스쿠버다이빙이 원인으로 추정되는 내경동맥박리로 인한 앞맥락동맥 영역 뇌경색

신다은,황양하,심동현 대한신경과학회 2020 대한신경과학회지 Vol.38 No.4

We report a case of anterior choroidal artery territory infarction due to internal carotid artery dissection presumably caused by scuba diving. A 44-year-old man presented with left facial palsy and hemiparesis. He had a history of scuba diving for 18 months. His last dive was 7 days ago, and he skipped decompression practice at that dive. We assumed that repetitive traumas and microbubbles during scuba diving, which made endothelium vulnerable to damage may have caused a carotid dissection.

외측무릎핵경색 환자에서 암점 형태로 발생한 양안 중심시야 결손

신다은,최광희,김용원,최우찬 대한신경과학회 2024 대한신경과학회지 Vol.42 No.2

Incongruous visual field defects, such as sectoranopia, can result from lateral geniculate nucleus infarction. We present a rare case of right lateral geniculate nucleus infarction that manifests as a left inferior homonymous paracentral scotoma. According to the retinotopic organization of the visual tract, central vision from the macula is delivered to the occipital pole via the posterior portion of the lateral geniculate nucleus. Consequently, not only can occipital pole infarction lead to central visual loss, but partial lateral geniculate nucleus infarction can also produce similar manifestations of central visual loss.

Characterization of thermostable bacteriophage CPD2 and its endolysin LysCPD2 as biocontrol agents against Clostridium perfringens

신다은,하은수,공민석,유상렬 한국식품과학회 2023 Food Science and Biotechnology Vol.32 No.14

Clostridium perfringens is one of the major foodborne pathogens in humans and animals. With the prevalence of antibiotic-resistant C. perfringens strains, bacteriophages and their endolysins have received considerable attention as promising alternatives to antibiotics. In this study, C. perfringens phage CPD2 was isolated from retail chicken samples. CPD2 belongs to the Podoviridae family and exhibits remarkable thermostability. While CPD2 has narrow host specificity, its endolysin LysCPD2 showed a broader lytic range, killing not only C. perfringens strains but other Gram-positive bacteria, such as B. cereus and B. subtilis. In addition, due to its exceptional thermal stability, LysCPD2 showed significant antibacterial ability against germinating C. perfringens spores during the heat activation process (75 °C for 20 min). Taken together, these results indicate that both thermostable phage CPD2 and its endolysin LysCPD2 can be used as efficient antimicrobial agents to control C. perfringens during thermal processing of foods.

우울증 진단 및 치료를 위한 챗봇 연구 동향 분석

신다은,오하영 한국정보통신학회 2023 한국정보통신학회논문지 Vol.27 No.3

South Korea has the highest incidence of mental diseases such as depression among OECD countries. It is important to identify the presence of mental diseases in the early stages, and to treat them so that the symptoms do not get worse, such as physical diseases. However, on the contrary the perception of mental illness in Korea is still somewhat negative. Therefore, it is important to establish a system that allows people to diagnose and treat initial symptoms of mental illness with electronic devices anytime, anywhere, even if they do not visit any facility. Therefore, in this study, the current criteria for diagnosis of depression and trends in chatbots related to depression were analyzed in relation to mental illness, especially depression. Additionally, a chatbot structure for diagnosis and treatment of depression for Koreans suffering from early depression of locating near the baseline in the diagnostic criteria for depression is proposed based on multi-turn conversation dataset and reinforcement learning. 대한민국은 우울증과 같은 정신적인 질환의 발병률이 OECD 국가 중 최고 수준이다. 신체적인 질환과 같이 정신적인 질환 역시 초기에 발병 유무를 파악하고, 증세가 더 심해지지 않도록 치료하는 것이 중요하다. 하지만 이와 반대로 아직 대한민국 내에서 정신적인 질환에 대한 인식은 다소 부정적인 편이다. 따라서, 시설에 방문하지 않더라도, 언제 어디에서든지 전자기기로 정신질환의 초기 증상을 진단하고 이를 치료할 수 있도록 하는 시스템을 구축하는 것이 중요하다. 따라서 본 연구에서는 정신질환 중 특히 우울증과 관련하여 현재 우울증 진단 기준 및 우울증 관련 챗봇에 대한 동향 분석을 진행하였다. 추가로 초기 우울증을 앓거나 우울증 진단 기준에서 기준선 근처에 위치하는 한국인을 위해, 우울증 진단 및 치료를 위한 챗봇 구조를 멀티턴 대화 데이터셋과 강화학습을 기반으로 하여 제안한다.

소아환자의 약물혈중농도 모니터링을 통한 Voriconazole 용량 조절 분석

신다은,안진서,김재송,손은선,장민정 한국병원약사회 2020 병원약사회지 Vol.37 No.4

Background : Voriconazole is the first-line treatment for invasive fungal infections, and therapeutic drug monitoring (TDM) is recommended because of its non-linear pharmacokinetic properties. Voriconazole was first approved for adults age 18 and older, which was subsequently approved for children with a maintenance dose of 7 mg/kg twice daily. However, dosing which is approved by the Korean Ministry of Food and Drug Safety (MFDS) was changed in 2013 to 9 mg/kg loading dose and 8 mg/kg maintenance dose, and the TDM criteria has not been validated for children. Thus, the purpose of this study was to confirm the effectiveness of the recommended dose by the MFDS and to contribute to establishing pediatric voriconazole dose guidelines by analyzing dose adjustment through the TDM. Methods : We retrospectively analyzed the TDM results of 32 children younger than age 18 who received voriconazole for the treatment of invasive fungal infection at Severance Hospital October 2016-June 2019. The therapeutic range of voriconazole was set to 1-5.5 mg/L. Results : A total of 32 patients were enrolled in this study and 101 TDM samples were collected (IV 52, PO 49). The mean of Ctrough was 2.43 ± 2.95 mg/L, of which 42.6% (43/101) reached the therapeutic range. Among 35 cases of the first TDM, the proportion of which reached therapeutic range in the MFDS recommended dosing group was 50.0%, and in the MFDS non-compliant group was 21.7% (p=0.130). Among 34 cases initially out of therapeutic range, the dose adjusted group was more effective reaching the therapeutic range than the dose non-adjustment group (64.7% vs. 17.6%, p=0.005). Conclusion : This study confirmed that when administrating voriconazole to pediatric patients, dose adjustment through the TDM is necessary because it significantly increases the rate of Ctrough within the therapeutic range.

평생학습자의 학습정향성에 의한 군집화와 특성탐구

신다은,김진화 한국방송통신대학교 미래원격교육연구원 2016 평생학습사회 Vol.12 No.1

학습정향성은 페다고지·앤드라고지·휘타고지 학습원리를 결정짓는 다원적인 학습특성 요소가 평생학습자에게 복합적으로 작용하여 나타나는 융합적 학습특성으로 정의된다. 본 연구는 학습정향성에 의해 평생학습자를 유용한 군집의 수와 크기로 분류하고, 각 군집의 속성과 특성을 탐구하는 데 목적을 두었다. 본 연구를 통해 다음과 같은 결과를 도출하였다. 첫째, 조사대상자인 평생학습자를 학습정향성에 따라 5개 집단으로 군집화하였으며, 각 군집은 학습속성을 고려하여 PO집단, PAO집단, AO집단, AHO집단, HO집단으로 명명하였다. 둘째, 군집화된 5개의 평생학습자 집단과 통계적으로 유의미한 관련변인은 최종학력, 직업, 평생교육프로그램 유형의 수, 평생교육기관 유형의 수, 평생교육프로그램 참여 횟수, 지식관리 수준, 평생학습실천 수준이었다. 이상의 연구결과는 평생교육의 페다고지·앤드라고지·휘타고지 학습원리가 연속체론적 학습정향성을 나타낸다는 사실을 실증적으로 확인한 것이며, 평생교육현장에서 평생학습자가 학습정향성에 의해 새로운 집단으로 분화되고 있음을 시사한다. 따라서 본 연구결과는 학습정향성에 의해 군집화된 평생학습자 집단을 위한 차별화된 교수·학습 전략을 구상하는 데 활용될 수 있을 것이다. Learning orientation is defined as complex mixture of lifelong learners’ learning characteristics which are functioned integrally by the multiple elements of learning characteristics related with determining the pedagogical, andragogical, and heutagogical learning principles. The objectives of this study were to cluster the lifelong learners based on learning orientation by the number and size of cluster and analyze the attributes and characteristics of each cluster. The findings were as follows. First, the lifelong learner were clustered as 5 groups with the different size and the entitled as the clustered group of PO, PAO, AO, AHO, and HO. Second, the significance variables related with five clustered groups of lifelong learners include 8 variables such as educational background, occupation, number of the involved program types, number of institution types, number of the participated programs, levels of knowledge management, and levels of lifelong learning practice. Those findings were suggestive of supporting evidence that the pedagogical, andragogical, and heutagogical learning principles in lifelong education is the theoretical continuum perspectives and imply that lifelong learners are divided into new groups according to learning orientation in the field of lifelong education. In conclusion, It will be possible to devise teaching and learning strategies for the clustered groups based on the attributes and characteristics of learning orientation.

애플리버셉트에 반응이 제한적인 습성나이관련황반변성에서 애플리버셉트 베바시주맙 교차투여 결과

신다은,김재휘 대한안과학회 2022 대한안과학회지 Vol.63 No.6

목적: 2개월 간격 애플리버셉트 주사에 반응이 제한적인 습성나이관련황반변성 환자를 대상으로 애플리버셉트와 베바시주맙 교차투여의 효과를 분석하고자 한다. 대상과 방법: 본 후향적 연구는 2개월 간격 애플리버셉트 주사에도 불구하고 망막하액 혹은 망막내액이 완전히 소실되지 않는 습성나이관련황반변성의 치료를 위해 애플리버셉트-베바시주맙 1개월 간격의 교차투여를 시행받은 환자를 대상으로 시행되었다. 교차투여 직전의 시력과 중심망막두께를 최종 교차투여 후의 값과 서로 비교하였다. 교차투여 전 및 최종 교차투여 후 망막하액 혹은 망막내액이 관찰되는 빈도를 추가적으로 확인하였다. 결과: 전체 18명을 대상으로 연구를 시행하였다. 진단 시부터 교차투여 전까지의 기간은 평균 37.9 ± 18.8개월이었으며, 평균 3.1 ± 2.2회의 교차투여가 시행되었다. 최대교정시력은 교차투여 전 평균 0.45 ± 0.28에서 교차투여 후 평균 0.36 ± 0.23으로 유의하게호전되었다(p=0.036). 중심망막두께의 경우 교차투여 전 평균 440.3 ± 122.9 μm에서 교차투여 후 평균 317.7 ± 103.5 μm로 유의하게 감소하였다(p=0.001). 망막하액과 망막내액은 교차투여 전 각각 94.4%, 55.6%에서 관찰되었으며, 교차투여 후 각각 22.2%, 11.1% 에서 관찰되었다. 결론: 2개월 간격 애플리버셉트 주사에 반응이 제한적인 습성나이관련황반변성에서 애플리버셉트-베바시주맙 1개월 간격의 교차투여는 망막하액/망막내액의 소실에 좋은 효과를 보였으며, 유용한 치료 방안 중 하나로 이용될 수 있을 것으로 생각된다.

평생학습자의 군집분석에 관한 연구동향 탐색

신다은,김진화 한국방송통신대학교 미래원격교육연구원 2016 평생학습사회 Vol.12 No.4

The objective of this study were to analyze the related research trends of the articles applied cluster analysis on learner and lifelong learner, and to identify and discuss the possibility of subdividing lifelong learners into new groups. The study results were as follows. First, the target of cluster analysis was mostly accounted for by adults from the aspect of life cycle and social groups, and college students, graduate school students and other workers from the aspect of social groups. Second, the classification criteria used for cluster analysis of lifelong learners included academic motivation, learning properties, personal disposition, etc. Third, in order to identify inherent attributes of the groups revealed through the cluster analysis and to analyze the correlation with characteristic factors of lifelong learners, major statistical techniques were employed. Fourth, the number of clusters applying the properties and attributes of lifelong learners was relatively high in 3 and 4; by giving a new name for each cluster, it tried to highlight the new meaning of the lifelong learner groups. The results implicates that there have been widespread efforts to re-recognize subdivided groups by using the properties and attributes of lifelong learners from the viewpoints of lifelong education rather than traditional viewpoints such as life cycle and social groups. Moreover, the results can be utilized as meaningful criteria and conditions for understanding and supporting lifelong learners in the field of studying and practicing lifelong education. 평생교육 실천현장이 확대됨에 따라 평생교육의 다양한 대상자를 포괄하는 평생학습자라는 개념이 사용되면서 관련 연구도 확산되고 있다. 평생학습자의 군집분석에 관한 연구는 새로운 집단세분화에 초점을 맞춘다. 이것은 오랫동안 통용되어 온 생애주기와 사회집단과 구별되는 평생학습자의 속성과 특성을 기반으로 한다. 이에 본 연구는 통계분석기법 중 하나인 군집분석을 적용한 연구동향을 분석하고, 연구대상으로서 평생학습자의 새로운 집단세분화의 가능성을 확인하여 논의하는 데 목적을 둔다. 연구의 결과는 다음과 같다. 첫째, 군집분석의 대상은 생애주기 측면에서 성인기, 사회집단 측면에서 대학(원)생과 기타(성인)가 많은 것으로 확인되었다. 둘째, 평생학습자의 군집분석에서 활용된 분류기준은 학습동기, 학습특성 등이었다. 셋째, 군집분석의 결과로 나타난 집단의 내재적 속성과 평생학습자 특성변인과의 관계성을 분석하기 위해 다양한 통계기법이 활용되었다. 넷째, 평생학습자의 속성과 특성을 적용한 군집의 수는 3개와 4개 집단이 상대적으로 많았고, 각 군집에 대해 새로운 명칭을 부여함으로써 평생학습자의 의미 있는 새로운 집단으로 부각하고자 하였다. 이러한 연구결과는 평생학습자를 생애주기와 사회집단과 같은 전통적 관점에서 벗어나, 평생교육의 관점에서 이들의 속성과 특성을 활용하여 세분집단을 재인식하려는 노력이 확산되고 있음을 시사한다. 또한 평생교육 연구 및 실천현장에서 평생학습자를 이해하고 지원하는 데 있어 의미 있는 기준과 조건으로 활용할 수 있다는 점을 함의한다.

A Case of Idiopathic Infratentorial Superficial Siderosis

신다은,Seok-Yul Yang,김영욱,유호성,Hoseok Lee 대한자기공명의과학회 2020 Investigative Magnetic Resonance Imaging Vol.24 No.1

Superficial siderosis is attributed to hemosiderin deposition in the subpial layers of the nervous system. The clinical features of infratentorial superficial siderosis (ISS) are hearing loss, cerebellar ataxia, and corticospinal tract signs and the most common cause of idiopathic ISS is a dural defect. As magnetic resonance imaging (MRI) has advanced, the diagnosis of infratentorial superficial siderosis can be confirmed by unique radiological findings in MRI. Here, we report on a female patient diagnosed with idiopathic ISS by means of clinical symptoms and radiological findings.

성인 고형암 환자의 고칼슘혈증 치료현황과 치료효과 분석

신다은,박설희,김성환,서성연,조윤희,조윤숙,임석아,이주연 한국임상약학회 2019 한국임상약학회지 Vol.29 No.3

Background: Hypercalcemia is an important metabolic emergency condition in cancer patients. Bisphosphonate is the treatment of choice for hypercalcemia, whereas calcitonin and hydration with furosemide are recommended for acute supportive therapy. However, data regarding real-world treatment patterns and outcomes of pharmacological treatments are limited. Therefore, we aimed to investigate the treatment patterns and clinical outcomes of hypercalcemia treatment in solid tumor patients. Methods: Electronic medical records of 123 adults with solid cancers and albumin-corrected calcium levels >10.5 mg/dL or ionized calcium levels >1.35 mmol/L were reviewed. We retrospectively analyzed the pharmacological treatment and recovery rate according to the severity of hypercalcemia. Results: A total of 177 cases were identified, of which 49 were not treated and 30 were treated with hydration only. In moderate-to-severe cases, 86.5% received pharmacological treatment. Thirty-four cases (19.2%) were treated with bisphosphonate alone and 58 cases (32.8%) were treated with bisphosphonate and calcitonin. In mild hypercalcemia cases, the recovery rate was higher for those receiving hydration only or pharmacological treatment (79.7%) than for those receiving no treatment (61.4%, p = 0.041). Most moderate-to-severe cases were treated with medication and of those treated, 56.3% recovered. The recovery rate was lower in those treated with bisphosphonate alone (38.2%) than in those who underwent calcitonin combination treatment (73.7%, p = 0.001). Conclusions: Bisphosphonate combined with calcitonin was found to be more effective than bisphosphonate alone for the treatment of moderate-to-severe hypercalcemia. Considering the current shortage of calcitonin, further efforts are required to ensure its stable supply.