생활 속 화학제품 피해를 조기에 발견하고 대응하는 체계 구축

김신범 한국방재학회 2022 한국방재학회지 Vol.22 No.5

예산과정에서의 Rent-Seeking비용의 추정에 관한 연구

金辛範 인제대학교 인문사회과학연구소 1998 인문사회과학논총 Vol.5 No.1

In this article I adopted some existing studies on rent-seeking field for the frame of reference. Emdedding on the theories of Tullock, rent-seeking features are on the main focus of this article. In practical aspect, rent-protection as well as rent-seeking should be considered. Extending the theory of James Buchanan, I established four level of rent-seeking in analyzing local government. Above all, the aspect of budget decision process, which is essentially normative logic, were included in this paper. Some suggestions were derived through intensive review of arguments in the rent-seeking literatures. Above all, the critical purpose of rent-seekig should be to find out some leverages to reduce rent-seeking activities and rend-seeking costs. This purpose is far more important in the Asian developing countries, which generally have common administrative phenomena of cultures of corruption, perquisites. Local government caused so many rent-seeking activities. With the clear theoretical foundation Korea needs to eliminate the sources of rent-seeking around the administrative regulations. Reducing of the numbers of candidates for the rent-seeking is necessary. In a sense, to introduce the notion of nepotism is recommendable in the distributing process of rents. Eetablishing the some institutions which enforce steeply rising of marginal costs of rent-seeking activities. Basically, the present settings which enables for administrative systems to have too much powers and resources should be changed in the long-term sense. The distribution on what role are to be alloted to market, local government, and to central government needs to reexamined.

F-91 금연치료 건강보험지원사업 시행 후 단일 의료기관의 치료 결과와 치료 후 금연 성공에 미치는 요인 분석

김신범,강현희,문화식,이상학,주현수 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.0

서론: 2015년 2월 이후 금연치료 건강보험지원사업 시행으로 흡연자의 병, 의원 금연치료가 더욱 용이해졌으나 실제 치료결과와 이에 영향을 미치는 요인은 잘 알려져 있지 않다. 본 연구에서는 가톨릭대학교 성바오로병원 금연클리닉의 실제 치료결과와 금연성공에 미치는 요인을 분석하였다. 방법: 가톨릭대학교 성바오로병원 금연클리닉을 방문한 사람을 대상으로 하였으며, 문진표를 바탕으로 기초정보를 분석하고 전화면담을 실시하여 금연치료 결과를 조사하였다. 결과: 2015년 4월부터 2017년 2월까지 총 330명의 흡연자가 금연클리닉을 방문하였다. 대상자 중 남성이 284명(86%)이었고 평균 나이는 54.8세였다. 하루 평균 흡연량은 0.91갑, 평균 흡연기간은 32.5년으로 평균 30.2갑년의 흡연력을 갖고 있었으며, 평균 니코틴의존도 점수는 5점이었다. 처음 방문 후 중단한 경우가 106명(32%)이었고 평균 방문 횟수는 3회였다. 금연치료 일정을 모두 마친 79명(24%) 중 금연에 성공한 참여자는 71명(90%)이었다. 전체 지원자에서 금연치료 후 3개월 금연율은 45.7% (151명)이었다. 예정된 6회의 금연치료 방문을 모두 완료한 경우(OR 3.6, [95% CI, 1.5-8.7])가 3개월 금연성공과 통계적으로 유의한 연관성을 보였다. 결론: 금연치료 건강보험지원사업 시행 후 금연치료를 받고 있는 흡연자 중 45%가 금연치료 후 3개월간 금연에 성공하여 금연지원 정책의 효과가 높다는 것을 알 수 있었다. 또한 예정된 금연치료 방문을 모두 완료한 경우 금연효과가 높은 것을 관찰할 수 있었다.

Assessment of the obstructive sleep apnea prevalence with polysomnography in Korean patients with idiopathic pulmonary fibrosis

김신범,조성배,이종민,김세원,이상학,강현희,김용현 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

Introduction: Several studies have shown that obstructive sleep apnea (OSA) prevalence in patients with idiopathic pulmonary fibrosis (IPF) is higher than it in the general population. However, most studies reported so far have been made on Westerners. The purpose of this study was to investigate OSA prevalence with polysomnography (PSG) in Korean patients with IPF. Method: Data was collected prospectively on 24 patients with IPF at St. Paul’s hospital. All patients were diagnosed with IPF by the 2011 An Official ATS/ERS/JRS/ALAT statement. All of them received PSG and OSA prevalence was estimated based on it. The IPF severity was evaluated using GAP index. All patients underwent pulmonary function tests within 6 months. Result: There were 20 males among 24 patients and the mean age was 76.5±7.5 years, mean BMI was 24.2±3.7. The GAP index score was 3.1±0.8 on average and GAP index stage 1, 2, and 3 were 18, 5, and 1, respectively. Eighteen patients were diagnosed with OSA. The OSA prevalence was 75%. The severity of OSA was 6 in mild, moderate, and severe, respectively. The Apnea-hypopnea index was 22.3±22.4. Sleep efficiency was 68.1±14.7%. The percentage of sleep stages were 30.9±18.2 for S1, 49.2±13.7 for S2, 7.3±7.7 for S3, and 12.4±7.1 for REM. The mean oxygen saturation nadir was 83.8±8.1%. Conclusion: The OSA prevalence was remarkably higher than the prevalence of the general population of 4% in Korean patients with IPF by PSG. Therefore, clinicians should have high index of suspicion of OSA and, if in doubt, perform PSG.

폐쇄성 수면 무호흡증과 간질성 폐질환

김신범,이상학,강현희,Kim, Shin Bum,Lee, Sang Haak,Kang, Hyeon Hui 대한수면의학회 2017 수면·정신생리 Vol.24 No.1

Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.

서서 일하는 노동자에게 의자를! (이슈와 현장) : 조직화와 연대를 위한 건강권 운동

김신범 한국노동사회연구소 2008 노동사회 Vol.136 No.-

P-109 Factors affecting the successful rigid bronchoscopic intervention in patients with post-intubation tracheal stenosis

김신범,강현희,문화식,이상학,임정욱,주현수,하직환 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-

Introduction: It is known as the rigid bronchoscopic intervention is an excellent therapeutic option to replace surgery in post-intubation tracheal stenosis (PITS). However, it is difficult to predict its outcome. We aimed to evaluate factors affecting the successful rigid bronchoscopic intervention in patients with PITS. Method: Data was collected retrospectively on 41 patients with PITS underwent rigid bronchoscopic intervention between October 2007 and July 2017 at St. Paul hospital. Successful therapeutic outcome was defined as maintaining the airway patency without stent insertion by bronchoscopic dilatation and surgery or stent reinsertion after stent removal. Results: In 9 of 41 patients, airway patency was maintained by conducting only bronchoscopic dilatation without stent insertion. Successful stent removal was performed in 21 of 32 patients who received the stent insertion. The length of stenotic lesion was a significant factor to determine the therapeutic outcome not only in group without stent insertion (p=0.005) but also in group with successful stent removal (p=0.022) by subgroup analysis. However, there was no statistically significant factor to determine the therapeutic outcome in multivariate logistic regression analysis. Conclusion: It is suggested that the length of stenotic lesion of tracheal stenosis may influence the successful therapeutic outcome of rigid bronchoscopic intervention. Further studies are needed to assess the significant factors affecting the successful rigid bronchoscopic intervention by including a larger number of patients.

한국 화학물질의 유통 현황 및 관리의 문제점

김신범 연구공동체 건강과대안 2016 의료와사회 Vol.- No.5

건강권, 노동자와 이웃의 연대로부터 - 화학물질 무엇이 문제이고, 어떻게 해야 하는가?

김신범 한국비정규노동센터 2013 비정규 노동 Vol.- No.99

Survey of the risk of having obstructive sleep apnea and sleep quality using questionnaires in Korean patients with idiopathic pulmonary fibrosis

김신범,조성배,이종민,김세원,이상학,강현희,김용현 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.-

Introduction: Previous studies have shown a high prevalence of obstructive sleep apnea (OSA) in patients with idiopathic pulmonary fibrosis (IPF) by polysomnography (PSG). However, it has the disadvantage of cumbersome and costly. In this research, we conducted a survey using questionnaires in Korean patients with IPF to study the possibility of having OSA and sleep quality. Method: All patients were diagnosed with IPF by the 2011 An Official ATS/ERS/JRS/ALAT statement. The results of the STOP-Bang questionnaire and the Berlin questionnaire were used to assess the risk of having OSA. Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were performed to investigate sleep quality. Result: There were 28 males among 32 patients and the mean age was 79.0±8.4 years, mean BMI was 24.1±4.0. The mean GAP index score was 3.6±1.1. The mean FVC (%) was 83.5±22.8 and the mean DLCO (%) was 72.0±23.7. Patients classified as high risk for OSA by the Berlin questionnaire and the STOP-Bang questionnaire was 37.5% and 46.8%. The mean ESS score was 7.2±5.5 and the mean PSQI score was 7.2±4.0. Conclusion: In this study using questionnaires as OSA screening tool, it was determined that a large number of patients with IPF were likely to have OSA. Furthermore, the sleep quality of IPF patients was significantly low. Clinicians treating IPF patients should pay more attention to OSA presence and sleep quality in patients.