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.

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

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

We presented one case of 43 years old man with ectopic ureter entering the seminal vesicle associated with ectopic renal dysplasia. He had complained of perineal and lower abdominal discomfort, hemospermia. The definite diagnosis was made by seminal vesiculogram through vas deferens. We report the case with brief review of literatures.
Adult ; Diagnosis ; Hemospermia ; Humans ; Seminal Vesicles* ; Ureter* ; Vas Deferens

Percutaneous nephrostomy has proved to be a safe and effective procedure to preserve renal function in obstructive uropathy by the development of radiologic technologies and experiences, which is associated with a low rate of significant complications. Bowel perforation is an unusual complication of this technique. We report a case of a nephro-colo-cutaneous fistula following percutaneous nephrostomy in a case of renal tuberculosis.
Fistula* ; Nephrostomy, Percutaneous* ; Tuberculosis, Renal

We studied 33 patients with acute urinary retention due to benign prostatic hyperplasia for evaluating the recovery of the detrusor muscle function and its affecting factors through the serial urodynamic studies prospectively. And ninety nine patients were studied for risk factors of acute urinary retention retrospectively. Among the 33 patients studied prospectively, detrusor contraction at immediate decompression was observed in 20 cases(60.7%) and was not observed in 13 cases (39.3%), and there was statistically significant difference in the retained volume and duration of retention between two groups. In 10 cases of non-contraction group at immediate decompression, serial urodynamic studies showed that detrusor contraction recovered within 2 days in 4 cases, but in 6 cases no detrusor contraction was found upto 5 days. Overall, detrusor function recovered in 80% or patients within 2 days. Among the patients studied for risk factors, hesitancy and interruption were the most common symptoms whereas urgency and urge incontinence were the least common. In conclusion, it is thought that acute urinary retention due to benign prostatic hyperplasia is resulted from temporary or permanent loss of detrusor muscle function due to overdistension, and the degree of retention duration and retained volume expressly affect the severity of loss of detrusor muscle function. The risk of acute urinary retention is higher in benign prostatic hyperplasia patients with obstructive symptoms rather than irritative symptoms.
Decompression ; Humans ; Prospective Studies ; Prostatic Hyperplasia* ; Retrospective Studies ; Risk Factors ; Urinary Incontinence, Urge ; Urinary Retention* ; Urodynamics

Since March 1978, 78 men, husbands of infertile couples who consulted our Severance Hospital Urologic department were instructed to collect seminal fluid samples after at least 3 days of abstinence. Of these 78 patients 28 (35.9%) demonstrated aspermia. The remaining 50 patients were evaluated with past history and physical examination. The semen was examined for liquefaction, volume, sperm motility, morphology, and WBC count. The results were as follows: 1. The mean age was 31.8 years and mean period of infertility was 3.4 years. 2. 34% of the patients had suffered from urethritis, or epididymitis. 3. Varicoceles were found in 14% of the patients. 4. The mean pH of the specimens was 7.4, time of liquefaction was 13.9 minutes and in all of the patients did liquefaction occur within 30 minutes. 5. The volume of the ejaculate averaged 3.4 ml, and in 6% of the patients the volume was below 1 ml. 6. The sperm concentration averaged 60.5 million/ml and 34% had concentrations less than 20 million. The total number of spermatozoa per ejaculate averaged 205.8 million and 26% had total sperm counts under 50 million. 7. Ployspermia was found in 2 men (4%) 8. The mean percentage of active sperm was 53.7% 9. The motile sperm count averaged 31.1 million/ml and the total motile sperm per ejaculate averaged 107.6 million. 10. The percentage of oval cells or normal sperm averaged 68.1% 11. In patients with WBC more than 5/HPF in semen, mean sperm motility (42.0%) was lower than that of the other group (60.3%) 12. According to the fertility index, infertile was 6%, subfertile 44%, relative fertile 30% and highly fertile 20%. 13. In patients with varicocele, mean of the sperm motility was lower than that of patients without varicocele.
Aspermia ; Epididymitis ; Family Characteristics* ; Fertility ; Humans ; Hydrogen-Ion Concentration ; Infertility ; Male ; Physical Examination ; Semen Analysis* ; Semen* ; Sperm Count ; Sperm Motility ; Spermatozoa ; Spouses* ; Urethritis ; Varicocele

Intercourse without ejaculation may be the result of anejaculation, retrograde ejaculation, nonemission, or aspermia. Twelve patients complaining ofnonejaculatory intercourse were studied. Two of them presented primarily with complaints of sexual dysfunction and 10 with infertility. All of them had primary infertility. Eight patients were anejaculation, which was primary in three and secondary in five. Four patients had nonemission. Six patients wanted early treatment for their infertility and underwent electroejaculation, which produced ejaculates in five. Intrauterine insemination was performed with the processed semen in three of the wives, but there are no pregnancies so far. We intend to keep trying such artificial insemination until we succeed.
Aspermia ; Ejaculation ; Humans ; Infertility ; Insemination ; Insemination, Artificial ; Male ; Pregnancy ; Semen ; Spouses

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

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*