• Tuberculosis and Respiratory Diseases
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• v.48 no.5
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• pp.766-772
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• 2000

Background : Pressure rise time (PRT) is the time in which the ventilator aclieves the set airway pressure in pressure-targeted modes, such as pressure control ventilation (PCV). With varying PRT, in principle, the peak inspiratory flow rate of the ventilator also varies. And if PRT is set to a shorter duration, the effective duration of target pressure level would be prolonged, which in turn would increase inspiratory tidal volume(Vti) and mean airway pressure (Pmean). We also postulated that the increase in Vti with shortening of PRT may relate inversely to the patients' basal airway resistance. Methods : In 13 paralyzed patients on PCV (pressure control 18$\pm$9.5 cm $H_2O$ $FIO_2\;0.6\pm0.3$, PEEP 5$\pm$3 cm $H_2O$, f 20/min, I : E1 : 2) with Servo 300 (Siemens-Elema, Solna, Sweden) from various causes of respiratory failure, PRT of 10 %, 5 % and 0 % were randomly applied. At 30 min of each PRT trial, peak inspiratory flow (PIF, L/sec), Vti (ml), Pmean (cm $H_2O$) and ABGA were determined. Results : At PRT 10%, 5%, and 0%, PIF were 0.69$\pm$0.13, 0.77$\pm$0.19, 0.83$\pm$0.22, respectively (p<0.001). Vti were 425$\pm$94, 439$\pm$101, 456$\pm$106, respectively (p<0.001), and Pmean were 11.2$\pm$3.7, 12.0$\pm$3.7, 12.5$\pm$3.8, respectively (p<0.001). pH were 7.40$\pm$0.08, 7.40$\pm$0.92, 7.41$\pm$0.96, respectively (p=0.00) ; $PaCO_2$ (mm Hg) were 47.4$\pm$15.8, 47.2 $\pm$15.7, 44.6$\pm$16.2, respectively (p=0.004) ; $PAO_2-PaO_2$ (mm Hg) were 220$\pm$98, 224$\pm$95, 227$\pm$94, respectively (p=0.004) ; and $V_n/V_T$ as determined by ($PaCO_2-P_E-CO_2$)/$PaCO_2$ were 0.67$\pm$0.07, 0.67$\pm$0.08, 0.66$\pm$0.08, respectively (p=0.007). The correlation between airway resistance and change of Vti from PRT 10% to 0% were r= -0.243 (p=0.498). Conclusion : Shortening of pressure rise timee during PCV was associated with increased tidal volume, increased mean airway pressure and lower $PaCO_2$.

• Korean Journal of Poultry Science
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• v.38 no.1
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• pp.59-69
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• 2011

This study was conducted to investigate the effects of dietary supplementation of CS682, a fermentation product of Actinomycetae(Nocardia sp. CS682), and its commercial product DSC682$^{(R)}$ on the performance, blood parameters, intestinal microflora, and immune response in laying hens. Hy-Line Brown$^{(R)}$ laying hens were housed in two bird cages. Feeding trial lasted 5 wk under 16.5 h:7.5 h(L:D) lighting regimen. In Exp.1, a total of 480 birds of 86 wk old were assigned to four dietary treatments: Control, Antibiotics (6 ppm avilamycin), CS682-0.1 (CS682 0.1%) and CS682-1.0 (CS682 1.0% supplementation). Each treatment was replicated five times with 24 birds (or 12 cages) per replication. In Exp. 2, a total of 1,000 birds of 26 wk old were assigned to five dietary treatments: Control, Antibiotics (6 ppm avilamycin), DCS682-0.05 (DCS682 0.05%), DCS682-0.1 (DCS682 0.1%), DCS682-0.2 (DCS682 0.2% supplementation). Each treatment was replicated five times with 40 birds (or 20 cages) per replication. In Exp. 1, there were no significant differences among treatments in egg production, egg weight, broken & soft egg production, feed intake, and feed conversion ratio. Also, there were no significant differences among treatments in eggshell thickness, eggshell color and Haugh unit. However, eggshell strength was significantly (p<0.05) greater in CS682 and Antibiotics treatments than Control, and egg yolk color was significantly (p<0.05) higher in CS682-1.0 than Control. In Exp. 2, feed intake was significantly (p<0.05) lower in DSC682-0.05 than Control. Lightness(L) of Hunter Lab color of eggshell of DCS and Antibiotics treatments was significantly (p<0.05) lower than Control. Egg yolk color of DCS 0.1 and 0.2 treatments was significantly (p<0.05) higher than Control. Haugh unit increased significantly (p<0.05) in Antibiotics and DCS682-0.1 treatments. The immunoglobulin levels of plasma (IgG and IgA) and eggyolk (IgY) were not significantly affected by treatments. Antibiotics and CS682 or DCS682 treatments significantly (p<0.05 or 0.01) influenced some of the erythrocytes and leukocytes parameters in blood. In Exp.1, mean corpuscular volume (MCV) decreased by CS682 treatments and mean corpuscular hemoglobin (MCH) was highest in Antibiotics treatments. In Exp.2, the level of monocyte (MO) decreased in DCS682-0.10 and 0.20 treatments. The cfu of C. perfringens and S. typhimurium in small intestinal content were highest in Control and lowest in Antibiotics in both experiments. In Exp. 2, DSC682-0.05 and -0.1 treatments were highest and Antibiotic treatment was lowest in Lactobacilli spp. The results of the present layer experiments indicated that supplementation of 0.1~0.2% CS682 or DCS682 may increase eggshell strength, color of eggshell and eggyolk, Haugh unit, and control harmful intestinal microbes.

• Radiation Oncology Journal
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• v.26 no.2
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• pp.104-112
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• 2008

Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

• Korean Journal of Organic Agriculture
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• v.16 no.4
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• pp.421-434
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• 2008

This study was carried out to estimate the selection of appropriate forage crops, proper application levels of livestock manure, and carrying capacity per unit area for organic livestock, as influenced by livestock manure application levels compared with chemical fertilizer to corn and sorghum $\times$ sorghum hybrid, in order to produce organic forages by utilizing livestock manure. For both corns and sorghum $\times$ sorghum hybrids, no fertilizer plots had significantly (p<0.05) lower annual dry matter (DM), crude protein (CP) and total digestible nutrients (TDN) yields than those of other plots, whereas the N+P+K plots ranked the highest yields, followed by 150% cattle manure plots and 100% cattle manure plots. Dry matter, CP and TDN yields of cattle manure plots were significantly (p<0.05) higher than those of no fertilizer and P+K plots. In applying cattle manure, the yields of cattle slurry plots tended to be a little higher than those of composted cattle manure plots. Assuming that corns and sorghum $\times$ sorghum hybrids produced from this trial were fed at 70% level to 450kg of Hanwoo heifer with 400g of average daily gain, livestock carrying capacity (head/year/ha) ranked the highest in N+P+K plots of the case of corns (mean 6.7 heads), followed by 150% cattle slurry plots (mean 5.6 heads), 150% composted cattle manure plots (mean 4.8 heads), 100% cattle slurry plots (mean 4.4 heads), 100% composted cattle manure plots (mean 4.3 heads), P+K plots (mean 4.1 heads), and no fertilizer plots (mean 3.1 heads). Meanwhile, in case of sorghum $\times$ sorghum hybrids, N+P+K plots (mean 5.7 heads) ranked the highest carrying capacity, followed by $100{\sim}150%$ cattle slurry plots (mean $4.8{\sim}5.2$ heads), 150% composted cattle manure plots (mean 4.7 heads), 100 % composted cattle manure plots (mean 4.3 heads), P+K plots (mean 3.8 heads), and no fertilizer plots (mean 3.4 heads). The results indicated that replacing chemical fertilizer by livestock manure application to cultivation soil for forage crops could enhance not only DM and TDN yields, but also organic stock carrying capacity. In conclusion, it was conceived that organic forage production by reutilizing livestock manure might contribute to reduced environmental pollution and the production of environment friendly agricultural products through resources recycling.

• Journal of Animal Science and Technology
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• v.45 no.1
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• pp.101-112
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• 2003

This study was conducted to investigate the effect of the level of concentrates and pasture grazing in 60 head of spring born Hanwoo heifers(initial body weight; 125.3kg) for 450days from six to 21 months in age. Feeding trial was conducted with 5 treatment(twelve heads/ treatment) which were T1(1.5% of apparent body weight in concentrates and indoor feeding for over-all period), T2(0.5% of apparent body weight in concentrates for pre-pasture grazing and pasture grazing), T3(1.0% of apparent body weight in concentrates for pre-pasture grazing and pasture grazing), T4(1.5% of apparent body weight in concentrates for pre-pasture grazing and pasture grazing), T5(2.0% of apparent body weight in concentrates for pre-pasture grazing and pasture grazing). During the total experimental period, average daily gains by treatments ranged from 0.322 to 0.465kg(average 0.405kg) and higher in the order of T5, T4, T1, T3 and T2, and increased with the level of concentrates feeding for pre-pasture grazing. TDN intakes required per unit of kilogram gain were 9.13 to 9.79kg(average 9.49kg) higher in the order of T1, T3, T5, T4 and T2, For the grazing period, they were ranged from 12.39 to 12.98kg(average 12.68kg), and were not significantly different. But TDN requirements of grazing groups was higher about 15.6% than the indoor feeding group’s. The rate of roughage to concentrates by treatments were 57.8 to 73.6%(average 63.7%). The body weight of 15 and 21 month in ages, that is, the ages at puberty and first conception by treatments were 201.2 to 230.7kg(average 223.8kg) and 270.2 to 331.4kg (average 307.6kg), respectively, and the latter were high per unit of 20.4kg by increasing the level of concentrates feeding for pre-pasture grazing every 0.5% addition of apparent body weight. The age of 225 and 275kg in body weight, that is, the body weight at puberty and first conception by treatments were 14.0 to 17.6 month (average 15.3 month) and 17.9 to 21.7 month(average 19.4), respectively, and the latter were shorter about 1.3 month by increasing the level of concentrates feeding every 0.5% addition of apparent body weight. According to the above results, it may be concluded that spring born Hanwoo heifers are raised at indoor have to feed with 1.8% of body weight in concentrates under full feeding of rice straws for all period from six to 21 months in age, but with 1.5% of apparent body weight in concentrates for grazing period.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.265-274
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• 1998

Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

• Journal of Life Science
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• v.19 no.11
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• pp.1538-1546
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• 2009

This study was conducted to estimate the in vitro fermentation characteristics and in situ degradabilities of total mixed rations fermented by the synbiotic co-cultures composed of various anaerobic microorganisms in the rumen of cow. Seventy two TMR bags (4 treatments $\times$ 6 fermentation days $\times$ 3 replications) were manufactured for in vitro and in situ experiments. The experiment was composed of four treatments including the control, the mould and bacteria synbiotics (T1), the mould and yeast synbiotics (T2) and the bacteria and yeast synbiotics (T3). Each treatment had six fermentation days (1, 3, 5, 7, 14, 21 day) with three replications. Two rumen cannulated Holstein cows (550 ㎏ of mean body wt) were used for in situ trial, and a total of 96 nylon bags were retrieved from the rumen according to eight fermentation times (1, 3, 6, 9, 18, 24, 48 and 72 hr). The mean fermentation temperatures of TMRs by supplementation of anaerobic micoorganism co-cultures ranged from $22.97^{\circ}C$ to $26.07^{\circ}C$, and tended to increase steadily during the entire period. pH values of the F-TMRs ranged from 4.39 to 4.98 and tended to decrease with the extension of the fermentation period, and decreased by supplementation of synbiotics (p<0.05). The ammonia concentrations of F-TMRs were not affected by addition of synbiotic co-cultures during the early fermentation period (within 7 days), but was lowest (p<0.05) in T3 during the late fermentation periods (after 14 days). Lactic acid concentration of F-TMR was lowest in T3 at 1 day of fermentation, but was not different from treatments in the other fermentation days. Microbial growth rates of F-TMR reached a peak at 7 days of fermentation, and afterward tended to decrease. In in situ experiment, the DM disappearance rates were higher in T1 than the control during early fermentation times (within 3 hours), but was vice versa at 48 hours of fermentation (p<0.05). There was no significant difference in effective DM degradability among treatments. NDF and ADF disappearance rates in situ were similar to those of DM. From the above results, the supplementation of synbiotics, particularly the mould and bacteria synbiotics, resulted in improving the pH and concentration of lactic acid of F-TMR as parameters of fermentation compare to the control, and also had higher in situ disappearance rates of DM, NDF and ADF than the control at early fermentation time. However, effective DM degradability was not affected by supplementation of synbiotics.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.311-323
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• 1998

Purpose : Prospective, single arm, Phase I/II clinical trial was performed to assess the efficacy and toxicity of the concurrent chemotherapy and definitive radiotherapy (RT) in patients with previously untreated locally advanced carcinoma of the uterine cervix. Methods and Materials : From Mar 1992 to January 1997, a total of 73 patients with advanced cervical carcinoma were entered on the protocol but 5 patients were excluded in analysis because of patients' refusal of treatment. Their ages ranged from 31 to 77 years, median 58 years. The International Federation of Gynecology and Obstetrics (FIGO) stage distribution was as follows: IIB 46, IIIA 2, IIIB 15 and IVA 5. RT consisted of external beam irradiation to 4,140-5,040 cGy/23-28 fractions plus high dose rate intracavitary treatments to deliver a dose of 30-35 Gy to point A in 6-7 fractions. During the intracavitary treatments parametrial boost was delivered for point B dose of 60 Gy in stage IIB and 65 Gy in stage IIIB. Two cycles of concurrent 5-fluorouracil and cisplatin (FP) chemotherapy (5-fluorouracil 1,000 mg/$m^2$/day continuous infusion for 4 days, day 1-4, 29-32 and cisplatin 20 mg/$m^2$/day intravenous bolus for 3 days day 1-3, 29-31) administered starting on day 1 of RT. Results : The median follow-up was 24 months (range 4-68+). Sixty-four patients were evaluable for survival rate in this protocol: The 5-year actuarial and disease-free survival rate were 52$\%$ and 64$\%$, respectively. The 5-rear actuarial survival for stage IIB and III+IVA patients were 58$\%$ and 36$\%$, respectively The 5-year disease-free survival rate for stage IIB and III+IVA patients were 71$\%$ and 40$\%$, respectively. Of the 68 patients evaluated for patterns of failure, overall recurrence rate was 27.9$\%$ (19/68) : local failure in 5.9$\%$ (4/68), distant metastasis in 10.3$\%$ (7/68) and both in 11.8$\%$ (8/68). Of the 64 patients evaluated for response at one month after the completion of treatment the complete response rate was 78$\%$ (50/64). Concurrent chemoradiation appear to be a well-tolerated regimen but there were two treatment-related deaths. Conclusion : Concurrent chemotherapy of FP with high-dose definitive RT in locally advanced carcinoma of the uterine cervix is feasible and effective with acceptable toxicities. This chemoradiation regimen may offer a modest survival benefit for advanced stage. Further follow-up of these patients will evaluate the impact of this regimen on the long-term local control and their survival.

• Journal of Oral Medicine and Pain
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• v.31 no.4
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• pp.283-296
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• 2006

Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1252-1264
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• 1998

Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.