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조경임 한국민사법학회 2022 民事法學 Vol.100 No.-
우리 법률과 판례는 여러 영역, 여러 국면에서 직접청구권을 인정한다. 본고에서의 직접청구권은 “채권자가 ‘채무자 등’의 채무자에 대해 직접 급부의 이행을 청구할 수 있는 청구권”을 가리킨다. 직접청구권자는 집행권원 확보 및 채권집행 절차를 거치지 않고도 제3채무자로부터 직접 급부를 추심할 수 있는 특별한 혜택을 누린다. 이러한 혜택은 간이한 결제수단일 수도 있고 실질적인 우선변제권일 수도 있다. 하지만 개별 직접청구권에 관한 논의들을 살펴보면 이에 대한 명확한 설명을 하지 못하고 있다. 직접청구권 전반을 아우르는 논의 또한 찾기 힘들다. 하지만 직접청구권을 둘러싼 갈등의 모습은 유사하며 분쟁 상황에서 고려하여야 하는 요소들 역시 대동소이하다. 다만 그 요소들 가운데 어떤 것에 더 비중을 두어야 하는지가 다를 뿐이다. 따라서 개별 제도와 법률관계 별로 구체적 타당성을 도모하는 것에서 한걸음 더 나아가 직접청구권 전체를 넓게 조망할 필요가 있다. 이에 본고에서는 직접청구권을 아우르는 이론을 고민하기 위한 출발점으로서 직접청구권 그 자체에 주목하였다. 모든 직접청구권은 공통적으로 추심권능(이행청구권능, 소구권능, 집행권능)과 변제수령권능을 가진다. 그리고 개별 직접청구권은 앞의 공통권능만을 그 내용으로 하는 ‘추심권능인 직접청구권’, 공통권능에 더하여 처분권능과 상계권능을 갖는 ‘채권인 직접청구권’, 공통권능에 상계권능 및 우선변제충당권능을 더하여 갖는 ‘담보물권자의 직접청구권’으로 분류할 수 있다. 어떠한 직접청구권이 위 세 가지 유형 중 어디에 해당하는지 고민하는 작업은, 복잡한 직접청구권의 법률관계를 이해하고 분석하는 데에 도움이 될 수 있으리라 생각한다. 직접청구권 제도를 적절히 규율하기 위해서 무엇보다 중요하게 달성되어야 하는 것은, 개별 직접청구권 제도의 취지와 기능을 명확히 하는 것이다. 이를 토대로 직접청구권자를 제도의 취지에 맞게 보호함으로써 직접청구권이 그 예정된 기능을 수행할 수 있도록 하여야 할 것인바, 채무자, 제3채무자, 채무자의 채권자 등 관련된 이들의 이해관계를 조화롭고 빈틈없이 조절할 수 있는 방안에 대한 고민이 지속되어야 할 것이다.
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조경임,이상희,장선희,이동원,이현숙,김태익 대한심장학회 2008 Korean Circulation Journal Vol.38 No.6
Background and Objectives: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocardiography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. Subjects and Methods: Strain echocardiography is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, nonused group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. Results: Six patients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E’, strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71±13.63% and 2.98±0.59s-1, p<0.05, respectively) than group B (27.21±10.49% and 2.21± 0.47s-1). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89±3.30% and -2.32 ±0.77s-1 p<0.05, respectively) than group B (-0.83±2.79% and -1.77±0.25s-1). There were no significant differences in C-reactive protein (CRP) and B-type natriuretic peptide (BNP) at the baseline, but BNP were significantly reduced in group A (822.9±798.3 pg/mL, p<0.05) than group B (1481.9±209.97 pg/mL) at the 12- month follow-up. Conclusion: The increased values of atrial peak systolic and diastolic strain/rate after treatment with RAS inhibitors revealed that passive stretching and shortening of LA wall might improve in some patients with AF even before LA size change possibly because of reduced atrial fibrosis and increased compliance. Our results indicated that strain echocardiography provides clinically useful information of LA function and remodeling and treatment with RAS inhibitors appears to preserve LA reservoir function in AF patients without visible LA structural change. Background and Objectives: Renin-angiotensin system (RAS) inhibitors are likely to reduce the development of atrial fibrillation (AF) by preventing atrial fibrosis. We attempted to assess the relevance of strain echocardiography for quantitative assessment of the left atrial (LA) status in AF, its modification by RAS inhibitors and changes of biochemical markers during cardiac remodeling in AF. Subjects and Methods: Strain echocardiography is performed 2 times (baseline and 12 month) in 60 patients with AF (RAS inhibitors-used group: 30, nonused group: 30). In an apical 4-chamber view, the regional analysis consisted of placing the region of interest cursor at the basal segments of the septal and lateral wall of LA. Mean peak systolic and early diastolic strain/rate are measured with LA end-systolic antero-posterior, longitudinal and transverse dimensions. Results: Six patients of RAS inhibitors-used group (group A, 20%) and three patients of non-used group (group B, 10%) were converted to normal sinus rhythm during the study. LA size, E wave velocity, E/E’, strain parameters showed no significant differences between groups at the baseline. There were no significant differences in LA size and E wave velocity between groups at the 12 months, however, peak systolic strain/rate were significantly higher in group A (36.71±13.63% and 2.98±0.59s-1, p<0.05, respectively) than group B (27.21±10.49% and 2.21± 0.47s-1). In addition, peak early diastolic strain/rate were significantly higher in group A (-1.89±3.30% and -2.32 ±0.77s-1 p<0.05, respectively) than group B (-0.83±2.79% and -1.77±0.25s-1). There were no significant differences in C-reactive protein (CRP) and B-type natriuretic peptide (BNP) at the baseline, but BNP were significantly reduced in group A (822.9±798.3 pg/mL, p<0.05) than group B (1481.9±209.97 pg/mL) at the 12- month follow-up. Conclusion: The increased values of atrial peak systolic and diastolic strain/rate after treatment with RAS inhibitors revealed that passive stretching and shortening of LA wall might improve in some patients with AF even before LA size change possibly because of reduced atrial fibrosis and increased compliance. Our results indicated that strain echocardiography provides clinically useful information of LA function and remodeling and treatment with RAS inhibitors appears to preserve LA reservoir function in AF patients without visible LA structural change.
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