Objective: The I-gel device and endotracheal tube are used for advanced airway management during cardiopulmonary resuscitation (CPR). This study compares differences in the ventilation volume according to the fixation methods (tape and band) of I-gel using a simulation manikin. Methods: I-gel was placed in an advanced life support simulator and fixed with either tape or band fixation, and an endotracheal tube was inserted using an endotracheal tube holder (AnchorFast). CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device (LUCAS) and an adult bag. CPR was performed for 30 minutes. Positional shifts of the I-gel and endotracheal tube and differences in the ventilation volume on the simulation manikin were subsequently measured. Five trials were carried out in each setting. Statistical analysis was carried out using SPSS version 27.0. A P-value <0.05 is considered significant. Results: The following positional shifts were obtained after 30 minutes of CPR: I-gel tape fixation, 4.96±0.72 mm; I-gel band fixation, no change; endotracheal tube holder, no change. The mean ventilation volumes obtained were 504.43± 14.42, 536.86±5.56, and 528.38±8.81 mL, respectively. Conclusion Our results indicate that the use of I-gel is as effective as an endotracheal tube for initial airway maintenance during CPR in the hospital. We recommend using an elastic band-type fixation device for the fixation method.

Twenty one ratients diagnosed with diabetic cystopathy in Yongdong Severance Hospital for 6 years were analysed for the clinical and urodynamic features. The mean age was 65.4 years (33-83) and females were twice in number when compared to males. The mean duration of diabetes was 9.7 years. The symptoms were urinary retention, residual urine sensation, abdominal straining, hesitancy, interruption, impaired voiding desire, dysuria in order of frequency. Significant bacteriuria was found in 62% of patients and was more frequent in females, In cases with confirmed bacteriuria, 62% of the identified bacteria was E. coli. Diabetic neuropathy was present in 100% and nephropathy in 77%, nephropathy in 43%. In the presence of one complication, there was a tendency for other concurrent complications. In urodynamic study, the residual urine volume, volume at first sensation, maximum intravesical pressure. compliance were larger than in normal persons and loss of reflex detrusor contraction was more frequent which means impaired bladder sensation and detrusor contractility in diabetic cystopathic patients. The age of patients, duration of diabetes, treatment mode of diabetes, level of blood sugar do not influence the severity of diabetic cystopathy Administration of cholinergics and intermittent catheterization showed a high cure rate and was throughout to be a good treatment mode.
Bacteria ; Bacteriuria ; Blood Glucose ; Catheterization ; Catheters ; Cholinergic Agents ; Compliance ; Diabetic Neuropathies ; Dysuria ; Female ; Humans ; Male ; Reflex ; Sensation ; Urinary Bladder ; Urinary Retention ; Urodynamics*

We analyzed one hundred and thirty nine cases of urodynamic findings of male patients who had voiding problems without organic or neurologic lesions. There were 45 patients (32.4%) with normal urodynamic findings and 94 patients (67.6%) with abnormal finding. The most frequent finding in the latter was high maximum urethral closure pressure in 41 cases (29.5%). The popular voiding symptoms were residual urine sensation (75.5%), frequency (67.6%), hesitancy (63.3%) and so on. There was no correlation between urodynamic findings and symptoms. Although many patients were lost to follow up, the results of the management were good. So we expect that it would be better to manage such patients according to the results of urodynamic findings than to manage only by the symptoms.
Humans ; Lost to Follow-Up ; Male* ; Sensation ; Urodynamics*

Since June 1978, 40 patients who had been taken renal arteriographies were analysed and following results were obtained. 1. Male to female ratio was approximately 1:1 and peak incidence was in the fifth decade. 2. The symptoms and signs as indications for renal arteriography were flank pain, gross hematuria, renal trauma, flank and abdominal mass, in decreasing order of frequency. 3. Renal arteriographies were performed in 8 patients who showed gross hematuria but normal excretory urography. In 6 patients arteriography showed clearly the absence of abnormal vasculature within the kidney. In the other two, the kidney were identified as having inflammatory change and arteriovenous malformation, respectively. 4. Arteriographically detected extravasation of urine which were not identified on excretory urography was noted in one case. 5. The over-all accuracy of the angiographic diagnosis of simple benign cyst and renal tumor was 100%.
Angiography* ; Arteriovenous Malformations ; Diagnosis ; Female ; Flank Pain ; Hematuria ; Humans ; Incidence ; Kidney ; Male ; Urography

A total of 41 anejaculatory men participated in the electroejaculation study. Mean patient age was 33.2 years (range 22 to 54 years). Greater than one million motile sperm were obtained in 26 patients(63.4%). We attempted intrauterine insemination on 25 occasions in 14 subjects' spouses. Four of them(28.6%) became pregnant ;two aborted and the other two delivered fullterm healthy babies.
Humans ; Insemination* ; Male* ; Pregnancy ; Spermatozoa ; Spouses

No abstract available.
Adenoma* ; Cervix Uteri* ; Female

No abstract available.
Adenoma* ; Cervix Uteri* ; Female

Electrical ejaculation is widely used for semen collection in ejaculation failure patients with various causes including spinal cord injury. Semen collected by this method show sperm with low quality, and decrease in sperm motility is especially evident; multifactors are responsible but there are some reports that electrical current and increased temperature during electrical ejaculation are the cause. To confirm this theories, we observed the direct effect of variable electrical current and temperature to the motility of normal sperm in vitro. Semen analysis was performed after temperature was maintained at 37, 39, 41, and 43 `C for 10 minutes and electrical current at 5, 10, 15, 20 Volts for 3, 7, and 10 minutes. 1. Sperm motility change with temperature: The ratio of motile sperm decreased significantly (n=32, p<0.01) from 82.20, 70.12, 60.93, 48.87% as the temperature rose 37, 39, 41, 43 `C, respectively. Factors related to motility (distribution of progressive form and rapid velocity) decreased as well and the distribution of static velocity increased. However, additional semen analysis 20 minutes after rests were not significantly different in sperm motility before and after any temperature changes. 2. Sperm change with electrical energy: The motility of the sperm decreased significantly according to increasing volts and time, which showed a time-dependent and voltage-dependent decrease. The ratio of motile sperm decreased significantly to increasing volts and time and factors related to motility (distribution of progressive form and rapid velocity) also decreased. The distribution of static velocity increased. However, additional semen analysis 20 minutes after rests were not significantly different in sperm motility before and after inducing electrical energies. These data suggest that the effect of electrical current and temperature to sperm motility is temporary and that the low quality of sperm collected by electrical ejaculation in patients with ejaculation failure may not be due to the effect of electrical ejaculation but the various conditions of the patients themselves.
Ejaculation ; Hot Temperature ; Humans ; Male ; Semen ; Semen Analysis ; Sperm Motility* ; Spermatozoa* ; Spinal Cord Injuries

Urinary incontinence is a relatively common and potentially disabling disease affecting the life quality of a patient. Many successful series in the treatment of incontinence by medical or surgical therapy using autologous materials have been reported. However, those who have structural abnormalities, injury around the urethra, and derangements in the nervous system could not be benefited by such treatments. In other countries, the artificial urethral sphincter, introduced in 1972, have achieved satisfactory results and then increased in use; but in Korea, it was not widely used because of many limitations and obstacles. Based on our ten-year experience with 10 cases of implantation of artificial urethral sphincter from 1987 to 1996, we tried to elucidate the present status, problems, and the possible ways of improvements of its use within this country. A total of ten male patients underwent implantations of the AMS Model 800 artificial urethral sphincter. Mean age was 34.5 (17-43) years. Mean follow-up was 4.2 (0.5-10) years. Two patients were spinal cord injury patients, 2 meningomyeloceles, and 6 posterior urethral injuries. Two patients had the prosthesis removed due to infection and cuff erosion. In the other 8 patients, 6 were dry (75.0 %) and 1 was improved (12.5 %) and 1 was wet (12.5 %). The revision rate was 20% (2/10) and overall improvement of incontinence was observed in 7 (87%) patients. The reasons for the low incidence of the implantation of artificial urinary sphincter in this country are as follows. According to the other reports, the most common application of artificial urinary sphincter in the west is in the post-prostatectomy incontinence accounting for about 60% of artificial urinary sphincter implantation whereas in this country, the majority of cases are patients who had trauma. Since radical prostatectomy has not been established well in the country (in the recent 4 years, totally only 53 cases were performed) and also the excellent performance of the transurethral surgery making the incidence of incontinence low, could be one of the reasons. In addition, the high price of the prosthesis over 4 million won and operation fee of 3 to 6 million won is a formidable burden to most patients. In the view of mechanical problem, the cuff size of the urethra in the oriental people is observed smaller than the western, and we must let the company prepare the cuff set of smaller size. In conclusion, if we solve those problems in our country, the artificial urethral sphincter is an effective device for treatment of urinary incontinence in patients who have failed more conservative modes of therapy.
Fees and Charges ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Linear Energy Transfer ; Male ; Meningomyelocele ; Nervous System ; Prostatectomy ; Prostheses and Implants ; Quality of Life ; Spinal Cord Injuries ; Urethra* ; Urinary Incontinence ; Urinary Sphincter, Artificial

PURPOSE: The onset and severity of voiding dysfunction in multiple system atrophy(MSA) is more early and severe than that of idiopathic Parkinson's disease(IPD). We compared the voiding symptoms and urodynamic findings in patients with MSA and IPD in order to elucidate the characteristics of their voiding dysfunction. MATERIALS AND METHODS: We reviewed urodynamic data from 19 men and 10 women with parkisonism. Of the 29 patients(mean age 66.5 years), 19 patients (mean age 68.7 years) had IPD and 10 patients(mean age 62.4 years) had MSA. The mean duration of the disease in all patients was 4 years and 10 months, and there was no significant difference between IPD and MSA. RESULTS: Detrusor hyperreflexia(DH) was seen in 8 patients, detrusor hypereflexia with impaired detrusor contractility(DHIC) in 3, detrusor hyperreflexia with bladder outlet obstruction(DHOB) in 4, impaired detrusor contractility(If) in 8, and normal findings in 6. In IPD, DH was noted in 5 patients, DHIC in 3, DHOB in 2, IC in 5 and normal in 4, and a similar distribution was seen in MSA. However, there was no significant difference in the prevalence of involuntary detrusor contraction between IPD and MSA. Irritative voiding symptoms were seen in 11 patients, obstructive symptoms in 10, and both in 8. Obstructive symptoms were dominate in IPD and irritative symptoms in MSA. Impaired relaxation of the voluntary sphincter was seen in 12(41%) patients with parkisonism,8 in IPD, and 4 in MSA. CONCLUSIONS: There was no difference between idiopathic Parkinson's disease and multiple system atrophy in mean age, sex, mean duration of disease, subjective voiding symptoms and urodynamic findings. Disease specific findings were not identified in patients with parkinsonism.
Female ; Humans ; Male ; Multiple System Atrophy* ; Parkinson Disease ; Parkinsonian Disorders ; Prevalence ; Reflex, Abnormal ; Relaxation ; Urinary Bladder ; Urodynamics*