PURPOSE: To investigate intraocular pressure (IOP) and ocular biometry change according to the posture change in healthy eyes. METHODS: Forty eight eyes of 48 healthy young subjects were enrolled. IOP, central anterior chamber depth (cACD), and axial length were measured after keeping each position for 10 minutes (upright, sitting, supine, and prone positions) by using the TonoPen(R) and A-scan ultrasonography. RESULTS: Mean IOP was 19.68 +/- 2.15 mm Hg in prone position, 17.19 +/- 1.33 mm Hg in supine position, 16.49 +/- 1.76 mm Hg in sitting position, and 15.33 +/- 1.34 mm Hg in upright position. Difference among the positions was statistically significant (p < 0.01). Mean cACD was 3.68 +/- 0.35 mm in upright position, 3.63 +/- 0.32 mm in supine position, 3.59 +/- 0.34 mm in sitting position, and 3.47 +/- 0.30 mm in prone position. Difference among the positions was statistically significant (p < 0.01) except for the difference between supine and sitting position. Linear regression analysis revealed that cACD was significantly associated with IOP in prone position (R2 = 0.139, p < 0.01). CONCLUSIONS: There was a significant change in IOP and cACD according to the posture change. cACD was significantly associated with IOP only in prone position.
Anterior Chamber ; Biometry ; Eye ; Intraocular Pressure ; Linear Models ; Posture ; Prone Position ; Supine Position

PURPOSE: The present study examined how intraocular pressure is affected by changes in sleeping posture (22-2400 hours) from the sitting position to the supine, prone, and lateral positions in normal subjects. METHODS: Ophthalmological examination was performed on 140 eyes of 70 healthy adult men, and changes in the intraocular pressure were measured according to posture during sleep. The subject was initially relaxed and the base intraocular pressure was measured in the sitting position. In order to reduce the influence of intraocular pressure among the positions, namely, the supine, the prone, and the lateral recumbent positions, the subject was seated for ten minutes before assuming each position. Intraocular pressure was measured twice at 0 and 10 minutes in each position, and the mean of the two values was used for comparison. RESULTS: Compared to the intraocular pressure in the sitting position, intraocular pressure increased significantly in the supine, prone, and lateral positions (p< 0.05). Compared to the base intraocular pressure, the intraocular pressure measured in the prone position showed the largest difference, increasing 6.34 mm Hg in the right eye and 6.43 mm Hg in the left eye. The intraocular pressure measured in the lateral position was 3.62 mm Hg higher in the right eye and 3.63 mm Hg higher in the left eye, and that in the supine position was 2.42 mm Hg and 2.28 mm Hg higher in the right and left eyes, respectively. CONCLUSIONS: The change in posture during sleeping from the sitting position to the supine, prone, and lateral positions caused increases in intraocular pressure in normal subjects. The results show that the change in sleeping posture induced by sleeping habits may raise intraocular pressure.
Adult ; Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Male ; Posture ; Prone Position ; Supine Position

OBJECTIVE: Galvanic vestibular stimulation (GVS) activates the vestibular afferents, and these changes in vestibular input exert a strong influence on the subject's posture or standing balance. In patients with Parkinson's disease (PD), vestibular dysfunction might contribute to postural instability and gait disorders. METHODS: Current intensity was increased to 0.7 mA, and the current was applied to the patients for 20 minutes. To perform a sham stimulation, the current intensity was increased as described and then decreased to 0 mA over the course of 10 seconds. The patient's status was recorded continuously for 20 minutes with the patient in the supine position. RESULTS: Three out of 5 patients diagnosed with PD with postural instability and/or abnormal axial posture showed a reduction in postural instability after GVS. The score for item 12 of the revised Unified Parkinson's Disease Rating Scale part 3 was decreased in these patients. CONCLUSIONS: The mechanism of postural instability is complex and not completely understood. In 2 out of the 5 patients, postural instability was not changed in response to GVS. Nonetheless, the GVS-induced change in postural instability for 3 patients in our study suggests that GVS might be a therapeutic option for postural instability.
Gait ; Humans ; Parkinson Disease* ; Posture ; Supine Position

BACKGROUND: Body posture, as a gravitational factor, has a clear impact on pulmonary ventilation and perfusion. In lung units with mismatched ventilation and perfusion, gas exchange and/or elimination of carbon dioxide can be impaired. In this situation, differences in the value of arterial and end-tidal carbon dioxide tension [Delta(PaCO2 - PETCO2)] are expected to increase. This study was conducted to observe how Delta(PaCO2 - PETCO2) changed according to the 3 different surgical positions, and to determine whether Delta(PaCO2 - PETCO2) is a reliable predictor of ventilation/perfusion mismatch when a patient is in different postural positions. METHODS: Fifty-nine patients were divided into either the chronic obstructive pulmonary disease (COPD) group (n = 29) or the non-COPD group (n = 30). PaCO2 and PETCO2 were measured during surgery in the supine, prone, and lateral decubitus positions after a 10 minute stabilization period. The Delta(PaCO2 - PETCO2) were calculated and compared among positions. RESULTS: The Delta(PaCO2 - PETCO2) decreased slightly in the prone position and increased significantly in the lateral decubitus position compared with the supine position in both groups. These patterns almost corresponded with the degree of ventilation/perfusion mismatch from the results of the radiological studies. The Delta(PaCO2 - PETCO2) in the COPD group was significantly greater than that in the non-COPD group at all surgical positions. CONCLUSIONS: Lateral decubitus position is associated with marked increase in Delta(PaCO2 - PETCO2), especially in patients with COPD. The Delta(PaCO2 - PETCO2) is a simple and reliable indicator to predict ventilation/perfusion mismatch at different surgical positions in patients with or without COPD.
Benzeneacetamides ; Carbon ; Carbon Dioxide ; Humans ; Lung ; Perfusion ; Piperidones ; Posture ; Prone Position ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Ventilation ; Supine Position ; Ventilation ; Ventilation-Perfusion Ratio

It has been known that Korean adults have brachycephalus in their skull shape as compared with neighboring orientals. However, there is no difference between Korean newborn infants and other oriental newborn infants in skull shape. Acquired factors seem to be more important than hereditary factors as a possible cause of brachycephalus in Korean adults. In order to study the process of brachycephalization in the skull shape, I measured head girth, head length, head width and cephalic index. Those results were divided into three categories, namely, feeding, period of ingestion of undaria pinnatifida (sea weed) soup and sleep posture. 1) I studied 1,371 newborn infants who were born in th busan Maternity baby health center and 1,521 newborn infants in the Daegu maternity baby health center from June 1,1976 to may 31,1977. In Busan group, average weight of male newborn was 3.45kg, headgirth34.31cm, head length 11.68cm, head width 9.57cm. and cephalic index 82.02. Average weight of female newborn was 3.34kg, head girth 33.79cm, head length11.54cm, head width 9.44cm. and cephalic index 81.96. In Daegu group, average weight of male newborn was 3.28kg, head girth 34.65cm,head length 11.85cm, head width 9.50cm. and cephalic index 80.31. Average weight of female newborn was 3.18kg., head girth 34.08cm., headlength11.62cm., head width 9.38cm. and cephalic index 80.81. There was statistically significant difference in each item (p<0.01) 2) It was also studied in the order of delivery in the family. In Busan group, first baby was 43.5%, second baby 38.8% and sum of first and second baby was 82.3%. In Daegu group, first baby was 47.2%, second baby was 30.3% and sum of first and second baby was 77.5%. 3) I studied 1,686 male and 1,175 female from one to twelve month olds who visited my clinic for check up and vaccination from January 1,1976 to March 31,1978. Head girth, head length and head width were measured 3,660 times for male and 2,607 times for female. 4) Feeding was divided into breast feeding, Mixed feeding and artificial feeding. Period of maternal ingestion of sea weed soup were one, two, three and four weeks. Sleep postures were supine, lateral and prone position. Occipital protuberance that is not in the middline was divided into right or left occipital protuberance. 5) There were neither significant differences in head girth, head length, head width and cephalic index between breast, mixed and artificial feeding nor period of maternal ingestion of seaweed soup. 6) There was either significant difference in the cephalic index between supine and lateral position or supine and prone position. 7) Among 2,861 infants, breast feeding was 75.0%, mixed feeding 15.1% and artificial feeding 9.9%. Occipital protuberance that is not in the midline was 59.3%, left occipital protuberance 27.1% and right occipital protuberance 32.2%. 8) Occipital protuberance that is not in the midline was 70.5% in the supine position, 24.6% in the lateral position and 0.0% in the prone position. There were significant differences among them. 9) Period of maternal ingestion of seaweed soup were one week 10.4%, two weeks 28.0%, three weeks 33.0% and four weeks 28.6%.
Adult ; Breast ; Breast Feeding ; Busan ; Daegu ; Eating ; Female ; Head ; Humans ; Infant* ; Infant, Newborn ; Male ; Nutritional Support ; Posture ; Prone Position ; Seaweed ; Skull* ; Supine Position ; Undaria ; Vaccination

OBJECTIVE: To compare the safety and efficacy of prone and modified recumbent positions on minimal invasive percutaneous nephrolithotomy. METHODS: A total of 62 patients with upper urinary calculi were grouped into two groups, one of which consisted of 27 patients who underwent the minimal invasive percutaneous nephrolithotomy with modified recumbent position, and the other 35 patients with prone position. There was no significant statistical difference in the age, gender and complications between the two groups before surgery (P>0.05). Duration of and blood loss during surgery, complications in the perioperative period, and the length of postoperative hospital stay were all recorded. The data were analyzed by SPSS 13.0. RESULTS: Surgery was successful in all cases. There was no failure to puncture nor need to resort to open surgery. Average operation duration for the modified recumbent position group was (85.1± 25.3) min vs (97.2±30.6) min for the prone position group. Mean blood loss during the operation was (117.5± 49.7) mL vs (149.3±53.1) mL. There were no severe complications during and after surgery in the modified recumbent position group. In the prone position group, s one patient suffered pneumothorax during the operation and two suffered selective renal artery embolization because of massive hemorrhaging following the operation. There were significant differences in blood loss during surgery, in complications during the perioperative period, and in length of postoperative stay in hospital (P<0.05) between the two groups. CONCLUSION The patients are safer and more easily tolerate the minimal invasive percutaneous nephrolithotomy in the modified recumbent position than in the prone position, though the treatment efficacy of these two kinds of operation is similar. It is recommended that the modified recumbent position should be used generally in the percutaneous nephrolithotomy.
Adult ; Aged ; Female ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Nephrostomy, Percutaneous ; methods ; Posture ; Prone Position ; Supine Position ; Ureteral Calculi ; surgery

Various techniques were evaluated to determine the best method for reducing small bowel involvement in pelvic irradiation. Fourteen patients receiving radiation in pelvic area were enrolled for this study. Five sets of small bowel images were obtained. Patients were positioned on a simulation couch with full bladder in prone and supine positions and 2 sets of images were taken. Then they were asked to empty their bladder and 2 sets of images were taken in prone and supine positions. A belly board device (BBD) was placed and one set of images was obtained. Using a software, the area of small bowel inside treatment field was contoured, measured, and analyzed. In both full and empty bladder cases, small bowel area reduction was observed in prone position as compared to supine position. Especially statistically significant reduction is noted in lateral film. An average decreases of 13% in PA and 26% in lateral direction were noted with bladder distention as compared to empty bladder. With the use of BBD for empty bladder, a significant reduction of 62.8+/-27.1% and 63.1+/-32.9% in PA and lateral directions were observed as compared to without BBD in prone position, respectively. In conclusion, the best sparing of small bowel concerning the area included in the treatment fields was achieved with BBD in prone position with empty bladder. However, further reduction is expected if the bladder was filled fully because the analysed data with empty vs full bladder study shows increased sparing of small bowel with distended bladder.
Humans ; Prone Position ; Supine Position ; Urinary Bladder

The purpose of this study is to evaluate the morphologic findings of the labrum and capsuloligamentous structures in the normal and unstable shoulders and to compare the effectiveness of double contrast arthrographic findings which were taken with supine and prone position. We reviewed the computerized tomographic arthrogram in 9 cases of normal shoulder and l3 cases of shoulder instability. We evaluated the shape of the labrum, the attachment of anterior capsule and the amount of capsular laxity. Capsular laxity was compared each others in normal, the unidirectional instability and the multidirectional instability. Among these materials, we simultaneously performed CT arthrogram with supine and prone position and evaluated which is more reliable and accurate. Scapular inclination was ahout 25 degrees in the supine position and ahout 60 degrees in the prone position. Normal glenoid labrum varied in size and shape, so its lack of a classic appearance might not indicate a labral tear. Variations existed in the anterior capsular attachment onto the glenoid. The anterior capsule was used to attach far away from the glenoid rim. but it might not indicate an anterior instability. With the prone position, the labral lesion took more excellent visualization due to the contrast coating on the glenoid labrum in both anterior and posterior. Anterior capsular expansion was seen well with prone position in anterior instability. In summary, for proper interpretation of the instability, awareness of the morphologic variations of the labrum and capsuloligamentous structure is important. CT double contrast arthrography with prone position has made a significant contribution to improving and easing the documentation of variety of anatomic abnormalities. Now we recommend the prone position in CT arthrogram for imaging glenoid labrum pathology in shoulder instability.
Arthrography ; Pathology ; Prone Position ; Shoulder* ; Supine Position

STUDY DESIGN: Cross-sectional study.PURPOSE: This was carried out to evaluate the benefit of a ‘fulcrum bending position’ compared with the standing position for evaluation of sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis.OVERVIEW OF LITERATURE: In lumbar X-ray, the standing position is the most common position used in determining abnormalities in lumbar movement. Lack of standardized method is one of the pitfalls in this technique. We hypothesized that the new technique, that is, fulcrum bending position, may reveal a higher translation and rotation in spondylolisthesis patients.METHODS: The extension lumbar radiographs of 36 patients with low-grade spondylolisthesis were included in the analysis and measurement. Sagittal translation and sagittal rotation were measured in both the routine standing position and in our new technique, the fulcrum bending position, which involves taking lateral cross-table images in the supine position wherein the patient lies on a cylindrical pipe to achieve maximum passive back extension by the fulcrum principle.RESULTS: Results of the measurement of sagittal translation in both positions revealed that compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 1.57 mm in translation of the vertebra position (95% confidence interval [CI], 0.52–2.61; p=0.004). The measurement of sagittal rotation in both positions revealed that when compared with the extension standing position, the fulcrum bending position achieved a statistically significant increase of 3.47° in the rotation of the vertebra (95% CI, 1.64–5.30; p<0.001).CONCLUSIONS: For evaluation of both sagittal translation and sagittal rotation in symptomatic patients with spondylolisthesis, compared with the extension standing position, the fulcrum bending position can achieve an increased change in magnitude. Our technique, that is, the fulcrum bending position, may offer an alternative method in the detection or exclusion of pathological mobility in patients with spondylolisthesis.
Cross-Sectional Studies ; Humans ; Methods ; Posture ; Spine ; Spondylolisthesis ; Supine Position

BACKGROUND: The respiratory cycle alters the size of the right internal jugular vein (RIJV). We assessed the changes in RIJV size during the respiratory cycle in patients under positive pressure ventilation. Moreover, we examined the effects of positive-end expiratory pressure (PEEP) and the Trendelenburg position on respiratory fluctuations. METHODS: A prospective study of 24 patients undergoing general endotracheal anesthesia was performed. Images of the RIJV were obtained in the supine position with no PEEP (baseline, S0) and after applying three different maneuvers in random order: (1) a PEEP of 10 cmH2O (S10), (2) a 10degrees Trendelenburg tilt position (T0), and (3) a 10degrees Trendelenburg tilt position combined with a PEEP of 10 cmH2O (T10). Using the images when the area was smallest and largest, cross-sectional area (CSA), anteroposterior diameter, and transverse diameter were measured. RESULTS: All maneuvers minimized the fluctuation in RIJV size (all P = 0.0004). During the respiratory cycle, the smallest CSA compared to the largest CSA at S0, S10, T0, and T10 decreased by 28.3 8.5, 8.0, and 4.4%, respectively. Furthermore, compared to S0, a 10degrees Trendelenburg tilt position with a PEEP of 10 cmH2O significantly increased the CSA in the largest areas by 83.8% and in the smallest areas by 169.4%. CONCLUSIONS: A 10degrees Trendelenburg tilt position combined with a PEEP of 10 cmH2O not only increases the size of the RIJV but also reduces fluctuation by the respiratory cycle.
Anesthesia ; Head-Down Tilt* ; Humans ; Jugular Veins* ; Positive-Pressure Respiration ; Prospective Studies ; Supine Position