• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.361-369
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• 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
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• v.66 no.3
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• pp.192-197
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• 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
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• no.39
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• pp.185-215
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• 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.