluorescence has been used in conjunction with angiography for laser angioplasty guidance. The effect of radiopaque contrast media on the excitation and detection of arterial fluorescence has not been previously reported. Accordingly, fluorescence emission spectra from human coronary artery necropsy specimens (n = 7) during excitation with pulsed excimer laser excitation (308 nm) was examined before and after the addition of three different contrast media, sodium and meglumine diatrizoate, sodium and meglumine ioxaglate, and iopamidol. A decrease in overall fluorescence intensity was observed at all wavelengths for each contrast agent examined. The decrease in intensity of fluorescence emission was more marked at wavelengths less than 410 nm than at wavelengths above 425 nm. Similar effects were observed for contrast media diluted with whole blood. Absorption spectra for all three contrast media demonstrated absorption in the ultraviolet centered around 240 nm. We conclude that preferential absorption in the ultraviolet range by contrast media interferes with the excitation and detection of laser-induced fluorescence; use of visible light excitation may obviate interference with laser-induced fluorescence analysis of plaque.

Angioplasty, Laser↗
PubMed1992

Contractile, metabolic and arrhythmogenic effects of ionic and nonionic contrast agents in the isolated rat heart.

Intracoronary administration of contrast agents may be associated with contractile dysfunction and arrhythmias. To further establish the mechanisms of these alterations, we studied high-energy phosphate metabolism, developed pressure, the occurrence of arrhythmias, and the effects of verapamil during infusion of ionic and nonionic agents in isovolumic, retrogradely perfused rat hearts using 31P nuclear magnetic resonance imaging (NMR). Diatrizoate meglumine (Renografin) infusion reduced developed pressure (DP) to 17.1 +/- 3.4% (p less than 0.001) of the control level, and immediately following termination of the infusion, sudden ventricular tachycardia (VT) was observed in four of six hearts. In the presence of verapamil, meglumine reduced DP to 13 +/- 1.9% of control values and none of these six hearts developed VT. Iopamidol infusion in the presence of verapamil (n = 6) and alone (n = 6) resulted in a decrease in DP to 87% of control value, and no arrhythmias, significant change in high-energy phosphate levels, or changes in pH were observed. These results suggest that contrast-induced contractile depression is not mediated by changes in high-energy phosphate metabolism or pH. Arrhythmias associated with meglumine administration alone and suppressed by verapamil are probably related to calcium loading.

Adenosine Triphosphate↗
PubMed1992

Comparison of two classes of non-peptide drugs as antagonists of neutrophil receptors for f-Met-Leu-Phe. Pyrazolons and iodinated radiographic contrast agents.

The radiographic contrast agent sodium diatrizoate (DTR) reportedly inhibits f-Met-Leu-Phe-induced chemotaxis in human neutrophils. DTR is also an ingredient of Ficoll-Paque, a density centrifugation medium widely used to purify human polymorphonuclear leukocytes (PMNs). Exposure of PMNs to DTR during preparation had no detrimental effect on subsequent binding characteristics of tritiated f-Met-Leu-Phe, probably owing to a rapid dissociation of DTR from the PMN receptors. DTR competed directly with f-Met-Leu-Phe for receptor binding, but was 160- and 640-fold less potent than phenylbutazone and 1,2-diphenyl-4-[3-(1-naphthyl)-propyl]-3,5-pyrazolidinedione (DPN; an analog of phenylbutazone), respectively. Iohexol and the methylamide of DTR did not compete with [3H]f-Met-Leu-Phe in receptor binding, supporting the existence of a definite interaction between iodinated aromatic molecules and the f-Met-Leu-Phe receptor. DTR did not inhibit prostaglandin synthesis, as did DPN. Both drugs inhibited chemotactic peptide-induced release of superoxide anion in a concentration-dependent manner, and were relatively selective for f-Met-Leu-Phe, as opposed to C5a. Both drugs at 10 microM interfered non-selectively with chemotactic peptide-induced beta-glucuronidase release from PMNs. Available non-peptide antagonists of f-Met-Leu-Phe exhibited other pharmacodynamic properties that could make them unsuitable for future in vivo studies designed to probe the physiological role of the receptor.

Binding, Competitive↗
PubMed1982

Contrast agents used for excretory urography impair platelet function in human patients.

The platelet function was investigated in 65 patients submitted to diagnostic excretion urography (injection of 60 ml contrast medium). Blood sampling was performed before (T0) 90 seconds after (T1) and 30 minutes after (T2) injection of the radiocontrast molecule (RCM). Five RCM of different osmolality ionicity and nature of the lateral chain have been tested. Platelet aggregation, platelet release of ATP, osmolality, total calcemia and ionized calcium level were determined on each plasma sample as well as RCM concentration at T1 and T2. Decrease (20 - 40%) of platelet aggregation occurred at T1, whichever platelet aggregating agent (ADP, collagen, Ristocetin or thrombin) were used (significant after Iopamidol 300 and Na Meg Ioxaglate). Platelet release of ATP induced by collagen was also decreased or delayed. These changes were rapidly reversible and a tendency to improvement was observed at T2. Among the five RCM tested, one (Na Diatrizoate) might be a proaggregating agent. No changes of osmolality occurred in the plasma and no correlation could be established between RCM concentration and platelet inhibition. A pathogenic hypothesis is suggested by the significant fall of total and ionized calcium level after RCM injection.

Adenosine Triphosphate↗
PubMed1975

Ureteroileosigmoidostomy. Long-term results.

Ureteroileosigmoidostomy has been performed on 86 patients during the past twenty years, primarily for carcinoma of the bladder. Twenty-seven patients survived longer than five years. Severe complications occurred in 25 cases, and 11 per cent of the series required subsequent surgery. Hydronephrosis developed in 10 per cent. Ureteral reflux could be demonstrated by diatrizoate meglumine (Gastrografin) enema in 6 patients only.

Acidosis↗
PubMed1980

In vitro effects of radiographic contrast media on the complement system.

The effect of several radiographic contrast media on the complement system in vitro was examined using quantitative crossed immunoelectrophoresis. Diatrizoate, iothalamate, metrizoate, and methiodal did not cause electrophoretic conversion of C3 or properdin factor B. In fact, the small degree of spontaneous conversion occurring when serum is incubated in polypropylene tubes was inhibited by these contrast media or by hypertonic sodium chloride. Metrizamide caused enhanced conversion of C3 and factor B that was only partially inhibited by ethylene glycol tetracetic acid (EGTA) but completely inhibited by ethylenediaminetetraacetic acid (EDTA). Iodipamide caused a unique electrophoretic alteration of C3 that was not affected by EDTA or several other inhibitors and that was not identical with the usual products of C3 activation. Iodipamide in very low concentrations inhibited complement activation through the classical pathway.

Citrates↗
PubMed1992

Serious or fatal complications after inadvertent administration of ionic water-soluble contrast media in myelography.

The consequences of the inadvertent administration, by the intrathecal route, of ionic contrast media instead of iopamidol in seven subjects are reported. The ionic compounds were diatrizoate, iodamide and ioxitalamate. The outcome was fatal in three out of seven subjects, and it depended on the type and the dose of the administered contrast agent. The serious or fatal reactions observed are a tragic confirmation of the predictive power of neurotoxicity data obtained in animal studies with various iodinated water-soluble compounds. The margin of safety, represented by the ratio of LD50 i.ce. in mice to clinical dose in humans, both normalized to bodyweight, appears to reliably reflect the risk of toxic reactions after intrathecal administration of iodinated contrast agents.

Adult↗