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Long-term Prognosis and Physiologic Status of Patients Requiring Ventilatory Support Secondary to Chest wall Disorders (흉벽질환에 의한 급성호흡부전 환자의 생리적 특성과 장기적인 예후)

  • Yoon, Seok Jin;Jun, Hee Jung;Kim, Yong Joo;Lee, Seung Jun;Kim, Eun Jin;Cha, Seung Ick;Park, Jae Yong;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.265-272
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    • 2006
  • Background: Chest wall deformities such as kyphoscoliosis, thoracoplasty, and fibrothorax cause ventilatory insufficiency that can lead to chronic respiratory failure, with recurrent fatal acute respiratory failure(ARF). This study evaluated the frequency and outcome of ARF, the physiologic status, and the long-term prognosis of these patients. Methods: Twenty-nine patients with chest wall disorders, who experienced the first requirement of ventilatory support from ARF were examined. The mortality and recurrence rate of ARF, the pulmonary functions with arterial blood gas analysis, the efficacy of home oxygen therapy, and the long-term survival rate were investigated. Results: 1) The mortality of the first ARF was 24.1%. ARF recurred more than once in 72.7% of the remaining 22 patients, and overall rate of successful weaning was 73.2%. 2) Twenty-two patients who recovered from the first ARF showed a restrictive ventilatory impairment with a mean FVC and TLC of 37.2% and 62.4 % of predicted value, respectively, and a mean $PaCO_{2}$ of 57mmHg. Among the parameters of pulmonaty functions. the FVC(p=0.01) and VC(p=0.02) showed a significant correlation with the $PaCO_{2}$ level. 3) There were no significant differences between the patients treated with conservative medical treatment only and those with additional home oxygen therapy due to significant hypoxemia in the patients with recurrent ARF and the mortality. 4) The 1, 3, 5-year survival rates were 75%, 66%, and 57%, respectively, in the 20 patients who had recovered from the first ARF, excluding the two patients managed by non-invasive nocturnal ventilatory support. Conclusion: These results suggest that active ventilatory support should be provided to patients with ARF and chest wall disorders. However, considering recurrent ARF and weak effect of home oxygen therapy, non-invasive domiciliary ventilation is recommended in those patients with these conditions to achieve a better long-term prognosis.

A Trial of Aerosolized Colistin for the Treatment of Nosocomial Pneumonia due to Multidrug-resistant Acinetobacter baumannii (다제내성 A. baumannii에 의한 병원획득폐렴에서 Colistin 분무치료의 시도)

  • Kim, Changhwan;Kim, Dong-Gyu;Kang, Hye-Ryun;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Shin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Choi, Young-Jin;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.102-108
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    • 2008
  • Background: Recently, multidrug-resistant (MDR) A. baumannii has been implicated for a significant proportion of nosocominal pneumonia in many intensive care units (ICUs), and its acquisition may increase mortality and the length of stay in the ICU. Aerosolized colistin has been successfully used in patients with cystic fibrosis, but there is a lack of data regarding the use of aerosolized colistin in patients with nosocomial pneumonia. Methods: We conducted the present study to assess the effectiveness of aerosolized colistin for the treatment of MDR A. baumannii nosocomial pneumonia. We retrospectively reviewed the medical records of 10 patients who had been hospitalized in the medical ICU and had received aerosolized colistin as a therapy for MDR A. baumannii pneumonia. Results: The mean duration of aerosolized colistin therapy was $12.7{\pm}2.4$ days. Nine (90%) of 10 patients showed a favorable response to the therapy. Follow-up cultures were available for all patients, and the responsible pathogen was completely eradicated. One patient suffered from bronchospasm, which resolved after treatment with nebulized salbutamol. Conclusion: Our results corroborate previous reports that aerosolized colistin may be an effective and safe choice for the treatment of nosocomial pneumonia caused by MDR A. baumannii. Larger prospective controlled clinical studies are warranted to validate further the effectiveness and safety of aerosolized colistin therapy.

Complications of transcatheter closure of atrial septal defects using the amplatzer septal occluder (심방 중격 결손의 경피적 폐쇄술 후 발생한 합병증에 관한 연구)

  • Jea, Seo Jin;Kwon, Hyo Jin;Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Son, Chang Sung;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.401-408
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    • 2008
  • Purpose : Transcatheter closure of atrial septal defects (ASD) is currently established therapy as an alternative to surgery. But rarely, complications are reported in some studies. We report early and intermediate term complications associated with transcatheter closure of atrial septal defects using the Amplatzer septal occluder (ASO). Methods : From June 2003 to May 2006, 64 patients underwent transcatheter closure of secundum ASD or patent foramen ovale using the ASO. The ratio of male to female was 1:2.4, the median age was 17 years (range: 2.6-64 years) and their median weight was 47.5 kg (range: 2.6-64 kg). Results : The median diameter of ASD measured with transthoracic or transesophageal echocardiography was 15 mm (range: 6-28 mm), the median balloon stretched diameter was 18 mm (range: 6.5-34 mm), and the median size of device was 19.5 mm (range: 6-36 mm), was little difference with balloon stretched diameter. There were 10 cases of complications: arrhythmia (2), device malformation (2), aorta to right atrial fistula (1), hemolytic anemia (1), mitral valve encroachment (1), malposition (1), residual shunt (1), and inferior vena cava perforation (1). Conclusion : Transcatheter closure of ASD using ASO is effective and safe therapy. However, significant complications such as aorta to atrial fistula, atrial erosion, or device embolization can happen, so an appropriate selection of patient and device in relevance to size and anatomy of ASD is important for successful closure.

Characteristics of Sleep Pattern among Korean College Students (한국 대학생의 수면 양상 특징)

  • Kim, Seog-Ju;Lyoo, In-Kyoon;Won, Chang-Yeon;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.13 no.1
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    • pp.15-21
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    • 2006
  • Introduction: The objective of the present study was to investigate bedtime, rise time and time-in-bed of Korean college students, separately on weekday and on weekend and to compare them. In addition, this study also aimed to evaluate the influence of gender, age and grade on the above sleep parmeters in Korean college students. Methods: Information regarding bedtime and rise time, separately on weekday and on weekend, of Korean college students were obtained by self-administered questionnaire. Questionnaires of 1,825 students (1,416 females and 409 males, age 18-30;mean age $21.1{\pm}2.2$) were used for statistical analyses. Results: Korean college students retired to bed 50 minutes later (00:49 on weekday;01:40 on weekend;t=39.67, p<0.001), rose 1 hour 58 minutes later (07:52 on weekday;09:50 on weekend;t=39.46, p<0.001), and slept 1 hour 8 minutes longer (t=13.33, p<0.001) on weekend. Compared to male students, female students had earlier rise time (t=8.96, p<0.01;t=3.89, p<0.01) and earlier bedtime both on weekday and weekend (t=7.10, p<0.01;t=6.04, p<0.01), and shorter time-in-bed on weekday (t=1.99, p<0.01). In addition, rise time delay and time-in-bed increase on weekend were more prominent in female students than in male students (t=3.41, p<0.01; t=3.68, p<0.01). Grade was correlated with bedtime and rise time on weekday (${\beta}=0.1022$, p<0.01;${\beta}=0.1009$, p<0.01), bedtime and time-in-bed on weekend (${\beta}=0.1096$, p<0.01;${\beta}=-0.0990$, p<0.01), and differences between week-day and weekend of the rise time and the time-in-bed (${\beta}=-0.0906$, p<0.01;${\beta}=-0.1115$, p=0.02). Conclusions: In this study, Korean college students had earlier bedtime/rise time and shorter time-in-bed on weekday than on weekend. These findings suggest that weekday sleep-wake schedule of Korean college students may be advanced relative to their biological sleep-wake cycle and that this discrepancy may be associated with weekday sleep deprivation. In addition, differences of sleep patterns between weekday and weekend were more prominent in female students and students with lower grade. Therefore, discrepancy between weekday sleep-wake schedule and biological sleep-wake cycle, as well as weekday sleep deprivation, might be more serious in female or lower-grade students.

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대순사상의 인문정신과 인류평안의 이념

  • 잔스촹
    • Journal of the Daesoon Academy of Sciences
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    • v.21
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    • pp.199-254
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    • 2013
  • 대순사상은 인간의 행위와 정신적 틀, 즉 몸과 마음을 닦고 세상을 다스리며 백성을 평안하게 하는 도리를 설파하고 있다. 우주 공간의 질서와 깊은 연관을 맺는 이러한 도리는 인간 자신의 인지(認知)와 심신 수양의 내용을 포함하며, 사람이 사회와 우주자연과의 관계를 어떻게 처리해 나갈 것인지에 관한 문제도 다루고 있다. 따라서 대순사상을 인문이라는 관점에 입각하여 분석해 볼 필요가 있다. 이탈리아에서 시작된 서양의 인문주의와 비교해 볼 때, 중국 전통의 인문정신은 인류 개체의 창조력과 그 성과를 인정하고, 인격적 수양과 개선을 주장하며, 사회의 조화를 강조하는 한편, 인류가 반드시 천지인의 조화로운 관계 속에서 개체와 전체의 생존을 파악해야 함을 강조한다. 이러한 인문정신은 『전경』에서도 찾아볼 수 있다. 그 하나가 모악산과 단주(丹朱)에 대한 서술인데, 모악산은 산 즉 '간'(艮)괘이며 단주는 적색에 상응하니 곧 '리'(離)괘가 된다. 이 두 괘가 서로 조합하면 '비(比)'괘가 되며, 『주역』의 비괘와 연관하여 서로 간의 모순을 없애고, '바둑'을 두는 기법을 거울삼아 심성을 다스리며, 인격을 완성하고, 인신이 조화를 이루도록 하며, 사회를 안정시킬 것을 말한다. 대순 신앙의 최종 목표는 지상천국을 건설하는 것인데, 이런 목표를 실현하기 위해서는 인격수양을 그 출발점으로 삼아야 한다. 인격수양의 목표는 바른 도인이 되기 위한 것이며, 이를 위해서는 수도 공부를 해야만 한다. 수도는 춘추시기 노자 이래로 유구한 문화적 전통을 지닌 것이지만, 대순진리회는 한국사회 역사의 경향과 현실의 필요에 부응하여 수도 이론을 새롭게 수립하였다. 이를 살펴보면, 대순진리회는 수도자가 '성(誠), 경(敬), 신(信)'에 힘쓰는 품격 함양을 매우 중시한다. 또 도인들이 가정의 화목에 힘써야 하며, 솔선수범하는 도인으로서 사회의 모범이 되어야 한다고 말한다. 이렇게 볼 때, 대순진리회는 '인도'(人道)를 함양함을 강조하고 있으며, 이것은 전통적인 유가에서 말하는 '수신, 제가' (修身, 齊家)의 정신과 그 의미가 맞닿아 있다. 또한 중국 도교의 '선도(仙道)를 이루고자 하면 먼저 인도(人道)를 행하라'는 사상적 취지와도 일치한다. 대순진리회에서 수도의 최종 목표는 도통이다. 도통은 수도자가 매우 높은 경지에 이르게 되었을 때 가지는 특수한 능력과 정신의 경지이다. '도통'에 대한 기록은 『장자·제물론』, 『문자』의 「부언편>(符言篇) 등에서 찾아볼 수 있는데, 대순진리회가 말하는 도통은 중국의 도가 전통에 보이는 도통과도 연관되지만 강한 인륜수양(人倫修養)적 특색을 지니고 있다는 점에서 차이가 있다. 이것은 대순진리회가 가지는 중요한 인문적 함의라 하겠다. 대순진리회는 수도 공부로써 광제창생·보국안민·지상천국건설의 사회적 이상을 실현하고자 한다. 조화로운 사회적 관계를 수립하기 위한 토대는 대순진리회의 종지 첫 번째인 음양합덕이다. 음양합덕은 대순진리의 인문 취지의 이론적 기초를 형성하는 사상이다. 음양합덕의 철학적 사고는 종지 두 번째인 신인조화(神人調化)의 이상으로 이어진다. 신인조화는 『상서·순전』(尙書·舜典)의 신인이화(神人以和)에서 그 사상적 연원을 찾아 볼 수 있다. 다만 신인이화가 율려 조화의 '결과'를 표현한 것이라면, 신인조화에서 중시하는 것은 '과정'이며 인간과 신의 상호작용이라는 점에 그 특징이 있다. 신인조화를 이루기 위해서는 공부를 해야 하며, 그 배후에는 인본(人本)의 사상이 깃들어 있다. 그것은 종지 세 번째인 '해원상생'의 내용에서 더욱 명확하게 드러난다. 신인조화가 인간과 신의 관계를 조화롭게 하는 것을 말한다면, 해원상생은 인간과 인간의 관계를 조화롭게 하는 것을 말한다. 또 다른 한편으로는 긴 역사의 과정 속에서 맺힌 원을 풀어 우주의 기운을 잘 통할 수 있게 하고 인간 사회의 정상적인 교류를 이루도록 한다. 이러한 내용은 사회적인 인문적 관심과 배려를 다분히 포함하고 있는 것이다. 대순진리회의 종지 네 번째인 도통진경은 수도의 가장 높은 경지를 말하는데, 이러한 이념은 노장 일파의 도가 학자들이 말한 순박한 본성으로 회귀하자는 정신에서 그 원류를 찾을 수 있을 것이다. 또한 이는 한진(漢晉)시대 이래 중국 도교가 추구했던 '진경' 의 의미와도 합치된다. 그러나 시대와 환경이 다름으로 인해, 대순진리회의 '진경'은 사회생활의 의미까지 내포한다. 비록 대순진리회의 경전이 인본(人本)을 명확히 밝히고 있지는 않으나, 대순진리회의 요의(要義) 중 하나인 인존사상은 대순진리회의 인문정신을 말해주는 것이다. 인존사상의 직접적인 기능은 평안(平安)으로서 삶을 이롭게 하는 것이다. 대순진리회는 우주대원의 진리를 '도'라 하였는데 이러한 '도'는 중국의 도가에서 말하는 '도'와 동일하며, 여기에는 '안(安)'의 의미가 포함되어 있다. 대순진리회의 신조 중 '안심', '안신'은 마음을 정(靜)하게 하고, 몸을 편하게 하는 것으로 볼 수 있지만, 심신의 공포와 두려움을 떨쳐내어 안전과 보호를 얻는다는 의미도 있으므로 결국 평안이 전제가 된다. 이렇듯 대순진리회에서는 '평안에 대한 희구'를 근본으로 하여 신앙인들이 열심히 수도에 정진하고 있다. 대순진리회가 인류 평안을 기본으로 하는 종교라는 점에서, 반드시 세인들의 환영을 받을 것임을 믿어 의심치 않는다.

A Study on the Meaning and Cultural Properties Value of Rock-Go-Board from the Viewpoint of Site and Location Characteristics (입지와 장소 특성으로 본 암각바둑판의 의미와 문화재적 가치)

  • Park, Joo Sung;Rho, Jae Hyun;Sim, Woo Kyung
    • Korean Journal of Heritage: History & Science
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    • v.44 no.4
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    • pp.172-205
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    • 2011
  • Go bears significant meanings in terms of cultural and entertaining functions in Asia Eastern such as China and Japan. Beyond the mere entertaining level, it produces philosophical and mythic discourse as well. As a part of effort to seek an identity of Korean traditional garden culture, this study traced back to find meanings of rock-go-board and taste for the arts which ancestors pursued in playing Go game, through analysis and interpretation of correlation among origin of place name, nearby scenery, carved letters and vicinal handed-down place name. At the same time, their position, shape and location types were interpreted through comprehensive research and analysis of stone-go-boards including rock-go-board. Particularly, it focused on the rock names related to Sundoism(仙道) Ideal world, fixed due to a connection between traces of Sundoism and places in a folk etymology. Series of this work is to highlight features of the immortal sceneries, one of traditional landscaping ideals, by understanding place identity and scenic features of where the rock-go-boards are carved. These works are expected to become foundation for promotion and preservation of the traditional landscaping remains. The contents of this study could be summarized as follows; First, round stone and square board for round sky and angled land, black and white color for harmony of yin and yang and 361paths for rotating sky are symbols projecting order of universe. Sayings of Gyuljungjirak(橘中之樂), Sangsansaho(商山四皓), Nangagosa(爛柯故事) formed based on the idea of eternity stand for union of sky and sun. It indicates Go game which matches life and nature spatiotemporally and elegant taste for arts pursuing beauty and leisure. Second, the stone-go-boards found through this research, are 18 in total. 3 of those(16.1%), Gangjin Weolnamsaji, Yangsan Sohanjeong and Banryongdae ones were classified into movable Seokguk and 15(83.9%) including Banghakdong were turned out to be non-movable rock-go-boards carved on natural rocks. Third, upon the result of materializing location types of rock-go-boards, 15 are mountain stream type(83.9%) and 3 are rock peak type(16.1%). Among those, the one at Sobaeksam Sinseonbong is located at the highest place(1,389m). Considering the fact that all of 15 rock-go-boards were found at mountainous areas lower than 500m, it is recognizable that where the Go-boards are the parts of the living space, not far from secular world. Fourth, there are 7 Sunjang(巡將) Go with 17 Hwajeoms(花點), which is a traditional Go board type, but their existences, numbers and shapes of Hwajeom appear variously. Based on the fact, it is recognizable that culture of making go-board had been handed down for an extended period of time. Among the studied rock-goboards, the biggest one was Muju Sasunam[$80(82)cm{\times}80(82)cm$] while the smallest one was Yangsan Sohandjeong Seokguk ($40cm{\times}40cm$). The dimension of length and breadth are both $49cm{\times}48cm$ on average, which is realistic size for actual Go play. Fifth, the biggest bed rock, an under-masonry with carved Go-board on it, was one in Muju Sasunam[$8.7m{\times}7.5m(65.25m^2)$], followed by ones in Hoengseong Chuiseok[$7.8m{\times}6.3m(49.14m^2$] and Goisan Sungukam[$6.7m{\times}5.7m(37.14m^2)$]. Meanwhile, the smallest rock-go-board was turned out to be one in Seoul Banghak-dong. There was no consistency in directions of the Go-boards, which gives a hint that geographical features and sceneries of locations were considered first and then these were carved toward an optimal direction corresponding to the conditions. Sixth, rock-go-boards were all located in valleys and peaks of mountains with breathtaking scenery. It seems closely related to ancestors' taste for arts. Particularly, rock-go-boards are apprehended as facilities related to taste for arts for having leisure in many mountains and big streams under the idea of union of sky and human as a primitive communal line. Go became a medium of hermits, which is a traditional image of Go-game, and symbol of amusement and entertainment with the idea that Go is an essence of scholar culture enabling to reach the Tao of turning back to nature. Seventh, the further ancient time going back to, the more dreamlike the Go-boards are. It is an evident for that Sundoism, which used to be unacceptable once, became more visible and realistic. Considering the high relation between rock-go-boards and Sundoism relevant names such as Sundoism peak in Danyang Sobaeksan, 4 hermits rock in Muju and Sundoism hermit rock in Jangsu, Sundoism hermit rocks and rock-go-boards are sceneries and observation spots to express a communication of worship and longing for Sundoism. Eighth, 3 elements-physical environment such as location type of the rock-go-boards, human activities concentrated on 8 sceneries and Dongcheongugok(洞天九曲) setup and relevancy to Confucian scholars, as well as 'Sangsansaho' motif and 'Nangagosa' symbolic meaning were used as interpretation tools in order to judge the place identity. Upon the result, spatial investigation is required with respect to Sunyoodongcheon(仙遊洞天) concept based on enjoyment to unify with the nature rather than Dongcheongugok concept of neo-Confucian, for Dongcheon and Dongmoon(洞門) motives carved around the rock-go-boards. Generally, places where mountain stream type rock-go-boards were formed were hermit spaces of Confucianism or Sundoism. They are considered to have compromised one other with the change of times. Particularly, in the rock-go-board at the mountain peak, sublimity-oriented advent of Sundoism is considered as a significant factor to control place identity. Ninth, including where the rock-go-boards were established, the vicinal areas are well-known as parts of Dongcheongugok and Palkyung(八景) mostly. In addition, many of Sundoism relevant expressions were discovered even in the neighboring carvings written by scholars and nobility, which means sophisticated taste based on longing for Sundoism world played a significant role in making go-board. The rock-go-board is an integration of cultural phenomena naturally managed by seclusion of scholars in the Joseon Dynasty as well as remains and essence of Korean traditional landscaping. Some rock-go-boards out of 17 discovered in South Korea, including ones in Sobaeksan Sinsunbong, Banghak-dong, Chungju Gongili, Muju Sasunam, Yangsan Eogokdong Banryongdae Seokguk, are damaged such as cracks in rocks or fainted lines by hardships of time and hand stains. Worse yet, in case of Eunyang Bangudae Jipcheongjeong board, it is very difficult to identify the shape due to being buried. Rock-go-boards are valuable sculptures in terms of cultural asset and artwork since they reflect ancestors' love for nature and longing for Sundoism world. Therefore, they should be maintained properly with right preservation method. Not only rock-boards itself but also peripheral places are excellent cultural heritages and crucial cultural assets. In addition, vicinal sceneries of where rock-goboards and pavilion spots are the representative remains of embracing prototype of Korean traditional landscaping and major parts of cultural properties.