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Biomedical subjects

R L Siegle

Publications and source records attributed to R L Siegle.

At least 37 records · Page 2Linked to original sources
PubMed1984

Advertising of contrast material: a developing problem.

Problems exist when indications for the use of new contrast agents and new indications for the use of conventional contrast agents are considered in relation to advertisements. Ultimately, the consumer pays the cost of expensive FDA testing, often to prove what is already obvious. Other medically indicated uses of a contrast agent may remain unapproved because there is no financial incentive to seek approval, and needed modifications in already approved advertisements may not be sought for the same reason. A cooperative effort among manufacturers, radiologists, and the FDA is needed to improve the process.

Advertising↗
PubMed1982

Urography with metrizamide in children.

Noionic contrast material could have particular value in pediatric urography because of the absence of osmotic diuresis and associated fluid loss. Excretory urograms were obtained in 23 children using metrizamide at 300 mg l/ml and administered at a dose of 2.2 ml/kg. The radiographs gave excellent urinary tract opacification without changes in serum osmolality. The calyces appeared sharp but undistended, there was increased occurrence of ureteral ridging, and the urinary bladders often remained undistended at the completion of the studied. The dense opacification attainable with isoosmolar metrizamide also gave the opportunity for performing urography with higher than normal kilovoltage and thus reducing radiation exposure to the child. Also in vitro studies demonstrated the significant radiation dose reduction possible with the higher kilovoltage technique.

Blood↗
PubMed1980

Rectal thiopental versus an intramuscular cocktail for sedating children before computerized tomography.

The sedative effects of rectal thiopental sodium and an intramuscular cocktail of meperidine hydrochloride, chlorpromazine hydrochloride and promethazine hydrochloride were compared in 72 pediatric patients undergoing computerized tomography (CT). Pediatric patients scheduled were randomly assigned to receive either the i.m. cocktail (2.0 mg/kg of meperidine, 1.0 mg/kg of both chlorpromazine and promethazine) or 25--45 mg/kg of thiopental rectally before scanning. Side effects, and onset, duration and depth of sedation were recorded by 14 unblinded investigators. Clarity of CT scans was rated by two blinded radiologists. Additional doses of sedatives were administered as necessary. Sedation was not achieved in 3% of the thiopental group or in 14+ of the i.m. cocktail group. Additional sedatives were required by eight patients in the thiopental group and by five patients in the cocktail group. The mean time for onset of sedation was 8 minutes with thiopental and 18 minutes with the cocktail. The mean duration of sedation was 7 hours for the cocktail group and 2.75 hours for the 25-mg/kg rectal thiopental group. All scans were diagnostic (acceptable) in the rectal thiopental group, but 14% of those in the i.m. cocktail group were nondiagnostic. Rectal thiopental is an effective alternative to an i.m. cocktail for sedating children before CT scans and may reduce the number of nondiagnostic scans.

Child↗
PubMed1979

Complement activation following intravenous contrast material administration.

Untoward reactions to iodinated contrast material (ICM) continue to be a significant medical problem. Complement components were assayed in patients having reactions to evaluate the possibility of complement activation in these reactions. Reactor group samples were drawn from patients during the contrast reactions and then 2 weeks later to provide the equivalent of preinjection baseline samples, Control patient values were determined from blood samples drawn from patients before and 20 minutes after ICM injections without reaction. There were consistent falls in total hemolytic complement (CH50) as well as C3, C4, and C5 in both the control group and the reactor group. These falls in the complement reached statistical significance only for CH50 in the reactor group. The results indicate that complement activation occurs after ICM injection. This activation can occur independent of clinical reactions; however, falls in total hemolytic complement and low hemolytic complement titers prior to ICM infusion may be related to the presence of anaphylactoid symptoms.

Adolescent↗
PubMed1979

Rectal thiopental for sedation of children for computed tomography.

Rectally administered thiopental was evaluated for sedation in pediatric computed tomography and compared with "cardiac cocktail" sedation. The drug produced sedation as effective as the "cocktail" with easier administration, more rapid onset, and shorter duration of sedation. Although no complications were observed, careful observation for respiratory depression is suggested.

Anesthesia, General↗
PubMed1978

Anaphylactoid reactions to iodinated contrast material.

A review of the literature involving anaphylactoid reactions to iodinated contrast material (ICM) suggests that the reactions are nonantibody-mediated but that a complex activation of inflammatory mediators occurs. Histamine release and/or complement activation has been demonstrated in both in vitro and in vivo experimental systems. It appears that pretreatment of selected cases (those patients previously exhibiting an anaphylactoid reaction) is effective in reducing the frequency and severity of subsequent reactions when readministration is necessary.

Adrenal Cortex Hormones↗
PubMed1976

Chronic urticaria and intermittent anaphylaxis. Reactions to lophendylate.

In a case of chronic, severe urticaria and intermittent episodes of anaphylaxis due to an iophendylate injection (Pantopaque) given in the course of myelography, almost complete relief was obtained from the removal of approximately 8 ml of residual iophendylate from the spinal canal. Data obtained from direct skin testing, Prausnitz-Küstner testing, peptide inhibition of Prausnitz-Küstner testing, and IgE levels quantitated before and after removal of iophendylate indicate that these symptoms were mediated via an IgE anti-iophendylate reaction.

Anaphylaxis↗
PubMed1976

Air embolus following pulmonary interstitial emphysema in hyaline membrane disease.

Two cases of hyaline membrane disease are presented complicated by severe, interstitial emphysema and resulting in death from air embolus. This is consistent with the experimental evidence of other investigators that shows that such an air embolus may be more common complication of hyaline membrane disease than previously expected.

Embolism, Air↗
PubMed1976

Changing clinical and roentgenographic patterns of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) occasionally deviates from the classical presentation of the disease. Small bowel dilatation and pneumatosis are frequently present prior to the actual onset of the clinical presentation. Pneumatosis intestinalis, an important diagnostic sign of NEC, is quite variable; it may be present, persist, worsen, or disappear; or at times it may not be present at all. A severe complication of necrotizing enterocolitis is perforation which in 50 percent of the cases presented without obvious free intra-abdominal air. Accumulation of fluid in the abdomen is stressed as strong evidence for perforation and a strong indication for surgery. The varying features indicate that NEC has a clinical spectrum that extends from benign to severe, and recognition of all these variations will lead to better diagnosis and to a better understanding of the disease. The clinical and roentgenologic variations make classification difficult but the variety most likely represents the combination of a great number of susceptible children and a greater recognition of the disease.

Air↗
PubMed1976

Intestinal perforations secondary to nasojejunal feeding tubes.

Infant alimentation by nasojejunal tube feeding has been successfully used since 1973. A significant complication is small bowel perforation by the tube; three cases are presented. The differential diagnosis includes spontaneous gastric perforation and necrotizing enterocolitis. Nasojejunal tube perforation almost always occurs in the distal duodenum. It is likely the result of peristaltic activity which propels the tube along the relatively rigid duodenal loop. Thus it is preferable to position the tube end distal to the ligament of Treitz.

Duodenal Diseases↗
PubMed1976

Early diagnosis of necrotizing enterocolitis.

This study demonstrates that the diagnosis of necrotizing enterocolitis can sometimes be made before the full-blown clinical and radiographic findings are manifest. Of 12 infants with films available prior to diagnosis of the disease, nine had early selective dilatation of small bowel and little or no air in the colon. Necrotizing enterocolitis should be foremost in the differential diagnosis when this finding is coupled with signs such as abdominal distention, acidosis, and diarrhea.

Enterocolitis, Pseudomembranous↗
PubMedDate not supplied

Measurement of histamine, complement components and immune complexes during patient reactions to iodinated contrast material.

Studies were performed on nine patients who had just suffered urticarial or bronchospastic reactions following injection of iodinated contrast material (ICM). The parameters studied were white cell histamine, serum complement components C'3 and C'4 and circulating immune complexes. The white cells of the nine patients demonstrated an average increase of 125% in intracellular histamine over the 3-4 week period following the ICM reaction. Control volunteers averaged only a 10% change. The data implies that there was a loss of white cell histamine during the ICM reaction with replenishment during the following 3-4 week period. Complement components C'3 and C'4 were normal. Circulating antigen-antibody complexes were sought via precipitin bands in agar gel using Clq. None could be isolated following seven ICM reactions. Thus these ICM reactions appeared to release histamine without detection of circulating immune complexes and with normal levels of two major complement components.

Antigen-Antibody Complex↗
PubMedDate not supplied

Development of a model using polypeptide antibodies for scintigraphy of the pancreas.

A study was designed to develop an agent for pancreatic scintigraphy with greater specificity for the pancreas than selenomethionine. A series of successful experiments was performed using rabbit-produced antibodies to the recently discovered hormone, pancreatic polypeptide. Via hemagglutination and radiolabeled hemagglutination studies, the antibody activity was demonstrated. Gel diffusion studies showed selective uptake by the rat pancreas of intravenously injected antibody and no uptake by the liver and spleen. Immunocytochemical studies on human tissue demonstrated the same selectivity for the pancreas. Also, the titers of different batches of rabbit-produced antibody were quantitated by the enzyme-linked immunospecific assay system. These studies indicate that polypeptide antibody has the potential for carrying a radionuclide selectively to the pancreas.

Animals↗