RESUMEN
PURPOSE: To prospectively evaluate the performance of an orally administered 0.1% barium suspension, Volumen, as a bowel-marking agent for multi-detector row computed tomography (CT). MATERIALS AND METHODS: This HIPAA-compliant study was approved by the Institutional Review Board and conformed to the institutional standards for research funded by a commercial sponsor. A total of 60 patients (33 women, 27 men; average age, 58.2 years) who were referred for multi-detector row CT of the pancreas were randomized into two groups. Prior to examination, group 1 consumed 1200 mL of Volumen over a 30-minute period and group 2 consumed 1200 mL of a solution containing three parts water and one part methylcellulose over a 30-minute period. Results were independently reviewed by two radiologists who were unaware of the contrast agent used. The degree of distention and the visualization of mural detail were qualitatively scored on a five-point scale. Differences were evaluated by using the Mann-Whitney test at a confidence level of 95%. RESULTS: There was significantly better distention in the stomach (P = .013), duodenum (P = .006), jejunum (P = .029), and ileum (P = .014) [corrected] in group 1 compared with group 2. Significant distention was also evident by comparing the products of the widest cross-sectional diameters in duodenum (P = .143), jejunum (P < .001), and ileum (P < .001). Group 1 also demonstrated significantly better visualization of mural features in the duodenum (P = .003), jejunum (P = .024), and ileum (P = .01) and a trend toward better visualization of mural features in the stomach (P = .092). CONCLUSION: Oral administration of Volumen provided excellent distention and excellent visualization of mural features in the gastrointestinal tract.
Asunto(s)
Sulfato de Bario , Medios de Contraste/administración & dosificación , Intestinos/diagnóstico por imagen , Enfermedades Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Administración Oral , Sulfato de Bario/administración & dosificación , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Estadísticas no ParamétricasRESUMEN
Rhodococcus sp. I24 can oxygenate indene via at least three independent enzyme activities: (i) a naphthalene inducible monooxygenase (ii) a naphthalene inducible dioxygenase, and (iii) a toluene inducible dioxygenase (TID). Pulsed field gel analysis revealed that the I24 strain harbors two megaplasmids of approximately 340 and approximately 50 kb. Rhodococcus sp. KY1, a derivative of the I24 strain, lacks the approximately 340 kb element as well as the TID activity. Southern blotting and sequence analysis of an indigogenic, I24-derived cosmid suggested that an operon encoding a TID resides on the approximately 340 kb element. Expression of the tid operon was induced by toluene but not by naphthalene. In contrast, naphthalene did induce expression of the nid operon, encoding the naphthalene dioxygenase in I24. Cell free protein extracts of Escherichia coli cells expressing tidABCD were used in HPLC-based enzyme assays to characterize the indene bioconversion of TID in vitro. In addition to 1-indenol, indene was transformed to cis-indandiol with an enantiomeric excess of 45.2% of cis-(1S,2R)-indandiol over cis-(1R,2S)-indandiol, as revealed by chiral HPLC analysis. The Km of TID for indene was 380 microM. The enzyme also dioxygenated naphthalene to cis-dihydronaphthalenediol with an activity of 78% compared to the formation of cis-indandiol from indene. The Km of TID for naphthalene was 28 microM. TID converted only trace amounts of toluene to 1,2-dihydro-3-methylcatechol after prolonged incubation time. The results indicate the role of the tid operon in the bioconversion of indene to 1-indenol and cis-(1S,2R)-indandiol by Rhodococcus sp. I24.