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Aesthetics of Samjae and Inequilateral Triangle Found in Ancient Triad of Buddha Carved on Rock - Centering on Formative Characteristics of Triad of Buddha Carved on Rock in Seosan - (고대(古代) 마애삼존불(磨崖三尊佛)에서 찾는 삼재(三才)와 부등변삼각(不等邊三角)의 미학(美學) - 서산마애삼존불의 형식미를 중심으로 -)

  • Rho, Jae-Hyun;Lee, Kyu-Wan;Jang, Il-Young;Goh, Yeo-Bin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • 제28권3호
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    • pp.72-84
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    • 2010
  • This study was attempted in order to offer basic data for implementing and applying Samjonseokjo(三尊石造), which is one of traditional stone construction method, by confirming how the constructive principle is expressed such as proportional beauty, which is contained in the modeling of Triad of Buddha Carved on Rock that was formed in the period of the Three States, centering on Triad of Buddha Carved on Rock in Susan. The summarized findings are as follows. 1. As a result of analyzing size and proportion of totally 17 of Triad of Buddha Carved on Rock, the average total height in Bonjonbul(本尊佛) was 2.96m. Right Hyeopsi(右挾侍) was 2.19m. Left Hyeopsi(左挾侍) was 2.16m. The height ratio according to this was 100:75:75, thereby having shown the relationship of left-right symmetrical balance. The area ratio in left-right Hyeopsi was 13.4:13.7, thereby the two area having been evenly matched. 2. The Triad of Buddha Carved on Rock in Seosan is carved on Inam(印岩) rock after crossing over Sambulgyo bridge of the Yonghyeon valley. Left direction was measured with $S47^{\circ}E$ in an angle of direction. This is judged to target an image change and an aesthetic sense in a Buddhist statue according to direction of sunlight while blocking worshipers' dazzling. 3. As for iconic characteristics of Buddha Carved on Rock in Seosan, there is even Hyeopsi in Bangasang(半跏像) and Bongjiboju(捧持寶珠) type Bosangipsang. In the face of Samjon composition in left-right asymmetry, the unification is indicated while the same line and shape are repeated. Thus, the stably visual balance is being shown. 4. In case of Triad of Buddha Carved on Rock in Seosan, total height in Bonjonbul, left Hyeopsi, and right Hyeopsi was 2.80m, 1.66m, and 1.70m, respectively. Height ratio in left-right Hyeopsibul was 0.60:0.62, thereby having been almost equal. On the other hand, the area ratio was 28.8:25.2, thereby having shown bigger difference. The area ratio on a plane was grasped to come closer to Samjae aesthetic proportion. 5. The axial angle of centering on Gwangbae was 84:46:50, thereby having been close to right angle. On the other hand, the axial angle ratio of centering on Yeonhwajwa(蓮華坐: lotus position) was measured to be 135:25:20, thereby having shown the form of inequilateral triangle close to obtuse angle. Accordingly, the upper part and the lower part of Triad of Buddha Carved on Rock in Susan are taking the stably proportional sense in the middle of maintaining the corresponding relationship through angular proportion of inequilateral triangle in right angle and obtuse angle. 6. The distance ratio in the upper half was 0.51:0.36:0.38. On the other hand, the distance ratio in the lower half was 0.53 : 0.33 : 0.27. Thus, the up-down and left-right symmetrical balance is being formed while showing the image closer to inequilateral triangle. 7. As a result of examining relationship of Samjae-mi(三才美) targeting Triad of Buddha Carved on Rock in Susan, the angular ratio was shown to be more notable that forms the area ratio or triangular form rather than length ratio. The inequilateral triangle, which is formed centering on Gwangbae(光背) in the upper part and Yeonhwajwa(lotus position) in the lower part, is becoming very importantly internal motive of doubling the constructive beauty among Samjae, no less than the mutually height and area ratio in Samjonbul.

An Essay on the Change of Jinju Sword Dance after being designated as an Important Intangible Cultural Asset (<진주검무> 중요무형문화재 지정 이후의 변화에 관한 소고)

  • Lee, Jong Sook
    • Korean Journal of Heritage: History & Science
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    • 제49권1호
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    • pp.4-21
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    • 2016
  • The purpose of this study is to investigate changes of Jinju Sword Dance, characteristics of the changes, and the current condition of its preservation and succession after the designation as the important intangible cultural property no. 12 in January 16th, 1967. In other words, this study understands the situation which has established the present state of after changes over generations. As of now. the year of 2015, the 3 generation holders have been approved since 1967. In 1967, 8 members of $1^{st}$ generation holders were selected from gisaengs of Gwonbeon. However, the succession training was incomplete due to conflicts among the holders, the deaths of some holders, and economic activities of the individuals. As the need of a pivot for succession training and activities was rising, Seong, Gye-Ok was additionally approved as the $2^{nd}$ generation holder on June $21^{st}$, 1978. Seong, Gye-Ok who had never been a gisaeng had dramatically changed with a lot of new attempts. After the death of Seong, Gye-Ok in 2009, Kim, Tae-Yeon and Yu, Yeong-Hee were approved as the $3^{rd}$ generation holders in February, 2010. Based on the resources including the "Cultural Research Reports of Important Intangible Cultural Properties" in 1966 and videos up to 2014, the changes of the dance and surroundings are as follow. 1. The formation of musical accompaniment has been changed during the 3 generations. In the video of the $1^{st}$ generation(in 1970), the performance lasted about 15 minutes, whereas the performance lasted 25 minutes in the video of the $2^{nd}$ generation. Yumbuldoduri rhythm was considered as Ginyumbul(Sangryeongsan) and played more slowly. The original dance requiring only 15 rhythms was extended to 39 rhythms to provide longer performance time. In the $3^{rd}$ generation, the dance recovered 15 rhythms using the term Ginyumbul. The facts that Yumbul was played for 3 minutes in the $1^{st}$ generation but for 5 minutes in the 3rd generation shows that there was tendency pursuing the slowness from the $2^{nd}$ generation. 2. For the composition of the Dance, the performance included additional 20 rhythms of Ginyumbul and Ah(亞)-shaped formation from the $2^{nd}$ generation. From the $3^{rd}$ generation, the performance excluded the formation which had no traditional base. For the movement of the Dance, the bridge poses of Ggakjittegi and Bangsukdoli have been visibly inflexible. Also, the extention of time value in 1 beat led the Dance less vibrant. 3. At the designation as an important intangible cultural property (in 1967), the swords with rotatable necks were used, whereas the dancers had been using the swords with non-rotatable necks since late 1970s when the $2^{nd}$ generation holder began to used them. The swords in the "Research Reports" (in 1966) was pointy and semilunar, whereas the straight swords are being used currently. The use of the straight swords can be confirmed from the videos after 1970. 4. There is no change in wearing Jeonlib, Jeonbok, and Hansam, whereas the arrangement of Saekdong of Hansam was different from the arrangement shown in the "Research Reports". Also, dancers were considered to begin wearing the navy skirts when the swords with non-rotatable necks began to be used. Those results showed that has been actively changed for 50 years after the designation. The $2^{nd}$ generation holder, Seong, Gye-Ok, was the pivot of the changes. However, , which was already designated as an important intangible cultural property, is considered to be only a victim of the change experiment from the project to restore Gyobang culture in Jinju, and it is a priority to conduct studies with historical legitimacy. First of all, the slowing beat should be emphasized as the main fact to reduce both the liveliness and dynamic beauty of the Dance.

A Study on the Heavy Metals Concentrations in the Air of the Dental Laboratories, in the Blood and Urine of Dental Laboratory Technicians (치과기공실 공기중 및 치과기공사의 혈액, 요중 중금속 함량에 관한 연구)

  • Cha, Sung-Soo
    • Journal of Technologic Dentistry
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    • 제10권1호
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    • pp.11-24
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    • 1988
  • The purpose of this study was to determine the concentration of cadmium, nickel and chromium in the air of the work-place, blood of and urine of workers and compare the level of those heavy metals by the duration of work, work-place, process of work, smoking and other factors. In this study, 48 male dental laboratory technicans and 72 office workers as the control group were subjected. The concentration of cadmium, nickel and chromium in their blood sand urine, and that of heavy metals in the air of their work-rooms were examined and analyzed from June I 1987 to September 30, 1987. The results were as follows : 1. The concentration of cadmium in the air was the highest in the porcelain part, $0.0087{\pm}0.0016mg/m^3$, that of nickel was the highest in the crown bridge part, $0.4253{\pm}0.0052mg/m^3$, and that of chrnmium was highest in the partial denture part, $0.1063{\pm}0.0024mg/m^3$. 2. cadmium, nickel and chromium concentrations in the blood and urine of dental laboratory techincians were higher that in the office workers'. Especially the concentration of cadmium in the blood($1.92{\pm}1.23{\mu}g$/100ml) of th dental laboratory techician was about two times as high as that in the office workers'($0.90{\pm}0.73{\mu}g$/100ml), and the concentration of nickel in the urine($48.53{\pm}38.83{\mu}g$/e) of the dental laboratory thchnician was about two times as high as that in the office worker's($20.24{\pm}15.35{\mu}g$/e). 3. there was no difference in the concentration of cadmium, nickel and chromium in the blood and urine with a longer duration of work. 4. The concentration of cadmium and chromium in the blood and urine differed significantly depending upon the place of work. The concentration of cadmium was the highest in the blood of dental laboratory technicians working kin the poreclain part marking at $2.53{\pm}1.08{\mu}g$/100ml. The chromium level was the heighest in the blood of partial denture park workers with a concentration of $3.60{\pm}1.02{\mu}g$/100ml. Concerning the level of cadmium in urine, it was the highest in the porcelain part workers with a concentration of $3.41{\pm}3.15{\mu}g$/e. 5. The concentration of cadmium in the urine of metal trimming and polishing group($2.64{\pm}2.41{\mu}g$/e) was higher than that of non-metal trimming and polishing group($1.39{\pm}1.18{\mu}g$/e). 6. The concentration of chromium in the blood of smoking group($2.46{\pm}1.54{\mu}g$/100ml)was higher than that lf non-smoking group($1.54{\pm}1.25{\mu}g$/100ml). 7. The height positive correlation coefficient was shown between the concentration of nickel and chromium in the blood among the all correlations between 3metals(Cd, Ni, Cr) in the blood and those in urine. The correlation coefficient was relatively high(r=0.605,,p<0.01). In general, the higher the concentration of heavy metals in the air of work places the higher the concention lf them in the blood and urine of workers, mere attention should be paid to the working environment of dental laboratory workers, Furthermore, continuous biological monitoring and further research are required for an efficient health management for dental laboratory workers.

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Long-term Variation of the Freezing Climate near the Han River and Seoul in Korea (서울 관측소와 한강 결빙 기후의 장기 변동)

  • Oh, Su-Bin;Byun, Hi-Ryong
    • Journal of the Korean earth science society
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    • 제32권7호
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    • pp.761-769
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    • 2011
  • Daily minimum temperature and freezing data of the Seoul weather station ($37^{\circ}$34'N, $126^{\circ}$57'E, Songwol-dong Jongno-gu Seoul, hereinafter Songwol) and freezing data of the Han River station ($37^{\circ}$30'N, $126^{\circ}$57'E, hereinafter Han River) were used to study the long-term variation of the freezing climate for Seoul, Korea, for the period of 100 years from 1907 to 2006. 'Freezing' of Songwol is defined that the water in outdoor fields is frozen, and 'freezing' of the Han River located 6 km away from Songwol is defined as the region 100 meters upstream of the second and fourth piers in the south end of the Han River Bridge is fully frozen. The mean first freezing date for Songwol was October 28, and one for Han River was December 28; these showed a late tendency, with the rate of 0.78 days $decade^{-1}$ and 3.47 days $decade^{-1}$, respectively. The mean annual freezing days was 159.06 days for Songwol and 50.33 days for Han River; each showed a $decade^{-1}$shorter tendency, with rates of 2.01 days $decade^{-1}$ and 5.24 days $decade^{-1}$, respectively. All the seven no-freezing years (1960, 1971, 1972, 1978, 1988, 1991, and 2006) for Han River came after 1950. The mean daily minimum temperatures of the first freezing dates for Songwol and Han River were $0.55^{\circ}C$ and $-12.22^{\circ}C$. The first freezing occurred after 6.43 days for Songwol and after 8.94 days for Han River with daily minimum temperature below $0^{\circ}C$. The annual minimum temperatures of Songwol and Han River exhibited positive correlations with the first freezing date and negative correlations with freezing days. The result shows that the freezing climate change is relevant to temperature change and is a part of overall climate change. By conducting additional studies with various methods and wider region, we will be able to monitor the freezing climate.

A Case of Carbamoyl Phosphate Synthetase 1 Deficiency with Novel Mutations in CPS1 Treated by Liver Cell Transplantation (신생아기에 새로운 CPS1 유전자 돌연변이가 확인되고, 간세포이식 시행 받은 Carbamoyl phosphatase synthetase 1 deficiency 1례)

  • Lee, Jisun;Yang, Aram;Kim, Jinsup;Park, Hyung-Doo;Lee, Sanghoon;Lee, Suk-Koo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • 제17권1호
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    • pp.31-37
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    • 2017
  • Carbamoyl phosphate synthetase 1 deficiency (CPS1D) is an autosomal recessive disorder of the urea cycle that causes hyperammonemia. Two forms of CPS1D are recognized: a lethal neonatal type and a less severe, delayed-onset type. Neonatal CPS1D cases often present their symptoms within the first days of life. Delayed-onset cases are predominantly adolescents or adults, and infantile delayed-onset cases are rare. Severe hyperammonemia in the neonatal period leads to serious brain damage, coma, and death if not treated promptly. Therefore, early diagnosis and acute treatment are crucial. Despite the improvement of treatments, including continuous hemodialysis, ammonia-lowering agents, and a low-protein diet, the overall outcome of severe forms of hyperammonemia often remains disappointing. As the liver is the only organ in which ammonia is converted into urea, liver transplantation has been considered as an elegant and radical alternative therapy to classical dietary and medical therapies. However, liver transplantation has many disadvantages, such as a considerable risk for technical complications and perioperative metabolic derangement, especially in neonates. Additionally, there is a lack of suitable donor organs in most countries. According to recent studies, liver cell transplantation is a therapeutic option and serves as a bridge to liver transplantation. Here, we report a Korean CPS1D patient with novel mutations in CPS1 who was treated by liver cell transplantation after being diagnosed in the neonatal period and showed a good neurodevelopmental outcome at the last follow-up at six months of age.

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A Study on Implementation of Primary Health Care Delivery System meet to Rural Area in Korea -Village Health Voluntary Worker Development- (우리 나라 농촌지역(農村地域)에 부합하는 1차(次) 보건의료전달체계(保健醫療傳達體系) 정착구현(定着具現)에 관한 연구(硏究) -마을 보건임원(保健任員) 개발(開發)-)

  • Koo, Y.C.;Wie, J.H.;Hwang, S.J.;Choi, S.S.
    • Journal of Preventive Medicine and Public Health
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    • 제12권1호
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    • pp.13-23
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    • 1979
  • A study was carried out from October 1977 to September 1978 in order to develope health care delively system which will meet to rural area in Korea. For the study objective a model of health care delivery system of Myun (township) area was developed which is adopted the net-work of village health voluntary worker who will play the role of bridge for communication related with health and illness between families or village people and health subcenter, and :he model health care delivery system net-work was set in the area of Soodong Myun, Yangju Gun. which is the rural health demonstration area of Ewha Womans University since 1972. The activities and attitude of 22 village health voluntary workers were observed and analized. during the study period. The results are as follows; 1. For the field activities of village health voluntary workers. a guide line which is described with specific behavioral objectives was developed and used for not only training of the workers but also evaluation of their field activities. 2. During the study period, the number of 971 village people were served primary health care service by village health voluntary worker and the service was classified largely into symptomatic medications (92%) and preventive measures (8%). 3. Comparative percentage of the number of 894 symptomatic cases cared by village health voluntary workers to 5,695 cases of patient treated by Soodong Health Subcenter during the same period was 15.7%. 4. Annual utility rate of village health voluntary worker by Myun total people was 16.1% but utility rate by Rie was varied from 38.2% to 2.8% which shown there were considerable differences in each Rie. In order to settle the village health care service, the obstructive factors of utility should be detected and their counter measure must be taken. 5. As the health need of village people increases, it is expected that the supplement of drug excluding present sit basic drugs is inevitable, but considering the ability of village health voluntary worker, the selection of additional drugs and education, plan should be carefully studied. 6. It is desirable that a financial resource for supplementary purchase of first aid kit, drugs and materials whould be alloted from village public fund like Saemaeul Women's Club fund, which has already practiced in a few villages in the study area. 7. As pointed out by village health voluntary workers, in order to improve the village health, village leaders should be in the center of it and the cooperation of whole village people is a core of healthful village development, and it is reasonable that the health subcenter backs up these voluntary health activities by village people in techniques. 8. It seems effective that a supplementary education for village health voluntary worker be accomplished by a planned education through regular meetings like worker's monthly meeting and irregular post guide when Myun Health Workers can handle the problems found during the round trip of villages. 9. It is desirable that village health voluntary workers, who are recommended by a civil voluntary organization like Saemael Woman's Club, are charged by natural villagc unit, are given a function of village health care service and used through basic education at health subcenter. 10. It is advisable that the village health voluntary worker's service is compensated not by a form of money, but by other way such as an exemption of medical fee of worker herself or her families in health subcenter can be one method. 11. Daily health activities of each village health voluntary worker should be reported to health subcenter by biweekly or monthly in order to get not only for basic data of the program but also for evaluation the program. It is recomandable that the report form should be simple and clear enough for village health voluntary worker to fill it effectively. 12. Village health care service should be developed into a Saemaeul Movement in which village people actively participate. For this, the appointed function of village health voluntary worker should be absorbed into those of living Environment Betterment Section or Family Planning Section of Saemaeul Women's Club or it is desirable that establish a new section, Village Health Promoting Section and make it involve the appointed functions of those sections mentioned above.

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A Study on the aspect of landscape change for Gwanghalluwon Garden (광한루원의 경관변화양상에 관한 고찰)

  • Lee, Won-Ho;Kim, Dong-Hyun;Kim, Jae-Ung;Ahn, Hye-In;Kim, Dae-Yeol;Cho, Un-Yeon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • 제32권2호
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    • pp.82-94
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    • 2014
  • This study aims to comprehend that Gwanghalluwon for aspects of landscape change in terms of construction garden(樓園). Transformation focused on the spatial structure is divided into four periods based on literature. And reflect of landscape elements in defunct or unattributable records from tale and novel. The results were as follows. First, The beginning of Gwanghanllu pavilion(廣寒樓) was the composition of the Gwangtongnu Pavilion(廣通樓). The pavilion is located amid beautiful scenery such as the close-range view of a small stream, and distant view Jiri Mountain. Analysis of literature shows that Gwanghallu pavilion was in succession to Gwangtongnu Pavilion's landscape. Secondly, Gwanghallu(廣寒樓) pavilion represents the characteristic of the garden since 1582. Built the Samsinsan(三神山), Construct Lake and bridge that represents the galaxy for realization of utopia reflect in Taoist ideology. Thirdly, Gwanghalluwon garden was recovered when from Jeong-yu-jae-ran(丁酉再亂) to the Japanese Ruling Era. It took Gwanghalluwon garden a long while to recover from original form. According to records, Gwanghalluwon garden is still being likened to the landscape of fairyland by inheriting landscape in the previous of Jeong-yu-jae-ran(丁酉再亂). Fourth, By the modern times, Gwanghalluwon Garden has personality of tourist attractions. Until now, the area of the Gwanghalluwon garden has been expended during the processes of three times. Fifth, Aspect of landscape change of Gwanghalluwon is wide-spreading mainly Gwanghallu pavilion. But elements of external expansion in garden by introduced into the facility irrelevant to the authenticity of the garden. Sixth, Comprehension the cultural landscape of the garden are limited by deficient records. But, the main elements in the Gwanghalluwon garden are commonly appeared on imaginary environment within a tale and a novel. In addition, culture of garden at the time was depicted in tale and novel. In this sense, cultural landscape in garden was able to estimate through imaginary environment within novel.

Effects of β-glucan and Xanthan gum-based Biopolymers on Plant Growth and Competition in the Riverbank (제방 환경 조건에서 베타글루칸-잔탄검 계열 바이오폴리머가 식물 생장 및 경쟁에 미치는 영향)

  • Jeong, Hyungsoon;Shin, Haeji;Jang, Ha-young;Kim, Eunsuk
    • Ecology and Resilient Infrastructure
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    • 제7권3호
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    • pp.208-217
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    • 2020
  • A biopolymer based on microorganism-derived β-glucan and xanthan gum is being studied as a new eco-friendly material that stabilizes the riverbank slope, and also promotes vegetation growth. However, it is still inconclusive whether biopolymers have a positive effect on plant performance in the riverbanks which are subjected to various climatic factors and plant competitions. For a practical ecological evaluation of the biopolymers, their effect on plant growth promotion was studied in a natural environment. Considering the relationship between competition and plant community formation, the effects of biopolymers on competition were also investigated. For four plant species (Echinochloa crus-galli, Pennisetum alopecuroides, Leonurus japonicus, and Coreopsis lanceolata), the biopolymer effects under intra/interspecific competition were tested at the riverbank (20 m × 10 m) near Samjigyo Bridge in Damyang-gun, Jeollanam-do. A biopolymer powder was mixed with water and commercial soil following the manufacturer's recommendations. The soil mixed with the biopolymer was filled in a pot or applied to the surface of the commercial soil with a thickness of 3 cm. Across the competition treatments, the biopolymer treatment promoted root growth of the target plant species and decreased the specific leaf area. The total biomass and shoot dry weight of P. alopecuroides increased in response to the biopolymer treatment. The competition treatment decreased the total biomass and shoot dry weight compared to the case without competition. Notably, such a competitive effect was similar in all the biopolymer treatments. Thus, biopolymers, when mixed with soil, promote the growth of some plant species, but do not appear to affect the competitive ability of plants.

A Study on the Landscape Symbolism of Tongdo-palkyung and It's Narrative Structure (통도팔경(通度八景)의 경관상징성(景觀象徵性)과 서사구조(敍事構造))

  • Rho, Jae-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • 제28권1호
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    • pp.27-37
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    • 2010
  • This study tries to illuminate the features and values of the Buddhist temple Palkyung by closely examining the forms, structures, and meanings of Tongdo-palkyung(通度八景) handed down at Tongdosa Temple, the best among Korea's Buddhist temples with its three treasures of Buddha, law of Buddha and Buddhist monks. The findings of this study can be summarized as the following. First of all, it reveals the meaning of the geographical name Yeongchuksan(靈鷲山), located to the west of Tongdosa, and a spectacular sight spread like an eagle's spread wings, as well as its location and spatial features. In particular, the arrangement features of a number of attached hermitages clearly show Yeongchuksan's world as being a temple with buddhist treasures. The multi-layered unfolding and centripetal intention of the scenery can be perceived through the shape of the Sshangryongnongju(雙龍弄珠形), around Tongdosa and the feature of the enclosed landscape encircling the steps of Hyeolcheo(穴處) Geumganggyedan. The substances and components of Tongdopalkyung include sound-based spectacles derived from Beoneumgu(梵音具) creating sounds related to religious rituals to enlighten and redeem mankind, such as Yeongji(影池: a holy pond with shadow reflections), drum sounds, and bell sounds along with physical features like pine trees, Dae(臺), waterfalls, Dongcheon (洞天), and a glow in the sky. On the other hand, Palkyung's geographical arrangements exhibit a circular spatial formation based on the main motif as Buddhist symbolism, beginning with the 'Gukjangsangseokpyo(國長生石標)' awakening the territoriality of Tongdosa and locating the first scene 'Mupunghansong(舞風寒松)' in its introductory area, with the features of water, bridge, pine grove, and Iljumun(gate) to stand for the influx. Six other scenes including 'Anyangdongdae(安養東臺)' are placed in the sacred precincts around Daeungjeon and Geumganggyedan while the glow of sunset at 'Danjoseong' just outside the domain closes the symbolic circular formation of the Tongdopalkyung, which coincides with the development of the Mandala figure symbolizing 'Gusanpalhae(九山八海)' centered in Sumisan(須彌山). What is more, Tongdopalkyung, while excluding primary scenic elements inside the temple, maximizes the domain of the mountain's entrance and the effects of the multi-layered mountain, mountain upon mountain, by intensifying the influx and centripetal qualities. The Tongdopalkyung analysis reveals the antithesis of four-coupled scenes conveying buddhist principles and thoughts on the basis of seasons, directions, space and time to display a narrative structural landscape when viewed from the temple's territoriality. Likewise, the characteristics and porch structures of Tongdopalkyung are tools and language of symbols to both externally strengthen the temple's territoriality and to internally, maximize the desires to the Land of Happiness as well as intensify religious wishes and the Mandala's multi-layered qualities through the meanings of time and space.

The Usefulness of Noninvasive Positive Pressure Ventilation as a New Weaning Method (새로운 이탈방법으로서 비침습적 양압환기법의 유용성)

  • Shim, Tae-Sun;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Lim, Chae-Man
    • Tuberculosis and Respiratory Diseases
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    • 제46권4호
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    • pp.500-511
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    • 1999
  • Background: Noninvasive positive pressure ventilation (NPPV) using facial or nasal mask have been widely used for several years in stable patients with chronic neuromuscular disease or central alveolar hypoventilation, and recently have been tried in patients with acute respiratory failure. In a few studies, NPPV was also used to rescue the patients with post-extubation respiratory failure. However, yet it has not been adopted as a weaning method in patients on long-term mechanical ventilation. So we performed this prospective clinical study to evaluate the usefulness of NPPV as a weaning method after removing endotracheal tube intentionally in patients on long-term mechanical ventilation. Method: Twelve patients who had been on invasive mechanical ventilation over 10 days were enrolled and 14 trials of NPPV were done. All had failed at least one weaning trial and showed ventilator dependence(pressure support requirement between 8-15cm $H_2O$, and PEEP requirement between 5-10cm $H_2O$), so tracheostomy was being considered. After removing the endotracheal tube, NPPV was applied using facial mask. Respiratory rate, arterial blood gas, pressure support level, and PEEP level were monitored just before intended extubation, at 30 minutes, 1 to 6, 6 to 12, 12 to 24 hours, 2nd day, and 3rd day following initiation of NPPV, and just before weaning from NPPV. The successful weaning was defined as spontaneous breathing off the ventilator for 48 hours or longer without respiratory distress. Results: The weaning through NPPV after intended extubation was successful in 7(50%) of 14 trials, and tracheostomy could be avoided in them. There were no differences in age, sex, APACHE III score, duration of invasive mechanical ventilation, baseline respiratory rate, $PaCO_2$ $PaO_2/FiO_2$, and ventilatory requirement(PS and PEEP) between the success and failure groups. In the success group, respiratory rate, pH, $PaCO_2$, and $PaO_2/FiO_2$ were not different between invasive MV and NPPV period. But in the failure group, pH decreased after 30 minutes of NPPV initiation compared with that of invasive MV($7.40\pm0.08$ vs. $7.34\pm0.06$, p<0.05). The causes of failure were worsening of ABG(n=3), retained tracheal secretion(n=2), mask intolerance(n=1), and flail chest(n=1). Conclusion: NPPV may be worth trying as a bridge method in weaning patients on long-term invasive mechanical ventilation.

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