The aim of this study was to investigate the mechanisms of the cardiodepressive action of ionic and non-ionic contrast media currently used in coronary arteriography. Experiments carried out on isolated preparations of cat papillary muscle, treated with increasing concentrations of Telebrix 39, Radioselectan, Hexabrix and Iopamidol 370 and 300, on the one hand and, on the other hand, a pre-determined dose of Telebrix and Iopamidol 300 during hypoxia and subsequent reoxygenation, showed that, at constant Ca2+ concentrations: (1) The cardiodepressive effects of contrast media are correlated with the hyperosmolality that they induce. When osmolality was higher than 400 mOsm, all the products caused a reduction of the peak force (PF: 40.49 +/- 5.15%), the maximum velocity of contraction (Vmax: 39.85 +/- 3.66%) and of the peak velocity of relaxation (Vrelax: 23.30 +/- 2.20%) (P less than 0.01). The time to peak force (TPF), on the other hand, remained constant, whereas the half-relaxation time (THR) was increased. No significant differences were observed between these effects and those induced by control iso-osmolar solutions when the same osmolality was induced. In practice, however, the critical hyperosmolality value of 400 mOsm is never reached when using non-ionic contrast media such as Hexabrix and Iopamidol 300. This could explain the excellent tolerance to these substances. (2) During hypoxia and reoxygenation, the effect of hyperosmolality is more marked. Thus, the non-ionic contrast medium, Iopamidol 300 (340 mOsm), reduces the hypoxic contractility depression (PF: 53.10 +/- 2.60% compared to the control values of 47.60 +/- 5.00%, P less than 0.01), whereas, at the same dose, the ionic medium Telebrix is hyperosmolar (440 mOsm) and induces a more pronounced hypoxic depression of contractility (P less than 0.01). The critical hyperosmolality is never reached during ventriculography (320 mOsm), whatever the medium used, but it can be observed during coronary arteriography. It is, therefore, important to use non-ionic contrast media in the investigation of unstable angina and of acute myocardium infarction.

In connection with 141 cases of parotid tumours, 21 adenopathies of the parotid region and 22 cases of parotitis, the authors define the role of ultrasonography in the exploration of the salivary glands. Use of simple criteria permits differentiation of benign from malignant tumours with a good degree of sensitivity (79.8% in our series). This score allows ultrasonography to be offered as the first complementary examination when dealing with a tumefaction of the parotid region. When ultrasonographic findings evoke a malignant lesion, a CT scan seems necessary to evaluate any extension in depth. In contrast, ultrasonography does not appear justified in cases of parotitis or lithiasic pathologies.

Seven cases of gastric leiomyoblastoma are reported, all of them benign. The subject of gastric leiomyoblastoma is reviewed from both clinical and pathologic aspects based on a review of 307 cases in the literature. Hemorrhage is a frequent sign (51.8%) but in 21.2% of cases leiomyoblastoma is asymptomatic. While such tumors have a malignant potential, a benign course was pursued in most of the cases (79.5%). The radiologic features of these tumors are similar to those of leiomyomas. An intramural location is the most common finding (41.4%) but intraluminal (22.7%), subserosal (25.7%) or dumbbell growth are also seen. In 31.3% of cases, the tumor is ulcerated.

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