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At least 1,747 records · Page 97Linked to original sources
PubMed1993

Effect of ionic contrast medium on plasma atrial natriuretic peptide.

To evaluate the effect of ionic contrast medium on plasma atrial natriuretic peptide (ANP) and its contributing factors, we measured plasma ANP, serum osmolality, pulmonary capillary wedge pressure (PCWP), femoral artery systolic pressure (FASP), and heart rate before and after left ventriculography with Rayvist in 13 patients suspected of coronary artery disease. The control values of plasma ANP, serum osmolality, and PCWP were 20.3 +/- 5.1 pg/ml, 293.5 +/- 1.5 mosm/kg, 6.6 +/- 0.8 mm Hg, respectively. Rayvist produced a significant increase in plasma ANP, serum osmolality, and PCWP at 1 minute (26.0 +/- 6.3 pg/ml, p < 0.05; 300.7 +/- 1.9 mosm/Kg, p < 0.001; 10.7 +/- 1.3 mm Hg, p < 0.001) and 5 minutes (27.3 +/- 6.3 pg/ml, p < 0.01; 296.8 +/- 1.9 mosm/Kg, p < 0.001; 10.4 +/- 1.7 mm Hg, p < 0.01) post left ventriculography. The FASP decreased significantly at 1 minute, followed by an insignificant increase at 5 minutes. The heart rate increased significantly at 1 minute but no significant change was noted at 5 minutes. We conclude that plasma ANP increases significantly after left ventriculography with Rayvist and its response may be related to left ventricular filling pressure and serum osmolality, but not to FASP or heart rate.

Adult↗
PubMed1977

Simultaneous iothalamate, creatinine, and urea clearances in children with renal disease.

Glomerular filtration rate (GFR) is often used to evaluate and manage patients with renal disease. Few studies in children have compared accurate estimations of GFR (clearance of inulin and/or iothalamate) with the clearance of creatinine which, because of simplicity, has been used as an approximation of GFR. At reduced levels of GFR, studies in adults suggest that the mean of the creatinine and urea clearances closely approximate the GFR. The present investigation shows that the clearance of creatinine approximates the GFR at normal levels; however, at reduced levels the creatinine clearance and the mean of the creatinine and urea clearances both overestimate the GFR as measured by iothalamate. The clearance of creatinine remains a useful clinical tool if its limitations at low levels of GFR are realized.

Adolescent↗
PubMed1993

The clinical and radiological evaluation of primary brain neoplasms in children, Part II: Radiological evaluation.

Data collected over the past 8 years on the radiological appearance of common pediatric primary brain neoplasms are presented. An emphasis is placed on the newer radiological imaging modality of magnetic resonance imaging (MRI). Part I of this article emphasized the clinical evaluation of these brain neoplasms. Three hundred eighty-five children with known brain neoplasms ranging in age from newborn to 18 years were evaluated with one or all of the following radiological modalities: MRI, computed tomography (CT), water-soluble myelography (WSM), WSM with CT, and angiography. Contrast-enhanced MRI and CT scans both were accurate in delineating these brain neoplasms although MRI provided better resolution and delineation than CT. Angiography provided information on the vascularity of the neoplasms and their relationship to prominent arterial and venous structures. Water-soluble myelography with CT and gadolinium-enhanced MRI of the spine were equally accurate in demonstrating metastatic spread to the spinal canal and spinal cord. Magnetic resonance imaging with gadolinium was more accurate than CT with contrast in demonstrating recurrent or residual neoplasm at the operative site and metastatic spread to the brain. Magnetic resonance imaging with gadolinium is the best radiological modality to fully evaluate pediatric brain neoplasms.

Brain↗
PubMed1977

Measurement of plasma contrast levels during excretory urography.

Ultraviolet spectrophotometry permits easy measurement of plasma levels of intravenously injected contrast media. The initial results are described from the determination of plasma methylglucamine iothalamate (Conray 60) levels during routine excretory urography in 10 normal patients. This simple procedure has many potential applications in the investigation of contrast media physiology.

Humans↗
PubMed1993

Effect of low-osmolality contrast media on red cell filterability.

The effects of low-osmolality contrast media (CM) on red blood cell (RBC) filterability were investigated using a recently developed nickel mesh filtration method. The conventional hypertonic CM iothalamate, low-osmolality iohexol, and the recently synthesized iomeprol were studied. Among them, the osmolality of iomeprol was the lowest. The impact of CM osmolality, viscosity, and iodine content on the RBC filterability was analyzed. Under equal iodine content or viscosity condition, the filterability order of RBCs suspended in CM was iomeprol > iohexol >> iothalamate, because of the osmolality of CM. Iomeprol caused small echinocytic changes but these had a negligible influence on RBC filterability. In conclusion, the osmotic effect of CM on RBC filterability is more predominant than the other CM effects, and iomeprol is the preferred CM for RBC filterability.

Adult↗
PubMed1977

Water soluble myelography.

Our experience with 451 water soluble myelograms has been presented. We feel that the advantages exceed the disadvantages and that a water soluble medium is essential for a truly diagnostic myelographic study.

Humans↗
PubMed1977

Cerebral angiography in acute cerebral infarction.

Cerebral angiography in the acute phase of clinically diagnosed stroke syndromes was evaluated in a prospective study of 104 consecutive patients over an eight month period at the Massachusetts General Hospital to determine the diagnostic yield. Of 68 patients subsequently documented to have retinal or cerebral hemispheric infarction, 63 (92.6%) had angiographic demonstration of occlusive lesions which appeared to correlate with the clinical deficit. These results are discordant with prior angiographic reports, 2,17,18,20 suggesting that delayed carotid artery angiography fails to show occlusive lesions (embolic) which may be shown acutely.

Acute Disease↗
PubMed1996

Total clearance and extracellular volume with 125I-iothalamate in peritoneal dialysis.

To assess treatment adequacy by calculating total clearance (CL) in patients on peritoneal dialysis (PD), fluids must be collected over 24 hours, a laborious procedure and prone to inaccuracy. CL calculation from the plasma disappearance curve of an injected tracer has none of the above inconveniences. We therefore compared creatinine clearance CR-CL with CL calculated from the plasma disappearance curve of 125I-iothalamate (IO) injected in a single intravenous bolus. Twelve patients aged 63 (44-80) years and on PD for four (1-44) months were studied in hospital. Nine plasma samples were taken for IO-CL after a bolus of 21 kBq/kg of tracer. The least-squares biexponential fitting according to Gauss-Newton-Raphson was then carried out: [Aexp(-at) + Bexp(-bt)], and clearance was calculated by the formula, IO-CL = dose/AUC, where AUC = A/a + B/b. Both CLs were normalized for 1.73 m2 of body surface. Agreement (r = 0.746, p = 0.005) for the CR-CL (6.8 +/- 1.9 mL/min) and IO-CL (7.6 +/- 1.9 mL/min) was good, with a difference of 0.9 +/- 1.4 mL/min (t = 2.182, p = 0.052). Extracellular volume (ECV), calculated from the IO plasma disappearance curve with the formula, ECV = dose/ bAUC, and including the endoperitoneal fluid, was 19.8 +/- 2.9 L (29.5 +/- 6.2% body weight).

Adult↗
PubMed1977

Safe amounts of contrast medium for angiocardiography in neonates and infants.

The results were analysed of 485 (biplane) cineangiocardiograms performed in 200 consecutive cardiac investigations on neonates (under 4 wk) and infants (4 wk to 1 yr). 10 deaths occurred during or within 24 h of cardiac catheterization, all in patients who were profoundly acidemic because of their hemodynamic disturbance. A total dose of Cardio-Conray at any one investigation of 4-5 ml/kg body weight was satisfactory and without undue risk. Single injections of 1.5-2.0 ml/kg body weight were safe whilst providing optimal diagnostic information. The interval between multiple injections did not appear to affect the risk to the patients.

Angiocardiography↗
PubMed1977

Accuracy of estimates of contrast media concentration.

An animal model was used to prepare 18 experimental roentgenograms with differing dilutions of Conray 400 in each renal pelvis. Fifty radiologists were asked to estimate the iodine concentrations after they had been shown examples with known iodine concentrations. It was found there was a great deal of variation in the ability of individual subjects to accurately estimate the iodine concentration present. When the urinary iodine was less than 25 mg/ml, contrast estimations became grossly unreliable. At higher concentrations, the average performance of the sixty subjects was fairly clos to observed densotimetric readings. This study demonstrates that the ability to estimate iodine concentration is similar to other perceptive abilities in demonstrating both thereshold sensitivity and a near normal distribution among observes of the ability to judge perceptable differences in contrast media density.

Absorptiometry, Photon↗
PubMedDate not supplied

Failure of insulin-like growth factor 1 to improve radiocontrast nephropathy.

Exogenous insulin-like growth factor 1 (IGF-1) has been reported to improve experimental ischemic acute renal failure. We investigated a possible beneficial role of IGF-1 in a model of radiocontrast nephropathy induced by indomethacin, nitro-L-arginine ester and iothalamate. Multiple injections of recombinant human IGF-1 (or its vehicle) at 150 microg/100 g body weight/day were given for 24 h starting 1 h after radiocontrast, or initiated 1 day after the insults and continued for 48 h. IGF-1 prevented neither the fall in creatinine clearance nor medullary thick ascending limb necrosis observed at 24 h. Similarly IGF-1, given for 2 days after renal failure had been established, did not accelerate functional recovery at 72 h, did not ameliorate catabolism and did not alter the morphological evolution of intrarenal damage. In conclusion, IGF-1 had no beneficial effects in this model of radiocontrast nephropathy.

Acute Kidney Injury↗
PubMed1997

Geriatric renal function: estimating glomerular filtration in an ambulatory elderly population.

In elderly individuals, serum creatinine may remain normal as glomerular filtration rate (gfr) declines. Therefore, the estimation of glomerular filtration utilizing mathematical models incorporates age as an important variable. In order to adjust drug dosages and diagnose renal disease earlier in the elderly, a variety of such simplified estimates of gfr have been applied. Unfortunately, no estimator is as accurate as the cumbersome gold standards (e.g. inulin or iothalamate clearance) and the reliability of each may vary with the particular clinical setting. The purpose of this study was to critically evaluate three commonly used estimators of gfr-i.e., creatinine clearance (CC), Cockroft-Gault (CG), and 100 over serum creatinine (100/SC)-comparing them to iothalamate clearance (IC) in a group of healthy ambulatory geriatric subjects (n = 41; ages 65-85). IC declined 1 ml/min per year of age in our sample. CC demonstrated a similar decline, a correlation of 0.83 with IC, and moderate error relative to IC of 17% at the mean (standard error [SE] = 12.3). In contrast, 100/SC correlated only 0.56 with IC, demonstrated a large positive bias (41 ml/min), and showed no age-related decline. An age correction to 100/SC similar to that utilized in the CG formula was clearly necessary. Despite the age and weight correction used in the CG formula, we found the estimates from it to be inaccurate (correlation = 0.5; SE = 23.8). A simpler age-corrected formula (Est. IC = 1/2 [100/SC] + 88-age) was derived and proved significantly superior to CG in our ambulatory geriatric sample, but still exhibited enough error (SE = 16.4) to question its clinical utility. It appears that serum creatinine based estimates of gfr in the elderly may not provide accurate results.

Age Factors↗