Experiences and Lessons of an On-line Biomedical Ethics Course / 한국의학교육

The Korea's first-ever on-line biomedical ethics education class began in September 1999. The class, one of the 18 on-line lectures offered in the Fall Semester, 1999 by Seoul National University Virtual Campus, allows the Korean general public the opportunity to attend an SNU lecture. Although the discussion sites are limited to the randomly selected 40 students taking the 16-week-long course, any one can read the instructor's lecture on the Internet. (http://snuvc. snu.ac.kr/class/h601) The topics of this course include abortion, euthanasia, organ transplantation, human cloning and etc. As members of the team responsible for this unprecedented biomedical ethics education program in Korea, we, the authors, report the experiences that the team went through both in preparing for and running the course. We concludes from the experience that we had that 16 weeks are too long for an on-line course without academic credits or sufficient number of tutors. Also, we suggest that in the near future the on-line biomedical ethics course should be able to be used for continuing education of such medical professions as medical doctors and nurses.

Clinical Study of Neonatal Seizure / 대한소아신경학회지

PURPOSE: Neonatal seizures are the most frequent major manifestation of neonatal neurologic disorders. The goal of this study is to help understanding neonatal seizure by analysis of etiology, clinical manifestation, method of diagnosis and prognosis. METHODS: Retrospective reviews were made on 73 cases of neonatal seizure who were admitted to the neonatal intensive care unit, Dongkang General Hospital for 4 years from March 1994 to February 1998. RESULTS AND CONCLUSION:1) Male to female ratio were 2.5 : 1.2) According to the gestational period, preterm babies were 11.0%, postterm babies were 2.7%, and term babies were 86.3%3) The causes of neonatal seizures were hypoxic ischemic encephalopathy (32.9%), hypocalcemia (20.5%), hypoglycemia (9.6%), sepsis (96%), benign idiopathic neonatal seizure (6.8%), intracerebral hemorrhage(5.5%), hyponatremia(1.4%), hypernatremia(1.4%), kernicterus, hyperammonemia, in order of frequency 4) The onset of neonatal seizures were within 24 hours of postnatal age in 21 cases (28.8%), on second and third days in 34.2%, and between fourth and seventh days in 13.7%. 5) The types of neonatal seizures were subtle (39.7%), generalized tonic (27.4%), focal clonic (16.4%), multifocal clonic (13.7%), focal tonic (4.1%), and myoclonic (2.8%), in order of frequency.6) The electroencephalographies were performed in 29 cases and showed abnormal findings in 16 cases (55.2%).7) The ultrasonograms were performed in 12 cases. Abnormal findings were detected in 50% of the patients, and the findings were periventrcular leukomalacias in 4 cases, intraventricular hemorrhage in 1 case, intracerebral hemorrhage in 1 case. The brain computed tomographies were done in 23 cases, and 8 patients showed abnormal findings; diffuse cerebral ischemia in 5 cases, focal cerebral ischemia in 2 cases, subdural hemorrhage in 1 case. The brain magnetic resonance imagings were done in 6 cases, and 3 patients showed abnormal findings; diffuse cerebral ischemia in 2 cases, corpus callosal agenesis in 1 case.8) Fifty six patients (76.7%) were discharged in improved state, 3 patients (4.1%) were discharged against medical advice, 2 patients (2.7%) were transfered other hospital, and 12 patients (16.5%) were expired.9) The follow-up examination were made on 44 cases (78.6%) during the period from 5 days to 30 months of age, and 10 cases showed neurologic sequalae; recurrent seizures in 5 cases, cerebral palsy in 5 cases, and other conbined eurologic sequalae in 4 cases.