• Tuberculosis and Respiratory Diseases
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• v.45 no.4
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• pp.813-822
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• 1998

Background: Extubation is recommended to be performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. Methods: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventilation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate $\times$ total ventilatory system resistance) at the 15cm $H_2O$ of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at PSmin). The measurements were repeated at PSmm, during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extubation. In intervention group, failure to continue weaning process was also considered as weaning failure. Results: Thirty-six patients with 42 times weaning trial were satisfied to the protocol. Mean PSmin level was 7.6 (${\pm}1.9$)cm $H_2O$. There were no differences in total ventilation times (TVT), APACHE III score, nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, and tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group ($10.4{\pm}1.25$ and $1.66{\pm}1.08$ J/L in work of breathing) ($191{\pm}232$ and $287{\pm}217$cm $H_2O$ s/m in pressure time product) ($0.33{\pm}0.09$ and $0.29{\pm}0.09$ L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success ($246{\pm}195$ hr, $0.43{\pm}0.11$ L) and the those with weaning failure ($407{\pm}248$ hr, $0.35{\pm}0.10$L) (P<0.05 in each). Conclusion : There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PS min.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.498-506
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• 2005

Background : This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules ($18{\mu}g$ once daily) with a ipratropium metered dose inhaler (2 puffs of $20{\mu}g$ q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). Method : After the initial screening assessment and a two-week run-in period, patients received either tiotropium $18{\mu}g$ once daily or ipratropium $40{\mu}g$ four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second ($FEV_1$) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. Result : In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted $FEV_1$ of 42 (12)% were analyzed. The trough $FEV_1$ response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. Conclusion : This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.

• Journal of Global Scholars of Marketing Science
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• v.18 no.4
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• pp.157-194
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• 2008

The popularity of communities on the internet has captured the attention of marketing scholars and practitioners. By adapting to the culture of the internet, however, and providing consumer with the ability to interact with one another in addition to the company, businesses can build new and deeper relationships with customers. The economic potential of online communities has been discussed with much hope in the many popular papers. In contrast to this enthusiastic prognostications, empirical and practical evidence regarding the economic potential of the online community has shown a little different conclusion. To date, even communities with high levels of membership and vibrant social arenas have failed to build financial viability. In this perspective, this study investigates the role of various kinds of influencing factors to online community loyalty and basically suggests the framework that explains the process of building purchase loyalty. Even though the importance of building loyalty in an online environment has been emphasized from the marketing theorists and practitioners, there is no sufficient research conclusion about what is the process of building purchase loyalty and the most powerful factors that influence to it. In this study, the process of building purchase loyalty is divided into three levels; characteristics of community site such as content superiority, site vividness, navigation easiness, and customerization, the mediating variables such as self congruency, consumer experience, and consumer to consumer interactivity, and finally various factors about online community loyalty such as visit loyalty, affect, trust, and purchase loyalty are those things. And the findings of this research are as follows. First, consumer-to-consumer interactivity is an important factor to online community purchase loyalty and other loyalty factors. This means, in order to interact with other people more actively, many participants in online community have the willingness to buy some kinds of products such as music, content, avatar, and etc. From this perspective, marketers of online community have to create some online environments in order that consumers can easily interact with other consumers and make some site environments in order that consumer can feel experience in this site is interesting and self congruency is higher than at other community sites. It has been argued that giving consumers a good experience is vital in cyber space, and websites create an active (rather than passive) customer by their nature. Some researchers have tried to pin down the positive experience, with limited success and less empirical support. Web sites can provide a cognitively stimulating experience for the user. We define the online community experience as playfulness based on the past studies. Playfulness is created by the excitement generated through a website's content and measured using three descriptors Marketers can promote using and visiting online communities, which deliver a superior web experience, to influence their customers' attitudes and actions, encouraging high involvement with those communities. Specially, we suggest that transcendent customer experiences(TCEs) which have aspects of flow and/or peak experience, can generate lasting shifts in beliefs and attitudes including subjective self-transformation and facilitate strong consumer's ties to a online community. And we find that website success is closely related to positive website experiences: consumers will spend more time on the site, interacting with other users. As we can see figure 2, visit loyalty and consumer affect toward the online community site didn't directly influence to purchase loyalty. This implies that there may be a little different situations here in online community site compared to online shopping mall studies that shows close relations between revisit intention and purchase intention. There are so many alternative sites on web, consumers do not want to spend money to buy content and etc. In this sense, marketers of community websites must know consumers' affect toward online community site is not a last goal and important factor to influnece consumers' purchase. Third, building good content environment can be a really important marketing tool to create a competitive advantage in cyberspace. For example, Cyworld, Korea's number one community site shows distinctive superiority in the consumer evaluations of content characteristics such as content superiority, site vividness, and customerization. Particularly, comsumer evaluation about customerization was remarkably higher than the other sites. In this point, we can conclude that providing comsumers with good, unique and highly customized content will be urgent and important task directly and indirectly impacting to self congruency, consumer experience, c-to-c interactivity, and various loyalty factors of online community. By creating enjoyable, useful, and unique online community environments, online community portals such as Daum, Naver, and Cyworld are able to build customer loyalty to a degree that many of today's online marketer can only dream of these loyalty, in turn, generates strong economic returns. Another way to build good online community site is to provide consumers with an interactive, fun, experience-oriented or experiential Web site. Elements that can make a dot.com's Web site experiential include graphics, 3-D images, animation, video and audio capabilities. In addition, chat rooms and real-time customer service applications (which link site visitors directly to other visitors, or with company support personnel, respectively) are also being used to make web sites more interactive. Researchers note that online communities are increasingly incorporating such applications in their Web sites, in order to make consumers' online shopping experience more similar to that of an offline store. That is, if consumers are able to experience sensory stimulation (e.g. via 3-D images and audio sound), interact with other consumers (e.g., via chat rooms), and interact with sales or support people (e.g. via a real-time chat interface or e-mail), then they are likely to have a more positive dot.com experience, and develop a more positive image toward the online company itself). Analysts caution, however, that, while high quality graphics, animation and the like may create a fun experience for consumers, when heavily used, they can slow site navigation, resulting in frustrated consumers, who may never return to a site. Consequently, some analysts suggest that, at least with current technology, the rule-of-thumb is that less is more. That is, while graphics etc. can draw consumers to a site, they should be kept to a minimum, so as not to impact negatively on consumers' overall site experience.

• MISULJARYO - National Museum of Korea Art Journal
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• v.96
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• pp.89-122
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• 2019

In this paper, I argue that the Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers by Jeong Su-yeong (1743~1831, pseudonym: Jiwujae) is a record of his private journeys to several places on the outskirts of Hanyang (present-day Seoul) and that it successfully embodies the painter's subjective perspective while boating on these rivers and going on outings to nearby mountains. Around 1796, Jeong Su-yeong traveled to different places and documented his travels in this 16-meter-long handscroll. Several leaves of paper, each of which depicts a separate landscape, are pieced together to create this long handscroll. This indicates that the Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers reflected the painter's personal subjective experiences as he went along his journey rather than simply depicts travel destinations. The Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers features two types of travel: boating and mountain outings on foot. Traveling by boat takes up a large portion of the handscroll, which illustrates the channels of the Hangang and Imjingang Rivers. Mountain outings correspond to the sections describing the regions around Bukhansan, Gwanaksan, and Dobongsan Mountains. Jeong Su-yeong traveled to this wide span of places not just once, but several times. The fact that the Hangang River system are not presented in accordance with their actual locations shows that they were illustrated at different points. After visiting the riversides of the Hangang and Namhangang Rivers twice, Jeong Su-yeong delineated them in fourteen scenes. Among them, the first eight illustrate Jeong's initial trip by boat, while the other six scenes are vistas from his second trip. These fourteen scenes occupy half of this handscroll, indicating that the regions near the Hangang River are painted most frequently. The scenes of Jeong Su-yeong's first boating trip to the system of the Hangang River portray the landscapes that he personally witnessed rather than famous scenes. Some of the eight scenic views of Yeoju, including Yongmunsan Mountain, Cheongsimru Pavilion, and Silleuksa Temple, are included in this handscroll. However, Jeong noted spots that were not often painted and depicted them using an eye-level perspective uncommon for illustrating famous scenic locations. The scenes of Jeong's second boating trip include his friend's villa and a meeting with companions. Moreover, Cheongsimru Pavilion and Silleuksa Temple, which are depicted in the first boating trip, are illustrated again from different perspectives and in unique compositions. Jeong Su-yeong examined the same locations several times from different angles. A sense of realism is demonstrated in the scenes of Jeong's first and second boating trips to the channels of the Hangang River, which depict actual roads. Furthermore, viewers can easily follow the level gaze of Jeong from the boat. The scenes depicting the Imjingang River begin from spots near the Yeongpyeongcheon and Hantangang Rivers and end with places along the waterways of the Imjingang River. Here, diverse perspectives were applied, which is characteristic of Imjingang River scenes. Jeong Su-yeong employed a bird's-eye perspective to illustrate the flow of a waterway starting from the Yeongpyeongcheon River. He also used an eye-level perspective to highlight the rocks of Baegundam Pool. Thus, depending on what he wished to emphasize, Jeong applied different perspectives. Hwajeogyeon Pond located by the Hantangang River is illustrated from a bird's-eye perspective to present a panoramic view of the surroundings and rocks. Similarly, the scenery around Uhwajeong Pavilion by the Imjingang River are depicted from the same perspective. A worm's-eye view was selected for Samseongdae Cliff in Tosangun in the upper regions of the Imjingang River and for Nakhwaam Rock. The scenes of Jeong Su-yeong's mountain outings include pavilions and small temple mainly. In the case of Jaeganjeong Pavilion on Bukhansan Mountain, its actual location remains unidentified since the pavilion did not lead to the route of the boating trip to the system of the Hangang River and was separately depicted from other trips to the mountains. I speculate that Jaeganjeong Pavilion refers to a pavilion either in one of the nine valleys in Wooyi-dong at the foot of Bukhansan Mountain or in Songajang Villa. Since these two pavilions are situated in the valleys of Bukhansan Mountain, their descriptions in written texts are similar. As for Gwanaksan Mountain, Chwihyangjeong and Ilganjeong Pavilions as well as Geomjisan Mountain in the Bukhansan Mountain range are depicted. Ilganjeong Pavilion was a well-known site on Gwanaksan that belonged to Shin Wi. In this handscroll, however, Jeong Su-yeong recorded objective geographic information on the pavilion rather than relating it to Shin Wi. "Chwihyangjeong Pavilion" is presented within the walls, while "Geomjisan Mountain" is illustrated outside the walls. Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers also includes two small temples, Mangwolam and Okcheonam, on Dobongsan Mountain. The actual locations of these are unknown today. Nevertheless, Gungojip (Anthology of Gungo) by Yim Cheonsang relates that they were sited on Dobongsan Mountain. Compared to other painters who stressed Dobong Seowon (a private Confucian academy) and Manjangbong Peak when depicting Dobongsan Mountain, Jeong Su-yeong highlighted these two small temples. Jeong placed Yeongsanjeon Hall and Cheonbong Stele in "Mangwolam small temple" and Daeungjeon Hall in front of "Okcheonam small temple." In addition to the buildings of the small temple, Jeong drew the peaks of Dobongsan Mountain without inscribing their names, which indicates that he intended the Dobongsan peaks as a background for the scenery. The Handscroll of a Sightseeing Trip to the Hangang and Imjingang Rivers is of great significance in that it embodies Jeong Su-yeong's personal perceptions of scenic spots on the outskirts of Hanyang and records his trips to these places.