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A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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Depositional Environment and Formation Ages of Eurimji Lake Sediments in Jaechon City, Korea (제천 의림지 호저퇴적물 퇴적환경과 형성시기 고찰)

  • 김주용;양동윤;이진영;김정호;이상헌
    • The Korean Journal of Quaternary Research
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    • v.14 no.1
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    • pp.7-31
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    • 2000
  • Quaternary Geological and geophysical investigation was performed at the Eurimji reservoir of Jaechon City in order to interprete depositional environment and genesis of lake sediments. For this purpose, echo sounding, bottom sampling and columnar sampling by drilling on board and GPR survey were employed for a proper field investigation. Laboratory tests cover grain size population analysis, pollen analysis and $^{14}C$ datings for the lake sediments. The some parts of lake bottom sediments anthropogenically tubated and filled several times to date, indicating several mounds on the bottom surface which is difficult to explain by bottom current. Majority of natural sediments were accumulated both as rolling and suspended loads during seasonal flooding regime, when flash flow and current flow are relatively strong not only at bridge area of the western part of Eurimji, connected to stream valley, but at the several conduit or sewage system surrounding the lake. Most of uniform suspend sediments are accumulated at the lake center and lower bank area. Some parts of bottom sediments indicate the existence of turbid flow and mudflow probably due to piezometric overflowing from the lake bottom, the existence of which are proved by CM patterns of the lake bottom sediments. The columnar samples of the lake sediments in ER-1 and ER-3-1 boreholes indicate good condition without any human tubation. The grain size character of borehole samples shows poorly sorted population, predominantly composed of fine sand and muds, varying skewness and kurtosis, which indicate multi-processed lake deposits, very similar to lake bottom sediments. Borehole columnar section, echo sounding and GPR survey profilings, as well as processed data, indicate that organic mud layers of Eurimji lake deposits are deeper and thicker towards lower bank area, especially west of profile line-9. In addition the columnar sediments indicate plant coverage of the Eurimji area were divided into two pollen zones. Arboreal pollen ( AP) is predominant in the lower pollen zone, whreas non-aboreal pollen(NAP) is rich in the upper pollen zone. Both of the pollen zones are related to the vegetation coverage frequently found in coniferous and deciduous broad-leaved trees(mixed forest) surrounded by mountains and hilly areas and prevailing by aquatic or aquatic margin under the wet temperate climate. The $^{14}C$ age of the dark gray organic muds, ER1-12 sample, is 950$\pm$40 years B.P. As the sediments are anthropogenetically undisturbed, it is assumed that the reliability of age is high. Three $^{14}C$ ages of the dark gray organic muds, including ER3-1-8, ER3-1-10, ER3-1-11 samples, are 600$\pm$30 years B.P., 650$\pm$30 years B.P., 800$\pm$40 years B.P. in the descending order of stratigraphic columnar section. Based on the interpretation of depositional environments and formation ages, it is proved that Eurimji reservoir were constructed at least 950$\pm$40 years B.P., the calibrated ages of which ranges from 827 years, B.P. to 866 years B.P. Ancient people utilize the natural environment of the stream valley to meet the need of water irrigation for agriculture in the local valley center and old alluvium fan area.

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Effect of Korean Mistletoe Extract and Lectin on the Preneoplastic Hepatic Lesion and Apoptosis in Experimental Hepatocarcinogenesis (실험적 간암모델에서 한국산 겨우살이 추출물 및 렉틴 투여가 전암성 병변의 생성 및 Apoptosis에 미치는 영향)

  • 김미정;김정희;이미숙
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.31 no.5
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    • pp.782-787
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    • 2002
  • This study was done to investigate the effects of Korean mistletoe water extract and lectin on the apoptosis and preneoplastic lesion in chemically induced rat hepatocarcinogenesis. To attain the above objectives, weanling Sprague-Dawley male rats were fed modified AIN-76 diets containing 10% corn oil for 9 weeks. One week after feeding starts, rats were intraperitoneally injected twice with a dose of diethylnitrosamine (DEN, 50 mg/kg body weight (BW). Rats were provided with 0.05% phenobarbital (PB) in drinking water from one week after DEN treatment until the end of experiment. During the period of PB treatment, rats were injected with mistletoe extract (100 $\mu\textrm{g}$/kg BW) and lectin (10 $\mu\textrm{g}$/kg BW) twice a week. At the end of 9th week, rats were sacrificed and the formation of hepatic glutathione S-transferase placental form positive (GST-P$^{+}$) foci, apoptosis, DNA fragmentation and apoptosis related proteins were determined respectively. The formation of GST-P$^{+}$foci was significantly decreased by mistletoe extract or lectin treatment. Although there was no effect on apoptosis and DNA fragmentation in hepatic tissue by mistletoe extract or lectin treatment, caspase-9 and fas-L were increased. These results suggest that Korean mistletoe extract and lectin have a potential to inhibit hepatocarcinogenesis by increasing apoptosis.sis.

A Study on the form of korean Women's Hair Style-From the Viewpoint of Woman's Hair Style in Cho-Sun Dynasty- (한국 여성의 수발양식 관한 연구 -조선시대 여성 수발법을 중심으로-)

  • 정상숙;조효순
    • Journal of the Korean Society of Costume
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    • v.41
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    • pp.95-105
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    • 1998
  • SOO-BAL(Hair Style) is a method Which match hair style to face and clothes with using hair covering and protecting the head. Also SOO-BAL includes personal ornaments using to avoid one's hair be disheveled. In a standpoint of beauty and spirit, etiquette SOO-BAL is a very important thing as one being dressed up. Until now, since just a form of hair style have been studied, hair styling process is nothing to be known and studied. Time after time, our unique traditional SOO-BAL is forgotten with clothes and then this th-esis will be classified hair styling form follow-ing a form of hair style in royal palace of the C-hosun dynasty. According to the record of HAE DONG HISTORY, it shows the same of attire between Ko-rean and chinese style in ae of the chosun. The reason in that there were no any certain boundary border and the interaction of culture between two countries was happened spontaneously at ancient time like the GOCHO-SUN age. Until the period of the three states, the korean attire be changed had gone with chinese one s-imilarly. The chinese form gave to influence on the EONJIN MEURI·POON-GI-MYEONG MEURI·JJO-CJIN MEURI·MOOK-EUN GOONG-BAL MEURI·OL-LIN MEURI·SSANGSANG-TU ME-URI be drawn wall painting in the KOKUR-YU. And a gold chignon accesso-ry unearthed in a MOO-RYOUNG royal mausoleum is proof of the korean attrire be changed with chinese. In the shilla dynasty at three years after Cjin-Deuk(A.D. 649) reign. It was recorded that the dynasty let women wear the form of chinese attire. Also in the koryo dyn-asty, a rod-like hairpin (BIN-YEU) and DANG-GI employing EON-JIN MEURI was used. The SOO-BAL based on the Confucianism had lots of regulations which limited to use ornaments with classes of society in the CHOSUN dynasty. Until YOUNG CHO and CHUNG CHO period. EONJIN MEURI be decorated GACHAE was announced by dynasty as ind-ulging in luxury. Women of yangban used a rod-like hairpin and a chignon accessory made by jewerly. And 1-owly women weared a rod-like hairpin made of born and wood to perfom EONJIN MEURI with PUNCHAE. Most unmarried women decorated with DDA-AH-NEULIN MEURI, GUI-MIT MEURI, specially in palace with SAE-ANG MEURI. At palace, one put on a full dress with KEUN MEURI, and a simple dress with ER-YEO MEURI be decorated DDERL-JAM The CHOP-JI MEURI manifested social rank, class. Kids at CHO-SUN age had BA-DUK-PANMEURI and JONG-JONG MEURI. The ornament things are GACHE, DDERL JAM with EON-JIN M-EURI, and all kinds of rod-like hairpin and chignon accessory used in JJOK MEURI. IN DANGGE, JE-BI-BURI DANGGI used by ummarried women. DO-TOO-RAK DANGGI and AP DANGGI on a dress suit, and BE-SSI DANGGI used by 3∼4 years ungrown kids etc. were used. And at palace, kinds of CHUPJI used with JJOK MEURI showed social rank. In CHOSUN age, women want to keep shiny hair washed at TA-NO festival day, a treatment of bald hair used a forked remedy. In CHOSUN age, woman Soo-Bal hair style has DAE-SOO·DDEU-KOO-JI MEURI·CHO-P-GI MEURI·EON-JIN MEURI·SAE-ANG MEURI· and so on. We could find out Soo-Bal was developed very well by these variety hair styles. I attatched all of the hair style pictures step by step, and also explained detail my research foll owing these pictures.

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Parent Materials and Pedogenic Properties of the "Yongil" Series Distributed in Eastern Coastal Area of Korea (한국 동남해안지대에 분포된 영일통의 모재와 생성학적 특성)

  • Yun, Eul-Soo;Jung, Yeun-Tae;Son, Il-Soo;Jung, Ki-Yuol;Lee, Dong-Chang
    • Korean Journal of Soil Science and Fertilizer
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    • v.35 no.3
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    • pp.137-144
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    • 2002
  • To obtain the basic information about pedo-genetic properties and origin of the parent materials of "Yongil" series in Korea, this study was conducted. The soil characteristics such as chemical and sand particles of typifying pedon, and distributional patterns in the area were analysed. The typifying pedon of "Yongil" series was distributed on the top of rolling area in the eastern coastal area of Korea, Yonggan-ri, Heunghae-eup, Pohang-si, Gyongbuk province. The results are as follows; The "Yongil" series in Korea was distributed on the rolling hill under altituede of 50m, and was used for cultivated upland, and the total acreage about 376ha. The content of sand was more than 50%, however the clay content in the depth of 40~100cm of the soil profile rapidly increased. The medium sand (0.5~0.1mm in size) are dominant among sand fraction, but coarse one are rare. So the rate of medium to total sand was higher in IIB horizon as 0.62~0.76 than A and C horizons. The content of heavy minerals in medium sand was low as 1.0~6.6% and the ratio of quartz to feldspars was higher in Ap2 and B1 horizon as 1.7 than IIB horizon which had less than 1.39. The cumulative curves of sand particles in Yeongil series showed the well sorted and differ from residuum soils derived from sand stone, but similar to dune soils(Haeri series). So it could be deducted from this study that "Yeongil" series are aeolian deposits derived from aeolian materials and have bisequum profile; the upper part depth of 40cm was recent cover sand, the horizon of 40~100cm depth was developed in Pleistocene epoch from the same materials.

Objective Analysis of the Set-up Error and Tumor Movement in Lung Cancer Patients using Electronic Portal Imaging Device (폐암 환자에서 Electronic Portal Imaging Device를 이용한 자세 오차 및 종양 이동 거리의 객관적 측정)

  • Kim, Woo-Cheol;Chung, Eun-Ji;Lee, Chang-Geol;Chu, Sung-Sil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.69-76
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    • 1996
  • Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.

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Effects of Soil Bulk Density on Saturated Hydraulic Conductivity and Solute Elution Patterns (토양의 용적밀도에 따른 포화수리전도도 및 음이온의 용출양상)

  • Kim, Pil-Joo;Lee, Do-Kyoung;Chung, Doug-Young
    • Korean Journal of Soil Science and Fertilizer
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    • v.30 no.3
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    • pp.234-241
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    • 1997
  • The effects of bulk densities(${\rho}_b$) on saturated hydraulic conductivity (Ksat) and solute elution patterns were investigated from five different bulk densities ranging from $1.1Mg/m^3$ to $1.5Mg/m^3$ with each increment of $0.1Mg/m^3$. The hydraulic conductivities observed were divided into two stages: (1) a linearly decrease with increase in bulk density up to $1.4Mg/m^3$, (2) a steady state where the bulk density is greater than $1.4Mg/m^3$. Using the saturated hydraulic conductivity at the steady state, we figured out the equation describing the correlation between bulk densities(${\rho}_b$) and saturated hydraulic conductivity(Ksat) as follows: $Ksat=-19.2({\rho}_b{^2})+6{\rho}_b+15.5$, (r=0.985). Electrical conductivity(EC) measured from the leachate of the soil column showed that EC at the same pore volume were decreased with an increase in the bulk density from $1.2g/cm^3$, $1.5g/cm^3$, as shown in the time taken to collect the same pore volume at each respective bulk density. The maximum relative concentrations (C/Co=1) from the breakthrough curves for the anions of $Cl^-$, $NO_3{^-}$ and $SO_4{^{2-}}$, which are weakly adsorbed on the soil particles, moved to the right of the graph, while a distinctive retardation occurs at the bulk density between $1.3Mg/m^3$ and $1.4Mg/m^3$. The time taken to recover about 90% of indigenous sulphate was approximately twice as those of chloride and nitrate, resulting in slightly stronger adsorption characteristics for sorption sites on the soil surface. Thus, we can conclude that the salt accumulation in green house soil might be significantly influenced by it's bulk density at the soil depth, as well as the adsorption capacity of ions for the sorption sites in soils.

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Effect of Dietary Supplementation of Vitamin A and Chronic Consumption of Ethanol on Oxidative Damage and Antioxidant System in Rats (비타민 A 보충 식이 및 에탄올의 만성적 급여가 흰쥐의 체내 산화적 손상과 항산화체계에 미치는 영향)

  • 양경미
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.2
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    • pp.278-286
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    • 2003
  • Alcohol is well known agent which can damage the human tissues such as liver via stimulating lipid peroxidation. On the other hand, carotenoids in addition to vitamins A, C and I play important roles in protecting these oxidative damages as well as preventing the production of free radicals. This study was carried out to investigate the effect of dietary vitamin A on lipid peroxidation and antioxidants status in ethanol-treated rats. In the experiment, male Sprague-Dawley rats weighing 160~180 g were given a liquid diet containing 36% of total calories as ethanol for 7 weeks. The pair-fed control rats received an isocaloric amount of diet containing sucrose instead of ethanol on the following day Additionally, the liquid diet contained adequate amount of $\beta$-carotene, retinyl acetate or 13-sis-reinoic acid except vitamin A-deficient diet. The results obtained are as follows. The levels of plasma and hepatic lipid peroxide were increased after chronic ethanol feeding in rats. Retinyl acetate supplementation significantly reduced lipid peroxidation induced by ethanol feeding Glucose 6-phosphatase activity was significantly reduced in rats fed vitamin A-deficient diet with ethanol and alkaline phosphatase activity was significantly induced in rats fed 13-cis-reinoic acid diet with ethanol. Catalase and alcohol dehydrogenase activities did not show a consistent tendency in experiment groups. The hepatic antioxidant enzyme activities did not significantly changed by chronic ethanol feeding groups. The striking decrease in conversion of $\beta$-carotene to retinol was observed in rats fed a $\beta$-carotene diet with ethanol feeding The level of retinol and retinoic acid in plasma and liver was decreased after chronic ethanol administration Based on this result, these data suggest that ethanol feeding enhances oxidative stress especially in those fed a vitamin A-deficient diet, and vitamin A supplementation, especially, retinyl acetate intake can prevent enhanced lipid peroxidation and related damage to some extent.

Influence of additional etching on shear bond strength of self-etching adhesive system to enamel (부가적인 산부식이 자가산부식 접착제의 법랑질에 대한 전단결합강도에 미치는 영향)

  • Yoo Sun-Jin;Kim Young-Kyung;Park Jeong-Won;Jin Myoung-Uk;Kim Sung-Kyo
    • Restorative Dentistry and Endodontics
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    • v.31 no.4
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    • pp.263-268
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    • 2006
  • Recently, self-etching adhesive system has been introduced to simplify the clinical bonding proce- dures. It is less acidic compared to the phosphoric acid, thus there is doubt whether this system has enough bond strength to enamel. The purpose of this study was to investigate the influence of additional etching on the adhesion of resin composite to enamel. Ninety extracted bovine permanent anterior teeth were used. The labial surfaces of the crown were ground with 600-grit abrasive paper under wet condition. The teeth were randomly divided into six groups of 15 teeth each. Clearfil SE $Bond^{\circledR},\;Adper^{TM}$ Prompt L-Pop and Tyrian $SPE^{TM}$ were used as self-etching primers. Each self-etching primers were applied in both enamel specimens with and without additional etching. For additional etching groups, enamel surface was pretreated with 32% phosphoric acid (UNI-ETCH, Bisco, Inc., Schaumburg, IL. USA). Hybrid resin composite Clearfil AP-X, (Kuraray Co., Ltd., Osaka, Japan) was packed into the mold and light-cured for 40 seconds. Twenty-four hours after storage, the specimens were tested in shear bond strength. The data for each group were subjected to independent t - test at p < 0.01 to make comparisons among the groups. In Clearfil SE $Bond^{\circledR}$, shear bond strength of additional etching group was higher than no additional etching group (p < 0.01). In $Adper^{TM}$ Prompt L-Pop and Tyrian SPE, there were no significant difference between additional etching and non-etching groups (p > 0.01). In conclusion, self-etching adhesive system with weak acid seems to have higher bond strength to enamel with additional etching, while self-etching adhesive system with strong acid seems not.

Taxonomical Classification and Genesis of Asan Series Distributed on Rolling and Hilly Areas (구릉지 토양인 아산통의 분류 및 생성)

  • Song, Kwan-Cheol;Hyun, Byung-Geun;Sonn, Yeon-Kyu;Park, Chan-Won;Chun, Hyen-Chung;Moon, Yong-Hee
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.6
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    • pp.1258-1263
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    • 2011
  • This study was conducted to reclassify Asan series based on the second edition of Soil Taxonomy and to discuss the formation of Asan series distributed on the rolling to hilly areas. Morphological properties of typifying pedon of Asan series were investigated and physico-chemical properties were analyzed according to Soil survey laboratory methods manual. The typifying pedon of Asan series has dark yellowish brown (10YR 4/4) gravelly loam Ap horizon (0-18 cm), strong brown (7.5YR 5/6) gravelly clay loam BA horizon (18-30 cm), red (2.5YR 4/6) gravelly clay loam Bt1 horizon (30-52 cm), red (2.5YR 4/8) gravelly clay loam Bt2 horizon (52-98 cm), and red (2.5YR 4/8) gravelly clay loam C horizon (98-160 cm). The typifying pedon has an argillic horizon from a depth of 30 to 98 cm and a base saturation (sum of cations) of less than 35% at 125 cm below the upper boundary of the argillic horizon. It can be classified as Ultisol, not as Inceptisol. It has udic soil moisture regime, and can be classified as Udult. Also that meets the requirements of Typic Hapludults. It has 18-35% clay at the particle-size control section, and has mesic soil temperature regime. Therefore Asan series can be classified as fine loamy, mesic family of Typic Hapludults, not as fine loamy, mesic family of Typic Dystrudepts. Asan series occur on rolling to hilly areas in residual materials derived from granite gneiss, schist, and gneiss rocks. They are developed as Ultisols with clay mineral weathering, translocation of clays to accumulate in an argillic horizon, and leaching of base-forming cations from the profile for relatively long periods under humid and temperate climates in Korea.