Development of severe junctional bradycardia after dexmedetomidine infusion in a polypharmacy patient: a case report and literature review

전소은,김은수,이선학,백성인,이현수,이도원 고신대학교(의대) 고신대학교 의과대학 학술지 2023 고신대학교 의과대학 학술지 Vol.38 No.1

The authors report a case of newly manifested severe junctional bradycardia following dexmedetomidine administration during spinal anesthesia in a polypharmacy patient. A 77-year-old woman receiving multiple medications, including a beta-blocker and a calcium channel blocker, underwent right total knee arthroplasty. After spinal anesthesia, intravenous dexmedetomidine was initiated as a sedative; her heart rate decreased, followed by junctional bradycardia (heart rate, 37–41 beats/min). Dexmedetomidine was discontinued, and a dopamine infusion was initiated. Seven hours after surgery, junctional bradycardia persisted; a temporary transvenous pacemaker was inserted, and the beta-blocker and calcium channel blocker were discontinued. The patient was discharged on postoperative day 11 without any sequelae. Anesthesiologists should be aware of dexmedetomidine’s inhibitory effects on the cardiac conduction system, especially in geriatric patients taking medications with negative chronotropic effects and in combination with neuraxial anesthesia.

Pharyngeal reperforation following incentive spirometry - A case report -

전소은,홍정민,권재영,황부영,윤기영 대한마취통증의학회 2018 Anesthesia and pain medicine Vol.13 No.4

Despite its widespread use, complication of incentive spirometry has been rarely reported. We report a case of pharyngeal reperforation following incentive spirometry. A 75-year-old female, had a history of long-term steroid use, entered the intensive care unit for maintenance of mechanical ventilation following surgical repair of a pharyngeal perforation. After ventilator weaning, incentive spirometry was implemented on postoperative day 4. Immediately after incentive spirometry use, patient’s neck began to swell, and subcutaneous emphysema was palpated. Pharyngeal reperforation was suspected on neck computed tomography, and emergency surgery was performed. Surgery revealed a 3-cm long rupture from the hypopharynx to the esophagus. The causes were thought to be delayed wound healing due to long-term steroid use and a sudden increase in pharyngeal pressure due to incentive spirometry. In conclusion, particular attention should be paid when using incentive spirometry after head and neck surgery in patients with a history of long-term steroid use.

소아 특발혈소판감소 자색반병 환자에서 항핵항체 검사의 양성률 및 임상적 의의

전소은,박성식,임영탁,Jun, So Eun,Park, Seong Sik,Lim, Young Tak 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.11

목 적: SLE에서는 진단 당시 및 경과 중에 약 15-20%에서 혈소판 감소가 발생하며, 5-16%에서는 혈소판 감소증이 첫 임상증상으로 발생할 수 있으므로 소아 ITP와 SLE와의 연관성이 강력히 제기되고 있다. 한편 항핵항체는 여러 자가면역질환의 선별검사로 주로 이용되고 있는데, 특히 자가면역질환의 임상증상이 발현되기 수개월 혹은 수년 전에 발현될 수 있다. 따라서 저자들은 소아 ITP로 진단된 환자들에서 항핵항체 검사의 양성률 및 임상적 의의를 조사하고자 본 연구를 시작하였다. 방 법: 2003년 1월부터 2006년 12월까지 부산대학교병원 소아청소년과에서 급성 ITP로 진단 받고, 진단 당시에 항핵항체 검사를 시행하였던 77예의 환아를 대상으로 하였다. 항핵항체 검사는 정량 및 정성 검사를 시행하였고, 1:40 이상을 양성으로 판정하였다. 항핵항체 검사 상 양성인 환자들은 1년 이상 역가를 주기적으로 추적관찰 하였다. 결 과: 1) 진단 당시 항핵항체 검사를 시행한 77예의 ITP 환자 중 남아는 38예(49.4%), 여아는 39예(50.5%)였으며, 평균 연령은 4.5세였고, 16예(20.8%)에서 항핵항체 검사 상 양성을 보였다. 2) 항핵항체 양성인 군에서 항핵항체의 정량 역가의 분포는 1:80-1:1,280으로 1:640이 16명 중 5명(30.7%)으로 가장 많았고, 항핵항체의 형은 homogeneous 형이 16명 중 6명(37.5%)으로 가장 많았다. 3) 항핵항체가 양성인 군의 평균 연령은 9.3세로 음성인 군의 3.3세에 비해 진단 당시 평균 연령이 의미 있게 높았다(P<0.05). 4) 항핵항체가 음성인 군의 남녀비는 비슷하였던 반면 항핵항체가 양성인 군은 여아가 81.3%로 현저히 높았다(P<0.05). 5) 진단 당시 혈소판 정중값은 항핵항체 양성군에서는 $18,400/{\mu}L$, 음성군에서는 $21,800/{\mu}L$으로 두 군 사이에 의미 있는 차이가 없었다. 6) 진단 당시 항핵항체의 역가 및 형은 만성 ITP 및 SLE로의 진행과 의의있는 관련이 없었다. 7) 급성 ITP 진단 당시 항핵항체 양성이었던 환자 중 1명이 추적관찰 41개월 후 SLE로 최종 진단되었다. 결 론: 소아 급성 ITP 환자에서 ANA 양성인 경우가 비교적 흔한 것으로 나타났으며, 만성 ITP와 SLE로의 진행에 대한 연관성은 더 많은 환자를 대상으로 한 연구를 통하여 밝혀져야 할 것이다. Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

데이터 증강 기반의 효율적인 포이즈닝 공격 방어 기법

전소은,옥지원,김민정,홍사라,박새롬,이일구 한국융합보안학회 2022 융합보안 논문지 Vol.22 No.3

Recently, the image processing industry has been activated as deep learning-based technology is introduced in the image recognition and detection field. With the development of deep learning technology, learning model vulnerabilities for adversarial attacks continue to be reported. However, studies on countermeasures against poisoning attacks that inject malicious data during learning are insufficient. The conventional countermeasure against poisoning attacks has a limitation in that it is necessary to perform a separate detection and removal operation by examining the training data each time. Therefore, in this paper, we propose a technique for reducing the attack success rate by applying modifications to the training data and inference data without a separate detection and removal process for the poison data. The One-shot kill poison attack, a clean label poison attack proposed in previous studies, was used as an attack model. The attack performance was confirmed by dividing it into a general attacker and an intelligent attacker according to the attacker's attack strategy. According to the experimental results, when the proposed defense mechanism is applied, the attack success rate can be reduced by up to 65% compared to the conventional method. 최근 이미지 인식 및 탐지 분야에 딥러닝 기반의 기술이 도입되면서 영상 처리 산업이 활성화되고 있다. 딥러닝 기술의 발전과 함께 적대적 공격에 대한 학습 모델 취약점이 계속해서 보고되고 있지만, 학습 시점에 악의적인 데이터를 주입하는 포이즈닝 공격의 대응 방안에 대한 연구가 미흡한 실정이다. 종래 포이즈닝 공격의 대응 방안은 매번 학습 데이터를 검사하여 별도의 탐지 및 제거 작업을 수행해야 한다는 한계가 있었다. 따라서, 본 논문에서는 포이즌 데이터에 대해 별도의 탐지 및 제거 과정 없이 학습 데이터와 추론 데이터에 약간의 변형을 가함으로써 공격 성공률을 저하시키는 기법을 제안한다. 선행연구에서 제안된 클린 라벨 포이즌 공격인 원샷킬 포이즌 공격을 공격 모델로 활용하였고, 공격자의 공격 전략에 따라 일반 공격자와 지능형 공격자로 나누어 공격 성능을 확인하였다. 실험 결과에 따르면 제안하는 방어 메커니즘을 적용하면 종래 방법 대비 최대 65%의 공격 성공률을 저하시킬 수 있었다.

선천성 낭성 선종양 폐기형의 임상적 고찰

전소은,박희주 대한 소아알레르기 호흡기학회 2008 Allergy Asthma & Respiratory Disease Vol.18 No.2

Purpose:Congenital cystic adenomatoid malformation (CCAM) is a rare variant of congenital pulmonary cystic disease, which is characterized by a proliferation of the dilated bronchiolar-like structure of varying size and/or distribution. In this study, we described the clinical manifestations of CCAM in a single institution during a 12-year period. Methods:Twenty patients diagnosed with CCAM who were admitted at Busan National University Hospital between January 1995 and December 2007, were investigated for their presenting characteristics, age at diagnosis, locations, histopathologic types, combined anomalies, treatments and outcomes. Results:Twenty patients diagnosed with CCAM were reviewed. Twelve males and eight females, the mean age of the patients was 7.5 years. The main symptoms were coughing, sputum, recurrent infection, chest pain, cyanosis, and tachypnea. Seven patients were antenatally diagnosed and two patients were incidentally diagnosed. Radiologic findings were multiple cysts in 15 cases, solitary cyst in 2, consolidation in 3, pleural effusion in 4, tracheal deviation in 2, and abscess in 1 case. The most common location of cystic lesion was the right lower lobe, which includes 9 cases (45%). According to Stocker's histologic classification of CCAM, type I was found in 11 cases (73%), type II in 2 cases and type III in 1 case. In 5 cases, there were combined anomalies including ipsilateral pulmonary sequestration, dextrocardia, pectus excavatum, patent ductus arteriosus, accessory bronchus, and bronchogenic cyst. Fifteen patients underwent lobectomy, two patients are going to have operation and other 3 patients were transferred from regional hospital after diagnosis. All patients who underwent surgical resection improved. Conclusion:CCAM is a rare but potentially life-threatening pulmonary anomaly, which can be found at different ages and presents with various clinical findings. The possibility of an underlying CCAM should be considered in children with recurrent pulmonary infections or persistent abnormalities on chest X-rays following an acute infection. Purpose:Congenital cystic adenomatoid malformation (CCAM) is a rare variant of congenital pulmonary cystic disease, which is characterized by a proliferation of the dilated bronchiolar-like structure of varying size and/or distribution. In this study, we described the clinical manifestations of CCAM in a single institution during a 12-year period. Methods:Twenty patients diagnosed with CCAM who were admitted at Busan National University Hospital between January 1995 and December 2007, were investigated for their presenting characteristics, age at diagnosis, locations, histopathologic types, combined anomalies, treatments and outcomes. Results:Twenty patients diagnosed with CCAM were reviewed. Twelve males and eight females, the mean age of the patients was 7.5 years. The main symptoms were coughing, sputum, recurrent infection, chest pain, cyanosis, and tachypnea. Seven patients were antenatally diagnosed and two patients were incidentally diagnosed. Radiologic findings were multiple cysts in 15 cases, solitary cyst in 2, consolidation in 3, pleural effusion in 4, tracheal deviation in 2, and abscess in 1 case. The most common location of cystic lesion was the right lower lobe, which includes 9 cases (45%). According to Stocker's histologic classification of CCAM, type I was found in 11 cases (73%), type II in 2 cases and type III in 1 case. In 5 cases, there were combined anomalies including ipsilateral pulmonary sequestration, dextrocardia, pectus excavatum, patent ductus arteriosus, accessory bronchus, and bronchogenic cyst. Fifteen patients underwent lobectomy, two patients are going to have operation and other 3 patients were transferred from regional hospital after diagnosis. All patients who underwent surgical resection improved. Conclusion:CCAM is a rare but potentially life-threatening pulmonary anomaly, which can be found at different ages and presents with various clinical findings. The possibility of an underlying CCAM should be considered in children with recurrent pulmonary infections or persistent abnormalities on chest X-rays following an acute infection.

메타버스 내 산업기밀 유출 대응을 위한 정책 및 제도에 관한 연구

전소은,오예솔,이일구,Jeon, So-Eun,Oh, Ye-Sol,Lee, Il-Gu 한국디지털정책학회 2022 디지털융복합연구 Vol.20 No.4

최근 실감형 가상공간 기술인 메타버스(Metaverse) 기술이 화두가 되고 있다. 하지만, 메타버스 환경에 대한 제도적 체계가 미흡해서 메타버스 내 생산, 저장, 가공, 이전되는 디지털 자산을 포함한 산업기밀 유출 문제에 대한 우려가 대두되고 있다. 사이버 공간의 해킹 공격을 방어하기 위한 디지털 포렌식 기술은 메타버스 공간에서 활용이 불가하고, 피해 범위 산정 및 책임 추적의 근거가 마련되어 있지 않아서 인력 유출 및 사이버 해킹에 대한 효과적인 대응이 어렵다. 본 논문에서는 메타버스에서 발생 가능한 산업기밀 정보의 범위와 유출 시나리오를 정의하고, 메타버스 내 유출 시나리오 별 발생가능한 문제점을 기반으로 메타버스 시대의 산업기밀 유출 대응을 위한 정책적·제도적 방안을 제안한다. 연구결과, 메타버스 내 산업기밀 유출 대응을 위해서는 역외 압수·수색 문제에 대한 표준화된 법률 마련 및 가상화폐 증거 수집 제도 마련이 필요한 실정임을 확인할 수 있었다. 본 연구를 통해 메타버스 기술에서 발생 가능한 문제에 사전 대비를 함으로써 산업 기술 발전에 기여할 수 있을 것이다. Metaverse, realistic virtual space technology has become a hot topic. However, due to the lack of an institutional system to the metaverse environment, concerns are rising over the leakage of industrial confidentiality, including digital assets produced, stored, processed, and transferred within the metaverse. Digital forensics, a technology to defend against hacking attacks in cyberspace, cannot be used in metaverse space, and there is no basis for calculating the extent of damage and tracking responsibility, making it difficult to respond to human resources leakage and cyberhacking effectively. In this paper, we define the scope of industrial confidentiality information and leakage scenario and propose policy and institutional measures based on problems in each metaverse scenario. As a result of the study, it was necessary to prepare a standardized law on Extra-territorial search and seizure issues and a system for collecting cryptocurrency evidence to respond to industrial confidentiality leaks in the metaverse. The study expects to contribute to industrial technology development by preparing in advance for problems that may arise in metaverse technology.

선천성 낭성 선종양 폐기형의 임상적 고찰

전소은 ( So Eun Jun ),박희주 ( Hee Ju Park ) 대한소아알레르기 및 호흡기학회 2008 소아알레르기 및 호흡기학회지 Vol.18 No.2

자연어 처리 기법을 이용한 상품평 분석에 관한 연구

전소은(So Eun Jeon),이영구(Young-gu Lee),박경철(Kyeong Cheol Park),백우진(Woojin Paik) 한국HCI학회 2009 한국HCI학회 학술대회 Vol.2009 No.2

Consumers express how they evaluate what they purchased by writing reviews especially when they purchased products online. By analyzing the reviews about a product, it will be possible to find out what the consumers liked and disliked about the product. It will be also possible to identify the general consensus on what matters in purchaing certain product type such as a laptop if many reviews about many instances of a particular product type is analyzed. However, it takes a lot of time to manually analyzing the reviews. Thus, we propose to use two natural language processing oriented computational techniques to analyze a large number of reviews. The techniques are text classification and information extraction. We developed 무 review analysis system and conducted experiments against the reviews about the laptop computers posted on the Naver information portal. 많은 소비자는 특히 온라인상에서 물건을 구입하고 그 물건에 대하여 자신이 좋아하는 점이나 싫어하는 것을 포함하는 평가를 웹에 올린다. 이 평가를 분석하여 소비자가 물건을 구매할 때 무엇에 관심을 가지고 중요하게 여기는가에 대하여 알 수있다. 에를 들어 노트북을 구매할 때 작성된 평가를 분석하면 어떤 기능이 중요한 구매 결정 요소이며 어떤 것들을 고쳐야 하는지에 대하여 알 수 있다. 하지만 많은 양의 자료를 수동으로 분석하기에는 시간이 많이 걸린다. 따라서 대량의 자료를 쉽게 분석할 수 있는 두 개의 자연어처리 기법을 이용한 자동 분석 방법을 구현하였다. 두 가지 방법은 자동 문서 분류와 자동 정보 추출이다. 네이버정보 포털에 있는 상품평을 개발한 시스템으로 분석하였고 평가 결과를 도출했다. 자동분석시스템의 정확율과 재현율 측면에서 유사한 시스템이 다른 자료유형 분석에 적용했을 때와 비교하여 비슷하였다.

현실보다 넓은 가상공간을 이동하기 위한 거리인식에 착각을 주는 요인

전소은(Jeon So Eun),안정현(Ahn Jeong Hyeon),공호진(Gong Ho Jin),김형석(Kim Hyung Seok) 한국통신학회 2017 한국통신학회 학술대회논문집 Vol.2017 No.6

주간의 저항성 운동과 크레아틴, 류신의 투여가흰쥐의 근 단백질 합성 및 골격근 특성에 미치는 영향

전소은 ( So Eun Jeon ),옥진아 ( Gin A Ok ),박현 ( Hyon Park ) 한국스포츠정책과학원(구 한국스포츠개발원) 2014 체육과학연구 Vol.25 No.1

이 연구에서는 8주간의 저항성 운동 시 크레아틴, 류신의 투여가 근 단백질 합성과 근비대에 어떠한 영향을 미치는지 규명하는데 그 목적이 있다. 실험동물은 SD계 흰쥐 수컷 32마리를 사용하였으며, 대조군(CON), 운동군(E), 운동과 크레아틴 투여군(EC), 운동과 크레아틴, 류신 투여군(ECL)으로 분류하였다. 저항성 운동은 점진적으로 증가시킨 중량을 꼬리에 연결하여 사다리를 오르는 방법을 이용하였으며(주 3회), 보조제 투여는 크레아틴은 250㎎/kg, 크레아틴+류신은 250+250㎎/kg의 양을 매일 구강 투여하였다. 실험 결과, 체중은 모든 집단에서 실험 초기에 비해 유의하게 증가하였고(p<.001), CON군의 체중이 저항성 운동을 실시한 세 집단의 체중보다 유의하게 많이 나갔다(p<.05). plantaris 무게는 E군이 CON군에 비해 유의하게 증가하였으며(p<.05), FHL 근육무게는 운동을 실시한 세 집단이 CON군에 비해 유의하게 증가하였다(p<.05). 또한 E군이 EC군, ECL군보다 유의하게 증가하였다(p<.05). 최대근력은 저항성 운동을 실시한 세 집단 모두 실험 초기에 비해 유의하게 증가하였으며(p<.001), 집단 간 차이는 없었다. Phospho-Akt 발현은 보조제를 투여한 EC군과 ECL군이 유의하게 감소하였으며(p<.05), Phospho-mTOR는 유의한 차이가 없이 증가하는 경향을 보였다. 따라서 저항성 운동은 근육량의 증가와 근력 향상에 긍정적인 영향을 미치지만, 추가적으로 처치한 크레아틴과 류신의 영향은 미비한 것으로 판단된다. 그러나 세포내 수준에서 phospho-mTOR 단백질 발현이 증가하는 경향을 보임으로써 그 가능성을 확인할 수 있었고, 추후에는 단백질 합성에 관여하는 다양한 요인들을 세밀하게 관찰하는 연구가 필요할 것으로 사료된다. The purpose of this study was to examine the effect of dietary creatine and leucine supplementation on protein synthesis and functional properties of skeletal muscle during 8 weeks of resistance exercise. Thirty two male Sprague-Dawley rat (5 weeks old) were randomly divided into four groups(8 rats per group): sedentary control group (CON), execise group(E), exercise with creatine supplementation group (EC), exercise with creatine, leucine supplementation group(ECL). Exercise groups were trained to climb a ladder with a weight secured to their tails (3day/week). The supplementation was administrated daily through oral gavage. Creatine supplementation was given at 250㎎/㎏/day. Creatine+leucine supplementation was given at 250+250㎎/㎏/day. All exercise groups presented significantly lower epididymal fat mass than CON (p<.05). E presented significantly higher plantaris mass than CON(p<.05). All exercise groups significantly presented higher FHL mass than CON(p<.05) and E presented higher FHL mass than EC, ECL(p<.05). EC, ECL presented significantly lower expression of Akt/PKB protein than CON, E(p<.05). There was no difference in the expression of m TOR protein. The results suggest that the creatine and leucine supplementation does not promote any additional hypertrophic effect on resistance trained skeletal muscle. But, creatine and leucine supplementation might have a potential benefit on skeletal muscle hypertrophy through the activation of protein synthesis.