In the unusual manifestation of right upper lobe collapse confusing with mediastinal or parenchymal mass, both alteration of the pulmonary vessels and shifting pattern of the collapsed lobe to the periphery on supine positionare the key to the diagnosis of it rather than mediastinal or parenchymal mass. The mechanisms of these unusual manifestation s are obscure, however lobar torsion and gravity factor are considered to be a main process. Authors have experienced 2 cases of unusual manifestations of right upper lobe collapse due to bronchogenic carcinomaduring resent 2 years in Kyung Hee University hospital, and prsent radiologic findings.
Carcinoma, Bronchogenic ; Diagnosis ; Gravitation

Colorectal endoscopic submucosal dissection (ESD) still remains a technically difficult procedure. The maintenance of tissue tension and good submucosal exposure during dissection is one of the most important factors for an effective and safe dissection. Although various traction methods have been developed, traction by gravity is one of the most useful method for colorectal ESD. Traction using adjunctive devices can thus be reserved for extremely difficult cases or for endoscopists in their learning periods for colorectal ESD.
Colorectal Neoplasms ; Gravitation ; Learning ; Traction

Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by changes in head position. BPPV is the most common etiology of recurrent vertigo and is caused by abnormal stimulation of the cupula by free-floating otoliths (canalolithiasis) or otoliths that have adhered to the cupula (cupulolithiasis) within any of the three semicircular canals. Typical symptoms and signs of BPPV are evoked when the head is positioned so that the plane of the affected semicircular canal is spatially vertical and thus aligned with gravity. Paroxysm of vertigo and nystagmus develops after a brief latency during the Dix-Hallpike maneuver in posterior-canal BPPV, and during the supine roll test in horizontal-canal BPPV. Positioning the head in the opposite direction usually reverses the direction of the nystagmus. The duration, frequency, and symptom intensity of BPPV vary depending on the involved canals and the location of otolithic debris. Spontaneous recovery may be expected even with conservative treatments. However, canalithrepositioning maneuvers usually provide an immediate resolution of symptoms by clearing the canaliths from the semicircular canal into the vestibule.
Gravitation ; Head ; Otolithic Membrane ; Semicircular Canals ; Vertigo

The shortage of internal medicine residents depict the contradictions and perversions in Korean medical system. Internal medicine is the foundation of medicine and the fact it serves as the most essential medical services for the people adds severe gravity to the issue. The fundamental problem derives from the contradictions in health insurance system. In fact, the poor medical fee and the failure of medical delivery system are the core drawbacks to the current crisis. Unless above matters are addressed to draw a constructive resolution, it is an undeniable fact that this may become a serious threat to the national health system and people's wellbeing.
Fees, Medical ; Gravitation ; Insurance, Health ; Internal Medicine*

Benign paroxysmal positional vertigo (BPPV) is characterized by brief recurrent episodes of vertigo triggered by head position changes. BPPV is one of the most common causes of recurrent vertigo. BPPV results from abnormal stimulation of the cupula within any of the three semicircular canals by free-floating otoliths (canalithiasis) or otoliths adhered to the cupula (cupulolithiasis). Typical symptoms and signs of BPPV are evoked when the head is positioned so that the plane of the affected semicircular canal is spatially vertical and thus aligned with gravity. Paroxysm of vertigo and nystagmus develops after a brief latency during Dix-Hallpike maneuver in posterior canal BPPV and supine roll test in horizontal canal BPPV. Usually positioning the head in the opposite direction reverses the direction of the nystagmus. The duration, frequency, and intensity of symptoms of BPPV vary depending on the involved canals and the nature of otolithic debris. Spontaneous recovery occurs frequently even with conservative treatment, however, canalith repositioning maneuvers are believed to be the best way to treat BPPV by moving the canaliths from the semicircular canal to the vestibule.
Gravitation ; Head ; Otolithic Membrane ; Semicircular Canals ; Vertigo

A variety of technique of dynamic pharmacocavernosometry have been described to evaluate cavernous veno-occlusive function: however, there is no uniquely reliable and standard method so far After intracavernous (IC) injection of 45 mg papaverine and 2.5 mg phenblamine, we performed gravity cavernosometry(GC) and pump cavernosometry(PC), ie, measurement of saline infusion rate needed to obtain and to maintain an erection and measurement of pressure decay for 30 seconds and pressure drop time to 75 mmHg when pump was turned off at 150 mmHg IC pressure. Final diagnosis of venous leakage was made by cavernosoeraphy done at 90 mmHg IC pressure. The parametric values measured by each method to diagnose venous leakage and correlation among these methods were analyzed. The etiology of impotence in 45 patients studied was psychogenic in 8, venogenic in 21, combined arteriogenic and venogenic in 16. The measurement of induction flow rate was less reliable(p<0.05) for the diagnosis of venous leak than the other methods of PC and GC (p<0.01). The standard deviations of the induction and maintenance flow rate and pressure drop time were similar to or even higher than mean values. There was correlation among all these methods. Therefore, GC and PC, particularly measurement of the intracorporeal pressure decay are believed to be valuable methods for diagnosis of the corporal-venous leakage.
Diagnosis ; Erectile Dysfunction ; Gravitation ; Humans ; Male ; Papaverine

OBJECTIVE: We report six patients with tuboovarian abscess (TOA) drained through sonographically guided transrectal route, in whom percutaneous or transvaginal approach was not accessible due to the risk of pelvic organ. METHOD: This procedure was performed under the guidance of transrectal ultrasound. Six patients with aged 25-42 years (mean 31.6 years), who had appendectomy(1), C/S(2), hyterectomy(1) and no operaion Hx(2). Size of abscess cavity was variable from three to eight centimeter. Catheter was removed when drainage amount was reduced less than 10 cc and the patient becomes afebrile. RESULT: Drainage was successfully done in all patients without any complication to the procedure. Fecal contamination was not occurred after transrectal drainage due to abdominal pressure and gravity ought to empty the abscess cavity. There was no problem in defecation due to the catheter and in its expulsion by defecation. Catheter was removed after 3-8 days (mean 6 days) without recurrent abscess. CONCLUSION: Transrectal drainage of abscess performed with ultrasound guidance is a safe, feasible procedure, which is well tolerated by patient and relatively easy procedure.
Abscess* ; Catheters ; Defecation ; Drainage* ; Gravitation ; Humans ; Ultrasonography

OBJECTIVE: To investigate the deficit of static and dynamic postural control in patients with chronic ankle sprain using dynamic posturography. METHOD: Twenty patients with unilateral recurrent ankle sprain and functional instability were assessed by Samsung medical center ankle injury score and by computerized dynamic posturography (EquiTest system, Neurocom , international, INC; USA). The posturography test was performed 3 times at 6 different simulated conditions such as fixed of force platform/open eyes/fixed of screen (condition 1), fixed/closed/fixed (condition 2), fixed/open/movement (condition 3), sway/open/fixed (condition 4), sway/closed/fixed (condition 5), sway/open/movement (condition 6). We evaluated anteroposterior sway of center of gravity of the patients and calculated equilibrium scores. We compared the equilibrium scores of patient group and normal data reported previously. We also compared the equilibrium scores of two subgroups of the patients according to severity of ankle injury. RESULTS: Patients showed significantly low equilibrium scores than normal one at the condition 4, 5 and 6 (p<0.05). The group B with severe ankle injury revealed low equilibrium scores at the condition 4, 5 and 6. Especially the group B showed statistically significance at condition 5 (p<0.05). CONCLUSION: Patients with chronic ankle sprain showed the deficit of dynamic postural control due to the proprioceptive dysfunction of injured ankle than normal person.
Ankle Injuries* ; Ankle* ; Gravitation ; Humans ; Proprioception

Benign paroxysmal positional vertigo (BPPV) is a clinical syndrome characterized by brief recurrent episodes of vertigo triggered by changes in head position with respect to gravity. BPPV is the most common cause of recurrent vertigo, with a lifetime prevalence of 2.4%. In this review article, the diagnosis of BPPV involving the posterior, horizontal and anterior semicircular canal are described.
Gravitation ; Head ; Prevalence ; Semicircular Canals ; Vertigo

Unsteadiness that people may continuously experience in everyday life is closely related to unilateral vestibulopathy. In human bipedal gait related to locomotion, supra-spinal control is responsible for gait rhythm. The vestibular system is involved in stable gait directly by adjusting the tension of the antigravity muscles and indirectly by producing information related to a change in the center of gravity according to the angular velocity and position of the head; thus, vestibular disorder gives rise to vestibular ataxia. Vestibular ataxia arises from vestibulo-spinal reflex impairment that changes the movement of the center of gravity in gait initiation, step length, stance width, the timing of ground reaction force, and pre-swing. In this way, information from studies related to locomotion is very important in vestibular rehabilitation.
Ataxia ; Gait ; Gravitation ; Humans ; Locomotion ; Muscles ; Reflex