Cholecystographic Medium Research Articles

ROENTGEN PROBLEMS IN EVALUATING THE ATROPHIC STOMACH OF THE ELDERLY

Gastric atrophy in the elderly may cause problems in the interpretation of gastrointestinal studies. Seventeen such cases are reported: 8 patients showed limited distensibility and irregularity of the distal stomach simulating scirrhous carcinoma; 6 patients showed gastric retention of food; and 2 patients showed gastric retention of oral cholecystographic medium. Awareness of these phenomena may prevent serious errors in roentgen diagnosis.

Toxicologic studies of iocetamic acid in rats and dogs

A new oral cholecystographic medium called iocetamicacid was submitted to a toxicologic study in rats and dogs. Dosages, which were equivalent to 200 and 1000 mg of the compound per kilogram of body weight per day and were 5 times and 25 times the human routine dose, were administered daily for 3 weeks in order to establish whether the substance exerted an untoward influence on vital organs. In the male rats the thyroid was activated by both doses, but no thyroid activation was demonstrable in dogs. There were no indications of damage of the cells of the liver or kidney. The study showed that iocetamic acid had no special affinity for the kidneys. With the exception of the increased thyroid activity in male rats, no changes were found which could be ascribed to the administration of iocetamic acid.

Combined use of ipodate and iopanoic acid for routine oral cholecystocholangiography.

Earliest attempts to visualize the bile ducts radiographically consisted of introducing an egg yolk through a Rehfuss tube placed in the duodenum, thereby stimulating the previously opacified gallbladder to eject the contrast material into the ducts. In 1949, Shehadi (1), while investigating iopanoicacid (Telepaque) as an oral cholecystographic contrast medium, observed that the extrahepatic bile ducts also opacified, particularly after a fat meal. Iopanoic acid was the first of the 3-iodinated contrast media, and subsequent 3-iodinated compounds proved inferior to it in that they produced a higher incidence of side-effects, yet offered less satisfactory visualization of the bile ducts (1). In 1959, Shehadi (1) tested ipodate (Oragrafin) as an oral cholecystographic contrast medium and obtained satisfactory visualization of the bile ducts as well as of the gallbladder when a fat meal was given. He found that ipodate, like iopanoic acid, was relatively free of toxicity. He estimated, however, that the inci...

Silver's syndrome: Report of a case with chromosomal and dermatoglyphic study

1. Shapiro, R.: Preliminary report on new cholecystographic medium, Radiology 60: 687, 1953. 2. Astwood, E. B.: Occurrence in sera of certain patients of large amounts of newIy isolated iodine compound, J. A. Am. Physicians 70: 183, 1957. 3. Hall, R. R., and Vander Loan, W. P.: Placental transmission of Teridax, a new cause of elevated PBI, Ctin. Res. 9': 71, 1961. 4. Shapiro, R.: Effect of maternal ingestion of iophenoxic acid on serum protein bound iodine of progeny, New England J. Med. 264: 378, t961. 5. Hall, R. R., and Vander Loan, W. P.: Effects of iophenoxic acid on tests of thyroid function, J. A. M. A. 177: 648, 1961. 6. Hung, W.: Elevation of protein bound iodine in an eight-year-old due to transplacental passage of an organic iodine dye, Pediatrics 37: 677, 1966.

ATHROMBOCYTOSIS FOLLOWING ORAL CHOLECYSTOGRAPHY.

ORAL cholecystography is probably considered by the patient to be the most tolerable gastrointestinal contrast radiologic study. This procedure was, until recently, considered by the physician also to be, save for minor gastrointestinal disturbances, generally free from adverse reactions. Increasing reports of renal complications secondary to use of oral cholecystographic agents have caused much recent concern, and have actually led to the withdrawal of one such agent, bunamiodyl sodium, from active clinical use. It is the purpose of this paper to report an unusual reaction of a different sort, a severe thrombocytopenia, occurring following the use of another cholecystographic medium, iopanoic acid. <h3>Report of a Case</h3> A 69-year-old white female was first seen ten days prior to hospital admission for severe epigastric pain with radiation between the scapula, severe nausea, slight epigastric tenderness, and a temperature of 99.2 F (37.3 C). At that time she was given a single injection

Clinical trial of ipodate. A new oral cholangiographic agent.

SINCE ITS INTRODUCTION in 1952, intravenous cholangiography using sodium iodipamide (Cholografin) has become a valuable and reliable method for the diagnosis of biliary tract disease, particularly following cholecystectomy. However, besides the risk and inconvenience involved in any intravenous procedure, serious reactions with the use of iodipamide have been reported in up to 2.5% of examinations in some series, with lesser reactions ranging as high as 38.8%. Thus, an oral contrast medium which could offer comparable results to those obtained by the intravenous method would have obvious advantages. Ipodate (Oragrafin) is a new cholecystographic and cholangiographic medium for oral administration which is rapidly excreted by the liver in sufficient quantity to produce opacification in the cystic and common bile ducts. It is prepared as the sodium or calcium salt of 3-(dimethylaminomethylamino)-2, 4, 6-triiodohydrocinnamic acid, with an iodine content of 61%. The sodium salt is available in 0.5-gm. capsules, and the calcium

The Effect of Maternal Ingestion of Iophenoxic Acid on the Serum Protein-Bound Iodine of the Progeny

IN 1957 Astwood1 reported markedly elevated levels A of serum protein-bound iodine (2000 to 14,000 microgm. per 100 ml.) in a group of patients who had received by mouth a cholecystographic medium, iophenoxic acid [3-(3-hydroxy-2,-4,-6-tri-iodophenyl)2-ethyl propionic acidj.‡ Furthermore, the abnormal iodine values persisted for an inordinately long period — that is, semilogarithmic plotting of the original data indicated that it would take thirty-three years for the level to fall to 1 microgm. per 100 ml. after ingestion of the usual dose of iophenoxic acid (3.0 gm.). The prolonged great elevation of the protein-bound iodine from this medium has been amply . . .

Biloptin--report on preliminary trial.

Biloptin—Report on Preliminary TrialF. H. Kemp and F. W. WrightF. H. KempThe Radcliffe Infirmary, OxfordSearch for more papers by this author and F. W. WrightThe Radcliffe Infirmary, OxfordSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/0007-1285-34-397-63SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutAbstractThe results of a trial of Biloptin, a new cholecystographic medium, are assessed. Previous article Next article FiguresReferencesRelatedDetailsCited byA Clinical Trial of Oral Cholecystographic Media: Telepaque, Biloptin, Osbil Tablets and Osbil CapsulesTim Healey and Ronald G. Grainger28 January 2014 | The British Journal of Radiology, Vol. 38, No. 445Review Savoir Interpréter la Scintigraphie du corps thyroide. By SavoieJ. C. and ValleeG., pp. 102, 1964 (Brussels. Albert de Visscher), Frs. b. 150.E. Eric Pochin28 January 2014 | The British Journal of Radiology, Vol. 38, No. 445Three Years Experience of Peroral Cholegraphy30 August 2016 | Acta Radiologica. Diagnosis, Vol. 2, No. 6The anomalous cystic duct: A surgical and radiological problemClinical Radiology, Vol. 13, No. 4Oral Cholegraphy by BiloptinDavid Stenhouse28 January 2014 | The British Journal of Radiology, Vol. 35, No. 417Solu-Biloptin: A Trial of “3-hour” CholecystographyA. W. Robinson29 May 2014 | The British Journal of Radiology, Vol. 35, No. 412Biloptin and Solu-Biloptin. Further Experience of Oral Cholecystography and CholangiographyC. G. Whiteside28 January 2014 | The British Journal of Radiology, Vol. 34, No. 401Review Radiologic Examination of the Small Intestine. By GoldenRoss, 2nd edn., pp. 560, 176 illus, 1960 (Springfield, Illinois, U.S.A., Chas C. Thomas), £11 8s.J. W. Laws28 January 2014 | The British Journal of Radiology, Vol. 34, No. 401 Volume 34, Issue 397January 1961Pages: 1-68 © The British Institute of Radiology History ReceivedSeptember 01,1960Published onlineJanuary 28,2014 Metrics Download PDF

Clinical trials with bunamiodyl (Orabilix) and comparison of it with iopanoic acid (Telepaque).

Orabilix, a new cholecystographic medium, was administered to 37 patients, 25 of whom were also investigated with iopanoic acid (Telepaque). Comparison of the two contrast media indicated slightly better tolerance with Orabilix, there being a reduction in the incidence of diarrhoea. The density of the gall-bladder shadow was as good with Orabilix as with Telepaque using a weight by weight equivalent of the two media.

Biloptin. A new oral contrast medium for cholecystography report of preliminary trial.

A trial of Biloptin, a new oral cholecystographic medium, on 60 cases is presented. The patients' reactions to the medium are analysed and discussed. The relative merits of oral and intravenous cholecystography are briefly reviewed.

Renal Insufficiency after Oral Administration of a Double Dose of a Cholecystographic Medium

IN the last several years iopanoic acid (3-[3-amino-2,4,6-tri-iodophenyl]-2-ethyl propanoic acid) has been widely used orally in cholecystography, providing excellent x-ray contrast and minimal toxicity. The usual dose is 6 tablets (3.0 gm.) taken ten to twelve hours before the scheduled cholecystogram. Side reactions, generally infrequent, are mild, and consist largely of nausea, vomiting, diarrhea and dysuria.1 , 2 Double doses are usually administered when there is poor or no visualization after the usual dose, and to delineate more clearly the biliary-duct system.The purpose of this paper is to report 2 cases of renal insufficiency, each of which followed the administration of . . .

The Evaluation of Iodinated Organic Compounds as Radiopaque Media

The general properties of X-ray contrast media are discussed with particular reference to the use of iodinated organic compounds in cholecystography and urography. The development of test procedures for the evaluation of radiopaques for X-ray visualization of the gallbladder and the upper urinary tract is described. Relative oral cholecystographic activity, from most to least active, was observed in the cat as follows: iopanoic acid, iophenoxic acid, iodoalphionic acid, and iodophthalein, in agreement with the relative order of activity reorted in the literature for these compounds in man. Diatrizoate sodium was found o produce earlier and better X-ray visualization of the uper urinary tract in the rabbit with less than half the systemic toxicity observed wig iodopyracet. The acute intravenous toxicity of diatrizoate sodium in the mouse, rat, rabbit, cat, and dog was found to be approximately half as great as that observed for iodopyracet, sodium iodomethamate, or sodium acetrizoate. An iodinated aromatic nucleus, to provide radiopacity, was found to be common to both cholecystographic and urographic media. The cholecystographic medium required a “transport mechanism” consisting of an alkanoic acid side chain containing 6 to 7 carions with 2 iodines in the aromatic nucleus and 5 carbons with 3 iodines in the radiopaque portion of the molecule. The urographic contrast medium required a carboxyl group to provide high water solubility and could contain an alkanoic acid chain with no more than three carbons.

Orabilex: a new cholecystocholangiographic medium: its use in visualizing the nonvisualized gallbladder and in oral cholangiography.

1. Orabilex meets the criteria of Shehadi for an ideal cholecystographic medium. 2. It produces less side reactions than other oral contrast materials used for oral cholecystography. 3. The medium resulted in very few instances of nonvisualization of the gallbladder, and in these surgery proved the gallbladder to be pathologic. 4. A modified method of visualizing the “nonvisualized” gallbladder, intra- and extrahepatic biliary radicles is described. 5. Considerable success has been achieved to date using this technique for visualizing the “non-visualized” gallbladder and the “postcholecystectomy” intra- and extrahepatic biliary radicles.

Experience with five orally given cholecystographic mediums.

The history of cholecystography has been reviewed in the literature. 1 Iodophthalein sodium (Iodeikon), producing a high degree of cholecystographic accuracy, was the first orally given cholecystographic medium to be popularized. In fact, it is doubtful whether the administration of subsequent orally given mediums actually has increased the accuracy of diagnosis for cholecystic disease. The chief objections to iodophthalein sodium were its disagreeable taste and the high incidence of nausea, vomiting, and diarrhea following oral administration. Iodoalphionic acid (Priodax) was tolerated much better and almost universally replaced iodophthalein sodium. Monophen, 2-(4-hydroxy-3,5-diiodobenzyl)-cyclohexane carboxylic acid, although well tolerated and capable of producing equally good cholecystograms, never became popular and is no longer manufactured. Although iodoalphionic acid is employed occasionally, iopanoic acid (Telepaque) and iophenoxic acid (Teridax) are the cholecystographic mediums used most frequently today. It is generally agreed that an ideal orally given cholecystographic medium should produce a gallbladder shadow of sufficient

A comparative clinical study of teridax (3 gm.) and telepaque (2 gm.) in routine cholecystography.

Following intensive comparative investigations of Priodax and Telepaque in varying doses under controlled circumstances for evaluating both the clinical side-effects and the roentgenographic efficacy, it was determined that, for routine use in a large institution, Telepaque in 2-gm. dosage constituted our cholecystographic medium of choice (1, 2). The subsequent introduction of Teridax necessitated further comparative studies to assess the possible advantages of this newer medium under identical conditions. Attention has been called to the potential disadvantages of Telepaque, namely, the presence of unabsorbed or excreted contrast material in the colon, which might obscure a portion of the gallbladder, and the intense opacification, which might obscure included stones. Inasmuch as Teridax is excreted almost completely in the urine and does not result in as dense gallbladder opacification, early reports emphasized the advantages of this medium in avoiding these difficulties. The chemical structure of Teridax—3 (3 hydroxy-2,4,6 triiodophenyl) 2-ethyl propionic acid—and Telepaque—3(3-amino-2,4,6 triiodophenyl) 2-ethyl propionic acid—indicate that they are closely related chemically and have approximately the same iodine content. The tabulation of side-effects was accomplished by questioning patients in conjunction with the taking of a history just prior to combined cholecystography and upper gastrointestinal examination. The resultant cholecystograms were evaluated according to the scale used in previous studies, the gallbladder shadows being classed as excellent, good, faint, or nonvisualization, with a notation as to the type of stones demonstrated. No side-effects were noted in 110 (71 per cent) of 155 cases. This is in fair agreement with the 77.5 per cent patients without side-effects in an early series elsewhere (3). The side-effects encountered in the present study are shown in Table I, where they are compared with those observed in the author's previous series with Telepaque (2). The side-effects of Teridax grouped under “other” include headaches in 3 cases, and dizziness, epigastric burning, gas, and abdominal cramp in 1 each. It is noted that the incidence of nausea and dysuria is slightly higher than in Teridax series reported by others (3, 4), but it is to be emphasized that these manifestations were mild in degree and that evaluation of such subjective sensations are difficult and may be considerably influenced by the manner of interrogation, which was the same as used in tabulating the comparative values for other media. To be noted is the slight overall advantage of Teridax in the number of asymptomatic patients, the slight increase in mild nausea with Teridax, and the more marked decrease in diarrhea with Teridax.

A comparison of a new cholecystographic medium, teridax, with telepaque.

Following completion of a study of Telepaque by Dunne, Jensen, and Hughes (1) in December 1952, that medium has been used routinely for oral cholecystography at the Cleveland Clinic. As has been reported by others—in up to 96 per cent of the cases examined—the excretion of this compound into the gastrointestinal tract results in the formation of opaque material in the colon (2, 3). In our experience this has frequently necessitated repeat films in order to obtain a view of the gallbladder area free from obscuring shadows. Because of this shortcoming, a clinical trial of Teridax was undertaken, the results of which are presented here. Teridax is a white, odorless, crystalline powder, containing 66.5 per cent iodine by weight, whose principal route of excretion is the urinary tract. With its use, opaque material rarely has been noted in the bowel. The chemical and physical properties, as well as the toxicology, have been reported elsewhere (3, 4). Teridax was given to 472 patients (254 men and 218 women), while a control series of 57 patients (20 men and 37 women) received Telepaque. No attempt was made at selection on any basis. The compound was given daily to from 5 to 20 patients in minimum doses of 4 tablets (3.0 gm.) for women and 5 tablets (3.75 gm.) for men. An additional tablet (0.75 gm.) was given for each 25 pounds of body weight over 150 pounds, up to a maximum of 8 tablets for men weighing over 200. Each patient was interviewed immediately after postero-anterior and decubitus films had been taken and was questioned in detail concerning nausea, vomiting, diarrhea, dysuria, headache, and itching. Any symptoms present prior to taking the tablets were critically assessed to determine whether they were in any way aggravated by ingestion of the compound. In order to classify the complaints as to degree of severity, and to secure findings comparable to those of Dunne et al. with Telepaque, we utilized the definitions of mild and severe nausea and diarrhea from their study (1). The films were interpreted later without review of the recorded reactions, and evaluation was based upon the definitions of Hoppe (1). The reactions encountered following Teridax and Telepaque in this series of 529 patients are tabulated in Columns 3 and 4 of Table I. Those reported by Dunne et al. with Priodax and Telepaque in 3.0-gm. doses are given in Columns 1 and 2, and those in a larger series of patients given Telepaque (1) in 2.0-gm. (for those weighing under 160 pounds) and 2.5-gm. doses (for those over 160 pounds) in Column 5. In Column 6 are recorded the complaints noted by Shapiro (3) in 204 patients examined after receiving 3.0-gm. doses of Teridax. The latter are recorded in a form different from the original to conform to our definitions. In our study, the most common complaints, in order of frequency, were diarrhea, dysuria, and nausea. Mild diarrhea occurred after Teridax somewhat less than one-half as often as after Priodax, but approximately twice as often as after the smaller dose of Telepaque.

Intravenous cholecystography and cholangiography; clinical trials with a new medium (biligrafin).

A clinical trial of a new intravenous cholecystographic medium, Biligrafin, is recorded. 120 unselected cases were examined with the drug, and the results compared with 100 similar cases examined by oral Telepaque. The results show that Biligrafin is of low toxicity and produces diagnostic results superior to those recorded with any oral medium. Cholangiography, as well as cholecystography, was possible in almost all cases where Biligrafin was used. Biligrafin proved of no diagnostic value in 10 cases with clinical or sub-clinical jaundice. This new intravenous medium undoubtedly represents a major advance in radiology of the biliary tract.

Teridax, a new cholecystographic medium.

Teridax was studied clinically in 96 patients. Sixtysix patients had excellent cholecystograms showing normally concentrating gallbladders. Thirty patients had nonfunctioning gallbladders and were studied with two other contrast media without visualization. All of these 30 cases were found at surgery to have abnormalities which explained the nonvisualization.

Experiences with telepaque, a new cholecystographic medium.

Experiences with telepaque, a new cholecystographic medium.

Experiences with Telepaque, a New Cholecystographic Medium

Experiences with Telepaque, a New Cholecystographic Medium