• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.40-45
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• 2016

Objective: The increasing use of imaging examinations such as computed tomography (CT) results in increased contrast media use, which increases contrast media-induced adverse reactions (AR). This study investigated the risk factors of ARs to nonionic iodinated contrast media. Methods: This study evaluated patients who were administered iodinated contrast media during CT scanning in Yeouido St. Mary's Hospital in Seoul, Korea in 2012. Among the subjects, those with contrast media-induced ARs were classified as the AR group. The control group included individuals without ARs who were selected through simple random sampling. The effects of sex, age, contrast media type and dose, CT region, previous contrast media administration, allergy history, and comorbidity were analyzed in the AR and control groups. Results: Multivariate logistic regression analyses were performed to evaluate the identified AR risk factors in 103 subjects in the AR group and 412 subjects in the control group. The results confirmed that the risk of developing ARs was significantly higher in females [odds ratio (OR): 2.206; 95% confidence interval (CI): 1.353-3.598], in individuals administered Iohexol (OR: 9.981; 95% CI: 2.361-42.193), in individuals with an allergy history (OR: 3.982; 95% CI: 1.742-9.101), and in individuals with comorbid asthma (OR: 6.619; 95% CI: 1.377-31.826). Most of the ARs were mild and immediate. Conclusion: In patients who were administered contrast media during CT scans, female gender, Iohexol use, allergy history, and asthma were risk factors for ARs. Therefore, special care is required for patients with such risk factors to prevent ARs.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.130-133
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• 2012

The purpose of this study is to assess the relationship between glomerular filtration rate (GFR) and age by using dynamic computed tomography (CT) and Patlak plot analysis in dogs. Fifteen dogs were used in this study. CT-GFR study was performed under general anesthesia using propofol and isoflurane. 1 ml/kg dosage of 300 mgI/ml iohexol was administered at a rate of 3 ml/s during GFR measurement. CT-GFR was determined with a single-slice dynamic acquisition and Patlak plot analysis. The individual and global GFR values were calculated to plasma clearance per body weight (ml/min/kg). Bodyweight ($mean{\pm}SD$) ranged from 2.0 to 5.7 kg ($3.31{\pm}1.13$ kg). Age ranged from 3 years to 13 years old ($7.14{\pm}3.30$). $Mean{\pm}SD$ creatinine ($0.53{\pm}0.34 $mg/dl), phosphorus ($4.1{\pm}1.2$ mg/dL), and albumin ($3.3{\pm}0.3$ mg/dL) concentrations and urine protein-to-creatinine ratios (all ratios were < 0.5) were within reference ranges. Abdominal ultrasonography revealed small-sized renal calculi, mineralization, or renal cyst at eight dogs. The global CT-GFR ranges shown in this study was 2.57 to 6.60 ml/min/kg. In this study, there was no trend toward weight-adjusted CT-GFR with increasing age. We found no relationships between age-related kidney dysfunction in fifteen dogs. Small-sized renal calculi or cysts did not affect renal function in this study. However, it is thought that a large sample size may have been required to document an age effect.

• Korean Journal of Radiology
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• v.21 no.10
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• pp.1178-1186
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• 2020

Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT). Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses. Results: Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications. Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.280-283
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• 2015

Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.451-453
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• 2023

We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.

• Journal of Veterinary Science
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• v.21 no.4
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• pp.55.1-55.11
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• 2020

Background: Computed tomography urography (CTU), based on the excretion of contrast medium after its injection, allows visualization of the renal parenchyma and the renal collecting system. Objectives: To determine the optimal contrast medium dose allocation ratio to apply in split-bolus CTU in dogs. Methods: This prospective, experimental, exploratory study used 8 beagles. In 3-phase CTU, unenhanced-, nephrographic-, and excretory-phase images were obtained with a single injection of 600 mg iodine/kg iohexol. In split-bolus CTU, two different contrast medium allocation ratios (30% and 70% for split CTU 1; 50% and 50% for split CTU 2) were used. Unenhanced phase image and a synchronous nephrographic-excretory phase image were acquired. Results: Although the attenuation of the renal parenchyma was significantly lower when using both split CTUs than the 3-phase CTU, based on qualitative evaluation, the visualization score of the renal parenchyma of split CTU 1 was as high as that of the 3-phase CTU, whereas the split CTU 2 score was significantly lower than those of the two others. Artifacts were not apparent, regardless of CTU protocol. The diameter and opacification of the ureter in both split CTUs were not significantly different from those using 3-phase CTU. Conclusions: Split-bolus CTU with a contrast medium allocation ratio of 30% and 70% is feasible for evaluating the urinary system and allows sufficient enhancement of the renal parenchyma and appropriate distention and opacification of the ureter, with similar image quality to 3-phase CTU in healthy dogs. Split-bolus CTU has the advantages of reducing radiation exposure and the number of CT images needed for interpretation.

• Korean Journal of Veterinary Research
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• v.41 no.3
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• pp.413-419
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• 2001

This study was performed to evaluate the renal hemodynamics using color Doppler ultrasonography in dogs with unilateral experimental hydronephrosis treated with transarterial embolization of the renal artery (TAE-RA). Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. The mean resistive index (RI) value of kidney was significantly increased at 4, 9, 17 days after ligation of ureter. Unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$body temperature, pulse, and respiratory rate were within normal ranges during procedures. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. In color Doppler ultrasonographic findings, there was no blood flow into the embolized kidneys treated by TAE-RA, however, blood flow signal was found in contralateral normal kidney of dogs treated with TAE-RA compared to that of normal kidney in normal control group. It is concluded that TAE-RA does not affect the hemodynamics of contralateral normal kidney in dogs with experimental hydronephrosis and color Doppler ultrasonography is simple and non-invasive modality for the monitoring of the revascularization of the renal artery after TAE-RA.