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Biomedical subjects

J Praestholm

Publications and source records attributed to J Praestholm.

At least 37 records · Page 2Linked to original sources
PubMed1987

Observer variability in assessment of angiographic vasospasm after aneurysmal subarachnoid haemorrhage.

In clinical practice and in many reported studies about incidences and time courses of vasospasm the angiographic spasms are judged by eye without clear definition of vessel narrowings. To evaluate the reliability of this diagnostic method two experienced neuroradiologists and two experienced neurosurgeons independently in two sessions, examined 30 carotid angiograms performed after an aneurysmal subarachnoid haemorrhage. The intra- and inter-observer agreements for the absent/present and localization diagnosis of vasospasm were calculated by means of Kappa statistics. Kappa values for both intra- and inter-observer agreement showed great variability and in general most of the agreements were not much better than chance expected agreement. The diagnostic method of judging angiographic vasospasm by eye without clear-cut definitions of vessels narrowings is unreliable and should not be used in the future, neither in clinical practice nor in research.

Cerebral Angiography↗
PubMed1984

Late effects of perivascular injection of Thorotrast in the neck.

Two cases of late sequelae of accidental perivascular injection of Thorotrast (thorium dioxide) during carotid arteriography are presented. The complaints of the patients and the clinical findings are due to topical granulomatous and fibrous reactions with compression of the carotid artery and cranial nerves, and influence upon larynx and trachea. For future decades it will still be necessary to be aware of this possible cause of neck tumours with oto-laryngeal and neurological symptoms.

Carotid Arteries↗
PubMed1983

A controlled clinical trial of iohexol and diatrizoate in aortofemoral angiography.

Iohexol is a recently synthesized non-ionic low-osmolar contrast medium. It has been compared to the conventional ionic hyperosmolar contrast medium diatrizoate (Urografin 60%) in a randomized double-blind crossover study of aortofemoral angiographies of 50 consecutive patients. The intraarterial blood pressures, the pulse rate and ECG were recorded continuously and the reactions of pain and warmth were evaluated. Iohexol caused significantly less haemodynamic changes than Urografin and also the pain reactions were significantly reduced. The quality of the angiograms was equal.

Adult↗
PubMed1982

Iopamidol, a new nonionic contrast medium in peripheral angiography.

Iopamidol (B 15,000), a new nonionic contrast medium, was compared to diatrizoate (Urografin 60%) in a controlled clinical trial using aortofemoral runoff angiography in a consecutive series of 50 severely arteriosclerotic patients. Iopamidol was found to be superior to the conventionally used contrast medium, as it significantly reduced the pain and discomfort following injection. Only slight to moderate alterations of aortic blood pressure and pulse rate were observed following the injection of both media. The hemodynamic influence of iopamidol, however, was significantly less pronounced than that of diatrizoate.

Angiography↗
PubMed1981

Direct measured systolic pressure gradients across the aorto-iliac segment in multiple-level-obstruction arteriosclerosis.

Patients with severe ischemia due to multi-level obstructions in the leg arteries both above and below the region were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aorto-iliac obstructions was compared to the angiographic findings. A consistent pressure gradient was found in the various types of arterial occlusions. In patients with occlusion of both the aorta and the iliac arteries, the systolic pressure drop was about 60% (range, 50-78%, SD 9%). The various types of iliac artery occlusions resulted in quite uniform systolic pressure drops of about 50% (range 35-68%, SD 9%). In contrast, the systolic pressure drop along different types of iliac stenoses showed a wide variation, ranging from a minimal drop to about 60%. The degree of stenosis on the angiogram was correlated significantly with the pressure drop. Due to large variations, however, the angiographic information was found to be useless in the individual patient. No difference in the pressure drop was found between cases in which rich and poor collateral networks were visualized.

Adult↗
PubMed1981

Supplementary angiography when lumbar angiograms fail to demonstrate the vessels to the leg.

The peripheral run-off arteries were insufficiently visualized due to occlusions in the aorto-iliac segments in studies of 10 patients (15 legs) in 183 consecutive aorto-femoral angiograms. Guided by a combination of the Doppler technique and fluoroscopy, the non-opacified and pulseless common femoral artery was catheterized. Angiography through this catheter usually showed patency of a part of the common femoral artery but occlusion of the superficial femoral artery. The deep femoral and crural arteries were well preserved. Intra-arterial pressure measurements showed larger pressure gradients along the occluded aorto-iliac segments in one-third of the patients with non-visualized leg arteries as compared with gradients in patients with similar proximal and distal occlusions but with good opacification of the leg arteries. In previous cases, non-visualization of the leg arteries was considered as representing non-reconstructable lesions by our vascular surgeons. The findings in the present study showed that in these patients surgical reconstruction of only the aorto-iliac segments will suffice to save the limb from amputation.

Angiography↗
PubMed1981

Transient acute renal failure and functional hemispheric depression after cerebral arteriography in diabetic patients.

Cerebral angiography was carried out in two diabetic patients in the evaluation of minor vascular ischemic episodes. A transient acute renal failure following cerebral angiography was accompanied by a transient comatose episode with severe unilateral neurological deficits. A functional depression of the injected hemisphere due to a contrast induced impairment of the blood-brain barrier is suggested as the pathophysiological background of the neurological complication.

Acute Kidney Injury↗
PubMed1979

Ioxaglate, a new low osmolar contrast medium used in femoral angiography.

Ioxaglate, a new monoacid, dimeric contrast medium was compared with diatrizoate (Urografin 60%) in a series of 61 femoral angiographies. In a double blind group of 34 examinations all patients preferred ioxaglate which caused slight pain in only five cases, whereas after diatrizoate 14 patients felt severe pain (six were unable to keep their legs still) and 12 felt slight pain. Increase in heart rate and decrease in systolic and diastolic arterial blood pressure was seen after both contrast medium injections, but significantly less after ioxaglate than after diatrizoate.

Adult↗
PubMed1978

Comparison of metrizamide and iodophendylate for cerebral ventriculography: a long-term ultrastructural study of the ventricular wall in the rat.

Cerebral ventriculography was performed on adult albino rats to compare the effect of metrizamide and iodophendylate on the ependymal wall. The animals were killed by vascular perfusion 1 month and 4 months after ventriculography. The ependymal layer and the underlying brain tissue were examined with the electron microscope. After the use of metrizamide the tissue appeared completely normal. The use of iodophendylate provoked accumulation of phagocytozing macrophages on the ependymal wall and storage of iodophendylate in the ependyma and underlying brain tissue. These changes were present both 1 and 4 months after ventriculography.

Animals↗
PubMed1978

Late meningeal effects of myelographic contrast media with special reference to metrizamide.

Two hundred and fifty-six myelograms in 192 patients were following by repeat myelography using a water-soluble contrast medium. The films of these re-examinations were analysed for signs of meningeal changes. Adhesive arachnoiditis had developed in five of 46 cases after methiodal sodium, in 24 of 96 cases after iothalamate meglumine, in seven of 12 cases after iocarmate meglumine, in seven of ten cases after iodophendylate, but in none of 90 cases after metrizamide. Dose of contrast medium, observation time and protein concentration of the CSF were found to be factors of importance for the development of adhesive arachnoiditis.

Adolescent↗
PubMed1977

Cardiovascular reactions to myelography with watersoluble contrast media.

Arterial blood pressure and heart rate were recorded for 5 to 7 h during myelography with iothalamate meglumine and metrizamide in 23 rabbits. After 0.6 ml iothalamate meglumine containing 280 mg I/ml a significant decrease in blood pressure and signs of circulatory failure were found. After identical doses of metrizamide and after reduction of the dose of iothalamate meglumine to 0.4 ml containing 140 mg I/ml no significant fall in blood pressure was recorded. A decrease of blood pressure was always accompanied by a decrease of heart rate. Arterial blood pressure and heart rate during experimental myelography are suggested as useful variables in the evaluation and comparison of new contrast media for myelography.

Anesthesia, Intravenous↗
PubMed1977

Experimental evaluation of watersoluble contrast media for myelography.

An experimental method for testing contrast media for myelography was developed and used to compare three watersoluble contrast media, iocarmate meglumine, iothalamate meglumine and metrizamide after suboccipital myelography in 120 rabbits. A further 71 rabbits served as controls. Iocarmate and iothalamate caused vigorous convulsions; metrizamide did not. Examination of the CSF revealed an acute pleocytosis after installation of the contrast media and after cisternal puncture with injection of hypertonic saline. Histological examination of the spinal cord, nerve roots and meninges revealed pathological changes in 1 or 32 unoperatec controls (3%). Leucocyte infiltrations were found in the meninges, nerve roots and spinal cord of about 20% of the animals after myelography, after cisternal puncture without injection or with injection of hypertonic saline. There were no significant quantitative differences between the experimental groups. Degenerative changes were seen only after myelography. No meningeal fibrosis was demonstrated. An abnormal leucocyte count in the primary CSF influenced the incidence of histological changes, indicating that only rabbits with CSF cell counts within normal limits should be used in future experiments.

Animals↗
PubMed1976

Histological changes in the central nervous system following intraventricular administration of oil-soluble contrast media. An experimental study in the rat.

Following injections of iodophendylate (Pantopaque) in adult rats, the contrast medium was shown to be refrained in the dilated cerebral ventricles for at least 180 days. Histological examination revealed macrophages containing phagocytosed lipid on the ependymal lining of the ventricles, but there was no leukocytic reaction to retained or encysted contrast material. The macrophages were considered to be involved in the removal of iodophendylate. The irritative reaction in the normal central nervous system was limited, as opposed to the severe reactions previously reported in animals with inflammation of the brain and meninges.

Animals↗