1.Comparison of differences in ventilation volume according to fixation method of I-gel during cardiopulmonary resuscitation in hospital: a study using a simulation manikin
Kang Lee KANG LEE ; Sang Yol SANG YOL ; Yong HWANG ; Jeong Woo CHOI
Journal of the Korean Society of Emergency Medicine 2023;34(3):189-199
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.
2.The Significance of Glomerulation in the Diagnosis of Interstitial Cystitis.
Korean Journal of Urology 1997;38(12):1343-1348
An objective finding for the diagnosis of interstitial cystitis (IC) is the so called `glomerulation`, petechial hemorrhages that occur after distention of the bladder. Glomerulation occurs in most IC patients and although there are some reports that it occurs in the normal bladder as well, there has been no actual study carried out to confirm this and further study into this matter is needed. Therefore, we induced glomerulations in non-IC patients and compared its frequency and severity with IC patients in order to elucidate the importance of glomerulation in IC. 25 (10 males, 15 females; mean age 44.3 years) IC patients received hydrodistention between Jan 1992 to Sep 1996 at the Department of Urology at Yongdong Severance Hospital. 12 (8 males, 4 females; mean age 47.5 years) non-IC patients who were to receive urological surgery under spinal or general anesthesia were selected for hydrodistention; there were 6 ureter stone, 4 BPH, and 2 stress urinary incontinence patients. 92.0% (23/25) of IC patients and 83.3% (10/12) of non-IC patients showed glomerulation and there was no statistical significance between the two groups. 76.0% (6 grade 2, 13 grade 3 glomerulation) of IC patients and 50.0% (3 grade 2, 3 grade 3) of non-IC patients showed glomerulation of grade 2 or higher. The frequency and severity of glomerulation was in an inverse relationship with trabeculation of the bladder. The sensitivity of glomerulation in the diagnosis of IC was 92.0% whereas the specificity was low with 16.7%. These findings suggest that glomerulation is nonspecific in IC and warrants further investigation.
Anesthesia, General
;
Cystitis, Interstitial*
;
Diagnosis*
;
Female
;
Hemorrhage
;
Humans
;
Male
;
Sensitivity and Specificity
;
Ureter
;
Urinary Bladder
;
Urinary Incontinence
;
Urology
3.The Transvaginal Bladder Neck Suspension by Raz for Stress Urinary Incontinence: A Review of 106 Cases.
Korean Journal of Urology 1996;37(7):789-793
From January, 1990 to December, 1995, 106 patients received transvaginal bladder neck suspension by Raz. Follow up periods ranged from 3 months to 5 years, and mean age of patients was 52.2 years. Severity of incontinence were grade 1 in 22, grade II in 83, and grade III in 1 patient. After minimum of 3 months follow up, 87 (82.1%) patients were completely cured and 14 (13.2%) patients reported minimal leaking, the final success rate being 95.3% (101/106). Degree of posterior urethral angle and grades of incontinence(classified either by Blaivas or Green) were not significant factors in predicting outcome. Grade of incontinence, preoperative irritative voiding symptoms, previous incontinence surgery, age, and menopause were not correlated with success. However the history of hysterectomy and overweight were related with lower success rate. Mean hospital stay was 6.1 days, and 50 (47.2%) patients performed intermittent catheterization at discharge but later all resumed normal voiding. Among 34 patients with urgency preoperatively 25 (73.5%) improved after operation, and de novo urgency was found in 11 (16.2%). Complications including urinary tract infection blood loss requiring transfusion were seen in one patient respectively, but no case of peritonitis, bladder perforation, and wound perforation was seen. Success rate of Raz operation is more than 90%, which was higher than other types of bladder suspension. Raz colpo-suspension can place bladder neck traction sutures accurately without causing obstruction or significant morbidity, therefore should be recommended as a premier mode of surgical treatment in patients with stress urinary incontinence.
Catheterization
;
Catheters
;
Female
;
Follow-Up Studies
;
Humans
;
Hysterectomy
;
Length of Stay
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Menopause
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Neck*
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Overweight
;
Peritonitis
;
Sutures
;
Traction
;
Urinary Bladder*
;
Urinary Incontinence*
;
Urinary Tract Infections
;
Wounds and Injuries
4.The Effect of Temperature and Electrical Energy on Sperm Motility.
Sang Yol MAH ; Young Deuk CHOI
Korean Journal of Urology 1997;38(2):129-135
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
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Hot Temperature
;
Humans
;
Male
;
Semen
;
Semen Analysis
;
Sperm Motility*
;
Spermatozoa*
;
Spinal Cord Injuries
5.The Clinical and Urodynamic Features of Diabetic Cystopathy.
Korean Journal of Urology 1990;31(6):883-888
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
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Bacteriuria
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Blood Glucose
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Catheterization
;
Catheters
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Cholinergic Agents
;
Compliance
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Diabetic Neuropathies
;
Dysuria
;
Female
;
Humans
;
Male
;
Reflex
;
Sensation
;
Urinary Bladder
;
Urinary Retention
;
Urodynamics*
6.Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review.
Ha Young KIM ; Sang Wan SHIN ; Jeong Yol LEE
The Journal of Advanced Prosthodontics 2014;6(5):325-332
PURPOSE: The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS: A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS: Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION: For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.
Dental Implants
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Denture Rebasing
;
Denture, Overlay*
;
Dentures
;
Female
;
Gingiva
;
Hemorrhage
;
Humans
;
Mandibular Prosthesis
;
Occlusal Adjustment
;
Oral Health
;
Patient Satisfaction
;
Periodontal Index
;
Survival Rate
;
Visual Analog Scale
;
Surveys and Questionnaires
7.Clinical Significance of the Renal Arteriography.
Korean Journal of Urology 1981;22(2):135-139
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*
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Arteriovenous Malformations
;
Diagnosis
;
Female
;
Flank Pain
;
Hematuria
;
Humans
;
Incidence
;
Kidney
;
Male
;
Urography
8.Endoscopic teflon injection in vesicoureteral reflux.
Korean Journal of Urology 1992;33(2):262-265
Twenty vesicoureteral reflux patients with 31 reflux renal units were treated with endoscopic Teflon injection. Twenty one reflux renal units were cured and the success rate after first injection was 67.7 %. In 5 more renal units the second injection was done and the refluxes were subsided in all cases. The overall success rate was 83.9 %. Teflon injection was also effective in vesicoureteral reflux with neurogenic bladder. There are many benefits of endoscopic Teflon injection in the treatment of vesicoureteral reflux but long term follow-up is needed and we must consider the possibility or complication especially in child.
Child
;
Follow-Up Studies
;
Humans
;
Polytetrafluoroethylene*
;
Urinary Bladder, Neurogenic
;
Vesico-Ureteral Reflux*
9.Dorsal Nerve Somatosensory Evoked Potential Test for Localizing the Lesion in Neurogenic Erectile Dysfunction.
Won Jae YANG ; Young Deuk CHOI ; Young Chul CHOI ; Sang Yol MAH ; Hyung Ki CHOI
Korean Journal of Urology 2000;41(5):645-649
No abstract available.
Erectile Dysfunction*
;
Evoked Potentials, Somatosensory*
;
Male
10.10-year Experience with Artificial Urethral Sphincter.
Sun Jung KANG ; Sang Yol MAH ; Taik LEE
Korean Journal of Urology 1997;38(2):192-197
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