• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.280-288
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• 2004

Background : Lung protective strategies, using low tidal volume in ARDS, improve survival rate in ARDS. However, low tidal volume ventilation may promote alveolar de-recruitment. Therefore, alveolar recruitment is necessary to maintain arterial oxygenation and to prevent repetitive opening and closure of collapsed alveoli in lung protective strategies. There has been a recent report describing improvement in arterial oxygenation with use of recruitment maneuver. However, impact of recruitment on outcome of ARDS is unknown. We evaluated whether short-term survival difference existed in patients with ARDS, who were performed alveolar recruitment maneuver(ARM) and prone position, according to response of alveolar recruitment or not. Methods : All patients who were diagnosed with ADRS and received mechanical ventilation were included. ARM were sustained inflation($35-45cmH_2O$ CPAP for 30-40 sec.) or increasing level of PEEP. If these methods were ineffective, alveolar recruitment with prone position was done for at least 10 hours. $P_aO_2/FiO_2$(P/F) ratio was determined before and at 0.5 and 2 hours after ARM. We defined a responder if the P/F ratio was increased over 50% of baseline value. We compared 10-days and 30-days survival rate between responders and non-responders. Results : 20 patients(M:F=12:8, $63{\pm}14age$) were included. Among them, 12 patients were responders and 8 patients were non-responders. In responders, P/F ratio was increased from $92{\pm}25mmHg$ to $244{\pm}85mmHg$. In non-responders, P/F ratio increased from $138{\pm}37mmHg$ to $163{\pm}60mmHg$. Among non-responders, P/F ratio was improved over 50% in 2 patients after prone position. Overall, 14 patients were responders after ARM and prone position. The 10-days and 30-days survival rate in responders was significantly higher than in non-responders(86%, 57% in responders and 33%, 0% in non-responders)(p<0.05). There was no significant difference between responders and non-responders in age($71{\pm}11$, $60{\pm}14$), lung injury score($2.8{\pm}0.2$, $2.9{\pm}0.45$), simplified acute physiology score(SAPS) II ($35{\pm}4.6$, $34{\pm}5.7$), positive end-positive pressure level($15.6{\pm}1.9cmH_2O$, $14.5{\pm}2.1cmH_2O$). Conclusion : ARM may improve arterial oxygenation in some patients with ARDS. These responders in patients with ARDS showed significant higher 10-days and 30-days survival rate than non-responders patients with alveolar recruitment.

• (The)Study of the Eastern Classic
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• no.57
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• pp.467-505
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• 2014

I am working on a series of Korean linguistic studies targeting Ganchal(old typed letters in Korea) for many years and this study is for the typology of the [Safety Expression] as the part. For this purpose, [Safety Expression] were divided into a formal types and semantic types, targeting the Chinese Ganchal and Hangul Ganchal of modern Korean Language time(16th century-19th century). Formal types can be divided based on whether Normal position or not, whether Omission or not, whether the Sending letter or not, whether the relationship of the high and the low or not. Normal position form and completion were made the first type which reveal well the typicality of the [Safety Expression]. Original position while [Own Safety] omitted as the second type, while Original position while [Opposite Safety] omitted as the third type, Original position while [Safety Expression] omitted as the fourth type. Inversion type were made as the fifth type which is the most severe solecism in [Safety Expression]. The first type is refers to Original position type that [Opposite Safety] precede the [Own Safety] and the completion type that is full of semantic element. This type can be referred to most typical and normative in that it equipped all components of [Safety Expression]. A second type is that [Safety Expression] is composed of only the [Opposite Safety]. This type is inferior to the first type in terms of set pattern, it is never outdone when it comes to the appearance frequency. Because asking [Opposite Safety] faithfully, omitting [Own Safety] dose not greatly deviate politeness and easy to write Ganchal, it is utilized. The third type is the Original position type showing the configuration of the [Opposite Safety]+Own Safety], but [Opposite Safety] is omitted. The fourth type is a Original position type showing configuration of the [Opposite Safety+Own Safety], but [Safety Expression] is omitted. This type is divided into A ; [Safety Expression] is entirely omitted and B ; such as 'saving trouble', the conventional expression, replace [Safety Expression]. The fifth type is inversion type that shown to structure of the [Own Safety+Opposite Safety], unlike the Original position type. This type is the most severe solecism type and real example is very rare. It is because let leading [Own Safety] and ask later [Opposite Safety] for face save is offend against common decency. In addition, it can be divided into the direct type that [Opposite Safety] and [Own Safety] is directly connected and indirect type that separate into the [story]. The semantic types of [Safety Expression] can be classified based on whether Sending letter or not, fast or slow, whether intimate or not, and isolation or not. For Sending letter, [Safety Expression] consists [Opposite Safety(Climate+Inquiry after health+Mental state)+Own safety(status+Inquiry after health+Mental state)]. At [Opposite safety], [Climate] could be subdivided as [Season] information and [Climate(weather)] information. Also, [Mental state] is divided as receiver's [Family Safety Mental state] and [Individual Safety Mental state]. In [Own Safety], [Status] is divided as receiver's traditional situation; [Recent condition] and receiver's ongoing situation; [Present condition]. [Inquiry after health] is also subdivided as receiver's [Family Safety] and [Individual Safety], [Safety] is as [Family Safety] and [Individual Safety]. Likewise, [Inquiry after health] or [Safety] is usually used as pairs, in dimension of [Family] and [Individual]. This phenomenon seems to have occurred from a big family system, which is defined as taking care of one's parents or grand parents. As for the Written Reply, [Safety Expression] consists [Opposite Safety (Reception+Inquiry after health+Mental state)+Own safety(status+Inquiry after health+Mental state)], and only in [Opposite safety], a difference in semantic structure happens with Sending letter. In [Opposite Safety], [Reception] is divided as [Letter] which is Ganchal that is directly received and [Message], which is news that is received indirectly from people. [Safety] is as [Family Safety] and [Individual Safety], [Mental state] also as [Family Safety Mental state] and [Individual Safety Mental state].