Effects on renal haemodynamics and tubular function of the contrast medium Ioxaglate in renal transplant patients.

The aim of this study was to evaluate the effects of Ioxaglate on renal haemodynamics and tubular function in renal transplant patients at increased risk of nephrotoxicity. 21 patients undergoing either intravenous pyelography or arteriography with Ioxaglate were studied. Renal clearance studies were carried out 1 day before and 1 day after administration of Ioxaglate (173 +/- 37 ml) injected into each patient. None experienced any adverse reaction. Mean serum creatinine, glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and urinary NAG excretion were unaltered by ioxaglate. No patient suffered a nephrotoxic reaction or acute oliguria that required dialysis as a result of the administration of contrast material. In the subset of seven patients receiving cyclosporine the same results were observed. In the subset of 10 patients with a GFR lower than 60 ml/min before injection of Ioxaglate were also observed no significant change in mean GFR, ERPF and urinary NAG excretion. Only two patients had a transient decrease of GFR of between 10 and 20%. The results of this study show that the ionic, low osmolar contrast medium ioxaglate may be used safely in patients with a renal transplant thus extending previous data obtained in patients with chronic renal failure.

Rectal malacoplakia in renal transplantation: MR features.

This report describes the CT and MRI features of rectal malacoplakia in a renal transplant recipient. The lesion appeared strongly hyperdense (105 HU) on unenhanced CT and demonstrated hypointense signal on T1- and T2-weighted MR imaging with slight homogeneous enhancement after gadolinium injection. These characteristics distinguish this lesion from other more common neoplastic, inflammatory rectal lesions that are typically isointense on T1-weighted imaging and enhance variably after gadolinium injection. Characteristic intracytoplasmic siderocalcific spherules in malacoplakia can produce suggestive features on unenhanced CT and MRI.

[Comparative evaluation of 2 fiber optic catheters for the continuous measurement of Svo2]. / Evaluation comparative de deux cathéters à fibres optiques permettant la mesure continue de la Svo2.

Nineteen intensive care patients with shock and acute respiratory failure were studied using two different fiber-optic catheters used for the continuous measurement of mixed venous blood oxygen saturation (SVO2). In groupe I patients (n = 11), a Swan-Ganz catheter with optic fibres emitting light characterized by three different wavelengths was used (Opticath Oximetrix). In groupe II patients (n = 8), a Sat-one Edwards catheter was used instead (only two different wavelengths). All the patients were studied in the early stages of shock, once all the calibration procedures had been carried out. An increase in FIO2, using PEEP, fluid replacement therapy and vasoactive drugs or diuretics all improved the cardio-respiratory status of each patient. After each new therapeutic procedure, SVO2 was measured in blood samples obtained from these catheters, and from the pulmonary artery (to give the reference value, using an OSM3 Hemoximeter). Over a period of 1.5 to 6 h, 119 measurements were carried out in Group I, and 91 in Group II. The correlation coefficient was higher with the Oximetrix catheter than with the Edwards one (r = 0.970 and 0.855 respectively; p less than 0.001). Moreover, the 24 h spontaneous drift of the former catheter was less than that of the latter (+3.3 +/- 3.1% vs. +9.3 +/- 7%, p less than 0.05). This study showed that a catheter with optic fibres emitting a light with three wavelengths is more accurate than one emitting only two for the measurement of changes in SVO2 in critically ill patients.