Background : Central venous catheters(CVCs) area major source of nosocomial infection. Chlorhexidine-silver sulfadiazine coated catheters (CHSS) were developed to reduce the rate of CVC infection. However, the clinical effectiveness of CHSS in comparison wth non-coated catheter (NCC) remains to be evaluated. Methods : From January 2004 to December 2004 in medical intensive care unit (ICU) of Asan Medical Center, CVCs were inserted in 446 cases. We retrospectively analyzed characteristics of patients and catheterization,the catheter-related infection rate and colonization, microbiologic findings, and insertion sites (subclavian, jugular, femoral) according to the type of inserted CVCs (NCC: 187 cases, CHSS: 259 cases). Catheter related infection is defined as catheter related bacteremia and catheter related non-bacteremic sepsis. Results : 1) The mean age of the patients in each group was
During the Japanese colonial era, traditional music performances were gradually diminishing and weakening in the particular condition of colonization. Meanwhile, from the time of enlightenment, Western genre performances were becoming vitalized with the influence of Western civilization that began to be spread steadily throughout the society. In that situation, traditional music performances tended to be mixed performances accompanied by Western ones, not independent performances. Mostly, they were accompanied by Western music, and also, they were performed along with other genres like plays, lectures, movies, dances, or magic, too. Such form of mixed performances accompanied by Western genres became even more vitalized in the 1920's and came to be positioned as a form of traditional music performances. Therefore, research on the forms of mixed performances between Western genres and traditional music is meaningful in examining the forms of traditional music performances that have not been studied in the history of Korean modern music and understanding the trends of traditional music performances which were generally found in the Japanese colonial era. However, such research has hardly been conducted concretely yet. Accordingly, concerning the forms of mixed performances between Western genres and traditional music in the 1920's, this author considered the background of vitalizing mixed performances between Western genres and traditional music mainly with newspaper articles of the time and their formal characteristics. Regarding the background of vitalizing the forms of mixed performances between Western genres and traditional music, from the 1920's, the forms of mixed performances between Western genres and traditional music became more vitalized than before. The causes of that may include the increase of groups hosting or sponsoring such performances from the 1920's and also the dramatic increase of such performances in general. Moreover, the increased performances were conducted in the forms of mixed performances mainly in order to satisfy the people's needs becoming diversified with the distribution of Western civilization. Concerning the formal characteristics of mixed performances between Western genres and traditional music, this researcher classified western genres performed with traditional music and examined what characteristics were found in such mixed performances of tradition music by the types of Western genres respectively. First, in the mixed performances type of western-type genre and traditional music, the number of programs for the western music had significant portion in general, and there were certain ensemble of the western music and traditional musical instrument that was rare at this period of time, and it also had the characteristics of classifying two genres to perform for each title or date. Second, in the mixed performances type of the drama and traditional music, the traditional music is directly participated in the drama with the similar type to the theater, or performed independently from the drama with the role of interlude performance for the stage conversion of the drama to have the characteristics of performing in audience publicity or entertainment. Third, in the mixed performances type of the lecture and traditional music, the traditional music is played before or after the lecture to play the role to set the atmosphere and entertainment for the lecture as displaying the feature to perform for the audience attraction. And, fourth, in the mixed performances type of the movie and traditional music, the traditional music sometimes directly participated in the movie or had the features of independent performance, and there was a characteristic to perform for the entertainment after showing a movie.
The result of the research conducted for the purpose of investigating the semantic value and the layout of the Cheongryu Gugok of Dorimsa Valley, which exhibits a high level of completeness and scenic preservation value among the three gugoks distributed in the area around Mt. Dongak of Gogseong is as follows.4) The area around Cheongryu Gugok shows a case where the gugok culture, which has been enjoyed as a model of the Neo-Confucianism culture and bedrock scenery, such as waterfall, riverside, pond, and flatland, following the beautiful valley, has been actually substituted, and is an outstanding scenery site as stated in a local map of Gokseong-hyeon in 1872 as "Samnam Jeil Amban Gyeryu Cheongryu-dong(三南第一巖盤溪流 淸流洞: Cheongryu-dong, the best rock mooring in the Samnam area)." Cheongryu Gugok, which is differentiated through the seasonal scenery and epigrams established on both land route and waterway, was probably established by the lead of Sun-tae Jeong(丁舜泰, ?~1916) and Byeong-sun Cho(曺秉順, 1876~1921) before 1916 during the Japanese colonization period. However, based on the fact that a number of Janggugiso of ancient sages, such as political activists, Buddhist leaders, and Neo-Confucian scholars, have been established, it is presumed to have been utilized as a hermit site and scenery site visited by masters from long ago. Cheongryu Gugok, which is formed on the rock floor of the bed rock of Dorimsa Valley, is formed in a total length of 1.2km and average gok(曲) length of 149m on a mountain type stream, which appears to be shorter compared to other gugoks in Korea. The rock writings of the three gugoks in Mt. Dongak, such as Cheongryu Gugok, which was the only one verified in the Jeonnam area, total 165 in number, which is determined to be the assembly place for the highest number of rock writings in the nation. In particular, a result of analyzing the rock writings in Cheongryu Gugok totaling 112 places showed 49pieces(43.8%) with the meaning of 'moral training' in epigram, 21pieces (18.8%) of human life, 16pieces(14.2%) of seasonal scenery, and 12pieces(10.6%) of Janggugiso such as Jangguchur, and the ratio occupied by poem verses appeared to be six cases(3.6%). Sweyeonmun(鎖烟門), which was the first gok of land route, and Jesiinganbyeolyucheon(除是人間別有天) which was the ninth gok of the waterway, corresponds to the Hongdanyeonse(虹斷烟鎖) of the first gok and Jesiinganbyeolyucheon of the ninth gok established in Jaecheon, Chungbuk by Se-hwa Park(朴世和, 1834~1910), which is inferred to be the name of Gugok having the same origin. In addition, the Daeeunbyeong(大隱屛) of the sixth gok. of land route corresponds to the Chu Hsi's Wuyi-Gugok of the seventh gok, which is acknowledged as the basis for Gugok Wollim, and the rock writings and stonework of 'Amseojae(巖棲齋)' and 'Pogyeongjae(抱經齋)' between the seventh gok and eighth gok is a trace comparable with Wuyi Jeongsa(武夷精舍) placed below Wuyi Gugok Eunbyeon-bong, which is understood to be the activity base of Cheongryu-dong of the Giho Sarim(畿湖士林). The rock writings in the Mt. Dongak area, including famous sayings by masters such as Sunsaeuhje(鮮史御帝, Emperor Gojong), Bogahyowoo(保家孝友, Emperor Gojong), Manchunmungywol(萬川明月, King Joengjo), Biryeobudong(非禮不動, Chongzhen Emperor of the Ming Dynasty)', Samusa(思無邪, Euijong of the Ming Dynasty), Baksechungpwoong(百世淸風, Chu Hsi), and Chungryususuk-Dongakpungkyung(淸流水石 動樂風景, Heungseon Daewongun) can be said to be a repository of semantic symbolic cultural scenery, instead of only expressing Confucian aesthetics. In addition, Cheongryu Gugok is noticeable with its feature as a cluster of cultural scenery of the three religions of Confucian-Buddhism-Taoism, where the Confucianism value system, Buddhist concept, and Taoist concept co-exists for mind training and cultivation. Cheongryu Gugok has a semantic feature and spatial character as a basis for history and cultural struggle for the Anti-Japan spirit that has been conceived during the process of establishing and utilizing the spirit of the learning, loyalty for the Emperor and expulsion of barbarians, and inspiration of Anti-Japan force, by inheriting the sense of Dotong(道統) of Neo-Confucianism by the Confucian scholar class at the end of the Joseon era that is represented by Ik-hyun Choi(崔益鉉, 1833~1906), Woo Jeon(田愚, 1841~1922), Woo-man Gi(奇宇萬, 1846~1916), Byung-sun Song(宋秉璿, 1836~1905), and Hyeon Hwang(黃玹, 1855~1910).
Background : Pulmonary aspergillomas usually arise from colonization and proliferation of Aspergillus in preexisting cavitary lung disease of any cause. About 15% of patients with tuberculous pulmonary cavities were found to have aspergilloma. We analyzed the clinical features and course of 91 patients with pulmonary aspergilloma. Method : During the ten-year period from June 1986 to May 1996, 91 patients whose condition was diagnosed as pulmonary aspergilloma at 4 university hospitals in Taegu city were reviewed. All patients fulfilled one of the following criteria : 1) histologic evidence of aspergilloma within abnormal air space in tissue sections, or 2) a positive Aspergillus serum precipitin test with the radiologic finding of a fungus ball. The histological diagno-sis was established in 81 patients(89.0%) and clinical diagnosis in 10 patients(11.0%). Results : 1) The age range was 22 to 65 years, with an average of 45 years. A male and female ratio was 1.7 : 1 (57 men and 34 women). 2) Hemoptysis was far the most frequent symptom(89%), followed by cough, dyspnea, weakness, weight loss, fever, chest pain. 3) In all but 14 cases(15.4%) there had been associated conditions. Pulmonary tuberculosis was far the most frequent underlying condition found(74.7%), followed by bronchiectasis (6.6%), cavitary neoplasm(2.2%), pulmonary sequestration(1.1%). 4) The involved area was usually in the upper lobes; the right upper lobe was involved in 39(42.9%), the left upper lobe in 31(34.1%), the left lower lobe in 13(14.3%), the right lower lobe in 7(7.7%), and the right middle lobe in 1(1.1%). 5) On standard chest roent geno gram the classic "bell-like" image of a fungus ball was found in 62.6% of the subjects. On CT scan, 88.1% of the subjects in which they were done. 6) The surgical therapy was undertaken in 76 patients, and medical therapy in 15 patients, including 4 patients with intracavitary instillation of amphotericin B. 7) The surgical modality was lobectomy in 55 patients(72.4%), segmentectomy in 16 patients(21.1%), pneumonectomy in 4 patients(5.3%), wedge resection in 1 patient(1.3%). The mortality rate was 3.9% (3 patients) ; 2 patients died of sepsis and 1 died of hemoptysis. The postoperative complications were encountered in 6 patients (7.9%), including each one patient with respiratory failure, bleeding, bronchopleural fistula, empyema, and vocal cord paralysis. 8) In the follow-up cases, each 2 patients of 71 patients with surgical treatment and 10 patients with medical treatment had recurrent hemoptysis. Conclusion : During follow-up of the chronic pulmonary disease with abnormal air space, if the standard chest roentgenograms are insufficient to detect a fungus ball, computed tomographic scan and serum precipitin test are likely to aid the diagnosis of patients with suspected pulmonary aspergilloma. A reasonable recommendation for management of a patient with aspergilloma would be to reserve surgical resection for those patients who have had severe, recurrent hemoptysis. And a well controlled cooperative study to the medical treatment such as intracavitary antifungal therapy is further needed.
Land was originally communized by a community in the primitive society of Korea, and in the age of the ancient society SAM KUK-SILLA, KOKURYOE and PAEK JE-it was distributed under the principle of land-nationalization. But by the occupation of the lands which were permitted to transmit from generation to generation as Royal Grant Lands and newly cleared lands, the private occupation had already begun to be formed. Thus the private ownership of land originated by chiefs of the tribes had a trend to be gradually pervaded to the communal members. After the, SILLA Kingdom unified SAM KUK in 668 A.D., JEONG JEON System and KWAN RYO JEON System, which were the distribution systems of farmlands originated from the TANG Dynasty in China, were enforced to established the basis of an absolute monarchy. Even in this age the forest area was jointly controlled and commonly used by village communities because of the abundance of area and stocked volume, and the private ownership of the forest land was prohibited by law under the influence of the TANG Dynasty system. Toward the end of the SILLA Dynasty, however, as its centralism become weak, the tendency of the private occupancy of farmland by influential persons was expanded, and at the same time the occupancy of the forest land by the aristocrats and Buddhist temples began to come out. In the ensuing KORYO Dynasty (519 to 1391 A.D.) JEON SI KWA System under the principle of land-nationalization was strengthened and the privilege of tax collection was transferred to the bureaucrats and the aristocrats as a means of material compensation for them. Taking this opportunity the influential persons began to expand their lands for the tax collection on a large scale. Therefore, about in the middle of 11th century the farmlands and the forest lands were annexed not only around the vicinity of the capital but also in the border area by influential persons. Toward the end of the KORYO Dynasty the royal families, the bureaucrats and the local lords all possessed manors and occupied the forest lands on a large scale as a part of their farmlands. In the KORYO Dynasty, where national economic foundation was based upon the lands, the disorder of the land system threatened the fall of the Dynasty and so the land reform carried out by General YI SEONG-GYE had led to the creation of ensuing YI Dynasty. All systems of the YI Dynasty were substantially adopted from those of the KORYO Dynasty and thereby KWA JEON System was enforced under the principle of land-nationalization, while the occupancy or the forest land was strictly prohibited, except the national or royal uses, by the forbidden item in KYEONG JE YUK JEON SOK JEON, one of codes provided by the successive kings in the YI Dynasty. Thus the basis of the forest land system through the YI Dynasty had been established, while the private forest area possessed by influential persons since the previous KORYO Dynasty was preserved continuously under the influence of their authorities. Therefore, this principle of the prohibition was nothing but a legal fiction for the security of sovereign powers. Consequently the private occupancy of the forest area was gradually enlarged and finally toward the end of YI Dynasty the privately possessed forest lands were to be officially authorized. The forest administration systems in the YI Dynasty are summarized as follows: a) KEUM SAN and BONG SAN. Under the principle of land-nationalization by a powerful centralism KWA JEON System was established at the beginning of the YI Dynasty and its government expropriated all the forests and prohibited strictly the private occupation. In order to maintain the dignity of the royal capital, the forests surounding capital areas were instituted as KEUM SAN (the reserved forests) and the well-stocked natural forest lands were chosen throughout the nation by the government as BONG SAN(national forests for timber production), where the government nominated SAN JIK(forest rangers) and gave them duties to protect and afforest the forests. This forest reservation system exacted statute labors from the people of mountainious districts and yet their commons of the forest were restricted rigidly. This consequently aroused their strong aversion against such forest reservation, therefore those forest lands were radically spoiled by them. To settle this difficult problem successive kings emphasized the preservation of the forests repeatedly, and in KYEONG KUK DAI JOEN, the written constitution of the YI Dynasty, a regulation for the forest preservation was provided but the desired results could not be obtained. Subsequently the split of bureaucrats with incessant feuds among politicians and scholars weakened the centralism and moreover, the foreign invasions since 1592 made the national land devasted and the rural communities impoverished. It happned that many wandering peasants from rural areas moved into the deep forest lands, where they cultivated burnt fields recklessly in the reserved forest resulting in the severe damage of the national forests. And it was inevitable for the government to increase the number of BONG SAN in order to solve the problem of the timber shortage. The increase of its number accelerated illegal and reckless cutting inevitably by the people living mountainuos districts and so the government issued excessive laws and ordinances to reserve the forests. In the middle of the 18th century the severe feuds among the politicians being brought under control, the excessive laws and ordinances were put in good order and the political situation became temporarily stabilized. But in spite of those endeavors evil habitudes of forest devastation, which had been inveterate since the KORYO Dynasty, continued to become greater in degree. After the conclusion of "the Treaty of KANG WHA with Japan" in 1876 western administration system began to be adopted, and thereafter through the promulgation of the Forest Law in 1908 the Imperial Forests were separated from the National Forests and the modern forest ownership system was fixed. b) KANG MU JANG. After the reorganization of the military system, attaching importance to the Royal Guard Corps, the founder of the YI Dynasty, TAI JO (1392 to 1398 A.D.) instituted the royal preserves-KANG MU JANG-to attain the purposes for military training and royal hunting, prohibiting strictly private hunting, felling and clearing by the rural inhabitants. Moreover, the tyrant, YEON SAN (1495 to 1506 A.D.), expanded widely the preserves at random and strengthened its prohibition, so KANG MU JANG had become the focus of the public antipathy. Since the invasion of Japanese in 1592, however, the innovation of military training methods had to be made because of the changes of arms and tactics, and the royal preserves were laid aside consequently and finally they had become the private forests of influential persons since 17th century. c) Forests for official use. All the forests for official use occupied by government officies since the KORYO Dynasty were expropriated by the YI Dynasty in 1392, and afterwards the forests were allotted on a fixed standard area to the government officies in need of firewoods, and as the forest resources became exhausted due to the depredated forest yield, each office gradually enlarged the allotted area. In the 17th century the national land had been almost devastated by the Japanese invasion and therefore each office was in the difficulty with severe deficit in revenue, thereafter waste lands and forest lands were allotted to government offices inorder to promote the land clearing and the increase in the collections of taxes. And an abuse of wide occupation of the forests by them was derived and there appeared a cause of disorder in the forest land system. So a provision prohibiting to allot the forests newly official use was enacted in 1672, nevertheless the government offices were trying to enlarge their occupied area by encroaching the boundary and this abuse continued up to the end of the YI Dynasty. d) Private forests. The government, at the bigninning of the YI Dynasty, expropriated the forests all over the country under the principle of prohibition of private occupancy of forest lands except for the national uses, while it could not expropriate completely all of the forest lands privately occupied and inherited successively by bureaucrats, and even local governors could not control them because of their strong influences. Accordingly the King, TAI JONG (1401 to 1418 A.D.), legislated the prohibition of private forest occupancy in his code, KYEONG JE YUK JEON (1413), and furthermore he repeatedly emphasized to observe the law. But The private occupancy of forest lands was not yet ceased up at the age of the King, SE JO (1455 to 1468 A.D.), so he prescribed the provision in KYEONG KUK DAI JEON (1474), an immutable law as a written constitution in the YI Dynasty: "Anyone who privately occupy the forest land shall be inflicted 80 floggings" and he prohibited the private possession of forest area even by princes and princesses. But, it seemed to be almost impossible for only one provsion in a code to obstruct the historical growing tendecy of private forest occupancy, for example, the King, SEONG JONG (1470 to 1494 A.D.), himself granted the forests to his royal families in defiance of the prohibition and thereafter such precedents were successively expanded, and besides, taking advantage of these facts, the influential persons openly acquired their private forest lands. After tyrannical rule of the King, YEON SAN (1945 to 1506 A.D.), the political disorder due to the splits to bureaucrats with successional feuds and the usurpations of thrones accelerated the private forest occupancy in all parts of the country, thus the forbidden clause on the private forest occupancy in the law had become merely a legal fiction since the establishment of the Dynasty. As above mentioned, after the invasion of Japanese in 1592, the courts of princes (KUNG BANGG) fell into the financial difficulties, and successive kings transferred the right of tax collection from fisherys and saltfarms to each KUNG BANG and at the same time they allotted the forest areas in attempt to promote the clearing. Availing themselves of this opportunity, royal families and bureaucrats intended to occupy the forests on large scale. Besides a privilege of free selection of grave yard, which had been conventionalized from the era of the KORYO Dynasty, created an abuse of occuping too wide area for grave yards in any forest at their random, so the King, TAI JONG, restricted the area of grave yard and homestead of each family. Under the policy of suppresion of Buddhism in the YI Dynasty a privilege of taxexemption for Buddhist temples was deprived and temple forests had to follow the same course as private forests did. In the middle of 18th century the King, YEONG JO (1725 to 1776 A.D.), took an impartial policy for political parties and promoted the spirit of observing laws by putting royal orders and regulations in good order excessively issued before, thus the confused political situation was saved, meanwhile the government officially permittd the private forest ownership which substantially had already been permitted tacitly and at the same time the private afforestation areas around the grave yards was authorized as private forests at least within YONG HO (a boundary of grave yard). Consequently by the enforcement of above mentioned policies the forbidden clause of private forest ownership which had been a basic principle of forest system in the YI Dynasty entireely remained as only a historical document. Under the rule of the King, SUN JO (1801 to 1834 A.D.), the political situation again got into confusion and as the result of the exploitation from farmers by bureaucrats, the extremely impoverished rural communities created successively wandering peasants who cleared burnt fields and deforested recklessly. In this way the devastation of forests come to the peak regardless of being private forests or national forests, moreover, the influential persons extorted private forests or reserved forests and their expansion of grave yards became also excessive. In 1894 a regulation was issued that the extorted private forests shall be returned to the initial propriators and besides taking wide area of the grave yards was prohibited. And after a reform of the administrative structure following western style, a modern forest possession system was prepared in 1908 by the forest law including a regulation of the return system of forest land ownership. At this point a forbidden clause of private occupancy of forest land got abolished which had been kept even in fictitious state since the foundation of the YI Dynasty. e) Common forests. As above mentioned, the forest system in the YI Dynasty was on the ground of public ownership principle but there was a high restriction to the forest profits of farmers according to the progressive private possession of forest area. And the farmers realized the necessity of possessing common forest. They organized village associations, SONGE or KEUM SONGE, to take the ownerless forests remained around the village as the common forest in opposition to influential persons and on the other hand, they prepared the self-punishment system for the common management of their forests. They made a contribution to the forest protection by preserving the common forests in the late YI Dynasty. It is generally known that the absolute monarchy expr opriates the widespread common forests all over the country in the process of chainging from thefeudal society to the capitalistic one. At this turning point in Korea, Japanese colonialists made public that the ratio of national and private forest lands was 8 to 2 in the late YI Dynasty, but this was merely a distorted statistics with the intention of rationalizing of their dispossession of forests from Korean owners, and they took advantage of dead forbidden clause on the private occupancy of forests for their colonization. They were pretending as if all forests had been in ownerless state, but, in truth, almost all the forest lands in the late YI Dynasty except national forests were in the state of private ownership or private occupancy regardless of their lawfulness.