수필:낙엽,아빠를 닮은 눈사람,햇빛을 잃은 아이들,완행버스,가난한 사람의 노자,애사서린 고장을 찾아서

양희석,신택한,문혜영,김종원,이광우,유두영 북한연구소 1983 北韓 Vol.- No.135

Magnetic Resonance Image Findings of Lumbar Prevertebral Aortocaval Structures in Korean Spinal Disorder Patients

양희석,김성호,장철훈,김오룡,조수호,배장호 대한신경외과학회 2004 Journal of Korean neurosurgical society Vol.36 No.6

Objective : The purpose of this study is to evaluate the level of lumbar spine corresponding to the prevertebral major vascular structures and the distance of the prevertebral available disc space (DPADS) of L5-S1 between the common iliac arteries and veins with preoperative magnetic resonance imaging (MRI) study. Methods : Three hundred and forty seven lumbar MRI films (200males and 147females) from spinal disorder patients were reviewed. The patients' age ranged 14 to 86 years (mean 45 years). The patients were divided into eight groups by 10-year interval from a teen to the eighties. There were evaluated age-related locational changes in the level of lumbar spine corresponding to the aortic bifurcation (AB) and the origin of inferior vena cava (OIVC). In addition, DPADS of L5-S1 between the common iliac arteries and veins were measured. Results : The common sites of the AB for the entire subject group were at the upper body of L4 (from the upper body of L3 to the lower body of L5). The common sites of the OIVC for the entire subject group were at the level of the L4-L5 disc space (from the upper body of L4 to the lower body of L5). The age-related changes in the location of the AB with a downward shift were statistically significant (p< 0.05). Similarly, age-related changes were observed in the OIVC, although this was more prominent in females (p<0.05). The average DPADS of L5-S1 was 34.48±10.00 mm. There were 27 cases(7.8%) who had the DPADS less than 20mm, and this narrow DPADS could make it very difficult to access the anterior disc space of L5-S1 because recently the popularly used anterior lumbar fusion materials were over 10 mm in diameter. Conclusion : These results may be helpful to minimize potential vascular injury and morbidity in anterior lumbar spinal surgery.

온도감응성 마이크로캐리어를 이용한 세포 계대배양

양희석,김병수,서지혜 한국조직공학과 재생의학회 2009 조직공학과 재생의학 Vol.6 No.13

Microcarrier culture systems are frequently used for large-scale culture of anchorage-dependent mammalian cells. Mass production of a large amount of cells needs serial propagation in microcarrier culture. This requires enzyme treatment which could be a complex step in large-scale cell culture and cause cell damage. Thus, we have developed thermo-sensitive microcarriers by incorporating poly-N-isopropylacrylamide (pNIPAAm) onto Cytodex-3® (pNIPAAm-Cytodex). In this study, we tested the feasibility of serial propagation of Vero cells cultured on pNIPAAm-Cytodex microcarriers in three-dimensional bioreactors. Cells cultured on pNIPAAm-Cytodex were detached from pNIPAAm-Cytodex by a moderate change in temperature without enzyme treatment. This would simplify the complex serial propagation steps, avoid cell damage possibly caused by enzyme treatment, and enable one to easily harvest cells, because cells can be detached from microcarriers without enzyme treatment. Vero cells adhered, spread, and grew successfully on the thermo-sensitive microcarriers similarly to Cytodex microcarriers, and were harvested by simple temperature changes, thereby avoiding the use of proteolytic enzymes and laborious and time-consuming processes. Moreover, Vero cells detached by temperature change reattached and grew on pNIPAAm-Cytodex after scale-up in a manner similar to culture on Cytodex. The pNIPAAm-Cytodex microcarrier culture method would be useful for the mass production of biologicals through large-scale suspension culture of anchorage-dependent mammalian cells. Microcarrier culture systems are frequently used for large-scale culture of anchorage-dependent mammalian cells. Mass production of a large amount of cells needs serial propagation in microcarrier culture. This requires enzyme treatment which could be a complex step in large-scale cell culture and cause cell damage. Thus, we have developed thermo-sensitive microcarriers by incorporating poly-N-isopropylacrylamide (pNIPAAm) onto Cytodex-3® (pNIPAAm-Cytodex). In this study, we tested the feasibility of serial propagation of Vero cells cultured on pNIPAAm-Cytodex microcarriers in three-dimensional bioreactors. Cells cultured on pNIPAAm-Cytodex were detached from pNIPAAm-Cytodex by a moderate change in temperature without enzyme treatment. This would simplify the complex serial propagation steps, avoid cell damage possibly caused by enzyme treatment, and enable one to easily harvest cells, because cells can be detached from microcarriers without enzyme treatment. Vero cells adhered, spread, and grew successfully on the thermo-sensitive microcarriers similarly to Cytodex microcarriers, and were harvested by simple temperature changes, thereby avoiding the use of proteolytic enzymes and laborious and time-consuming processes. Moreover, Vero cells detached by temperature change reattached and grew on pNIPAAm-Cytodex after scale-up in a manner similar to culture on Cytodex. The pNIPAAm-Cytodex microcarrier culture method would be useful for the mass production of biologicals through large-scale suspension culture of anchorage-dependent mammalian cells.

3D Printer Application for Endoscope-Assisted Spine Surgery Instrument Development: From Prototype Instruments to Patient-Specific 3D Models

양희석,박정윤 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.1

Developing new surgical instruments is challenging. While making surgical instruments could be a good field of application for3D printers, attempts to do so have proven limited. We designed a new endoscope-assisted spine surgery system, and using a 3Dprinter, attempted to create a complex surgical instrument and to evaluate the feasibility thereof. Developing the new surgical instrumentsusing a 3D printer consisted of two parts: one part was the creation of a prototype instrument, and the other was the productionof a patient model. We designed a new endoscope-assisted spine surgery system with a cannula for the endoscope andworking instruments and extra cannula that could be easily added. Using custom-made patient-specific 3D models, we conducteddiscectomies for paramedian and foraminal discs with both the newly designed spine surgery system and conventional tubularsurgery. The new spine surgery system had an extra portal that can be well bonded in by a magnetic connector and greatly expandedthe range of access for instruments without unnecessary bone destruction. In foraminal discectomy, the newly designed spinesurgery system showed less facet resection, compared to conventional surgery. We were able to develop and demonstrate the usefulnessof a new endoscope-assisted spine surgery system relying on 3D printing technology. Using the extra portal, the usabilityof endoscope-assisted surgery could be greatly increased. We suggest that 3D printing technology can be very useful for the realizationand evaluation of complex surgical instrument systems.

보험금청구권과 상속관련 법적 문제

양희석 (사)한국보험법학회 2017 보험법연구 Vol.11 No.2

Life insurance's main purpose is ensuring the survival of the bereaved family members after they die, so usually someone who is not an insured person is designated as an insurance beneficiary. If the heirs of the insured or the beneficiary of the insurance obtain the right to claim the insurance, various legal issues occur related to inheritance. However, the commercial law does not have a related regulation, and it causes confusion in practice. If the heir becomes the beneficiary of the insurance, the benefit of the beneficiary of the insurance is the inherentor's own property, not inherited property, as it is due to the effect of the life insurance contract. The intention of the party seems to include not only the status of the heir of the beneficiary but also the inheritance rate of the insurance beneficiary among coinheritor, so the amount calculated under Korean Civil Law is fair. Even if the heir refuses the succession at the time of death of the insured, he/she can take any proceeds. Any beneficiary who intentionally causes the death of the insured is disqualified form receiving the proceeds according to the policy terms. Meanwhile, Korean Civil Law prescribes disqualification of inheriting those who have committed acts referred to in non-ethics behavior. According to the prescription, the disqualification of succession is disqualified form receiving the proceeds according to the policy terms. Although the right to claim insurance is the inheritor's own property and not included in the object of econsultation division of inheritance property, it is valid in principle of private autonomy to include and divide. When one of the inheritors of a insured is designated as a insurance beneficiary, he/she can take death benefits. However, death benefits has certain points of likeness to inheritance in that is it paid by the his death, in some exceptional cases there is special circumstances that harms the equity of other inheritance seriously, the death benefits can beregarded as special benefits in Korean Civil Law. And in this case, death benefit as special benefits can be counted on the basis for legal reserve of inheritance. 생명보험은 피보험자가 사망한 후 유족들의생활을 보장하는 것을 주된 목적으로 하므로 피보험자가 아닌 타인을 보험수익자로 지정하는 것이 통상적인데, 피보험자가 사망하여 피보험자나 보험수익자의 상속인들이 보험금청구권을 취득하는 경우 상속과 관련된여러 가지 법적 쟁점들이 문제된다. 그러나 상법에서는 이와 관련된 규정을 두고 있지 않아실무상 혼란을 야기하고 있다. 상속인이 보험수익자가 되는 경우에 보험수익자의 보험금청구권은 타인을 위한 생명보험계약의 효력으로 당연히 생기는 것으로서 상속재산이 아니라 상속인의 고유재산이 된다. 이때당사자의 의사는보험수익자의상속인의지위 뿐아니라그상속비율까지 포함하는것이라고 보이므로 보험금청구권은 이들의 상속분의 비율에 따라 귀속한다. 상속인이 고유재산으로보험금청구권을취득하는경우상속채무에대하여한정승인을하거나상속을포기하더라도보험금청구권을행사하여보험금을수령할수있게된다. 보험수익자중일부가보험사고를발생시킨 경우당해보험수익자에대하여만 상법에따라보험자가면책되며 나머지수익자들에 대해서는 면책된 부분을 제외한 나머지 보험금만 지급하면 된다. 민법상 상속결격의경우소급하여상속인의지위를상실하고보험의선의성, 계약자의의사에반하므로해당법정상속인은 보험금청구권을 취득하지 못한다. 피보험자나 보험수익자의 상속인이 보험금청구권을 취득하는 경우 고유재산이므로 상속재산분할대상에 포함되지 아니하나, 비록 상속인의고유재산이더라도상속인들이상속인들사이에공평을기하기위하여스스로상속재산분할협의 대상에 포함시켜 분할하는 것은 사적 자치의 원칙상 유효하다. 상속인 중 일부를 보험수익자로 지정한 경우, 비록 상속인의 보험금청구권은 상속재산이아니라 상속인의 고유재산에 해당하지만, 피상속인인 보험계약자가 보험료를 지급하였으면이는 유증이나 사인증여에 준하는 무상처분에 해당하며, 공동상속인 간의 형평을 도모할 필요가있으므로 특별수익에준하는것으로보아 공동상속인간의형평을심각하게 해하는사정이 있는 경우에는 반환을 긍정할 수 있고, 유류분을 침해하는 경우에는 유류분반환대상에도 해당할 수 있다.

조선소 선반기계가공 근로자에서 발생한 우측 슬관절 내외측 반월상연골손상 1례

양희석,김정일,정갑열,김세영,정지현,최석환 대한직업환경의학회 2011 대한직업환경의학회 학술대회 논문집 Vol.2011 No.11

Comparison between heparin-conjugated fibrin and collagen sponge as bone morphogenetic protein-2 carriers for bone regeneration

양희석,Wan-Geun La,Yong-Min Cho,Wangsoo Shin,Guw-Dong Yeo,김병수 생화학분자생물학회 2012 Experimental and molecular medicine Vol.44 No.5

Bone morphogenetic protein-2 (BMP-2) is used to promote bone regeneration. However, the bone regeneration ability of BMP-2 relies heavily on the delivery vehicle. Previously, we have developed heparin-conjugated fibrin (HCF), a vehicle for long-term delivery of BMP-2 and demonstrated that long-term delivery of BMP-2 enhanced its osteogenic efficacy as compared to short-term delivery at an equivalent dose. The aim of this study was to compare the bone-forming ability of the BMP-2 delivered by HCF to that delivered by clinically utilized BMP-2 delivery vehicle collagen sponge. An in vitro release profile of BMP-2 showed that HCF released 80% of the loaded BMP-2 within 20days, whereas collagen sponge released the same amount within the first 6 days. Moreover, the BMP-2 released from the HCF showed significantly higher alkaline phosphatase activity than the BMP-2 released from collagen sponge at 2 weeks in vitro. Various doses of BMP-2 were delivered with HCF or collagen sponge to mouse calvarial defects. Eight weeks after the treatment,bone regeneration was evaluated by computed tomography, histology, and histomorphometric analysis. The dose of BMP-2 delivered by HCF to achieve 100% bone formation in the defects was less than half of the BMP-2 dose delivered by collagen sponge to achieve a similar level of bone formation. Additionally, bone regenerated by the HCF-BMP-2 had higher bone density than bone regenerated by the collagen sponge-BMP-2. These data demonstrate that HCF as a BMP-2 delivery vehicle exerts better osteogenic ability of BMP-2 than collagen sponge, a clinically utilized delivery vehicle.

암보험에서 임상학적으로 악성이나 병리학적으로 양성인 경우 암인지 여부 -대법원 2018. 6. 28. 선고 2018다203395 판결-

양희석 (사)한국보험법학회 2019 보험법연구 Vol.13 No.1

Nowadays there are lots of dispute about cancer insurance, as being developed the diagnostic technique, found early many kinds of tumors. But it has lacked of discussion the issue in spite of finding the clue to the problem in judicial dimension. In interpreting the insurance contract, understanding the consistent criterion of our Supreme court is very important point. The standard cancer insurance terms provide cancer should be originally reconized by pathological examination, and substitutingly reconized by clinical examination only if histological examination is impossible. The problem is whether the clinical exmination can be reconized as proof of cancer in spite of pathologically positive reaction. It has been practically causing confusion among rather different conclusions about the same issue. The former court decesion about pituitary tumor(supreme court 2002. 7. 12. 2002da19940) has allowed borderline malignancy or benign tumour as cancer if it’s critical and dangerous in aspect of occuring part. But the recent court decision about pituitary tumor(supreme court 2018. 6. 28. 2018da203395) denies it and decide “Uunless the policyholder and insurance company make a commitment to pay more malignant tumors for benign tumors that are at risk for malignangt tumors at the time the insurance contract is concluded, insurance company can not simply pay the insurance against the explicit commitment with the risk. If so, there is a fear the the reasons for the payment of insurance money become unclear and may be arbitrarily expanded or reduced”. The clinical examination can not be accepted easily in cancer insurance. The proof of cancer should be strict. In this sense, the recent supreme court also reconizes it. 암보험약관은 암에 대한 진단확정은 원칙적으로 병리학적 진단 방법에 따르고 병리학적 진단이 가능하지 않을 때는 임상학적 진단이 보충적으로 사용될 수 있다고 정하고 있다. 그동안 판례는 일관된 해석을 하지 못하고 구체적인 사안에 따라 병리학적으로는 암이 아님에도 불구하고 임상학적으로 발생 부위, 재발가능성 등에 비추어 위험하다고 인정되는 경우 암으로 인정한 판례와 병리학적 진단을 우선한 판례들로 나뉘고 있었다. 특히, 뇌하수체 종양에 관한 대법원 2002. 7. 12. 선고 2002다19940 판결에서 조직학적으로 악성에 해당하지 아니하더라도 임상학적으로 볼 때 악성이라면 암보험에서 담보하는 '암'에 해당한다고 볼 수 있다고 판시한 이후로 위 2002다19940 판결을 인용한 판결들이 대법원 및 하급심에서 반복되었다. 그러나 임상학적으로 암인지 여부에 대해서는 개별 사안마다 판단이 다를 수밖에 없으므로 분쟁의 소지를 더욱 크게 만든다. 따라서 임상학적 진단을 기초로 보험금 청구를 인정하는 것은 신중할 필요가 있다. 더구나 암보장의 경우 보험금이 크고 분쟁이 많으므로 암의 증명은 조직학적 증명으로 명확하여야 하며, 단순히 임상학적으로 인정하는 것은 신중해야 한다. 최근 선고된 대법원 2018. 6. 28. 선고 2018다203395 판결은 위 2002다19940 판결과 동일한 뇌하수체 종양으로서 임상학적 양상도 거의 유사했던 사안으로서 “보험계약체결 당시 악성종양에 준할 만큼 위험한 양성종양에 대해서도 악성종양으로 보아 보험금을 지급한다는 약정을 하지 않은 이상 단순히 그 위험성만으로 명시적 약정에 반하여 보험금을 지급할 수는 없다. 이렇게 해석하면 보험금 지급사유가 매우 불분명해지고 자의적으로 확대 또는 축소될 여지도 있다.”라고 판시한 것은 대수의 법칙에 따라 위험의 동질성을 전제로 한 통계적 기초 위에 위험단체 내의 위험을 전가시키고 분산시키는 보험의 원칙과 약관의 객관적 획일적 해석에 원칙에 따른 것으로서 타당하다고 보이며, 그동안 혼재된 판결들을 정리하고 판례의 방향을 정립한 것이라고 생각된다.

고객경쟁력강화를 위한 고객자산 구축에 관한 연구

양희석 한국국제문화교류학회 2014 문화교류와 다문화교육 Vol.3 No.1

오늘날 기업은 고객만족을 실현하기 위해 고객경쟁력을 향상할 수 있는 기업전략을 실행해야 한다. 고객경쟁력 강화전략은 고객만족을 효과적으로 실현할 수 있는 전략적 방안으로서 고객자산(가치)을 기반으로 전개되는 틀이다. 종전의 연구에서는 고객만족이 실현되면, 고객반응행동이 유발된다고 보았으나, 이 는 고객반응행동의 지속성에 대한 설명이 부족하다. 고객자산(가치)을 기반으로 고객관 계가 유지되면, 고객의 자발적 행동의도가 강화되고, 고객의 충성도가 제고되며, 고객의 재방문(구매)의도가 실현되고, 고객의 이탈이 방지되며, 타 기업으로의 전환장벽이 강 화되고, 고객유지가 강화되는 것으로 나타난다. 즉, 확고한 고객자산(가치)의 기반이 구 축되면, 고객경쟁력이 강화되어 고객만족이 실현되고, 결과적으로 기업의 성과가 향상 된다고 할 수 있겠다. 따라서, 고객경쟁력을 강화할 수 있는 요체는 고객자산(가치)을 구축하고 강화할 수 있는 전략적 접근을 시도해야 한다. 고객자산(가치)을 구축하고 관 리함으로써 고객만족이 실현되고, 고객경쟁력이 더욱 강화될 수 있을 것이다. 본 고에서는 고객만족과 고객자산의 구조적 관계를 규명하고, 고객경쟁력을 강화할 수 있는 고객자산의 구축에 대해 고찰해 보고자 한다. To strengthen customer competitive capability is the essential strategic topic in marketing activities of modern company. Therefore it’s vey important for company to have a customer competitiveness, Previous articles about customer satisfaction asserted that customers satisfied reveal some responsiveness, customer loyalty, customer retention etc.. But those approaches have not a sustainable description of responsiveness. The customer competitiveness is a strategic approach on the basis of a customer equity(value) to realize a customer satisfaction effectively. This article will present a solution of a customer competitiveness to strengthen a company competitiveness. Understanding to drivers of customer equity(value) and relations between customer competitiveness and customer equity(value) will be needed. The customer equity(value) is composed of a value equity, a brand equity and retention equity. Driving a customer equity will realize a customer satisfaction, and inhance a customer relationship.

‘한장만 건지자’

양희석 한국노동조합총연맹 2010 월간 한국노총 Vol.2010 No.2