BACKGROUND: Plasma clearance of iohexol (Omnipaque(r)) which used widely in radiologic procedure is considered as useful method for estimation of GFR because iohexol is neither reabsorbed nor secreted from tubule after filtered as inulin and its extrarenal clearance is negligible. Plasma clearance of iohexol can be calculated from two compartment model or one compartment model with Brochner-Mortensen (B-M) modification which convenient and reliable. But there were controversies about sufficient sampling numbers and times for B-M modification of iohexol clearance. METHODS: Nineteen healthy Korean without renal disease underwent measurement of iohexol clearance. Iohexol was given as a single iv dose, and 14 blood sample were drawn up to 300 min. A reference GFR was iohexol clearance calculated from two-compartment model using 14 samples (CL-T). From 8, 3 and 2 samples clearances were calculated by B-M modification (CL-M8, 3 and 2 respectively). The accuracy of estimates was evaluated as percent of estimates falling within 10% above or below the reference GFR. Accuracy of CCr and equations for GFR estimation were also compared. RESULTS: CL-T, CL-M8, CL-M3 and CL-M2 were not different (101.9+/-24.0, 101.9+/-18.7, 101.7+/-18.6, 101.9+/-19.5 mL/min/1.73 m2 respectively). Accuracy of CL-M8, 3 and 2 were not different (74%, 84% and 79% respectively, p>0.05). MDRD equation had higher accuracy (47%) compared with other equations. CONCIUSION: These results indicate that sampling number for measuring iohexol plasma clearance using simplified method might be reduced to only two without accuracy loss in Korean without renal disease.
Inulin ; Iohexol* ; Plasma*

PURPOSE: We wanted to evaluate the clinical efficacy of an increased computed tomography attenuation coefficient (CTAC) of urine after the oral administration of iohexol in neonates who are suspected of suffering with neonatal necrotizing enterocolitis (NEC). MATERIALS AND METHODS: During a recent 1 year-period, seventeen neonates were admitted for suspected NEC, and they were divided into the suspected and definite groups based on their clinical signs and radiographic findings; we also included ten normal neonates as the control group. Diluted iohexol was administered and the CTACs of collected urine samples at 8-12 hour intervals were measured. Comparative analysis of the three groups was done and statistical significance was determined by the Scheffe test. RESULTS: Among 17 neonates, there were 13 neonates in the suspect group and 4 neonates in the definite group. The mean CTACs of urine in each group were 2711 HU (control group), 3411 HU (suspected group), and 7625 HU (definite group), respectively. There was a significant difference between the mean CTAC of the definite group and that of the control or suspected groups (Scheffe t >2.65). However, no statistically significant difference was seen between the suspected and control groups (Scheffe t=1.14). CONCLUSION: Although measurements of the CTAC of urine showed no significant diagnostic efficacy in the suspected group, the CTAC of urine, which reflects the correlated degree of bowel mucosal injury, can be a useful aid for determining the severity and progression of NEC.
Administration, Oral ; Colitis ; Enterocolitis, Necrotizing ; Humans ; Infant, Newborn* ; Iohexol ; Water*

We report a case of severe chemical meningitis complicating iohexol myelography. Cerebrospinal fluid findings include a white blood cell count of 1700(94% polymorphouse cell, 6% lymphocyte ), sugar 20mg/dl and p rotein 170mg/dl. Chemical meningitis can not be distinguished from acute bacterial meningitis on the basis of the clinical findings and cerebrospinal fluid examination. A cerebrospinal fluid gram stain and culture were the only reliable test in deciding the etiology of the meningitis. The authors report this rare complication from iohexol myelography with review of pe rtinent literature.
Cerebrospinal Fluid ; Iohexol* ; Leukocyte Count ; Lymphocytes ; Meningitis* ; Meningitis, Bacterial ; Myelography

Iohexol has been widely used in extensive clinical evaluation of spinal problem. We report a 46-year-old man with generalized tonic-clonic status epilepticus which began with spreading myoclonus after iohexol injection for cervical myelography. The status epilepticus which started with spreading myoclonus followed by encephalopaty has controlled 8 hours after the initiation of treatment. The encephalopathy improved completely 8 days after treatment with glucocorticoids and anticonvulsant.
Glucocorticoids ; Humans ; Iohexol* ; Middle Aged ; Myelography* ; Myoclonus ; Status Epilepticus*

BACKGROUND: The aim of this study was to compare the accuracy of the position of the epidural catheter inserted from three different lumbar intervertebral spaces, L2-3, L3-4, and L4-5, in infants and children. METHODS: Seventy-five children were randomly allocated to 3 groups according to the epidural catheter insertion site (L2-3, L3-4, and L4-5). The epidural catheter tip was identified using 50% diluted Iohexol and fluoroscopy. The incidence of correct position was compared among the groups and between infants and children. RESULTS: The incidence of correct position was significantly higher in the L2-3 group as compared to the L3-4 and L4-5 groups (P = 0.023 and P = 0.046 respectively). The incidence of correct position was higher in infants compared to children (P = 0.017). CONCLUSIONS: The L2-3 intervertebral space is preferable during epidural catheter insertion in children older than 1 year, but a low lumbar level should be considered in infants because they have a higher risk of neural damage.
Analgesia, Epidural ; Catheters ; Child ; Fluoroscopy ; Humans ; Incidence ; Infant ; Iohexol ; Pediatrics

We encountered a patient who had a rare occurrence of a seizure after lumbar myelography from the beginning of this untoward side effect. Clinical trials with iohexol in myelography have demonstrated a good tolerability of this water-soluble contrast medium. However, there have been a few reports that have shown acute adverse reactions such as headaches, vomiting, psychosis, confusion and generalized tonic-clonic seizures. Despite the reports on the safety of iohexol use, it may cause a generalized seizure attack without an epileptogenic history. Therefore, thorough attention and the preparation for emergency treatments for the seizure are essential in every myelography using iohexol as a contrast medium. Moreover, in order to avoid unwanted legal problems, the patients and their family need to be informed of the necessity and possible side effects associated with myelography.
Emergency Treatment ; Headache ; Humans ; Iohexol* ; Myelography* ; Psychotic Disorders ; Seizures* ; Vomiting

Meningeal irritation signs sometimes develop after myelography due to bacterial infection by contamination during the procedure or chemical irritiation by contrast media itself. CSF profiles of chemical meningitis often mimick those of bacterial meningitis, sometimes causing difficulty in differentiation, but in that case clinical course soon reverse in short time without any complication. Postmyelography chemical meningitis by metrizamide (AmipaqueR) has been well described but iohexol (OmnipaqueR) has rarely been reported to cause chemical meningitis. We experienced a patient of chemical meningitis by iohexol and here descibe the case.
Bacterial Infections ; Contrast Media ; Humans ; Iohexol ; Meningitis* ; Meningitis, Bacterial ; Metrizamide ; Myelography*

Iodinated contrast media (CM) can cause immediate and late reactions. We treated a patient with a recurrent generalized maculopapular rash and a fever that occurred within two days of exposure to iodinated CM, iopromide (Ultravist(R)), for chest computed tomography. We performed skin testing including prick tests, intradermal tests, and patch tests. Our findings indicated a late skin reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM such as ioversol (Optiray(R)), iohexol (Iobrix(R)), and iobitridol (Xenetix(R)). In this study, we report the case of a patient diagnosed with a late adverse reaction to Ultravist(R) in addition to cross-reactions to other iodinated CM.
Contrast Media ; Exanthema ; Fever ; Humans ; Intradermal Tests ; Iohexol ; Patch Tests ; Skin ; Skin Tests ; Thorax ; Triiodobenzoic Acids

Using Omnipaque CT cisternogram, author prospectively studied on the level of physiologic CSF reflux into ventricles in 42 cases, who had not history of brain pathology or abnormal findings in neurologic examination. Results were as follows: 1) Age of all cases ranged from 26 to 78 years and male to female ratio was 2.8:1. 2) Of 7 cases used control, 6 cases showed maximum reflux at 2 hours scan and remaining 1 showed at 5 hours. 3) CSF reflux to 4th ventricle were detected in all cases, but reflux to Aqueductus of sylvius, posterior 3rd ventricle, anterior 3rd ventricle, foramen Monro and lateral ventricle were in 17 out of all 42 cases(40.5%), 12/42(28.6%), 3/42(7.2%), 3/42(7.2%), 2/42(4.8%) respectively. 4) Cases with reflux to 4th ventricle could be considered as normal, but authors with reflux above 4th ventricle need follow-up scan after 3 to 6 hours to decide as normal.
Brain Diseases ; Female ; Follow-Up Studies ; Humans ; Hydrocephalus ; Iohexol ; Lateral Ventricles ; Male ; Neurologic Examination ; Prospective Studies

BACKGROUND: Cervical epidural injection, performed via the interlaminar approach, represents a useful interventional pain management procedure indicated in patients with a cervical herniated disk. Due to thedecreased epidural space in the cervical region, cervical epidural injections may result in potentially serious complications, especially during a large volume injection. METHODS: Thirty-four patients with neck pain due to a cervical herniated disk that were referred to the pain clinic for cervical epidural steroid injection were randomized into two groups. One group received a cervical epidural injection of 4 ml drug and the other group received 2 ml drug. The injected mixture included triamcinolon, ropivacaine and omnipaque. Spread levels of the drug after injection were estimated with the use of C-arm fluoroscopy. RESULTS: Spread levels to the cephalad for patients in the two groups were 4.88 +/- 0.78 segments and 4.53 +/- 0.49 segments, respectively. Spread levels to the caudad for patients in the two groups were 4.59 +/- 0.93 segments and 4.47 +/- 0.51 segments, respectively. The results showed no significant difference in the spread level between the two groups. CONCLUSIONS: Use of a small volume of drug (2 ml) can provide a sufficient spread level of the injected drug that is desirable for patients with a cervical herniated disk.
Epidural Space ; Fluoroscopy ; Humans ; Injections, Epidural ; Intervertebral Disc Displacement ; Iohexol ; Neck Pain ; Pain Clinics ; Pain Management