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Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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Comparison of Lens Dose in accordance with Bismuth shielding and Patient position in Brain perfusion CT (Brain Perfusion CT에서 Bismuth 차폐와 환자의 자세 변화에 따른 수정체 선량 비교 연구)

  • Gang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.47-52
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    • 2018
  • Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.

A Study on Smoking Behavior and The Influencing Factors Among High School Male Students in Korea (고등학교(高等學校) 남학생(男學生)의 흡연행위(吸煙行爲)와 관련요인(關聯要因) 분석(分析))

  • Chang, Young Mee
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.193-215
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    • 1991
  • This study is aimed at providing basic information applicable to setting up the education programs and strategies to prevent smoking among high school students by analysing smoking behavior and influencing factors. The samples consisted of 814 students, 557 parents and 362 teachers selected randomly from 8 high schools, one from each school district in Seoul. Date Analyses were made through Chi-Square test, Factor Analysis, One Way ANOVA, Multiple Regression, Correlation. SPSS/$PC^+$program was utilized. Smoking behavior (continuous smoking, re-smoking, ex-smoking, never smoking, daily smoking, occasional smoking) were used as dependent variables. Influencing factors (male students, habits, attitudes and knowledge toward smoking, home life, school life, juvenile delinquency, friendship, demographic parent's and teacher's recognition toward male students smoking) were used as in dependent variables. The major findings of the study are as follows : 1. The total smoking rate occupies 41.1% whereas the continuous smoking rate stands at 19.2%, re-smoking rate 9.5%, ex-smoking rate 12.4% and never smoking rate 58.9%. 2. The total smoking rate among high school students is significantly correlated with their monthly expenditures and type of school (p<0.001). The continuous smoking rate also shows the same tendency. As the length of butt get shorter, the current smoking rate increase. The duration of smoking is in proportion to its continuity. The major motive of smoking is curiousity whereas that re-smoking is to follow friend's behavior. The study shows that peer pressure is the most powerful factor influencing smoking behavior of students. Friends and fellow students encourage to pick up smoking and resume smoking even alter one stops smoking. 3. The correlationship between favorable attitudes toward smoking and the current smoking rate and its continuity is statistically significant(p<0.05, p<0.01, p<0.001). 4. The stability and harmony of family life and the current smoking rate show negative correlationship. The daily smoking amount of father is in proportion to the continuity of students' smoking. When parents are in favor of smoking, it is more likely that the experimental smoking rate increase the smoking rate increases, and vice versa. The more acceptable attitudes toward smoking among siblings is also one of the factors to increase the smoking rate and continuity (p<0.001). The more lenient the attitudes of parents toward their children's association with smoking friends, the higher the smoking rate. When students have difficulties in adjusting to school life, it is more likely that the current smoking rate and continuity increase. 5. The continuity of smoking and friendship are significantly correlated (p<0.05, p<0.01, p<0.001). 6. The continuity of smoking and juvenile delinquency are significantly correlated (p<0.001). 7. The difference in attitudes and smoking reasons of parents and students is significantly correlated to different smoking behavior (p<0.01, p<0.001). While smoking knowledge does not significantly influence their smoking behavior, it is noted that in the case of teachers, smoking reason (p<0.05), attitudes (p<0.001) and knowledge (p<0.05) strongly influence their smoking behavior. 8. There is a significantly correlation among the smoking reasons, attitudes and knowledge between students and parents(p<0.001). As for the correlationship between regularity and smoking amount and other influencing factors, the daily smoking amount is in proportion to depth of inhalation and duration of smoking, negative attitudes of parents unstability of family, dissatisfaction of family members, juvenile delinquency, strong smoking reasons and positive attitudes towards smoking. 9. In the case of daily smokers depth of inhalation is significantly correlated to the duration of smoking, juvenile delinquency, acceptability of parents, dissatisfaction of family members and smoking reasons. The duration of smoking motives is significantly correlated to juvenile delinquency, high acceptability of parents, strong smoking motive and positive attitudes toward smoking. 10. It is noted that 40% of parents and 30% of teachers do not recognize the significant correlationship between and the relative influencing factors mentioned above.

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The Chemical Properties and Fertilizer Effect of a Residual By-product of Glutamic Acid Fermentation -I. Chemical properties and effect on the growth of corn (구르타민 산발효잔사가공물(酸醱酵殘渣加工物)의 성질(性質)과 비효 -I. 그 성질(性質)과 옥수수에 대(對)한 비효)

  • Hong, Chong Woon;Jung, Yee Geun;Park, Chon Suh;Kim, Yung Sup
    • Korean Journal of Soil Science and Fertilizer
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    • v.6 no.3
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    • pp.159-163
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    • 1973
  • A by-product from glutamic acid fermentation prepared by treating the fermentation residue with sulfuric acid and ammonium hydroxide was studied in the light of its chemical properties by chemical analysis and X-ray diffraction technique. Its effectiveness as fertilizer was also investigated with corn as test plant. The results are summarized as following. 1. The chemical analyses and study with X-ray diffraction technique revealed that the by-product contains an appreciable quantity of water soluble ammonium as ammonium sulfate and ammonium chloride, water soluble amino acid and in-soluble organic carbon. Particularly, the X-diffraction pattern of the material indicated the presence of unidentified water soluble double salt of ammonium sulfate and ammonium chloride. 2. The water soluble ammonium in this material was found to be as effective as urea on the growth of corn plant. 3. The organic portion of the material was found to be equally effective on the growth of corn plant as the other sources of organic matter such as compost and rice bran. It was, however found that the organic matter in the fermentation residue is more persisting in the soil than the compost and rice bran. 4. It was noticed that the application of the fermentation by-product, lowers the soil pH significantly. Inspite of the pH lowering effect, the absorption of iron by corn plant was surpressed by the application of this material.

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A Study on the Ship`s Collision Avoiding Action Analyzed from a Viewpoint of Ship Kinematics (선체운동학적으로 본 충돌회피동작에 관한 연구)

  • 김기윤
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.14 no.2
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    • pp.97-112
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    • 1978
  • The rule 15, 16 and 17 of International Regulations for Preventing collisions at Sea direct actions to avoid collision when two power-driven vessels are crossing. But these rules do not present the safety minimum approaching distances outside which a give- way vessel deeps out of the way of a stand-on vessel. In this paper, the author analyzed the ship's collision avoiding actions from a viewpoint of ship kinematics as the method to calculate this distance. The author worked out mathematic formulas for calculating the safety minimum approaching distances outside which the give-way vessel takes the actions to avoid collisions in accordance with the cross angles of the crossing vessels' courses. Figuring out actually the values of maneuvering indices of the M. S. Koan Ack San (GT: 224tons), the training ship of the National Fisheries University of Busan and the M. S. Golden Clover (GT: 101, 235tons) of the Eastern Shipping Co., Ltd. through their Z test, the author applied these values to the calculating formulas and calculated the safety minimum approaching distances. The results of calculations are as follows; 1. The greatest distance is to be kept by the give-way vessel to avoid collision when the cross angle of courses is 90$^{\circ}$ or near it. In such case the safety minimum approaching distance of a small vessel must be more than 5 times of her own length and that of a large vessel more than 11 times of her own length. 2. Collision danger is greater when crossing angle is obtuse than in an acute angle, therefore greater distance is to be kept by the give-way vessel to avoid collision in the case of the obtuse angle. 3. The actions to be taken to avoid collisions by the give-way vessel in Rule 16 and by the stand-on vessel in Rule 17(a)(ii) of International Regulations for Preventing Collisions at Sea, must be done outside the above safety minimum approaching distance. When inevitably such actions are to be taken within the safety minimum approaching distance, they should be accompanied with engine motions.

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Determination of Short Term Prognosis Among Chronic Obstructive Lung Disease with Acute Respiratory Failure According to Simplified Acute Physiology Score (만성 폐쇄성 폐질환에서 급성 호흡부전 발생시 Simplifed Acute Physiology Score에 따른 단기예후의 평가)

  • Lee, Sang-Pyo;Sung, Yun-Up;Kim, Sang-Hoon;Kim, Bong-Sik;Kim, Young-Jun;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.532-539
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    • 1993
  • Background: Physician's estimates of patient survival often influence clinical decisions, especially those near the end of life. In addition. clinical decisions frequently reflect trade-offs between morbidity and length of survival. As a result, accurate estimates of survival can be extremely useful in clinical decision. When the episode of acute respiratory failure in chronic obstructive lung disease, evaluation of the severity of the condition and short term prognosis is difficulit based on the available clinical or paraclinical data at the time of admission. Method: In this study, we performed a retrospective study in Chung Ang University Hospital, 74 patients (51 males, 23 females), who were hospitalized with chronic obstructive lung disease with acute respiratory failure from 1980 to 1992. We evaluated these patients to determine lung prognostic factors at time of admission in the Intensive Care Unit (ICU) that predict short term survival, and to determine the possible application of the Simplified Acute Phsiology Score (SAPS) to this population, All patients were treated with similar regimen during the hospitalization. Results: The results were as follows: 1) Hospital mortality was 34%(25/74 patients) and surival rate was 66%(49/74 patients) in COPD with acute respiratory failure. The prognosis of the older age was much poorer than those of the young age. 2) There was no difference in mortality according to the results of basal pulmonary test and arterial blood gas analysis. 3) The SAPS at admission was higher in those patients who expired(10.8) than the survived(6.5), and there was positive correlation between SAPS and mortality (r=0.91, p<0.05). 4) Prognostic factors in acute respiratory failure complicating COPD which were identifiable at time of admission to the ICU were as follows: cachexia, encephalopathy, serum creatinine and phosphate. Conclusion: In conclusion, the SAPS might have a good prognostic value for determination of short term survival among chronic obstructive lung disease with acute respiratory failure.

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Diagnosis of Malignant Pleural Effusion by using Aberrant Methylation of p16 and RARB2 (p16과 RARB2 유전자의 비정상적인 메틸화 검사를 이용한 악성 흉수의 진단)

  • Rha, Seo Hee;Lee, Su Mi;Koo, Tae Hyoung;Shin,, Bong Chul;Huh, Jung Hun;Um, Soo Jung;Yang, Doo Kyung;Lee, Soo-Keol;Son, Choonhee;Roh, Mee Sook;Bae, Ho-Jeong;Kim, Ki Nam;Lee, Ki Nam;Choi, Pil Jo
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.4
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    • pp.285-292
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    • 2008
  • Background: A diagnosis of malignant pleural effusion is clinically important, as the prognosis of lung cancer patients with malignant pleural effusion is poor. The diagnosis will be difficult if a cytological test is negative. This study was performed to investigate whether the detection of hypermethylation of the p16 (CDKN2A) and retinoic acid receptor b2 (RARB2) genes in pleural fluid is useful for a diagnosis of malignant pleural effusion. Methods: Pleural effusion was collected from 43 patients and was investigated for the aberrant promoter methylation of the RARB2 and CDKN2A genes by use of methylation-specific PCR. Results were compared with findings from a pleural biopsy and from pleural fluid cytology. Results: Of 43 cases, 17 cases of pleural effusion were due to benign diseases, and 26 cases were from lung cancer patients with malignant pleural effusion. Hypermethylation of the RARB2 and CDKN2A genes was not detected in the case of benign diseases, independent of whether or not the patients had ever smoked. In 26 cases of malignant pleural effusion, hypermethylation of RARB2, CDKN2A or either of these genes was detected in 14, 5 and 15 cases, respectively. The sensitivities of a pleural biopsy, pleural fluid cytology, hypermethylation of RARB2, hypermethylation of CDKN2A, or hypermethylation of either of the genes were 73.1%, 53.8%, 53.8%, 19.2%, and 57.7%, respectively; negative predictive values were 70.8%, 58.6%, 58.6%, 44.7%, and 60.7%, respectively. If both genes are considered together, the sensitivity and negative predictive value was lower than that for a pleural biopsy, but higher than that for pleural fluid cytology. The sensitivity of hypermethylation of the RARB2 gene for malignant pleural effusion was lower in small cell lung cancers than in non-small cell lung cancers. Conclusion: These results demonstrate that detection of hypermethylation of the RARB2 and CDKN2A genes showed a high specificity, and sensitivity was higher than for pleural fluid cytology. With a better understanding of the pathogenesis of lung cancer according to histological types at the molecular level, and if appropriate genes are selected for hypermethylation testing, more precise results may be obtained.

A Study of Job Satisfaction and Related Factors of the National Hospital Nurses (국립병원 간호사의 직무만족과 관련요인 연구)

  • Suh Gil-Hee;Kim Ok-Hee
    • Journal of Korean Public Health Nursing
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    • v.7 no.2
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    • pp.53-66
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    • 1993
  • By this time, a few of previous studies of factors related to separation from their jobs and job satisfaction only have dealt with the separation rate. the cause of separation and related factors that induce job satisfaction and incentive factors, the actualities of morale some suggestions for reduction of the separation rate. This study is attempted to determine factors that have effect on job satisfaction of national hospital nurses. and to proide information and materials for the development of the administration of nursing through the appreciation of factors influencing on job satisfaction between isolated ward nurses and general ward nurses working at national hospitals. 185 nurses of national hospitals responsed th this study, and were divided into two groups. Group 1: 57 nurses working at isolated wards for tuberculosis patients and Group 2 : 128 nurses at general wards. Relevant data were collected from August, 5, 1992 through August 20, 1992. The questionnaire consisted of 8 genalized items and 4 items concerning job satisfaction. The collected data were processed with SPSS, and the relationship among vaviables was analyzed by means of $X^2-test$, Pearson Correlation, Multiple Regression. The results of this study are as follows: 1. There is no significant difference between two groups in terms of generalized items. Age distributions show $44.3\%$ under the category of less than 34. and $55.7\%$ under the category more than 35, $19.3%$ was single and $74.6\%$ was married respectively. 2. $79.4\%$ of the nurses have the desire to have in-service education under the satisfactory physical environments such as welfare system, accommodating structures and facilities, instruments or management systems of the hospital, but under the category of unsatisfactory circumstances, $60.3\%$ have the intention of having in- service education. The concern in terms of in-service education shows statistically significant difference between two groups $(X^2=8.85,\;p<0. 05)$. This result accepts the hypothesis that good physical environments could intensify interests in service education. 3. The extent of satisfaction related to psychological environments is heightend according to good physical environments. In result, the hypothesis that the extent of satisfaction in terms of physical environments could raise satisfaction about psychological environment is accepted. 4. In the light of the extent of satisfaction about physical environments, $33.3\%$ of isolated ward nurses are satisfied with physical environments, but only $11.7\%$ of general ward nurses are satisfied. $(X^2=10.88,\; p<0.01)$. This result shows that the satisfaction degree about phusicalenvironments of isolated war nurses was higher than that of general ward nurses in spite of high physical and psychological risks due to exposure to infection. Consequently. the hypothesis was rejected that the satisfaction degree about physical environments would be lower in isolated ward nurses than in general ward nurses. 5. The fact that $87.7%$ of isolated ward nurses took interest in service education and $53.19\%$ of general ward nurses took interest in service education demonstrats that isolated ward nurse have more interest in service education than gerneral ward nurses. The result shows that the hypothesis is accepted that isolated ward nurses would have mor interests in service education than general ward nurses. 6. In the extent of satisfaction about physical environments such as morale human relationship promotion, there is no significant difference between two groups in terms of statistics. The hypothesis is rejected that satisfaction about psychologic environments would be high in isolated ward nurses than in general ward nurses. In conclusion. factors influencing on job satisfaction are considered to have effect on. another, and also interdisciplinary amelioration of factors accompanied with systematic inter cooperative investigation is necessary.

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Nursing Professor's inspection and Status of Patient's Records and Informed Consent for Clinical Practice of Nursing Student in Korea and Japan (한·일 간호대학생의 임상실습 시 환자의 설명동의 및 기록관리와 지도실태)

  • Cho, Yooh-Yang;Kim, In-Hong;Yamamoto, Fujie;Yamasaki, Fujiko
    • Journal of agricultural medicine and community health
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    • v.31 no.1
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    • pp.35-46
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    • 2006
  • Objectives: In recently. the management and protection on individual information in patient's medical & nursing records have been very important, and that need a guideline. The purpose of this study was to investigate the status of using the patient's nursing records of nursing students in clinical practice, to find and discuss the patient's informed consent, and status of education and management concerned to patient's nursing records. Methods: This study used a mailing survey. data collected from September 24th to October 31th in 2002. The subject were 333 professors who are major in adult nursing, pediatric nursing, psychological nursing of 111 university of nursing department and nursing college. And then we received the survey mail from 103 professors that respondent rate was 30.9%. Results: The characteristics of study subjects showed 49.0% of university. 51.0% of college of nursing. 50.0% of the subjects practiced point the patient by oral approval in clinical practice. But when the decision of the patient was very difficult, 21.6% of the subjects take to informed consent from his or her families. During the clinical practice, 49.0% of the subjects were explain to patient about clinical practice and contents of the nursing student, only 7.8% of the subjects were explain to patient with nursing records. 52.0% of the subjects were took out records from the hospital, only 17.6% of the subjects had standard of the patient's informed consent and standard of handling practice records. 17.6%-92.2% of the subjects that educate and manage concern to patient's nursing records.

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Compact Orthomode Transducer for Field Experiments of Radar Backscatter at L-band (L-밴드 대역 레이더 후방 산란 측정용 소형 직교 모드 변환기)

  • Hwang, Ji-Hwan;Kwon, Soon-Gu;Joo, Jeong-Myeong;Oh, Yi-Sok
    • The Journal of Korean Institute of Electromagnetic Engineering and Science
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    • v.22 no.7
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    • pp.711-719
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    • 2011
  • A study of miniaturization of an L-band orthomode transducer(OMT) for field experiments of radar backscatter is presented in this paper. The proposed OMT is not required the additional waveguide taper structures to connect with a standard adaptor by the newly designed junction structure which bases on a waveguide taper. Total length of the OMT for L-band is about 1.2 ${\lambda}_o$(310 mm) and it's a size of 60 % of the existing OMTs. And, to increase the matching and isolation performances of each polarization, two conducting posts are inserted. The bandwidth of 420 MHz and the isolation level of about 40 dB are measured in the operating frequency. The L-band scatterometer consisting of the manufactured OMT, a horn-antenna and network analyzer(Agilent 8753E) was used STCT and 2DTST to analysis the measurement accuracy of radar backscatter. The full-polarimetric RCSs of test-target, 55 cm trihedral corner reflector, measured by the calibrated scatterometer have errors of -0.2 dB and 0.25 dB for vv-/hh-polarization, respectively. The effective isolation level is about 35.8 dB in the operating frequency. Then, the horn-antenna used to measure has the length of 300 mm, the aperture size of $450{\times}450\;mm^2$, and HPBWs of $29.5^{\circ}$ and $36.5^{\circ}$ on the principle E-/H-planes.