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지방자치단체의 불용액 현황- 개념, 발생원인과 시사점 -
전성만,김성주,하혜수 한국지방행정학회 2022 한국지방행정학보 (KLAR) Vol.19 No.3
This article examines local goverment’s unused-spending status-quo by defining unused-spending concepts based on theoretical approach and highlighting the relationshp between central-local financial actitvities. As a result, we argue that the perception of local government’s unused-spending depends largely on how organizational performances are; there are different approach between agent theory approach and resource based view approach. we found the external factors increasing the unused-spending at the relationship between local government and central government’s department. Local governments’ financial autonomy depends largely on the amount of subsidy from central government’s project. This relationship influences the growth of the unused-spending by rapid project process short time lag to spend budget implementation. Also, it reduces local government’s creative budget plan before receiving the subsidy. we suggest policy alternatives to manage the unused-spending amount at local government. Our suggestions is about the improvement of the special fund account by using sunset law that designate the termination of governmental program unless the legislature affirmatively acts to renew it.
전성만,차재관,김상호,김재우 대한신경과학회 2006 대한신경과학회지 Vol.24 No.4
Background: Clopidogrel has been widely used in the treatment of acute atherothrombosis. However, until now, there has been little information about its resistance during the acute stage of ischemic stroke. In this study, we investigated platelet responsiveness after using clopidogrel in acute ischemic stroke. Methods: ADP (10 uM) induced platelet aggregation was serially measured in 81 acute ischemic stroke patients at initial, after 24 hrs and 5 days since using clopidogrel. We defined Clopidogrel resistance as less than 30% decrease in platelet aggregation by clopidogrel and investigated the differences of clinical and laboratory findings between the Clopidogrel response and resistance groups. Results: The baseline ADP induced platelet aggregation was 10.2±5.5 ohm and was significantly (p<0.05) reduced to 4.0±4.5 ohm after the use of Clopidogrel. After 5 days of treatment, the clopidogrel resistance was observed in 18.5% of patients. Of the 15 patients with clopidogrel resistance, 12 patients (80%) had large artery atherosclerotic infarctions, 2 others had an unknown type of stroke, and 1 patient had small vessel disease. The patients with clopidogrel resistance showed significantly higher initial clinical severity (p=0.015), C-reactive protein levels (p=0.001) and WBC counts (p<0.001) than those with good responsiveness. In multiple logistic regression analysis, the WBC count was significantly correlated with the clopidogrel resistance (p=0.01). Conclusions: Our results indicate that the clopidogrel resistance was observed in up to 18.5% of patients with acute ischemic stroke and might be affected by enhanced inflammatory reactions.