The Establishment of Wonsan Laborers' Hospital during the Japanese Occupation and Its Significance / 의사학

On July 3, 1928, the Wonsan Labor Union established the Wonsan Laborers' Hospital in Seoku-dong, Wonsan for the purpose of reducing medical consultation fees for its members. The union's efforts to improve the welfare of its members include the establishment of an educational institute, a consumers union, a barbershop, and a relief department. The Laborers' Hospital, which began with ten wards, was led by a team of two doctors, one midwife, two pharmacists, and four nurses. The two doctors were Cheol-sun Cha and Jeong-kwon Lee, and the midwife/nurse was Sun-jeong Kim. Union members received a 40% discount on medicine, and this was utilized by a daily average of 60 to 70 workers, or 21,000 workers annually. The Laborers' Hospital was clearly distinct from medical facilities founded as charity institutions in that funds were raised by the recipients themselves, and that the recipients formed a community based on their common status as laborers. However, the Wonsan Laborers' Hospital was shut down in roughly April 1929 due to the breaking of the general strike, and the heightened suppression of union activities prevented any additional opening of laborers' hospitals until Korea's liberation from Japan. Nevertheless, the history of the Wonsan Laborers' Hospital represents a key development in Korea's health coverage. It is not adequate to declare, as was the case in past research, Korea's health coverage to be simply an imitation of the Western system and lacking its own history. Despite some differences in scale and operation, the development of health coverage in the Korean peninsula is in line with the history of health coverage development in the West. The Wonsan Laborers' Hospital, founded and operated by the laborers themselves, thus holds great significance in the history of Korea's health coverage, The findings of this study are expected to stimulate new and more diverse discussions on the history of health coverage in Korea.

The Effect of Venoarterial Extracorporeal Lung Assist ( ECLA ) Using a Small - sized Membrane Oxygenator in Hypoxic Dogs / 대한마취과학회지

After the heart-lung machine was used for the open heart surgery, it was hypothesized that the extracorporeal circulation might be applicable to the management of acute respiratory failure. The development of silicone membrane minimized the possible physical or chemieal damages to blood perfused into the oxygenator. Extracorporeal lung assist(ECLA) using a membrane oxygenator has been recognized as a therapeutic modality for acute respiratory failure, To simplify and reduce the voulme of the ECLA circuit, a small oxygenator, surface area 0.3 m2, was developed by Kurare Co., Japan. It was composed of non-microporous hollow fibers. We performed venoarterial(VA) ECLA to evaluate the gas transfer of the Kurare oxygenator. The priming volume of the ECLA circuit was about 150 ml. Venous blood was drained via the right external jugular vein. The maximum bypass flow rate was about l060 ml/min. Oxygenated blood was perfused into aortic arch via the right carotid artery. The increase of arterial oxygen tension was about 58 mmHg during VA ECLA. It was confirmed that Kurare oxygenator was adequate for the oxygenation support on hypoxic dogs. We tried this ECLA circuit on a postoperative cardiac patient on May, 20, 1991. After 90 hours VA ECLA, she recovered without any complicatioris.

Aneurysm of the Radial Artery following indwelling of a Catheter in a Patient with Chronic Renal Failure / 대한마취과학회지

Radial artery cannulation is a well established clinical technique for continuous monitoring of arterial blood pressure and serial sampling of arterial blood in critically ill patients. This method is regarded generally as safe, but complications are reported uncommonly. We report a case of false aneurysm of the radial artery following repeated puncture and catheter indweling for 8 days, and discuss briefly about the complication of arterial cannulation. It should be remembered that in arterial cannulation, we must use aseptic techniques, and the catheter must not be indwelt at one point for a long time.