• Korean Journal of Radiology
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• v.21 no.11
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• pp.1230-1238
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• 2020

Objective: We aimed to assess the effects of remote ischemic pre-conditioning (RIPC) on the incidence of contrast-induced nephropathy (CIN) after an intravenous (IV) or intra-arterial injection of contrast medium (CM) in patient and control groups. Materials and Methods: This prospective, randomized, single-blinded, controlled trial included 26 patients who were hospitalized for the evaluation of the feasibility of transcatheter aortic valve implantation and underwent investigations including contrast-enhanced computed tomography (CT), with Mehran risk scores greater than or equal to six. All the patients underwent four cycles of five minute-blood pressure cuff inflation followed by five minutes of total deflation. In the RIPC group (n = 13), the cuff was inflated to 50 mm Hg above the patient's systolic blood pressure (SBP); in the control group (n = 13), it was inflated to 10 mm Hg below the patient's SBP. The primary endpoint was the occurrence of CIN. Additionally, variation in the serum levels of cystatin C was assessed. Results: One case of CIN was observed in the control group, whereas no cases were detected in the RIPC group (p = 0.48, analysis of 25 patients). Mean creatinine values at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 88 ± 32 μmol/L, 91 ± 28 μmol/L and 82 ± 29 μmol/L, respectively (p = 0.73) in the RIPC group, whereas in the control group, they were 100 ± 36 μmol/L, 110 ± 36 μmol/L, and 105 ± 34 μmol/L, respectively (p = 0.78). Cystatin C values (median [Q1, Q3]) at the baseline, 24 hours after injection of CM, and 48 hours after injection of CM were 1.10 [1.08, 1.18] mg/L, 1.17 [0.97, 1.35] mg/L, and 1.12 [0.99, 1.24] mg/L, respectively (p = 0.88) in the RIPC group, whereas they were 1.11 [0.97, 1.28] mg/L, 1.13 [1.08, 1.25] mg/L, and 1.16 [1.03, 1.31] mg/L, respectively (p = 0.93), in the control group. Conclusion: The risk of CIN after an IV injection of CM is very low in patients with Mehran risk score greater than or equal to six and even in the patients who are unable to receive preventive hyperhydration. Hence, the Mehran risk score may not be an appropriate method for the estimation of the risk of CIN after IV CM injection.

• The Korean Journal of Physiology
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• v.15 no.1
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• pp.27-36
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• 1981

Relatively little has been done on the metabolic changes of the lung produced by the excessive alcohol ingestion to the point of the acute alcohol intoxication. In the present study, an effort was made to clarify the possible changes of the pulmonary surfactant system by the acute alcohol ingestion. The dynamic pulmonary compliance and the levels of protein and inorganic phosphorus (Pi) of both lung lavage and extract were chosen as the parameters of the pulmonary surfactant activities. The albino rats of both sexes were used, and 1.5 ml of 50% ethanol per 100 g body weight was given by oral intubation, and the experiment was performed at 1, 3, 6, 12, and 24 hours after the alcohol ingestion. The rat was sacrificed by cutting the carotid arteries, and blood sample for the determination of hematocrit(Hct) and the blood alcohol concentration was obtained. Both lungs were completely removed without dammage to the lung tissue, and the pulmonary compliance was measured by the changes of pressure-volume(P-V) curves by inflating or deflating the lung with air. Immediately after the P-V curves were recorded, the lung lavage was obtained by washing the lobes with 15ml of isotonic saline 3 times with a syringe. Next, total lungs were homogenized and filtered to obtain the lung extract. The protein and Pi levels were measured using the lung lavage and extract as the samples, and the lung/body weight ratio(L/B ratio) was also calculated. The results thus obtained were compared with the normal values and summarized as follows. The blood alcohol concentration reached the highest level of $0.71{\pm}0.02\;g\;%$ at 1 hr and gradually decreased until 24 hrs$(0.36{\pm}0.02\;g%)$ after the alcohol ingestion, but all the experimental groups showed significant increase comparing with the normal. The highest Hct value was obtained at 1hr$(64.86{\pm}2.45%)$ and significantly elevated value was continued throughout the experiment. The L/B ratio was significantly lowered from 3hrs until 24hrs after the alcohol ingestion but from 6 th hr on, a generally elevated value was observed with a significant value at 12 hrs and gradual recovery to the normal value at 24 hrs after the alcohol ingestion. The pulmonary compliance at inflation and deflation did not change appreciablly from the normal until 3 hrs after the alcohol ingestion but from 6 th hr on, a generally elevated value was observed with a significant value at 12 hrs and gradual recovery to the normal value at 24 hrs after the alcohol ingestion. The protein level of the lung lavage stowed a significantly increased value of $12.36{\pm}0.35\;mg/gm(3rd hr)$, $12.70{\pm}0.74\;mg/gm(12 th hr)$, and $12.65{\pm}0.88\;mg/gm(24 th hr)$, respectively, comparing with the normal value of $10.65{\pm}0.62\;mg/gm$, and the Pi level also showed a similar tendency of significant increase at 12th hr $(7.65{\pm}0.63\;{\mu}mol/gm)$ and 24 th hr$(6.70{\pm}0.36\;{\mu}mol/gm)$ comparing with the normal value of $5.32{\pm}0.20\;{\mu}mol/gm$. The protein level of the lung extract in the alcohol group was generally similar to the normal value with a slight decrease at 1st and 3 rd hr, tut the Pi level of the lung extract was generally increased in the alcohol group, and a significant increase was observed at 6 th hr$(17.77{\pm}1.54\;{\mu}mol/gm)$, 12 th hr$(13.92{\pm}0.78\;{\mu}mol/gm)$ and 24 th hr$(14.57{\pm}0.53\;{\mu}mol/gm)$ of the alcohol ingestion comparing with the normal value of $10.34{\pm}0.37\;{\mu}mol/gm$. From the above, it may be concluded that the acute alcohol intoxication produces the metabolic changes of the lungs by the increased surfactant activities and elevated pulmonary compliance.

• Journal of the Korean Geographical Society
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• v.43 no.3
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• pp.296-311
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• 2008

In order to examine the rates and factors of path widening in Mount Halla, the retreat of path sidewalls was monitored at 32 sites of Seongpanak Hiking Trail located between 875 m and 1,400 m in elevation. The mean rate of sidewall retreat for the period 2002-2008 is 50.6 mm, equivalent to 10.0 mm/yr. The retreat rate of frozen period is 19.3 mm/yr, while the rate of unfrozen period is 4.3 mm/yr. The latter is divided into the rainy and dry periods that exhibit the retreat rates of 5.9 mm/yr and 2.9 mm/yr, respectively. The retreat rate of sidewalls is also varied with seasons; winter shows the maximum rate of 42.2 mm/yr, while summer exhibits the minimum rate of 1.3 mm/yr. Spring and fall show the intermediate rates of 13.9 mm/yr and 6.4 mm/yr, respectively. Soil hardness and elevation are not closely related to the retreat rate of sidewalls, even though the retreat rate is larger at the north-faced sidewalls than the south-faced sidewalls during the frozen period. Pipkrake is likely to be the most important factor contributing to the path widening in that the retreat of winter months accounts for 76.7% of the total retreat. The hiking trail is placed under the climatic conditions which develop pipkrake in 85 days annually. In addition, it is usual to observe the path sidewall covered with pipkrake in the freezing month of December and the thawing months of March and April. On the other hand, deflation and rainsplash erosion are not important due to the weak wind speed and the forested trail. Rainwash is also insignificant in that the path has been almost paved to mitigate trampling effects. Although biological activity is not dominant, hikers cause a large retreat of sidewalls in the thawing months since they would walk on the sidewalls to avoid snow-melting pools on the path.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.91-98
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• 2008

Purpose: Radio-isotopes (RI) use has been steadily developing due to industrial and technical development in the modern medical society. Particularly, popularization of domestic cyclotrons dramatically enable hospitals to produce and use diagnostic radio-isotopes. Generally, only specific facilities such as hospitals, research institutes, nuclear power plants and universities can use radio-isotopes, they are also responsible for ventilation system. The strength of radioactivity in the air is strongly regulated and controlled by korea atomic energy law in Korea Institue of Nuclear Safety (KINS), so that air radioactivity exposure can lead to environmental pollution surrounding places. In this study, we'd like to find out the investigation and the present condition of the controlled ventilation system in domestic hospitals by an emission standard from KINS, and try to reach an agreement about how to use the ventilation system. Result: Definition of filters, features and structures of pre-filters, hepa-filters, charcol filters, filter exchange procedures and precautions are explained. RI deflation concentration and filter exchange cycle have been presented as a standard prescribed in the rules of KINS. The Radiation Control Management System (RCMS) introduced by Seoul National University Bundang Hospital linking to digital pressure gauge with computer controller in another medical facilities were described in details. Conclusions: The system of medical facilities using RI has been remarkably developing in 21 century. Especially, radiation safety control system has also been grown rapidly into the subdivision, specialization, advanced technology along with international technical improvement. However, As far as current RI ventilation system is concerned, it has nothing better than doing in the past. Preferentially, to reinforce this, more sophisticated system with strict periodic filter exchange and exhaust air control guidance should be introduced by applying brilliant domestic information technology for RCMS and digital gauge method. From personal point of view as a radiation safety manager, I have provide with present problems and improvements. Futhermore, more improved guidance should be conducted.