The purpose of this study is to investigate changes of the cardiac output and the cardiac muscle contractility during postural gradient changes in man. Subjects consisted of 15 healthy males that they were aged 23-24 years. The Cardiac output and the contractility were calculated using the impedance cardiogram that were recorded by new apparatus developed in Yonsei Medical Center. The impedance cardiogram was recorded in different 7 gradients which were 0degrees, +/-2degrees, +/- 45degrees and +/-90degrees according to the head position, but it was continuously recorded at each gradient. The each postural gradient was changed after supine resting, 15-20 min, and continued in 5 min. Results of this study were following, 1. The cardiac output was decreased at head up posture (+2degrees, +45degrees and +90degrees) because of decreasing stroke volume. But the cardiac output was increased at head down posture (-2degrees, -45degrees and -90degrees) by increasing stroke volume. 2. The cardiac output was significantly changed at +/-45degrees and +/-90degrees after immediately gradient changes, but it was no significant difference at 0 and +/-2degrees postures from that of supine resting state. 3. At +/-45degrees and +/-90degrees, the cardiac muscle contractility was increased, and in head up posture, amounts of change were more larger than in head down posture.
Cardiac Output* ; Cardiography, Impedance ; Electric Impedance ; Head ; Humans ; Male ; Myocardium* ; Posture ; Stroke Volume

To study on the left ventricular contractility and the cardiac vector of fighter pilots, 56 pilots and 15 normal cadets were selected and they were divided into six groups by flight time (hours). To evaluate the left ventricu-lar contractility of subjects, R amplitude of chest V1 , V5 , V6 lead were recorded by ECG, and R-Z interval were recorded by ICG (impedance cardiography). And, to evaluate the cardiac vector of subjects, mean QRS vec-tor of I, II, V2 , V6 lead were recored by ECG. Results of this study are following, 1) Systolic and diastolic blood pressure were decreased against flight time. 2) Sv1 +Rv5 was decreased against flight time; Sv1 +Rv5 was 27.8 mm in 50 hr Group that is the longest among the group, and 23.7 mm in 2,000 hr Group that is the shortest among the groups. V6 /V5 was no significant difference among the groups. 3) R-Z interval was decreased against flight time; R-Z interval was 166.8 X10(-3) sec in 50 hr Group that is the longest among the group, and 154.4 X10(-3) sec in 2,000 hr Group that is the shortest among the groups. 4) In frontal plan, the range of QRS vector axis was +57.3 degrees ~ +78.2 degrees that was deviated to left of body center according to the flight time. In horizon-tal plan, the range of QRS vector axis was -29.6 degrees ~ +47.2 degrees that was deviated to back of body center according to the flight time. In both plan, the amplitude of QRS vector was tend to decreasing against the flight time. Results of this study indicate that the cardiac function of fighter pilots was doubted to degenerate or weaken. Conclusionally, fighter pilots have to increase their cardioventricular fitness by the aerobic training and other methods.
Axis, Cervical Vertebra ; Blood Pressure ; Electrocardiography ; Thorax

Nine athletes and ten nonathletes were selected randomly to study the changes of cardiac function during exercise by impedance cardiography. The speed of the treadmill was maintained at 3.4 mph, and its grade was increased by 1% (Balke protocol). The exercise was continued until the target heart rate (THR), 85% of maximum oxygen uptake (VO2max). The measured parameters for pre- and post-exercise were stroke volume (SV), heart rate (HR), and cardiac output (CO). Average stroke volume of athletes at pre-exercise, 71.1 ml, was higher than that of nonathletes, 64.6 ml, and stroke volume of the former at post-exercise, 97.0 ml, was also higher than that of the latter, 85.2 ml. Therefore, despite the lower heart rate, cardiac outputs of athletes at pre- and post-exercise, 4.98 and 16.3 L/min, were higher than those of nonathletes, 4.87 and 14.2 L/min. For the second phase of the study, cardiac outputs of three subjects were measured during the continuous treadmill exercise with newly developed electrodes and shoes for minimizing motion artifact. Though there were several studies measuring cardiac output during continuous bicycle exercise, this is thought to be the first study in the world measuring cardiac output during continuous treadmill exercise without aid of ensemble averaging.
Adult ; *Cardiac Output ; *Cardiography, Impedance ; *Exertion ; Heart Rate ; Human ; Sports Medicine ; Stroke Volume ; Support, Non-U.S. Gov't

Bochdalek hernia through Bochdalek foramen, defect at the posterolateral side of the diaphragm is one of the congenital diaphragmatic hernias. It usually occurs in infants, but very rare in old age and also on the right side. We experienced the right-side Bochdalek hernia including kidney herniation in 68 years old man man ifested by hemoptysis. CT scan revealed diaphragmatic defect and herniated liver, colon and kidney. Thoracotomy was performed and the 10 cm-sized large defect was closed with patch. After then, the patient has been well without symptom.
Aged ; Colon ; Diaphragm ; Hemoptysis ; Hernia* ; Hernia, Diaphragmatic ; Humans ; Infant ; Kidney* ; Liver ; Thoracotomy ; Tomography, X-Ray Computed

Background: and Purpose: Verbal and nonverbal fluency tests are the conventional methods for examining executive function in the elderly population. However, differences in impairments result in fluency tests in patients with mild cognitive impairments (MCIs) and Alzheimer’s disease (AD) and in neural correlates underlying the tests still necessitate concrete evidence. Methods: We compared the test performances in 27 normal controls, 28 patients with MCI, and 20 with AD, and investigated morphological changes in association with the test performances using structural magnetic imaging. Results: Patients with AD performed poorly across all the fluency tests, and a receiver operating characteristics curve analysis revealed that only category fluency test discriminated all the 3 groups. Association, category, and design fluency tests involved temporal and frontal regions, while letter fluency involved the cerebellum and caudate. Conclusions Category fluency is a reliable measure for screening patients with AD and MCI, and this efficacy might be related to morphological correlates that underlie semantic and executive processing.

Background/Aims: To compare the efficacy and safety of procedural sequence in same-day bidirectional endoscopy. Methods: We searched OVID-MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar to identify randomized controlled trials that compared the procedural sequences in same-day bidirectional endoscopy, including esophagogastroduodenoscopy (EGD) and colonoscopy. The sedative and analgesic doses required, discomfort and satisfaction scores, procedure time, recovery time, adenoma detection rate, and failed cecal intubation were evaluated. Adverse effects, including respiratory and cardiovascular complications, were also assessed. Results: We included six studies, with 1,848 patients in total. The requirement for sedative treatment was significantly lesser in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (standardized mean difference [SMD], –0.39; 95% confidence interval [CI], –0.54 to –0.24; p = 0.12; I2 = 49%). Discomfort, scored by patients during the EGD procedure, was significantly lesser in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (SMD, –0.45; 95% CI, –0.80 to –0.09; p = 0.02; I2 = 73%), while it was comparable during colonoscopy between the two sequences. Recovery time was significantly shorter in the EGD-colonoscopy sequence than in the colonoscopy-EGD sequence (SMD, –0.47; 95% CI, –0.65 to –0.30; p = 0.28; I2 = 21%). Total procedure duration, EGD, colonoscopy, cecal intubation time and incidence, incidences of pathologic findings, and adenoma detection were comparable between the two sequences. There was no significant difference in the incidences of desaturation, hypotension, hypertension, bradycardia, and tachycardia between the two sequences. Conclusions When conducting same-day bidirectional endoscopy, EGD followed by colonoscopy is the most beneficial sequence to be used because patients require lower sedative doses, recover faster, and report lesser discomfort.

Choroid plexus cysts (CPCs) are the most commom neuroepithelial cysts, occuring in more than 50% of some autopsy series. They are typically small and asymptomatic and are discovered incidentally in older patients, usually in the trigone of the lateral ventricle. Symptomatic CPCs (usually exceptionally large, 2-8 cm) are rare. The authors report a case of large symptomatic choroid plexus cyst, located in the trigone of the right lateral ventricle in a 26-yr-old man who presented with headache and vomiting. The patient underwent endoscopic removal through a burr hole placed 3 cm from the midline and just behind the hair line. The histological examination of the cyst wall was consistent with choroid epithelium. Despite of postoperative intraventricular hemorrhage and catheter infection, he discharged home without neurologic deficits. The endoscopic fenestration rather than excision should be considered as the first surgical procedure because the goal of treatment is shrinkage of the cyst until normal cerebrospinal fluid flow is restored.
Adult ; Brain Diseases/diagnosis/pathology/*surgery ; *Choroid Plexus ; Cysts/diagnosis/pathology/*surgery ; Endoscopy ; Humans ; Male

BACKGROUND AND OBJECTIVES: Circulating endothelial progenitor cells (EPCs) play a key role in the maintenance of endothelial homeostasis and promote vascular repair. A reduced number of EPCs and the functional activity have been associated with several cardiovascular risk factors. However, the relationship between the number of EPCs and circadian rhythm of the blood pressure (BP) remains unclear. The purpose of the present study was to evaluate the relationship between the circadian rhythm of the BP and EPCs in patients with essential hypertension. SUBJECTS AND METHODS: A total of 45 patients with essential hypertension who were newly identified by outpatient BP measurements, underwent 24-hour ambulatory BP monitoring. Among the 45 patients with essential hypertension, 20 were classified as dippers (12 men and 8 women; mean age 48+/-14 years) and 25 as non-dippers (14 men and 11 women; mean age 52+/-18 years). The EPC count was isolated from the peripheral bloodstream and quantified by flow cytometry. RESULTS: The baseline clinical characteristics were similar between the dipper and non-dipper hypertensive patients. The circulating EPCs were statistically reduced in the non-dipper patients as compared to the dippers (104+/-60 vs. 66+/-47 EPCs per 106 mononuclear cells, p=0.027). The circulating EPC level correlated positively with the circadian changes in the systolic and diastolic BP (r=0.435, p=0.003, and r=0.310, p=0.038, respectively). CONCLUSION: The present study demonstrated that the EPC count was reduced in the peripheral bloodstream in non-dipper hypertensive patients.
Blood Pressure ; Circadian Rhythm ; Homeostasis ; Humans ; Hypertension ; Male ; Outpatients ; Phosphorylcholine ; Risk Factors ; Stem Cells