Eosinophilia caused by iodinated radiographic contrast media.

Statistically significant eosinophilia was noted in the peripheral blood of a group of 108 patients 48 h after the administration of iodinated radiographic contrast medium (RCM). The duration of eosinophilia was approximately 6 days. Eosinophilia had no accompanying clinical symptoms except for two cases where urticaria appeared. The incidence of eosinophilia was irrespective of dosage or type of RCM. Possible mechanisms responsible for eosinophilia have been considered. Since eosinophilias of other aetiologies are common, it is of practical importance to distinguish these from RCM-induced eosinophilias.

Intravenous cholangiography by bolus injection of meglumine iotroxamate and meglumine iodoxamate: a comparative trial of two new contrast media.

The meglumine salts of iodoxamic and iotroxamic acids are recently developed intravenous cholangiographic media. In several studies these two media have been shown to be significantly better than meglumine iodipamide and meglumine ioglycamate for opacification of the biliary tree and incidence of adverse effects. As part of a multi-centre double-blind trial 100 patients were given iodoxamate or iotroxamate. Comparisons of opacification, side effects and renal excretion of contrast were made. The results showed no statistically significant difference in biliary tree opacification; more frequent renal excretion of contrast with iodoxamate; and contrary to previous reports a slightly higher incidence of side effects with iotroxamate.

Biliary iodipamide and iodoxamate excretion as function of basal bile flow in normal, common bile duct obstructed and liver-damaged dogs.

The investigation was performed in 6 cholecystectomized chronic bile fistula dogs in which, except in complete common bile duct obstruction, the bile was diverted and replaced with a constant taurocholate infusion of 0.3 mumoles per min. per kg. Iodipamide and iodoxamate were i.v. infused at a rate of 6.7 mumoles per minute per kg for 30 minutes. Different degrees of extrahepatic obstruction were simulated by producing different intrabiliary pressure conditions. Progressive hepatic parenchymal disease was induced by oral administration of dimethylnitrosamine. In both conditions basal (precontrast) bile flow, maximum biliary excretion rate and bile concentration of the contrast agents decreased with increasing hepatic dysfunction. This investigation suggests that, regardless of the underlying mechanism, the bile iodine concentration required for radiographic visualization of the biliary system is no longer attained in intravenous cholangiography when the basal bile flow decreases below 2 microliter per min per kg in the presence of a physiologic bile salt plasma pool. In hepatic dysfunction alkaline phosphatase correlated better with the maximum biliary excretion rate and concentration of the contrast agents than SGPT, SGOT, and serum bilirubin and therefore seems to be the best parameter to predict the chance of a successful intravenous cholangiography.

A double-blind comparison of meglumine iotroxate (Biliscopin) and meglumine iodoxamate (Cholovue).

A double-blind comparison of two recently introduced cholangiocholecystographic agents was carried out in 80 patients. Both agents proved to be equally effective in opacifying the gall-bladder and the bile ducts. The visualization of the bile ducts after cholecystectomy was slightly better after meglumine iotroxate administration. Both agents showed evidence of hepatic toxicity in mild or moderate degree. However, there were 3 cases in which adverse hepatotoxic reactions t meglumine iodoxamate have been observed. Careful observation of patients receiving this drug is advised.

Clinical experience with infusion cholegraphy using iotroxamide (Biliscopin ) (author's transl). / Klinische Erfahrungen bei der Infusionscholegraphie mit Iotroxamid (Biliscopin).

Forty-three cholangio-cholecystographies were carried out with iotroxamide. A the same time, the behavior of various serum enzymes was controlled. Iotroxamide satisfactorily demonstrated the biliary tract for the diagnosis in 37 of our patients (86.5%). Only an inadequate or incomplete evaluation was possible for 6 of our patients (13.5%). Due to the pharmacokinetic characteristics of iotroximide, the time-density ratio is very favorable. As a result, the contrast radiograph of the biliary tract including the gallbladder was available for evaluation as early as 30 minutes after the infusion and almost always within 60 minutes. Minor subjective side effects were observed in only 4 cases. With the exception of 2 cases with obstructed bile flow, the serum-enzyme level was not significantly altered after administration of the contrast medium.

[Pharmacokinetics and plasma albumen binding of iotroxic acid (Biliscopin), iodoxic acid (Endomirabil) and ioglycamine (Biligram) (author's transl)]. / Pharmakokinetik und Plasmaeiweissbindung von Iotroxinsäure (Biliscopin), Iodoxamsäure (Endomirabil) und Ioglycaminsäure (Biligram)

Pharmacokinetic data after injection of the new cholegraphic contrast medium iotroxic acid (Biliscopin) in man are reported and compared with the results of injections of ioglycamate and iodoxic acid. Iotroxic acid is less completely bound to plasma proteins than ioglycamate, but significancy more so than iodoxamate. Plasma protein binding depends on contrast concentration in the plasma, as does excretion in the urine. Biliary transport rate and maximal iodine concentration in the gall bladder are higher after injections of iotroxinate and iodoxamate than after ioglycamate.

Interaction of ligandin with radiographic contrast media.

Ligandin (Y protein) is an abundant cytoplasmic glutathione transferase present in liver, kidney and gut in various animals and man. Its interaction with four radiologic contrast media (Telepaque, 3-(3 amino-2,4,6, triiodophenyl -2 ethylpropanoic acid, sodium salt; Hypaque, sodium -3, 5-diacetamido-2,4,6,-triiodobenzoate; Cholografin, N,N'adipyl-bis-(3-amino-2,4,6-triiodobenzoic acid) N-methyl-glucosamine; Diodrast, 3,5-Diiodo-4-pyridone-N-acetic acid, Diethanolamine Salt was investigated by observing inhibitory effects on the enzyme-catalyzed conjugation of glutathione with 1-chloro-2, 4-dinitrobenzene. Lineweaver-Burk plots of reciprocal initial velocity versus reciprocal inhibitor concentrations at fixed glutathione and chlorodinitrobenzene concentrations demonstrate non-competitive inhibition by all contrast media except Diodrast. No conjugates of contrast media with glutathione were formed. It is postulated that intracellular accumulation of contrast media is aided by intracellular binding with ligandin. Inhibition of the GSH transferase activity of ligandin can disrupt the mercapturate formation, an important detoxification process.

Binding of 2,4,6,-triiodobenzoic derivatives with blood cells. I. Binding of 125I-labeled uropolin with lymphocytes and erythrocytes during separation of blood in uropolin-dextran gradient.

125I-labeled Uropolin (syn. Uropolinum, Uromiro, Urografin) is bound to lymphocytes and erythrocytes if used to isolate lymphocytes in uropolin-dextran gradient. After 24-hr storage of 4 degrees C lymphocytes retained 60% of their radioactivity, and erythrocytes 87% under the same conditions.

[Intravenous cholegraphy with Chologram (a double blind comparison with Bilivistan) (author's transl)]. / Intravenöse Cholegraphie mit Chologram, Doppelblindstudie gegen Bilivistan

A double blind comparison between Ioglycamid (Bilivistan) and the new I-V cholegraphic medium Iotroxamid (proposed trade name Chologram) is reported. Chologram produces better pictures and it is better tolerated. Pharmaco-kinetic data are published for the first time.