The purpose of this study was to identify the relationships between trunk sway (TS) and the motion of center of pressure (COP) during quiet upright stance. Eight young healthy subjects (averaged 24±6.7 years) including 3 females were recruited for this study. By comparing TS with COP, we found that TS is moving in phase with COP both in lateral and sagittal plane. On the basis of observations that the COP-TS error signal is very similar to the changes of friction between the feet and floor. We also found that the friction is the impetus of trunk sway obeying the Newton's law. Then, a dynamic model between TS and COP can be identified. The results showed that TS and the motion of COP are in accordance with a specific differential equation. Supporting TS is v and COPS is u, then u can be expressed as : u=-Hm/k v+hv, where H, k, h are constants, m is the body mass. The simulation results fitted the experimental findings very well. The results suggested that TS instead of COP is a promising index for human standing ability assessment.

An 87-year-old woman with unknown fever origin was admitted to our internal department. We could not determine the fever origin from clinical findings, serious blood data, urine data, bacteriological data, and images obtained by ultrasonography, computed tomography and magnetic resonance. Body inflammatory findings did not respond to several antibiotics we used. Gallium scintiphotography revealed abnormal radioisotope uptake in the bilateral inguinal region. And ultrasonography and enhanced computed tomography showed tumors in front of the bilateral femur neck. Moreover, bone scintiphotography (^99mTc) revealed abnormal radioisotope uptake in the bilateral hip joints. We performed resection of the right inguinal tumor. The tumor was solid mass 30×20×20mm in size. It was covered with an articular capsule in front of the right femur neck. We identified the mass as bilateral tuberculous granulation with Langhans-type giant cells pathologically. It was only with difficulty that we firmly diagnosed the case as tuberculous arthritis of bilateral hip joints because the fever origin was unknown. It is important to diagnose tuberculous arthritis by use of various imaging techniques. We should take tuberculous infection into consideration when we encounter a case of arthritis of unknown fever origin or a case of antibiotics resistant arthritis.

Upper gastrointestinal endoscopy is an invasive examination. Cardiovascular and respiratory adverse effects are commonly observed in patients undergoing endoscopy. We investigated prospectively the cardiovascular and respiratory changes every oneminute before, during and after routine endoscopy. Sixteen healthy adult patients were enrolled in this study. Systolic blood pressure, diastolic blood pressure, pulse rate and percutaneous arterial oxygen saturation (SpO₂) were recorded every one-minute throughout the procedure. Systolic and diastolic blood pressure increased significantly one minute after the insertion of the endoscope. Increases in pulse rate were noted after the insertion of the endoscope. Rate pressure product increased significantly one minute after the insertion of the endoscope. No significant change in SpO₂ was observed during endoscopy. Our results indicated that upper gastrointestinal endoscopy might induce cardiovascular stress and abnormality. Therefore, we should carefully insert and manipulate upper gastrointestinal endoscope.

Keeping upright stance is important to other complex motions like locomotion and running for human beings. The mechanism of balance-keeping control in upright standing is still unknown. This study was conducted to analyze the body sway by using a simple PID (proportional, integral, derivative) control model and to investigate the influence of vision on its gains. Ten healthy subjects took part in the study. The upright body was modeled as one-link inversed pendulum model. While determining the model parameters according to subject's physical statue, the gain of PID parameters, (K_P, K_D, K_I are gains of proportion, derivative, and integral respectively.) could be estimated. Four kinds of visual patterns, (three for central visual field stimulation, one is eyes closed) were designed for visual stimulation. The results showed that the gain of K_D was decreased significantly in eyes closed (131.5±37.6 Nms/rad in eyes open and 90.4±26.0 Nms/rad in eyes closed, p<0.001), and, K_P, K_I were not changed. The results suggested that the PID control model was a promising means for individual balance ability analysis and that the visual effect on balance-keeping control in upright standing was analogized to a damper in the mechanical system.

PURPOSE: For patients with acute respiratory failure due to lung edema or atelectasis, Surplus lung water that is not removed during an initial stay in the Intensive Care Unit (ICU) may be related to early ICU readmission. Therefore, we performed a retrospective study of patient management during the first ICU stay for such patients. MATERIALS AND METHODS: Of 1,835 patients who were admitted to the ICU in the 36 months from January, 2003 to December, 2005, 141 were patients readmitted, and the reason for readmission was lung edema or atelectasis in 21 patients. For these 21 patients, correlations were investigated between body weight gain at the time of initial ICU discharge (weight upon discharge from the ICU ÷ weight when entering the ICU) and the time to ICU readmission, between body weight gain and the P/F ratio at ICU readmission, between the R/E ratio (the period using a respirator (R) ÷ the length of the ICU stay after extubation (E)) and the time to ICU readmission, between the R/E ratio and body weight gain, and between body weight gain until extubation and the time to extubation. RESULTS: A negative linear relationship was found between body weight gain at the time of initial ICU discharge and the time to ICU readmission, and between body weight gain at the time of ICU discharge and the P/F ratio at ICU readmission. If body weight had increased by more than 10% at ICU discharge or the P/F ratio was below 150, readmission to the ICU within three days was likely. Patients with a large R/E ratio, a large body weight gain, and a worsening P/F ratio immediately after ICU discharge were likely to be readmitted soon to the ICU. Loss of body weight during the period of respirator support led to early extubation, since a positive correlation was found between the time to extubation and body weight gain. CONCLUSION: Fluid management failure during the first ICU stay might cause ICU readmission for patients who had lung edema or atelectasis. Therefore, a key to the prevention of ICU readmission is to ensure complete recovery from lung failure before the initial ICU discharge. Strict water management is crucial based on body weight measurement and removal of excess lung water is essential. In addition, an apparent improvement in respiratory state may be due to respiratory support, and such an improvement should be viewed cautiously. Loss of weight at the refilling stage of transfusion prevents ICU readmission and may decrease the length of the ICU stay.
Humans ; Intensive Care Units/*statistics & numerical data ; Patient Readmission/*statistics & numerical data ; Pulmonary Atelectasis/physiopathology/*therapy ; Pulmonary Edema/physiopathology/*therapy ; Retrospective Studies ; Time Factors ; Weight Gain