쿄토의정서(議定書)상의 국제적(國際的) 의무준수체제(義務遵守體制)

李哉協 경희법학연구소 2000 경희법학 Vol.35 No.-

The First Clinical Trial of Beta-Calcium Pyrophosphate as a Novel Bone Graft Extender in Instrumented Posterolateral Lumbar Fusion

이재협,장봉순,Ul-Oh Jeung,Kun-Woo Park,Min-Seok Kim,이춘기 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.3

Background: Porous β-calcium pyrophosphate (β-CPP) was developed to improve the fusion success of posterolateral lumbar fusion(PLF). The possibility of accomplishing PLF using a mixture of porous β-CPP and iliac bone was studied. This paper reports theradiologic results of PLF using the β-CPP plus autograft for lumbar degenerative disease as a bone graft extender. Methods: A prospective, case-matched, radiographic study evaluating the results of short segment lumbar fusion using a β-CPPplus autograft was performed to compare the effi cacy of β-CPP plus autograft with that of an autograft alone for short segmentlumbar fusion. Thirty one consecutive patients (46 levels) underwent posterolateral fusion with pedicle screw fi xation and additionalposterior lumbar interbody fusion. In all patients, 3 mL of β-CPP plus 3 mL of autogenous bone graft was placed randomly inone side of a posterolateral gutter, and 6 mL of autogenous iliac bone graft was placed on the other. The fusion rates, volumes offusion masses, and bone absorption percentage were evaluated postoperatively using simple radiographs and 3 dimensional computedtomography (3D-CT) scans. Results: The control sides treated with an autograft showed signifi cantly better Lenke scores than the study sides treated withβ-CPP at 3 and 6 months postoperatively, but there was no difference between the two sides at 12 months. The fusion rates (confirmed by 3D-CT) were 87.0% in the β-CPP group and 89.1% in the autograft group, which were not signifi cantly different. Thefusion mass volumes and bone absorption percentage at 12 months postoperatively were 2.49 mL (58.4%) and 1.89 mL (69.5%) forthe β-CPP and autograft groups, respectively, and mean fusion mass volume was signifi cantly higher in the β-CPP group. Conclusions: β-CPP combined with an autograft is as effective as autologous bone for grafting during instrumented posterolateralspinal fusion. These fi ndings suggest that β-CPP bone chips can be used as a novel bone graft extender for short-segmentposterolateral spinal fusion.

광각형광안저혈관조영술을 통한 베체트 포도막염 환자에서의 아달리무맙 치료효과 평가분석

이재협,유형곤 대한검안학회 2022 Annals of optometry and contact lens Vol.21 No.3

목적: 베체트 포도막염 환자에서 아달리무맙 치료를 시행한 후 광각형광안저혈관조영술을 통해 치료효과를 분석해보고자 한다. 대상과 방법: 베체트병으로 진단받고, 조절되지 않는 포도막염으로 아달리무맙 치료를 시작하여 30주 이상 경과 관찰하였던 17명의환자의 32안에 대해 후향적 의무기록 분석을 시행하였다. 광각형광안저혈관조영술을 통해 시신경유두 형광누출, 망막정맥 형광누출, 모세혈관 형광누출 등으로 나누어 포도막염의 상태를 평가하고, 혈관누출을 중심부와 주변부로 나누어 아달리무맙 치료 시작 이후30주까지의 치료 반응을 평가하였다. 결과: 아달리무맙 치료 시행 후 환자들의 최대교정시력과 초광각형광안저혈관조영술 점수는 6주, 14주, 30주 모두에서 유의한 감소를보였다. 형광누출의 경우 아달리무맙 치료 시작 전과 비교하여 치료 시작 후 30주째 망막정맥과 모세혈관의 형광누출은 현저히 줄었으나(p=0.032, p=0.004), 시신경유두 과형광은 상대적으로 지속되었다(p=0.083). 각 경과 관찰 시기마다 중심부 망막혈관 형광누출의 유의한 감소가 있었으나, 주변부 망막혈관 형광누출의 경우 0-6주, 6-14주, 14-30주 기간 동안 유의한 변화는 없었다. 결론: 베체트 환자의 포도막염 치료효과에 대한 평가 방법으로 광각형광안저혈관조영술을 이용할 수 있다. 망막혈관의 형광누출을파악하는 것이 중요하며 그 위치에 따라 누출 양상의 차이가 있다.

국제환경법상 형평성 원칙의 적용: 교토의정서에서의 개도국의 의무부담

이재협 대한국제법학회 2004 國際法學會論叢 Vol.49 No.1

시간 경과에 따른 티타늄 합금 피질골 나사못의 골결합능 평가

이재협,장봉순,이춘기 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적: 본 연구의 목적은 티나늄 합금 피질골 나사못을 삽입 후 시간에 따른 나사못의 골결합 양상을 평가하는 것이다. 대상 및 방법: 길이 24 mm, 두께 3.5 mm 티타늄 합금 피질골 나사못 54개를 30 kg 내외의 수컷 잡견의 양측 후자 중간 간부에 삽입하면서 삽입시와 제거시의 토크 값 측정, 방사선 사진 촬영, 비탈석회화 조직 검사, 조직형태학 검사 및 주사현미경 검사를 수술 직후 및 술 후 2주, 4주, 8주에 시행하였다. 결과: 삽입시의 토크 값 (1.76±0.609 cNㆍm)에 비해 2주 제거시의 토크 값 (1.14±0.470 cNㆍm)이 유의하게 낮았으며 (p=0.0071). 4주 제거시 토크 값 (2.57±1.36 cNㆍm)은 다소 증가하였고 8주 제거시 토크 값 (3.18±0.499 cNㆍm)이 삽입시보다 유의하게 증가하였다 (p=0.0005). 조직학 소견 상 삽입 2주째에는 나사못과 골과의 접촉이 매우 적었고 섬유성 피막이 나사못과 골과의 경계면에 형성되어 있었으나 시간이 지남에 따라 점차 골과 나사못의 결합양상이 향상되는 소견을 관찰할 수 있었다. 나사못과 접촉한 골의 분률은 2주 제거시 (22.4±12.9%) 보다 8주 제거시 (33.1±18.5%)가 더 높았으나 통계적 유의성은 없었다 (p=0.15). 결론: 티타늄 합금 피질골 나사못은 삽입 직후보다 2주째에 골결합력이 유의하게 감소하였는데, 이는 아마도 삽입시 발생한 열손상이나 압박에 의한 섬유화에 기인하는 것으로 사료된다. 따라서, 골절 등의 치료를 위해 나사못을 삽입할 경우 일정 기간 동안 삽입시보다 고정력이 감소하므로 운동이나 체중 부하시 유의하여야 하며, 삽입 초기의 골-나사못 고정력 감소를 개선시키는 것이 임상결과 향상을 위해 중요하다고 사료된다. Purpose: To evaluate the osseointegration of titanium alloy cortical screws with the passage of time. Materials and Methods: Fifty four titanium alloy cortical screws (24 mm in length, 3.5 mm in diameter) were implanted bilaterally in the tibial diaphysis of adult mongrel male dogs of similar size and weight (30±5 kg). The insertion torques, radiographs, undecalcified histology, histomorphometric analysis and extraction torques were evaluated at 2, 4 and 8 weeks after surgery. Results: The extraction torque at 2 weeks (1.14±0.470 cNㆍm) was significantly lower than the insertion torque (1.76±0.609 cNㆍm)(p=0.0071), the extraction torque at 4 weeks (2.57±1.36 cNㆍm) was slightly improved and the extraction torque at 8 weeks (3.18±0.499 cNㆍm) was significantly higher than insertion torque (p=0.0005). Direct bony contact in the early phase was poor and intervening fibrous tissue was observed at the bone-screw interface. However, the fixation between the bone and the screws improved with time. The percentage of bone-screw contact at 8 weeks (33.1±18.5%) was higher than that of 2 weeks (22.4±12.9%), but not statistically significant. Conclusion: Because of thermal injury or pressure necrosis, the fixation strength of titanium alloy cortical screws at 2 weeks after implantation is significantly lower than at the insertion time. So, we should keep in mind the initial phase weakness of screw fixation when we allow the patients the range of motion exercise or weight bearing and the improvement of the initial phase fixation is very important in clinical results.

Internet을 기반으로 한 Cutting Plotter 공유시스템 개발

이재협 한국기술교육대학교 산학협동연구센터 1999 교수현장연구학기제 연구결과보고서 Vol.1999 No.1

교토의정서의 조림 청정개발체제에 대한 법적 검토

이재협 서울국제법연구원 2008 서울국제법연구 Vol.15 No.1

The Clean Development Mechanism is one of the market mechanisms created by the Kyoto Protocol in order to offset the carbon emissions of Annex I countries and to promote the sustainable development of non-Annex I countries. The Afforestation and Reforestation Clean Development Mechanism (A/R CDM) has many benefits in terms of sustainable development, but the current emission trading markets have not responded favorably to the A/R CDM project participants. The extremely low registered number of A/R CDM demonstrates essential weaknesses of forestry-based CDM projects': non-permanance, socio-economic impact assessment, and the sovereignty retained for pursuing nation's sustainability objects. The current architecture of CDM rules, however, cannot enhance sustainable development and these rules must be amended to follow accomplish the ultimate goal of the Kyoto Protocol. First, the eligibility requirement must be streamlined. Second, the ownership of CERs must be resolved through entering into a contract that has a provision on sequestration right. A model law specifying nation's legislation related to legal ownership of the CER's legal right needs to be developed. Third, a number of CDM reform proposals must be considered seriously. Discounting the value of CERs arising from particular regions or type, as well as recognizing the deforestation abatement projects as A/R CDM activities are viable options for the post-2012 negotiations. Fourth, a variety of economic incentives and governmental assistance to induce project proponents to participate in the A/R CDM must be provided.

사내변호사와 법치주의 - 한국의 기업법무부서에 대한 경험적 고찰 -

이재협 대한변호사협회 2009 人權과 正義 : 大韓辯護士協會誌 Vol.- No.400

The number of in-house counsels in Korean companies has significantly grown for the past 10 years and the trend will continue because of the increasing supply of lawyers produced by the new law school system and the liberalization of the legal market. The growth of corporate in-house counsels may be regarded as one indicator of incorporating global standards in business. In this connection, in-house counsels are expected to enhance the rule of law in the corporate setting. This paper empirically examines whether and how the in-house counsels serve to facilitate the rule of law in the corporate sector. Based on survey questionnaires and in-depth interviews with the in-house counsels in Korea, this paper analyzes their composition, independence, roles, and the interaction with other departments in companies. The findings of the study suggest that the number of in-house counsels and the independence of corporate legal departments have greatly increased, while they tend to be engaged in routine legal affairs such as reviewing contracts, do not have many chances to participate in critical corporate decisions, and have limited interactions and communication with non-legal departments in the companies. It is suggested that the in-house counsels and corporate legal departments have somewhat limited influence in enhancing the rule of law in the corporate sector. 한국기업의 사내변호사는 지난 10년간 급격히 증가하였고, 그러한 경향은 법학전문대학원을 통한 법률가 공급이 증가하고 법률시장이 개방함에 따라 계속될 것으로 전망된다. 기업의 사내변호사의 증가는 기업경영에 있어 글로벌 스탠더드를 수용하게 되는 하나의 지표가 된다. 이러한 측면에서 사내변호사는 기업 법치주의를 증진시킬 것으로 기대되고 있다. 이 논문은 사내변호사의 증가 및 역할의 증대가 기업 내 의사결정을 법적 규칙에 의해 이루어지게 하는 데 어떠한 역할을 하는지를 경험적으로 고찰하였다. 국내 기업의 사내변호사들을 대상으로 설문지와 면접방법을 활용하여 기업법무부서의 독립적 위상, 전문적․자율적 역할의 수행, 최고의사결정에의 참여, 기업 내 타부서와의 관계 및 의사소통의 정도를 분석하였다. 분석 결과에 의하면 사내변호사의 사내변호사는 법률가 커뮤니티 내에서 점진적으로 비중이 증가되어 왔고, 그 역할에 있어서도 계약검토를 비롯한 일상적 법률문제의 판별과 관리로부터 정보흐름의 통제 및 준법감시로 전문적 업무영역이 확장되어 왔으나 대다수의 기업에서 그러한 현상이 일반적으로 나타난 것은 아니었다. 또한 대기업 법무부서에서는 부서장이 최고의사결정에 참여하고 있지만 사내변호사들의 법률적 위험평가가 항상 적절히 수용되고 있지는 않은 것으로 나타났다. 법무부서의 업무는 주로 경영지원적 차원에서 이루어져 사내변호사들이 경영진의 의사결정과정에 주도적으로 참여한다고 보기는 어려웠다. 현업부서와의 관계에 있어서도 밀접한 공조체제를 제도화해 놓은 일부 기업을 제외하고는 현업부서와 법무부서와의 시각차 및 서로에 대한 인식의 간극이 존재하였다. 규모와 독립적 위상의 측면에서 기업법무부서는 괄목할 만한 성장을 보였다고 할 수 있는 반면, 기업 내 법치를 위한 사내변호사들의 역할이 아직은 다소 제한적으로 이루어지고 있음을 시사하는 것이다.

The Effect of Poloxamer 407-Based Hydrogel on the Osteoinductivity of Demineralized Bone Matrix

이재협,백해리,이경미,이현경,임성빈,김용성,이지호,장봉순,이춘기 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.4

Background: Demineralized bone matrix (DBM) is used for bone healing due to its osteoinductivity, but it requires a carrier for clinical application. Here, we report the effects on the osteoinductivity of DBM by use of a poloxamer 407-based hydrogel as the carrier, compared to sterile water. Methods: DBM-W and DBM-H represent 27 wt% of DBM with sterile water and DBM with a poloxamer 407-based hydrogel, respectively. Both of the compositions were applied to human mesenchymal stem cell (MSC) cultures, and monitored for alkaline phosphatase (ALP) staining and ALP activity. Six 10-week-old athymic nude rats were used for abdominal muscle grafting with either DBM-W or DBM-H, and were tested by plane radiography, microfocus X-ray computed tomography (CT), and decalcified histology to evaluate ectopic bone formation. Results: The DBM-W group showed stronger ALP staining at 7, 14, and 21 days of treatment, and significantly higher ALP activity at 7 and 14 days of treatment, compared to the DBM-H group. Plane radiography could not confirm the radio-opaque lesions in the rat ectopic bone formulation model. However, ectopic bone formation was observed in both groups by micro-CT. Compared to the DBM-H group, the DBM-W group showed higher bone volume, percent bone volume and trabecular number, and the difference in percent bone volume was statistically significant. Decalcified histology found bony tissue with lamellation in both groups. Conclusions: Our results suggest that poloxamer 407-based hydrogel has efficacy as a DBM carrier since it shows ectopic bone formation, but its effects on the quality and quantity of osteoblastic differentiation in rat abdominal ectopic bone and MSC are considered negative.

Negative Effect of Rapidly Resorbing Properties of Bioactive Glass-Ceramics as Bone Graft Substitute in a Rabbit Lumbar Fusion Model

이재협,유현승,Jun-Hyuk Seo,이도윤,장봉순,이춘기 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.1

Background: Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. Methods: This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5–6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). Results: In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. Conclusions: The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.