• Tuberculosis and Respiratory Diseases
• /
• v.44 no.6
• /
• pp.1326-1331
• /
• 1997

Background : Weaning is the process of switching a patient from mechanical ventilator to spontaneous breathing. A number of different weaning techniques can be employed. At recent study, conventional spontaneous breathing trial was superior to other techniques, such as intermittent mandatory ventilation(IMV) or pressure support ventilation(PSV). But adequate observation time of the spontaneous breathing trial was not determined. We reported the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotrachial tube. In this study, we tried to shorten the spontaneous breathing time from 60 minutes to 30 minutes. If weaning success was predicted after 30 minutes spontaneous breathing, extubation was done without reconnection with ventilator. Methodes : Subjects consisted of 42 mechanically ventilated patients from August 1994 to July 1995. The weaning trial was done when the patients recovered sufficiently from respiratory failure that originally required ventilatory assistance, the patients became alert and showed stable vital sign, and arterial $O_2$ tension was adequated($PaO_2$ > 55 mmHg) with less than 40% of inspired oxygen fraction. We conducted a careful physical examination when the patients was breathing spontaneously through the endobronchial tube for 30 minutes. We terminated the trial if a patients was any of following signs of distress; cyanosis, diaphoresis, tachypnea(above 30 breaths per minute), and extreme tachycardia. Patients who had none of this features during spontaneous breathing for 30 minutes were extubated promptly. Result : 17 weaning trials of 15 patients were done in 42 mechanically ventilated patients. Successful weaning and extubation was possible in 14 trials of total 17 trials. In this 14 patients, 8 patients were extubated after 30 minutes spontaneous breathing, 3 patients were extubated after 60 minutes spontaneous breathing, and 3 patients needed over 3 hours for extubation from weaning. We found similar overall success rate compared with weaning following a 60 minutes spontaneous breathing trial. Conclusion : From the result of present study, we believe that weaning and extubation from mechanical ventilation following a 30 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method.

• Proceedings of the Membrane Society of Korea Conference
• /
• 1999.07a
• /
• pp.39-42
• /
• 1999

Perfluoropolymers represent the ultimate resistance to hostile chemical environments and high service temperature, attributed to the presence of fluorine in the polymer backbone, i.e. to the high bond energy of C-F and C-C bonds of fluorocarbons. Copolymers of Tetrafluoroethylene (TEE) and 2, 2, 4Trifluoro-5Trifluorometoxy- 1, 3Dioxole (TTD), commercially known as HYFLON AD, are amorphous perfluoropolymers with glass transition temperature (Tg)higher than room temperature, showing a thermal decomposition temperature exceeding 40$0^{\circ}C$. These polymer systems are highly soluble in fluorinated solvents, with low solution viscosities. This property allows the preparation of self-supported and composite membranes with desired membrane thickness. Symmetric and asymmetric perfluoropolymer membranes, made with HYFLON AD, have been prepared and evaluated. Porous and not porous symmetric membranes have been obtained by solvent evaporation with various processing conditions. Asymmetric membranes have been prepared by th wet phase inversion method. Measure of contact angle to distilled water have been carried out. Figure 1 compares experimental results with those of other commercial membranes. Contact angles of about 120$^{\circ}$for our amorphous perfluoropolymer membranes demonstrate that they posses a high hydrophobic character. Measure of contact angles to hexandecane have been also carried out to evaluate the organophobic character. Rsults are reported in Figure 2. The observed strong organophobicity leads to excellent fouling resistance and inertness. Porous membranes with pore size between 30 and 80 nanometers have shown no permeation to water at pressures as high as 10 bars. However high permeation to gases, such as O2, N2 and CO2, and no selectivities were observed. Considering the porous structure of the membrane, this behavior was expected. In consideration of the above properties, possible useful uses in th field of gas- liquid separations are envisaged for these membranes. A particularly promising application is in the field of membrane contactors, equipments in which membranes are used to improve mass transfer coefficients in respect to traditional extraction and absorption processes. Gas permeation properties have been evaluated for asymmetric membranes and composite symmetric ones. Experimental permselectivity values, obtained at different pressure differences, to various single gases are reported in Tab. 1, 2 and 3. Experimental data have been compared with literature data obtained with membranes made with different amorphous perfluoropolymer systems, such as copolymers of Perfluoro2, 2dimethyl dioxole (PDD) and Tetrafluorethylene, commercialized by the Du Pont Company with the trade name of Teflon AF. An interesting linear relationship between permeability and the glass transition temperature of the polymer constituting the membrane has been observed. Results are descussed in terms of polymer chain structure, which affects the presence of voids at molecular scale and their size distribution. Molecular Dyanmics studies are in progress in order to support the understanding of these results. A modified Theodoru- Suter method provided by the Amorphous Cell module of InsightII/Discover was used to determine the chain packing. A completely amorphous polymer box of about 3.5 nm was considered. Last but not least the use of amorphous perfluoropolymer membranes appears to be ideal when separation processes have to be performed in hostile environments, i.e. high temperatures and aggressive non-aqueous media, such as chemicals and solvents. In these cases Hyflon AD membranes can exploit the outstanding resistance of perfluoropolymers.

• Journal of the Korean Geographical Society
• /
• v.29 no.2
• /
• pp.137-165
• /
• 1994

Structural adjustment of industry (or industrial restructuring) seems to be inherent in the process of capitalist economic development, which tends to be proceeded with shifts from one stage to another in order to overcome structural crises generated in each stage. The structural adjustment of industry is necessarily accompanied with regional restructuring, since it is not only projected on spece, but also mediated by space. Such a restructuring necessitates industrial and uneven regional devlopment through which capital can seek excessive profits over the rate of socio-spatial average. The industrial restructuring and uneven regional development in the 1980s in Korea can be seen as a process in which capital attempted with a strong support of the govenment to overcome the crises in the end of 1970s and hence to go on rapid economic growth. In this process, capital, especially monopoly capital concentrated into few conglomerates, pursued both extensive expansion and intensive development of industry simultaneously. In results, the Korean economy could eliminate some of peripheral characters and maturate the Fordist accumulation system. The extensive expansion of the Korean industry in the 1980s was stimulated mainly through the enlargement and adjustment of investment for equipment facilities which was planned to exclude or rationalize traditional light industries on some places, and to continue rapid growth of key heavy-chemical industries, especially of fabricated metal industry, on other places. In this process, keeping mainly the existing developmental axis which polarized the Seoul Metroplitan region and the Southeast region in Korea, the enhancing spatial mobiiity of capital and the further differentiating division of labour enforced a tendency of concentration of all types of industry in the Seoul Metropolitan region, and at the same time provoked the diffusion of some industries over Jeolla and Chungchong regions in a considerable extent. The intensive development of industriai structure in the 1980s was pursued through the strategic encouragement of subcontracting small firms mainly which produced assembling components, the technical enhancement and factory (semi-) automation, and the enrichment of service industries for estate management, finance, distribution and retailing which supported and complemented the production of goods. In this process, enabling capital to extend and elaborate its domination over space through the reorganization of regulating systems, the Fordist division of labour generated a socio-spatial hierarchy in the nation-wide scale that characterized: the Seoul Metropolitan region as an overmaturated (or overarching) Fordist region performing the conceptive functions of management, research and development, in which all types of industry (including service industries) tended to be reconcentrated; Kyungsang region as a maturated Fordist region with excutive branches of large conglomerates and with subcontracting firms around them which produced standardized products through the automized production processes in secialized Fordist industries or rationalized traditional industries; and Jeolla and Chungchong regions as newly devloping Fordist regions with newly migrated branches and some subcontracting small firms-in relatively older Fordist industries or partly rationalized traditional industries. From these analyses, it can be argued that the structural adjustment of the Korean industry in the 1980s, which had carried out both through the extensive expansion and the intensive deveiopment, strengthened further uneven regional development process, even though it appears to have reduced apparently the economic and regional disparity by balancing numerically large and small firms and by extending the Fordist industrial space nation-wideiy. And it seems more persuasive to see that the Korean industrial structure in the 1980s maturated the Fordist system of accumulation, but not yet transformed towards the post-Fordist (or the so-called flexible) accumulation system, even though the Korean economy in the 1990s seems to be under a pressure of restructuring towards the latter system.

• Journal of Chest Surgery
• /
• v.40 no.6 s.275
• /
• pp.399-406
• /
• 2007

Background: Ischemia-reperfusion injury related to unsuccessful myocardial protection affects postoperative ventricular function and mortality during open-heart surgery. We prospectively compared the effects of administration of histidine-tryptophan-ketoglutarate (HTK) solution and cold blood cardioplegia (CBC) on myocardial protection and clinical outcome in patients undergoing mitral valve surgery. Material and Method: Seventy patients with mitral regurgitation (MR) undergoing mitral valve surgery were randomly divided into the HTK group (n=31) and the CBC group (n=31 ): eight patients were excluded. Perioperative hemodynamics, cardiac medications, pacing, postoperative outcomes and complications were recorded during the hospital stay. All patients received follow-up for at least 6 months postoperatively for morbidity and mortality. Resuか: There were no significant differences in the hemodynamics between the groups during the study period, except for the mean pulmonary artery pressure (MPAP), PCWP and CVP that were lower in the HTK group at 15 min after weaning of CBP. There were no differences for inotropic support and pacing during the 12 hrs postoperatively between the groups. CK-MB values on day 1 and day 2 were $77{\pm}54$ and $41{\pm}23$ for the HTK group and $70{\pm}69$ and $44{\pm}34$ for the CBC group, respectively (p=NS). Postoperative clinical outcomes were similar in both groups for at least 6 months during the follow-up period. Conclusion: These results suggest that the use of HTK solution is as safe as cold blood cardioplegia in terms of myocardial protection.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.3
• /
• pp.361-369
• /
• 1995

Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

• Tuberculosis and Respiratory Diseases
• /
• v.66 no.3
• /
• pp.192-197
• /
• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• Korean Security Journal
• /
• no.39
• /
• pp.185-215
• /
• 2014

Since North Korea has used terror crime as a means of unification under communism against South Korea, South Korea has been much damaged until now. And the occurrence possibility of terror crime by North Korean authority is now higher than any other time. The North Korean terror crimes of Kim Il Sung era had been committed by the dictator's instruction with the object of securing governing fund. However, looking at the terror crimes committed for decades during Kim Jung Il authority, it is revealed that these terror crimes are expressed as a criminal behavior because of the conflict to accomplish the power and economic advantage non powerful groups target. This study focused on the power conflict in various causes of terror crimes by applying George B. Vold(1958)'s theory which explained power conflict between groups became a factor of crime, and found the aspect by ages of terror crime behavior by North Korean authority and responding plan to future North Korean terror crime. North Korean authority high-ranking officials were the Labor Party focusing on Juche Idea for decades in Kim Il Sung time. Afterwards, high-ranking officials were formed focusing on military authorities following Military First Policy at the beginning of Kim Jung Il authority, rapid power change has been done for recent 10 years. To arrange the aspect by times of terror crime following this power change, alienated party executives following the support of positive military first authority by Kim Jung Il after 1995 could not object to forcible terror crime behavior of military authority, and 1st, 2nd Yeongpyeong maritime war which happened this time was propelled by military first authority to show the power of military authority. After 2006, conservative party union enforced censorship and inspection on the trade business and foreign currency-earning of military authority while executing drastic purge. The shooting on Keumkangsan tourists that happened this time was a forcible terror crime by military authority following the pressure of conservative party. After October, 2008, first military reign union executed the launch of Gwanmyungsung No.2 long-range missile, second nuclear test, Daechung marine war, and Cheonanham attacking terror in order to highlight the importance and role of military authority. After September 2010, new reign union went through severe competition between new military authority and new mainstream and new military authority at this time executed highly professionalized terror crime such as cyber/electronic terror unlike past military authority. After July 2012, ICBM test launch, third nuclear test, cyber terror on Cheongwadae homepage of new mainstream association was the intention of Km Jung Eun to display his ability and check and adjust the power of party/military/cabinet/ public security organ, and he can attempt the unexpected terror crime in the future. North Korean terror crime has continued since 1980s when Kim Jung Il's power succession was carried out, and the power aspect by times has rapidly changed since 1994 when Kim Il Sung died and the terror crime became intense following the power combat between high-ranking officials and power conflict for right robbery. Now South Korea should install the specialized department which synthesizes and analyzes the information on North Korean high-ranking officials and reinforce the comprehensive information-collecting system through the protection and management of North Korean defectors and secret agents in order to determine the cause of North Korean terror crime and respond to it. And South Korea should participate positively in the international collaboration related to North Korean terror and make direct efforts to attract the international agreement to build the international cooperation for the response to North Korean terror crime. Also, we should try more to arrange the realistic countermeasure against North Korean cyber/electronic terror which was more diversified with the expertise terror escaping from existing forcible terror through enactment/revision of law related to cyber terror crime, organizing relevant institute and budget, training professional manpower, and technical development.