[Severe reactions caused by Conray-400 used in ventriculography and myelography].
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This is a report of myelography findings obtained in 50 patients with B 15000 (Iopamidol), a new non ionic water-soluble contrast medium. The procedure was easily carried out with a tilting table wired to a TV image amplifier. The dose of contrast medium injected intrathecally was 10 divided by 15 cm3 of a preconstituted solution containing iodine 200 or 300 mg/cm3. There were no accidents or major complications. The myelograms obtained with the test material afforded accurate diagnosis of intramedullary and extramedullary lesions, and signally of intervertebral disk protrusion and hernia.
The non-ionic water-soluble contrast medium Iopamidol was used for urography in 10 patients and for angiography in 20 patients. In every investigation excellent visualization was obtained and non adverse reaction occurred. Good tolerability to Iopamidol permitted to carry out painless peripheral angiography and translumbar angiography without general anaesthesia.
An account is given of a study of 118 patients, including 67 with renal failure of varying severity, examined nephrangiotomographically with the aid of both a non-ionic contrast medium (iopamidol) and a conventional medium (sodium diatrizoate and methylglucamine). It is shown that the advantages presented by rapid injection of the medium, and the obtaining of prompt vascular data, are accompanied by those offered by the non-ionic medium, since it induces reduced osmotic diuresis, which permits satisfactory visualisation of the excretory ducts, even in patients with very low glomerular filtration values.
The article reports on experiences collected with intrathecal contrast amplification in computerised tomography, using the nonionic contrast media metrizamide and iopamidol in a total of 80 examinations. The side effects are caused by the examination technique - which is discussed in detail -, the pathophysiology of CSF dynamics and the pharmacodynamics of the contrast media, but such side effects can be kept low if the relevant principles are observed. This makes the method both feasible and valuable.
Tolerance of two contrast media was compared by a double blind study. High doses of iodine (45 g) were used for both contrast substances. Sodium Ioglicinate was giving best radiological contrast but produced more side-effects, especially nausea, as compared to Methylglucamine-Ioglicinate. On the contrary Methylglucamine-Ioglicinate did not give best density but did produce less side-effects. Thus the investigator has to consider very carefully, which of the compounds has to be preferred.
Our aim was to evaluate the possible role of prostaglandins (PG) on renal calcium excretion in humans through the PG inhibitory effects of indomethacin. Renal calcium excretion was evaluated by a technique of impulse analysis which gives a specific index of tubular calcium transport. Several parameters were derived from this specific transport function W(t): 1) the fractional excretion of filtered calcium as % of total dose (FECa % TD); 2) the peak excretion rate; 3) the mean transit time (MTT, min). The aforementioned parameters were determined in 7 healthy subjects in basal conditions and again after 10 days of treatment with 100 mg indomethacin daily. FECa was significantly (P less than 0.02) higher with indomethacin (8.18 +/- 0.97) than under basal conditions : (5.02 +/- 0.57). The peak excretion rate and MTT remained unchanged after indomethacin. These results indicate that indomethacin increases renal calcium excretion. As indomethacin did not produce any significant change in glomerular filtration rate (125 +/- 7 ml/min before v.s. 129 +/- 9 after) one can assume that PG play a role in tubular calcium reabsorption. However the mechanism remains to be elucidated : direct action of mediated through the cyclic AMP system.
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The effect of ingestion of 60 ml sodium iothalamate (Gastro-Conray; Maybaker)--a radiographic contrast medium--on resting lower oesophageal sphincter (LOS) pressure was studied in 10 normal human volunteers. Compared with a barium meal, which does cause a fall in LOS pressure, Gastro-Conray did not affect the sphincter tone. The importance of this is discussed.
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Seven commonly used arthrographic contrast media were examined in vitro for bactericidal effects against Staphylococcus aureus under various conditions simulating clinical settings, using a wide range of bacterial populations (10(1) to 10(8) colony-forming units per ml). The media tested were: sodium diatrizoate and megulumine diatrizoate (E.R. Squibb and Sons, Renogragin-60 and Renografin-76), megulumine diatrizoate (E. R. Squibb and Sons, Renografin-M-60), sodium iothalamate and megulumine iothalamate (Mallinckrodt Chemical Works, Vascoray), sodium iothalamate (Mallinckrodt Chemical Works, Conray 400), meglumine iothalamate (Mallinckrodt Chemical Works, Conray 60), and sodium diatrizoate (Winthrop Laboratories, Hypaque sodium 50%). Effects secondary to the contrast medium used, dilution ratios of the specimens, and time elapsed between the collection and cultivation of the specimens were examined. The contrast material used was found to affect bacterial growth: the Renografin materials showed a bactericidal or bacteriostatic effect, while Vascoray, the Conray materials, and Hypaque sodium 50% failed to inhibit bacterial growth. Bacterial inoculum size exhibited a direct bearing on the bactericidal or bacteriostatic effects of the Renografin but had no effect with the other media. The results indicate that Vascoray, Conray and Hypaque sodium 50% are superior to the Renografin materials for use in arthrography and other procedures in which the aspirate is submitted for microbial culture, because they interfere less with the recovery of these microorganisms.
Iopamidol, a new non-ionic, monomeric contrast medium with low osmolality has been well established in our angiographic routine procedures according to the favourable results obtained in more than 300 controlled trials. The general tolerance (demonstrated by the rate of systemic adverse reactions) of the lower concentrated solution (300 mg iodine/ml) is a little bit better than that of the higher concentrated one (370 mg iodine/ml). We could demonstrate a significant difference between the two preparations regarding to local side effects such as pain and heat sensations. The results of 100 intraindividual double blind studies (only peripheral angiography) specially referring to local side effects showed the high significant decrease of pain and heat sensations after application of Iopamidol as compared to the results gained by the ionic Ioxitalamate and Ioglicinate. There was no remarkable difference between Iopamidol and Ioxaglate which is a dimeric but equally low osmolar substance. The role of osmolality in the generation of side effects is pointed out. In consequence the advantages of using contrast media of reduced osmolality particularly in peripheral angiography must be emphasized.
Prior to abdominal and pelvic computed tomographic (CT) scans in children, bowel opacification was performed with dilute sodium ioxitalamate, meglumine and sodium diatrizoate, or barium sulfate. CT scans of 112 patients using one of these contrast agents were reviewed to compare "image quality." We have obtained the best organ and tissue definition when dilute sodium ioxitalamate was utilized to opacify the gastrointestinal tract.