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To investigate the incidence, risk factors and prognosis for contrast-induced acute kidney injury (CI-AKI) according to ESUR and KDIGO criteria in patients undergoing angiography. We evaluated 260 patients undergoing angiography and/or intervention therapy from April 2011 to January 2012 in the Second Xiangya Hospital of Central South University. All patients received low-osmolality contrast agent (ioversol). Serum creatinine was measured before angiography or at 48 or 72 h after procedure. The multivariate logistic regression was used to analyze the risk factors of CI-AKI. The major adverse events were observed in a year of follow-up. Among the 260 patients, 23 experienced CI-AKI and the incidence was 8.8% according to ESUR criteria. Twelve patients experienced CI-AKI and the incidence was 4.6% according to KDIGO criteria. The multivariate logistic regression analysis showed that diabetes mellitus and dehydration were the independent risk factors for CI-AKI according to ESUR criteria; In another KDIGO criteria, chronic kidney disease (CKD), hypercholesterolemia and diabetes mellitus were the independent risk factors for CI-AKI. The prognosis study showed that the mortality of patients with CI-AKI were significantly higher than those without CI-AKI (P0.05). The incidence of CI-AKI is associated with diagnostic criteria. Diabetes mellitus, CKD, dehydration and hypercholesterolemia were the independent risk factors for CI-AKI. CI-AKI is a relevant factor for mortality in a year after angiography and/or intervention therapy.目的：应用ESUR和KDIGO标准评价血管造影患者碘造影剂急性肾损伤(contrast-induced acute kidney injury，CI-AKI)的发生率、危险因素及预后。方法：选择2011年4月至2012年1月在中南大学湘雅二医院行血管造影或(和)介入治疗的患者260例，所有患者均使用低渗对比剂碘佛醇。造影前及造影后48，72 h抽血检测SCr水平。多因素logistic回归分析影响CI-AKI发生的危险因素。追踪随访造影剂使用后1年内的主要不良事件。结果：260例患者中，符合ESUR标准的CI-AKI患者23例，CI-AKI的发生率为8.8%；符合KDIGO标准的CI-AKI患者12例，CI-AKI的发生率为4.6%。多因素logistic回归分析显示：应用 ESUR标准，糖尿病和脱水是CI-AKI发生的独立危险因素；应用KDIGO标准，慢性肾脏病、高胆固醇血症、糖尿病是CI-AKI发生的独立危险因素。预后研究表明：CI-AKI患者的死亡率明显高于非CI-AKI患者(P0.05)。结论：CI-AKI的发生率与诊断标准的选择有关；糖尿病、慢性肾脏病、脱水、高胆固醇血症是介入诊疗患者CI-AKI发生的独立危险因素。CI-AKI是介入诊疗患者造影后1年内死亡相关的原因之一。.

The technique for introducing a water soluble radiopaque contrast medium selectively into either temporomandibular synovial space for the purpose of arthrography is described. A total of 146 ar-thrograms were studied. The usefulness of arthrography in clinical re-search is contrasted with the limitations of its use in clinical diagnosis. The importance of the integrity of the capsular sulci to the normal working of the joint is revealed. The mean sizes of normal upper and lower joint cavities were measured and related with the large joint cavities found in cases of recurrent dislocation, because of their relevance to surgical treatment. Opaque arthrography in the pain-dysfunction syndrome suggests that the joint mechanisms in clicking jaw and in intermittent locking are closely related, and are likely to be connected with hesitations of meniscal movement.

THE common therapeutic practice of attempting to lower the blood pressure of hypertensive patients makes it wise to determine whether such lowering of blood pressure may have any adverse influence. In view of the relationship of arterial pressure to renal filtration, the frequency with which hypertensive states are associated with pathologic glomerular changes and the associated abnormalities which might influence arteriolar renal blood flow, it seemed especially desirable to determine whether therapeutically induced significant falls in blood pressure would affect renal function. This problem has been previously investigated by the urea clearance as the criterion of renal function. It was found 1 that there was a decrease in urea clearance during the period that the blood pressure of hypertensive patients was decreased by spinal anesthesia. In view of the admitted defects of urea clearance as a method of determining renal function, we have reinvestigated the problem with the more precise

A new class of coumarin-based iridium tris-cyclometalated complexes has been developed. These complexes are highly emissive, with emission colors ranging from green to orange-red. Besides modification of ligand structures, color tuning was realized by incorporation of ligands with different electrochemical properties in a heteroleptic structure. The organic light-emitting diodes (OLEDs) using these compounds as emissive dopants are highly efficient and stable. Unlike other Ir(III) phosphorescent dopants, these coumarin-based Ir(III) dopants can effectively trap and transport electrons in the emissive layer.

1. Arthrography of the shoulder demonstrates the gross pathological changes in adhesive capsulitis of the shoulder. In true adhesive capsulitis, or frozen shoulder, arthrography shows a very definite decrease in joint capacity with obliteration of the reflected axillary fold. In many instances the subscapularis bursa is decreased in size or not visualized at all but, as a rule, the bicipital sheath is well outlined. 2. This procedure can serve as a diagnostic aid to differentiate true adhesive capsulitis from stiff and painful shoulder due to other causes. 3. A mixture of twelve cubic centimeters of 35 per cent diodrast and four cubic centimeters of 1 per cent procaine appears to be the ideal solution to use for injection of shoulder joints. This amount gives arthrograms with excellent detail, and the procaine prevents any pain when the solution is injected into the joint.

To predict quantitatively drug interaction kinetics from the single-drug clearance studies, we examined the effect of iodopyracet (IOD) on sulfamethizole (SMZ) excretion in rabbits. Even though the decline of systemic IOD plasma concentration was linear, the renal clearance of SMZ decreased significantly in the presence of IOD. The results could be described by a perfusion model incorporated with the competitive inhibition for tubular secretion. For IOD with a high extraction ratio, it was suggested that a heavy load of the drug was supplied to the sites of secretion and caused the saturation of transport systems, even though the renal excretion kinetics were apparently linear in respect to the systemic circulation. These facts indicated that a linear relationship between the concentrations in the systemic circulation and at the sites of tubular secretion can not always be presumed. Consequently, SMZ-IOD interaction study stressed the importance of the drug concentrations at the sites of interaction for quantitative elucidation of drug-drug interactions.

Recently, complementary DNA (cDNA) encoding a p-aminohippurate (PAH) transporter designated rat organic anion transporter 1 (OAT1) was isolated. OAT1, a multispecific organic anion transporter at the basolateral membrane, is exclusively expressed in the middle segment of the proximal tubule in the rat kidney. It has been proposed that OAT1 is indirectly involved in PAH uptake via the Na(+) dicarboxylate cotransporter. In this study, in molecular biologic experiments using OAT1-expressing Xenopus laevis oocytes, we obtained evidence that (99m)Tc-mercaptoacetylglycylglycylglycine (MAG3) is transported via OAT1.Capped OAT1 complementary RNA (cRNA) was synthesized from library plasmid cDNA linearized with BamHI using in vitro transcription. Defolliculated oocytes were injected with 10 ng of OAT1 cRNA. Two to 3 d after injection, uptake of (99m)Tc-MAG3 was measured using ND96 solution containing 18.5 kBq of (99m)Tc-MAG3. Before the uptake experiments, OAT1-expressing oocytes were preincubated for 2 h with 1 mmol/L glutarate (a dicarboxylate), to generate an outwardly directed glutarate gradient. Then, after incubation for 60 min at room temperature, radioactivity of oocytes was determined. For the inhibition experiments, uptake was assessed in the absence or presence of inhibitor: 2 mmol/L of PAH, o-iodohippurate (OIH), probenecid, 3,5-diiodo-4-pyridone-N-acetate (iodopyracet), furosemide, ethacrynic acid, glucoheptonate, maleic acid, L-Tyr, or tetraethylammonium (TEA) or 0.1 mmol/L of 2,4-dinitrophenol (DNP).Na(+) had a significant effect on (99m)Tc-MAG3 uptake (P0.05). Accumulated glutarate stimulated simultaneous (99m)Tc-MAG3 uptake and glutarate excretion (P0.001). The following compounds significantly inhibited (99m)Tc-MAG3 uptake: PAH, 8.5% +/- 16.2% of (99m)Tc-MAG3 uptake in the absence of an inhibitor; OIH, 26.4% +/- 21.7%; probenecid, 29.1% +/- 12.4%; iodopyracet, 15.8% +/- 7.9%; furosemide, 30.5% +/- 15.7%; ethacrynic acid, 21.6% +/- 10.6%; glucoheptonate, 35.6% +/- 22.6%; and maleic acid, 60.1% +/- 18.7%. (99m)Tc-MAG3 accumulation in Xenopus laevis oocytes was not significantly inhibited by TEA, L-Tyr, or DNP.The following substances had a cis-inhibitory effect on (99m)Tc-MAG3 transport: PAH, OIH, probenecid, iodopyracet, furosemide, ethacrynic acid, and glucoheptonate. Glutarate had a trans-stimulative effect on (99m)Tc-MAG3 transport. (99m)Tc-MAG3 acts as a substrate of OAT1, an organic anion/dicarboxylate exchanger.

The intravenous injection of cimetidine in a dose of 20 mg/kg enhanced verografine and iodamide excretion in chronic canine experiments. The higher verografine and iodamide excretion was due to their increased renal tubular secretion. In dogs, cimetidine unchanged the secretion of cardiotrast, a test agent for anionic transport. Possible extrarenal mechanisms of action of cimetidine on verografine and iodamide transport were also examined.

In order to quantify the renal handling of iodopyracet (IOD) and sulfamethizole (SMZ), single-drug clearance studies in rabbits were performed under quasi-steady state conditions with stepwise increasing the infusion rate of IOD or SMZ. Although concentration dependence of plasma protein binding was observed for both drugs, the urinary excretion rate of IOD was proportional to its total plasma concentration at low total plasma concentrations of 0.05-0.8 mM. On the other hand, the relationship between urinary excretion rate and total plasma concentration of SMZ was a concave-ascending curve at low plasma concentrations and the renal clearance of SMZ was sensitive to changes in plasma protein binding. However, renal clearances referenced to unbound plasma concentration at total plasma concentrations of 0.05 mM for IOD and SMZ were 9.5 and 38 l/h, respectively. Those values were much greater than the effective plasma flow in rabbits. These facts indicated that the intrinsic clearances at the sites of tubular secretion were high and that the rates of secretion were fully or partially limited by the renal plasma flow. Furthermore it was suggested that unbound drug was liberated from plasma protein at the sites of tubular secretion. The data obtained at high plasma concentrations indicated that the tubular secretion of IOD had capacity limited characteristics and that the urinary excretion of SMZ involved tubular reabsorption as well as saturable tubular secretion. From the data obtained, a perfusion-limited pharmacokinetic model was constructed characterizing the excretory processes, namely, glomerular filtration, passive tubular reabsorption, saturable tubular secretion and reequilibrium between bound and unbound drugs in plasma. For both drugs, the estimates for bulk flow rate were reasonable values of effective renal plasma flow and the dissociation constants for tubular secretion agreed well with those for in vitro renal cortex accumulation, suggesting that the kinetic model based on physiological concepts was useful for the understanding of the drug elimination processes.

In chronic experiments on dogs it was shown that verografin and iodamide are excreted from the body not only by filtration but by tubular excretion as well. The maximal transport of verografin and iodamide is significantly lower than that of cardiotrast. In experiments on rats similar results were obtained. Concurrent administration of verografin and iodamide with cardiotrast decreases their excretion in the urine in rats that is probably due to competition for the common transport system in the epithelium of renal tubules.

A review of the wide spectrum of radiopharmaceuticals developed over the last 15 yr for application in the evaluation of diseases of the kidney and urinary tract is presented below. The radiolabeled contrast agents including Hippuran have been extensively applied for renal function assessment. The kinetics of clearance of many of these agents are not yet satisfactorily established, and there is no ideal agent for routine clinical application, particularly by external counting methods. Many agents for intrarenal blood flow measurement have been reported that have yet to be adapted for obtaining clinical information. Renal morphology has been studied using several radiopharmaceuticals that are either fixed in the renal tubules for a sufficiently long time (chlormerodrin, 99m Tc-Fe ascorbic acid) or cleared from the kidneys fairly rapidly (Hippuran). These agents suffer from several disadvantages because of suboptimum energy of the radiolabel for use with imaging equipment, or relatively high radiation dose, or slow rate of excretion with inadequate organ specificity. It is hoped that the development of new radiopharmaceuticals tagged with radionuclides that have ideal imaging characteristics ( 99m Tc or 111 In) and satisfactory renal clearances will provide a major breakthrough in the continuing search for satisfactory renal agents for imaging and function tests in the near future.

6 minutes after Joduron® 70% (0.5 ml/kg), Biligrafin® 30% (0.4 ml/kg), Urografin® 60% (0.5 ml/kg), Urovison® 58% (0.5 ml/kg), Urovist® 65% (0.75 ml/kg) and Conray® 70% (0.5 ml/kg) (within 1 minute injected) the level of circulating histamine in plasma is increased from less than 1.0 ng/ml to 2.0–2.5 ng/ml. The elevated levels return to normal within 20 minutes, in the case of Joduron® 70% and Biligrafin® 30% slower than after the other contrast media. Urivison® 30%, infused over 4 minutes (total dose 4 ml/kg), as dextrose 50%-solution (0.5 ml/kg) failed to change histamine concentration in plasma. Obviously the histamine liberating effect of the contrast media is a specific effect of these agents.

A review of methods used in performing radionuclide renal clearance is presented. Adequate radionuclide substitutes for inulin and paraaminohippurate (PAH) have made possible a variety of techniques for measuring glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). The major deterrents to the standard inulin and PAH clearance procedures, including difficult chemical determinations, continuous intravenous infusions, timed catheterized urine collections, and frequent blood sampling, have been varyingly eliminated by the newer radionuclide clearance techniques: chemical determinations are replaced by simple gamma counting; the need for continuous infusions is obviated by the ability to quantitate gamma activity at very high and very low concentrations; urine collections can be eliminated by the analysis of plasma disappearance or by measuring the infusion rate necessary to maintain a constant plasma level; frequent blood sampling can be minimized by external gamma monitoring or by utilizing established volumes of distribution and inter-compartmental clearance based on patient studies. An attempt is made to present superficially the basic concepts used in analyzing plasma disappearance after a single intravenous injection. Mathematical derivations are not presented in depth, although some considerations of the two-compartment system are given in the Appendix. Although there are few disadvantages in using the newer radionuclide techniques compared with the standard infusion methods, direction from an individual with a firm foundation and genuine interest in renal physiology is paramount in establishing these procedures as acceptable and reproducible substitutes for measuring GFR and ERPF.

Externally monitored radioisotopic renal function studies have proven to be diagnostically useful in a variety of urinary tract disorders. Controversy, however, concerning everything from equipment and patient preparation to information content and interpretation has surrounded the procedure since its inception. The theses presented here are that the choice of equipment is determined by the intended use, that a few major physiologic events determine the shape of the curves produced in the studies, that the information content exceeds what has been extracted to date, and that subtle renal abnormalities are better detected by intercomparison of a patient's two kidneys than by comparison to values derived from a selected normal population. Choice of patient preparation and interpretation of the results depend on understanding the physiology involved in the procedure.

A NUMBER of investigators have studied the recovery of renal function after acute renal failure.1 2 3 4 5 6 7 8 9 10 The clearance of inulin, thiosulfate, mannitol, creatinine, para-aminohippurate and iodopyracet (Diodrast) have been found to be low early in the diuretic phase during recovery. After this, the clearance of these substances increases and returns toward the normal state. Lowe5 has reported a long-term follow-up study of 14 cases of acute renal failure. In his series, clinical recovery was good, but clearance values remained below the lower limit of normal for as long as three years. This paper records another long-term follow-up study of 16 patients . . .

In recent years a great deal of interest has been focused on the anaphylactoid reactions produced by organic iodide contrast media. One aspect of this problem has been the feasibility of employing premedication to prevent such occurrences. Antihistamines have been rather widely administered for this purpose, although evidence indicates that their effectiveness has not fulfilled expectations. As an example, in 1958 Finby, Evans, and Steinberg (1) found that antihistamines were unsuccessful in preventing major reactions, whether given orally or intravenously. They concluded that the antihistamines were useful in therapy, but not in prophylaxis. Because some radiologists mix the antihistamines in the same syringe employed for the contrast medium, this study was undertaken to determine whether any pharmacological incompatibility develops. An analysis of these reactions is one objective of this communication. Another possibility is that of pharmacological incompatibility between the plastic disposable syringes...

Lateral ventricular choroid plexuses (LVCP), fourth ventricular choroid plexuses (FVCP) and diaphragm muscle from 1–4-week-old and adult dogs were incubated with p-aminohippuric acid (PAH) and mannitol and accumulation was expressed as tissue: medium concentration ratios (T/M) T/M mannitol of adult LVCP and FVCP were significantly less (P < 0.05) than for animals 1 week old; T/M mannitol in diaphragm muscle did not change with age. PAH accumulation by both plexuses was an active process, poorly developed in the LVCP and FVCP (T/M= 2.12;T/M= 1.97, respectively) of animals 1 week old, but well established in the adult (T/M= 4.04;T/M= 3.84, respectively). Maximum accumulation of PAH by the LVCP occured in 2-week-old animals and by the FVCP in the adult.

1. The principles devised by the authors [1949] for the determination of the renal clearance of inulin have been applied to the determination of the renal clearance of diodone and the tubular excretory capacity for diodone. 2. Following the intravenous injection of diodone in amounts suitable for the measurement of both renal clearance and tubular excretory capacity, the volume of distribution of diodone continues to increase for the duration of the experiments. It is concluded that equilibration of diodone between the plasma and the extravascular component of the volume of distribution does not occur under the conditions of the experiment. 3. Formulae are derived for the renal clearance of diodone and the maximal tubular excretory capacity for diodone incorporating functions which are demanded by the failure of the establishment of equilibration. 4. The formula for the renal clearance of diodone is applied to fourteen subjects possessing widely different clearance values, and the formula for the maximal tubular excretory capacity for diodone is applied to twelve of these subjects. The values calculated by the formulae agree closely in every case with the average values experimentally determined, following intravenous injections of diodone. 5. The calculative errors introduced into the formulae by the simplifying assumption that the volume of distribution of diodone is linearly related to time, between defined limits of time, are shown to be of similar magnitude to the limits of the error in the chemical determination of diodone in the plasma. 6. The formulae can be applied without the need for accurate urine collection over short clearance periods. They necessitate the passage of urine approximately 25 and 120 minutes (for the maximal tubular excretory capacity for diodone) and 20 and 60 minutes (for the renal clearance of diodone) after the injection of known amounts of diodone, and a minimum of two blood samples for each determination taken at the time of urine passage. 7. The errors introduced in the determinations of inulin and diodone clearance and the maximal tubular excretory capacity for diodone by sampling venous blood are discussed briefly. 8. The results of a further five estimations of inulin clearance employing the authors' method (loc. cit.), and their comparison with average values experimentally determined, are also included.

1. Sheep, which had access to a solution containing 1.3% sodium chloride as their sole source of drinking water for 6 months or more, were infused with a hypertonic solution (10%) of sodium chloride, and their ability to tolerate this salt load was compared with that of a similar group of sheep which drank only rain water.2. The sheep which drank the rain water were often affected by the infusion and exhibited signs resembling potassium deficit. No such signs were apparent in the animals which consumed saline water.3. Glomerular filtration rates were increased in all sheep by the hypertonic saline infusion, the increases being greater in the sheep which were maintained on the saline water. Effective renal plasma flow rates, though extremely variable, behaved in a similar manner.4. Plasma values for sodium and chloride were increased in all sheep, but remained at a higher level for a longer period in the sheep which consumed rain water. The diuresis produced by hypertonic saline appeared to persist for a longer period in the sheep which drank rain water, while the excretion of sodium and chloride tended to be greater in the sheep maintained on saline water.5. Plasma potassium was reduced in all sheep and urinary excretion of potassium increased. The latter response was more pronounced in the sheep which drank the rain water.6. Filtered loads of sodium, chloride and potassium were greater in the sheep which were accustomed to drinking saline water. However, the amounts of potassium excreted were greater than those filtered in the rain water sheep and less than those filtered in the sheep which drank saline water. It therefore seems that secretion of potassium into the kidney tubules predominated in the former group and reabsorption prevailed in the latter.7. Reabsorption of free water in excess of solute was greater in the kidney tubules of the sheep which drank saline water.8. Increased blood volume and greater dilution of plasma proteins occurred in the sheep which drank rain water.

Intestinal vessels were first made radiopaque by translumbar aortography. The contrast media employed in the early days were sodium iodide and iodopyracet (Diodrast). Necrosis and perforation of the small intestine occasionally attended their use. This was thought to be due either to the inherent toxicity of the medium or to its excess concentration (9). It was hoped that sodium acetrizoate (Urokon) would be less dangerous, but intestinal necrosis and deaths were reported following the injection of 70 per cent Urokon into the mesenteric arteries. When sodium diprotrizoate (Miokon), sodium diatrizoate (Hypaque), and methylglucamine diatrizoate (Renografin) became available, they were believed to be safer than sodium iodide, Diodrast, or Urokon. Lloyd (6) in comparative studies showed Hypaque to be less toxic than Miokon, and this was confirmed by Stokes (13) and Chaplin and Carlsson (1). Fischer and Eckstein (3) found fewer systemic effects with Renografin in cerebral angiography than with either Urokon or...

The procedure for performing the radioactive iodopyracet renogram in children has been described. Confirmation of the test as a useful method for detection of unilateral renal disease has been demonstrated for children, as previously reported for adults. At the present stage of development, the major use of the procedure relates to its advantage as a screening test for subjects with hypertension, either with known renal disease or in those in whom renal abnormalities are not defined by the usual kidney function studies.

The total concentration of radiopaque agents in plasma can be determined spectrophotometrically after elimination of interfering factors using a double column filled with cross-linked dextran-gel Sephadex G-25c and Se-Sephadex 25c. The method gives a linear relationship between the total concentration in the sample and the maximum concentration in the eluate and is sensitive to about 50μg/ml of radiopaque agent.

(1953). The Influence of Diphenhydramine (Benadryl) on the Side-Effects of Diodone in Urography. Acta Radiologica: Vol. 39, No. 4, pp. 299-307.

excerpt In the minds of some there has been a question as to whether intravenous pyelography is indeed a renal function test or should be used primarily for anatomic demonstration of the collecting systems. The general feeling has been that the procedure could at best give a gross estimate of kidney excretory capacity. Attempts at evaluation of renal function by film analysis have been made (1, 2). In 1942, Kornblum and Fetter (1) compared estimates of renal function from intravenous pyelograms with the phenolsulfonphthalein excretion test and found reasonably good correlation. It is evident that intravenous pyelography does test the excretory power of the kidneys for the organic iodide employed. In 1942, Findley (3) measured chemically the amount of organic iodide excreted in the urine after the intravenous injection of iodopyracet (Diodrast). He found that the iodide excretion could be correlated with urea clearance. Chemical measurements of organic iodide, however, are very difficult. For more rapid an...

1. 1. Intravenous pyelograms were taken of rabbits prior to and after hysterectomy and castration, after ethinyl estradiol administration, and following estradiol and relaxin administration. 2. 2. Intravenous pyelograms were taken of a pregnant rabbit on the twentysecond day of gestation. 3. 3. The pyelograms taken after relaxin administration demonstrated delay in complete filling of the ureters and appearance of the dye in the bladder comparable to that seen in the pregnant rabbit. 4. 4. This delay in ureteral and bladder filling is due, we believe, to atonicity of the ureteral musculature caused by estradiol relaxin therapy.

The whole blood clearance of Diodrast (I131) following a single intravenous injection was used to estimate renal blood flow. This method was compared to renal blood flow simultaneously determined by the PAH constant infusion technique. A correlation coefficient of 0.930 was found. The Diodrast clearance method is recommended because it is simple and rapid, and it avoids the necessity for urine collection.

Renal tubular transport of Diodrast-I131 was studied in Necturus by newly devised autoradiographic methods used in conjuction with classical clearance methods. Clearance measurements on individual animals indicate different types of over-all tubular transport ranging from secretion into tubular urine, heretofore reported in many species, to reabsorption out of tubular urine, so far reported only in Necturus. Diodrast content of tubular urine as disclosed by autoradiography both corroborates clearance data and provides evidence that proximal tubules are the major site of Diodrast transport irrespective of direction. This view is supported by inulin-C14 autoradiographs. In addition, significant amounts of Diodrast were accumulated within proximal tubular cells during all types of transport. With less than 3 mg Diodrast/100 ml arterial plasma, the estimated intracellular concentration ranged from 2 to 19 times that in plasma. At higher plasma levels, tubular transport was overwhelmed and intracellular concentration no longer exceeded that in plasma. These results support a previously formulated theory of simultaneous, bidirectional movement of Diodrast across tubular cells in Necturus kidney.

The rose bengal hepatogram is now established as a highly sensitive liver function test that also supplies diagostic information on vascular abnormalities of the liver and on the degree of biliary tract obstruction. No other single procedure gives as much useful information for the differential diagnosis and management of patients with diseases of the liver and biliary tract. The rose bengal-BSP blood clearance stress test is capable of detecting minimal liver damage in rabbits and asymptomatic liver disease in man. However, further investigation is needed for final assessment of its maximum sensitivity. New tracer techniques using colloidal gold/sup 198/ and rose bengal have been developed in animal studies for further evaluation of liver vascular disorders; both procedures are clinically applicable. The Diodrast renogram is becoming recognized as a simple, rapid, nontraumatic office procedure for estimating individual kidney functions. It is especially valuable as a screening test for hypertensive patients suspected of having disease of one kidney. Most hypetensives with normal renograms may be spared the discomfort, time, and expense of hospitalization and complicated urological diagnostic procedures. Recent modifications in the instrumentation and the use of Miokon in place of Diodrast have increased the reliability of the renogram while simplifying itsmore » performance. These tracer tests are unique in providing data on multiple functions simultaneously with complete freedom from drug reactions; radiation exposure is many times less than from X-ray examinations of these organs.« less

The effects of intra-carotid injection and topical application of Diodrast on the electrical activity of the brain in humans, cats and monkeys are described. These effects are complex and have been classified as: 1. 1. Augmentation of activity when an increase of previously present discharges or an altogether new type of discharge occurs. 2. 2. Decreased activity when diminution of previously present discharges occurs. 3. 3. If abnormal discharges such as spikes or slow waves are present in the resting record the drug may have a profound effect on them in either an augmenting or a decreasing sense. Slow activity is most often increased whereas the effect on a spike discharge may be augmenting or decreasing, depending on many variables. 4. 4. The most commonly encountered effect would seem to be irritative or convulsive in nature as instanced by the precipitation of electrical seizure discharges in cortical epileptic foci and the prolongation of high-frequency bursts in single-unit responses evoked by peripheral stimulation. The augmentation of evoked responses as recorded on the pial surface over (in) primary sensory receiving areas followed by the subsequent appearance of responses in association areas could well be due to a similar irritative effect, as could also the desynchronization effect when rhythmic burst activity is abolished. 5. 5. It would seem likely that the augmentation of delta foci in the neighborhood of destructive lesions and some instances of flattening of rhythmic burst activity is due to a depression or disruption of neuronal activity which has little in common with the irritative effects.