이상기압 : 고공환경

朴恒培 대한의사협회 1996 대한의사협회지 Vol.39 No.5

巡回診療事業의 問題點과 改善方向 : 一部 無醫地域에 對한 地域社會診斷을 中心으로

朴恒培 漢陽大學校 1979 論文集 Vol.13 No.-

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical aerivice program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be helpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget, tome and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may bring practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (desganated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all diseases and injuries experienced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patient; 84% of all cases have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedidcs (objects of primary care). Besides, 20 % of the cases required professional managements of level beyond the mobile team's capability and in this sense one may couclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest followings for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yieled up to primary health care unit of the village and the mobile services should largely be yieled up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of .the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

宇宙船室 大氣環境

朴恒培 대한의학협회 1969 대한의학협회지 Vol.12 No.5

순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로)

박항배,최동욱,Park, Hung-Bae,Choi, Dong-Wook 대한예방의학회 1978 예방의학회지 Vol.11 No.1

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent m

Environmental Hygiene in Aero-Space Medicine

朴恒培 공군본부 의무감실 1960 항공의학 Vol.8 No.1

일산화탄소 중독에 대한 고압산소 요법의 효과에 관한 연구

박항배 공군본부 의무감실 1969 항공의학 Vol.17 No.1-2

우리나라 산업장의 대기오염

朴恒培 대한의학협회 1971 대한의학협회지 Vol.14 No.10

지상발표 : 결핵환자의 폐내 혼합감염에 대한 임상적 관찰

박항배,김기호 대한결핵 및 호흡기학회 1963 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.17 No.-

고온폭로시의 생리적변화와 내성의 한계

박항배 한양대학교 의과대학 1984 한양의대 학술지 Vol.4 No.1

Five healthy, nonacclimatized male subjects were exposed to a moderate heat stress level of 57.2℃ (DBT), 15-20mmHg (pH₂O), 0.75M/sec (air current). Rectal temperature, mean skin temperature, heart rate, body weight before and after the experiment were recorded in every 5 minutes and mean body temperature and the rate of body heat storage was computed. Craig index of thermal strain was also determined and the relationship among those parameters were investigated. The summary of the findings was as follows. 1. The average length of voluntary tolerance time was 45 minutes (25 to 70 min) which virtually agreed with results of previous studies. 2. The amount of heat storage voluntarily tolerated (the value at the time of ceasing experiment) was 1.66-1.91 Cal per kilogram. Individual variation was large owing partly to small number of experiments and wide distribution of subject's ages. 3. Craig index was 2.63 in average (2.14-3.02) and the considerable degree of relationship was noted between the index and the rate of heat storage and voluntary tolerance time, both.

一算化炭消中毒에 對한 過酸化水素灌腸法의 治療效果에 關한 實驗的硏究

朴恒培 漢陽大學校環境科學硏究所 1981 環境科學論文集 Vol.2 No.-

일산화탄소중독 치료의 궁극적인 목적은 CO와의 결합으로 기능을 상실한 혈색소로부터의 CO의 해리를 촉진시키고 그간 뇌, 심근 등 중요 조직의 산소분압을 50mmHg 이상으로 유지시켜줌으로써 이들 vital organ의 손상을 방지하는 데 있다. 과산화수소가 체내에서 분해되어 혈중 산소분압을 높인다는 사실은 이론상으로나 과거 여러 연구자들의 실험에서 밝혀진 바이지만 저자들은 과산화수소의 관장으로 이미 혈색소와 결합된 CO를 해리시키는 데 어느 정도의 효과를 기대할 수 있는지 보기 위하여 본 실험을 시행하였으며 그 결과 유의의한 성적을 얻었다. 과산화수소 관장에 의한 일산화탄소 중독의 치료방법은 부작용이 적고 단 한 사람의 의사에 의해 복잡한 시설이나 장비없이 손쉽게 시행할 수 있으며 1기압이하의 100% 산소흡입보다 우수한 효과를 기대할 수 있다는 여러가지 장점을 지니고 있으므로 우리나라의 현 여건으로 보아 고압산소 치료와 병행, 또는 부득이한 경우 이를 대치할 수 있는 차선의 방법이라 생각되나 임상적용을 위하여는 본 실험의 결과를 토대로 보다 광범위한 실험과 방법의 개선 및 보완이 필요할 것이다. The ultimate goal of treatmete of carbon monoxide poisoning is to promote dissociation of carboxyhemoglobin and to maintain arterial pO₂above 50mmHg throughout the course of treatment to protect vital organs from damage caused by hypoxia. The hyperbaric chamber designed and manufactured for this purpose has obiousely made an enormous contribution and yet has several handicaps be overcome by any means. These handicaps are; the financial impact to purchase the chamber (especially in a small, remote community), an extra manpower requiremant to operate the device, limitation in the capacity of the chamber (one man type), and the possible hazard of oxygen intoxication and dysbarism. The primary objective of this study is to develope a new therapeutic measure as an alternative to the hyperbaric chamber when it is not available or contraindicated. The effect of intestinal perfusion with hydrogen peroxide has been studied by many investigators and was known to be an excellent way of extrapulmonary oxygen supply. The advantage of this method will include; 1) much more amount of oxygen is delivered to the tissue than one would expect from 100% saturation with oxygen at 1 ata, 2) the procedure is simple and most economical, 3) neither sophisticated equipment nor extra manpower is required. As a study preliminary to the clinical application, authors conducted a series of experimant to observe the effect of hydrogen peroxide enema on dissociation of carboxyhemoglobin in intoxicated rabbit blood. Using an animal gas chamber, 20 rabbits were exposed to CO gas of 6,000 ppm for 60 minutes. Ten rabbits of control group were given 10 cc of warmed normal saline solution by rectal perfusion and for the other 10 of the experimental group, the same amout of 1% H₂o₂solution was given by the same way. Two blood specimens were drawn from each rabbit; the first one immediately following the exposure and the second one after rectal perfusion, about 30 minutes after the first sampling. The result was as follows; 1) The decrease in carboxyhemoglobin concentration during the first 30 minutes in the control and experimental group were 18.18±4.49% and 23.03±4.13% respectively showing the significant difference (p<0.05) between the two groups. 2) Hemoglobin and hematocrit value showed no significant difference between two groups and not altered significantly by intestinal perfusion with H₂O₂.