[Generalized urticarial exanthema caused by subcutaneous injection of methylene blue]. / Gegeneraliseerd urticarieel exantheem door subcutane injectie van methyleenblauw.

A case of generalized urticarial rash due to subcutaneous administration of methylene blue for lymphangiography is presented. The urticarial lesions were coloured blue.

Angiotensin converting enzyme inhibition improves diagnostic procedures for renovascular hypertension in dogs.

In renovascular hypertension adaptive mechanisms in the poststenotic kidney are a probable cause of the 20 to 25% false-negative findings during rapid sequence urography or [123I]o-iodohippurate renography. We blocked the renin-angiotensin system in an effort to increase the yield of these diagnostic procedures. Chronically instrumented, salt-depleted conscious dogs were used in which a light (n = 5), moderate (n = 4), or severe (n = 2) renal artery stenosis was induced. Before stenosis 10 of the dogs showed no left-right differences with either diagnostic procedure, and angiotensin converting enzyme (ACE) inhibition did not change this result. Two to 3 weeks after induction of a renal artery stenosis, all dogs showed signs of renovascular hypertension. However, only 50% of the renograms and 22% of the urograms showed differences between the two kidneys indicative of the presence of stenosis. After ACE inhibition, all previously negative test results became positive (abnormal) and previously existing left-right differences became more evidence. Electromagnetically measured renal blood flow on the stenotic side did not change during ACE inhibition (146 +/- 13 vs 145 +/- 21 ml/min), whereas contralateral blood flow showed a distinct increase (207 +/- 18 vs 282 +/- 20 ml/min, p less than 0.01). In conclusion, ACE inhibition markedly improves the sensitivity of rapid sequence urography and hippurate renography in the diagnosis of renovascular hypertension in the two-kidney, one clip Goldblatt hypertensive dog. The effects of ACE inhibition on the handling of the different tracers do not appear to be related to its effects on renal blood flow or systemic blood pressure.

A comparative study of intravenous digital subtraction angiography and ventilation-perfusion scans in suspected pulmonary embolism.

We observed 102 patients suspected of having pulmonary emboli (PE) who underwent ventilation-perfusion (V/Q) lung scintigraphy and IV digital subtraction angiography (DSA). Only five DSA studies were inadequate for interpretation. In 81 of the remaining 97 patients (83.5 percent) the results of both studies correlated regarding the probability of PE. In 50 patients the results of both studies were highly suggestive of PE; in 31 patients DSA and V/Q were normal or classified as low probability of PE. There was disagreement in 3/97; in 13/97 one or both studies were nondiagnostic. The clinical data of these 16 patients are given. Conventional catheter pulmonary angiography was indicated in 11/102 patients to establish a firm diagnosis of PE. The results of V/Q and DSA correlated in 83 percent (49/59) of patients without chronic obstructive pulmonary disease (COPD) and in 84 percent (32/38) of the patients with COPD.