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Supraclavicular Brachial Plexus block with Arm-Hyperabduction (상지(上肢) 외전위(外轉位)에서 시행(施行)한 쇄골상(鎖骨上) 상완신경총차단(上腕神經叢遮斷))

  • Lim, Keoun;Lim, Hwa-Taek;Kim, Dong-Keoun;Park, Wook;Kim, Sung-Yell;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.214-222
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    • 1988
  • With the arm in hyperabduction, we have carried out 525 procedures of supraclavicular brachial plexus block from Aug. 1976 to June 1980, whereas block with the arm in adduction has been customarily performed by other authors. The anesthetic procedure is as follows: 1) The patient lies in the dorsal recumbent position without a pillow under his head or shoulder. His arm is hyperabducted more than a 90 degree angle from his side, and his head is turned to the side opposite from that to be blocked. 2) An "X" is marked at a point 1 cm above the mid clavicle, immediately lateral to the edge of the anterior scalene muscle, and on the palpable portion of the subclavian artery. The area is aseptically prepared and draped. 3) A 22 gauge 3.5cm needle attached to a syringe filled with 2% lidocaine (7~8mg/kg of body weight) and epineprine(1 : 200,000) is inserted caudally toward the second portion of the artery where it crosses the first rib and parallel with the lateral border of the muscle until a paresthesia is obtained. 4) Paresthesia is usually elicited while inserting the needle tip about 1~2 em in depth. If so, the local anesthetic solution is injected after careful aspiration. 5) If no paresthesia is elicited, the needle is withdrawn and redirected in an attempt to elicit paresthesia. 6) If, after several attempts, no paresthesia is obtained, the local anesthetic solution is injected into the perivascular sheath after confirming that the artery is not punctured. 7) Immediately after starting surgery, Valium is injected for sedation by the intravenous route in almost all cases. The age distribution of the cases was from 11 to 80 years. Sex distribution was 476 males and 49 females (Table 1). Operative procedures consisted of 103 open reductions, 114 skin grafts combined with spinal anesthesia in 14, 87 debridements, 75 repairs, i.e. tendon (41), nerve(32), and artery (2), 58 corrections of abnormalities, 27 amputations above the elbow (5), below the elbow (3) and fingers (17), 20 primary closures, 18 incisions and curettages, 2 replantations of cut fingers. respectively (Table 2). Paresthesia was obtained in all cases. Onset of analgesia occured within 5 minutes, starting in the deltoid region in almost all cases. Complete anesthesia of the entire arm appeared within 10 minutes but was delayed 15 to 20 minutes in 5 cases and failed in one case. Thus, our success rate was nearly 100%. The duration of anesthesia after a single injection ranged from $3\frac{1}{2}$ to $4\frac{1}{2}$, hours in 94% of the cases. The operative time ranged from 0.5 to 4 hours in 92.4% of the cases(Table 3). Repeat blocks were carried out in 33 cases when operative times which were more than 4 hours in 22 cases and the others were completed within 4 hours (Table 4). Two patients of the 33 cases, who received microvasular surgery were injected twice with 2% lidocaine 20 ml for a total of $13\frac{1}{2}$ hours. The 157 patients who received surgery on the forearms or hands had pneumatic tourniquets (250 torrs) applied without tourniquet pain. There was no pneumothorax, hematoma or phrenic nerve paralysis in any of the unilateral and 27 bilateral blocks, but there was hoarseness in two, Horner's syndrome in 11 and shivering in 7 cases. No general seizures or other side effects were observed. By 20ml of 60% urcgratin study, we confirm ed the position of the needle tip to be in a safer position when the arm is in hyperabduction than when it is in adduction. And also that the humoral head caused some obstraction of the distal flow of the dye, indicating that less local anesthetic solution would be needed for satisfactory anesthesia. (Fig. 3,4).

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Treatment Level of a Pond System for Ecological Treatment and Recycling of Animal Excreta (생태적 축산폐수 처리 및 재활용 연못시스템의 폐수처리수준)

  • Yang, Hong-Mo;Rhee, Chong-Ouk
    • Korean Journal of Environmental Agriculture
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    • v.17 no.1
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    • pp.70-75
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    • 1998
  • A model of pond system is developed for treatment and recycling of excreta from twenty-five adult dairy cattle. It is composed of wastewater treatment ponds and small fish ponds. Those are three facultative ponds in series; primary-secondary-tertiary pond and these are designed to rear carps without feeding. A pit is constructed at the bottom of primary pond for efficient sludge sedimentation and effective methane fermentation. It is contrived to block into it the penetration of oxygen dissolved in the upper layer of pond water. The excreta from the cattle housed in stalls are diluted by water used for clearing them. The washed excreta flow into the pit. The average yearly $BOD_5$ concentration of influent is 398.7mg/l. That of the effluent from primary, secondary and tertiary pond of the system is 49.18, 27.9, and 19.8.mg/l respectively. Approximate 88, 93, and 95 % of BOD5 are removed in each pond. The mean yearly SS concentration of influent is 360.5 mg/l That of the effluent from each pond is 53.4, 45.7, and32.7mg/l respectively. Approximate 86, 88, and 91% of SS are removed in each pond. The $BOD_5$ concentration of secondary and tertiary pond can satisfy 30mg/l secondary treatment standard. The SS concentration of effluent from tertiary pond, however, is slightly greater than the standard, which results from activities of carps growing in the pond. The average yearly total nitrogen concentration of influent is 206.8mg/l and that of the effluent from each pond is 48.6, 30.8, and 21.0mg/l respectively. Approximate 74, 88, and 90% of total nitrogen are removed in each pond. The mean yearly total phosphorous concentration of influent is 20.7mg/l and that of the effluent from each pond is 5.3, 3.2, and 2.1mg/l respectively. Approximate 97, 98, and 99% of total phosphorous are removed in each pond. The high removal of nitrogen and phosphorous results from active growth of algae in the upper layer of pond water. Important pond design parameters for southern part of Korea -- areal loading of BOD5, liquid depth, hydraulic detention time, free board, and pond arrangement -- are taken up.

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Experimental Study on the Hysteresis of Suction Stress in Unsaturated Sand (불포화 모래의 흡입응력 이력현상에 대한 실험적 연구)

  • Song, Young-Suk;Choi, Jin-Su;Kim, Gyo-Won
    • The Journal of Engineering Geology
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    • v.22 no.2
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    • pp.145-155
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    • 2012
  • The matric suction and volumetric water content of Jumunin standard sand with a relative density of 60% were measured using an Automated Soil-Water Characteristic Curve (SWCC) apparatus during both drying and wetting processes. The test time for the drying process was longer than that for the wetting process, because the flow of water is likely to be protected by air trapped in voids within the soils during the drying process. Based on the matric suction and volumetric water content, the SWCC was estimated using the model proposed by van Genuchten (1980). For the drying process, the unsaturated fitting parameters ${\alpha}$, n, and m were 0.399, 8.586, and 0.884, respectively; for the wetting process, the values were 0.548, 5.625, and 8.220, respectively. The hysteresis phenomenon occurred in the SWCCs, which means the SWCC of the drying process is not matched with the SWCC of the wetting process. Using these unsaturated parameters, we estimated the Suction Stress Characteristic Curve (SSCC), based on the relationship between suction stress and the effective degree of saturation. The suction stress showed a rapid decrease when the matric suction exceeds the Air Entry Value (AEV). Therefore, the effective stress of unsaturated soils is different from that of saturated soils when the matric suction exceeds the AEV. The suction stress of the drying process exceeds that of the wetting process for a given effective degree of saturation. The hysteresis phenomenon was also recognized in SSCCs. The hysteresis phenomenon of SSCCs arises from that of SWCCs, which is induced by the ink bottle effect and the contact angle effect. In the case of a sandy slope, the suction stress is positive and acts to enhance the slope stability as the water infiltrates the ground, but is negative when the suction stress exceeds the AEV. The results obtained for the wetting process should be applied in analyses of slope stability, because the process of water infiltration into ground is similar to the wetting process.

Expression of Neuronal Nitric Oxide Synthase (nNOS) in Developing Rat Kidney (분화중인 흰쥐 콩팥의 요세관에서 nNOS의 발현)

  • Song, Ji-Hyun;Ryu, Si-Yun;Kim, Jin;Jung, Ju-Young
    • Applied Microscopy
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    • v.38 no.2
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    • pp.141-148
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    • 2008
  • Nitric oxide (NO) is an important regulator of renal blood flow, glomerular hemodynamics, and tubule transport processes in the kidney. There is also evidence that NO is involved in cell cycle regulation and mitotic division. During development the nNOS expression pattern differs from that observed in adult animals. However, little is known about temporal and spatial patterns of nNOS expression in the developing kidney. The purpose of this study was to establish the time of expression and the distribution of nNOS in the developing rat kidney. Kidneys from 14-, 16-, 17-, 18-, and 20-day-old fetuses, 1-, 4-, 7-, 14-, and 21-day-old pups, and adult animals were preserved and processed for immunohistochemistry. In the adult kidney, nNOS was detected in the parietal epithelium of Bowman s capsule, macula densa, descending thin limb and inner medullary collecting duct. nNOS immunoreactivity appeared first in the distal tubule anlage at 15 days of gestation, and in all epithelial cells of developing thick ascending limbs (TAL) as well as macula densa of 17- and 18-day-old fetuses. From 20 days of gestation to 14 days after birth, nNOS was expressed in the newly formed cortical TAL, which are located in the medullary ray, whereas in mature TAL of juxtamedullary nephrons, nNOS immunolabeling gradually decreased in intensity and became restricted to the macula densa. In inner medullary collecting ducts, nNOS immunoreactivity appeared first at 7 days after birth in the papillary tip and gradually ascended to the border between outer and inner medulla. In the descending thin limb and parietal epithelium of Bowman's capsule, weak nNOS immunoreactivity was observed at 14 days after birth and labeling gradually increased to adult levels at 21 days after birth. These results suggest that differential expression of nNOS in the developing kidney is an important physiological regulator of renal function during kidney maturation.

Influence of the Asian Monsoon on Seasonal Fluctuations of Water Quality in a Mountainous Stream (산간 계류성 하천의 계절적 수질변동에 대한 몬순강우의 영향)

  • Shin, In-Chul;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.38 no.1 s.110
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    • pp.54-62
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    • 2005
  • The present study was to determine how seasonal rainfall intensity influences nutrient dynamics, ionic contents, oxygen demands, and suspended solids in a lotic ecosystem. Largest seasonal variabilities in most parameters occurred during the two months of July to August and these were closely associated with large spate of rainfall. Dissolved oxygen (DO) had an inverse function of water temperature (r = = = - 0.986, p<0.001). Minimum pH values of<6.5 were observed in the late August when rainfall peaked in the study site, indicating an ionic dilution of stream water by precipitation. Electrical conductivity (EC) was greater during summer than any other seasons, so the overall conductivity values had direct correlation (r = 0.527, p<0.01) with precipitation. Ionic dilution, however, was evident 4 ${\sim}$ 5 days later in short or 1 ${\sim}$ 2 weeks in long after the intense rain, indicating a time-lag phenomenon of conductivity. Daily COD values varied from 0.8 mg $L^{-1}$ to 7.9 mg $L^{-1}$ and their seasonal pattern was similar (r = 0.548, p<0.001) to that of BOD. Total nitrogen (TN) varied little compared to total phosphorus (TP) and was minimum in the base flow of March. In contrast, major input of TP occurred during the period of summer monsoon and this pattern was similar to suspended solids, implying that TP is closely associated (r = 0.890, p<0.01) with suspended inorganic solids. Mass ratios of TN : TP were determined by TP (r= -0.509, p<0.01) rather than TN (r= -0.209, p<0.01). The N : P ratios indicated that phosphorus was a potential primary limiting nutrient for the stream productivity. Overall data suggest that rainfall intensity was considered as a primary key component regulating water chemistry in the stream and maximum variation in water quality was attributed to the largest runoff spate during the summer monsoon.

The physical geography in general:yesterday and tomorrow (자연지리학 일반: 회고와 전망)

  • Son, Ill
    • Journal of the Korean Geographical Society
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    • v.31 no.2
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    • pp.138-159
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    • 1996
  • There has been a tendency for Geomorphology and Climatology to be dominant in Physical Geography for 50 years in Korea. Physical Geography is concerned with the study of the totality of natural environment through the integrated approaches. But, an overall direction or a certain paradigm could not be found, because major sub-divisions of Physical Geography have been studied individually and the subjects and the approaches in studying Physical Geography are enormously diverse. A consensus of opinion could not also exist in deciding what kind of the sub-divisions should be included in the physical geography in general and how those should be summarized. Furthermore it would be considered imprudent to survey the studies of Physical Geography besides those of Geomorphology and Climatology due to the small number of researchers. Assuming that the rest of Physical Geographical studies with the exception of Geomorphological and Climatological studies are the Physical Geography in general, the studies of Physical Geogrpahy in general are summarized and several aspects are drown out as follows. First the descliption of all possible factors of natural environments was the pattern of early studies of Physical Geography and the tendency is maintained in the various kinds of research and project reports. Recently Physical Geographers have published several introductory textbooks or research monographs. In those books, however, the integrated approaches to Physical Geography were not suggested and the relationship between man and nature are dealt with in the elementary level. Second, the authentic soil studies of Physical Geographers are insignificant, because the studies of soil in Physical Geography have been mostly considered as the subsidiary means of Geomorphology Summarizing the studies of Soil Gegraphy by physical geographers and other Pedologists, the subjects are classified as soil-forming processes, soil erosions, soil in the tidal flat and reclaimed land, and soil pollution. Physical Geographers have focused upon the soil-forming processes in order to elucidate the geomorphic processes and the past climatic environment. The results of other subjects are trifling. Thirdy Byogeygrayhers and the results of studies are extremely of small number and the studies of Biogeography in Korea lines in the starting point. But, Biogeography could be a more unifying theme for the Physical-human Geography interface, and it would be expected to play an active part in the field of environmental conservation and resource management. Forth, the studies of Hydrogeography (Geographical Hydrology) in Korea have run through the studies of water balance and the morphometric studies such as the drainage network analysis and the relations of various kinds of morphometric elements in river. Recently, the hydrological model have introduced and developed to predict the flow of sediment, discharge, and ground water. The growth of groundwater studies is worthy of close attention. Finally, the studies on environmental problems was no mole than the general description about environmental destruction, resource development, environmental conservation, etc. until 1970s. The ecological perspectives on the relationship between man and nature were suggested in some studies of natural hazard. The new environmentalism having been introduced since 1980s. Human geographers have lead the studies of Environmental Perception. Environmental Ethics, Environmental Sociology, environmental policy. The Physical geographers have stay out of phase with the climate of the time and concentrate upon the publication of introductory textbooks. Recently, several studies on the human interference and modification of natural environments have been made an attempt in the fields of Geomorphology and climatology. Summarizing the studies of Physical Geography for 50 years in Korea, the integrated approaches inherent in Physical Geography disappeared little by little and the majol sub-divisions of Physical Ceography have develop in connection with the nearby earth sciences such as Geology, Meteorology, Pedology, Biology, Hydrology, etc been rediscovered by non-geographers under the guise of environmental science. It is expected that Physical Geography would revive as the dominant subject to cope with environmental problems, rearming with the innate integrated approaches.

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A Method of Evaluating the Spatial Difference between Two Numerical Surfaces (두 개의 수치 평면에 대한 공간적 차이의 측정 방법)

  • Lee Jung-Eun;Sadahiro Yukio
    • Journal of the Korean Geographical Society
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    • v.41 no.2 s.113
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    • pp.212-226
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    • 2006
  • Surface data generally represent continuous distribution of geographical or social phenomena of a region in urban analysis. Instances include distribution of temperature, population of region, and various distributions related to human activities. When spatial data are given in the form of surface, surface comparison is required as a way of comprehending the surface change or the relationship between two surfaces. As for previous approaches of surface comparison, there are visualization, quantitative methods and qualitative method. All those approaches, however, show the difference between two surfaces in a limited way. Especially, they are not able to distinguish spatial difference between two surfaces. To overcome such problem, this paper proposes a method of comparing two surfaces in terms of their spatial structure. Main concept of the method comes from earth moving problem and the method is named minimum surface transformation, here. When a surface is transformed into another, total surface volume moved in the process of transformation should be the minimum. Both quantitative and spatial differences between two surfaces are evaluted by total surface volume moved and the distribution of moved surface volume of each cell respectively. The method is applied to hypothetical and actual data. From the former, it is understood that the method explains how two surfaces are quantitatively and spatially different. The result of the latter shows that moved total surface volume decreases as time goes by which fits the actual situation that population change rate gets smaller. Concerning the other measure of surface difference, the distribution of $X_{ij}$ describes detailed flow of surface volume than that of simply subtracting surface volume by indicating to what direction the population change occurs.

The Effect of Inhibition of Heme Oxygenase-1 on Chemosensitivity of Cisplatin in Lung Cancer Cells (폐암세포주에서 Heme Oxygenase-1의 억제가 Cisplatin의 항암제 감수성에 미치는 영향)

  • Kim, So-Young;Kim, Eun-Jung;Jang, Hye-Yeon;Hwang, Ki-Eun;Park, Jung-Hyun;Kim, Hwi-Jung;Jo, Hyang-Jeong;Yang, Sei-Hoon;Jeong, Eun-Taik;Kim, Hak-Ryul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.33-42
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    • 2007
  • Background: Heme oxygenase-1 (HO-1) is known to modulates the cellular functions, including cell proliferation and apoptosis. It is known that a high level of HO-1 expression is found in many tumors, and HO-1 plays an important role in rapid tumor growth on account of its antioxidant and antiapoptotic effects. Cisplatin is a widely used anti-cancer agent for the treatment of lung cancer. However, the development of resistance to cisplatin is a major obstacle to its use in clinical treatment. We previously demonstrated that inhibiting HO-1 expression through the transcriptional activation of Nrf2 induces apoptosis in A549 cells. The aim of this study was to determine of the inhibiting HO-1 enhance the chemosensitivity of A549 cells to cisplatin. Materials and Methods: The human lung cancer cell line, A549, was treated cisplatin, and the cell viability was measured by a MTT assay. The change in HO-1, Nrf2, and MAPK expression after the cisplatin treatment was examined by Western blotting. HO-1 inhibition was suppressed by ZnPP, which is a specific pharmacologic inhibitor of HO activity, and small interfering RNA (siRNA). Flow cytometry analysis and Western blot were performed in to determine the level of apoptosis. The level of hydrogen peroxide ($H_2O_2$) generation was monitored fluoimetrically using 2',7'-dichlorofluorescein diacetate. Results: The A549 cells showed more resistance to the cisplatin treatment than the other cell lines examined, whereas cisplatin increased the expression of HO-1 and Nrf2, as well as the phosphorylation of MAPK in a time-dependent fashion. Inhibitors of the MAPK pathway blocked the induction of HO-1 and Nrf2 by the cisplatin treatment in A549 cells. In addition, the cisplatin-treated A549 cells transfected with dither the HO-1 small interfering RNA (siRNA) or ZnPP, specific HO-1 inhibitor, showed in a more significantly decrease in viability than the cisplatin-only-treated group. The combination treatment of ZnPP and cisplatin caused in a marked increase in the ROS generation and a decrease in the HO-1 expression. Conclusion: Cisplatin increases the expression of HO-1, probably through the MAPK-Nrf2 pathway, and the inhibition of HO-1 enhances the chemosensitivity of A549 cells to cisplatin.

Characteristic Distributions of Nutrients and Water Quality Parameters in the Vicinity of Mokpo Harbor after Freshwater Inputs (담수 유입에 따른 목포항 주변해역의 영양염 및 수질인자 분포 특성)

  • Kim, Yeong-Tae;Choi, Yoon-Seok;Cho, Yoon-Sik;Choi, Yong Hyeon;Jeon, Seungryul
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.21 no.6
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    • pp.617-636
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    • 2015
  • The Mokpo coastal waters receive discharges from three artificial lakes(Youngsan, Youngam, Geumho) and other terrigenous freshwater inflows(streams, sewage treatment effluent, fresh groundwater), which exhibit very high concentrations of nutrients and/or organic matters. To understand spatial distributions of nutrients(DIN, DIP, DSi) and other water quality parameters(Chl-a, water temperature, salinity, DO, COD, SS), field surveys were conducted at 10 stations in the Mokpo harbor and adjacent estuaries on May, July, September, and November 2008 within 10 days following discharge events from artificial lakes. In this study, the freshwater flow rate influxed by the operation of sea dike sluice had significant influence on water qualities of the Mokpo coastal waters, although nutrient concentrations in other freshwater sources such as streams, sewage treatment effluent, and fresh groundwater were much higher. As a result of statistical analysis, DIN, COD, and Chl-a had a negative correlation with salinity. Therefore it was shown that discharge extents, time, and nutrients from the Youngsan lake were major impact factors dominating the spatial characteristics of nutrients and other water quality parameters in the Mokpo harbor and adjacent waters. However, despite non-discharge from the Youngsan Lake on September of this investigated period, it was observed that the nutrient addition was taking place in the lower layer of the estuary suggesting nutrient supply through different pathways. This result has emphasized the need to implement the combined assessment about the cumulative impacts on the Youngsan Estuary environment and ecosystem due to freshwater inputs derived from the artificial lakes as well as other terrigenous inflows, or benthic releases.

The Prototype and Structure of the Water Supply and Drainage System of the Wolji Pond During the Unified Silla Period (통일신라시대 월지(月池) 입·출수 체계의 원형과 구조)

  • Kim, Hyung-suk;Sim, Woo-kyung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.124-141
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    • 2019
  • This research explored the relationship between the water quality issue of Wolji Pond (Anapji Pond) with the maintenance of the channel flow circulation system. The water supply and drainage system closely related to the circulation system of pond has been reviewed, rather than the existing water supply and drainage system that has been analyzed in previous studies. As a result of reviewing the water supply system, it has been learned that the water supply system on the southeastern shore of Wolji Pond, being the current water supply hole, has been connected to the east side garden facility (landscaping stone, curved waterway, storage facility of water) between the north and south fence and the waterway. This separate facility group seems to have been a subject of the investigation of the eastern side of Wolji Pond, with the landscaping stones having been identified in the 1920's survey drawings. The water supply facility on the southeastern shore, being the suspected water supply hole, seems to have some connection with the granite waterway remaining on the building site of Imhaejeon (臨海殿) on the southern side of Wolji Pond. It is inferred that it provides clean water, seeing that the slope towards the southwestern shore of Wolji Pond becomes lower, the landscaping stones have been placed in the filter area, and it is present in the 1920's survey drawings and the water supply hole survey drawing of 1975. The water drainage facility on the northern shore is composed of five stages. The functions of the wooden waterway and the rectangular stone water catchment facility seem not to be only for the water drainage of Wolji Pond. In light of the points that there are wood plugs in the wooden waterway and that there is a water catchment facility in the final stage, it is judged that the water of Balcheon Stream (撥川) may be charged in reverse according to this setup. Namely, the water could enter and exit in either direction in the water drainage facility on the northern shore It also seems that the supply to the wooden waterway could be opened and shut through the water catchment facility of rectangular stone group as well. The water drainage facility on the western shore is very similar to the water drainage facility on the northern shore, so it is difficult to avoid the belief that it existed during the Silla Dynasty, or it has been produced by imitating the water drainage facility on the northern shore at some future point in time. It seems to have functioned as the water drainage facility for the supply of agricultural water during the Joseon Dynasty. The water supply and drainage facilities in Wolji Pond have been understood as a systematized distribution network that has been intertwined organically with the facility of Donggung Palace, which was the center of the Silla capital. Water has been supplied to each facility group, including Wolji Pond, through this structure; it includes the drainage system connecting to the Namcheon River (南川) through the Balcheon Stream, which was an important canal of the capital center.