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BMC Gastroenterology Aug 2019Intramural esophageal bronchogenic cyst is very rare. Surgical removal of the cysts is advised even the patients are asymptomatic, since the cyst can lead to...
BACKGROUND
Intramural esophageal bronchogenic cyst is very rare. Surgical removal of the cysts is advised even the patients are asymptomatic, since the cyst can lead to complications, and there is a risk of malignant transformation. Thoracotomy or thoracoscopy is the most commonly used approach for complete excision of the cysts. To our knowledge, this is the first report to excise intramural esophageal bronchogenic cyst completely by endoscopic submucosal tunnel dissection (ESTD).
CASE PRESENTATION
A 40-year-old male was referred to our hospital due to the detection of a submucosal tumor at the distal esophagus. The tumor was found during gastroendoscopy in a general health check-up. The patient had no symptoms. A benign esophageal tumor was confirmed by endoscopic ultrasonography (EUS) and computed tomography (CT). On the basis of these results, ESTD was performed. During the procedure, a cystic mass was observed between the mucosa and the muscular layers of the esophagus, and a hybrid knife was used for dissection. Histopathological examination showed the cyst wall was lined by pseudostratified ciliated columnar epithelium, consistent with a bronchogenic cyst. The esophagography using meglumine diatrizoate showed no leakage on the seventh day after ESTD. The patient remained asymptomatic and had a regular diet during the follow-up period.
DISCUSSION AND CONCLUSIONS
We successfully utilized ESTD for complete removal of esophageal bronchogenic cysts originating from the muscularis propria. The approach appeared safe, providing a minimally invasive treatment option for patients.
Topics: Adult; Bronchogenic Cyst; Endoscopic Mucosal Resection; Esophageal Cyst; Esophagoscopy; Humans; Male; Tomography, X-Ray Computed; Ultrasonography
PubMed: 31462259
DOI: 10.1186/s12876-019-1072-3 -
BMC Oral Health Jan 2017Micro-CT (μCT) studies that combine simulated canals with meglucamine diatrizoate to evaluate the shaping ability of nickel-titanium (NiTi) rotary instruments are...
BACKGROUND
Micro-CT (μCT) studies that combine simulated canals with meglucamine diatrizoate to evaluate the shaping ability of nickel-titanium (NiTi) rotary instruments are lacking in the literature. The purpose of this study was to evaluate the shaping ability of three new different nickel-titanium rotary instruments in simulated root canals using μCT.
METHODS
Thirty simulated root canals with a curvature of 60° were randomly allocated into the following 3 groups (n = 10): Group 1, ProTaper Universal (PTU) rotary system; Group 2, Reciproc single-file system; and Group 3, K3XF rotary system. Pre- and post-instrumented images of simulated canals were scanned with μCT via a radiopaque contrast technique to build a 3-dimensional (3D) model. Canal transportation, volumetric change and centring ability were evaluated in each group. Instrument failure and preparation time were also recorded. The Kruskal-Wallis test was used for statistical analysis and the significance level was set at p = 0.05.
RESULTS
Reciproc produced greater volume change in the apical part of the canals compared with PTU and K3XF (p < 0.05). K3XF exhibited less transportation and better centring ability at the 2- and 3-mm levels from the apical foramen compared with PTU and Reciproc (p < 0.05). There were no significant differences in the centring ratio and transportation between PTU and Reciproc. Preparation time was significantly shorter in the Reciproc group (p < 0.05).
CONCLUSIONS
Under the conditions of our study, all of the canals were 3D reconstructed successfully via the radiopaque contrast technique. Reciproc showed enhanced apical volume changes and K3XF exhibited better centring ability when compared with other groups.
Topics: Contrast Media; Dental Instruments; Diatrizoate Meglumine; Equipment Design; Imaging, Three-Dimensional; In Vitro Techniques; Nickel; Root Canal Preparation; Titanium; X-Ray Microtomography
PubMed: 28068971
DOI: 10.1186/s12903-016-0326-5 -
Resolution of adhesive small bowel obstruction with a protocol based on Gastrografin administration.Journal of Medicine and Life 2019The use of Gastrografin may have a therapeutic effect on resolving adhesive small bowel obstruction. Adhesive Small Bowel obstruction (ASBO) accounts for the majority of...
The use of Gastrografin may have a therapeutic effect on resolving adhesive small bowel obstruction. Adhesive Small Bowel obstruction (ASBO) accounts for the majority of patients with small bowel obstruction. Most patients are managed conservatively; frequent admissions create a considerable burden. We sought to examine the adherence to the Bologna guidelines for the management of ASBO in a high volume tertiary center and whether or not Gastrografin had a therapeutic effect. A comparison was made between an initial retrospective audit looking at ASBO and a prospective re-audit after applying standards derived from the Bologna guidelines. During re-audit it was found that more patients underwent conservative management and fewer patients had surgery as first line management. In the re-audit, those who had to undergo surgery within/after a period of 72h of conservative management were also fewer. Whether they were managed surgically primarily or after a period of conservative management, the average length of stay was also shorter. In comparison to the preliminary audit, there appeared to be no change in the way that medical history and physical examination was documented during the re-audit. However, there was a marked difference in the use of appropriate blood tests and CT scans. Changes were made successfully following the initial audit results and have been implemented, thus closing the audit loop. This study shows that the use of Gastrografin has decreased the need for surgical intervention in a group of patients with small bowel obstruction.
Topics: Diatrizoate Meglumine; Humans; Intestinal Obstruction; Prospective Studies; Reference Standards; Retrospective Studies; Tissue Adhesions
PubMed: 31123519
DOI: 10.25122/jml-2018-0082 -
Singapore Medical Journal Apr 2009Nonoperative measures using an oral water soluble contrast agent is a significant development in the management of patients with postoperative small bowel obstruction. (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Nonoperative measures using an oral water soluble contrast agent is a significant development in the management of patients with postoperative small bowel obstruction.
METHODS
In this prospective randomised trial, patients were randomised into two groups: Group A patients were given an oral water soluble contrast agent and Group B patients were managed conventionally. Surgery was performed as and when indicated. The end-points of the study were to evaluate the time interval between admission and relief of obstruction, the length of hospital stay and the need for surgery.
RESULTS
Of a total of 41 patients, 21 were in Group A and 20 were in Group B. The mean age of Group A patients was 40.48 +/- 14.96 years and it was 43.40 +/- 16.33 years for Group B patients (p-value is 0.553). There were 17 males and four females in Group A, and 14 males and six females in Group B (p-value is 0.441). In Group A, 14 patients had relief of obstruction after administration of the contrast material, and the mean time for relief of obstruction was 7.47 hours. In Group B, 18 patients had relief of obstruction and the time interval was 35.20 hours (p-value is less than 0.001). The mean length of hospital stay was 3.43 +/- 1.08 days for Group A and 5.33 +/- 2.95 days for Group B (p-value is 0.029). Seven patients in Group A and two in Group B were operated on (p-value is 0.071).
CONCLUSION
Administration of an oral water soluble contrast agent in postoperative small bowel obstruction helps in the earlier resolution of the obstruction and decreases the length of hospital stay.
Topics: Adult; Aged; Aged, 80 and over; Contrast Media; Diatrizoate Meglumine; Female; Humans; Intestinal Obstruction; Intestine, Small; Intubation, Gastrointestinal; Length of Stay; Male; Middle Aged; Postoperative Complications; Prospective Studies; Radiography; Reoperation; Treatment Outcome; Young Adult
PubMed: 19421678
DOI: No ID Found -
Medical Science Monitor : International... Mar 2021BACKGROUND This retrospective cohort study from a single center aimed to compare patient outcomes following the use of the water-soluble contrast medium Gastrografin in...
Use of the Water-Soluble Contrast Medium Gastrografin in Treatment of Adhesive Small Bowel Obstruction in Patients with and Without Chronic Radiation Enteropathy: A Single-Center Retrospective Study.
BACKGROUND This retrospective cohort study from a single center aimed to compare patient outcomes following the use of the water-soluble contrast medium Gastrografin in the treatment of adhesive small bowel obstruction (ASBO) in patients with and without a history of chronic radiation enteropathy (CRE). MATERIAL AND METHODS Fifty-nine patients with CRE-induced small bowel obstruction (SBO) and 53 patients with ASBO at Jinling Hospital between April 2014 and February 2018 were enrolled. The patients were given 100 ml Gastrografin through a naso-jejunal tube, and erect abdominal X-rays were taken. Risk factors were found to be correlated with successful non-operative management (SNM) through statistical analyses. RESULTS The success rate of conservative treatment was higher in the Gastrografin group than in the control group (P<0.05). The Gastrografin challenge test is predictive of need for surgery in CRE-induced SBO and ASBO (AUC=0.860 and 0.749, respectively). The predictors associated with SNM in the CRE-induced SBO group were the total dose of radiotherapy, the Gastrografin challenge test, and previous operations for SBO. In the ASBO group, the predictors were the Gastrografin challenge test and previous operations for SBO. The operation rate of SBO patients with Gastrografin treatment was significantly lower than that in the control group (P<0.05). CONCLUSIONS The findings from this study showed that the use of Gastrografin effectively resolved ASBO in patients with and without a history of CRE, but a long-term requirement for surgery could not be avoided. The Gastrografin challenge may be a useful test to predict surgical outcomes.
Topics: Adult; Aged; Cohort Studies; Contrast Media; Diatrizoate Meglumine; Female; Humans; Intestinal Obstruction; Intestine, Small; Male; Middle Aged; Radiation Injuries; Retrospective Studies; Solubility; Tissue Adhesions; Treatment Outcome; Water
PubMed: 33771966
DOI: 10.12659/MSM.930046 -
Kidney International Jan 1995The incidence of nephrotoxicity occurring with the nonionic contrast agent, iohexol, and the ionic contrast agent, meglumine/sodium diatrizoate, was compared in 1196... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The incidence of nephrotoxicity occurring with the nonionic contrast agent, iohexol, and the ionic contrast agent, meglumine/sodium diatrizoate, was compared in 1196 patients undergoing cardiac angiography in a prospective, randomized, double-blind multicenter trial. Patients were stratified into four groups: renal insufficiency (RI), diabetes mellitus (DM) both absent (N = 364); RI absent, DM present (N = 318); RI present, DM absent (N = 298); and RI and DM both present (N = 216). Serum creatinine levels were measured at -18 to 24, 0, and 24, 48, and 72 hours following contrast administration. Prophylactic hydration was administered pre- and post-angiography. Acute nephrotoxicity (increase in serum creatinine of > or = 1 mg/dl 48 to 72 hours post-contrast) was observed in 42 (7%) patients receiving diatrizoate compared to 19 (3%) patients receiving iohexol, P < 0.002. Differences in nephrotoxicity between the two contrast groups were confined to patients with RI alone or combined with DM. In a multivariate analysis, baseline serum creatinine, male gender, DM, volume of contrast agent, and RI were independently related to the risk of nephrotoxicity. Patients with RI receiving diatrizoate were 3.3 times as likely to develop acute nephrotoxicity compared to those receiving iohexol. Clinically severe adverse renal events were uncommon (N = 15) and did not differ in incidence between contrast groups (iohexol N = 6; diatrizoate N = 9). In conclusion, in patients undergoing cardiac angiography, only those with pre-existing RI alone or combined with DM are at higher risk for acute contrast nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Acute Kidney Injury; Aged; Angiocardiography; Diabetes Complications; Diatrizoate Meglumine; Double-Blind Method; Female; Humans; Incidence; Infusions, Intravenous; Iohexol; Male; Middle Aged; Prospective Studies; Renal Insufficiency; Risk Factors
PubMed: 7731155
DOI: 10.1038/ki.1995.32 -
Archives of Disease in Childhood Nov 1986Twenty-five (37%) patients with cystic fibrosis attending our clinic have experienced acute meconium ileus equivalent. In one year 37 of 40 episodes were treated with...
Twenty-five (37%) patients with cystic fibrosis attending our clinic have experienced acute meconium ileus equivalent. In one year 37 of 40 episodes were treated with single dose oral Gastrografin with an 81% success rate, 75% being treated as outpatients. Patients found this treatment preferable to other recommended treatment.
Topics: Acute Disease; Adolescent; Adult; Child; Child, Preschool; Cystic Fibrosis; Diatrizoate Meglumine; Female; Humans; Infant; Intestinal Obstruction; Male
PubMed: 3789794
DOI: 10.1136/adc.61.11.1128 -
Kidney International Nov 1988The clearance of creatinine has been shown to overestimate GFR in patients with renal disease and in kidney transplant recipients. Alternate means for measuring GFR... (Comparative Study)
Comparative Study
The clearance of creatinine has been shown to overestimate GFR in patients with renal disease and in kidney transplant recipients. Alternate means for measuring GFR involve the use of constant infusion and, frequently, of radioisotopes. We report herein the measurement of GFR with the use of a radiocontrast agent (diatrizoate meglumine) injected subcutaneously with a small amount of epinephrine (0.05 ml of 1:1000). The concentrations of this marker of glomerular filtration in blood and in urine were measured with high-performance liquid chromatography. The results demonstrate that with this method of administration stable blood levels are observed for at least three hours. Furthermore, creatinine clearance overestimated GFR by 50% and by 68% in patients with renal disease and in renal transplant recipients, respectively. This method offers several advantages: 1) the use of commonly available and inexpensive materials; 2) obviates the need for the use of constant infusions; and 3) avoids the use of radioisotopes.
Topics: Adult; Chromatography, High Pressure Liquid; Diatrizoate Meglumine; Epinephrine; Female; Glomerular Filtration Rate; Humans; Kidney Diseases; Kidney Transplantation; Male; Middle Aged; Reference Values
PubMed: 3059027
DOI: 10.1038/ki.1988.239 -
Journal of the American College of... Apr 1988Myocardial contrast echocardiography was performed during coronary angiography with 2 ml of sonicated meglumine diatrizoate sodium 76% (meglumine) in 40 patients...
Myocardial contrast echocardiography was performed during coronary angiography with 2 ml of sonicated meglumine diatrizoate sodium 76% (meglumine) in 40 patients (ranging in age from 25 to 79 years) before and 10 to 15 s after intracoronary injection of papaverine, 8 mg into the right coronary artery (n = 43) and 10 mg into the left (n = 46). The same protocol was repeated in 17 patients 5 to 10 min after completion of coronary angioplasty. In 13 patients with normal coronary angiograms, peak contrast intensity corrected for background myocardial intensity was measured in 36 regions and was found to increase after papaverine from 36 +/- 16 to 55 +/- 22 U (p less than 0.001). In contrast, in the 27 patients with angiographic evidence of coronary artery disease, peak intensity in 64 regions remained unchanged after papaverine (35 +/- 22 versus 36 +/- 23 U). An increase in peak intensity greater than or equal to 10 U was 80% sensitive and 92% specific for coronary artery disease. After successful coronary angioplasty, peak intensity in the involved regions improved significantly (p less than 0.001) during baseline contrast injections (from 32 +/- 16 to 50 +/- 25 U) as well as in the postpapaverine contrast injections (from 30 +/- 12 to 60 +/- 26 U). In conclusion, measurement of peak contrast intensity after intracoronary injections of sonicated meglumine provides a relative index of myocardial perfusion that allows assessment of regional coronary reserve in patients with coronary artery disease. This may be of particular value in evaluating the immediate effects of coronary angioplasty on myocardial perfusion.
Topics: Adult; Aged; Angioplasty, Balloon; Coronary Angiography; Coronary Circulation; Coronary Disease; Diatrizoate Meglumine; Echocardiography; Female; Humans; Male; Middle Aged; Papaverine
PubMed: 2965174
DOI: 10.1016/0735-1097(88)90205-7 -
Kidney International Apr 1992Oxidant-mediated renal injury has been suggested as an important mechanism of acute renal failure induced by contrast media. Since volume depletion has been recognized...
Oxidant-mediated renal injury has been suggested as an important mechanism of acute renal failure induced by contrast media. Since volume depletion has been recognized as a predisposing factor for contrast media nephropathy, the present study was designed to characterize host-defense mechanisms against oxidant-mediated renal injury during volume depletion. Antioxidant enzyme activities in renal cortex were compared between acutely water deprived (WD, 72 hours) and non-WD rats. WD rats had reduced activities of catalase and superoxide dismutase activities (on average, 48% and 60% of values in non-WD, respectively). In separate groups of WD rats, saline or one of three different contrast media, namely diatrizoate meglumine/diatrizoate sodium (DTZ), ioxaglate meglumine/ioxaglate sodium (IXG), and iohexol (IHX) was injected. Both GFR and renal plasma flow rate, measured 24 hours later, was some 50% less in DTZ-injected than saline-injected WD rats. WD rats treated with IXG and IHX had similar GFR to saline-treated rats. In DTZ-treated WD rats, specific products of membrane lipid peroxidation, phosphatidylcholine and phosphatidylethanolamine hydroperoxide, determined by chemiluminescent HPLC, were more than two-fold higher than saline, IXG, or IHX-treated WD rats. DTZ did not induce renal dysfunction and enhance lipid peroxidation in non-WD rats. Therefore, DTZ appeared to induce oxidant-mediated injury only in WD rats. When WD rats were pretreated with polyethylene glycol-coupled catalase (1.4 mg x 2 days), renal cortical catalase activity remained at a level similar to that of non-WD rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Animals; Antioxidants; Body Water; Catalase; Contrast Media; Diatrizoate; Drinking; Kidney; Kidney Cortex; Lipid Peroxides; Male; Rats; Rats, Inbred Strains; Sodium Chloride; Water Deprivation
PubMed: 1513081
DOI: 10.1038/ki.1992.153