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편측폐환기 및 폐부종에서 호흡요법이 심혈관계와 혈액가스에 미치는 영향
최병권,양홍석,이채성 대한마취과학회 1988 Korean Journal of Anesthesiology Vol.21 No.3
Nowadays, the importance of respiratory therapy is increasing with the development of modern medicine. Especially effective roupiratory care in the field of anesthesia and intensive care unit has close releatinship to the decrease of mortality or morbidity of the critically ill patients. Compared with spontaneous respiration, so various phusiological changes related to these methods can occur. Because most modernized ventilations can choose the various respiratory pattens according to the patients' respiratory condition, it is ideal to select the respiratory mode which is least hazardous and most effective to the patients. To confirm the effects of respiratory therapy on the cardiovascular system and arterial blood gas in one-lung ventilation and in pulmonary edema, we made one-lung ventilation by deep right endobronchial intubation and pulmonary edema was induced by oleic acid (0.05g/kg. IV) to 12 mongrel dogs. And we ovserved the cardiovascular changes and arterial blood gas analysis in the situation of applying the inspiratory pause (0.25 sec. and 0.5 sec) and positive end-expiratory pressure (5 cm H_2O and 10 cm H_2O). The results were as follows: 1) One-Lung Ventilation (1) Insipratory pause There were no changes of cardiovascular system and arterial blood gas in the inspiratory pause of 0.25 and 0.5 sec. (2) PEEP In 5 cmH_2O of PEEP there was no change of cardiovascular system, but there was decrease in PCO_2(P<0.01) on arterial blood gas. In 10 cmH_2O of PEEP there was increase in heart rate(P<0.05) and decrease in cardiac output(P<0.05). THere was decrease in PCO_2(P<0.01), but there were no changes of pH and PO_2 on arterial blood gas. 2) Pulmonary Edema (1) Inspiratory pause There was increase in heart rate(P<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5 sec. inspiratory pause. (2) PEEp In 5 cmH_2O of PEEP there was incrase in heart rate(P<0.01), but there was no change of arterial blood gas in the 0.25 and 0.5 sec. inspiratory pause. In 10 cmH_2O of PEEP there decreas in sBP,dBP,MAP,increase in heart rate(P<0.05) and decrease in cardiac output(P<0.01). There were increase in pH(P<0.05) and PO_2(P<0.01), decrease in PCO_2. According to the above results in the condition of one-lung ventilation mechanical ventilation with inspiratory pause (0.25 or 0.5 sec.) was not helpfur to respirrotry care. 5 cmH_2O PEEP could improve the pulmonary ventilation without ay changes of cardiovascular system, but 10 cm H_2O PEEP increased heart rate and decrease cardiac output. In the condition of pulmonary edema, mechanical ventilation with inspiratory pause (0.25 or 0.5 sec.) could not improve the pulmonary ventilation with depression of cardiovascular system. PEEP (55 or 10 cmH_2O) could improve the pulmonary condition in proportion to PEEP, but it also depressed the cardiovascular system. Therefore we concluded that mild degree PEEP(5 cmH_2O) may be helpfurl to the one-lung ventilation or pulmonary edema.
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영국에서의 해사분쟁해결 수단으로서의 해사중재의 동향에 관한 분석
최병권 한국해양비즈니스학회 2022 해양비즈니스 Vol.- No.53
The LMAA is the most important institution in maritime arbitration in London. Members of the LMAA constitute the majority of London Maritime Arbitrations. The number of LMAA arbitrators appointed in 2020 was 3,010, the highest since 2015, confirming the high general awareness of the LMAA in dispute resolution in the shipping industry. LMMA has published a new set of terms and conditions for all 'complete' proceedings (the 2021 edition of the LMAA Terms), the 2021 edition of the LMAA Medium Arbitration Proceedings and the 2021 edition of the LMAA Small Claims Procedure. All are effective as of May 1, 2021, and apply to new arbitrations commenced after that date. While some amendments are only fine-tuning of the rules, others are particularly important in light of the recent challenges posed by the global pandemic of COVID-19. After analyzing statistics on maritime disputes, this study compares and analyzes maritime arbitrations in London, New York and Singapore. In addition, after analyzing the role of the court in the arbitration procedure and the specific problems in maritime arbitration, the considerations of British maritime arbitration after Brexit are considered.
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최병권 대한마취과학회 1983 Korean Journal of Anesthesiology Vol.16 No.2
Tramadol(Tridol) was developed by Grunenthal GmbH as a new non-narcotic analgesic agent. It was used as a new anestheic agent by Stoffregen who works in Hagen, West Germany, instead of neutrolept-anesthetics which make sometimes cause severe post-anesthetic repiratory insufficiency. From September to December 1982, 40 cases of balanced anesthesia with controlled tramadol infusion were performed at Chung Ang Univ. Hospital. The anesthetic results were compared with 72 cases of halothane anesthesia; 1) During anesthetic induction, changes of systolic blood pressure were similar in both 2 groups, but the heart rate was stabler in the tramadol group. 2) Tramadol has little effect on muscular relaxatin. 3) Tramadol anesthesia has very rapid post-anesthetic consciousness recovery time and this little respiratory depression. 4) Post-operative pain was minor in tramadol anesthesia compared to neurolept-anesthesia. 5) The technique of use was very simple, safe and economically cheap in balanced anesthesia with controlled tramadol-infusion.
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최병권 대한마취과학회 1982 Korean Journal of Anesthesiology Vol.15 No.4
82 patients who had not specific disturbed conditions, were examined potassium metabolism with various surgical stress in pre-and post-anesthesia. Author determines degrees of surgical stress by factors of surgical duration and estimated blood loss. And measured potassium concentration, pH, pCO2, pO2 and osomlarity in serum on pre-and post-anestbetic pericd, with excreted urinary potassium during surgery. The results are followed; 1) The plasma potassium concentration was more decreased following severer surgical stress. 2) Uninary potassium concentration and amount were more increased following severer surgical stress. 3) The pathophysiology of potassium disturbance with surgical stress was asociated by increased secretion of mineralocorticoid and anti-diuretic hormone. 4) After post-anesthesia, patients with severe surgical stress should be measured serum potassium concentration and corrected.
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