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PubMedDate not supplied

Rectal "oven mitt": the importance of considering a serious underlying injury.

A 20-year-old man presented with a rectal "oven mitt," which was removed transanally. Rigid proctosigmoidoscopy revealed no apparent perforation, but subsequent contrast enema using meglumine diatrizoate demonstrated an extraperitoneal rectal perforation, which was probably caused by a wooden stick used to forcefully introduce the glove through the patient's anus. Thus, rectal injuries may be caused not by the foreign object itself, but by another object used as an introducer.

Adult↗
PubMedDate not supplied

Ca2+ and cyclic adenosine monophosphate involvement in radiographic contrast medium-induced renal vasoconstriction.

PURPOSE: To investigate the role of extracellular Ca2+ and cyclic 3'-5' adenosine monophosphate (cAMP), a known second messenger promoting smooth muscle relaxation, in preventing renal vasoconstriction induced by radiographic contrast medium (RCM). MATERIALS AND METHODS: Isometric contractions of rabbit renal artery were elicited by potassium chloride and increasing concentrations of meglumine/sodium diatrizoate. To determine the contribution of extracellular Ca2+, nifedipine, a blocker of voltage-dependent L-type Ca2+ channels (VDCC), was applied. The contribution of cAMP was investigated by applying the nonspecific phosphodiesterase (PDE) inhibitors papaverine and theophylline and the specific PDE inhibitor milrinone, all of which prevent degradation of cAMP. Forskolin, an activator of cAMP by stimulating adenylyl cyclase (AC), was also investigated. RESULTS: RCM elicited contractions that were 24.5% of the KCl control contraction, which was reduced by nifedipine (100 mumol/L) by 34.7%. Papaverine, theophylline, and milrinone inhibited RCM-induced contractions by 69.8%, 64.3%, and 43.7%, respectively. Forskolin reduced the response by 82.2%. CONCLUSION: Ca2+ influx through VDCC partially contributes to RCM-induced renal artery vasoconstriction. Intracellular cAMP appears to be an important second messenger pathway for prevention of this response. These findings emphasize the role of second messenger systems involved in adverse RCM effects and the potential prevention of these effects.

Animals↗
PubMedDate not supplied

Targeting of different ethiodized oil-doxorubicin mixtures to hypovascular hepatic metastases with intraarterial and intraportal injections.

PURPOSE: The distribution of different ethiodized oil-doxorubicin mixtures within and around hypovascular liver metastases in athymic nude mice was compared following either intraarterial or intraportal injections. MATERIALS AND METHODS: Six different mixtures of doxorubicin and ethiodized oil in water-soluble contrast material, shaken for 5, 10, 15, and 30 minutes, respectively, were prepared and the size of the oil droplets in the mixtures evaluated. Intraarterial and intraportal injections of mixtures shaken for 10 and 15 minutes were performed in mice bearing hypovascular hepatic colorectal metastases. In vivo video microscopy was used to evaluate microvascular flow and the biodistribution and the size of the oil droplets within and around the tumors. RESULTS: Oil droplets smaller than 20 microns in diameter were taken up by tumor nodules. There was no significant difference in oil droplet accumulation within the tumor between intraarterial and intraportal injections. Oil droplets larger than 20 microns occluded small and medium portal branches. The optimum combination was 0.1 mL of ethiodized oil in 2 mL of diatrizoate sodium meglumine (Renografin-76) shaken for 15 minutes at 800 rpm, which formed droplets smaller than 20 microns (92%). CONCLUSION: Avascular regions of hepatic metastases may be embolized with ethiodized oil-anticancer drug mixtures containing oil droplets smaller than 20 microns. Since these droplets penetrate to the tumor interstitium with either intraarterial or intraportal injections, chemoembolization via the arterial route seems preferable for treatment of unresectable hypovascular hepatic metastases since it is easier to perform. The conclusions drawn from this study are limited to the animal model for experimental hypovascular hepatic metastases.

Animals↗
PubMed1995

Effect of contrast media on in vitro bleeding time: assessment by a hollow fiber instrument.

RATIONALE AND OBJECTIVES: We used a global screening device that operates under physiologic flow conditions to monitor the effects of ionic and nonionic contrast media (CM) on hemostasis. METHODS: This flow dynamic technique perfuses unanticoagulated whole blood through a hollow fiber. A leak in the fiber is created by a precision needle, and the resulting pressure fluctuations within the fiber are monitored to examine the ability of the hemostatic system to close the leak by forming a stable platelet plug. RESULTS: Both ionic and nonionic CM (25% CM/blood, v/v) were shown to lengthen the mean in vitro bleeding times (IVBTs) compared with normal blood. Ionic CM (ioxaglate and diatrizoate) consistently produced IVBTs longer than 30 min. The nonionic CM iopamidol, iohexol, and ioversol gave mean IVBTs of 16.43, 17.63, and 19.84 min, respectively. CONCLUSION: Of the three nonionic CM tested, iopamidol had the greatest probability (31%) of producing an IVBT in the normal range, with probabilities of 5% and 7% for iohexol and ioversol, respectively. Thus, iopamidol offered the least anticoagulant effect among the ionic and nonionic CM we studied.

Bleeding Time↗
PubMed1995

Effects of iodinated contrast media on pulmonary airway resistance in anesthetized guinea pigs.

RATIONALE AND OBJECTIVES: Bronchospasm is occasionally observed following iodinated X-ray contrast medium administration. We performed an in vivo study in guinea pigs to investigate the effects of a number of iodinated contrast media on pulmonary airway resistance and the mechanisms underlying the potential bronchoconstrictor effect. METHODS: The contrast media studied were the pharmaceutical formulations of iomeprol (400 mg I/ml), iopamidol (370 mg I/ml), and iohexol (350 mg I/ml), which are nonionic, triiodinated contrast media; diatrizoate (370 mg I/ml), an ionic, triiodinated contrast medium; iotrolan (300 mg I/ml), a nonionic, hexaiodinated contrast medium; and iocarmate (280 mg I/ml) and ioxaglate (320 mg I/ml), which are both hexaiodinated and ionic contrast media. Each contrast medium was administered intravenously at 2 g I/kg. Changes in pulmonary airway resistance were evaluated by measuring intratracheal pressure at the moment of maximum insufflation, or maximal insufflation pressure (MIP), in anesthetized guinea pigs submitted to forced ventilation. RESULTS: All contrast media except ioxaglate caused mean increases of MIP of no more than 20%. By contrast, ioxaglate caused a marked bronchoconstrictor effect, increasing MIP by 242% +/- 46%. Of the drugs tested for antagonistic action on this increase in MIP, salbutamol inhibited almost completely the increase in MIP for the first 40 min posttreatment. Similarly, lysine acetylsalicylate and indomethacin consistently reduced MIP after contrast media administration to levels only 30% and 14% above those of baseline precontrast media, respectively. Promethazine had only a minor inhibitory effect, and the response to prednisolone varied. CONCLUSION: There was no apparent relationship between the size of the increase in airway resistance and the charge or molecular weight of the contrast agent molecule or the pharmaceutical formulation. The increase induced by ioxaglate must be attributed to inherent molecular toxicity mediated through a direct action on the production of bradykinin and/or the prostanoid products of the cyclooxygenase pathway, rather than through a direct action on the release of histamine.

Airway Resistance↗
PubMed1996

Role of intracellular calcium stores in contrast medium-induced renal vasoconstriction.

RATIONALE AND OBJECTIVES: Renovascular smooth muscle contractility, an important factor in contrast media-induced nephrotoxicity, depends on intracellular Ca2+ concentration, which is composed of extracellular Ca2+ influx and intracellular Ca2+ release. These factors were investigated in contrast media-induced renal vasoconstriction in an in vitro model. METHODS: KCl-induced isometric contractions of rabbit renal artery were compared with contractions elicited by contrast media (diatrizoate, iohexol, iopamidol). Measurements were made after incubation with the Ca2+ channel blockers nifedipine, verapamil, and diltiazem to assess the role of extracellular Ca2+ influx and after ryanodine and thapsigargin to investigate the role of intracellular Ca2+ release. RESULTS: The Ca2+ channel blockers partially inhibited contractions induced by contrast media, while KCl-induced contractions were completely abolished. Ryanodine and thapsigargin also markedly inhibited contrast media-induced contractions. CONCLUSION: Ionic and nonionic contrast media induced quantitatively different renal vasocontractions. Ca2+ channel blockers inhibited this vasocontraction only slightly compared with intracellular Ca2+ release blockers.

Animals↗
PubMed1997

Attenuation of contrast material-induced renal artery vasoconstriction by nitric oxide donors.

RATIONALE AND OBJECTIVES: The authors studied the role of the endothelium and associated endothelial pathways in contrast material-induced renal vasoconstriction. MATERIALS AND METHODS: Isometric contractions in human and rabbit renal artery rings with intact and denuded endothelium were stimulated with phenylephrine and increasing concentrations of the ionic contrast material diatrizoate, the nonionic contrast materials iopamidol and iomeprol, and the dimeric contrast material iodixanol in a tissue perfusion bath. Rings with intact endothelium were incubated with endothelium-stimulating compounds such as the NO synthetase inhibitor Ng nitro-L-arginine methyl ester (L-NAME) to study the endothelium-mediated vasomotor regulation and the NO-liberating substances molsidomine (SIN-1) and nitroprusside (NPR) to study the endothelial-mediated vasorelaxation before being stimulated with contrast material. RESULTS: Contrast material-induced, dose-dependent, reversible renal artery contractions are dependent on the type of contrast material. No differences in the contractions were found between intact and denuded rings. L-NAME had no effect on contrast material-induced contractions. Contractions were inhibited by the NO donors SIN-1 and NPR. SIN-1 was the most potent inhibitor. CONCLUSION: Contrast material-induced renal vasoconstriction is endothelium-independent. Selective pharmacologic stimulation of the endothelium by NO donors, however, may still be useful in the prophylaxis of contrast material-induced renal vasoconstriction and, thus, potentially nephrotoxicity.

Animals↗
PubMed2003

Pharmaceutical and personal care products in sewage treatment works.

In this study a number of analytical procedures are described to determine pharmaceuticals and personal care products (PPCPs) and their metabolites during sewage treatment. The work shows that PPCPs occur in sewage influent and are removed by various wastewater treatment processes. PPCPs include a wide range of chemicals such as prescription drugs as well as diagnostic agents, fragrances, sun-screen agents, and various other compounds commonly present in household items (e.g. detergents, cleaners, toothpastes etc.). During this study a number of PPCPs including painkillers (aspirin, ibuprofen), cholesterol control medication (clofibric acid), antibacterial agents (triclosan), musks (including galaxolide and tonalide), X-ray contrast media (diatrizoate), cancer treatment drugs (cyclophosphamide) and anti-depressant drugs (fluvoxamine) were investigated. Analysis was carried out using a number of techniques. Samples were extracted using solid phase extraction or liquid-liquid extraction and the extracts analysed using capillary gas chromatography-mass spectrometry (GC-MS) with selected ion monitoring or liquid chromatography mass spectrometry (LC-MS) or LC-MS-MS. The results obtained show that aspirin, clolibric acid, diatrozate, fluvoxamine and cyclophosphamide were not detected in any of the crude sewage or sewage effluent samples above the limit of detection of the applied methods. Ibuprofen was detected in all crude sewage samples as well as in all effluent samples with one exception. Removal of ibuprofen by the different STWs was generally between 80-100%, with the exception of one STW where removal was poor (14.4 to 44%). Triclosan was also detected in all crude sewage samples and in all sewage effluent samples. The highest concentration of triclosan detected was 3100 ng l(-1). A high removal efficiency was observed in effluent samples taken on two occasions (average removal 95.6%). The concentrations of musks detected in the crude sewage were generally low except for galaxolide and tonalide. The results from STW effluent samples showed significant removal of galaxolide (70-83% removal) except at one STW (STW 1) where removal was low (57% and 39%). Similar removal efficiencies for tonalide were achieved at these STWs (73-96%) except at STW 1 where removal was poor (53%).

Chromatography, Liquid↗
PubMed1998

Adenosine and extracellular volume in radiocontrast media-induced nephropathy.

Renal hemodynamic changes could play a key role in radiocontrast media-induced nephropathy (RCIN), although the pathophysiological mechanisms are unclear. We investigated the role of adenosine in RCIN caused by sodium diatrizoate (Urografin, 3 ml/kg) in nitro-L-Arg methyl ester (L-NAME)-hypertensive rats in different hydration states [eight weeks of L-NAME (50 mg/liter) in drinking water; high or low sodium intake for the last two weeks]. In clearance experiments under thiobutabarbital anesthesia in these previously mentioned animals, glomerular filtration rate (GFR), renal blood flow (RBF), and mean arterial pressure (MAP) were measured in the presence or absence of the adenosine A1-receptor antagonist 8-cyclopropyl-1,3-dipropylxanthine (DPCPX, 100 microg/kg bolus plus 10 microg/kg/hr). DPCPX or pretreatment did not change control hemodynamics. Contrast medium caused GFR and RBF to fall significantly in volume-depleted rats (from 0.29 +/- 0.02 to 0.21 +/- 0.02 ml/min/100 g and 5.4 +/- 0.3 to 4.0 +/- 0.4 ml/min, respectively) without change in MAP. In volume-expanded rats, changes were not significant (0.25 +/- 0.01 to 0.24 +/- 0.02 ml/min/100 g and 5.6 +/- 0.3 to 5.3 +/- 0.4 ml/min, respectively). In the volume-depleted rats, changes were prevented by DPCPX (0.27 +/- 0.02 to 0.24 +/- 0.02 ml/min/100 g and 4.8 +/- 0.1 to 5.0 +/- 0.1 ml/min, respectively). The acute hemodynamic effects elicited by contrast medium in L-NAME hypertensive rats thus can be prevented by volume expansion. Adenosine, via A1-receptors, contributes to the adverse effects of contrast media.

Acute Kidney Injury↗
PubMed1995

Islet isolation from the pancreas of large mammals and humans: 10 years of experience.

Despite experience, that has been obtained in the field of islet isolation in large mammals for about the past 20 years, allo- and autotransplantation of both human and porcine islets are still not routine procedures. The reasons for islet isolation and purification associated problems, which prevent a continuous isolation success and regular islet transplantation, can be categorized to variables related to 1) pancreas donor; 2) pancreas procurement; 3) isolation-techniques and 4) purification techniques. The development of porcine and human islet isolation was carried out by the authors since 1986. During this period several techniques for the isolation and purification of human and porcine islets were compared with regard to their influence on islet isolation outcome, integrity of islet morphology, islet in-vitro and in-vivo function: sequential vs continuous digestion-filtration, counterflow elutriation vs neutral density separation, conventional density gradient centrifugation vs Cobe cell separation and discontinuous vs continuous gradient purification. Furthermore, we analysed the influence of donor factors and variables related to organ procurement on islet isolation success. From this experience we concluded that successful porcine islet isolation is possible if islets of adult donors are isolated utilizing the continuous digestion-filtration following distension with UW-solution prior to a neutral density gradient purification on a Cobe. Human islets can be successfully isolated by digestion-filtration and purified utilizing a continuous Ficoll-sodium-diatrizoate gradient on a Cobe when intact pancreata are harvested after a secondary pancreatic warm ischemia time < 20 min from adult donors > 30 years.

Adult↗
PubMed1979

[Evaluation of hepatic and renal function after visceral angiography (author's transl)].

A prospective study was carried out in 25 patients following visceral angiography using, on average, 3.5 (2.3 to 4.3) ml/kg. of sodium methyl glucamine diatrizoate 76%. No significant changes were found in the liver enzymes (SGTP, LDH and alkaline phosphatase). On the other hand, there was a significant but temporary rise of serum creatinine from 0.9 +/- 0.2 mg% to 1.2 +/- 0.3 mg% as well as transient proteinuria (7 cases) and microhaematuria (6 cases). With the usual contrast doses for visceral angiography, the kidney appears to be the critical organ. In order to reduce the risks of renal complications, contrast doses should be kept to below 4 ml/kg. if possible; angiography should be carried out only if the patient is well hydrated and the indications for angiography should be particularly stringent if there is previous renal damage.

Adult↗
PubMed1979

Endothelial permeability increase produced by angiographic contrast media.

Permeability changes of the thoracic aortic wall of the rat were examined under light microscopy using the silver staining method. Methylglucamine salts of common angiographic contrast media and metrizamide were tested using a constant iodine concentration. Statistically significant differences between these media were found. The contrast agents were divided into three groups according to the extent of increasing endothelial damage: 1. Metrizamide and methylglucamine diatrizoate, 2. Methylglucamine metrizoate in the presence of calcium and methylglucamine iodamide, 3. Methylglucamine iothalamate. The osmolality of the contrast media was determined. The ionic contrast agents were equal in hypertonicity and metrizamide was nearly isotonic. The endothelial damage caused by the radiographic contrast media seems to depend both on chemical structure and on hypertonicity.

Animals↗
PubMed1997

Virtual computed tomography gastroscopy: a new technique.

BACKGROUND AND STUDY AIMS: The aim of the present study was to establish a suitable method for virtual computed tomography (CT) gastroscopy. PATIENTS AND METHODS: Three-millimeter helical CT scans of a pig stomach were obtained after air insufflation and instillation of diluted diatrizoic acid (Gastrografin), and with double contrast. In addition, three patients with gastric tumors were studied after ingestion of an effervescent agent (Duplotrast, 6 g) and intravenous injection of hyoscine butylbromide (Buscopan, 1 ml). Virtual endoscopy images were computed on a Sun Sparc 20 workstation (128 megabytes of random access memory, four gigabytes of hard disk space), using dedicated software (Navigator, General Electric Medical System Company). The endoscopy sequences were compared with real endoscopic examinations and with anatomical specimens. RESULTS: In the cadaver studies, the best results were obtained with plain air insufflation, whereas virtual CT gastroscopy with diluted contrast and with double contrast showed artifacts simulating polyps, erosions, and flat ulcers. Patient studies showed good correlation with the fiberoptic endoscopy findings, although large amounts of retained gastric fluid substantially reduced the quality of the surface reconstruction. CONCLUSION: These preliminary results show that virtual CT gastroscopy is able to provide insights into the upper gastrointestinal tract similar to those of fiberoptic endoscopy. However, due to the limited spatial resolution of the CT protocol used, as well as inherent image artifacts associated with the Navigator program's reconstruction algorithm, the form of virtual CT gastroscopy studied was not capable of competing with the imaging quality provided by fiberoptic gastroscopy.

Animals↗
PubMed1980

Ipodate and 8-anilino-1-naphthalene sulfonic acid block receptor binding of T3 in rat liver.

We have determined that 8-anilino-1-naphthalene sulfonic acid (ANS) and ipodate are effective inhibitor in vitro of 125I-T3 binding to rat hepatic nuclei receptors. Both of these agents are estimated to have a Kd for the T3 receptor of about 1--2 x 10(-4) M. Indirect preliminary studies suggest that ANS is a non-competitive inhibitor and ipodate is a competitive inhibitor of T3 binding. Compounds such as tyropanoate and diatrizoate and iodide had no effect on T3 receptor binding. Further in vivo studies with ipodate suggested that T3 receptor binding inhibition also occurred when ipodate was given intravenously to rats.

Anilino Naphthalenesulfonates↗
PubMed2005

Iodinated radiographic contrast media possess antioxidant properties in vitro.

PURPOSE: To study potential properties of iodinated radiographic contrast media (IRCM) for intravascular use in in vitro free radical generating reactions. MATERIAL AND METHODS: Superoxide (*O2-) and hydroxyl (*OH) radicals were generated in xanthine oxidase and Fenton reactions. *O2- was assayed by the nitroblue tetrazolium (NBT) method, whereas *OH was assayed by an aromatic hydroxylation (2-hydroxybenzoic acid) method. Total antioxidant status (TAS) of test substances was determined by a colorimetric assay. Finally, acetyl-cholinesterase (AChE) activity was measured in the absence and presence of IRCM. RESULTS: High concentrations (>50 mM) of IRCM inhibited *O2- production, ionic more than non-ionic IRCM. Medium concentrations (25-50 mM) of IRCM reduced *OH production, and both types of IRCM were equally potent. Low concentrations (<25 mM) of non-ionic IRCM displayed higher antioxidant capacity than their ionic counterparts when tested in the TAS assay. Visipaque 320 (iodixanol) was found to have the highest TAS value, followed by Omnipaque 350 (iohexol), Hexabrix 320 (ioxaglate), and Urografin 370 (diatrizoate). CONCLUSION: IRCM have in vitro antioxidant properties in concentrations relevant for their clinical application. These properties may therefore be of potential importance when evaluating IRCM effects in vivo, particularly those concerning cardiovascular and renal function.

Acetylcholinesterase↗
PubMed1997

Permeability of contrast media through hemodialysis membrane.

PURPOSE: To compare the permeability of 10 contrast media (CM) through the hemodialysis membrane. MATERIAL AND METHODS: An experimental model was constructed from clinical hemodialysis equipment. The 10 CM that were used were: diatrizoate, iothalamate, iopamidol, iohexol, iopromide, ioversol, iomeprol, ioxaglate, iodixanol and iotrolan. They were dissolved into the dialysate. Each solution ran into the blood circuit of the dialyzer at a rate of 200 ml/min and into the dialysate circuit of the dialysis machine at a rate of 500 ml/min. Permeability was expressed as clearance, calculated from the iodine concentration at the afferent and efferent lines of the dialyzer, and from the blood-flow rate. RESULTS: The clearance of all the monomeric CM was superior to that of all the dimeric CM. Values of clearance and molecular weight correlated well. CONCLUSION: The molecular weight of a contrast medium is the main factor that influences the efficiency of CM removal by hemodialysis.

Cellulose↗
PubMed1977

Iodinated radiological contrast media as radiosensitizers.

This paper describes the radiosensitizing effects of diatrizoic (DA) and iothalamic (ITA) acids and of iodipamide (IP) on the survival of E coli B/r irradiated with X-rays and with high-intensity electron pulses. All compounds at concentrations between 10 and 50 mM display a strong sensitizing effect in the presence of oxygen (DMF between 0-1 and 0-3) and are much less effective in nitrogen. In N2O the degree of sensitization is intermediate between oxygen and nitrogen. The situation is the same at pH 7 or 5-6. Solutions of DA, ITA and IP irradiated at pH lower than 6 become highly toxic to bacteria added after irradiation, for several hours after X-irradiation or several minutes after pulsed irradiation. The maximum toxic effect occurs with 2 krad of X-ray and with 6-8 krad of electrons. Oxygen must be present in order to observe the bactericidal activity. This is not affected by scavenging hydrated electrons with nitrate, but is completely cancelled by scavenging OH radicals with formate. It is also cancelled by adding thiosulphate to the irradiated solutions immediately before the bacteria. In the presence of nutrient broth, the radiosensitizing effect is absent after irradiation with pulsed electrons; whereas after X-irradiation it is reduced when the concentration of sensitizers is 50 mM. The experimental data appear to be compatible with a mechanism operated by short and long-lived transients resulting from the radiolysis of iodinated contrast media.

Cell Survival↗