Lee, Jong Beum; Kim, Seung Hyun; Oh, Seung Chul; Lee, Yong Chul; Lee, Kwan Seh
Amipaque is a water soluble, non-ionic myelographic contrast media, and owing to its high diagnostic accuracy and safety, its use is gradually increasing. The authors studied the complication after amipaque lumber myelography in 61 patients with low back pain during the period from January 1981 to November 1981 in Chung Ang University Hospital. The results were as follows: 1. Total complication rate was 52% (32 of 61)and there was no sexual difference in its occurrence. 2. In total, no difference in complication rate was found between head-up positioned group with a degree of 30 .deg. (group I) after procedure and head-up positioned group with a degree of 70 .deg. (group II) but female patients had more complication rate in group I than in group II (75% vs 50%). Headache was more common in group I and nausea was more common in group II. 3. Headache was most common complication (44%) and there was no sexual difference in its occurrence. 4. No significance difference in complication rate was found between patients proved to have HNP and patients to have not. 5. Complications were less common in patients with punctured level of L 4-5 than in patients with L 2-3 or L 3-4 level punture
Cohen, M.; Smith, W.L.; Smith, J.A.; Gresham, E.L.; Schreiner, R.; Lemons, J.
Metrizamide (amipaque) has not been used previously as a diagnostic contrast agent in the gastrointestinal tract. Metrizamide is a water-soluble isotonic contrast material having many advantages over barium and existing hypertonic water-soluble agents. There are many clinical situations in children in which metrizamide should be the contrast agent of choice for investigating the gastrointestinal tract. Four neonates are presented in whom barium or gastrografin were absolutely contraindicated. In each case metrizamide gave excellent visualisation of the gastrointestinal tract. It could be followed through the bowel giving excellent visualisation even up to 120h after ingestion. No harmful effects were noted in the four cases studied. (author)
Ekeland, A.; Uflacker, R.
Physiologic saline, meglumine metrizoate (Isopaque) and metrizamide (Amipaque) were injected into the ear artery of Wedder rabbits. The effect on the microcirculation in previously inserted ear chambers was recorded by cinematography. Following injection of the contrast media, the circulation was slow, followed by a phase with arteriolo-venular shunting and poor capillary circulation. (Auth.)
The aim of this investigation has been to find a safe and suitable contrast medium (CM) for radiological evaluation of the gastrointestinal tract (GIT) in cases where leakage outside the GIT can be suspected. An experimental study was carried out to evaluate the reactions of various available CM in the bronchi and lungs, mediastinum, pleura and peritoneum of rats. The CM evaluated in the experimental study were, pure barium sulphate (without any additives), commercial barium sulphate (Micropaque, with additives), Dionosil, Hytrast, Gastrografin, Amipaque (in pleura Omnipaque) and Hexabrix. (Auth.)
Traegaardh, B. (Malmoe Allmaenna Sjukhus, Malmoe, Sweden); Lynch, P.R. (Temple Univ., Philadelphia, PA (USA). School of Medicine)
The new monoacid dimer ioxaglic acid (P286), the non-ionic metrizamide (Amipaque) and diatrizoate (Renografin 76) were compared regarding their effects on left ventricular pressure, the first derivative of left ventricular pressure, aortic pressures and on ECG changes during left and right coronary angiography in dogs. Ioxaglate was found to affect most of these parameters less than diatrizoate probably due to its lower osmolality. Ioxaglate should be regarded suitable for coronary angiography. However, ioxaglate was found to have greater effects on the cardiac function than the equiosmolar metrizamide. This is probably due to the chemotoxicity of the anion or possibly to the sodium content of the ioxaglic acid solution.
Pokorny, L.; Kelemen, J.
Forty-seven dogs or seventy-four kidneys, respectively, were used in studies into the activity of metrizamide (Amipaque). The angiograms were of good quality; as compared with contrast media tested before, the incidence of abnormalities was somewhat lower, and the symptoms (spasm, inhomogeneous nephrogram) were less important. Histological examination showed that plenty of homogeneous pink proteinlike substance had accumulated in many tubules as well as in the lumen of the Bowman's capsules; fibroses were seen in several parts after 7 and 28 days, respectively. However, the evaluation of the renal function showed no considerable changes in the laboratory values. (orig.) [de
Lee, Yong; Kang, Heung Sik; Chang, Kee Hyun; Han, Seoul Heui; Kwon, Oh Sung; Myung, Ho Gin
The study was conducted to compare the side effects in myelography of the two non-ionic water-soluble contrast medias, lopamidol (Niopam) and Metrizamide (Amipaque). A total of 111 patients were examined, 64 with lopamidol and 47 with Metrizamide. Side effects consisted of headache, nausea, vomiting, dizziness, urinary difficulty, muscular pain, seizure, neurobehavioral disturbance, neurological sign change, vital sign change and etc. The common side effects were headache, nausea, vomiting and dizziness in order of frequency. Most of the side effects were subsided within 24 hours following myelography. lopamidol myelography caused fewer and milder side effects than Metrizamide study. The side effects were more commonly observed in cervical, thoracic or total myelography than in lumbar myelography with either lopamidol or Metrizamide. There was no significant correlation between incidence of the side effects and premedication with phenobarbital or valium injection before myelography and CSF sampling during the procedure.
Pokorny, L.; Kelemen, J.
A possible application of the non-ionizing contrast material metrizamid (Amipaque Vascularsup(R), Amipaquesup(R)) for renal angiography was experimentally investigated in dogs. 1.5, 3, 10 or 25 ml contrast medium was injected into one kidney. The animals were killed immediately, 3 hours, 24 hours, 7 or 28 days after angiography, and the kidneys were histologically investigated. In several cases the angiograms showed small alterations (transitory vasospasm, inhomogeneous spots on the nephrogram). Histology revealed in the initial period a homogeneous, pinkish, protein-like substance in the Bowman capsule and in the lumen of the tubuli, whereas later infiltrations by round cells and local accumulation of connective tissues were found. (L.E.)
Dalmstrom, K.; Svinn, K.
The synthesis of contrast media for medical radiography is followed out since their introduction in late 50's. A discussion is presented on the genesis of undesirable side effects of ionic contrast media due to the sodium and meglumine cations, the hypertonicity of the media and the iodinated molecule itself. The advantages of the new non-ionic non-dissociating low osmolar contrast media is stressed and its low chemotoxicity is explained in the light of their chemical structure. The qualities of the specific representatives of new three generations of non-ionic contrast media are analysed and compared: 1) metrizamide (Amipaque, Nycomed) - a soluble monomer; 2) iopamidol (Iopamiro, Bracco), iohexol (Omnipaque, Nycomed), iopromid (Ultravist, Schering), iopentol (Imagopaque, Nycomed), ioversol (Optiray Mallincrodt) - monomers, more tolerable and with lower toxicity; 3) ioxaglat, iotrolan and iodixanol -monoacidic dimers with lower osmolarity. Results from clinical trial and monitoring programs in large patients' groups are presented. The severity and incidence of the observed side effects in different organs and systems including the risk's groups are given. Compared to the conventional ionic media, the occurence of undesired effects has been reduced to about 1/6 with the use of the new products. The review unabiguously show the advantages of the non-ionic contrast media. 6 tabs., 2 figs., 26 refs
Chung, Jin Wook; Kim, Hyung Jin; Kim, Seung Hyup; Park, Jae Hyung; Chang, Kee Hyun
Till now, there is no consensus about appropriate contrast agents for use in clinical investigation in suspected perforation of the esophagus. Gastrografin, most widely used water soluble contrast agent, is less sensitive in detection of fistulous tract and can induce pulmonary edema, leading to death occasionally, if aspirated. Barium sulphate has been contraindicated without actual evaluation of its effect on mediastinum by experimental and clinical study. The purpose of this experimental study is to evaluate the type of tissue reaction and its severity in mediastinum and, as a result, to propose appropriate contrast agents in various clinical situations of suspected esophageal leakage. Barium sulphate, Hytrat, Gastrografin, Telebrix, Hexabrix, Amipaque, Niopam, and Ultravist were injected into mediastinum of 20 rats in each. The tissue reaction of injection sites were examined microscopically and graded according severity of inflammatory reaction with serial follow up from 1 day to 8 weeks after injection. The results are as follows, 1. Barium sulphate and Hytrast produced highly significant (p<0.01) tissue reaction compared to saline group and early inflammatory reaction was more severe in Hytrast. 2. Water soluble agents produced no significant reaction in mediastinum compared to saline control group and proved to be safe in the situation of leakage into mediastinum. 3. Injected barium caused no death during 8 week follow up in spite of large injected amount and histologically produced localized indolent granuloma after 4 weeks which is expected not to cause any delayed complications. In consideration of above results, superior physical characteristics of barium sulphate and drawbacks of Gastrografin, we concluded as follows. 1. For postoperative assessment of esophageal anastomosis, Barium sulphate is the contrast agent of choice
Nyman, Ulf; Ekberg, Olle; Aspelin, Peter
The Swedish radiologist Torsten Almén is the first clinical radiologist ever to have made a fundamental contribution to intravascular contrast medium design, the development of non-ionic contrast media. He became emotionally triggered by the patients' severe pain each time he injected the ionic "high-osmolar" contrast media when performing peripheral arteriographies in the early 1960s. One day he got a flash of genius that combined the observation of pain, a pathophysiological theory and how to eliminate it with suitable contrast media chemistry. After self-studies in chemistry he developed the concept of iodine contrast media not dissociating into ions in solution to reduce their osmolality and even reach plasma isotonicity. He offered several pharmaceutical companies his concept of mono- and polymeric non-ionic agents but without response, since it was considered against the chemical laws of that time. Contrast media constructed as salts and dissociating into ions in solution was regarded an absolute necessity to achieve high enough water solubility and concentration for diagnostic purposes. Finally a small Norwegian company, Nyegaard & Co., took up his idea 1968 and together they developed the essentially painless "low-osmolar" monomeric non-ionic metrizamide (Amipaque) released in 1974 and iohexol (Omipaque) in 1982 followed by the "iso-osmolar" dimeric non-ionic iodixanol (Visipaque) released in 1993. This has implied a profound paradigm shift with regard to reduction of both hypertonic and chemotoxic side effects, which have been a prerequisite for the today's widespread use of contrast medium-enhanced CT and advanced endovascular interventional techniques even in fragile patients. © The Foundation Acta Radiologica 2016.