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인요한 대한산부인과학회 2010 연수강좌 Vol.43 No.-
북한은 자연재해와 경제적인 어려움으로 인하여 주민들의 영양 및 위생상태를 비롯한 전반적인 보건의료상황이 열악하고 기존의 의료체계도 많이 위축, 약화된 실정이다. 이러한 북한의 보건, 의료환경을 향상시키기 위해서 국내외적으로 인도적인 지원이 다각도로 모색되고 있다. 예전에 비해 식량, 보건의료, 농업 상황이 다소 호전되기는 했지만 아직도 보건의료 분야의 원조는 미미한 수준이어서 더욱 체계적이고도 활성화된 지원대책이 절실히 요구되고 있다. 대부분 경화를 주고 구입해야 하는 현대의약품과 각종 의료장비의 부족으로 북한 보건의료체계의 회복은 전반적으로 경제회복에 비해 뒤쳐질 것이라 예상된다. 다행히 최근 여러 대북지원단체들은 식량뿐만 아니라 보건의료 분야에도 높은 관심을 가지고 적극적인 지원활동을 펴 오고 있으며, 보건의료 원조사업들도 점차 긴급구호 차원에서 벗어나 장기적이고도 지속적인 개발지원으로 방향을 바꾸어 나가고 있다.
인요한,한아름 대한의사협회 2008 대한의사협회지 Vol.51 No.12
Firefighters are facing occupational hazards such as exposures to a variety of carcinogens and toxic agents, heat, physical stress and psychological stress. This occupation involves an increased risk of particular health concerns including cardiovascular diseases, cancers, and reproductive hazards. Cardiovascular diseases are the leading cause of lifetime mortality among the firefighters as well as the principal cause of on-duty deaths. In spite of “healthy worker effect”, a number of studies have found an increased risk of cardiovascular disease morbidity and mortality in firefighters. There are various carcinogens in the fire smoke. Many studies address that some types of cancers are related to firefighting. These cancers include brain tumors, cancers of hematopoietic and lymphatic systems, cancers of genitourinary tract, and skin cancers. To date, the relationship between firefighting and reproductive hazards has not been widely studied. However, since firefighters are exposed to various chemical and physical hazards which might influence the reproductive systems, the concerns are raising. It is important to recognize that firefighters are at a risk of several significant health problems. To reduce the risk, it should be encouraged to use protective equipments efficiently and manage physically exerted firefighters appropriately at the fire scene. Furthermore, we should activate not only screening programs to detect health risk factors, but also medical programs to help firefighters maintain a good physical fitness.
구급차의 종류 및 주행속도에 따른 흉부압박법의 성공률에 대한 연구
임경수,인요한,황성오 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2
Chest compressions performed in a controlled environment can generate adequate coronary perfusion pressure, but compression is frequently inadequate even when CPR is performed under optimal circumstances, In Korea the average highway of road is narrow and curved more than in other countries, and the back-space in ambulance of Korea is limited to perform CPR. As a result, the CPR in a moving ambulance is no effective in Korea. We studied the effectiveness of chest compression in a moving ambulance by the use of a CPR manikin(Skillmeter Resusci Annie, Laerdal company). The ambulance was driven without a warming siren with obeying all the traffic signals and rules. Eight emergency physicians performed a total of 8 sessions of 2 minutes of continuous chest compression on the manikin in the ambulance(Van-type). They did the same thing in truck-type ambulance. We compared the results between small ambulance(Van type) and large ambulance(Truck type). To compare the effectiveness of manual and mechanical cardiac massage, the mechanical cardiac resuscitator(Thumper: Michigan company) was used. The success rate of manual CPR in a constant speed was not different between the Van-type ambulance and Truck-type ambulance(p>0.05), but mean percentage of correct compression by mechanical chest compressor showed 100%(p=0.004). The success rate of manual CPR in driving at downtown was 67.4± 15.7 in Van-type ambulance, but that was 93.4 ± 5.2 in Truck-type ambulance(p=0.007). These results demonstrate that the performance of manual chest compression in a moving ambulance(Van type) is suboptimal. As the patient care area in the Van-type ambulance is much more spacious than that of the Truck-type ambulance, the diminution of compression efficacy in the smaller ambulance is consistent with the assumption that space is the most important factor in the ability to perform adequate CPR in a moving ambulance. Although the results were good in a truck-type ambulance, chest compression was performed for only 2 minutes. It is difficult for one person to deliver manual chest compression in a moving ambulance for a long period. Mechanical chest compression may be employed where manual compression is technically difficult to perform.