정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

도장작업시 유해인자들의 노출수준과 작업환경관리실태

이세기,문덕환,이채관,황용식,선병관,손병철,김대환,이창희,김휘동,이채언 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.5

Objectives: For the purpose of preparing the fundamental data and assessing the status of exposure level of chemical substances in painting process. Methods and Materials: The author determined the concentration of organic solvents, lead(Pb), Chromium(Cr), and Toluene-2, 4-diisocyanate(TDI) in air of painting process to 90 industries classified by 15 types of manufacturing industry during a period from Jan. 1st 2001 to Dec. 31st 2001. Results: The results were as follows: 1. The geometric mean level of each chemical substance was 0.1706 ppm for exposure index in organic solvents, 0.0019㎎/㎥ for Pb, 0.0024 ㎎/㎥ for Cr, and 0.0004ppm for TDI, respectively. 2. The exposure level of each chemical substances by type of painting was the highest in dipping and brush painting for organic solvent, in spray-painting for TDI, and in spray gun-painting for Pb and Cr, respectively. 3. The exposure level of each chemical substances by type of local ventilation equipment was higher in enclosed and booth type for organic solvents. Cr, and TDI, and in exterior type for Pb, respectively than those of other types. 4. The exposure level of each chemical substances by type of hazardous material arresting media was higher in using water for organic substances, in using bag filter for Pb, TDI, respectively than those of other types. Conclusion: According to above results, this study suggests that the exposure level by type of industry exceeded the exposure level in wooden furniture and metal furniture manufacturing industry for organic solvents and Pb, respectively.

췌장 선방세포암 1예

이화정,지준호,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.

원발성 후복막 점액낭샘암종 1예

지준호,이화정,박승찬,박정철,최은정,서혜진,이원식,이정림,배병조,손경락,이경희 영남대학교 의과대학 2008 Yeungnam University Journal of Medicine Vol.25 No.2

Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.

위절제술 환자의 표준진료지침 개발 및 적용 효과

김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

화학적 요부 교감신경절 차단에서 한 분절 차단과 두 분절 차단의 비교

김종일,이규종,이상곤,민병우,반종석,문철준 대한마취과학회 2001 Korean Journal of Anesthesiology Vol.41 No.4

Chemical Lumbar Sympathetic Block: Comparison of One- Versus Two-needle Techniques Chul-Jun Mun, M.D., Kyu-Jong Lee, M.D., Sang-Gon Lee, M.D., Jong-Il Kim, M.D.^* Jong-Suk Ban, M.D., and Byung-Woo Min, M.D. Department of Anesthesiology, Fatima Hospital, Daegu, Korea ^*Kim Jong Il Pain Clinic, Daegu, Korea Background: It was frequently noticed in the course of performing a two-needle sympathectomy, that satisfactory spread of contrast solution could be produced by injection through only one of the needles. This led to a closer examination of the merits of single-needle technique. Methods: Forty patients were randomized into two groups. Patients in the single-needle group (n = 20) were injected at the second or third lumbar sympathetic ganglia, while patients in the two-needle group (n = 20) were injected at the second and thired lumbar sympathetic ganglia. Lumbar sympathetic blocks were performed using 3 ml of alcohol and the spread of injectate was verified with C-arm fluoroscopy. The indicators of a successful sympathetic block are increasing skin temperature, decreasing pain, and anhidrosis in the distal extremity. Results: The duration of anhidrosis was 12.2 ?? 2.6 months (mean ?? SD) in the single-needle group versus 13.6 ?? 3.6 months (mean << SD) in the two-needle group. Conclusions: As these results were not significantly different from those obtained in patients having considered to be effective for a neurolytic ;i,bar sympathectomy. (korean J Anesthesiol 2001; 41: 439~443)

대화형 다목적 의사결정기법의 수송의사결정 모형에의 적용

이상도,유병철 東亞大學校 大學院 1990 大學院論文集 Vol.15 No.-

The decision making problem is the course to select the best solution from feasible solution, all the alternatives considered, Recently, the above problem has been concerned about multiple objective decision making as the optimized course of the complicated decision making included multiple criteria or multiple objective and regared this thesis as the most active parts. This thesis has been studied interactive multiple objective decision making to get the most favorite preference solution, taking into consideration algorithm taken the efficent solution. Presenting the interactive algorithm which can get the optimization solution not to use preference funtion in the efficient solution groups, we have investigated the more reliable optimization in searching for the final solution. We have tried the application for transportation problem decision making model into having the capability and applicability for practical purposes. The interactive multiple objective decision making presented in this thesis, would be able to apply the decision making under the certainty and finite for the feasible alternatives, also in complianace with the preference on decision maker. In the merit problems, the above theme will be necessitated not for prior information but for progressive articulation of preference information. But the interactive approach in the general flaws would be troubled for the defect on preference information induced in the interactive changable process of the decision maker. Because of including the uncertainty for many decision making problems in the expected study, we would tried to have the application for fuzzy set theory and interactive method about the practical problems.

대학생의 노인복지에 대한 인식도

차병준,김무룡,김기열,차경미,김귀희,김현실,서인선,임상규,이순자,위광복,남철현 慶山大學校 保健福祉硏究所 1999 保健福祉硏究 Vol.2 No.-

The purpose of this study is to grasp the change of consciousness of young people in order to seek new approach of policy for aged era. 1,200 students attending collages and universities in three small or medium sized cities were inquired for 2 months, from October 1 to November 30, 1996. The result is as follows. 1. The characteristic of the respondents of this survey is that they include 72.1% of women, 40.4% of people aged between 20 to 21, and 49.1% of people who do not have any religion. Those who are from big cities and those who are form farming villages or fishing village occupy equally 40.2%, those who reside in that cities for a long period 49.0%, and those who live with their family 60.9%. 2. The family feature of the subject is that 31.5% of them are those whose father is the age of 55 and more than 55, 10% of them are those whose mothers age is so, 33.1% of them have 5 family members, 29.5% of them have the family income of 1,000,000 to 1,490,000 won, 83.9% of them are from middle class, 47.7% of them are the people whose grand parents have passed away, 70.4% of them live apart from their grand parents, and 60.9% of them are second child. 3. 64.0% of males, 70% of respondents who are aged over 24, 58.1% of respondents who are from rural communities, 62.4% of respondents who live in rural area, and 58.3% of respondents who live alone, prefer to live with grand parents, marked higher rate than other groups. The groups whose father and mother are the age of more than 55 marked higher rate of 55.9% and 58% each than any other groups(p<0.05). The groups whose family member is less than three, whose grand parents both have passed away in middle class, who live with their grand parents, and who are second children, give more positive answers than any other groups. 4. Those who are older, who are buddhists, who are from rural area or live in rural area, whose family is small, whose family income is small, who are from lower class and whose grand parents are still alive, shows preference to support their parents after marriage. 5. Females(89.4%), those who are from small or medium sized cities(89%), who live with their family(85.6%), whose father is the age of 55 and more than 55, whose mother is the age of 54 and less than 54, whose family member is 6, who are from middle class, whose grandparents are still alive and who are the eldest child in their family, give more response that they prefer to live apart from their children in their old age than any other groups. 6. What elderly people need most right now is past time(42.3%), and the respondents whose age is 20 to 21, who are buddhists, who are from middle sized cities and live alone, whose parents are the age of more than 55, who have small family income, who live with their grand parents and who are second children show higher level than any other groups. 7. 76.8% of respondents answer that they do not need their parent's fortune, marked still higher rate than the opposite answer. Those who are older, who are buddhists, who are from big cities, who reside in rural area, who live alone and have smaller family, who are in bad family economic conditions and who live with grand parents present higher rate of positive response. 8. 59.3% of respondents reply that they think about death from time to time, and those who are female, who are in the age of 20 to 21, who are christian, who live with their family, whose siblings or other family members offer their education expenses show higher rate than any other groups. 9. 92.3% of respondents answer that the budget for welfare facility for elderly people is very small. The younger the respondents are and the worse economic condition they have among those who live in big cities, the more answered that. 10. 50% of respondents think social security should provide for their old age, and 42.8% of them believe they themselves provide against it. The respondence that social security ought provide for it appeared more among those whose age are over 24, who are female, who reside in rural area, who are christian, who are in bad economic condition, and who ever used medical institutions in recent one month, marked higher level than other groups. 11. The adequate time of retirement is 59.97±5.60 for public officers, the highest and 59.28±6.35 for teachers, the next. 12. 35.2% of respondents reply that the adequate budget for the old age after their retirement at the age of 60 is 220 million won, showed the highest level of respondence. 13. The factors which affect on the old people in the charged welfare facilities are sex(p<0.01), the type of housing(p<0.05) and whole family income(p<0.05). 14. The factors which affect on remarriage are sex(p<0.05) and religion(p<0.05). For varying old population and expanded welfare service for them, government and relevant authority should give more attention to secure the budget, establish effective plans to expand various program and the facilities for elderly people in order that elderly people spend the rest of life time more happily and more fruitfully. To do that, each college and university should open Health courses, and educate and inform about health and welfare.

세라믹 정밀여과막과 한외여과막을 이용한 광촉매로 전처리된 아크릴 폐수의 처리

이광현,김종팔,강병철 대한상하수도학회 2002 상하수도학회지 Vol.16 No.4

The application of ceramic microfiltration membrane and ceramic ultrafiltration membrane and reverse osmosis membrane using acrylic wastewater pretreated by photocataiyst was discussed with the variation of appled pressure and temperature. Turbidity were shown high removal efficiency in ceramic microfiltration membrane and ceramic ultrafiltration membrane process using acrylic wastewater pretreated by photo-catalyst. Ceramic microfiltration membrane and ceramic ultrafiltration membrane using acrylic wastewater pretreated by photo-catalyst was shown that COD and T-N were not highly affected with the variation of appled pressure and temperature. It was shown that removal efficiency of COD and T-N with ceramic microfiltration membrane and ceramic ultrafiltration membrane was low. Removal efficiency of COD with reverse osmosis membrane was better with permeate by ceramic ultra filtration membrane than with permeate by ceramic microfiltration membrane. T-N and TDS were shown high removal efficiency in reverse osmosis membrane.

미국 주정부 예산정책입안과정에 관한 연구 : 위스콘신주를 중심으로 Policy Implications for Korean Budget Process

이병철 울산대학교 1998 사회과학논집 Vol.8 No.1

본 연구는 위스콘신주의 예산정책입안과정을 한국의 경우와 비교하여 분석하고 이의 결과에 따른 한국의 예산입안과정의 새로운 방향모색을 위한 정책대안을 제시해 보는데 목적을 두었다. 본 연구에서 제시된 정책대안을 요약하여 정리하면 다음과 같다. 첫째, 세입과 세출간에 균형을 유지하는 예산과정을 우리도 지금 당장은 어렵더라도 향후 적용이라는 전제하에 이를 위한 기반을 지금부터 마련해 나가야 할 것이다. 둘째, 예산의 증액만을 능사로 생각하고 이를 능력으로 인정받는 한국의 잘못된 예산관을 바꾸어야 할 것이다. 정확한 추계와 수요에 입각하여 합리적인 예산규모를 도출하여야 할 것이며 기관이기주의에 기인된 잘못되고 왜곡된 자원배분은 시정되어야 할 것이다. 셋째, 우리나라의 경우도 위스콘신주의 의회회계국의 수준에 까지는 못미치더라도 국회에 예산실을 마련하여 행정부의 예산안편성에 대한 견제를 하며 행정부와는 다른 차원에서 세입ㆍ세출추계 등을 하여 예산의 보다 효율적인 운영에 일조를 할 수 있게 하는 방안도 전향적으로 검토해 보아야 할 것이다. 넷째, 예산심의과정에서 청문회개최를 의무화하는 과정도 긍정적으로 생각해 보아야 할 것이다. 예산이란 국가정책을 가능케하는 것이며 그만큼 국민에겐 부담을 얹어주는 행위인만치 부담자이면서 수혜자인 국민의 의견과 의지를 듣고 가늠해 보는 과정이 필요로 된다고 할 수 있다. 다섯째, 예산이 의회에 의해 통과된 후에 대통령이 예산의 전체나 일부를 선택적으로 거부할 수 있는 개별항목별거부권(item veto power)을 갖게 하는 것도 긍정적으로 고려해 볼 수 있을 것이다. 그러나 아직 한국의 행정부와 의회간의 관계가 조정과 화합의 차원보다는 갈등과 견제의 역할이 더욱 일반화되어진 정치문화풍토를 가지고 있기 때문에 개별항목별거부권이 대통령에게 더욱 효과적으로 의회를 견제하는 자의적인 수단으로 악용될 여지가 있는만치 이에 대한 제도적인 보장장치도 병행하여 마련되어져야 할 것이다. 여섯째, 예산입안과정을 통해 예산이 최종적으로 승인되면 법으로의 위상을 차지하는 미국의 경우를 참고할 가치는 있다고 생각한다. 일곱째, 주정부간에 다소 차이가 있지만 예산이 단일항목이나 혹은 일련의 분리된 법안으로 통과될 수가 있어서 예산과정의 신축성과 유연성을 보장하는 제도라는 측면에서 우리도 긍정적으로 고려해 볼수 있기는 하겠지만 이러한 개별성의 인정은 신축성과 유연성을 가져온다는 잇점보다는 예산입안과정상의 형평성문제에서 야기되는 실이 더욱 클 수 있을 것이기 때문에 이에 대해서는 신중한 검토를 거친후 적용여부를 결정하는 것이 타당할 것으로 생각이 든다. 여덟째, 위스콘신주의 위원회간의 조정의 수준이 높은 것도 우리가 참고해야 할 사항으로 이해가 된다. 마지막으로 우리도 위스콘신주와 같이 2년예산제도를 가지는 점을 신중히 고려해 볼 수 있을 것이다. 이상의 정책대안은 이상적일 수도 있겠지만 미래적 시각에서 우리의 예산입안과정상의 문제점과 미비점을 보완해 줄 수 있는 대체적 대안이 될 수 있다는 점에서 전향적이고 긍정적으로 분석, 평가되고 검토되어야 할 것이다. 이미 앞에서도 말을 하였지만 위스콘신주의 예산제도들이 우리의 땅에 적실성있고 시의성있게 토착화되기 위해선 예산과정이 이루워지는 정치, 행정문화가 성숙되어져야 하며 이를 운영하는 정치인, 행정관료, 그리고 국회의원들의 가치관이나 도덕성, 자질, 전문성 등이 새롭게 일구워져야 할 것이다. 그리고 예산과정을 지켜보는 국민들의 감시와 참여의 눈도 깨어 있어야 할 것이다. 아무리 좋은 제도라고 하더라도 그것을 지혜롭게 활용하지 못한다면 뜻있는 발전과 의미를 발견하기는 어려울 것이기 때문이다. Wisconsin has a biennial, or two-year, budget. It is proposed by the governor in January of every odd-numbered year and is enacted by the legislature in the early summer of that year. It estimates the revenue to be collected during the following two years and authorizes the spending for each year of that period. Wisconsin has the constitutional requirement of a balanced budget and particular budget components and characteristics. The legislature's Joint Finance Committee(JFC) holds public hearings on the whole budget. The governor has the item veto power. The process of analyzing the budget and identifying potential vetoes has evolved, in Wisconsin, into a process whereby words, letters, or even individual digits can be eliminated. The legislature convenes to consider overriding the governor's vetoes. Override occurs only if two-thirds of the members of each house of the legislature vote to retain in the budget whatever the governor has sought to eliminate. Over a year in gestation and with a life span of only two years, the biennial budget becomes law. This wisconsin budget process has different components and characteristics from korean budget process. Korea has very precious chance to track the passage process of a wisconsin budget bill. So wisconsin budget may be reference framework of reinventing korean budget process. In this context, this study focuses on building the policy alternatives for reinventing korean budget process by wisconsin budget. Policy alternatives are as follows : Firstly, Korean budget process needs to have the constitutional requirement of a balanced budget. Secondly, Korean budget process needs to have optimal and rational budget size. Thirdly, In order to check the departments of administration, Korean budget process needs to have the office of budget in the National Assembly. Fourthly, Korean budget process needs to hold public hearings on the whole budget. Fifthly, The president need to have the item veto power in budget process. Sixthly, Budget needs to change from budget to law in korean budget process. Seventhly, Korean budget process needs to have flexible and viable committee cooperation and coordination. Eighthly, Korean budget process needs to have a biennial, or two-year, budget.