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Rechtliche Probleme $\ddot{u}$ber die Patienten im Arztvertarg (의료계약의 당사자로서의 "환자"와 관련한 문제에 대한 검토)

  • Kim, Min-Joong
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.253-286
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    • 2009
  • Die $\ddot{a}$mrztliche Behandlung des Patienten durch den Arzt geschieht im Rahmen eines Rechtsverh$\ddot{a}$ltnisses. Das Arzt-Patienten-Rechtsverh$\ddot{a}$ltnis stellt regelm$\ddot{a}$ssig der Arztvertrag oder Behandlungsvertrag dar. Arzt und Patient schliessen einen Arztvertrag ab. Grunds$\ddot{a}$tzlich verbindet der Arztvertrag die Partner pers$\ddot{o}$nlich. Aber minderj$\ddot{a}$hrige Patienten sind gesch$\ddot{a}$ftsunf$\ddot{a}$hig oder in der Gesch$\ddot{a}$ftsf$\ddot{a}$higkeit beschr$\ddot{a}$nkt. Minderj$\ddot{a}$hrige Patienten verm$\ddot{o}$gen also allein grunds$\ddot{a}$tzlich keine wirksamen Willenserkl$\ddot{a}$rungen abzugeben und somit keine wirksamen Arztvertr$\ddot{a}$ge zu schliessen. Arztvertr$\ddot{a}$ge von minderj$\ddot{a}$hrigen Patienten sind nur bei Einwilligung der gesetzlichen Vertreter wirksam. Vom Abschluss des Arztvertrags ist deutlich die Einwilligung zur Behandlung zu unterscheiden. Die Einwilligung ist kein Rechtsgesch$\ddot{a}$ft. Die Einwilligung durch die Eltern erfolgt nur solange der minderj$\ddot{a}$hrige Patient nicht reif genug ist, die Entscheidung selbst zu treffen. Jugendlicher Patient ist z.B. in der Lage, die Einwilligung selbst zu geben, sofern er Wesen, Bedeutung und Tragweite der Behandlung zu verstehen vermag. Der Vorschriften des KBGB zur Gesch$\ddot{a}$ftsf$\ddot{u}$hrung ohne Auftrag gelten, wenn der Arzt einen Bewusstlosen versorgt. Nach $\S$734 KBGB erfolgt die Gesch$\ddot{a}$ftsf$\ddot{u}$hrung ohne Auftrag dann zu Recht, wenn sie dem Interesse und dem wirklichen oder mutmasslichen Willen des Patienten entspricht. Der Patient kann aus einem Ausland stammen. F$\ddot{u}$r ausl$\ddot{a}$ndische Patienten gilt generell das koreanische Recht. Grunds$\ddot{a}$tzlich sollte man einen des Koreanischen nicht m$\ddot{a}$chtigen Ausl$\ddot{a}$nder nach M$\ddot{o}$glichkeit in seiner Sprache aufkl$\ddot{a}$ren und dann den Arztvertrag abschliessen. Aufgrund der Privatautonomie kann jeder Patient frei entscheiden, ob, mit wem und wor$\ddot{u}$ber er einen Arztvertrag abschliesst. Deswegen ist auch der Wille des Anh$\ddot{a}$ngers vom Sekten und abweichenden Lebensauffassung grunds$\ddot{a}$tzlich zu ber$\ddot{u}$cksichtigen. Zum Beispiel handelt der Zeuge Jehovas auf eigene Gefahr, wenn er eine notwendige Behandlung ablehnt. Aber die Freiheit, eine gebotene Behandlung abzulehnen, kann in Konflikt mit dem Schutz des minderj$\ddot{a}$hrigen Patienten gelangen. Sobald die sektiererische oder abweichende Haltung droht, einen minderj$\ddot{a}$hrigen Patienten zu gef$\ddot{a}$hrden, hat das elterliche Sorgerecht einzuschr$\ddot{a}$nken.

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Human Surfactant Protein-A(SP-A) Gene Locus Associated with Mycoplasma pneumoniae Pneumonia in Korean Children (Mycoplasma pneumoniae 폐렴과 관련된 폐 표면 활성제 단백-A(Human Surfactant Protein-A) 유전자 대립 형질)

  • Kim, Seung Soo;Lee, In Kyu;Ko, Jung Ho;Oh, Myung Ho;Bae, Chong Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.376-379
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    • 2005
  • Purpose : Mycoplasama pneumoniae is a leading cause of pneumonia and exacerbates other respiratory conditions such as asthma. Surfactant protein A(SP-A) is involved in surfactant physiology and surfactant structure, and plays a major role in innate host defense and inflammatory processes in the lung. In this study, SP-A mediated mycoplasma cidal activity. The candidate-gene approach was used to study the association between the SP-A gene locus and Mycoplasama pneumoniae pneumonia in the genetically homogeneous Korean population. Methods : PCR-cRFLP-based methodology was used to detect SP-A genotype. The forty nine children with Mycoplasama pneumoniae pneumonia were matched to 50 nomal neonates. Results : The specific frequencies for the alleles of the SP-A1 and SP-A2 gene in the study population were : $6A^2=21$ percent, $6A^3=45$ percent, $6A^4=11$ percent, $6A^8=9$ percent, $6A^{14}=8$ percent, 1A=11.3 percent, $1A^0=38$ percent, $1A^1=12.7$ percent, $1A^2=9.2$ percent, $1A^5=15.5$ percent, $1A^7=2.9$ percent, $1A^8=4.9$ percent, $1A^9=2.2$ percent, others=3.3 percent. The frequencies of specific genotypes such as $1A^2$ was higher than control group, significantly. Conclusion : $1A^2$ are susceptible factors for Mycoplasama pneumoniae pneumonia. We conclude that the SP-A gene locus($1A^2$) is an important determinant for predisposition to Mycoplasama pneumoniae pneumonia in children.

A PROPERTY OF COFUNCTORS SF(X,A)

  • So, Kwang Ho
    • Kyungpook Mathematical Journal
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    • v.13 no.2
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    • pp.235-240
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    • 1973
  • A k-dimensional vector bundle is a bundle ${\xi}=(E,P,B,F^k)$ with fibre $F^k$ satisfying the local triviality, where F is the field of real numbers R or complex numbers C ([1], [2] and [3]). Let $Vect_k(X)$ be the set consisting of all isomorphism classes of k-dimensional vector bundles over the topological space X. Then $Vect_F(X)=\{Vect_k(X)\}_{k=0,1,{\cdots}}$ is a semigroup with Whitney sum (${\S}1$). For a pair (X, A) of topological spaces, a difference isomorphism over (X, A) is a vector bundle morphism ([2], [3]) ${\alpha}:{\xi}_0{\rightarrow}{\xi}_1$ such that the restriction ${\alpha}:{\xi}_0{\mid}A{\longrightarrow}{\xi}_1{\mid}A$ is an isomorphism. Let $S_k(X,A)$ be the set of all difference isomorphism classes over (X, A) of k-dimensional vector bundles over X with fibre $F^k$. Then $S_F(X,A)=\{S_k(X,A)\}_{k=0,1,{\cdots}}$, is a semigroup with Whitney Sum (${\S}2$). In this paper, we shall prove a relation between $Vect_F(X)$ and $S_F(X,A)$ under some conditions (Theorem 2, which is the main theorem of this paper). We shall use the following theorem in the paper. THEOREM 1. Let ${\xi}=(E,P,B)$ be a locally trivial bundle with fibre F, where (B, A) is a relative CW-complex. Then all cross sections S of ${\xi}{\mid}A$ prolong to a cross section $S^*$ of ${\xi}$ under either of the following hypothesis: (H1) The space F is (m-1)-connected for each $m{\leq}dim$ B. (H2) There is a relative CW-complex (Y, X) such that $B=Y{\times}I$ and $A=(X{\times}I)$ ${\cap}(Y{\times}O)$, where I=[0, 1]. (For proof see p.21 [2]).

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Carbon Catabolite Repression (CCR) of Expression of the XylanaseA Gene of Bacillus stearothermophilus No.236

  • Ha, Gyong-Sik;Choi, Il-Dong;Choi, Yong-Jin
    • Journal of Microbiology and Biotechnology
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    • v.11 no.1
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    • pp.131-137
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    • 2001
  • Previous work has identified that only the catabolite responsive element A (creA; previously called cre-2) out of two potential cre sequences (cre-1: nucleotide +160 to +173 and cre-2: +173 to +186), recognized within the coding region of the xylanaseA gene (xynA) of Bacillus stearothermophilus No.236, was actually, was actually involved in the carbon catabolite repression(CCR) of xynA expression in B. subtilis. However, the level of CCR of xynA expression in the original B.stearothermophilus No.236 strain (70-fold repression). Therefore, to search for an additional cre element in the promoter region, the upstream region of the xynA gene was subcloned by chromosome walking, and as a result, another potential cre element (nucleotide -124∼-137; designated creB) was recognized in this region. The cre-like sequence revealed a high homology to the cre consensus sequence. The xylanase activity of B. subtilis MW15 bearing pWPBR14 (containing creA and creB) cultured in a medium containing xylose as the sole carbon source was about 7.7 times higher than that observed for the same culture containing glucose. B. subtilis MW15 bearing pWPBR23 (containing only creA) produced an activity about 2.4 times higher. This pattern of CCR was confirmed using derivatives of xynA::aprA fusion plasmids. Furthermore, a measurement of the amounts of the xynA transcript showed a similar pattern as that for the production of xylanase. In addition, the synthesis of xylanase in B. subtilis QB7115 [a catabolite control protein A (ccpA) mutant strain] carrying pWPBR14 was almost completely relieved from glucose repression. Together, these results lead to a conclusion that the CCR of the expression of the xynA gene is mediated by CcpA binding at creA and creB sites in B. subtilis.

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A WblA-Binding Protein, SpiA, Involved in Streptomyces Oxidative Stress Response

  • Kim, Jin-Su;Lee, Han-Na;Lee, Heung-Shick;Kim, Pil;Kim, Eung-Soo
    • Journal of Microbiology and Biotechnology
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    • v.23 no.10
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    • pp.1365-1371
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    • 2013
  • The Streptomyces coelicolor wblA gene is known to play a negative role in both antibiotic biosynthesis and the expression of genes responding to oxidative stress. Recently, WhcA, a WblA ortholog protein, was confirmed to interact with dioxygenase-encoding SpiA ($\underline{s}$tress $\underline{p}$rotein $\underline{i}$nteracting with Whc$\underline{A}$) in Corynebacterium glutamicum. We describe here the identification of a SpiA ortholog SCO2553 protein ($SpiA_{sc}$) that interacts with WblA in S. coelicolor. Using heterologous expression in E. coli and in vitro pull-down assays, we show that WblA specifically binds $SpiA_{sc}$, and is influenced by oxidants such as diamide. These data indicate that the interaction between WblA and $SpiA_{sc}$ is not only specific but also modulated by the redox status of the cell. Moreover, a $spiA_{sc}$-disruption mutant exhibited a less sensitive response to the oxidative stress induced by diamide present in solid plate culture. Real-time RT-PCR analysis also showed that transcription levels of oxidative stress response genes (sodF, sodF2, and trxB) were higher in the $spiA_{sc}$-deletion mutant than in wild-type S. coelicolor. These results show that $SpiA_{sc}$ negatively regulates WblA during oxidative stress responses in S. coelicolor.

CsA Affects the Rat Submandibular Glands via Regulating the CypA Expression

  • Lee, Eun-Joo;Hong, Young-Gil;Yoo, Hong-Il;Yang, So-Young;Kang, Jee-Hae;Kim, Min-Seok;Kim, Sun-Hun
    • International Journal of Oral Biology
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    • v.37 no.4
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    • pp.153-159
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    • 2012
  • The effects of the an immunosuppressive drug cyclosporine A (CsA), on the salivary gland are largely unknown, even though clinical trials for the stimulation of salivation using CsA have been attempted. Cyclophilin A (CypA) is known to be a binding protein for CsA. CypA has cell proliferation and tissue matrix change activities. In our present study, the presence of CypA in the gland and effects of CsA on CypA expression were investigated by immunohistochemistry, immunoblotting and RT-PCR analyses. CypA was immunohistochemically detected in various kinds of ducts in the submandibular glands of Sprague Dawley rats. The CypA mRNA level was highest at postnatal day 1 and gradually decreased in a time-dependent manner up to adulthood. The expression of CypA increased after a 10 day subcutaneous administration of CsA in postnatal day 1 rats. Surgical sections of the chorda-lingual nerve with impaired salivation showed no changes in CypA expression. A cell proliferation assay using PCNA anti-serum showed increased cell division following CsA treatment. These results suggest that CsA and CypA may act on ductal cells to regulate saliva composition rather than salivation levels.

Comparison and an evaluation of a component technology for a Web system development and application based on CBD (CBD 기반의 웹 시스템 개발 적응을 위한 컴포넌트 기술 비교 평가)

  • 나윤지
    • The Journal of the Korea Contents Association
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    • v.2 no.4
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    • pp.59-66
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    • 2002
  • As for the software development, it is complicated, and size of software is growing larger. And contraction of a software development period is required acutely because it is short a period of software life cycle. Also, it becomes harder development and a maintenance because it is short a life cycle of developed software. According to this an effort is increased in order to reduce a development cost and time as using a component to have been implemented previously in development of software. A current component technology is developing into a very fast speed and is bringing a large change into development of a Web base system in addition to existing software development method. In this paper, we were handling a related technology for Web system development of a CBD base systematically and derived an issue to apply it to development of a Web system and presented an efficient practical use method of a component technology. First of all we looked into a component technology and a CBD methodology systematically and described a component technology in Web. Also, we proposed a method to increase development and efficiency of practical use of a Web system based on a component. The this study result can decrease a development cost of a Web system and a load of maintenance management through the re-use of a code.

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A Study of Pulse Diagnosis in "Onbyeongjobyeon(溫病條辨)" ("온병조변(溫病條辨)"에 나타난 맥진(脈診) 연구(硏究))

  • Kwon, Jung-Hyun;Baik, You-Sang
    • Journal of Korean Medical classics
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    • v.23 no.3
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    • pp.23-48
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    • 2010
  • Onbyeong(溫病) is called an acute epidemic febrile disease caused by warm pathogen, a major symptom of Onbyeong is high fever. Doctrine of Onbyeong is a study of an occurrence, progress and treatments of an acute epidemic febrile disease. Doctrine of Onbyeong is valid in the Cheong Dynasty at China. Now, a theory of doctrine of Onbyeong at China and Korea is being applied in not only an acute febrile disease but also many other lifestyle diseases. Onbyeongjobyeon is a book written by Oguktong(吳鞠通). Oguktong was influenced by Jangjung-gyeong(張仲景) "Sanghanron(傷寒論)". Oguktong had organized Seopcheonsa(葉天士)'s medical thoughts and Oguktong's medical experiences. A Samcho(三焦) deteriorated case is divided into three groups - Upper, Middle and Lower-energizer - that is discussed of a vertical progress of Onbyeong. And a Wigiyeonghyeol(衛氣營血) deteriorated case is divided into four groups - Wi, Gi, Yeong and Hyeol - that is discussed of a horizontal progress of Onbyeong. In Korean medicine, there are four types of diagnosis which are watching, listening, asking and taking. Informations, got by four types diagnosis are synthesized and classified for medical treatments. A pulse diagnosis belongs to a method by taking a wrist among four diagnosis. A Korean Medicine doctor makes a conclusion of cause, region and condition of disease by taking a pulse. Because all organs in human body are connected by a meridian system. organs conditions are reflected in a meridian system. So by taking a pulse, a progress and a prognosis of disease is diagnosed In this thesis, by taking a pulse on "Onbyeongjobyeon(溫病條辨)", a location and a feature of disease's cause with weakness and strength of a vital force are examined, and a character of a pulse diagnosis of Onbyeong is examined.

An Evaluation of Major Nutrients of Four Farmed Freshwater Eel Species (Anguilla japonica, A. rostrata, A. bicolor pacifica and A. marmorata) (국내양식 민물장어 4 종(Anguilla japonica, A. rostrata, A. bicolor pacifica 및 A. marmorata)의 주요 영양성분의 평가)

  • Ahn, Jun Cheul;Chong, Won-Seog;Na, Jin Ho;Yun, Hyoeng Bok;Shin, Kyung Jae;Lee, Kyeong Woo;Park, Jun Taek
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.48 no.1
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    • pp.44-50
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    • 2015
  • The basic and main nutritive ingredients of two temperature (Anguilla japonica and A. rostrata) and two tropical (A. bicolor pacifica and A. marmorata) fresh water eel species that are farmed domestically were evaluated. With exception of A. rostrata, eels cultured at the same farm were used for analysis. The contents of crude protein were in the order A. marmorata (17.7%)>A. rostrata (17.5%)>A. bicolor pacifica (17.4%)>A. japonica (15.8%) and the contents of crude lipids were A. japonica (21.5%)>A. rostrata (15.4%)>A. bicolor pacifica (10.5%)>A. marmorata (8.9%). These values differed significantly even among the three species of eel farmed under identical culture conditions. In comparison, all four species of eel showed similar pattern in overall amino acid composition, although slight differences in the compositions of some amino acids were observed. The fatty acid compositions of muscle tissues were notably different among four species of eel, especially between the tropical and temperature eels. In a taste-test of the meat of the four eel species, which considered taste, flavor and texture, the overall preference was in the order A. japonica, A. marmorata, A. bicolor pacifica and A. rostrata.