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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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Agricultural Geography of Rice Culture in California (미국 캘리포니아주(州)의 벼농사에 관한 농업지리학적 연구)

  • Lee, Jeon;Huh, Moo-Yul
    • Journal of the Korean association of regional geographers
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    • v.2 no.1
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    • pp.51-67
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    • 1996
  • There are three main rice-growing regions in the United States: the prairie region along the Mississippi River Valley in eastern Arkansas; the Gulf Coast prairie region in southwestern Louisiana and southeastern Texas; and the Central Valley of California. The Central Valley of California is producing about 23% of the US rice(Fig. 1). In California. most of the crop has been produced in the Colusa, Sutter, Butte, Glenn Counties of the Sacramento Valley since 1912, when rice was commercially grown for the first time in the state(Fig. 2). Roughly speaking, the average annual area sown to rice in California is about 300,000 acres to 400,000 acres during the last forty years(Fig. 3). California rice is grown under a Mediterranean climate characterized by warm, dry, clear days, and a long growing season favorable to high photosynthetic rates and high rice yields. The average rice yield per acre is probably higher in California than in any other rice-growing regions of the world(Fig. 4). A dependable supply of irrigation water must be available for a successful rice culture. Most of the irrigation water for California rice comes from the winter rain and snow-fed reservoir of the Sierra Nevada mountain ranges. Less than 10 percent of rice irrigation water is pumped from wells in areas where surface water is not sufficient. It is also essential to have good surface drainage if maximum yields are to be produced. Rice production in California is highly mechanized, requiring only about four hours of labor per acre. Mechanization of rice culture in California includes laser-leveler technology, large tractors, self-propelled combines for harvesting, and aircraft for seeding, pest control, and some fertilization. The principal varieties grown in California are medium-grain japonica types with origins from the cooler rice climates of the northern latitudes (Table 1). Long-grain varieties grown in the American South are not well adapted to California's cooler environment. Nearly all the rice grown recently in California are improved into semidwarf varieties. Choice of variety depends on environment, planting date, quality desired, marketing, and harvesting scheduling. The Rice Experiment Station at Biggs is owned, financed, and administered by the rice industry. The station was established in 1912, as a direct result of the foresight and effort of Charles Edward Chambliss of the United States Department of Agriculture. Now, The station's major effort is the development of improved rice varieties for California.

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Technical Standards and Safety Review of the Low and Intermediate Level Radioactive Waste Disposal Facility (중.저준위 방사성폐기물 처분시설에 대한 기술기준 및 안전심사)

  • Cheong, Jae-Hak;Lee, Kwan-Hee;Lee, Yun-Keun;Jeong, Chan-Woo;Rho, Byung-Hwan
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.6 no.4
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    • pp.357-368
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    • 2008
  • On July 31, 2008, the Government issued the construction and operation permit for the first low and intermediate level radioactive waste disposal facility in the Republic of Korea. In this paper, the fundamental regulatory framework, regulatory requirements and technical standards of the disposal facility are introduced, and the phased review process adopted for evaluation of the safety of the facility is briefly described. The Atomic Energy Act sets forth a stepwise regulatory framework for the whole life-cycle of the disposal facility such as siting, design, construction, operation, closure and institutional control. More detailed regulatory requirements and technical standards are stipulated in the subsequent regulations of the Atomic Energy Act and a series of Notices issued by the Ministry of Eduction, Science and Technology. The Korea Institute of Nuclear Safety, as entrusted by the Ministry under the Atomic Energy Act, conducted safety review on the disposal facility, and evaluated the compliance with relevant criteria in all technical elements(i.e. siting and structural safety, radiological environmental impact, operational safety, systems and components, quality assurance, and total systematic performance assessment, etc.). The overall safety review process can be phased into inception phase, initial review phase, main review phase and completion phase. The review results were reported to and deliberated by the five Sub-committees of the Special Committee on Nuclear Safety, and then reported to the Ministry. The Ministry issued the construction and operation permit of the disposal facility through the deliberation of the review results by the Nuclear Safety Commission. Hereafter, the safety of the repository will be reassured by a series of subsequent regulatory inspections and reviews under the Atomic Energy Act. In addition, the licensee's continuous implementation of the "Safety Promotion Plan" may also enhance the long-term safety of the repository and contribute to build-up the confidence of the safety case.

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Effect of Seedling Age on Growth and Yield at Transplanting of Sorghum (Sorghum bicolor L. Moench) (수수 묘의 이식 시기가 생육 및 수량에 미치는 영향)

  • Jo, Su-Min;Jung, Ki-Youl;Kang, Hang-Won;Choi, Young-Dae;Lee, Jae-Saeng;Jeon, Seung-Ho
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.61 no.1
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    • pp.50-56
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    • 2016
  • Direct seeding of sorghum (Sorghum bicolor L. Moench) has a problem of low yield including poor establishment. This poor establishment results from poor quality seed, poor seedbed preparation, seedling pests, poor sowing technique and high soil temperature. This study sought to establish the age at which sorghum seedlings can be transplanted with minimal effects on grain yield. Transplants were raised in 128 nursery tray pot. Five seedling ages were established by transplanting at 10 (T10), 15 (T15), 20 (T20), 25 (T25) and 30 (T30) days after planting (DAP). The treatment combinations were arranged in a randomized complete block design and replicated three times with an individual plot size of $6{\times}5m^2$. Each plot had five ridges with a planting space of $0.60{\times}0.20m^2$ at one plants per stand. Results showed that seedling age on transplanting significantly affected growths and yields to sorghum after transplanting. Plant heights and diameters of transplants at T15 were longer than the other transplants. Conclusively, The advantages of this practice were better control of crop density and greater yields; either to fill gaps after emerging and thinning of crops or to compensate for a growth period that was too short for a complete crop cycle.

Environmental effects from Natural Waters Contaminated with Acid Mine Drainage in the Abandoned Backun Mine Area (백운 폐광산의 방치된 폐석으로 인한 주변 수계의 환경적 영향)

  • 전서령;정재일;김대현
    • Economic and Environmental Geology
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    • v.35 no.4
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    • pp.325-337
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    • 2002
  • We examined the contamination of stream water and stream sediments by heavy metal elements with respect to distance from the abandoned Backun Au-Ag-Cu mine. High contents of heavy metals (Pb, Zn, Cu, Cd, Mn, and Fe) and aluminum in the waters connected with mining and associated deposits (dumps, tailings) reduce water quality. In the mining area, Ca and SO$_4$ are predominant cation and anion. The mining water is Ca-SO$_4$ type and is enriched in heavy metals resulted from the weathering of sulfide minerals. This mine drainage water is weakly acid or neutral (pH; 6.5-7.1) because of neutralizing effect by other alkali and alkaline earth elements. The effluent from the mine adit is also weakly acid or neutral, and contains elevated concentrations of most elements due to reactions with ore and gangue minerals in the deposit. The concentration of ions in the Backun mining water is high in the mine adit drainage water and steeply decreased award to down stream. Buffering process can be reasonably considered as a partial natural control of pollution, since the ion concentration becomes lower and the pH value becomes neutralized. In order to evaluate mobility and bioavailability of metals, sequential extraction was used for stream sediments into five operationally defined groups: exchangeable, bound to carbonates, bound to FeMn oxide, bound to organic matter, and residual. The residual fraction was the most abundant pool for Cu(2l-92%), Zn(28-89%) and Pb(23-94%). Almost sediments are low concentrated with Cd(2.7-52.8 mg/kg) than any other elements. But Cd dominate with non stable fraction (68-97%). Upper stream sediments are contaminated with Pb, and down area sediments are enriched with Zn. It is indicate high mobility of Zn and Cd.

Analysis of Algal Response Effects Using Nutrient Enrichment Bioassays in Shingu Reservoir (신구저수지 식물플랑크톤성장에 대한 제한 영양염 분석)

  • Lee, Jae-Yon;Lee, Sang-Jae;Lee, Jae-Hoon;Bae, Dae-Yeul;Choi, Ji-Woong;Hwang, Soon-Jin;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.41 no.spc
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    • pp.35-41
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    • 2008
  • Nutrient Enrichment Bioassays (NEBs) were conducted in the laboratory during June $22{\sim}28$, 2006 in order to determine primary limiting factor on the phytoplankton growth. For the NEBs, the water was sampled using a 10L polyethylene-lined container and dispensed into 2.5L container in the laboratory. The algal growths response in the control (C) and three treatments of phosphorus (P), 2-fold phosphorus (2P), and nitrate nitrogen $(NO_3-N)$ were monitored during 7 days. In the cubitainers which were spiked as P (T1) and 2P (T2) Chl-${\alpha}$ concentrations were decreased during the test period and the final concentrations was low than initial values. However, Chl-${\alpha}$ in the cubitainers which were spiked as $NO_3$(T3) and $P+NO_3$(T4) showed significant increases compared to the initial values, indicating that in the short-term experiments, nitrogen seemed to be a primary limiting nutrient during the periods of NEBs experiment. Long-term ambient nutrient data of TP and TN, and TN:TP mass ratios, however, showed a potential phosphorus limitation on phytoplankton growth and previous other researchers showed a variations of limiting nutrients by nitrogen or phosphorus depending on the seasons sampled and locations. In this study nitrogen as primary limiting nutrient in the NEBs seem to be an seasonal effect rather than the consistent nitrogen limitation.

Effects of Dissolved Oxygen and Depth on the Survival and Filtering Rate and Pseudofeces Production of a Filter-feeding Bivalve (Unio douglasiae) in the Cyanobacterial Bloom (남조류 대발생 환경에서 수심과 용존산소 변화에 따른 담수산 이매패(말조개)의 생존율, 여과율 및 배설물 생산)

  • Park, Ku-Sung;Kim, Baik-Ho;Um, Han-Yong;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.41 no.spc
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    • pp.50-60
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    • 2008
  • We performed the experiment to evaluate the effect of different DO concentrations (0.5, 4.5 and 9.0 $mgO_2L^{-1}$) and water depths (20, 50 and 80 cm) on the filtering rate, mortality, and pseudifeces production of Unio douglasiae against the cyanobacterial bloom (mainly Microcystis aeruginosa). A solitary-living bivalve U. douglasiae was collected in the upstream region of the North Han River (Korea). The harvested mussels were carefully transferred to the laboratory artificial management system, which was controlled temperature $(18{\pm}2^{\circ}C)$, flow rate (10L $h^{-1}$), food $(Chlorella^{TM})$, sediment (pebble and clay), light intensity (ca. $20{\mu}mol$ photons), and photocycle (12 L : 12 D). In the field observation, the mussel mortality was significantly correlated with water temperature, pH and DO concentration (P<0.05). The mortality was decreased with water depth; 65, 90, 80% of mortality at 20, 50, 80 cm water-depth, respectively. Filtering rate (FR) showed the highest value at 50 cm water depth, and thereby the concentration of chlorophyll-${\alpha}$ decreased continuously by 94% of the control at the end of the experiment. In contrast, FR decreased by 34% of the initial concentration at 20 cm water depth. Over the given water-depth range, the mussel FR ranged from $0.15{\sim}0.20L\;gAFDW^{-1}hr^{-1}$ during the 18hrs of experiment, and thereafter, they appeared to be approximately 0.11, 0.26 and 0.30 L $gAFDW^{-1}hr^{-1}$ at 20, 50 and 80cm water depth, respectively. FR was highest with the value of 0.46L $gAFDW^{-1}hr^{-1}\;at\;0.5mgO_2 L^{-1}$ at the early stage of the experiment, while it increased with DO concentration. Maximum pseudofaeces production was 11.2 mg $gAFDW^{-1}hr^{-1}\;at\;9.0mgO_2L^{-1}$. Our results conclude that U. douglasiae has a potential to enhance water quality in eutrophic lake by removing dominant cyanobacteria, but their effects vary with environmental parameters and the water depth at which they are located.

Agronomic Characteristics of Sorghum × Sudangrass Hybrids 'Cadan 99B' and 'Sweet Sioux WMR' in Middle and Southern Region of Korea (중부 및 남부지역에서의 수수 × 수단그라스 교잡종 'Cadan 99B' 및 'Sweet Sioux WMR' 품종특성)

  • Hwang, Tae-Young;Ji, Hee Chung;Kim, Ki Yong;Lee, Sang-Hoon;Lee, Ki-Won;Kim, Ki-Su;Choi, Gi Jun
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.37 no.4
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    • pp.254-263
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    • 2017
  • This study was carried out to introduce of agronomic characteristics, forage yields and quality of Sorghum ${\times}$ Sudangrass hybrids 'Cadan 99B' and 'Sweet Sioux WMR' from 2015 to 2016 in middle and southern regions of Korea. The field experiment design was complete in seven varieties with three repetitions. Sorghum ${\times}$ Sudangrass hybrids were sown on mid-May in middle region, and end-May in southern region of Korea, in 2015 and 2016. The observed average heading date of Cadan 99B and Sweet Sioux WMR were July 22. The heading dates of Cadan 99B and Sweet Sioux WMR were 8 days earlier than SX-17 and 5 days earlier than brown mid-rid (BMR) Revolution. The sugar contents of Cadan 99B and Sweet Sioux WMR were 6.5 and $6.9Brix^{\circ}$, respectively. Comparison with BMR variety, the sugar contents of Candan 99B and Sweet Sioux WMR were 0.2 and $0.6Brix^{\circ}$ higher than Revolution, respectively. The average of dry matter (DM) yield for 2 years and 2 regions of Cadan 99B (24,587kg/ha) were the highest among the seven varieties, but there was no significant difference among other varieties except headless control variety Jumbo (19,119kg/ha) and LATTE (20,778kg/ha) (p>0.05). The crude protein (CP) and in vitro dry matter digestibility (IVDMD) of Cadan 99B were 7.5% and 60.2%, and Sweet Sioux WMR were 6.9% and 60.7%, respectively. The results of this study indicated that Sorghum ${\times}$ Sudangrass hybrids Cadan 99B and Sweet Sioux WMR are earlier heading dates and higher than SX-17, and high yields of DM in middle and southern regions of Korea.

Effect of Octreotide on Patients with Malignant Bowel Obstruction (악성장폐색 환자에서 Octreotide의 치료 효과)

  • Park, Ji-Chan;Jang, Yi-Sun;Jeon, Eun-Kyoung;Kim, Dong-Kyu;Lee, Wook-Hyun;Lee, Guk-Jin;You, Si-Young;Choi, Hyun-Ho;Park, Suk-Young
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.194-198
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    • 2009
  • Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

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The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System (말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황)

  • Shin, Dong-Wook;Choi, Jin-Young;Nam, Byung-Ho;Seo, Won-Seok;Kim, Hyo-Young;Hwang, Eun-Joo;Kang, Jina;Kim, So-Hee;Kim, Yang-Hyuck;Park, Eun-Cheol
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.181-189
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    • 2010
  • Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.