• Neonatal Medicine
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• v.16 no.2
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• pp.213-220
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• 2009

Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.

• Neonatal Medicine
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• v.16 no.2
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• pp.154-162
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• 2009

Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

• Neonatal Medicine
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• v.16 no.2
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• pp.172-181
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• 2009

Purpose: To identify trends in causative bacterial organisms for neonatal sepsis and antimicrobial susceptibilities over 10 years in one neonatal intensive care unit. Methods: We retrospectively reviewed the cases of culture-proven neonatal sepsis between January 1998 and December 2007. The 10-year period was divided into two phases (phase I, 1998-2002; phase II, 2003-2007) to distinguish the differences during the entire period. Results: Total 350 episodes of neonatal sepsis were identified in 315 neonates. The common pathogens of early-onset sepsis were S. epidermidis, S. aureus, P. aeruginosa, and E. cloacae in phase I, and S. epidermidis and E. cloacae in phase II. In cases of late-onset sepsis, coagulase negative Staphylococcus, S. aureus, and K. pneumoniae were isolated frequently in both phases. The incidence of sepsis caused by multi-drug resistant organisms decreased with strict infection control. Gram positive organisms showed 0-20% susceptibility to penicillin, ampicillin, and cefotaxime in both phases. Sensitivity to amikacin for Enterobacter spp. increased, whereas P. aeruginosa showed decreased sensitivity in phase II. Between 50% and 60% of other gram negative bacteria, except P. aeruginosa, were susceptible to cefotaxime in phase II in contrast to phase I. Greater than 80% of gram negative bacteria were sensitive to imipenem except P. aeruginosa and ciprofloxacin in both phases. Conclusion: The trend in causative microorganisms and antimicrobial susceptibilities can be used as a guideline for selection of appropriate antibiotics. A particular attention should be paid to infection control, especially to reduce sepsis caused by multi-drug resistant organisms.

• Journal of Life Science
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• v.17 no.10
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• pp.1447-1451
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• 2007

Through the screening of marine natural compounds that inhibit cancer cell proliferation, we previously reported that pectenotoxin-2 (PTX-2) isolated from marine sponges exhibits selective cytotoxicity against several cell lines in p53-deficient tumor cells compared to those with functional p53. However, the molecular mechanisms of its anti-proliferative action on malignant cell growth are not completely known. To further explore the mechanisms of its anti-cancer activity and to test whether the status of p53 in liver cancer cells correlates with their chemo-sensitivities to PTX-2, we used two well-known hepatocarcinoma cell lines, p53-deficient Hep3B and p53-wild type HepG2. We have demonstrated that PTX-2 markedly inhibits Hep3B cell growth and induces apoptosis whereas HepG2 cells are much more resistant to PTX-2 suggesting that PTX-2 seems to act by p53-independent cytotoxic mechanism. The apoptosis induced by PTX-2 in Hep3B cells was associated with the modulation of DNA fragmentation factor (DFF) family proteins, up-regulation of pro-apoptotic Bcl-2 family members such as Bax and Bcl-xS and activation of caspases (caspase-3, -8 and -9). Blockade of the caspase-3 activity by caspase-3 inhibitor, z-DEVD-fmk, prevented the PTX-2-induced growth inhibition in Hep3B cells. Moreover, treatment with PTX-2 also induced phosphorylation of AKT and extracellular-signal regulating kinase (ERK), but not c-Jun N-terminal kinase (JNK) and p38 mitogen-activated protein kinase (MARK). Specific inhibitors of PI3K inhibitor (LY294002) and ERK1/2 inhibitor (PD98059) significantly blocks PTX-2-induced-anti-proliferative effects, whereas a JNK inhibitor (SP600125) and a p38 MAPK inhibitor (SB203580) have no significant effects demonstrating that the pro-apoptotic effect of PTX-2 mediated through activation of AKT and ERK signal pathway in Hep3B cells.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• Journal of Korean Theatre Studies Association
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• no.52
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• pp.117-157
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• 2014

Cette ${\acute{e}}tude$ est pour l'objectif de rechercher sur $l^{\prime}{\acute{e}}criture$ $th{\acute{e}}{\hat{a}}trale$ de la mort et le deuil dans les $th{\acute{e}}{\hat{a}}tres$ chez Young-sun Yun(1954-2007) ${\grave{a}}$ travers des textes dramatiques ${\acute{e}}crits$ par $lui-m{\hat{e}}me$, qui ${\acute{e}}tait$ aussi le metteur en $sc{\grave{e}}ne$ depuis 1994 dans le $th{\acute{e}}{\hat{a}}tre$ contemporain en $Cor{\acute{e}}e$. Cette $th{\grave{e}}se$ est $commenc{\acute{e}}$ ${\grave{a}}$ ${\acute{e}}crire$ pas pour apprendre ses textes mais pour comprendre la ralation entre les textes et les ${\exp}{\acute{e}}riences$ de l'auteur. Ici, pour cela, j''ai $analys{\acute{e}}$ ses 4 $pi{\grave{e}}ces$ $th{\acute{e}}{\hat{a}}trales$ produites ${\grave{a}}$ cette ${\grave{e}}poque$, dont (1994), (2000), $d{\acute{e}}biteur$, mon $p{\grave{e}}re$ est $progress{\acute{e}}$ de cancer>(1996), (2005), en referrant les rapports entre $l^{\prime}{\acute{e}}criture$ dramatique et de la mort et le deuil de $p{\grave{e}}re$. Cette ${\acute{e}}tude$ $pr{\acute{e}}suppose$ un certain situation psychologue de l'auteur sur la mort et le deuil de personnage '$p{\grave{e}}re$'. L'auteur dramatique et le metteur en $sc{\grave{e}}ne$ du $th{\acute{e}}{\hat{a}}tre$ Young-sun Yun propose certaines orientations de la mort de son $p{\grave{e}}re$ dans ses texts dramatiques: le sentiment de victime sous le pouvoir absolu de son $p{\grave{e}}re$. Chez lui, ${\acute{e}}crire$ le texte dramatique, c'est transmettre les amertumes d'esprit et une forme de $r{\acute{e}}flextion$ vis-${\grave{a}}$-vis de la relation avec son $p{\grave{e}}re$ surtout le $probl{\grave{e}}me$ $inachev{\acute{e}}$ de deuil. c'est-${\grave{a}}$-dire fournir des sentiments coupables et des $anxi{\acute{e}}t{\acute{e}}s$ qui $r{\acute{e}}sident$ au fond de son coeur, tout au long de sa vie. Pour cette objecif, il est ${\acute{e}}vident$ qu'il faudra toujours partir du texte et y revenir. J'ai $essay{\acute{e}}$ de ne pas $r{\acute{e}}duiser$ $l^{\prime}{\acute{e}}tude$ des textes au respect myope des paroles des personnage et rester la $r{\acute{e}}flextion$ pshchologique sur la mort et le processu de deuil. J'ai $essay{\acute{e}}$ d'appuyer mes remarques sur les sources $autoris{\acute{e}}es$: psychanalytiques en la $mati{\grave{e}}re$. C'est pourquoi j'ai cru devoir $pr{\acute{e}}senter$ cette recherche de l'analyse sous la forme d'une $synth{\grave{e}}se$ des principaux concepts de la $th{\acute{e}}orie$ de la pshchologie moderne qui permettent l'analyse des textes dramatiques.(Dany Nobus, David K. Switzer, Fritz Riemann, Giles Deleuze, Sigmund Freud, Julia Kristeva) Et auiss j'ai $essay{\acute{e}}$ de explorer l'imaginaire des paroles dans les textes en ses rapports avec l'auteur et les personnages et entre les personnages. Ainsi conçu, j'ai $analys{\acute{e}}$ les formes de paroles en ce qui concerne la mort de $p{\grave{e}}re$ et le deuil. Cette $mani{\grave{e}}re$ s'est $r{\acute{e}}v{\acute{e}}l{\acute{e}}e$ efficace pour montrer comment des traces de sentiment se transforment dans des textes. Dans les pluparts des personnages chez les textes de Young-sun Yun, on peut voir si $d{\acute{e}}finitivement$ leur cicatrices personnelles, $sensibilit{\acute{e}}s$ $m{\hat{e}}l{\acute{e}}s$, ce 'je-ne-pourrai-rien-contre-mon-$p{\grave{e}}re$' ou 'je-ne-sais-quoi-et-presque-$apr{\grave{e}}s$-la mort-de-mon pere'. Pour $d{\acute{e}}pouiller$ cet aspect, j'ai $montr{\acute{e}}$ qu'il n'y avait pas de $v{\acute{e}}rit{\acute{e}}s$ objectives, mais que la $subjectivit{\acute{e}}$ doit trouver le jeu triangulaire entre l'inconscient de l'auteur par les paroles des textes et par les rapports entre le symbolisant et le $symbolis{\acute{e}}$ dans les $repr{\acute{e}}sentation$ socio-culturelle en $Cor{\acute{e}}e$ d'aujourd'hui.

• The Journal of the Petrological Society of Korea
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• v.28 no.1
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• pp.25-38
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• 2019

The Muju-Seolcheon area, which is known to be located in the boundary of Ogcheon Belt and Ryeongnam Massif (OB-RM), consists of age unknown or Precambrian metamorphic rocks (MRs) [banded biotite gneiss, metasedimentary rocks (black phyllite, mica schist, crystalline limestone, quartzite), granitic gneiss, hornblendite], Mesozoic sedimentary and igneous rocks. In this paper are researched the structural characteristics of each deformation phase from the geometric and kinematic features and the developing sequence of multi-deformed rock structures of the MRs, and is considered the boundary location of OB-RM with the previous geochemical, radiometric, structure geological data. The geological structure of this area is at least formed through four phases (Dn-1, Dn, Dn+1, Dn+2) of deformation. The Dn-1 is the deformation which took place before the formation of Sn regional foliation and formed Sn-1 foliation folded by Fn fold. The Dn is that which formed the Sn regional foliation. The predominant Sn foliation shows a NE direction which matches the zonal distribution of MRs. A-type or sheath folds, in which the Fn fold axis is parallel to the direction of stretching lineation, are often observed in the crystalline limestone. The Dn+1 deformation, which folded the Sn foliation, took place under compression of NNW~NS direction and formed Fn+1 fold of ENE~EW trend. The Sn foliation is mainly rearranged by Fn+1 folding, and the ${\pi}$-axis of Sn foliation, which is dispersed, shows the nearly same direction as the predominant Fn+1 fold axis. The Dn+2 deformation, which folded the Sn and Sn+1 foliations, took place under compression of E-W direction, and formed open folds of N-S trend. And the four phases of deformation are recognized in all domains of the OB-RM, and the structural characteristics and differences to divide these tectonic provinces can not be observed in this area. According to the previous geochemical and radiometric data, the formation or metamorphic ages of the MRs in and around this area were Middle~Late Paleproterozoic. It suggests that the crystalline limestone was at least deposited before Middle Paleproterozoic. This deposition age is different in the geologic age of Ogcheon Supergroup which was recently reported as Neoproterozoic~Late Paleozoic. Therefore, the division of OB-RM tectonic provinces in this area, which regards the metasedimentary rocks containing crystalline limestone as age unknown Ogcheon Group, is in need of reconsideration.