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김영석,김완식,박동호,정연탁,김미연 대한마취과학회 1979 Korean Journal of Anesthesiology Vol.12 No.4
In recent years, there has been renewed interest in preoperative methods to reduce gastric acidity, thus lessening the risk of a serious pulmonary reactions following aspiration of gastric contents. Emergency obstetrical patients frequently have large volumes of gastric fluid. It is less commonly appreciated that patients fasting prior to eleetive surgery afterive in operating room with large gastric fluid volumea with a low pH. Prophylactic preoperative oral administration of antacids hae been shown to reduce preoperative gastric aeidity.in significant percentage of patients, but aspiration of antacids can be associated with pulmonary complications, and there use may be associated with increased gastric volume. Preoperative adrpinistration of glycopyrrolate may decrease the frequency of surgicsl patients with a low gastric pH, and it appears that the volume of gastric fluid may be reduced by medication that relax the pylorus. However, none of thease pharmacologic manuevers completely abolisbes the possibility of serious pulmonary damage with aspiration. Mendelson and Teabeat demonstrated the importance of pH in the etiology of acid aspiration and it is generally accepted that the critical pH is 2. 5 or less, i.e. the risk of aerious pulmonary reaction increases progressively as the pH of the aspirate falls below 2.5. A critical voIume of acid aspirate is also neceasary for widespread pulmonary damage to occur irrespective of a low gastric pH. The critical volume is rhesus monkeys has been shown to be 0.4 ml/kg, but the critical volume in man is less well difined. Several investigators have determined the patient to be at risk of serious pulmohary complications with aspiration if at least 25 ml of gastric fluid with a pH of 2.5 or less is aspirated. The present study was undertaken to investigate the effects on the volume and pH of gastric juice under general anesthesia. The 35 patienta were studied, and were divided. into 4 group account to the kind of premedicants, N.P.O. time, weight, and obstetric patients Gastric juice, aspirated through a Levine tube, was examined for pH and. volume under general anesthesia.
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김영석,김완식,황영희,김흥대,김교상,장경덕 대한마취과학회 1981 Korean Journal of Anesthesiology Vol.14 No.1
The segmental spread of epidural analgesia was measured in seventeen surgical patients aged between 17 and 52 years, and in fourteen patients between 60 and 77 years. The upper level in the young was 6.29(±1.56) thoracic vertebra level, but in the elderly was 4(±0.65) thoracic vertebra level at 20 minutes after epidural injection of 1.5% lidocaine 20㎖. A given volume of solution spreads to 0.9, 1.07, 1.54, 2.29 segments greater upper extent at 5, 10, 15, 20 minutes after epidural injection and 0.57, 1.07 segments greater lower extent at 5, 10 minutes in the elder than young. So with increasing age relatively small amounts of solution are required, to produce the same extent of anesthesia in the yonung.
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김영석 서울대학교 법학연구소 2022 서울대학교 法學 Vol.63 No.3
In principle, a judgment rendered in a foreign country is effective only within the country, thus whether to recognize or enforce the judgment must be in accordance with the laws of the recognizing and enforcing country. In this regard, Article 217① of the Civil Procedure Act of the Republic of Korea provides four requirements: (1) Jurisdiction, (2) Service (excluding service by public notice and similar types of service), (3) public policy, and (4) reciprocity, and the judgment studied in this paper, 2017-Da-257746 Judgment(hereinafter ‘the Judgment’), deals with the Service. The Judgment concluded that service to a person who has a certain personal relationship with the recipient (hereinafter ‘substituted service ⓐ’) is legitimate service as a requirement for recognition and enforcement. It held that substituted service ⓐ is not similar to ‘service by public notice,’ and repealed all existing precedents that took a different position. The Judgment is meaningful, legally valid, and consistent with the practice of Cross-Border Transactions, in which service abroad is frequently performed. However, the Judgment does not clearly distinguish the two positions the Republic of Korea has in this case, which are the service-implementing country and recognizing/enforcing country, respectively. Meanwhile, although not directly stated in the Judgment, service deemed to be served to the recipient upon shipment (hereinafter ‘substituted service ⓑ’) should be treated the same as ‘substituted service ⓐ’ since it significantly violates the defendant’s right to defend and is similar to service by public notice. Also, it should be noted that direct service by a foreign court without diplomatic channels to domestic residents except for its own citizens is inappropriate. This is in line with the Supreme Court’s 92-Da-2585 Judgment that limited the scope of consular service to its citizens for the same purpose, which was not repealed by the Judgment. Furthermore, it is desirable to make a reply stating that service is not possible in situations where there is no choice but to serve by public notice or similar service such as ‘substituted service ⓑ.’ Otherwise, facing an embarrassing situation might happen where an application for recognition and enforcement is applied after serving by public notice duly under the domestic law. Attention should also be paid to electronic service, currently being considered in the EU, U.K and U.S., since there will be a revolution for the current service system based on physical service. Lastly, it is also necessary to somewhat ease the existing strict service system and widely utilize service by public notice or publication in insolvency matters because collective debt processing procedures require efficient and effective proceedings. In the past, it was not easy to properly handle service abroad unless it was a service at the place where they met by chance, but the overseas service system had developed a lot since then. In a modern society where foreign creditors and overseas assets become commonplace, I look forward to the establishment of service system that can more effectively protect the rights of the parties harmoniously. 외국에서 내려진 재판은 그 재판을 발령한 국가 내에서만 효력을 가지는 것이 원칙이므로, 해당 재판의 승인⋅집행 여부는 승인⋅집행국가에서 정한 바에 따라야 한다. 이와 관련하여 우리나라 민사소송법은 제217조 제1항에서 ① 국제재판관할권, ② 송달(공시송달이나 이와 유사한 방식의 송달 제외), ③ 공서양속, ④ 상호보증이라는 네 가지 요건을 외국재판의 승인⋅집행의 요건으로 규정하고 있고, 대상판결은 그중 두 번째 요건인 ‘송달’을 다루고 있다. 대상판결은 보충송달은 ‘공시송달과 유사한 방식의 송달’에 해당하지 않으므로 보충송달의 방식으로 진행된 외국재판은 승인⋅집행요건을 적법하게 충족한 것이라고 보고, 이와 다른 입장을 취했던 기존 선례들을 대상판결의 견해에 배치되는 범위에서 모두 변경하였다. 이러한 판시는 본인과의 관계 등에 비추어 실제 본인에게 서류가 전달될 가능성이 높은 보충송달을 전형적인 의제송달에 해당하는 공시송달과 명확히 구분한 것으로서 법리적으로 타당하고, 국외송달이 빈번하게 문제되는 국제거래 실무에도 부합하는 유의미한 판시라고 생각된다. 다만, 우리나라가 송달실시국으로서의 지위와 승인⋅집행국으로서의 지위를 겸유하게 된 본 사안에서 대상판결이 양 지위를 명확히 구분하지 않음으로써 다소 불명확하게 논거를 적시한 아쉬운 측면은 있다. 한편, 대상판결에서 직접 설시하지는 않았지만, 그 취지에 비추어 발신주의에 기초하여 송달이 의제되는 발송송달은 패소한 피고의 방어권을 현저히 침해하므로 승인⋅집행요건으로서의 적법한 송달에 해당하지 않는다고 보아야 할 것이다. 외국법원이 외교상의 경로를 거치지 않고 자국민이 아닌 국내거주자에게 직접 우편송달(postal channels)의 방식으로 송달하는 것도 부적법하다고 보아야 하고, 대법원 92다2585 판결이 같은 취지에서 영사송달의 범위를 자국민으로 제한한 것은 대상판결과 배치되는 것이 아니므로 지금도 여전히 유효한 법리라는 점에 유의하여야 한다. 그밖에 송달 촉탁을 받았으나 공시송달/발송송달을 할 수밖에 없는 상황에서는 향후 승인⋅집행국가로서 난처한 상황에 처해지는 것을 피하기 위해 ‘송달불능회신’을 하는 것이 바람직하다. 전자적 송달이 도입된다면 기존의 국외송달 시스템은 대변혁의 시대를 맞이하게 될 것이므로, 현재 EU나 영미국가에서 고려되고 있는 전자적 송달에 대하여도 관심을 둘 필요가 있음은 물론이다. 도산사건과 같이 신속하고 통일적인 절차 진행이 필요한 집단적 채무처리절차에서는 기존의 엄격한 송달체계를 다소 완화하여 의제적 송달에 준하는 공고를 넓게 활용할 필요도 있다. 국외채권자와 국외자산 등이 빈번하게 문제되는 현대사회에서 효율적이면서도 당사자들의 권리를 충분히 보호할 수 있는 송달체계가 확립되기를 기대한다.
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