This study explores the lexical bundles in the speech of Korean English language users who share the same heritage language and culture, Korean, but with different proficiency in English: Korean-Americans whose first language is English (2nd-generation Korean-Americans; G2KAs), bilingual Korean-Americans who started to learn English at an early age (1.5-generation Korean-Americans; G1.5KAs), and Koreans who learned English in Korea (L2Ks). One of the big differences between native (NSs) and non-native speakers (NNSs) is that NNSs use verb-related lexical bundles dominantly unlike NSs. Thus, the structural patterns of lexical bundle uses in addition to verb uses were examined. The results were consistent to previous studies showing increasing use of lexical bundles with increase in English proficiency; NSs (G2KAs) used the lexical bundles more than G1.5KAs and L2Ks. However, in contrast to previous studies, G2KAs mostly used VP-related lexical bundles, G1.5KAs used lexical bundles in the widest range, and L2Ks used the most lexical verbs. The paper elaborates the details of the results and suggests further studies including the new group of English users, G1.5KAs, to help understand a possible influence of their heritage language and culture on English speaking.
Figure 1. Posterior-anterior chest X-ray revealing diffuse reticular and cystic lung changes. A 32-year-old man with past medical history of central diabetes insipidus (DI) of previously unknown etiology and hidradenitis suppurativa (HS) presented with worsening dyspnea and bilateral chest tightness. He had no history of smoking, marijuana, or drug abuse. Physical examination was significant for decreased breath sounds of the right and left lower lung fields. A radiograph of the chest showed low lung volumes with diffuse reticulation and cystic changes of both lungs (Figure 1). Computerized tomography scan of the chest (Figure 2) revealed diffuse, bilateral, irregular cysts throughout the lungs. No other infiltrates or effusions were present. Pulmonary function testing showed a mixed obstructive and restrictive ventilatory defect with reduced diffusing capacity of the lung for carbon monoxide. The differential given the cystic findings on computerized tomography were: Langerhans cell histiocytosis (LCH), Birt-Hogg-Dubé syndrome, lymphocytic interstitial pneumonia, amyloidosis, and potential cystic metastases. Biopsy of the skin lesion within the right axilla (Figures 3 and 4) was performed, which revealed LCH and not HS. Given these findings, the patient's DI was investigated with brain magnetic resonance imaging (Figure 5), which found a pituitary microadenoma. The patient's constellation of symptoms and cystic imaging findings were attributed to multifocal adult LCH, which differs from pulmonary LCH in that it often occurs in nonsmokers, causes diffuse rather than upper and mid-lung field-predominant cystic disease, and involves visceral organs in addition to lymph nodes, bone, skin, and pituitary (1). He was started on cytarabine owing to multiorgan involvement that was unresponsive to corticosteroids. His DI and skin lesion improved in response to chemotherapy, but his lung function continued to deteriorate. Multifocal LCH is an inflammatory neoplasm, and typical lesions are composed of approximately 8 to 30% BRAF or mitogenactivated protein kinase mutant tumor cells and the stromal cells they recruit (1-5). Given the recent discovery of targetable driver mutations, some patients may be considered for therapy with BRAF or mitogenactivated protein kinase extracellular signal-regulated kinase inhibitors after appropriate genetic analysis. Lung involvement can occur in isolation or in conjunction with multiorgan disease. In those with multiorgan disease, DI is seen in 30% of adult patients,
Congenital heart disease (CHD)-associated pulmonary arterial hypertension (PAH) includes a heterogeneous patient population that can be characterized by the underlying cardiac malformation. CHD-associated PAH has an estimated prevalence of 5–10% in adult patients, with an increasing number of patients surviving to adulthood because of advances in the surgical management and the development of pulmonary arterial hypertension (PAH)-targeted pharmacotherapy. Although limited data exist, targeted PAH pharmacotherapy has proven to be beneficial in patients with CHD-associated PAH, with observed improvement in functional class, increase in exercise capacity, and improvement in quality of life and cardiopulmonary hemodynamics. Additionally, there has been increasing interest in the “treat-to-close” strategy. PAH-targeted pharmacotherapy may be used to optimize cardiopulmonary hemodynamics so as to improve patients’ operability in repairing the cardiac defect. Although there have been significant advances in the management of this disease state in the past 2 decades, mortality remains high, and ongoing clinical trials are needed to better understand the treat-to-close strategy.
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