Gastrointestinal radiology from the time of Walter B. Cannon to the 21st century

Crucial Roles of Systemic and Tissue Lipid Peroxidation Levels and Anti-Oxidant Defences Following Contrast Agent Application

Background

One of the most important side effects of contrast pharmaceutical agents, which are used very common in routine radiology practice, is contrast induced nephropathy. Even ischemia, oxidative stress and osmolality related cytotoxic effects are considered, the molecular mechanisms underlying this pathology have not been identified completely yet.

Objectives

The aim of the current study was to reveal the role of oxidative stress and antioxidant enzymatic defence mechanisms in the aetiopathogenesis of contrast-induced nephropathy. We also studied possible alleviating effects of N-acetylcysteine (NAC), a potent antioxidant, to obtain extra information regarding the molecular mechanisms underlying this pathology.

Materials and Methods

This is an clinical-experimental study, This study was conducted of Istanbul/Turkey between September 15, 2012 and April 15, 2013. Three groups of male rats were randomly set up as a control group (C), a 100 mg/kg intraperitoneal NAC + 7 mL/kg contrast agent group (N + CIN) and a 7 mL/kg intraperitoneal contrast agent group (CIN). They were placed in individual metabolic cages 48 hours after agent administration to obtain 24-hour urine samples. Renal function tests (albumin, urea, creatinine, total protein) were conducted, oxidative stress parameters (Cu, Zn superoxide dismutase activity - Cu, Zn-SOD; advanced oxidation protein products - AOPP; protein carbonyls - PCO; total thiol groups - T-SH; and lipid hydroperoxides -LHP) were measured and tissues were analysed histopathologically.

Results

Compared with the control group, groups CIN and N + CIN had significantly higher urea and LHP levels (P < 0.05 and P < 0.001, respectively) and significantly lower Cu, Zn-SOD activity and creatinine clearance (P < 0.05). There was no statistically significant difference between the groups in PCO or AOPP levels despite differences in descriptive statistics.

Conclusions

Contrast-agent-induced nephropathic changes are more closely related to the magnitude of lipid peroxidation than protein oxidation.

Effects of ionizing radiation on respiratory function tests and blood parameters in radiology staff

AIM

To evaluate pulmonary function tests and blood parameters and their relationship with sociodemographic data for radiology staff continuously exposed to ionizing radiation.

SUBJECTS AND METHODS

Thirty-eight personnel from Suleyman Demirel University Training and Research Hospital, Radiology Unit, were included in this study. Sociodemographic data were evaluated by a questionnare that was developed by the researchers. Height and weight measurements were performed with a standard scale and meter. Routine blood parameters and spirometric lung function measurements of the cases were recorded. Statistical significances were determined by independent t-test, analysis of variance (ANOVA), bivariate correlation and Kruskal-Wallis tests using SPSS 18.0.

RESULTS

The mean age was 32.42 ± 5.5 years; 19 patients (50%) were male and 19 patients (50%) were female. Body mass index (BMI) was calculated as 25.68 ± 0.47 for men and 24.58 ± 1.13 for women. Forced vital capacity (FVC), forced expiratory volume in the 1st second (FEV1), peak expiratory flow (PEF) and maximum mid-expiratory flow (FEF25-75) showed negatively statistically significant differences between gender (p < 0.01). In addition, FEV1 and FEF25-75 also demonstrated statistically negatively significant difference with the type of task (p < 0.05). A statistically significant negative difference was found between FEF25-75 value and time to start smoking (p < 0.05). Among FVC, FEV1, PEF and FEF25-75 values and alcohol usage, statistically significant positive difference was detected (p < 0.05). Statistically significant positive difference was found among FVC, PEF and FEF25-75 values and sports activity (p < 0.05). According to BMI groups, statistically significant positive difference with FVC, FEV1 and PEF values were found (p < 0.05). Statistically significant correlations were found among FVC value and haemoglobin level (Hgb), haematocrit level (Hct) and mean corpuscular volume (MCV), among FEV1 value and Hgb, MCV, among PEF value and red blood cell count (RBC), Hgb, Hct, MCV, red cell distribution width (RDW), and between FEF25-75 value and MCV.

CONCLUSION

Although respiratory functions of radiology staff are affected by many factors, continuous exposure to ionizing radiation is one of the important parameters. Radiology staff should be informed about factors that negatively affect the respiratory functions.

The future of barium radiology

Barium radiology of the gastrointestinal tract has had a long history but its survival into the next century will be a challenge. The numbers of barium studies performed has declined in recent decades due to several factors; also, health care reforms in the United States will further impact on the use of barium examinations. The future status of these radiological procedures will change depending on these factors and the organ system being examined; an increased emphasis on functional evaluation of the gastrointestinal tract will also have an effect on the evolving role of barium radiology. We provide a brief historical review of the evolution of barium radiology in the twentieth century, discuss the present and changing status of the various gastrointestinal examinations, and offer our thoughts concerning the potential future of this specialty.