비심인성 흉통 진단 및 치료의 최신지견

민양원 ( Won Min Yang ),이풍렬 ( Poong Lyul Rhee ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.2

Noncardiac chest pain (NCCP) is defined as recurring, angina-like, retrosternal chest pain of noncardiac origin. Although patients with NCCP have excellent long-term prognosis, most suffer persistently from their symptoms. Several pathophysiological mechanisms have been suggested, including gastroesophageal reflux disease (GERD), esophageal motility disorder, esophageal hypersensitivity, and psychological comorbidity. Among them, GERD is the most common cause of NCCP. Therefore, GERD should first be considered as the underlying cause of symptoms in patients with NCCP. Empirical proton pump inhibitor (PPI) treatment with a preferably double dose for more than 2 months could be cost-effective. PPI test can also be used for diagnosis of GERD-related NCCP, but it should be considered for patients with NCCP occurring at least weekly and its duration should be at least 2 weeks. However, upper endoscopy and esophageal pH monitoring are necessary when the diagnosis of GERD is uncertain. Esophageal impedance-pH monitoring could further improve the diagnostic yield. Patients with GERD-related NCCP should preferably be treated with a double dose PPI until symptoms remit (may require more than 2 months of therapy for optimal symptom control), followed by dose tapering to determine the lowest PPI dose that can control symptoms. However, treatment of patients with non-GERD.related NCCP is challenging. An empirical treatment of antidepressants could be considered. If there are specific esophageal motility disorders, smooth muscle relaxants or endoscopic treatment may be considered in selected cases. If none of these traditional treatments is effective, a psychology consultation for cognitive behavioral therapy should be considered.

비심인성 흉통 환자에서 보행성 24시간 식도 내압과 산도 검사의 유용성

김지연,박지은,이지영,김동완,박무인,박선자,구자영 고신대학교 의학부 2004 高神大學校 醫學部 論文集 Vol.19 No.1

Background: Esophageal disorders are common cause of noncardiac chest pain. The aim of this study was to investigate the relationship between spontaneous chest pain and esophageal disorders in patient with frequent disabling noncardiac chest pain (NCCP). Methods: Between March 2001 and June 2002, 23 patients who had an episode of NCCP, were studied with 24-hr ambulatory esophageal motility and pH system. The recordings were analyzed with fully automated techniques. The analysis was done with the 97.5th percentile of amplitude and duration of all esophageal contractions in each patient whether a pain episode was related to abnormal motility or not. Results: Fifteen patients experienced total 87 spontaneous chest pain episodes, nine episodes(10.3%) occurred during abnormal motility, whereas 18 episodes(20.7%) were associated with pH<4 and 11 episodes(12.6%) had both abnormalities. Overall, 15 of 23 patients(65.2%) had at least one chest pain episode correlating with abnormal motility or reflux was found in 11 patients(47.8%). Conclusion: Esophageal motor abnormalities and reflux are common causes of NCCP, and 24-hour recording of esophageal pressure and pH was useful in patient with NCCP.

비심인성 흉통 환자에서 보행성 24시간 식도 내압과 산도 검사의 유용성

김지연,박지은,이지영,김동완,박무인,박선자,구자영 고신대학교(의대) 고신대학교 의과대학 학술지 2004 고신대학교 의과대학 학술지 Vol.19 No.1

Background : Esophageal disorders are common cause of noncardiac chest pain. The aim of this study was to investigate the relationship between spontaneous chest pain and esophageal disorders in patients with frequent disabling noncardiac chest pain (NCCP). Methods : Between March 2001 and June 2002, 23 patients were analyzed with fully automated studied with 24-hr ambulatroy esophageal motility and pH system. The recordings were analyzed with fully automated techniques. The analysis was done with the 97.5th percentile of amplitude and duration of all esophageal contractions in each patient whether a pain episode was related to abnormal motility or not. Results : Fifteen patients experienced total 87 spontaneous chest pain episodes. Nine episodes (10.3%) occurred during abnormal motility, whereas 18 episodes (20.7%) were associated with pH<4 and 11 episodes (12.6%) had both abnormalities. Overall, 15 of 23 patients (65.2%) had at least one chest pain episode correlating with abnormal motility or pH. Using the symptom index of 25% as criteria, a correlation between one or more chest pain episodes and abnormal motility or reflux was found in 11 patients (47.8%) Conclusion : Esophageal motor abnormalities and reflux are common causes of NCCP, and 24-hour recording of esophageal pressure and pH was useful in patient with NCCP.

중소기업 적합업종제도에 대한 법적 연구

강현호(Kang, Hyun-Ho),이제희(Lee, Je-Hee) 한국토지공법학회 2014 土地公法硏究 Vol.67 No.-

2008년 금융위기 이후, 대기업과 중소기업간 양극화가 사회문제로 부각되었다. 정부는 대․중소기업간 사회적 갈등을 해소하고, 기업경쟁력을 향상하기 위하여 중소기업 적합업종제도를 도입하였다. 정부는 민간의 자발적 합의를 통해 중소기업 적합업종이 결정되는만큼 통상분쟁의 소지가 없다고 밝혀왔지만 2014년 3월 미국 무역대표부(USTR)는 중소기업 적합업종제도를 한국의 무역장벽으로 지적하였다. 동반성장위원회는 정부의 사인으로 구성되어 있으며 「대․중소기업 상생협력 촉진에 관한 법률」에 따라 공무의 성격을 가지는 중소기업 적합업종지정 업무를 위탁받아 자신의 이름으로 수행하고 있다. 정부는 동반성장위원회에 예산을 지원하고 있으며 사후적 감독이 가능한 만큼 동반성장위원회는 공무수탁사인에 해당한다. 동반성장위원회의 중소기업 적합업종지정에 따른 조치를 관련 기업이 이행하지 않을 경우, 중소기업청의 사업조정이라는 법적 조치가 가능한 만큼 중소기업 적합업종 지정행위는 항고소송의 대상이 되는 처분적 행정행위이다. 동반성장위원회의 중소기업 적합업종지정은 한․미 FTA에서 규정한 투자유치국이 채택하는 정부의 조치이며 투자자는 동 조치로부터 보호받아야 한다. 한․미 FTA에서는 투자분야의 경우, 투자유치국이 투자자의 투자 재산을 직접수용하거나 간접수용도 할 수 없다. 투자유치국의 조치가 공공목적 등의 예외적인 경우에도 투자자에 대한 적절한 보상이 이루어져야 한다. 중소기업 적합업종지정은 투자자의 재산을 직접 수용하지는 않지만 투자자의 재산권에 대한 심각한 제약을 가져오며 투자자에게 합리적으로 기대되는 경제적 이익을 상당 부분 박탈하는 만큼 간접수용에 해당한다. 국경간 서비스분야는 유보분야를 제외한 전 분야에서 시장접근 제한 조치를 취할 수 없는 만큼 서비스분야의 중소기업 적합업종지정 역시 통상분쟁을 야기할 수 있다. 중소기업 적합업종지정에 따른 통상분쟁의 소지를 없애기 위해서 적합업종 지정이 정부의 조치로 인정되는 행정행위적 요소를 제거할 필요가 있다. 첫째, 동반성장위원회 설치와 중소기업 적합업종 지정 업무를 부여한 상생법의 개정을 통해 동반성장위원회의 업무를 국가사무와 분리시킬 필요가 있다. 둘째, 동반성장위원회가 정부의 직․간접적 영향으로부터 독립적으로 운영되어야 한다. 셋째, 중소기업 적합업종지정에 대한 합의가 이루어지지 않은 경우 부여되는 동반성장위원회의 사업조정 신청권을 삭제하는 것이 필요하다. 넷째, 향후 동반성장위원회에서 수행하는 중소기업 적합업종지정과 동반성장지수산정 업무의 분리를 검토할 필요가 있다. 대․중소기업의 상생은 헌법에서 정한 중소기업의 보호․육성을 위해 필요하다. 그러나 지금은 다른 나라와의 교역 없이 독자적 생존이 불가능한 시대이다. 특히, 양자간 자유무역협정에서 환태평양경제동반자협정(TPP)과 같은 다자간 자유무역협정의 시대가 도래한 만큼 글로벌 시각에서 중소기업 관련 정책이 통상분쟁의 소지가 없는지 면밀히 검토할 때이다. Since the financial crisis in 2008, the economic gap has fast grown between large businesses and small and medium enterprises(SMEs). The Korea government has responded to this economic and also social issue by implementing a policy of designating suitable industries only for SMEs in an effort to mediate complaints of unfair or unequal competition between large and small businesses.“The process of selecting suitable industries only for SMEs would be controlled under fully autonomous decisions of stakeholders,” said the Chairman of National Commission on Corporate Partnership(NCCP), composed of civil experts, implementing assigned duties under the‘Act on the promotion of collaborative cooperation between large enterprises and small–medium enterprises’. He also added that designating suitable industries for SMEs is consistent with obligations under the Korea-U.S. Trade Agreement(KORUS FTA). The United States Trade Representative(USTR) however asserts that ‘designating suitable industries for SMEs’ is one of the trade barriers in Korea, citing that the NCCP is a partially government-funded organization created by the Korean National Assembly. USTR contends that‘designating suitable industries for SMEs’ performed by NCCP is inconsistent with KORUS FTA rules. The main purpose of designating suitable industries for SMEs is increasing SMEs’competitiveness by limitations on market access. NCCP performs assinged duies in accordance with the law. NCCP is examined by the Board of Audit and Inspection as the budget support of government. As a result, NCCP is a official-trustee private individual. In case of firms and individual executives who fail to comply with the decision of designating suitable industries for SMEs, Small and Medium Business Administration (SMBA) may recommend or order business coordination to interested parties. Designating suitable industries for SMEs is a measure adopted and maintained by central government and an administrative disposition. It is not a direct expropriation but a regulatory one that interferes with the use of property and frustrates foreign investors’reasonable economic expectations. Also it may cause severe economic damage to investors to outweigh the public interest with balancing test. Therefore, designating suitable industries for SMEs constitutes an indirect expropriation. In the field of cross-border trade in services, government shall not adopt regulations imposing limitations on market access to service suppliers. For the avoidance and settlement of trade disputes caused by ‘designating suitable industries for SMEs’, elements of administrative acts have to be eliminated. First, it is necessary given in trust to NCCP is abolished with revising ‘Act on the promotion of collaborative cooperation between large enterprises and small – medium enterprises’. Second, NCCP shall be run from the government. Third, the law shall deprive NCCP of the right to apply to SMBA for business coordination. Finally, a ‘in-win scorecard’on how large businesses co-exit with SMEs and designating suitable industries for SMEs shall be implemented by separate organizations.

코로나19 등 대응을 위한 “유리창 부착용 항바이러스 동필름” 성능분석 사례연구

김성제(Seong Je Kim) 한국방재안전학회 2021 한국방재안전학회 논문집 Vol.14 No.1

세계적인 코로나19 대유행의 시대에, 현재 치료제·백신이 개발, 시판 중인 단계에서 병원내 교차감염의 위험성이 있는 상황이므로, 개인적으로는 후천적인 면역력을 제고하고 사회환경적으로 구리이온의 성능에 의한 생활방역체제를 일반화해야 한다. 감염확산방지를 위해 동서고금의 연구개발사례를 근거로 항균동 필름의 필요성 및 항바이러스 성능실험을 통해 효능성을 분석했다. 한국건설생활환경시험연구원(KCL)에서 항균성능인증 및 “국가승인 성능인증기관”에서 항바이러스 시험성적 인증을 받게 되었다. 당시 질병관리본부의 허가를 받은 실험재료인 NCCP 43326 Human corona virus(BetaCoV/Korea/KCDC03/2020)을 분양받아 생물안전기준에 맞게 생체외 실험실에서 In Vitro시험 결과, 항바이러스 성능시험에서 감염된 세포의 활성제거율이 만족할만한 결과를 도출하고 성능을 인증받게 되었다. 항후 코로나19 바이러스 확산방지대책으로 항바이러스 동필름이 시공된 유리창 공간내에서의 실험군과 항균동필름이 없는 동일조건의 대조군을 비교하는 질(質)적인 임상실험연구가 추가 필요하다. In the era of the global coronal 19 pandemic, there is a risk of cross-infection in hospitals at the stage where treatments and vaccines are currently being developed and marketed, so individuals should enhance their acquired immunity and generalize their living systems by the performance of copper ions in the social environment. In order to prevent the spread of infection, the need for anti-bacterial film and its efficacy were analyzed through anti-viral performance tests based on research and development cases of worldwide and immemorial time. he Korea Construction Research Institute (KCL) has received anti-bacterial performance certification and anti-viral test scores from the “National Approval Performance Certification Agency.” At the time, NCCP 43326 Human Corona virus (BetaCoV/Korea/KCDC03 /2020), which was approved by the Centers for Disease Control and Prevention, was introduced to ensure that the activity rate of infected cells was satisfied in the anti-viral performance test. Anti-proliferation measures for the Corona 19 virus require a quality clinical trial study comparing the experimental group within the glass space where the antiviral copper film is constructed with the comparator of the same condition without copper film.

두부 적합업종 지정이 사회후생에 미치는 영향

황인학(Hwang In hak),한현옥(Han Hyun Ok) 한국경제연구원 2014 규제연구 Vol.23 No.2

중소기업 적합업종 지정제도'가 시행된 지 3년이 되면서 동 제도의 효과에 대한 논란이 비등하고 있다. 이에 본 연구는 두부산업을 대상으로 동 제도가 관련 기업의 행태와 시장구조, 그리고 시장성과 및 사회후생에 어떤 영향을 미쳤는지 과점시장 이론에 기초하여 사례분석을 시도한다. 두부는 대기업 3사의 시장점유율 합계가 80%를 넘지 않도록 하는 내용으로 2011년 12월 1일부터 중기 적합업종으로 지정되었다. 그 이후 대기업 간 할인 경쟁이 자제되고 소비자의 실제 지불가격이 높아지면서 대기업의 이익률(손실률)은 증가(감소)하였다. 본 연구에서 두부산업에 적합한 지배기업 모형을 이용하여 사회적 후생손실(DWL) 함수를 도출하여 추정한 결과, 대기업 3사의 매출총액 대비 DWL은 2011년에 0.2%였으나 2012년에는 1.3%, 2013년에는 3.0%로 증가한 것으로 나타난다. The National Commission on Corporate Partnership (NCCP) designated the tofu market as a type of business suitable for SMEs in the end of 2011 in order for levelling the playing field between large businesses and SMEs. This paper examines the effects of the designation on market competition and social welfare. The tofu market in Korea consists of three dominant firms and many fringe firms. Based on dominant firm theory, we thus derive the deadweight loss function depending on the dominant firms' market shares, profits and behavior. We measure the deadweight loss in the market from 2011 to 2013, and find that the deadweight loss has increased since the designation. We suspect the results come from the refrainment of competition among the dominant firms caused by the designation. The total market share of the dominant firms has been restricted not to exceed 80% after the designation. To satisfy the restriction, they reduced promotional activities such as price discount or 1+1 event. As a result of it, it seems that the profitability of each large firm is improved but consumers end up paying more.