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생태근대화론을 활용한 환경정책의 지속가능성평가 기본모형 연구
문순홍,정규호 한국환경정책학회 2000 環境政策 Vol.8 No.1
This paper aims to build the sustainability assessment basic model of environmental policies from the viewpoint of ecological modernization theory. For this purpose it is consisting of three steps to review theories and to find assessment's components. First Our Common Future, which is broadly known as the Brundtland Reports, is analysed to induce 'assessment principles' of sustainability such as futurity, fairness and ecology. Each principles has 'assessment scope' between weak and strong sustainability. Secondly through critical reviewing the previous trials of environment and policy assessments, we confirm the desirable 'assessment level and time'. For the preventive effects of sustainabilily assessment, it is more significant to move analysing focal point from project to policy level and analysing time from policy outcomes to agenda setting and decision making. Thirdly we review the theories of ecological modernization, which have been providing the theoretical foundation for preventive and integrative environmental policles after the middle of 1980's. Thereafter 'technology and economics', 'politics and administration', and' society and culture' are selected as the areas of policy analysis and assessment. Lastly we figure out the basic model of environmental policy assessment based on the principles, scope and areas of sustainability
심판막 치환술을 받는 환자에서 Fentanyl-O2 마취중의 심혈관 반응
문순홍,권무일 대한마취과학회 1989 Korean Journal of Anesthesiology Vol.22 No.6
Intravenous administration of high dose of fentanyl is gaining wide popularity as the sole anesthetic agent for patients undergoing cardiac surgery because of its favorable characteristics such as, simplicity, stable hemodynamics and supression or modification of stress response to surgery. But some investigators reported the necessity of supplementary anesthetic agent in addition to fentanyl to maintain hemodynamic stability during the surgical procedure. Therefore, we measured the heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP), and rate pressure product(RPP) at induction, tracheal intubation, skin incision, and sternotomy time to evaluate the cardiovascular responses to surgical procedure under fentanyl-O₂ anesthesia on 12 patients with acquired valvular heart disease. The patients were anesthetized with a loading dose (30μg/kg fentanyl for induction and 1.5μg/ kg/min until sternotomy) followed by continuous infusion of fentanyl (0.3μg/kg/min untihe end of cardiopulmonary bypass.) The patients required total doses of 108±4.6μg/kg fentanyl for the entire operation. These measurements were compared with control data (before induction). The results were as followings: 1) During induction (infusion of fentanyl 30μg/kg), HR, SBF, DBP, MAP, and RPP revealed no significant change compared with control data. 2) During intubation and skin incision, HR, SBP, DBP, MAP, and RPP slightly increased but were not statistically significant (p$gt;0.05) 3) During sternotomy, SBP increased from 119.8±16.36 torr to 136.5±15.22 torr, DBP increased from 79.1±12.76 torr to 95.4±10.87 torr, MAP increased from 99.4±13.96 torr to 115.5±12.70 torr, and RPP increased from 10929±2206 torr.beats/min to 13889±2865 torr. beats/min (p$lt;0.05). HR increased from 90.7±8.71 beats/min to 100.2±13.79 beats/min, but was not statistically significant(p$gt; 0.05). 4) One of the patients had recall of the sternotomy and spreading of the chest with the sternal retractor. These data demonststhetic doses of fentanyl and O produce minimal change in cardiovascular dynamics during the surgical procedures except sternotomy time. Our findings suggest that fentanyl-O₂ anesthesia may be an attractive anesthetic technique in patients with valvular heart disease undergoing valve replacement operations but, will be needed considerations about infusion method, dosage of fentanyl and use of supplementary anesthetic agent according to patients conditions.