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PubMed1977

A review of the findings on computed cranial tomography following intravenous contrast media.

The diagnostic contribution of contrast enhancement by intravenous injection of meglumine diatrizoate was assessed in 121 patients who received both plain and contrast enhanced cranial CT scans. The use of contrast enhancement was found to provide both an increased sensitivity in detection of lesions and some improvement in pathological differentiation of lesions. The use of contrast enhancement in addition to plain CT scans increases the reliability of CT scans in excluding such conditions as neoplasms, abscesses, and vascular malformations. Because the use of contrast medium is associated with morbidity (and significantly extends the length of the total study), the decision to employ contrast enhancement must be based upon a careful evaluation of the clinical, other radiological, and plain CT findings in the individual patient.

Brain Diseases↗
PubMedDate not supplied

[A mathematical analysis of the relationship of the clinical manifestations of side effects to the blood biochemical indices in subjects undergoing x-ray contrast studies].

During 73 single contrast investigations with 76% triobrast, 76% verographin, 76% urographin, urotrast and omnipaque-300, 65% of patients had clinical adverse reactions which were mainly mild. In 79% of cases, the syndrome of side effects consisted of one clinical manifestation. The occurrence of clinical adverse reactions caused by diatrizoate derivatives was proved to be associated with the elevation of blood levels of histamine and prostaglandin F2 alpha, with the activation of the complement system by an alternative pathway and to be independent of the sex and age of patients. According to the effects of contrast media on these blood biochemical parameters, patients are classified as "tolerant" and "sensitive", the proportion of the latter is 50-80%. With this, plasma histamine levels greater than values of the capacity of the complement system to activate by the alternative pathway greater than blood prostaglandin F2 alpha amounts may serve as mathematically significant criteria for the likelihood of side reactions occurring in the contrast diagnosis with diatriazoates. An elevated diastolic pressure is a valid symptom of side effects of the radioopaque media tested by us on the human body.

Adolescent↗
PubMedDate not supplied

Renal cortical retention of contrast medium after angiography as assessed by delayed CT: a multivariate analysis.

Renal cortical retention (RCR) of contrast medium discovered by delayed X-ray examination is sometimes reported in patients with problems in the urinary system. However, we frequently found RCR even in patients with normal renal function. Therefore, we examined the incidence and factors involved in RCR by delayed computed tomography (CT) 12-24 hours after angiography in 168 patients. RCR was found in 80 of 168 cases (48%). Ioxaglate (60%) and iohexol (60%) showed higher incidences of RCR than diatrizoate (37%) and iopamidol (37%). Multivariate logistic regression analysis was performed to determine the predisposing factors of RCR. Dose of administered contrast medium by body weight (p = 0.004), age (p = 0.009), sex (p = 0.013), type of contrast medium (p = 0.003), serum albumin (p = 0.011), and serum creatinine (p = 0.002) were identified as significant and independent predisposing factors of RCR. We suggest that RCR is not a rare phenomenon if delayed CT is carried out.

Adolescent↗
PubMed1996

Non enzymatic liver cells isolation: citrate-perchlorate technique.

In the present study we describe a non-enzymatic technique for the isolation of rat hepatocytes by perfusion of liver through portal vein. The perfusion media consist of 1 mM sodium perchlorate, 5 mM sodium citrate, 10 mM glucose, 129 mM NaCl and 0.1% bovine-serum albumin at pH 7.4. After purification through diatrizoate gradient, electron microscopical studies revealed that most of purified hepatocytes were well preserved and presented a normal ultrastructure, thus correlating with previous biochemical results. The present method enables the recovery of metabolically and morphologically normal hepatocytes.

Animals↗
PubMed1996

Are 5-HT1A receptors involved in the control of reflex bradycardia induced by intracoronary injection of contrast medium in humans?

Transient vagal bradycardia occurring during coronary arteriography (CA) immediately following intracoronary injection of ionic contrast medium is believed to be a component of the von Bezold-Jarisch reflex (BJ). Data obtained from experimental animals using buspirone (BSP) and other 5-HT1A receptor ligands suggest that these serotonergic receptors modulate the excitability of cardiac vagal motoneurones (CVM). This is a preliminary investigation of the possible effects of BSP in altering the bradycardia of patients submitted to CA for diagnostic purposes. Patients were divided into two age- and race-matched groups: control (C:N = 45, age 58.6 +/- 1.6 years, mean arterial blood pressure (MAP) 109 +/- 2.4 mmHg, heart rate (HR) 79 +/- 2.9 bpm) and BSP-treated (B:N = 14, age 58.9 +/- 2.1 years, MAP 111 +/- 4.5 mmHg, HR 76 +/- 3.4 bpm). The prevalent underlying pathology was coronary artery disease. Patients with acute angina, congestive heart failure, symptomatic arrhythmia and patients requiring atropine were excluded. CA was performed by a standard procedure using diatrizoate (MD-76) as contrast agent. The left and then the right coronary ostia were selectively catheterized and 8 ml of contrast medium was injected (over a period of 3 sec). HR was measured from ECG tracings before and after contrast injection into the left (LC) and right (RC) coronary arteries. Peak bradycardia was measured as the longest R-R interval during the first 15 sec after the injection minus the pre-injection R-R value, and reported as delta R-R. Group B patients received BSP tablets 48 and 24 h before the examination (30 mg/day po). There was no statistically significant difference (P > 0.05) in bradycardia between groups (C:LC = -147 +/- 23, RC = -155 +/- 25; B: LC = -143 +/- 44, RC = -234 +/- 56 msec). These results suggest that, in contrast to experimental animals, the central 5-HT1A receptors of humans are not relevant for modulating the excitability of CVM in the BJ reflex. However, since drugs and diseases can affect the responses, further studies are necessary to clarify this issue.

Adult↗
PubMed1998

Prophylactic abdominal drainage after elective colonic resection and suprapromontory anastomosis: a multicenter study controlled by randomization. French Associations for Surgical Research.

BACKGROUND: Only 4 controlled trials have investigated whether prophylactic abdominal drainage was of value after colonic resection. None have been able to find any statistically significant difference, but the number of patients was small and the beta error risk was high. OBJECTIVES: To compare patients who underwent abdominal drainage with those who did not for the rate and severity of complications after elective colonic resection followed immediately by anastomosis of the suprapromontory colon and to compare suction drains with nonsuction drains. PATIENTS: Between September 1990 and June 1995, 319 patients (135 men and 184 women), whose mean age was 67 years (range, 22-95 years), with carcinoma, benign tumors, or colitis, located anywhere between the ascending and sigmoid colons, were included in the study. Patients were comparable for demographic characteristics, except that there were more patients with ascites in the group that did not undergo abdominal drainage (P<.02). INTERVENTIONS: After 2 protocol violations, 156 patients were randomized to the abdominal drainage group and 161 to the no abdominal drainage group. All 317 anastomoses were tested for airtightness intraoperatively and repaired if leakage was found (n=71), and all patients with anastomoses received a routine diatrizoate sodium enema to detect infraclinical leakage. MAIN OUTCOME MEASURES: The postoperative complications possibly influenced by drainage included (1) deep complications for which drainage can lead to early diagnosis, such as generalized or localized peritonitis, intraabdominal hemorrhage, or hematoma; (2) complications believed to be enhanced by drainage, such as an operative wound (an abscess, disruption, or incisional hernia) or pulmonary (microatelectasis) and intestinal obstructions; and (3) complications directly due to the drains, such as ulcerations leading to fistulae, hemorrhages, drainage tract infections, difficulty in removal, intra-abdominal retention, and incisional disruptions. Subsidiary end points were the severity of these complications as assessed by the number of related subsequent operations and deaths. RESULTS: Twenty-six patients overall (8%) had postoperative complications possibly influenced by drainage (9% in the group that underwent abdominal drainage and 8% in the group that did not). This difference was not statistically significant (P<.90). One patient had a fistula directly imputable to drainage. There was no difference between suction and nonsuction drainage (P<.90). CONCLUSIONS: Routine abdominal drainage after colonic resection and immediate anastomosis decreases neither the rate nor the severity of anastomotic leakage. It can, occasionally, be detrimental.

Abdomen↗
PubMed1978

Silent perforations of the stomach and duodenum by needles.

We present a series of ten patients consecutively admitted to the hospital after swallowing 12 household sewing needles. Ten of these needles, one in each patient, had perforated either the stomach or the duodenum, but in no case did the perforation cause any abdominal symptoms or signs. Immediately after arrival in the emergency ward, the diagnosis was made in most cases by means of a diatrizoate meglumine swallow, which showed the tip of the needle protruding outside the gastrointestinal tract. In the first few cases, the diagnosis was made by finding the needle in the same position after repeated plain abdominal roentgenograms. This method, however, served to delay the diagnosis of perforation. All patients were operated on immediately after the diagnosis of perforation was made, except for two who had an additional ingested needle. Operation was delayed in these patients until the second needle was spontaneously eliminated. Perforation was confirmed by operation in all cases in the present series, the operative extraction of the needle was simple, and recovery was uneventful. The fact that patients may remain asymptomatic despite perforation of their stomach or duodenum by sharp, fine foreign bodies is no cause for procrastination of surgery, as severe complications may subsequently result.

Adolescent↗
PubMed1989

Changing patterns of treatment and survival in neonates with meconium ileus.

This report describes 51 neonates with meconium ileus and emphasizes a changing pattern of treatment and improved survival. Twenty-four neonates had uncomplicated meconium ileus due to inspissated meconium obstructing the distal ileum. Twenty-seven neonates had 41 complications of meconium ileus including volvulus (18), bowel atresia (13), perforation (5), and giant cystic meconium peritonitis (5). Nine patients with uncomplicated cases responded to nonoperative clearing of meconium using a meglumine diatrizoate (Gastrografin) enema. Six of 7 patients with enema failures underwent laparotomy, purse-string enterotomy, and intraluminal irrigation. The remaining 9 patients with uncomplicated meconium ileus had resection and enterostomy. Complicated cases were managed by resection and anastomosis (13) or enterostomy (14). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 85% for those with complicated meconium ileus. Nonoperative Gastrografin enema or enterotomy-irrigation can relieve obstruction in uncomplicated meconium ileus and avoid an enterostomy in most cases.

Cystic Fibrosis↗
PubMed1980

A new density gradient system for the separation of human red blood cells.

A new density system for the separation of human red blood cells by density-gradient centrifugation is described. The gradient medium is made with colloidal silica particles coated with polyvinylpyrrolidone suspended in aqueous solution of meglamine diatrizoate. By this method, more than 10 red-cell fractions can be separated. These show different ages (by creatine content and 59Fe in vivo labelling) and different characteristics (ie, potassium content). A 40-fold enrichment in reticulocytes can be obtained in the top layers, with a great improvement of specific activity in labelling procedures of newly synthesized globin chains. The method is simple, rapid, inexpensive, reliable, nontoxic for erythrocytes, and is suitable for globin synthesis and other studies of erythrocyte metabolism.

Cell Separation↗
PubMed1980

Connective tissue activation. XV. Stimulation of glycosaminoglycan and DNA synthesis by a polymorphonuclear leukocyte factor.

Human synovial fibroblasts in culture have been stimulated to augment hyaluronate synthesis and glucose utilization by connective tissue activating peptides (CTAP) extracted from human spleen, lymphocytes, platelets, granulocytes, and tumour cells. The platelet-derived mediator CTAP-III also stimulated DNA synthesis in synovial fibroblasts, but CTAP-I from lymphocytes and spleen did not. The present study demonstrates the mitogenic potential of a granulocyte mediator (CTAP-PMN). Normal granulocytes were prepared with Ficoll-diatrizoate gradients, platelet contamination being estimated by phase microscopy and by radioimmunoassay for the platelet-specific protein, beta-thromboglobulin. CTAP-PMN preparations derived from 4 x 10(7) cells/ml stimulated culture 3H-thymidine incorporation to 3.56 +/- 1.32 (SD) times control levels. Although exposure of preparations to thiols reduced their mitogenicity, CTAP-PMN was relatively heat-stable. SDS gel electrophoresis of active fractions suggested a molecular weight between 12,700 and 15,700 daltons. In double immunodiffusion, antisera to CTAP-III showed no reactivity with CTAP-PMN. CTAP-PMN or other granulocyte factors capable of stimulating fibroblast DNA synthesis may play a role in chronic proliferative synovitis or in other settings where exudative inflammation is accompanied by connective tissue growth.

Connective Tissue↗
PubMed1986

Measurement of urinary cystine and cysteinyl-penicillamine in patients with cystinuria.

A high-performance liquid chromatographic method with electrochemical detection (LC/EC) was developed to measure cystine and cysteinyl-penicillamine disulfide in the urine of patients screened or treated for cystinuria. Urine was acidified, centrifuged to remove urinary protein, diluted and injected. The disulfides were separated on a reversed-phase column, reduced at the upstream electrode of a dual electrochemical detector with gold-mercury amalgam (Au/Hg) electrodes and the resultant thiols measured at the downstream electrode. The sample preparation is simple, the analysis rapid, specimens can be easily batched and the specificity of the method is better than those of two other separative procedures with which it was compared. The coefficient of variation for cystine in cystinuric urine is 6.7%, 5.5% and 3.2% for levels of 0.09, 0.52 and 1.02 mmol/l respectively, and for cysteinyl-penicillamine disulfide 2.6% and 7.5% for levels of 0.45 and 0.98 mmol/l respectively. Urine for analysis of these disulfides should not be collected within 24 hours of administration of the radiopaque agent diatrizoate but no other interference to the assay has been noted. This method is suitable as a screen for cystinuria in patients with renal tract calculi, for ongoing monitoring of cystinuric patients and to check patient compliance with d-penicillamine therapy.

Amino Acids↗
PubMedDate not supplied

MR assessment of iodinated contrast-medium-induced nephropathy in rats using ultrasmall particles of iron oxide.

The purpose of this study was to determine the diagnostic value of ultrasmall particles of iron oxide (USPIO)-enhanced MR imaging at different concentrations to evaluate experimental nephropathy. This study was conducted in 23 uninephrectomized rats using a model of iodinated contrast media-induced renal failure. Eleven rats received selective intra-arterial renal administration of diatrizoate (370 mg I/ml) and were compared to two control groups, including five animals injected with isotonic saline and seven noninjected animals. MR imaging was performed 28 hours after the procedure, including T1- and T2-weighted images before and after intravenous administration of successively 5 mumol Fe/kg and 60 mumol/kg of USPIO. Results were interpreted qualitatively and quantitatively with respect to pathologic data, and differences were studied statistically. The maximal signal intensity decrease was noted in normal kidneys in cortex (-65 +/- 4%) and medulla (-84 +/- 5%) on T2-weighted images after injection of 60 mumol/kg of USPIO. At this dose, diseased kidneys displayed less signal intensity decrease than normal kidneys on T2-weighted images (p = .05). Moreover, qualitative analysis showed that the highest sensitivity and specificity to diagnose kidney involvement were obtained with T2-weighted MR images (75% and 91%, respectively) when 60 mumol/kg of USPIO were used (p < .01). USPIO should be useful for in vivo evaluation of the severity of experimentally induced iodinated contrast media renal impairment in animals.

Animals↗
PubMed1991

Effect of L-phenylalanine methyl ester on the colony formation of hematopoietic progenitor cells from human bone marrow.

We have previously shown that L-phenylalanine methyl ester (PME) is capable of removing monocytes and enhancing the growth of hematopoietic colonies from human peripheral blood (PB) mononuclear cells (MNC). In the present study, we further compared the effect of PME on the colony formation of bone marrow (BM) and PB. Low density (less than or equal to 1.077 g/ml) MNC were obtained by Ficoll-diatrizoate density gradient centrifugation. Granulocyte/macrophage colony-forming units (CFU-gm) and erythroid burst-forming units (BFU-e) were cultured in agarose with conditioned media (CM) and/or interleukin 3 (IL-3), granulocyte colony-stimulating factor (G-CSF) and granulocyte/macrophage-CSF (GM-CSF). Treatment of BM MNC with 5 mM PME for 15 min at room temperature yielded a nucleated cell recovery of 44.8 +/- 5.0% (mean +/- SE; N = 8). CFU-gm were enriched 2.7-fold (range 2.0 to 4.8). Using CM or CM supplemented with G-CSF or GM-CSF has minimal effect on the enrichment. Leukocyte differentials revealed that 94.3 +/- 3.05% of the monocytes, as well as 91.2 +/- 1.60% of the cells in the neutrophilic maturation series were removed by PME. Incubation for 40 min in PME abolished CFU-gm formation. BFU-e were not enriched by the PME treatment. In contrast, 40 min incubation of PB MNC produced higher enrichment of CFU-gm than that obtained from 15 min of treatment, although lower cell recovery was obtained with the longer treatment time. In conclusion, we have demonstrated that phagocytic cells can be removed from BM or PB MNC by PME treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Marrow↗
PubMed1983

Effects of radiographic contrast media on the serum complement system.

The authors explored the activation of the complement system produced by a nonionic organic iodine compound, namely iopamidol, which is proposed as a contrast medium for radiographic examination by intravenous and intra-arterial injection. The study was conducted in vitro versus established ionic contrasts (diatrizoate, iothalamate, acetrizoate) and a nonionic compound (metrizamide). The adopted experimental model was the immunohemolytic detector system, in which the immune complex consisted of goat erythrocytes sensitized with the corresponding antibody (hemolysin), and complement (C') was supplied by guinea pig serum. All the products caused complement activation. The results show that nonionic contrast media produce less activation of the complement system than the traditional ionic contrast. Thus the use of nonionic contrast for radiological procedures necessitating the introduction of contrast material into the blood compartment would imply a reduced risk of anaphylactoid reactions.

Animals↗
PubMed1993

Ileocolonic anastomosis after right hemicolectomy for carcinoma: stapled or hand-sewn? A prospective, multicenter, randomized trial.

440 patients were prospectively enrolled in a randomized, multicenter trial to compare 4 types of manual (84 interrupted end-to-end, 77 continuous end-to-end, 82 interrupted end-to-side, and 91 continuous end-to-side) (polyglycolic derived suture) and 1 type of stapled (106 side-to-side with GIA+TA devices) ileocolonic anastomosis after right hemicolectomy for carcinoma. The trial was designed according to Schwartz' pragmatic formulation. All 5 groups were well-matched, except for a lower rate of intraoperative sepsis in the stapled group (P < 0.02). The main end point was anastomotic leakage detected clinically or by routine sodium diatrizoate enema on the 8-10th postoperative day. Results showed that stapled ileocolonic anastomosis was associated with less anastomotic leakages (2.8%) than all the other techniques combined (8.3%). In spite of the fact that staples are approximately ten times more expensive, our results suggest performing side-to-side (GIA+TA) mechanical anastomosis after right resection for carcinoma.

Adult↗
PubMed1981

Topographic studies of gangliosides of intact synaptosomes from rat brain cortex.

Gangliosides in the external surface of intact synaptosomes from rat brain cortex have been studied by oxidation of exposed galactose and galactosamine groups with galactose oxidase followed by reduction with labeled sodium borohydride. Purified synaptosomes were labeled, disrupted by osmotic shock, and the particulate components fractionated on diatrizoate to give four synaptosomal membrane fractions (A-D) and a mitochondrial pellet (E). Fractions A and B represent synaptosomal plasma membranes. When intact synaptosomes were labeled, the major portion of the total radioactivity incorporated into ganglioside fraction was found to be in GM1 3 species. With isolated membrane fractions little selectivity was seen: (1) more label was present compared to intact synaptosomes, and (2) zones corresponding to GM2, GM1, GD1a, GD1b were the major gangliosides labeled. The results confirm the conclusion that membrane fractions A and B are derived from the exposed synaptosome surface and also show that GM1 is the major ganglioside species available for enzyme oxidation at the surface.

Animals↗
PubMed1978

Effect of ethanol on glucose and water absorption in hamster jejunum in vivo. Methodological problems: anesthesia, nonabsorbable markers, and osmotic effect.

We studied the effect of ethanol on glucose and water absorption in vivo. In preliminary experiments, using sodium amytal anesthesia, we found that control animals, whose jejunal segment was perfused without ethanol, required more anesthetic agent than those perfused with ethanol. Thus, to allow for unbiased comparison of the absorption data between the two groups of animals, all absorption studies were carried out on conscious restrained hamsters. We found that ethanol did not influence the permeability of the jejunum to polyethylene glycol (PEG) and meglumine diatrizoate. In addition, ethanol did not influence the time required for the onset of steady-state absorption. Using both the gravimetric and the electrical methods, we were unable to show any measurable osmotic pressure exerted by ethanol (150-1050 mM) on the hamster jejunum. In the absorption studies we found that perfusion of the hamster jejunum with five increasing concentration of ethanol (450-1050 mM) appeared to cause a concentration-dependent depression in steady-state glucose transport. Water transport was depressed only when 4.8% (1050 mM) ethanol was perfused.

Alcoholic Intoxication↗
PubMed1981

Recovery of heterokaryons at high cell densities following isolation using irreversible biochemical inhibitors.

The selection of heterokaryons using irreversible biochemical inhibitors provides an effective method for isolating fusion products between any types of cultured cells. One weakness of the technique is that the surviving heterokaryons can only be obtained at low culture densities, making their analysis cumbersome. This report describes the use of Ficoll-sodium diatrizoate gradients to partially separate viable from nonviable cells and characterizes the effects of initial plating density and medium volume on heterokaryon survival. The combined result of optimizing these parameters increases cell rescue and permits heterokaryons to attach at densities of 60,000 cells/cm 2 instead of 600 cells/cm 2. These modifications substantially improve the ease of using irreversible biochemical inhibitors to isolate purified populations of heterokaryons.

Animals↗