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민간투자사업에 대한 건설보조금 지급 조항을 포함한 실시협약의 적법성 연구
안태훈 국회입법조사처 2024 입법과 정책 Vol.16 No.1
정부는 민간투자사업에 대한 건설보조금 지급을 실시협약에서 규정하고 있다. 또한 대법원 판례는 건설보조금 지급을 규정한 실시협약이 국회 의결 없이 시행될 수 있는 계약이 라고 제시하고 있다. 그러나 본 연구에서는 법률 및 문헌 조사를 통하여 건설보조금 지급 조항을 포함하는 실시협약이 국고채무부담행위이며, 국회의 의결을 받아야 하는 지출원 인행위에 해당됨을 살펴보았다. 또한 「보조금관리법」에서 규정한 보조금의 편성・집행 절차를 고려할 때, 건설보조금 지급 조항을 실시협약에 수록할 수는 있는 법적 근거를 확인할 수 없었다. 따라서 현행 법률하에서 주무관청이 민간투자사업자와 건설보조금을 포함하는 실시협약을 체결하기 위해서는 관련 법률의 개정이 필요하다. The government stipulates the provision of construction subsidies for private investment projects in the implementation agreement. Furthermore, the Supreme Court precedent indicates that the implementation agreement specifying the provision of construction subsidies can be a contractual act that can be enforced without the approval of the National Assembly. However, this study examines through legal and literature research that the implementation agreement containing the provision of construction subsidies is an act incurring national debt, falling under an expenditure act requiring approval from the National Assembly. Additionally, considering the budgeting and execution procedures for subsidies specified in the ‘Subsidy Management Act,’ there was no legal basis identified for including the provision of construction subsidies in the implementation agreement. Therefore, under the current law, it is necessary to amend relevant laws for the competent authority to enter into an implementation agreement with private investment entities, including construction subsidies.
안태훈,이영환,이규목,김유리,윤권하 대한자기공명의과학회 2017 Investigative Magnetic Resonance Imaging Vol.21 No.4
Primary mesenteric liposarcoma is rare. It is difficult to make an accurate preoperative diagnosis of the myxoid type of liposarcoma by using imaging such as ultrasound or computed tomography (CT) due to the very small amount of fat that is located in the tumor. We report a case of primary myxoid liposarcoma of the mesentery which was difficult to differentiate from other solid mesenteric tumors with a myxoid component such as low grade fibromyxoid sarcoma, myxoid leiomyosarcoma or myxoma. Use of chemical shift magnetic resonance (MR) imaging to detect small fat components and its cystic appearance with solid components on the MR images can be useful to differentiate myxoid liposarcoma from the other mesenteric tumors with a myxoid component.
Effect of hydroxyethyl starch on blood glucose levels
안태훈,정기태,심수빈,최우영 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.4
Background: Hydroxyethyl starch (HES), a commonly used resuscitation fluid, has the property to induce hyperglycemia as it contains large ethyl starch, which can be metabolized to produce glucose. We evaluated the effect of 6% HES- 130 on the blood glucose levels in non-diabetic patients undergoing surgery under spinal anesthesia. Methods: Patients scheduled to undergo elective lower limb surgery were enrolled. Fifty-eight patients were divided into two groups according to the type of the main intravascular fluid used before spinal anesthesia (Group LR: lactated Ringer’s solution, n = 30 vs. Group HES: 6% hydroxyethyl starch 130/0.4, n = 28). Blood glucose levels were measured at the following time points: 0 (baseline), 20 min (T1), 1 h (T2), 2 h (T3), 4 h (T4), and 6 h (T6). Results: Mean blood glucose levels at T5 in the LR group and T4, T5 in the HES group, increased significantly compared to baseline. There were no significant changes in the serial differences of mean blood glucose levels from baseline between the two groups. Conclusions: Administration of 6% HES-130 increased blood glucose levels within the physiologic limits, but the degree of glucose increase was not greater than that caused by administration of lactated Ringer’s solution. In conclusion, we did not find evidence that 6% HES-130 induces hyperglycemia in non-diabetic patients.
Effects of PEEP on the thermoregulatory responses during TIVA in patients undergoing tympanoplasty
안태훈,Jung-Woo Yang 대한마취통증의학회 2011 Korean Journal of Anesthesiology Vol.61 No.4
Background: During general anesthesia, core temperature decreases, largely due to heat loss caused by peripheral vasodilation, resulting in heat redistribution to peripheral tissues. Multiple factors contribute to body temperature regulation during general anesthesia. It was reported that baroreceptor unloading by positive end-expiratory pressure (PEEP) attenuates anesthetically-induced hypothermia. So, we evaluated the effects of PEEP on thermoregulatory responses during total intravenous anesthesia (TIVA). Methods: Forty healthy patients scheduled for tympanoplasty were allocated two groups, Group ZEEP (zero end-expiratory pressure, n = 20) and Group PEEP (PEEP application of 5 cmH_2O, n = 20). Ambient temperature was maintained at 22-24℃, and anesthesia was induced and maintained with propofol-remifentanil. The core temperature and the temperature difference between forearm and fingertip skin were monitored before and after the induction of general anesthesia having a duration of 180 minutes. Results: The core temperature gradient (Ti-Tf ) was higher in patients with ZEEP than with PEEP. The core temperature was maintained at a higher level in patients with PEEP. Additionally, the vasoconstriction threshold was higher in patients with PEEP. Conclusions: It seems that PEEP attenuates anesthetically-induced hypothermia during TIVA.