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      • KCI등재

        Childhood Brugada Syndrome in Two Korean Families

        이윤식,백재숙,김소연,서상원,권보상,김기범,배은정,박성섭,노정일 대한심장학회 2010 Korean Circulation Journal Vol.40 No.3

        Since the first descriptions of Brugada as a new clinical entity defined by sudden cardiac death in patients with typical electrocardiogram (ECG) patterns, Brugada syndrome (BS) has been increasingly diagnosed. This syndrome is known as a disease that is inherited via an autosomal dominant trait, and the SCN5A mutation has been found in 20-25% of BS patients. Because BS primarily manifests in adulthood, little information is available on BS during childhood. Although there have been several reports on adult BS in Korea, pediatric BS has not been reported. Herein, we report on childhood BS in two families. One infantile BS patient and his family had a novel SCN5A mutation (c.4035G>T, p.W1345C, heterozygote) in domain III of the sodium channel.

      • KCI등재

        Long QT Syndrome: a Korean Single Center Study

        이윤식,권보상,김기범,오세일,배은정,박성섭,노정일 대한의학회 2013 Journal of Korean medical science Vol.28 No.10

        The long QT syndrome (LQTS) is a rare hereditary disorder in which affected individuals have a possibility of ventricular tachyarrhythmia and sudden cardiac death. We investigated 62 LQTS (QTc≥0.47 sec) and 19 family members whose genetic study revealed mutation of LQT gene. In the proband group, the modes of presentation were ECG abnormality (38.7%), aborted cardiac arrest (24.2%), and syncope or seizure (19.4%). Median age of initial symptom development was 10.5 yr. Genetic studies were performed in 61; and mutations were found in 40 cases (KCNQ1 in 19, KCNH2 in 10, SCN5A in 7, KCNJ2 in 3, and CACNA1C in 1). In the family group, the penetrance of LQT gene mutation was 57.9 %. QTc was longer as patients had the history of syncope (P=0.001), ventricular tachycardia (P=0.017) and aborted arrest (P=0.010). QTc longer than 0.508 sec could be a cut-off value for major cardiac events (sensitivity 0.806, specificity 0.600). Beta-blocker was frequently applied for treatment and had significant effects on reducing QTc (P=0.007). Implantable cardioverter defibrillators were applied in 6 patients. Congenital LQTS is a potentially lethal disease. It shows various genetic mutations with low penetrance in Korean patients.

      • CDN서비스-적용영역확대, 토털 아웃소싱 서비스로!

        이윤식,Lee, Yun-Sik 한국데이터베이스진흥원 2006 디지털콘텐츠 Vol.4 No.-

        대용량 콘텐츠의 수요가 증가하면서 이를 전송해주는 CDN서비스에 대한 관심이 증폭되고 있다. 콘텐츠 공급자의 공급 망 서비스 대행에서 출발한 CND은 인터넷 서비스 영역이 확장됨에 따라 CDN영역도 자연스럽게 확대되고 있다.

      • KCI등재

        박근혜 정부의 대북정책과 남북협력

        이윤식 사단법인 한국평화연구학회 2014 평화학연구 Vol.15 No.1

        The purpose of this research thesis is to review how ‘The Process of Trust on the Korean Peninsular’, one of policies toward North Korea, that was declared by the Geun-hye Park’s administration needs to be made in order to keep it operating abnormally, without cease, unlike ‘Non-Nuclear Proliferation and Openness 3000’ that the former administration of Myeong-park Lee’s pursued as a policy toward North Korea. To do it, this thesis mainly focused on the cooperation between the North and South(Gaeseong Industrial Complex, Separated families, Humanitarian aids). First, this research thesis examined what the cooperation between the North and South is; how such cooperation is viewed in ‘The Process of Trust on the Korean Peninsular’ and should be promoted. Second, this thesis conducted an analysis of the cooperation between the North and South by the Geun-hye Park’s administration which has marked the 1st anniversary since its inauguration, in comparison to the issue surrounding Gaeseong Foundation and humanitarian aids to North Korean residents fueled throughout 2013, and then examined the meanings, current status and tasks. Lastly, this research thesis researched the factors of restriction of the cooperation with the North and South under’ The Process of Trust on the Korean Peninsular. Currently, the North-South relationships are in a too deadlock to find out their breakpoint as to the universal humanity-related issues. To overcome it, it is of a matter of consequence to recover, through dialogue between each government authority, the two nations’ deteriorating relationships and trust. ‘The Process of Trust on the Korean Peninsular’ is one of the most optimal policies pursued, reflecting the cases and examples of the achievements and limits of the policies toward the North Korea that have made and put for the last 15 years. If the ‘strategy of the operation’ is well-planned, the North and South Korean governments will reach a good conclusion on the cooperation between the two nations. 본 논문의 목적은 박근혜 정부의 대북정책인 ‘한반도 신뢰프로세스’가 이명박 정부의 대북정책인 ‘비핵․개방․3000’과 같이 개점 휴업 상태에 빠지지 않고 정상적으로 작동되게 하기 위해 어떻게 해야 하는지 남북간 협력(개성공단, 이산가족문제, 인도주의적 지원)을 중심으로 살펴보는데 있다. 본 논문은 먼저, 남북협력이란 무엇이며, 한반도 신뢰프로세스에서는 남북협력을 어떻게 바라보고 있고 어떻게 추진해 나갈 것인지 살펴보았다. 다음으로, 정부 출범 1년여를 맞이한 박근혜 정부 하의 남북협력을 2013년 동안 불거진 개성공단과 인도적 사안(이산가족문제, 대북지원문제) 등으로 분류해 그 의미, 현황, 과제(전망)를 중심으로 살펴보았다. 마지막으로 한반도 신뢰프로세스 하의 남북협력의 제약요인은 무엇인지 살펴보았다. 현재 남북관계는 인류 보편의 문제를 놓고도 상호 접점을 찾을 수 없을 만큼 냉각되어 있는 바, 우선 경색된 남북관계를 당국자간 대화로 신뢰를 회복하는 것이 중요하다. 한반도 신뢰프로세스는 지난 15년간 대북정책의 성과 및 한계를 교훈 삼아 설계된 최적의 정책이기 때문에 실제 가동 시에 ‘운용의 묘’를 잘 살린다면 남북협력 관련 좋은 성과를 도출할 수 있을 것이다.

      • KCI등재

        Pediatric Emergency Room Presentation of Congenital Heart Disease

        이윤식,백재석,권보상,김기범,배은정,노정일,최정윤,윤용수 대한심장학회 2010 Korean Circulation Journal Vol.40 No.1

        Background and Objectives: Only a few studies have specifically investigated the reasons for emergency room (ER) visits in patients with congenital heart disease (CHD). The aim of this study was to identify the major reasons for ER presentation among patients with CHD that were acutely and seriously ill at a tertiary medical center in Korea. Subjects and Methods: All 368 admissions of patients with CHD via the ER from 2003 to 2008 were enrolled. We conducted a retrospective study with review of the medical records. Results: Eighty two patients were newly diagnosed as having CHD. Their major presentations were: symptoms of heart failure (41.5%), murmur (31.7%), and cyanosis (18.3%). There were 286 visits that were cases with known CHD. Their major presentations were respiratory tract infection (24.1%, 2.7±4.1 years of age), dysrhythmia (16.4%, 16.7±9.5 years), symptoms of heart failure (14.3%, 7.6±9.4 years), aggravated cyanosis (5.6%, 0.8±1.4 years), protein-losing enteropathy (4.9%), hemoptysis (4.5%), drug side effects (4.1%), and infective endocarditis (3.0%). There were significant correlations between the age distributions and major modes of presentation. Surgical treatments were required within 1 month in 38%, and 2.7% of all patients died during hospitalization. The patient group with respiratory infections and CHD showed the highest mortality (5.8%). Atrial flutter was the most frequent arrhythmia (70.2%)and 70% of these patients were post-Fontan surgery condition. The causes of heart failure in the patients with previous surgical repair were: pulmonary hypertension, myocardial dysfunction, valve regurgitation, and uncorrected lesions. Conclusion: Improved understanding of the common problems in the ER can help prepare clinicians to manage patients that present with CHD.

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