The purpose of this study is to show clearly whether the complexity of the cycle of head fluctuation during walking is influenced with walking speed. Thirty young healthy males and females volunteered as subjects for this study. Subjects walked 40 m, and they were instructed to walk “slowly”, “a little slowly”, “usual speed”, “a little fast” and “fast” depending on their subjectivities. The head fluctuation of the right-and-left direction during a walk was measured by using an accelerometer. In addition, the complexity of the head fluctuation of the right-and-left direction cycle was calculated by utilizing Approximate Entropy (ApEn). After the value of ApEn was standardized at the walking speed, each walking speeds were compared. As a result, the value of ApEn increased at the slowly speed, and decreased with the increases in the walking speed. And the value of ApEn showed plateau or decrease at a little faster than free walking speed. From our results, it thought a possibility that Central Pattern Generator is optimized at the free walking speed. In conclusion, it is clear that walking speed have influenced on the complexity of the walking cycle.

Background/Aims: The necessity for pharyngeal anesthesia during upper gastrointestinal endoscopy is controversial. This study aimed to compare the observation ability with and without pharyngeal anesthesia under midazolam sedation. Methods: This prospective, single-blinded, randomized study included 500 patients who underwent transoral upper gastrointestinal endoscopy under intravenous midazolam sedation. Patients were randomly allocated to pharyngeal anesthesia: PA+ or PA– groups (250 patients/group). The endoscopists obtained 10 images of the oropharynx and hypopharynx. The primary outcome was the non-inferiority of the PA– group in terms of the pharyngeal observation success rate. Results: The pharyngeal observation success rates in the pharyngeal anesthesia with and without (PA+ and PA–) groups were 84.0% and 72.0%, respectively. The PA– group was inferior (p=0.707, non-inferiority) to the PA+ group in terms of observable parts (8.33 vs. 8.86, p=0.006), time (67.2 vs. 58.2 seconds, p=0.001), and pain (1.21±2.37 vs. 0.68±1.78, p=0.004, 0–10 point visual analog scale). Suitable quality images of the posterior wall of the oropharynx, vocal fold, and pyriform sinus were inferior in the PA– group. Subgroup analysis showed a higher sedation level (Ramsay score ≥5) with almost no differences in the pharyngeal observation success rate between the groups. Conclusions Non-pharyngeal anesthesia showed no non-inferiority in pharyngeal observation ability. Pharyngeal anesthesia may improve pharyngeal observation ability in the hypopharynx and reduce pain. However, deeper anesthesia may reduce this difference.