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Biomedical subjects

R F Spataro

Publications and source records attributed to R F Spataro.

15 recordsLinked to original sources

New and old contrast agents: pharmacology, tissue opacification, and excretory urography.

In equivalent doses for intravenous urograms conventional ionic contrast agents give iodine concentrations in the urine of approximately 30 mg iodine/ml, nonionic contrast media provide approximately 50 mg iodine/ml, and the ionic dimer Hexabrix approximately 70 mg iodine/mL. These new low osmolality, contrast media provide significantly higher urinary iodine concentrations than conventional ionic contrast media, provide better diagnostic quality excretory urograms, better patient tolerance, and fewer adverse side-effects and serious reactions. These new low osmolality, contrast media have significant advantages in intravenous urography in both safety and efficacy when compared to conventional higher osmolality contrast media.

Contrast Media

The current state of hysterosalpingography.

The authors present an overview of the current status of hysterosalpingography, discussing the advantages and disadvantages of various cannulas, contrast media, and methods of contrast medium introduction. Thirty-two figures illustrate a variety of abnormal findings including among others: intravasation of contrast medium, salpingitis isthmica nodosa, manifestations of pelvic inflammatory disease, the effects of DES exposure, Ascherman's syndrome, adenomyosis, carcinoma, polyps, myomata and developmental uterine abnormalities.

Fallopian Tube Diseases

High-dose clinical urography with the low-osmolality contrast agent Hexabrix: comparison with a conventional contrast agent.

A double-blind clinical trial was performed in 60 patients to compare Hexabrix (ioxaglate meglumine and ioxaglate sodium) and Renografin-60 (diatrizoate meglumine and diatrizoate sodium). Use of Hexabrix produced higher urinary iodine concentrations, lower urine volumes at 30 minutes, and excretory urograms significantly better in diagnostic quality, as rated by four independent observers. There was no difference in nephrogram quality between contrast agents. Patients receiving Hexabrix had less of an increase in heart rate and demonstrated a slight rise in mean arterial blood pressure, rather than the biphasic rise then fall seen with Renografin-60. There was no significant change for up to 96 hours after urography in results of hematology, clinical chemistry, or urinalysis, except for an increase of 0.005 in urine specific gravity with Renografin-60. Patients reported significantly less body heat, heat in the injection arm, and overall discomfort with Hexabrix. There was a similar amount of nausea and vomiting in the two groups. Hexabrix also caused histaminic-type reactions in three patients.

Adult

Medical and economic considerations in using a new contrast medium.

In deciding to use a new intravascular contrast medium, the considerations should be patient safety, Imaging efficacy, and cost. Balancing these factors, use can be estimated. With the new low-osmolality contrast media, particularly the nonionic media, the expected increased patient safety must be balanced against the much higher cost.

Canada

Early medullary cystic disease: a urographic diagnosis?

Excretory urography of a patient with an early stage of medullary cystic disease demonstrated an inhomogeneous, streaky nephrogram confined to the medulla, presumably due to accumulation of contrast material in dilated tubules. This was seen best one to two hours after contrast injection and may represent a specific urographic finding which does not appear to have been described previously in this condition.

Adolescent

Characteristics of calcification in tumors of the pineal gland.

Thirty-two cases of proved pineal tumor were analyzed. Calcification was seen in 75%. The size, character, and position of the calcification were useful indicators of abnormality on plain-film evaluation. Fray's cranioangle method was more sensitive than Oon's method in determining abnormal position of the calcified pineal tumor on the lateral skull film. Most calcifications were displaced postero-inferiorly or inferiorly, which can be explained by obstructive hydrocephalus or direct tumor expansion.

Adolescent

Diagnosis of nonopaque calculi by computed tomography.

Computed tomography can aid in the distinction of calculi from both tumors and clots in the urinary tract. Its availability, simplicity of interpretation, and noninvasiveness establish it as an important diagnostic modality in selected cases when calculus is in the differential diagnosis of upper urinary tract filling defects.

Adult

The use of percutaneous nephrostomy and urinary alkalinization in the dissolution of obstructing uric acid stones.

Two patients are described who presented with complete urinary obstruction secondary to nonopaque uric acid stones. They were treated with percutaneous nephrostomy for urinary diversion and urinary alkalinization by local irrigation and oral sodium bicarbonate therapy with complete dissolution of the stone after 16 and 21 days of therapy. Percutaneous nephrostomy with urinary alkalinization is a reasonable, relatively safe alternative to surgical stone removal for patients with obstructing uric acid stones.

Aged

Adult polycystic kidney disease: a review of 100 cases.

Herein we review 100 cases of adult polycystic kidney disease. Flank pain was the most common presentation in these cases. In 20% of the patients calculi were noted and 10% had obstruction. The average patient age at death was 57 years. The importance of tomography is emphasized with key radiographic features, such as bilateral large kidneys, inhomogeneous nephrogram, caliceal distortion and poorly defined renal margins. Cystic involvement of the liver and spleen may help to confirm the diagnosis. Differential diagnosis includes bilateral multiple simple cysts, angiomyolipomatosis and bilateral renal carcinomas.

Adolescent

Urinary tract obstruction in polycystic renal disease.

The incidence and cause of urinary tract obstruction in 100 consecutive patients with polycystic renal disease are reported. Because of nonspecific symptoms, poor renal function, and calyceal distortion, obstruction may be difficult to detect. A number of patients had infundibular obstruction caused by a calculus, clot, or inflammation and edema of the pelvocalyceal wall.

Humans

Aqueductal stenosis and hydrocephalus: rare sequelae of mumps virus infections.

A case of a rare acquired form of aqueductal stenosis and hydrocephalus developing as a late sequela of mumps virus infection of the central nervous system is presented. The experimental studies of mumps induced aqueductal stenosis in hamsters and mice and the four previously reported cases in the literature are reviewed.

Animals

Epinephrine enhanced knee arthrography.

The effect of .3 cc of 1:1000 epinephrine on iodine concentration, total iodine content, fluid volume and radiographic quality was evaluated in knee arthrograms in dogs. With the addition of epinephrine the iodine concentration and total iodine content were significantly higher initially and remained significantly higher than in controls over a one hour period. The fluid volume in the knee was significantly lower with epinephrine. Initially both contrast absorption and dilution have major effects in decreasing iodine concentration. With increasing time the effect of contrast absorption becomes the major factor, having a two of three times greater effect on decreasing iodine concentration. With epinephrine radiographs were judged significantly better early and while the quality deteriorated rapidly in the controls the enhanced quality with epinephrine persisted up to one hour. Epinephrine is a very useful adjunct in enhancing the quality of knee arthrography.

Animals