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    Effects and Roles of Recipient Countries' Governance on Official Development Assistance for Health - Focusing on Control of Corruption and Accountability of Recipient countries in HIV/AIDS Aids -

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    ํ•™์œ„๋…ผ๋ฌธ (๋ฐ•์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋ณด๊ฑด๋Œ€ํ•™์› : ๋ณด๊ฑดํ•™๊ณผ(๋ณด๊ฑด์ •์ฑ…๊ด€๋ฆฌํ•™์ „๊ณต), 2014. 8. ์–‘๋ด‰๋ฏผ.๋ณด๊ฑด์˜๋ฃŒ ํ•ด์™ธ์›์กฐ์˜ ํšจ๊ณผ์„ฑ์— ๋Œ€ํ•œ ๊ฑฐ๋ฒ„๋„Œ์Šค, ํŠนํžˆ ์ˆ˜์›๊ตญ์—์„œ์˜ ๋ถ€ํŒจ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ์˜ ์ค‘์š”์„ฑ์€ ๋‹น์—ฐ ๋ช…์ œ๋กœ ๋ฐ›์•„๋“ค์—ฌ์ง€๊ณ  ์žˆ์Œ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ์„œ์ˆ ์  ์ฐจ์›์˜ ๋…ผ์˜์—๋งŒ ๋จธ๋ฌผ๋Ÿฌ ์žˆ์—ˆ์œผ๋ฉฐ, ์›์กฐ ํšจ๊ณผ์„ฑ๊ณผ์˜ ์—ฐ๊ฒฐ์ด ๊ตฌ์ฒด์ ์ธ ์ธก์ •์˜ ๋‹จ๊ณ„๋กœ ์ด์–ด์ง€์ง€๋Š” ๋ชปํ•˜์˜€๋‹ค. ๋”๊ตฐ๋‹ค๋‚˜ ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ์–ด๋– ํ•œ ๋‹ค๋ฅธ ์ œ๋ฐ˜ ์กฐ๊ฑด๋“ค๊ณผ ๋™๋ฐ˜๋˜์–ด ํšจ๊ณผ๋ฅผ ๋‚˜ํƒ€๋‚ด๋Š”์ง€์— ๋Œ€ํ•œ ๊ณ ๋ฏผ์€ ์‹ค์ฆ์  ์ฐจ์›์ด ์•„๋‹Œ ๋‹ด๋ก ์  ์ฐจ์›์—์„œ๋„ ๋งค์šฐ ๋ถ€์กฑํ•˜์˜€๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ๋ณด๊ฑด์˜๋ฃŒ ํ•ด์™ธ์›์กฐ ํŠนํžˆ Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome(HIV/AIDS)์˜ ๋Œ€์‘์—์„œ ์ˆ˜์›๊ตญ์˜ ๋ถ€ํŒจ ํ†ต์ œ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ์˜ ํšจ๊ณผ์™€ ์—ญํ• ์„ ์‚ดํŽด๋ณด๋Š” ๊ฒƒ์„ ๋ชฉ์ ์œผ๋กœ ํ•˜์˜€๋‹ค. ์ด๋ฅผ ์œ„ํ•ด ๋‘ ๊ฐ€์ง€์˜ ์—ฐ๊ตฌ๊ณผ์ •์„ ๊ฑฐ์ณค๋Š”๋ฐ, ์šฐ์„  ์ด๋ก ์  ๊ฒ€ํ† ๋ฅผ ์œ„ํ•˜์—ฌ ๊ฑฐ๋ฒ„๋„Œ์Šค์™€ ๋ณด๊ฑด์˜๋ฃŒ ํ•ด์™ธ์›์กฐ์—์„œ์˜ ๊ฑฐ๋ฒ„๋„Œ์Šค, ๋˜ํ•œ ๊ทธ ์ค‘์—์„œ๋„ ๋ถ€ํŒจ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ์„ ์ค‘์‹ฌ์œผ๋กœ ๊ฐœ๋…์˜ ํ๋ฆ„์„ ์ •๋ฆฌ๋ฅผ ํ•˜์˜€๊ณ , ๋ณธ ๋ถ„์„์˜ ๋Œ€์ƒ์ธ HIV/AID ์งˆ๋ณ‘์˜ ์ž„์ƒ์ ยท์—ญํ•™์  ํŠน์„ฑ, ๊ทธ๋ฆฌ๊ณ  HIV/AIDS ๋ฐœ์ƒ์˜ ์›์ธ ์š”์ธ๊ณผ HIV/AIDS ์›์กฐ๋ฅผ ์œ„ํ•œ ๊ตญ์ œ์‚ฌํšŒ์˜ ๋…ธ๋ ฅ ๊ทธ ์ค‘์—์„œ๋„ ๋ถ€ํŒจ ํ†ต์ œ์™€ ์ฑ…๋ฌด์„ฑ ์ œ๊ณ ์— ๋Œ€ํ•˜์—ฌ ๋…ผ์˜๋ฅผ ํ•˜์˜€๋‹ค. ๋‹ค์Œ์œผ๋กœ ์ˆ˜์›๊ตญ ์ •๋ถ€์˜ ๋ถ€ํŒจ ํ†ต์ œ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ ์ˆ˜์ค€์ด HIV/AIDS์›์กฐ๊ฐ€ ์œ ๋ณ‘๋ฅ ๊ณผ ๋ฐœ์ƒ๋ฅ ์ด๋ผ๋Š” ๊ฑด๊ฐ•์„ฑ๊ณผ์— ๋Œ€ํ•ด ๊ฐ€์ง€๋Š” ํšจ๊ณผ์—์„œ ์–ด๋– ํ•œ ์—ญํ• ์„ ํ•˜๋Š”์ง€๋ฅผ ๋ณ€์ˆ˜๋“ค ๊ฐ„์˜ ๊ด€๊ณ„๊ฐ€ ์ž˜ ๋ฐ˜์˜๋œ dynamic panel System-Generalized Method of Moments(GMM) ๋ฐฉ๋ฒ•์„ ์ด์šฉํ•˜์—ฌ ์ธก์ •ํ•˜์˜€๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ HIV/AIDS ์ˆ˜์›๊ตญ์—์„œ ๋‚ฎ์€ HIV/AIDS ์œ ๋ณ‘๋ฅ ์ด๋ผ๋Š” ๊ฒฐ๊ณผ์กฐ๊ฑด์ด ๋‚˜ํƒ€๋‚˜๊ธฐ ์œ„ํ•ด์„œ๋Š” ์–ด๋– ํ•œ ํ•„์š”์กฐ๊ฑด๋“ค์ด ์žˆ๊ณ , ์ˆ˜์›๊ตญ์˜ ๋ถ€ํŒจํ†ต์ œ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ์ด๋ผ๋Š” ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ๋‹ค๋ฅธ ์š”์ธ๋“ค๊ณผ ์–ด๋–ป๊ฒŒ ๊ฒฐํ•ฉ๋˜์–ด ๊ทธ๋Ÿฌํ•œ ๊ฒฐ๊ณผ ์กฐ๊ฑด์„ ํ˜•์„ฑํ•˜๋Š”๊ฐ€์— ๋Œ€ํ•˜์—ฌ Fuzzyset/Qualitative Comparative Analysis(Fs/QCA)์„ ํ†ตํ•˜์—ฌ ๊ทœ๋ช…ํ•˜์˜€๋‹ค. ๋ถ„์„ ๊ฒฐ๊ณผ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™๋‹ค. ์šฐ์„  ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ์›์กฐํšจ๊ณผ์„ฑ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ๋ ฅ์€ HIV/AIDS์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ ์ง€ํ‘œ์— ๋”ฐ๋ผ ๊ทธ๋ฆฌ๊ณ  ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ์ฐจ์›์— ๋”ฐ๋ผ ๋‹ค๋ฅด๊ฒŒ ๋‚˜ํƒ€๋‚ฌ๋‹ค. ๋ถ€ํŒจ์˜ ํ†ต์ œ๋Š” HIV/AIDS์˜ ์œ ๋ณ‘๋ฅ ์— ๋Œ€ํ•˜์—ฌ ๋…๋ฆฝ์ ์ธ ํšจ๊ณผ๋กœ๋„, ๊ตํ˜ธ์ž‘์šฉ์œผ๋กœ๋„ ์œ ์˜ํ•˜์ง€ ์•Š์•˜๊ณ , ์›์กฐ ๋ณ€์ˆ˜๋ฅผ ํฌํ•จํ•œ ๋‹ค๋ฅธ ํ†ต์ œ๋ณ€์ˆ˜๋“ค๋„ ์œ ๋ณ‘๋ฅ ์— ๋Œ€ํ•˜์—ฌ ์œ ์˜ํ•œ ํšจ๊ณผ๊ฐ€ ์—†์—ˆ๋˜ ๋ฐ˜๋ฉด HIV/AIDS ๋ฐœ์ƒ๋ฅ ์— ๋Œ€ํ•˜์—ฌ๋Š” ๋…๋ฆฝ์ ์ธ ํšจ๊ณผ๋ฅผ ๋ณด์˜€๋‹ค. ์ฆ‰ ๋ถ€ํŒจ์˜ ํ†ต์ œ๋Š” ์›์กฐ ๋ณ€์ˆ˜์˜ ํšจ๊ณผ๋ฅผ ์ƒ์Šน์‹œ์ผœ์ฃผ๊ฑฐ๋‚˜ ์ƒ์‡„์‹œ์ผœ์ฃผ๋Š” ์ž‘์šฉ์€ ์—†๋‹ค๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ฑ…๋ฌด์„ฑ๋„ ๋ถ€ํŒจ์˜ ํ†ต์ œ์™€ ์œ ์‚ฌํ•˜๊ฒŒ HIV/AIDS์˜ ์œ ๋ณ‘๋ฅ ์— ๋Œ€ํ•œ ํšจ๊ณผ๋Š” ์œ ์˜ํ•˜์ง€ ์•Š์•˜์ง€๋งŒ ๋ฐœ์ƒ๋ฅ ์— ๋Œ€ํ•˜์—ฌ๋Š” ์›์กฐ์™€์˜ ๊ตํ˜ธ์ž‘์šฉ ๋ณ€์ˆ˜๊ฐ€ ์Œ์˜ ๊ณ„์ˆ˜๋กœ์„œ 5%์ˆ˜์ค€์—์„œ ์œ ์˜ํ•˜์˜€๋‹ค. ์ฆ‰ ์ฑ…๋ฌด์„ฑ์ด ์ผ์ •์ˆ˜์ค€ ์ด์ƒ์ธ ๊ตญ๊ฐ€์—์„œ๋Š” ์ฑ…๋ฌด์„ฑ์˜ ์ ์ˆ˜๊ฐ€ ๋†’์„์ˆ˜๋ก ์›์กฐ๊ฐ€ HIV/AIDS ๋ฐœ์ƒ๋ฅ ์„ ๋‚ฎ์ถ”๋Š” ํšจ๊ณผ๋Š” ๋” ์ปค์ง€์ง€๋งŒ. ๊ทธ๋ ‡์ง€ ์•Š์€ ๊ฒฝ์šฐ ์›์กฐ๊ฐ€ ์ฆ๊ฐ€ํ• ์ˆ˜๋ก ์˜คํžˆ๋ ค ๋ฐœ์ƒ๋ฅ ์„ ์ฆ๊ฐ€์‹œํ‚ค๋Š” ์•…์˜ํ–ฅ์ด ์ปค์ง€๋Š” ๊ฒฐ๊ณผ๋ฅผ ๋ณด์˜€๋‹ค. ์ด๋Ÿฌํ•œ ๊ฒฐ๊ณผ๋Š” ์ด์ƒ ์ˆ˜์น˜๋ฅผ ์ œ์™ธํ•œ ๋ถ„์„, ๊ฒฐ์ธก๊ฐ’์„ ๋Œ€์ฒดํ•œ ํ›„์˜ ๋ถ„์„, ์ธ๊ถŒ๋ณ€์ˆ˜๋ฅผ ํฌํ•จํ•œ ๋ถ„์„ ๋“ฑ ๋‹ค์–‘ํ•œ ๋ฏผ๊ฐ๋„ ๋ถ„์„์—์„œ๋„ ํฌ๊ฒŒ ๋‹ฌ๋ผ์ง€์ง€ ์•Š์•˜๋‹ค. ๋งˆ์ง€๋ง‰์œผ๋กœ ์ถฉ๋ถ„์กฐ๊ฑด ๊ฒ€์ฆ๊ฒฐ๊ณผ๋ฅผ ํ†ตํ•ด ์‚ดํŽด๋ณธ ๋‚ฎ์€ HIV/AIDS ์œ ๋ณ‘๋ฅ ์„ ๋งŒ๋“ค์–ด ๋‚ด๋Š” ์›์ธ์กฐ๊ฑด ์กฐํ•ฉ์˜ ๋ถ„์„์—์„œ๋Š” ์ธ์ข…์–ธ์–ด๋ถ„ํ™”์ˆ˜์ค€๊ณผ ์ด์Šฌ๋žŒ๊ต ๋น„์œจ์ด ๋‚ฎ๊ณ , 1์ธ๋‹น Gross National Income(GNI)๋Š” ๋†’์œผ๋ฉฐ, ์†Œ๋“๋ถˆํ‰๋“ฑ์€ ๋‚ฎ๊ณ , ์—ฌ์„ฑ์˜ ๊ต์œก๋ถˆํ‰๋“ฑ ์ˆ˜์ค€์ด ๋‚ฎ์œผ๋ฉฐ, TV๋ณด์œ  ๊ฐ€๊ตฌ๋น„์œจ๊ณผ ๋ณด๊ฑด์˜๋ฃŒ์ง€์ถœ๋น„์œจยทํ”ผ์ž„๋„๊ตฌ ์‚ฌ์šฉ๋น„์œจ์ด ๋†’๊ณ , ๊ฑฐ๋ฒ„๋„Œ์Šค ์ˆ˜์ค€์ด ๋‚ฎ์€ ์กฐํ•ฉ, ๊ทธ๋ฆฌ๊ณ  ์ธ์ข…์–ธ์–ด๋ถ„ํ™”์ˆ˜์ค€๊ณผ ์ด์Šฌ๋žŒ๊ต ๋น„์œจ์ด ๋‚ฎ์œผ๋ฉฐ, 1์ธ๋‹น GNI๋Š” ๋†’์œผ๋ฉฐ ์†Œ๋“๋ถˆํ‰๋“ฑ์€ ๋†’์œผ๋ฉฐ, ์—ฌ์„ฑ์˜ ๊ต์œก๋ถˆํ‰๋“ฑ์ˆ˜์ค€์ด ๋‚ฎ์œผ๋ฉฐ TV ๋ณด์œ  ๊ฐ€๊ตฌ ๋น„์œจ๊ณผ ํ”ผ์ž„๋„๊ตฌ ์‚ฌ์šฉ๋น„์œจ์ด ๋†’๊ณ  ๊ฑฐ๋ฒ„๋„Œ์Šค ์ˆ˜์ค€์ด ๋†’์€ ์กฐํ•ฉ์ด ๋‚ฎ์€ HIV/AIDS๋ผ๋Š” ์กฐ๊ฑด์„ ๋งŒ๋“ค์–ด๋‚ด๋Š” ๊ฒƒ์œผ๋กœ ๋ถ„์„๋˜์—ˆ๋‹ค. ์ฒซ ๋ฒˆ์งธ ์š”์ธ์—์„œ๋Š” ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ์ˆ˜์ค€์ด ๋†’์ง€ ์•Š๋”๋ผ๋„, ๋‹ค๋ฅธ ๋ชจ๋“  ์š”์ธ๋“ค์˜ ์กฐ๊ฑด์ด ์ข‹๋‹ค๋ฉด, ํŠนํžˆ ๋ถˆํ‰๋“ฑ ์ˆ˜์ค€์ด ๋‚ฎ์œผ๋ฉด HIV/AIDS์˜ ์œ ๋ณ‘๋ฅ ์ด ๋‚ฎ์„ ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ฒƒ์œผ๋กœ ํ•ด์„ํ•  ์ˆ˜ ์žˆ์ง€๋งŒ ๊ตญ๊ฐ€์  ๋งฅ๋ฝ์„ ์‚ดํŽด๋ณด์•˜์„ ๋•Œ ์ด๋Ÿฌํ•œ ์กฐ๊ฑด์ด ํ˜•์„ฑ๋˜๊ธฐ๋Š” ์–ด๋ ต๊ณ , ๋˜ํ•œ ์‹ค์ œ๋กœ๋„ ์‚ฌ๋ก€๊ตญ๊ฐ€์˜ ์ˆ˜๊ฐ€ ์ ์€ ๊ฒƒ์œผ๋กœ ๋ณด์•„ ์ด๋Ÿฌํ•œ ์กฐํ•ฉ์œผ๋กœ์„œ ๋‚ฎ์€ HIV/AIDS๋ผ๋Š” ์กฐ๊ฑด์ด ํ˜•์„ฑ๋˜๋Š” ๊ฒƒ์€ ํ˜„์‹ค์—์„œ ๋‚˜ํƒ€๋‚˜๊ธฐ ์‰ฝ์ง€ ์•Š์Œ์„ ์ง์ž‘ํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ๋‘ ๋ฒˆ์งธ ์›์ธ ์กฐ๊ฑด์˜ ์กฐํ•ฉ์—์„œ๋Š” ์ด์Šฌ๋žŒ ๋น„์œจ๊ณผ ์†Œ๋“๋ถˆํ‰๋“ฑ ์š”์ธ์ด HIV/AIDS์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ์— ๋‹จ๋…์œผ๋กœ ์ž‘์šฉํ•  ๋•Œ์™€๋Š” ๋ฐ˜๋Œ€์˜ ๋ฐฉํ–ฅ์„ฑ์œผ๋กœ ์กฐํ•ฉ์ด ๋˜์—ˆ๊ณ  ๋˜ํ•œ ๋†’์€ ๋ณด๊ฑด์˜๋ฃŒ ์ง€์ถœ๋น„์œจ์ด๋ผ๋Š” ์กฐ๊ฑด์ด ํฌํ•จ๋˜์ง€ ์•Š์•˜๋Š”๋ฐ, ์ด๋Š” ์ด ๋‘ ๊ฐ€์ง€ ์กฐ๊ฑด์ด ์ข‹์ง€ ์•Š๋”๋ผ๋„, ๊ทธ๋ฆฌ๊ณ  ๋ณด๊ฑด์˜๋ฃŒ ์ง€์ถœ๋น„์œจ ์กฐ๊ฑด์— ์ƒ๊ด€์—†์ด ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ์ข‹๋‹ค๋ฉด ์ด ์š”์ธ์—์„œ์˜ ๋ถ€์ •์  ์˜ํ–ฅ์„ ์ƒ์‡„ํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋ผ๋Š” ํ•ด์„์ด ๊ฐ€๋Šฅํ•˜๋‹ค . ๋ณธ ์—ฐ๊ตฌ๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™์€ ์ด๋ก ์ ยท์ •์ฑ…์  ํ•จ์˜๋ฅผ ์ง€๋‹Œ๋‹ค. ์šฐ์„ , ๋ณด๊ฑด์˜๋ฃŒ ์›์กฐ์—์„œ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ํšจ๊ณผ์„ฑ์— ๋Œ€ํ•˜์—ฌ ๊ทธ๊ฐ„์˜ ์—ฐ๊ตฌ ์ค‘ ๊ฐ€์žฅ ๋ณ€์ˆ˜๋“ค ๊ฐ„์˜ ๊ด€๊ณ„๊ฐ€ ์ž˜ ๋ฐ˜์˜๋œ ์ธก์ •๋‹จ๊ณ„๋กœ ์ œ๊ณ ํ•˜์˜€๊ณ , ๋”์šฑ์ด ๊ตฌ์ฒด์ ์ธ ์งˆํ™˜์˜์—ญ์—์„œ์˜ ํšจ๊ณผ๋ฅผ ๋ถ„์„ํ•œ ๊ฒƒ์€ ์ฒ˜์Œ์ด๋ผ๋Š” ์ ์—์„œ ์˜์˜๊ฐ€ ํฌ๋‹ค. ๋˜ํ•œ ๋ถ€ํŒจ์˜ ํ†ต์ œ์™€ ์ฑ…๋ฌด์„ฑ์€ ๊ฐ™์€ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ์š”์†Œ๋ผ๊ณ  ํ•˜๋”๋ผ๋„ ์›์กฐ์˜ ํšจ๊ณผ์„ฑ์œผ๋กœ ๋‚˜ํƒ€๋‚˜๋Š”๋ฐ ์ž‘์šฉํ•˜๋Š” ์–‘์ƒ์ด ๋‹ค๋ฅธ ๊ฒƒ์„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ์œผ๋ฉฐ, ์›์กฐ์™€ ์ฑ…๋ฌด์„ฑ์˜ ์œ ์˜ํ•œ ๊ตํ˜ธ์ž‘์šฉ์„ ํ†ตํ•ด ๋‹จ์ˆœํ•œ ์›์กฐ์•ก์˜ ์ฆ๊ฐ€๋Š” ์ˆ˜์›๊ตญ์˜ ๊ฑฐ๋ฒ„๋„Œ์Šค ์ˆ˜์ค€์ด ์ผ์ •์ˆ˜์ค€ ์ด์ƒ์œผ๋กœ ํ™•๋ณด๋˜์ง€ ์•Š๋Š”๋‹ค๋ฉด HIV/AIDS์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ๋กœ ์—ฐ๊ฒฐ๋˜๊ธฐ๊ฐ€ ์–ด๋ ต๋‹ค๋Š” ์ •์ฑ…์  ํ•จ์˜๋ฅผ ํ™•์ธํ•  ์ˆ˜ ์žˆ์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ํŠน์„ฑ๊ณผ ์–‘์ƒ์„ ์ž˜ ํŒŒ์•…ํ•˜๋Š” ๊ฒƒ์€ ์ˆ˜์›๊ตญ์— ๋Œ€ํ•œ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ์กฐ๊ฑด๋ถ€ ์›์กฐ ํ˜น์€ ๊ฑฐ๋ฒ„๋„Œ์Šค ์ž์ฒด๋ฅผ ์œ„ํ•œ ์›์กฐ์˜ ์ „๋žต ์ˆ˜๋ฆฝ ์‹œ ๋„์›€์ด ๋  ๊ฒƒ์ด๋‹ค. ๋˜ํ•œ, ๋ณธ ์—ฐ๊ตฌ๋Š” ๋‚ฎ์€ HIV/AIDS ์œ ๋ณ‘๋ฅ ์— ํ•„์š”ํ•œ ์กฐ๊ฑด, ๊ทธ๋ฆฌ๊ณ  ๊ด€๋ จ๋œ ์š”์ธ๋“ค์˜ ๊ฒฐํ•ฉ์ธ๊ณผ๊ตฌ์กฐ๋ฅผ Fs/QCA๋ฅผ ํ†ตํ•˜์—ฌ ์ฒ˜์Œ์œผ๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค๋Š” ์˜์˜๋ฅผ ์ง€๋‹Œ๋‹ค. ์›์กฐ์˜ ํšจ๊ณผ์„ฑ์€ ๋‹ค๋ฅธ ์š”์ธ๋“ค๊ณผ ์ „ํ˜€ ๊ด€๋ จ์ด ์—†์ด ์ข‹์€ ๊ฑฐ๋ฒ„๋„Œ์Šค ๋งŒ์œผ๋กœ ์ œ๊ณ ์‹œํ‚ฌ ์ˆ˜๋Š” ์—†์œผ๋ฏ€๋กœ ๊ฑฐ๋ฒ„๋„Œ์Šค์™€ ๋‹ค๋ฅธ ์š”์ธ๋“ค๊ณผ์˜ ๊ฒฐํ•ฉ์  ์š”์ธ๋“ค์„ ๋ถ„์„ํ•˜๋Š” ๊ฒƒ์€ ์ค‘์š”ํ•˜๋‹ค. ๋ถ„์„ ๊ฒฐ๊ณผ, ์ •์ฑ…์‹œํ–‰์— ์žˆ์–ด ์‚ฌํšŒ์˜ ๋‹จ๊ฒฐ, ์›ํ™œํ•œ ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜, ๋ถˆํ‰๋“ฑ ์ˆ˜์ค€์€ ๋‹ค๋ฅธ ์š”์ธ๋“ค๋ณด๋‹ค HIV/AIDS์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ์— ๋”์šฑ ์ค‘์š”ํ•จ์ด ํ™•์ธ๋˜์—ˆ๊ณ , ์‚ฌํšŒ๊ฒฝ์ œ์  ์š”์ธ์ด ๊ฑด๊ฐ•์„ฑ๊ณผ์— ํ•„์š”ํ•œ ์กฐ๊ฑด์ž„์ด ๋‹ค์‹œ ํ•œ ๋ฒˆ ํ™•์ธ๋˜์–ด ์ด๋Ÿฌํ•œ ์‚ฌํšŒ๊ฒฝ์ œ์  ์ œ๋ฐ˜ ์š”๊ฑด์˜ ๊ฐœ์„ ์— ๋Œ€ํ•œ ๋…ธ๋ ฅ์ด ์„ ํ–‰ ํ˜น์€ ๋™์‹œ์— ๊ฐ™์ด ์ง„ํ–‰๋˜์–ด์•ผ ํ•œ๋‹ค๋Š” ์ •์ฑ…์  ์‹œ์‚ฌ์ ์„ ์ฃผ์—ˆ๋‹ค. ๋˜ํ•œ ์ข‹์ง€ ์•Š์€ ๊ฑฐ๋ฒ„๋„Œ์Šค๋ฅผ ๋‹ค๋ฅธ ์›์ธ์กฐ๊ฑด๋“ค๋กœ ์ƒ์‡„ํ•˜๋Š” ๊ฒƒ ๋ณด๋‹ค๋Š” ๊ฑด์ „ํ•œ ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ๋‹ค๋ฅธ ์›์ธ์กฐ๊ฑด๋“ค๊ณผ์˜ ๊ฒฐํ•ฉ์„ ํ†ตํ•˜์—ฌ ๋‚ฎ์€ HIV/AIDS๋ผ๋Š” ์กฐ๊ฑด์„ ๋งŒ๋“ค์–ด๋‚ด๋Š” ๊ฒƒ์ด ๋” ์šฉ์ดํ•˜๊ณ  ํ˜„์‹ค์ ์œผ๋กœ ์‹คํ˜„๊ฐ€๋Šฅํ•œ ๊ฒฝ๋กœ์ž„์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ๋ถ„์„์˜ ๊ฒฐ๊ณผ๋Š” HIV/AIDS์˜ ์œ ๋ณ‘๋ฅ  ๋ฌธ์ œ๋Š” ์–ด๋Š ํ•œ ๊ฐ€์ง€ ์š”์ธ์—๋งŒ ์ •์ฑ…์  ์ฒ˜๋ฐฉ์„ ํ•œ๋‹ค๋ฉด ํšจ๊ณผ๊ฐ€ ์—†๊ฑฐ๋‚˜ ๋งค์šฐ ๋ฏธ๋ฏธํ•  ๊ฒƒ์ด๋ฉฐ ๊ฑฐ๋ฒ„๋„Œ์Šค ์ œ๊ณ ์— ๋”์šฑ ๋…ธ๋ ฅ์„ ํ•ด์•ผ ํ•œ๋‹ค๋Š” ์ ์„ ์‹œ์‚ฌํ•ด์ค€๋‹ค. ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋กœ ๋‚˜ํƒ€๋‚œ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ํŠน์ง•๊ณผ ์–‘์ƒ์„ ๊ณ ๋ คํ•˜์—ฌ ๋ถ€ํŒจ ํ†ต์ œ์™€ ๋ฏผ์ฃผ์  ์ฑ…๋ฌด์„ฑ ์ œ๊ณ ๋ฅผ ์œ„ํ•œ ๋…ธ๋ ฅ์„ ๋” ๊ตฌ์ฒด์ ์ด๊ณ  ์‹ค์งˆ์ ์ธ ์ˆ˜์ค€์œผ๋กœ ์ œ์‹œํ•ด๋ณด๋Š” ๊ฒƒ์ด ๋‚จ์€ ์ˆ™์ œ๋ผ๊ณ  ํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์ด๋‹ค.Although importance of governance on effectiveness of development assistance for health, especially, control of corruption and accountability of recipient countries, is widely recognized around the world, there has only been descriptive level of discussions without specific measurements. In addition, there has never been any discussion on with what other conditions, governance shows effects on effectiveness of aid. This study aims to research roles and effects of governance, specifically, control of corruption and accountability of recipient countries, in national response to HIV/AIDS through foreign aid. For this, two studies were performed. First study is to measure effects of control of corruption and accountability in the effectiveness of HIV//AIDS aid on HIV/AIDS outcomes such as prevalence and incidence using dynamic panel system-GMM. The other study is to investigate using Fs/QCA what factors are necessary for low HIV/AIDS prevalence and with what other factors, control of corruption and accountability forms low HIV/AIDS prevalence. Results is as follows. First, effects of governance on aid effectiveness are dependent on type of HIV/AIDS outcomes and dimensions of governance. Control of corruption has neither significant independent nor interactive effect on prevalence and any other control variables do not show significant effect on prevalence. In other words, control of corruption has no synergetic or offsetting effect with aid. However, effect of accountability on incidence is significant at 5% level showing negative coefficient while accountability on prevalence is the same as control of corruption. This means that higher the accountability level is, greater the effect of lowering HIV/AIDS incidence become, in countries with an accountability above certain level while more aid raise the incidence of HIV/AIDS below certain level of accountability. This result is robust from various sensitivity analyses. Lastly, Sufficiency test through Fs/QCA shows two combination of factors can constitute low HIV/AIDS prevalencecondition. First combination of factors is low share of ethnolinguistic fractionalization and Muslim, high GNI per capita, low inequality of income and female education, high share of house with TV and health expenditure, high share of condom use and low governance. Second combination is low share of ethnolinguistic fractionalization and Muslim, high GNI per capita and income inequality, low inequality of female education, high share of house with TV and condom use and high governance. First solution means that if all other conditions are favourable, especially, level of inequality is low, those countries can havelow HIV/AIDS prevalencecondition, even if level of governance is not high. However, national contexts of examplary countries shows that this combination of conditions is difficult to happen in real world. In fact, the number of countries meeting showing this combination is low. On the other hand, second solution shows that good governance can offset negative effect of low share of Muslim and high level of income inequality on HIV/AIDS prevalence. This study have implications in terms of theoretical and policy perspective. First of all, this study raised the level of discussion about effect of governance in health aid from just descriptive discussion to specific measurement stage. Especially, this study is the first time to analyze the effect of governance in aid for specific disease. Another remarkable point is that control of corruption and accountability shows a different characteristics in influencing on HIV/AIDS outcome. Accountability is interactive with aid while control of corruption has independent effect, indicating that mere expansion of fund scale for HIV/AIDS can not be linked to good HIV/AIDS outcomes unless certain level of governance is prerequisite. Good understanding of characteristics of governance can be helpful when establishing strategies for aid conditioned on good governance or aid for governance itself. In addition, this study is the first to investigate necessary condition and conjunctural causation for low HIV/AIDS prevalence using Fs/QCA. Analyzing combination of other factors with governance is very important attempt because aid effectiveness cannot be levelled up only by good governance. The result of this analysis reconfirms once more that consolidation of society, good communication within society, low inequality are more important than any other factors and all sub-factors in socioeconomic category are important conditions for HIV/AIDS prevalence, which means that effort for improving general socioeconomic conditions is accompanied before or simultaneously with aid. Although not-good governance condition can also make low HIV/AIDS prevalence, offset by other good conditions, this is less feasible in real world than making low HIV/AIDS prevalence condition with good governance. This result implies that improving governance is more practical path to low HIV/AIDS prevalence and policy intervention on mere certain one point may not be effective. Based on characteristics of each dimensions of governance from the results of this study, more specific and practical efforts for raising level of control of corruption and accountability can be planned in the future.์ œ1์žฅ ์„œ ๋ก  1 ์ œ1์ ˆ ์—ฐ๊ตฌ์˜ ๋ฐฐ๊ฒฝ ๋ฐ ํ•„์š”์„ฑ 1 ์ œ2์ ˆ ์—ฐ๊ตฌ์˜ ๋ชฉ์  ๋ฐ ๋…ผ๋ฌธ์˜ ๊ตฌ์„ฑ 6 ์ œ2์žฅ ์ด๋ก ์  ๋…ผ์˜ 9 ์ œ1์ ˆ ๊ฑฐ๋ฒ„๋„Œ์Šค 9 1. ๊ฑฐ๋ฒ„๋„Œ์Šค/๊ตญ๊ฐ€๊ฑฐ๋ฒ„๋„Œ์Šค 9 2. ๋ณด๊ฑด์˜๋ฃŒ ํ•ด์™ธ์›์กฐ ๊ฑฐ๋ฒ„๋„Œ์Šค : ๋ถ€ํŒจ์˜ ํ†ต์ œ/์ฑ…๋ฌด์„ฑ 19 ์ œ2์ ˆ HIV/AIDS 33 1. HIV/AIDS ์งˆํ™˜์˜ ์—ญํ•™ ๋ฐ ๋ฐœ์ƒ ์š”์ธ 33 2. HIV/AIDS ๋Œ€์‘์— ๋Œ€ํ•œ ๊ตญ์ œ์‚ฌํšŒ์˜ ๋…ธ๋ ฅ 40 ์ œ3์žฅ ๊ฑฐ๋ฒ„๋„Œ์Šค๊ฐ€ ๋ณด๊ฑด์˜๋ฃŒ ODA์˜ ํšจ๊ณผ์— ๋ฏธ์น˜๋Š” ์˜ํ–ฅ : HIV/AIDS ์›์กฐ๋ฅผ ์ค‘์‹ฌ์œผ๋กœ 45 ์ œ1์ ˆ ์—ฐ๊ตฌ์˜ ์˜์˜ 45 ์ œ2์ ˆ ์„ ํ–‰ ์—ฐ๊ตฌ 49 1. ๊ตญ๊ฐ€์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ์— ๋Œ€ํ•œ ๊ฑฐ๋ฒ„๋„Œ์Šค์˜ ์˜ํ–ฅ ์—ฐ๊ตฌ 49 2. HIV/AIDS์˜ ์„ฑ๊ณผ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์š”์ธ ๋ถ„์„ ์—ฐ๊ตฌ 53 ์ œ3์ ˆ HIV/AIDS์˜ ์›์กฐ์—์„œ์˜ ๊ฑฐ๋ฒ„๋„Œ์Šค์— ๋Œ€ํ•œ ์ด๋ก ์  ๊ณ ์ฐฐ 56 1. HIV/AIDS ์›์กฐ์—์„œ์˜ ๋ถ€ํŒจ 57 2. HIV/AIDS ์›์กฐ์—์„œ์˜ ์ฑ…๋ฌด์„ฑ 65 3. HIV/AIDS ์›์กฐ์—์„œ์˜ ์ •์น˜์  ํ—Œ์‹ ๋„(political commitment)๊ณผ ์ธ๊ถŒ 71 ์ œ4์ ˆ ๋ถ„์„์—ฐ๊ตฌ์˜ ๊ฐ€์„ค 75 ์ œ5์ ˆ ๋ถ„์„ ๋ฐฉ๋ฒ• 76 1. ์—ฐ๊ตฌ ๋ชจํ˜• 76 2. ๋ถ„์„ ๊ธฐ๋ฒ• 82 3. ๋ณ€์ˆ˜์˜ ์„ ์ • 97 ์ œ6์ ˆ ๋ถ„์„ ๊ฒฐ๊ณผ 121 1. ๊ธฐ์ดˆํ†ต๊ณ„ ๋ถ„์„ 121 2. OLS ๋ถ„์„ ๊ฒฐ๊ณผ 125 3. Dynamic Panel System-GMM ๋ถ„์„ ๊ฒฐ๊ณผ 130 4. ๋ฏผ๊ฐ๋„ ๋ถ„์„ 137 ์ œ7์ ˆ ๊ณ ์ฐฐ 153 1. ๋ถ„์„์˜ ์š”์•ฝ ๋ฐ ํ•ด์„ 153 2. ์—ฐ๊ตฌ์˜ ์ด๋ก ์  ยท์ •์ฑ…์  ํ•จ์˜ 157 3. ๋ถ„์„์˜ ํ•œ๊ณ„์  ๋ฐ ์ถ”ํ›„ ์—ฐ๊ตฌ๊ณผ์ œ 161 ์ œ4์žฅ HIV/AIDS ์ˆ˜์›๊ตญ์—์„œ ๊ฑฐ๋ฒ„๋„Œ์Šค์™€ HIV/AIDS์˜ ๊ฑด๊ฐ•์„ฑ๊ณผ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒฐํ•ฉ์  ์š”์ธ ์—ฐ๊ตฌ 164 ์ œ1์ ˆ ์—ฐ๊ตฌ์˜ ์˜์˜ 164 ์ œ2์ ˆ ์„ ํ–‰์—ฐ๊ตฌ ๊ฒ€ํ†  170 ์ œ3์ ˆ ๋ถ„์„ ๋ฐฉ๋ฒ• 172 1. Fs/QCA์— ๋Œ€ํ•œ ์ด๋ก ์  ํƒ์ƒ‰ 172 2. ๋ถ„์„ ๋ชจํ˜• 181 3. ์—ฐ๊ตฌ๋ฌธ์ œ 185 4. ๋ถ„์„ ์ž๋ฃŒ 186 5. ๊ฐœ๋…๋ณ„ ์š”์†Œ ์ง€์ˆ˜ํ™” ๋ฐ ํผ์ง€์…‹ ์ ์ˆ˜ํ™” 188 ์ œ4์ ˆ ๋ถ„์„ ๊ฒฐ๊ณผ 205 1. ํผ์ง€์…‹ ์ ์ˆ˜ 205 2. ์ง„์‹คํ‘œ 212 3. ํ•„์š”์กฐ๊ฑด ๊ฒ€์ฆ 214 4. ์ถฉ๋ถ„์กฐ๊ฑด ๊ฒ€์ฆ 215 ์ œ5์ ˆ ๊ฒฐ๋ก  233 1. ์—ฐ๊ตฌ์˜ ์š”์•ฝ 233 2. ์ด๋ก ์  โ€ค ์ •์ฑ…์  ํ•จ์˜ 235 3. ์—ฐ๊ตฌ์˜ ํ•œ๊ณ„ 237 ์ œ5์žฅ ๊ณ  ์ฐฐ 239 ์ œ1์ ˆ ์—ฐ๊ตฌ์˜ ์š”์•ฝ 239 ์ œ2์ ˆ ์—ฐ๊ตฌ์˜ ํ•จ์˜ 243 1. ์—ฐ๊ตฌ์˜ ์ด๋ก ์  ํ•จ์˜ 243 2. ์—ฐ๊ตฌ์˜ ์ •์ฑ…์  ํ•จ์˜ 245 ์ œ6์žฅ ๊ฒฐ๋ก  ๋ฐ ์ œ์–ธ 248Docto

    ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ ์ง„์–‘์กฐ์˜ ่ชฟๆง‹ๆˆ ์—ฐ๊ตฌ --๊น€์ฃฝํŒŒโ€ค์ตœ์˜ฅ์‚ผโ€ค๊ฐ•ํƒœํ™โ€ค๊น€๋ณ‘ํ˜ธ๋ฅ˜๋ฅผ ์ค‘์‹ฌ์œผ๋กœ-

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ์Œ์•…๊ณผ, 2012. 8. ์ด์ง€์˜.๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ๋Š” 19์„ธ๊ธฐ ๋ง์— ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ์˜ ๋ช…์ธ ๊น€์ฐฝ์กฐ(1865๏ฝž1919)์— ์˜ํ•ด ํ˜•์„ฑ๋˜์—ˆ๋‹ค. ๊น€์ฐฝ์กฐ์—๊ฒŒ ์ „์ˆ˜ํ•œ ํ•œ์„ฑ๊ธฐ, ์ตœ์˜ฅ์‚ผ, ๊น€๋ณ‘ํ˜ธ, ๊ฐ•ํƒœํ™์˜ ์‚ฐ์กฐ๋Š” ๊ฐ๊ฐ ๊น€์ฃฝํŒŒ๋ฅ˜, ์ตœ์˜ฅ์‚ผ๋ฅ˜, ๊น€๋ณ‘ํ˜ธ๋ฅ˜, ๊ฐ•ํƒœํ™๋ฅ˜๋กœ ์ „ํ•ด์ง€๊ณ  ์žˆ๋‹ค. ์ด ๋„ค ๊ฐ€์ง€ ์‚ฐ์กฐ๋“ค์€ ํ˜„์žฌ ํ™œ๋ฐœํžˆ ์—ฐ์ฃผ๋˜๋Š” ์‚ฐ์กฐ๋“ค๋กœ ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ์˜ ๊ณ„๋ณด ์ƒ ๊ฐ™์€ ๊ณ„์—ด์— ์žˆ์ง€๋งŒ ์„ธ์›”์ด ํ๋ฅด๋ฉด์„œ ๊ฐ€๋ฝ์ด ์ฒจ๊ฐ€, ๋ณ€ํ˜•๋˜์–ด ์ƒ๋‹นํžˆ ๋‹ค๋ฅธ ๋ชจ์Šต์„ ๋„๊ณ  ์žˆ๋‹ค. ์ด ๋„ค ๊ฐ€์ง€ ๋ฅ˜ํŒŒ์˜ ์ง„์–‘์กฐ๋Š” ๋‹ค์–‘ํ•œ ์„ ํ–‰์—ฐ๊ตฌ์—์„œ ๊ฐ๊ธฐ ๋‹ค๋ฅธ ๋ถ„์„๋ฐฉ๋ฒ•์„ ์‚ดํŽด๋ณด๊ณ  ์žˆ์ง€๋งŒ, ๋ณธ ์—ฐ๊ตฌ ์—์„œ๋Š” ์กฐ์˜ ์˜๋ฏธ๋ฅผ ์Œ์˜ ๋†’์ด์™€ ๊ตฌ์„ฑ์Œ์˜ ์—ญํ• ์ด๋ผ๋Š” ๋‘ ๊ฐ€์ง€ ์ธก๋ฉด์—์„œ ๋™์‹œ์— ์‚ดํŽด๋ณด์•˜๋‹ค. ๊ทธ ๊ฒฐ๊ณผ ๊น€์ฐฝ์กฐ๊ณ„ ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ์ธ ๊น€์ฃฝํŒŒ, ์ตœ์˜ฅ์‚ผ, ๊ฐ•ํƒœํ™, ๊น€๋ณ‘ํ˜ธ๋ฅ˜ ์‚ฐ์กฐ๋Š” ์šฐ์กฐ์ฒญ ํ‰์กฐ-์šฐ์กฐ์ฒญ ๊ณ„๋ฉด์กฐ-๋Œ์žฅ-ํ‰์กฐ์ฒญ ํ‰์กฐ-ํ‰์กฐ์ฒญ ๊ณ„๋ฉด์กฐ ๋ผ๋Š” ๊ณตํ†ต์ ์ธ ์ง„ํ–‰ ํ›„์— ์ตœ์˜ฅ์‚ผ๋ฅ˜์™€ ๊น€๋ณ‘ํ˜ธ๋ฅ˜์˜ ๊ฒฝ์šฐ์—๋Š” ํ‰์กฐ์ฒญ ๊ณ„๋ฉด์กฐ๋กœ ์ง„ํ–‰ํ•˜์˜€์œผ๋ฉฐ ๊น€์ฃฝํŒŒ๋ฅ˜์˜ ๊ฒฝ์šฐ ํ‰์กฐ์—‡์ฒญ ๊ณ„๋ฉด์กฐ-ํ‰์กฐ์ฒญ ๊ณ„๋ฉด์กฐ๋กœ์˜ ์ง„ํ–‰์„ ๋ณด์ด๊ณ  ๊ฐ•ํƒœํ™๋ฅ˜๋Š” ์šฐ์กฐ์ฒญ ํ‰์กฐ-ํ‰์กฐ์ฒญ ๊ณ„๋ฉด์กฐ์˜ ์ง„ํ–‰์„ ๋ณด์ด๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค. ๋˜ํ•œ ์ฒญ์˜ ์ด๋™์‹œ ๋„ค ๊ฐ€์ง€ ๋ฅ˜ํŒŒ๊ฐ€ ๊ฐ๊ธฐ ๋‹ค๋ฅธ ํŠน์ง•์ ์ธ ์„ ์œจ์ง„ํ–‰์„ ๋ณด์ผ ๊ฒƒ์œผ๋กœ ์˜ˆ์ƒ๋˜์—ˆ์œผ๋‚˜ ๊ฒฐ๊ณผ์ ์œผ๋กœ๋Š” ์„œ๋กœ ๋น„์Šทํ•œ ์„ ์œจ์ง„ํ–‰์„ ๋ณด์˜€๋‹ค. ์Œ์„ ๋ˆŒ๋Ÿฌ ํ‘œํ˜„ํ•จ์œผ๋กœ์จ ์Œ์˜ ๊ฒฝ๊ณ„๋ฅผ ํ—ˆ๋ฌผ์–ด ์ฒญ์˜ ์ด๋™์„ ์ง„ํ–‰ํ•˜๋Š” ๊ฒƒ, ๋™์ผ์Œ ์ง„ํ–‰ ๋˜๋Š” ์™„์ „4๋„ ๋‚ด์ง€๋Š” ์™„์ „5๋„ ์ง„ํ–‰, ๋™์ผ๊ตฌ์„ฑ์Œ์˜ ์—ญํ• ๋ณ€ํ™”์˜ ์„ธ ๊ฐ€์ง€ ๋ฐฉ๋ฒ•์ด ๊ทธ๊ฒƒ์ด๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ์˜ ์กฐ๊ฐ€ ๊ฐ€์ง€๋Š” ์˜๋ฏธ๋ฅผ ์ฒญ๊ณผ ์„ ๋ฒ•์œผ๋กœ ๋™์‹œ์— ๋ถ„์„ํ•˜๊ณ  ์ฒญ์˜ ์ด๋™์„ ์œจ์„ ํŒŒ์•…ํ•˜๋ ค ํ–ˆ๋‹ค๋Š”๋ฐ ์˜์˜๊ฐ€ ์žˆ๋‹ค.๊ตญ๋ฌธ์ดˆ๋ก โ…ฐ ๋ชฉ ์ฐจ โ…ฑ ํ‘œ ๋ชฉ ์ฐจ โ…ณ ์•…๋ณด๋ชฉ์ฐจ โ…ด โ… . ์„œ๋ก  1 1. ๋ฌธ์ œ์ œ๊ธฐ ๋ฐ ์—ฐ๊ตฌ๋ชฉ์  1 2 .์—ฐ๊ตฌ๋ฒ”์œ„ ๋ฐ ์—ฐ๊ตฌ๋ฐฉ๋ฒ• 6 โ…ก. ๊ฐ€์•ผ๊ธˆ์‚ฐ์กฐ ์ง„์–‘์กฐ์˜ ่ชฟๆง‹ๆˆ 10 1. ๊น€์ฃฝํŒŒ๋ฅ˜ 10 2. ์ตœ์˜ฅ์‚ผ๋ฅ˜ 22 3. ๊ฐ•ํƒœํ™๋ฅ˜ 28 4. ๊น€๋ณ‘ํ˜ธ๋ฅ˜ 33 5. ๊น€์ฃฝํŒŒ, ์ตœ์˜ฅ์‚ผ, ๊ฐ•ํƒœํ™, ๊น€๋ณ‘ํ˜ธ๋ฅ˜ ์ง„์–‘์กฐ ์กฐ ๊ตฌ์„ฑ ๋น„๊ต 38 โ…ข. ์ฒญ์˜ ์ด๋™์‹œ ๋ฅ˜ํŒŒ๋ณ„ ์„ ์œจ์˜ ํŠน์ง• 48 1. ๊น€์ฃฝํŒŒ๋ฅ˜ 48 2. ์ตœ์˜ฅ์‚ผ๋ฅ˜ 49 3. ๊ฐ•ํƒœํ™๋ฅ˜ 50 4. ๊น€๋ณ‘ํ˜ธ๋ฅ˜ 52 โ…ฃ.๊ฒฐ๋ก  55 ์ฐธ๊ณ ๋ฌธํ—Œ 56 Abstract 58 ์ฐธ๊ณ ์•…๋ณด 60Maste

    ๋ฏธ์„ธ์ „์‚ฐํ™”๋‹จ์ธต์ดฌ์˜ ๋ฐ ์˜๋ฃŒ์šฉ CAD ๋ฅผ ์ด์šฉํ•œ ๊ทผ๊ด€์น˜๋ฃŒ ์ˆ ์‹์— ๋”ฐ๋ฅธ ์ฒด์ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› ์น˜์˜ํ•™๋Œ€ํ•™์› ์น˜์˜๊ณผํ•™๊ณผ, 2017. 8. ์ •์‹ ํ˜œ.Use of Micro-Computed Tomography and Computer-Aided Design in Comparative Volumetric Analyses of Endodontic Armamentarium Department of Dental Biomaterials Science Seoul National University School of Dentistry Anna Hwayoung Yi (Supervisor: Prof. Shin Hye Chung) 1. Objectives The purpose of root canal treatment (RCT) is to chemo-mechanically disinfect and shape the canal space, and thereafter create hermetic seal of the canal system using obturant and sealer. Part one of the present study is a comparative analysis of the root canal morphological changes induced by the two different file systems, ProTaper Next (PN) (Dentsply Maillefer, Ballaigues, Switzerland), the conventional rotary full sequence system (RFSS), and the newly introduced WaveOne Gold (WG) (Dentsply Maillefer), which is a reciprocating file (RF) system. This is represented by the volumetric changes before and after the shaping of canals with varying degrees of curvature severity. Part two of the present study is a comparative analysis of the volumetric changes of the three different sealers spanning 8 weeks post-obturation ex vivo. The sealers studied include the conventional epoxy resin-based AH Plus (AP) (Dentsply Maillefer), a calcium silicate-based EndoSeal MTA (ES) (Maruchi, Wonju, Republic of Korea), and a cold flowable gutta-percha (GP) named Guttaflow 2 (G2) (Coltรจne Whaledent, GmBH+Co KG, Langenau, Switzerland). 2. Material and Methods The sample teeth were selected following the inclusion criteria: no root caries, un-treated root canals, and complete apexification. To compare the effect of the two different file systems, the mesiobuccal and distobuccal canals were randomly categorized into two groups (n = 32/group) โ€“ the rotary PN group and the reciprocating WG group. To compare the effect of the three different sealers, the palatal canals were randomly classified into three groups (n = 12/group) and were named the AP group, ES group, and G2 group respectively for AH Plus, EndoSeal MTA and Guttaflow 2. In part one, the canal preparation was executed to the pre-determined working length up to the apical size of 25 (PN: X2 25/06WG: Primary 25/07) following the respective manufacturers protocols. In part two, the canals were prepared up to the apical size of ISO 40 with Protaper NEXT X4 for standardization. In part two, each AP, ES, G2 sealer was prepared whilst adhering to the corresponding manufacturers instructions, and single-cone technique with ISO 40 GP cone (Meta Biomed, Chungju, South Korea) was used. After the canal filling, the coronal cavity was sealed with Fuji II LC (GC, Tokyo, Japan). All root surfaces, except for the 2 mm radius encircling the apical foramen, were covered with varnish before being stored in a separate sealed container with 5 mL of phosphate-buffered saline solution at 37 C. The micro-computed tomography (microCT) images (SkyScan1172, SkyScan, Aartselaar, Belgium) were taken at 24 hours, 1 week, 2 weeks, 4 weeks and 8 weeks post-obturation. The scanned images were reconstructed using NRecon version 1.6.2.0 (SkyScan, Belgium). The reconstructed images were visualized into three-dimensional (3D) models for volumetric analyses using two medical computer-aided design (CAD) software programs (Mimics, Materialise N.V., Leuven, Belgium3-matic, Materialise N.V.). All used PN and WG files, as well as the obturated specimen were prepared for viewing under field emission scanning electron microscopy and energy dispersive x-ray spectroscopy. The statistical analyses was performed using SPSS version 24 (SPSS, Chicago, USA) with the statistical significance set at P < 0.05, whilst using Levene's test, one-way analysis of variance, Tukey's HSD test, Dunnett's T3 test and independent samples t-test for different comparison types. 3. Results In part one, WG group resulted in statistically significant canal deviation at coronal-third of straighter canals compared to that of curved canals, which may clinically translate to the risk of cervical canal transportation during relatively routine root canal treatments of straight canals. Its shaping ability, however, was not significantly different from that of ProTaper Next at a given canal-third at a given curvature severity. In part two, ES group showed a statistically significant increase in the total volume at 8-weeks, compared to that of the AH group. There was an increase in volume of the G2 group, but without statistical significance compared to the ES group. The volumetric increase in the ES group, further supported by the FE-SEM observations, clinically translates to the potential for ES to provide continued filling of the canal wall interface as an endodontic sealer, via continued hydroxyapatite (HA) crystal growth in the presence of bodily fluid.I. Shaping Ability of ProTaper Next and WaveOne Gold File Systems 1 Introduction 1 Material and Methods 3 Results 7 Discussion 8 Figures and Tables 12 II. Volumetric Study of Endodontic Sealers 16 Introduction 16 Material and Methods 18 Results 23 Discussion 24 Figures and Tables 27 References 34 ๊ตญ๋ฌธ์ดˆ๋ก 43Maste

    Immunohistochemical localization of nitric oxide synthase in the developing rat brain

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    ํ•™์œ„๋…ผ๋ฌธ(๋ฐ•์‚ฌ)--์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› :์˜ํ•™๊ณผ ํ•ด๋ถ€ํ•™์ „๊ณต,1997.Docto

    ํ•œ๊ตญ ์•„์ด๋Œ ์‚ฐ์—…์—์„œ์˜ ์†Œ๋…€ ์ด๋ฏธ์ง€ ๋ธŒ๋žœ๋“œํ™” ๊ฒฝํ–ฅ์— ๊ด€ํ•œ ์—ฐ๊ตฌ

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๋””์ž์ธํ•™๋ถ€, 2017. 2. ๊น€๊ฒฝ์„ .์˜ค๋Š˜๋‚  ์‚ฐ์—…์€ ํฌ์ŠคํŠธ๋ชจ๋”๋‹ˆ์ฆ˜์˜ ์˜ํ–ฅ๊ณผ ์ •๋ณดํ†ต์‹  ๋ฐ ๋Œ€์ค‘๋งค์ฒด์˜ ๋ฐœ๋‹ฌ๋กœ ์ธํ•ด ๊ณผ๊ฑฐ์™€ ๋‹ฌ๋ฆฌ ํฌ๊ฒŒ ๋ณ€ํ™”ํ•˜์˜€๋‹ค. ๊ทผ๋Œ€ ์‚ฐ์—…์—์„œ ์ƒํ’ˆ์˜ ์‚ฌ์šฉ๊ฐ€์น˜๋‚˜ ๊ตํ™˜๊ฐ€์น˜๊ฐ€ ์ค‘์š”ํ•˜๊ฒŒ ์—ฌ๊ฒจ์กŒ๋‹ค๋ฉด ํ˜„๋Œ€ ์‚ฐ์—…์—์„œ๋Š” ๊ธฐํ˜ธ๊ฐ€์น˜๊ฐ€ ๊ฐ€์žฅ ์ค‘์š”ํ•œ ์ƒํ’ˆ๊ฐ€์น˜๊ฐ€ ๋˜๋ฉฐ ๊ธฐํ˜ธ๋‚˜ ์ƒ์ง•, ์ด๋ฏธ์ง€ ๊ทธ ์ž์ฒด๊ฐ€ ์ƒํ’ˆ์ด ๋œ๋‹ค. ์ด๋Ÿฌํ•œ ๋ณ€ํ™”์— ๋”ฐ๋ผ ์˜ค๋Š˜๋‚  ์‚ฐ์—…์€ ๋ฌธํ™”์‚ฐ์—…์œผ๋กœ ์ „ํ™˜๋˜์—ˆ์œผ๋ฉฐ, ์ด์— ์‚ฐ์—…๊ณผ ๋ฌธํ™”์˜ ๊ตฌ๋ถ„์ด ๋ชจํ˜ธํ•ด์ง€๋ฉด์„œ ํ˜„๋Œ€์‚ฌํšŒ๋Š” ํ”ํžˆ ์†Œ๋น„์˜ ์‚ฌํšŒ๋กœ ๋ช…๋ช…๋˜๊ฒŒ ๋˜์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ํ˜„๋Œ€์˜ ์†Œ๋น„๋ฌธํ™”๋Š” ์ธ๊ฐ„์˜ ์‚ถ ์—ญ์‹œ ํฌ๊ฒŒ ๋ณ€ํ™”์‹œ์ผฐ์œผ๋ฉฐ, ํŠนํžˆ ์Šค์Šค๋กœ๋ฅผ ์ธ์‹ํ•˜๋Š” ๋ฐฉ์‹์— ํฐ ์˜ํ–ฅ์„ ์ฃผ์—ˆ๋‹ค. ์ธ๊ฐ„์€ ์ด์ œ ์ง์ ‘์ ์ธ ๋ฌผํ’ˆ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ์ด๋ฏธ์ง€๋ฅผ ์†Œ๋น„ํ•จ์œผ๋กœ์จ ๊ทธ ์ด๋ฏธ์ง€์— ์ž์‹ ์˜ ํ™˜์ƒ์„ ํˆฌ์˜ํ•˜๋Š” ๋ฐฉ์‹์œผ๋กœ ์Šค์Šค๋กœ์˜ ์ •์ฒด์„ฑ์„ ๊ตฌ์„ฑํ•œ๋‹ค. ์ด๋Ÿฌํ•œ ํ˜„๋Œ€์‚ฌํšŒ์˜ ์ด๋ฏธ์ง€ ์†Œ๋น„๋ฐฉ์‹์„ ๊ทน๋‹จ์ ์œผ๋กœ ๋ณด์—ฌ์ฃผ๋Š” ๊ฒƒ ์ค‘ ํ•˜๋‚˜๊ฐ€ ์‹ค์žฌ ์ธ๊ฐ„์„ ์ฒ ์ €ํ•œ ํ›ˆ๋ จ์„ ํ†ตํ•ด ์ด๋ฏธ์ง€ ์ƒํ’ˆ์œผ๋กœ ํ™˜์›ํ•˜๋Š” ์•„์ด๋Œ ์‚ฐ์—…์ด๋ผ๊ณ  ํ•  ์ˆ˜ ์žˆ๋‹ค. ํ•œ๊ตญ์—์„œ ์•„์ด๋Œ ์‚ฐ์—…์€ ๋ณธ๋ž˜ ๋Œ€์ค‘์Œ์•…์‚ฐ์—…์˜ ํ•˜์œ„์žฅ๋ฅด๋กœ์„œ ํŠน์ • ์—ฐ๋ น๋Œ€๋‚˜ ์ง‘๋‹จ์—์„œ๋งŒ ์†Œ๊ตฌ๋˜๋Š” ํ•˜์œ„๋ฌธํ™”์  ํŠน์„ฑ์ด ๊ฐ•ํ–ˆ์œผ๋‚˜ 2000๋…„๋Œ€ ํ›„๋ฐ˜ ์ดํ›„ ์„ธ๋Œ€์  ํŠน์„ฑ ๋ฐ ๋งค์ฒด์˜ ๋‹ค๋ณ€ํ™”๋กœ ์ธํ•ด ์ „์„ธ๋Œ€๋ฅผ ์•„์šฐ๋ฅด๋Š” ์‚ฌํšŒ๋ฌธํ™”์  ์„ฑ๊ฒฉ์„ ๊ฐ–๊ฒŒ ๋˜์—ˆ๋‹ค. ์ด๋Ÿฌํ•œ ๋ฐฐ๊ฒฝ์— ๋”ฐ๋ผ ๋ณธ ์—ฐ๊ตฌ๋Š” ์ด์ œ ํ•œ๊ตญ ์‚ฌํšŒ์—์„œ๋Š” ์ผ๋ฐ˜์ ์ธ ๋Œ€์ค‘๋ฌธํ™”ํ˜„์ƒ์ด ๋œ ์•„์ด๋Œ ์‚ฐ์—…์„ ๋งค๊ฐœ๋กœ ํ˜„๋Œ€์ธ๋“ค์ด ์ด๋ฏธ์ง€๋ฅผ ์†Œ๋น„ํ•˜๊ณ  ์žฌ์ƒ์‚ฐํ•˜๋Š” ๊ณผ์ •์„ ํ†ตํ•ด ์Šค์Šค๋กœ์˜ ์ •์ฒด์„ฑ์„ ํ˜•์„ฑํ•˜๊ณ  ์˜๋ฏธ๋ฅผ ์ƒ์‚ฐํ•˜๋Š” ๋ฐฉ์‹์„ ์‹œ๊ฐ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜์˜ ๊ด€์ ์—์„œ ํƒ๊ตฌํ•˜๊ณ ์ž ํ•œ๋‹ค. ๋˜ํ•œ ์•„์ด๋Œ ์‚ฐ์—… ๋‚ด์—์„œ๋„ ๊ฑธ๊ทธ๋ฃน์— ์ง‘์ค‘ํ•˜์—ฌ ๊ทธ๋“ค์ด ์ƒ์‚ฐํ•˜๋Š” ์†Œ๋…€ ์ด๋ฏธ์ง€๋ฅผ ์ฃผ์š”ํ•œ ๋…ผ์˜์˜ ๋Œ€์ƒ์œผ๋กœ ์‚ผ๊ณ ์ž ํ•œ๋‹ค. ํ˜„๋Œ€์— ์ด๋ฅด๊ธฐ๊นŒ์ง€ ๋‹ค์–‘ํ•œ ๋งค์ฒด๋ฅผ ํ†ตํ•ด ๋ฐ˜๋ณต์ ์œผ๋กœ ์ƒ์‚ฐ๋˜๊ณ  ์žˆ๋Š” ์†Œ๋…€๋ผ๋Š” ํ‘œ์ƒ์€ ๊ทผ๋Œ€์˜ ๋‚จ์„ฑ์ฃผ์˜์  ์‚ฌํšŒ์งˆ์„œ์— ์˜ํ•ด ํƒ€์žํ™”๋œ ๊ฒฐ๊ณผ๋ฌผ์ด๋ฉฐ, ์—ฌ์„ฑ๊ณผ ๋‚จ์„ฑ,์œ ์•„์™€ ์„ฑ์ธ์˜ ๊ฒฝ๊ณ„์— ์œ„์น˜ํ•œ ๋ชจํ˜ธํ•˜๊ณ  ์ด์ค‘์ ์ธ ๊ฐœ๋…์œผ๋กœ, ๋‚จ์„ฑ๋“ค์—๊ฒŒ๋Š” ์„ฑ์  ํŒํƒ€์ง€์˜ ๋Œ€์ƒ์ด, ์—ฌ์„ฑ๋“ค์—๊ฒŒ๋Š” ์ž๊ธฐ๋™์ผ์‹œ์˜ ๋Œ€์ƒ์ด ๋œ๋‹ค. ๋”ฐ๋ผ์„œ, ์†Œ๋…€ ์ด๋ฏธ์ง€๋Š” ๊ทธ๊ฒƒ์ด ๊ฐ€์ง„ ์‚ฌํšŒ๋ฌธํ™”์  ๋ณตํ•ฉ์„ฑ๊ณผ ๋‚จ์„ฑ๊ณผ ์—ฌ์„ฑ ๋ชจ๋‘์—๊ฒŒ ์†Œ๋น„์™€ ํ–ฅ์œ ์˜ ๋Œ€์ƒ์ด ๋œ๋‹ค๋Š” ๋ณดํŽธ์„ฑ์˜ ์ธก๋ฉด์—์„œ ์—ฐ๊ตฌ ๋Œ€์ƒ์ด ๋  ๋งŒํ•˜๋‹ค๊ณ  ํŒ๋‹จํ–ˆ๋‹ค. ๋˜ํ•œ, ๊ทธ๊ฐ„ ์‹œ๊ฐ ๋””์ž์ธ ๋ถ„์•ผ์—์„œ์˜ ์—ฐ๊ตฌ๊ฐ€ ์  ๋”๋‚˜ ์ •์ฒด์„ฑ๊ณผ ๊ด€๋ จํ•ด์„œ๋Š” ๋งŽ์ด ์ด๋ฃจ์–ด์ง€์ง€ ์•Š์•˜๋‹ค๋Š” ์ ์—์„œ ํŠน์ • ์‹œ๊ฐ๋ฌธํ™”๋ฅผ ์†Œ๋…€๋ผ๋Š” ์  ๋”์  ์ •์ฒด์„ฑ์„ ํ†ตํ•ด ํ•ด์„ํ•˜๊ณ ์ž ํ•œ ์‹œ๋„๋Š” ์˜๋ฏธ ์žˆ์„ ์ˆ˜ ์žˆ๋‹ค. ์—ฐ๊ตฌ๊ณผ์ •์€ ํฌ๊ฒŒ ๋‘ ๊ฐ€์ง€๋กœ ๋‚˜๋‰˜๋Š”๋ฐ, ๋จผ์ € ์†Œ๋…€ ์ด๋ฏธ์ง€์— ๋Œ€ํ•œ ์‚ฌํšŒ๋ฌธํ™”์  ๋ฐฐ๊ฒฝ์„ ํƒ๊ตฌํ•œ๋‹ค. ์ด ์žฅ์—์„œ๋Š” ์†Œ๋…€๋ฌธํ•™, ์†Œ๋…€๋งŒํ™”, ์†Œ๋…€์• ๋‹ˆ๋ฉ”์ด์…˜, ๊ฑธ๊ทธ๋ฃน ๋“ฑ์œผ๋กœ ์ด์–ด์ง€๋Š” ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ๊ณ„๋ณด๋ฅผ ํƒ๊ตฌํ•˜๊ณ  ๊ทธ๊ฒƒ์˜ ๊ธฐํ˜ธํ•™์  ํ•ด์„๊ณผ ์—ฌ์„ฑํ•™์  ํ•ด์„์„ ์ •๋ฆฌํ•œ๋‹ค. ๋‘๋ฒˆ์งธ๋Š” ์†Œ๋…€ ์ด๋ฏธ์ง€๋ฅผ ์‹œ๊ฐ ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜์˜ ๊ด€์ ์—์„œ ๋ถ„์„ํ•œ๋‹ค. ์ด ๋…ผ์˜์—์„œ๋Š” ๋ฌธํ™”์‚ฐ์—… ๊ตฌ์กฐ์—์„œ ์ƒํ’ˆ์˜ ๊ธฐํ˜ธ์™€ ์ƒ์ง•์ด ์‹œ๊ฐํ™” ๋œ ์‚ฐ๋ฌผ๋กœ์„œ ๋ธŒ๋žœ๋“œ๋ผ๋Š” ๊ฐœ๋…์„ ์†Œ๊ฐœํ•˜๊ณ  ๊ทธ๊ฒƒ์„ ์‹œ๊ฐ์  ๋ถ„์„์˜ ํ‹€๋กœ์จ ์‚ฌ์šฉํ•œ๋‹ค. ์ด์— ๋”ฐ๋ผ ์†Œ๋…€ ์ด๋ฏธ์ง€๊ฐ€ ๊ฑธ๊ทธ๋ฃน์ด๋ผ๋Š” ํ˜•ํƒœ๋ฅผ ํ†ตํ•ด ์ ์ฐจ ๋ธŒ๋žœ๋“œํ™” ๋˜๊ณ  ์žˆ๋Š” ํ˜„์ƒ์„ ์ œ์‹œํ•˜๊ณ , ์‚ฌํšŒ์˜ ํ๋ฆ„์— ๋”ฐ๋ผ ์ด ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ๋“ค์˜ ์†Œ๋…€ ์ด๋ฏธ์ง€๊ฐ€ ์–ด๋–ป๊ฒŒ ๋ณ€ํ™”ํ•ด ์™”๋Š”์ง€ ๋ถ„์„ํ•œ๋‹ค. ๋ชจ๋“  ๊ฒƒ์ด ์ƒํ’ˆ์ด ๋˜๋Š” ํ˜„๋Œ€ ์†Œ๋น„์‚ฌํšŒ์—์„œ ์ธ๊ฐ„ ์—ญ์‹œ ๊ธฐํ˜ธ์™€ ์ด๋ฏธ์ง€์˜ ์ƒํ’ˆํ™”๋ผ๋Š” ํƒˆ๊ทผ๋Œ€์  ์‚ฐ์—… ๊ตฌ์กฐ์˜ ํ‹€์„ ๋ฒ—์–ด๋‚  ์ˆ˜ ์—†๋‹ค. ๋”ฐ๋ผ์„œ ์˜ค๋Š˜๋‚  ์ธ๊ฐ„์€ ์Šค์Šค๋กœ ๊ธฐํ˜ธ์  ์ƒํ’ˆ์ด ๋˜๊ธฐ๋„ ํ•˜๊ณ , ๋˜ ๊ทธ ์ƒํ’ˆ์„ ์†Œ๋น„ํ•˜๋ฉด์„œ ์ž์‹ ์˜ ์ •์ฒด์„ฑ์„ ๊ตฌ์„ฑํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์ด๋‹ค. ์ด๋Ÿฌํ•œ ์‚ฌํšŒ๋ฌธํ™”์  ๋งฅ๋ฝ์— ๋”ฐ๋ผ ์ตœ๊ทผ ๊ฑธ๊ทธ๋ฃน์„ ํ†ตํ•ด ๋Œ€๋Ÿ‰ ์ƒ์‚ฐ๋˜๊ณ  ์žˆ๋Š” ์†Œ๋…€ ์ด๋ฏธ์ง€๋Š” ๋‹ค์–‘ํ•œ ์„ฑ๋ณ„๊ณผ ์„ธ๋Œ€์— ์†Œ๊ตฌํ•˜๋ฉด์„œ ๋งŽ์€ ์ด๋“ค์˜ ์‚ถ๊ณผ ์ž๊ธฐ์ธ์‹์— ์˜ํ–ฅ์„ ์ฃผ๊ณ  ์žˆ์œผ๋ฉฐ, ์‹œ๊ฐ ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜์˜ ๊ด€์ ์—์„œ๋Š” ๋ธŒ๋žœ๋“œ๋ผ๋Š” ๊ธฐํ˜ธ ์ฒด๊ณ„๋ฅผ ํ†ตํ•ด ๊ทธ ์ •์ฒด์„ฑ์„ ๋”์šฑ ๊ฐ•ํ™”ํ•˜๊ณ  ๋‹ค์–‘ํ•œ ์˜์—ญ์œผ๋กœ ํ™•์‚ฐ ๋ฐ ๋‹ค๋ณ€ํ™”ํ•˜๋ฉด์„œ ์šฐ๋ฆฌ ์‚ฌํšŒ์—์„œ์˜ ํŒŒ๊ธ‰๋ ฅ์„ ์‹ฌํ™”์‹œํ‚ค๊ณ  ์žˆ๋‹ค. ๊ฒฐ๋ก ์ ์œผ๋กœ, ์˜ค๋Š˜๋‚  ์ƒํ’ˆํ™”๋œ ์†Œ๋…€ ์ด๋ฏธ์ง€๋Š” ์šฐ๋ฆฌ ์Šค์Šค๋กœ๋ฅผ ๋น„์ถฐ๋ณด๋Š” ๊ฑฐ์šธ๋กœ์„œ, ํ˜„ ์‹œ๋Œ€์ƒ์„ ํ•จ์ถ•์ ์œผ๋กœ ๋ณด์—ฌ์ฃผ๋Š” ํˆฌ์˜์ฒด์˜ ์—ญํ• ์„ ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ด์— ๋ณธ ์—ฐ๊ตฌ๋Š” ํ•œ๊ตญ ์•„์ด๋Œ ์‚ฐ์—…์—์„œ, ๊ฑธ๊ทธ๋ฃน์„ ํ†ตํ•ด ๋ธŒ๋žœ๋“œํ™” ๋˜๊ณ  ์žˆ๋Š” ์†Œ๋…€ ์ด๋ฏธ์ง€๋ฅผ ์‚ดํŽด๋ด„์œผ๋กœ์จ ์˜ค๋Š˜๋‚  ์ธ๊ฐ„๊ณผ ์ด๋ฏธ์ง€ ๊ทธ๋ฆฌ๊ณ  ์‚ฐ์—…์˜ ๊ด€๊ณ„๋ฅผ ์ดํ•ดํ•˜๊ณ , ๋™์‹œ์— ์—ฌ์„ฑ์˜ ์ด๋ฏธ์ง€๊ฐ€ ์†Œ๋…€๋ผ๋Š” ์ธ๋ฌผ ํ‘œ์ƒ์„ ํ†ตํ•ด ์–ด๋–ป๊ฒŒ ์ƒ์‚ฐ๋˜๊ณ  ๋ณ€ํ™”ํ•ด์™”๋Š”์ง€ ์‚ดํŽด๋ณด๊ณ ์ž ํ•œ ๋ฐ์— ์—ฐ๊ตฌ์˜ ๋ชฉ์ ๊ณผ ์˜์˜๊ฐ€ ์žˆ๋‹ค๊ณ  ํ•˜๊ฒ ๋‹ค.์ œ 1์žฅ: ์„œ๋ก  1 1. ์—ฐ๊ตฌ๋ฐฐ๊ฒฝ ๋ฐ ์˜๋„ 2 2. ์—ฐ๊ตฌ๋ฐฉ๋ฒ• 5 ์ œ 2์žฅ: ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ์ด๋ก ์  ๋ฐฐ๊ฒฝ 7 1. ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ํ˜•์„ฑ๊ณผ ๋ณ€ํ™”๊ณผ์ • 8 1.1 ์†Œ๋…€๊ฐœ๋…๊ณผ ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ํ˜•์„ฑ ์ผ๋ณธ ์†Œ๋…€๋ฌธํ™” ๋ฅผ ์ค‘์‹ฌ์œผ๋กœ 8 1.2 ๊ฑธ๊ทธ๋ฃน ์žฅ๋ฅด์˜ ๋“ฑ์žฅ๊ณผ ๋ณ€ํ™”๊ณผ์ • 17 2. ์ธ๊ฐ„๊ณผ ์ด๋ฏธ์ง€์— ๋Œ€ํ•œ ๊ธฐํ˜ธํ•™์  ํ•ด์„ 22 2.1 ๋ฌธํ™”์‚ฐ์—…๊ณผ ์ด๋ฏธ์ง€ 22 2.2 ์ด๋ก ์  ๋ฐฐ๊ฒฝ: ์žฅ ๋ณด๋“œ๋ฆฌ์•ผ๋ฅด, ํฌ์ŠคํŠธ๋ชจ๋˜ ๊ธฐํ˜ธํ•™ 24 2.3 ์ธ๊ฐ„๊ณผ ์ด๋ฏธ์ง€ 26 3. ์†Œ๋…€ ์ด๋ฏธ์ง€์— ๋Œ€ํ•œ ์—ฌ์„ฑ์ฃผ์˜์  ํ•ด์„ 28 3.1 ์†Œ๋…€ ์ด๋ฏธ์ง€์™€ ์  ๋”์ •์ฒด์„ฑ 28 3.2 ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ์—ฌ์„ฑ์„ฑ ๋ณ€ํ™”๊ณผ์ • 29 3.3 ์†Œ๋…€ ์ด๋ฏธ์ง€์˜ ์—ฌ์„ฑ์„ฑ, ์–ด๋–ป๊ฒŒ ๋ณผ ๊ฒƒ์ธ๊ฐ€ 38 ์ œ 3์žฅ : ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ์†Œ๋…€ ์ด๋ฏธ์ง€์— ๋Œ€ํ•œ ์‹œ๊ฐ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜์  ๋ถ„์„ 41 1. ํ•œ๊ตญ ์•„์ด๋Œ ์‚ฐ์—…๊ณผ ์‹œ๊ฐ์ปค๋ฎค๋‹ˆ์ผ€์ด์…˜ 42 1.1 ํ•œ๊ตญ ์•„์ด๋Œ ์‚ฐ์—…์˜ ๋ณ€ํ™” 42 1.2 ๋ธŒ๋žœ๋“œ์˜ ๊ฐœ๋… 44 1.3 ํ•œ๊ตญ ์•„์ด๋Œ ์‚ฐ์—…๊ณผ ๋ธŒ๋žœ๋“œ 47 2. ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ ์ „๋žต 51 2.1 ํ•œ๊ตญ ์•„์ด๋Œ ๊ฑธ๊ทธ๋ฃน ๊ฐœ๊ด€ 51 2.2 ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ ์ „๋žต์˜ ๋ณ€ํ™” ๊ณผ์ • 53 3. ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ์˜ ์†Œ๋…€ ์ด๋ฏธ์ง€ 64 3.1 ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ์˜ ์†Œ๋…€ ์ด๋ฏธ์ง€ ์ง€ํ˜•๋„ 64 3.2 ํ•œ๊ตญ ๊ฑธ๊ทธ๋ฃน ๋ธŒ๋žœ๋“œ์˜ ์†Œ๋…€ ์ด๋ฏธ์ง€ ๋ณ€ํ™” ๊ณผ์ • 75 ์ œ 4์žฅ : ์ตœ์ข… ์ž‘์—… 86 1. ๋ธŒ๋žœ๋“œํ™”ํ•œ ์†Œ๋…€ 87 2. ์„ ํ–‰ ์—ฐ๊ตฌ ์ž‘์—…: ์•„์‹œ์•„์˜ ์†Œ๋…€๋“ค 89 3. ์ตœ์ข… ์ž‘์—… 93 3.1 ์ž‘์—… ์˜๋„ ๋ฐ ๋ฐฉ๋ฒ• 93 3.2 ๋ฐฐ๊ฒฝ ์ด๋ก : ๊ฐœ๋…๋ฏธ์ˆ  95 3.3 ์‹œ์•ˆ ์ž‘์—… 99 3.4 ์ตœ์ข… ์ž‘์—…: Girls 107 ์ œ 5์žฅ : ๊ฒฐ๋ก  117 ์ฐธ๊ณ ๋ฌธํ—Œ 121Maste

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    ํ•™์œ„๋…ผ๋ฌธ(์„์‚ฌ) --์„œ์šธ๋Œ€ํ•™๊ต ๋ณด๊ฑด๋Œ€ํ•™์› :ํ™˜๊ฒฝ๋ณด๊ฑดํ•™๊ณผ (ํ™˜๊ฒฝ๋ณด๊ฑดํ•™๊ณผ),2009.8.Maste

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    ํ•™์œ„๋…ผ๋ฌธ (์„์‚ฌ)-- ์„œ์šธ๋Œ€ํ•™๊ต ๋Œ€ํ•™์› : ๊ตญ์ œํ•™๊ณผ, 2017. 2. ๋ฐ•์ฒ ํฌ.The goal of this paper is to discover how prime ministers office (Kantei) is at the center of Japans security policy making. This research particularly focuses on the parallel comparison between Koizumi and Abe regimes security policy making process while analyzing interaction among Kantei, politicians, bureaucrats and public opinion. Conventional academic discourses on the prime minister in Japans policy making are simply divided into three parts: prime ministers power is weak, strong or changeable depending on prime ministers individual leadership style. However, dichotomous thinking of whether the prime minister is merely strong or weak based on institutional factors or individual characteristic cannot effectively explain the sudden rise and fall of Japanese prime ministers leadership from 2001 to 2015 and paying attention to the organization of Kantei and its dynamism with politicians, bureaucracy and public opinion is important. Therefore, the paper deals with dynamics of policy making process among Kantei, politicians, bureaucrats and the public. Based on the result of comparison between Koizumi and second Abe administrations Kantei diplomacy, author argues that, with institutional benefit, both Koizumi and Abes Kantei which is comprised of professional and influential people were at the center of policy making process and effectively prevented the opposition from veto players such as politicians, bureaucrats and public. However, on the other hand, Koizumi and Abe had different strategies and Abe Kantei is more powerful than Koizumi Kantei because he holds veto players more tightly in his grip. Moreover, the comparison with weak premiership from 2006 to 2012 presents that it is convincing that strong Kantei leadership is back when Kantei which is organized by qualified and powerful people should overcome the influence from three veto players including politicians, bureaucrats and the public.I. INTRODUCTION 1 1. Puzzle 3 2. Purpose of Thesis 5 3. Methodology 7 II. LITERATURE REVIEW 10 1. Japans Policy Making Discourse since the 1970s 10 2. Discourse on the Role of Prime Minister in Policy Making Process 12 1) Weak Prime Minister School 12 2) Strong Prime Minister School 15 3) Prime Minister Leadership Style School 19 3. Contribution to Previous Literature 21 III. KOIZUMIS SECURITY POLICY MAKING PROCESS 25 1. Ceaseless Reform Kantei 27 2. Case Study: Kantei-led Three Security Bills 31 1) The Anti-Terrorism Special Measures Law in 2001 34 2) Emergency Legislation in 2003 35 3) Iraq Special Measures Legislation in 2003 37 3. Dynamics of Policy Making Process 39 1) Kantei and Politicians: Coalition First Strategy 39 2) Kantei and Bureaucracy: Reform the Castle of Demons 44 3) Kantei and Public Opinion: Influence Through Political Compromise 46 IV. ABES SECURITY POLICY MAKING PROCESS 52 1. Crisis Breakthrough Kantei 55 2. Case Study: Kantei-led Collective Self-Defense and Security Bill 60 1) Unfinished Business: NSC and State Secrecy Law in 2013 61 2) Changing Interpretation of Collective Self-Defense in 2014 64 3) Security Bills in 2015 67 3. Dynamics of Policy Making Process 71 1) Kantei and Politicians: Keeping Enemies Close Strategy 71 2) Kantei and Bureaucracy: Intimate Control with Personnel Choice 74 3) Kantei and Public Opinion: No Need to Compromise 77 V. COMPARISON BETWEEN KOIZUMI AND ABE 82 1. Commonality and Difference between Koizumi and Abe 82 2. Comparison with Weak Premiership 88 3. Analytical Findings 94 VI. CONCLUSION 98Maste

    [๊ณ ์šฉ๋™ํ–ฅ] OECD ํšŒ์›๊ตญ๊ฐ€์˜ ์ฒญ๋…„์‹ค์—… ๋™ํ–ฅ : ์ธ๋ ฅ์‹คํƒœ์กฐ์‚ฌ ๊ฒฐ๊ณผ๋ฅผ ์ค‘์‹ฌ์œผ๋กœ

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    ํ†ต๊ณ„์ฒญ์ด ๊ณตํ‘œํ•œ ๊ธˆ๋…„ 3์›” ๊ณ ์šฉ๋™ํ–ฅ์— ๋”ฐ๋ฅด๋ฉด ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ์‹ค์—…์ž์ˆ˜๋Š” 807์ฒœ๋ช…, ์‹ค์—…๋ฅ ์€ 3.6%์ด๋‹ค. ์ด ์ค‘ 15โˆผ29์„ธ ์ฒญ๋…„์ธต ์‹ค์—…์ž์ˆ˜๋Š” 406์ฒœ๋ช…์œผ๋กœ ์ „์ฒด์‹ค์—…์ž์ˆ˜์˜ 50.3%๋ฅผ ์ฐจ์ง€ํ•˜๋ฉฐ, ์‹ค์—…๋ฅ ์€ 8.1%๋กœ ์ „์ฒด ์‹ค์—…๋ฅ ๋ณด๋‹ค ์•ฝ 2.3๋ฐฐ ๋†’์€ ๊ฒƒ์œผ๋กœ ๋‚˜ํƒ€๋‚ฌ๋‹ค. 15์„ธ ์ด์ƒ ๋…ธ๋™๊ฐ€๋Šฅ์ธ๊ตฌ 37,226์ฒœ๋ช… ์ค‘ ์ฒญ๋…„์ธต์ด ์ฐจ์ง€ํ•˜๋Š” ๋น„์œจ์€ 28.0%์ž„์„ ๊ณ ๋ คํ•œ๋‹ค๋ฉด ์ฒญ๋…„์ธต์˜ ์‹ค์—…์ž๋Š” ๊ทธ๋ƒฅ ์ง€๋‚˜์น  ์ˆ˜ ์žˆ๋Š” ๋ฌธ์ œ๊ฐ€ ์•„๋‹˜์„ ์•Œ ์ˆ˜ ์žˆ๋‹ค. ์‚ฌ์‹ค ์ฒญ๋…„์ธต ์‹ค์—…๋ฌธ์ œ๋Š” ์šฐ๋ฆฌ๋‚˜๋ผ์—์„œ๋งŒ ๋ฐœ์ƒ๋˜๋Š” ๋ฌธ์ œ๊ฐ€ ์•„๋‹ˆ๊ณ  ๋Œ€๋ถ€๋ถ„์˜ ์„ ์ง„๊ตญ๊ฐ€๋“ค์ด ํ•ด๊ฒฐํ•ด์•ผํ•  ์ค‘์š”๊ณผ์ œ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค. ๋”ฐ๋ผ์„œ โ€œ2002๋…„ OECD ๊ณ ์šฉ์ „๋ง ๋ณด๊ณ ์„œโ€์— ์‹ค๋ ค์žˆ๋Š” ์ฒญ๋…„์ธต ์‹ค์—… ๊ด€๋ จ ํ†ต๊ณ„ํ‘œ๋ฅผ ๊ธฐ์ดˆ๋กœ ํšŒ์›๊ตญ๊ฐ€๋“ค์˜ ์ฒญ๋…„์ธต ์‹ค์—…๋™ํ–ฅ์„ ์‚ดํŽด๋ณด๋ฉด์„œ ์šฐ๋ฆฌ๋‚˜๋ผ๊ฐ€ ์ฒ˜ํ•ด ์žˆ๋Š” ์ฒญ๋…„์‹ค์—…์˜ ํ˜„์ฃผ์†Œ๋ฅผ ์ดํ•ดํ•˜๊ธฐ๋กœ ํ•˜์ž. 1. ๊ฒฝ์ œํ™œ๋™์ฐธ๊ฐ€์œจ 2. ์ทจ์—…๋น„์œจ 3. ์‹ค์—…

    (A) clinical study of leiomysarcomas of gastrointestinal tract

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    ์˜ํ•™๊ณผ/์„์‚ฌ[ํ•œ๊ธ€] ์œ„์žฅ๊ด€ ํ‰ํ™œ๊ทผ์œก์ข…์€ ๋‚ฎ์€ ๋ฐœ์ƒ๋นˆ๋„์™€ ๋Š๋ฆฐ ์„ฑ์žฅ์†๋„ ๋ฐ ์ž„์ƒ์ฆ์„ธ์˜ ๋‹ค์–‘์„ฑ ๋•Œ๋ฌธ์— ์ข…์–‘์ด ์–ด๋Š์ •๋„์˜ ํฌ๊ธฐ์— ์ด๋ฅด๊ธฐ ์ „๊นŒ์ง€๋Š” ํŠน๋ณ„ํ•œ ์ž๊ฐ ์ฆ์„ธ๋ฅผ ๋ณด์ด์ง€ ์•Š์•„ ์กฐ๊ธฐ ์ง„๋‹จ์ด ์–ด๋ ต๊ณ  ์ง„๋‹จ๋‹น์‹œ ์ด ๋ฏธ ์ง„ํ–‰๋œ ๊ฒฝ์šฐ๊ฐ€ ๋งŽ์•„์„œ ์˜ˆํ›„๊ฐ€ ๋ถˆ๋Ÿ‰ํ•œ ์•…์„ฑ์ข…์–‘์œผ๋กœ ์•Œ๋ ค์ ธ ์žˆ๋‹ค. ๋˜ํ•œ ์ง€๊ธˆ๊นŒ์ง€์˜ ๋ฌธํ—Œ๋ณด๊ณ ๊ฐ€ ๋Œ€๋ถ€๋ถ„ ์ฆ๋ก€๋ณด๊ณ ์ด๊ณ  ๋ณด๊ณ ๋œ ์ƒ์กด์œจ์˜ ์ฐจ์ด๊ฐ€ ๋งŽ์œผ๋ฉฐ ๋šœ๋ ทํ•œ ์น˜๋ฃŒ์ง€์นจ ์ด ์—†๋Š” ์ƒํƒœ์ด๋‹ค. ์ด์— ์ €์ž๋Š” 1980๋…„ 1์›”๋ถ€ํ„ฐ 1989๋…„ 12์›”๊นŒ์ง€ ์ตœ๊ทผ 10๋…„๊ฐ„ ์—ฐ์„ธ๋Œ€ํ•™๊ต ์˜๊ณผ๋Œ€ํ•™ ๋ถ€์† ์„ธ๋ธŒ๋ž€์Šค๋ณ‘์›๋ฐ ์—ฐ์„ธ ์•”์„ผํ„ฐ์—์„œ ์›๋ฐœ์„ฑ ์œ„ ์žฅ๊ด€ ํ‰ํ™œ๊ทผ์œก์ข…์œผ ๋กœ ํ™•์ง„๋œ 33์˜ˆ๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์ž„์ƒ์ƒ๊ณผ ์ถ”์ ์กฐ์‚ฌ๋ฅผ ํ†ตํ•œ ์ƒ์กด์œจ ๋ฐ ์ด์— ๋ฏธ์น˜๋Š” ์˜ˆํ›„์ธ์ž์— ๋Œ€ํ•˜์—ฌ ๋ถ„์„ํ•จ์œผ๋กœ์„œ ํ–ฅํ›„ ์น˜๋ฃŒ์˜ ์ง€์นจ ๋ฐ ์žฌ๋ฐœ๋ฐฉ์ง€์— ๊ธฐ์—ฌํ•˜๊ณ ์ž ๋ณธ ์—ฐ๊ตฌ๋ฅผ ์‹œ์ž‘ํ•˜์—ฌ ๋‹ค์Œ๊ณผ ๊ฐ™์€ ๊ฒฐ๊ณผ๋ฅผ ์–ป์—ˆ๋‹ค. 1. ์œ„ ์žฅ๊ด€ ํ‰ํ™œ๊ทผ์œก์ข…์˜ ํ˜ธ๋ฐœ์—ฐ๋ น์€ 40-60๋Œ€์ด๋ฉฐ ํ‰๊ท ์—ฐ๋ น์€ 54.7์„ธ์˜€๊ณ  ๋‚จ๋…€๋น„๋Š” 1.5:1์ด์—ˆ๋‹ค. 2. ์žฅ๊ธฐ๋ณ„ ๋ถ„ํฌ๋Š” ์œ„์žฅ 9์˜ˆ(27%), ์†Œ์žฅ19์˜ˆ (58%), ๋Œ€์žฅ 5์˜ˆ(15%)์˜€๋‹ค. 3. ์ฃผ์š” ์ž„์ƒ์†Œ๊ฒฌ์€ ๋ณต๋ถ€์ข…๊ดด(55%), ๋ณตํ†ต(36%), ์ถœํ˜ˆ(24%)์˜ ์ˆœ์ด์—ˆ๋‹ค. 4. ์ˆ˜์ˆ ์ „ ๋ฐ”๋ฅจ์กฐ์˜์ˆ , ๋‚ด์‹œ๊ฒฝ ๊ฒ€์‚ฌ, ๋ณต๋ถ€ ์ „์‚ฐํ™” ๋‹จ์ธต์ดฌ์˜๋“ฑ์„ ๋ณ‘ํ–‰ํ•˜์—ฌ 10์˜ˆ (30%)์—์„œ ์œ„ ์žฅ๊ด€ ํ‰ํ™œ๊ทผ์œก์ข…์„ ์ง„๋‹จํ•˜์˜€๊ณ , 5์˜ˆ (15%)์—์„œ ์ˆ˜์ˆ ์ „ ์กฐ์งํ•™์  ์ง„๋‹จ์ด ๊ฐ€๋Šฅํ•˜์˜€๋‹ค. 5. ์ข…์–‘์˜ ํ‰๊ท ํฌ๊ธฐ๋Š” 11.3cm (2.5-27.0 cm)์ด์—ˆ๊ณ  5cm ๋ฏธ๋งŒ 6์˜ˆ(18%), 5-10cm 9์˜ˆ (27%), 10cm ์ด์ƒ 18์˜ˆ (55%)์˜€๋‹ค. 6. ๋ณ‘๋ฆฌ์กฐ์ง์†Œ๊ฒฌ์„ ๋“ฑ๊ธ‰๋ณ„๋กœ ๋ถ„๋ฅ˜ํ•œ ๊ฒฐ๊ณผ ์ €๋„ ํ‰ํ™œ๊ทผ์œก์ข… 15์˜ˆ, ๊ณ ๋„ ํ‰ํ™œ๊ทผ์œก์ข… 18์˜ˆ์˜€์œผ๋ฉฐ ์กฐ์งํ•™์  ๋ถ„ํ™”๋“ฑ๊ธ‰๊ณผ ์ข…์–‘์˜ ๋ฐœ์ƒ๋ถ€์œ„, ํฌ๊ธฐ, ์ฃผ์œ„์กฐ์ง ์นจ์œค์ •๋„์˜ ๊ด€๊ณ„๋Š” ํ†ต๊ณ„์  ์œ ์˜ํ•˜์ง€ ์•Š์•˜๋‹ค. 7. ์ˆ˜์ˆ ์  ์ฒ˜์น˜ ๊ฒฐ๊ณผ ๊ทผ์น˜์  ์ ˆ์žฌ์œจ์€ 64%์˜€๊ณ  ๊ณ ์‹์  ์ ˆ์ œ์œจ์€ 24%๋กœ ์ „์ฒด ์ ˆ์ œ์œจ์€ 88%์—ˆ๋‹ค. 8. ๊ทผ์ง€์  ์ ˆ์ œ์ˆ  ํ›„ ์ „์ด๊ฐ€ ๊ฐ€์žฅ ํ˜ธ๋ฐœํ•œ ๋ถ€์œ„๋Š” ๊ฐ„์ด์—ˆ๋‹ค. 9. ์ˆ˜์ˆ ํ›„ ๋ฐฉ์‚ฌ์„  ์น˜๋ฃŒ๋‚˜ ํ•ญ์••ํ™”ํ•™์š”๋ฒ•์€ ์ƒ์กด๊ธฐ๊ฐ„์˜ ์—ฐ์žฅ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜์ง€ ๋ชปํ–ˆ๋‹ค. 10. ์ „์ฒด ํ™˜์ž์˜ 3๋…„, 5๋…„ ์ƒ์กด์œจ์€ ๊ฐ๊ฐ 41.6%, 17.2%์˜€๋‹ค. 11. ์ƒ์กด์œจ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ์˜ˆํ›„์ธ์ž๋ฅผ ๋‹ค๋ณ€๋Ÿ‰๋ถ„์„ (Multivariated analysis)ํ•œ ๊ฒฐ๊ณผ ๋ณ‘๋ฆฌ์กฐ์งํ•™์  ๋ถ„ํ™”๋“ฑ๊ธ‰๋ฐ ์ฃผ์œ„์กฐ์ง ์นจ์œค์—ฌ๋ถ€๊ฐ€ ์ค‘์š”ํ•˜์˜€๋‹ค. ์ด์ƒ์˜ ๊ฒฐ๊ณผ๋ฅผ ์ข…ํ•ฉํ•˜๋ฉด ์œ„์žฅ๊ด€ ํ‰ํ™œ๊ทผ์œก์ข…์€ ์˜ˆํ›„์ธ์ž์— ์ค€ํ•ด์„œ ์น˜๋ฃŒ๊ณ„ํš์ด ์ƒˆ์›Œ์ ธ์•ผ ํ•˜๊ณ , ๋ถˆ๋Ÿ‰ํ•œ ์˜ˆํ›„ ์ธ์ž์˜ ๊ฒฝ์šฐ ์ˆ˜์ˆ ํ›„ ๋ฐฉ์‚ฌ์„  ์น˜๋ฃŒ๋‚˜ ํ•ญ์••ํ™”ํ•™์š”๋ฒ•๋“ฑ์˜ ๋ณ‘ํ•ฉ์š”๋ฒ•์˜ ํ•„์š”์„ฑ์ด ์ œ๊ธฐ๋˜๋‚˜ ํ–ฅํ›„ ์ด์— ๋Œ€ํ•œ ์ „ํ–ฅ์  ์—ฐ๊ตฌ๊ฐ€ ํ•„์š”ํ•  ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค. [์˜๋ฌธ] Thirty-three patients with primary gastrointestinal leiomyo-sarcoma treated at Yonsei Medical Center from Jan.1980 to Dec.1989 were studied retrospectively to identify clinical presentation, hiatopathologic feature, treatment modality, and possible prognostic factors. The following results were obtained. 1. The median age of the patients was 54.7 years. The male and female ratio was 1.5 to 1. 2. The primary site was stomach 9, small bowel 19, and large bowel in 5. 3. The poet common symptom and sign were abdominal mass (55%), abdominal pain (36%), and bleeding (24%). 4. It was possible to obtain a preoperative diagnosis using barium study combined with endoscopic biopsy and abdominal CT scan in 10 cased (30%) of gastrointestinal leiomyosarcomas. 5. The average sine of tumors was 11.3 cm(2.5-27.0 cm). 6. The low grade tumors were 15 cases, and high grade tumors were 18 cases. The histopathologic grading was not significantly correlated with site and size of tumor, and invasion of adjacent organs. 7. The overall resectability was 88% ; 64% of the tumor were rejected curatively and 24% were palliatively. 8. The most common trite of metastasis after curative resection was liver. 9. The postoperative radiation therapy and/or chemotherapy did not influence to survival . 10. The actuarial 3-and 5-year survival rate of gastrointestinal leiomyosarcoma were 41.6%, 17.2%. 11. The multivariate analysis for prognostic factors showed a prognosis based on histopathologic grade and invasion of adjacent orleans. It is concluded that the gastrointestinal leiomyosarcoma should be managed according to prognostic factors, and further trial of combined modality treatment for patients with adverse prognostic factors is warrented.restrictio
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