음성 및 텍스트 데이터로부터 Bi-LSTM과 CNN의 4-stream 기반 우울증 진단

조아현 조선대학교 대학원 2022 국내석사

Depression is a disease that causes changes in emotions, thoughts, and behavior, and it falls into severe depression by leaving the disease unattended, which can lead to various problems. Currently, the diagnosis of depression is based on inconsistent subjective opinions of clinicians. In addition, it is done in a way that patients directly tell their conditions through questionnaires. However, these methods have disadvantages in that they are limited and difficult to diagnose accurately because objective opinions are excluded. Therefore, we need a system that objectively and accurately diagnoses depression by considering various data and features. Recently, interest in automated system design has been increasing in the field of the affective computing community and artificial intelligence to efficiently diagnose depression. In particular, based on deep learning technology, research on depression diagnosis is being actively conducted using multi-mode, which can utilize much information by fusion of multiple data rather than a single-mode using one data. In this paper, we propose a depression diagnosis model based on a 4-stream of Bidirectional Long Short Term Memory(Bi-LSTM) and Convolutional Neural Network(CNN) from audio and text data. One-dimensional features of speech signals were extracted using Mel Frequency Cepstral Coefficient(MFCC) and Gammatone Cepstral Coefficients(GTCC). Also, two-dimensional features were extracted from the Bark spectrogram, ERB spectrogram, and Log-Mel spectrogram based on time-frequency transformation. These features were applied to Bi-LSTM, and CNN-based transport learning models such as VGGish, YAMNet, and OpenL3. For text data, word-encoding was used to map the text into sequences with numeric indices. And word embedding concepts were used to represent all words as dense numeric vectors. These texts were applied to Bi-LSTM, and the CNN model based on n-gram. Finally, the softmax values of the four deep learning models were ensembled using the late score fusion method to diagnose depression based on the 4-stream. The data used in the experiment is the Extended Distress Analysis Interview Corpus Wizard of Oz (EDAIC-WOZ) depression database designed to help diagnose people's psychological distress state. The noise was removed from speech data, and unnecessary words were cleaned up from text data through preprocessing to improve data quality. Also, extending the depression data solved the class imbalance problem. The experimental results showed that the performance was improved from min 1.22% to max 2.44% more when using the 4-stream model than the single model. In addition, the proposed model was more competitive than the 2-stream-based model of the previous study under the same data conditions. Likewise, the proposed model showed good performance when evaluating the performance using the EDAIC-WOZ database. These results proved that the proposed model is effective in diagnosing depression.

Toxic effects on hematological parameters, antioxidant enzymes and stress indicators in far eastern catfish, Silurus asotus depending on the exposure to silver particle size (nano and micro)

조아현 선문대학교 일반대학원 2024 국내석사

본 연구의 목적은 수인성 은나노입자 (AgNPs) 및 은마이크로입자 (AgMPs)에 노출된 메기, Silurus asotus의 혈액학적 성상, 항산화 효소 및 스트레스 지표를 측정하여 은 입자 크기에 따른 독성 효과를 평가하는 것이었다. S. asotus (평균 체중: 95.6 ± 33.0g; 평균 체장: 25.5 ± 2.4cm)는 0, 4, 8, 64 및 128 mg/L 농도의 AgNPs와 0, 4, 8, 16, 32, 64, 128, 256, 512 mg/L 농도의 AgMPs에 5일 및 10일 동안 노출되었다. 혈액학적 성상, 항산화 효소 및 스트레스 지표는 입자 크기에 따라 AgMPs에 비해 AgNPs에 의해 유의적인 영향을 받았음을 확인하였다. 128 mg/L 이상의 AgNPs 및 AgMP 노출은 헤모글로빈(Hb) 함량 및 헤마토크릿(Hct) 값이 유의적으로 변화했다. 64 mg/L 이상의 AgNPs 및 256 mg/L 이상의 AgMPs에 노출은 S. asotus의 간과 아가미에 산화 스트레스가 유발되어 슈퍼옥시드 디스뮤타제 (SOD) 및 카탈라아제 (CAT) 수치가 유의적으로 변화했다. 또한, 수인성 AgNPs 및 AgMPs 노출 후 S. asotus에서 열충격 단백질 70 (HSP 70) 및 열충격 단백질 90 (HSP 90) 수치가 유의적으로 변화했다. 본 연구에서 은 입자 크기에 따른 독성 영향는 혈액학적 성상, 항산화 효소 및 스트레스 지표에서 유의적인 변화를 보였다. 따라서 은 입자 크기(AgNPs 및 AgMPs)에 따른 독성 영향에 대한 유의적인 변화를 확인하였으며, 이는 S. asotus가 은 입자 크기에 따라 독성 영향의 유의적인 차이가 존재함을 시사했다. The purpose of this study was to evaluate the toxic effects of silver nanoparticles (AgNPs) and silver microparticles (AgMPs) according to particle size by measuring the hematological parameters, antioxidant enzymes and stress indicators in far eastern catfish, Silurus asotus exposed to waterborne AgNPs and AgMPs. S. asotus (mean weight, 95.6 ± 33.0 g; mean length, 25.5 ± 2.4 cm) were exposed to AgNPs at concentration of 0, 4, 8, 64 and 128 mg/L and AgMPs at concentration of 0, 4, 8, 16, 32, 64, 128, 256 and 512 mg/L for 5 and 10 days. Hematological parameters, antioxidants enzymes and stress indicators were significantly affected by AgNPs compared to AgMPs in a concentration-dependent manner. Exposure to ≥128 mg/L AgNPs and AgMPs induced a significant alteration in hemoglobin (Hb) content and hematocrit (Hct) values. However, exposure to ≥64 mg/L AgNPs and ≥256 mg/L AgMPs induced oxidative stress in the liver and gill of S. asotus, thereby resulting in a significant changes in the levels of superoxide dismutase (SOD) and catalase (CAT) levels. The heat shock protein 70 (HSP 70) and heat shock protein 90 (HSP 90) levels were significantly altered in S. asotus after waterborne AgNPs and AgMPs exposure. The toxic effects depending on silver particle size showed significant changes in hematological parameters, antioxidant enzymes and stress indicators. Therefore, toxic effects depending on silver particle size (AgNPs and AgMPs) had significant effects, thereby suggesting the existence of dependent toxic effects following silver particle size in S. asotus.

습도조건에 따른 PEG 처리 수침고목재의 특성 변화

조아현 충북대학교 2020 국내석사

The chemical treatment of waterlogged woods is not only for maintaining the original form, but also increasing the physical properties. These physical properties are important role in safely maintaining the treated woods, so that we could display the woods as long as possible. The most widely used materials as the chemical for waterlogged woods is PEG (Polyethylene glycol). Since PEG has advantages in view of dimensional stability, water solubility, safety in the human health, and economics. In most previous studies, the dimensional stability was the principle topic. The change of the physical properties of the impregnated woods in PEG by various relative humidity conditions has been rarely considered as a research topic. This study therefore aimed at investigating the changes in physical properties as well as common conditions, viz. the surface color and texture and the amount of PEG free-flowing back from the PEG-treated woods, at different relative humidity conditions. To accomplish the main purpose, a water-logged wood (Prinus group) dated between B.C. 1,602 and B.C. 1,486 by the radiocarbon dating was used as an experimental material and PEG#4000 was used for impregnation. Three different impregnation methods under different drying conditions were applied to the study as follows: 1) impregnation in 80% PEG#4000 and then drying in nature (hereafter PEG80), 2) impregnation in 40% PEG#4000 and then drying in the vacuum freeze drying equipment (hereafter PEG40), and 3) impregnation in 40% PEG#4000 with t-butanol, and then drying in the vacuum freeze drying equipment (hereafter TB40). The impregnation treatment was fulfilled using 62 wood blocks with approximately 2.5(R)×2.5(T)×2.5(L) ㎝ from the water-logged wood. For the test to measure the amount of PEG#4000 free-flowing back from the PEG-treatesd woods under different relative humidity (RH) conditions, the impregnated woods were placed under RH 90% for 4 weeks and then under RH 30% for 4 weeks as well. Such test was repeated 3 times (hereafter 1-rep, 2-rep, and 3-rep) and, at each time, the weight of a blotting paper placed under the blocks. In addition, the color and texture were measured and verified using a colorimeter and a stereomicroscope, and the compressive strength was measured using a universal material machine, as well. All measurement values for each experimental condition were obtained from 5 blocks. As a result, L* values, which showed the largest change in L*, a*, and b*, considerably decreased after 2-rep and/or 3-rep. In the surface observation, some PEG crystals formed by PEG free-flowing back from the PEG-treated woods were verified on the surfaces after 3-rep. For the more, it was verified there is almost no more PEG existing in the vessel lumina on digital images by a FE-SEM (Field Emission Scanning Electron Microscope). The amount of PEG free-flowing back from the PEG-treated woods were increasing more and more according to the repetition. In the test of the compressive strength, the heartwood showed higher values than the sapwood. The compressive strength of TB40 continuously decreased according to the repetition, whereas PEG80 and TB40 increased. These obtained results would be an useful fundamental data to effectively organize a plan for impregnating waterlogged woods and stably preserving the treated woods as long as possible.

대학 축구선수의 스포츠 경쟁 불안이 스포츠 수행 전략에 미치는 영향

조아현 명지대학교 대학원 2024 국내석사

본 연구의 목적은 한국 대학 축구선수의 경기 전 기분 상태를 비교하고 인구통계학적 특성과 출전 여부 유/무에 따라 설문지의 하위요인들을 구분하여 스포츠 경쟁 불안 상태가 스포츠 전략 분석에 영향을 미치는지 알아보는데 목적이 있으며 선수들의 경쟁 불안 상태가 스포츠 수행 전략 즉 경기력에 실증적 영향을 미치는지 규명하기 위해 국내 대학교 축구팀에 소속되어 있는 축구선수 114명을 대상으로 설문지를 배부를 통하여 조사하였다. 분석 방법은 SPSS 프로그램을 활용하여 빈도분석, 탐색적 요인분석, 신뢰도 분석, 대응 표본 t검정, 독립표본 t검정, 상관관계분석, 다중회귀분석을 실시하였으며, 다음과 같은 결론을 도출하였다. 첫째, 대학 축구선수들의 경기 일주일 전과 경기 직전의 출전 여부 유/무에 따라 기분 상태에 차이가 없지만 하위요인에 따라 비출전선수가 출전선수보다 활력이 높게 측정되었으며, 출전 여부 유/무에 따른 경기 일주일 전과 경기 직전은 출전선수가 우울과 활력에서 비출전선수는 기분 상태의 하위요인 불안, 우울, 분노, 활력, 피로, 혼란에서 유의한 차이가 나타났다. 둘째, 대학 축구 선수들의 학년과 포지션에 따라 스포츠 경쟁 불안의 차이가 나타나지 않았지만, 출전 여부 유/무에 따라 비출전선수가 인지적 불안과 신체적 불안이 높으며 상태 자신감 부분은 출전선수가 더 높게 측정되었다. 셋째, 스포츠 경쟁 불안의 하위요인 인지적 불안이 높을수록 스포츠 수행 전략의 하위요인 컨디션 조절, 긴장 풀기가 낮아졌으며, 인지적 불안이 높을수록 감정조절(부정적)이 높아졌다. 스포츠 경쟁 불안의 하위요인 신체적 불안이 높을수록 스포츠 수행 전략의 하위요인 긴장 풀기가 낮아지며, 신체적 불안이 높을수록 감정조절(부정적)이 높아졌다. 마지막으로 스포츠 경쟁 불안의 상태 자신감이 높을수록 자기조절, 심상 목표 설정, 컨디션 조절, 긴장 풀기가 높아지며, 감정조절이 낮아짐을 알 수 있었다. 넷째, 스포츠 경쟁 불안이 하위요인인 상태 자신감이 수행 전략의 하위요인인 자기조절, 컨디션 조절, 심상 목표 설정, 긴장 풀기에 긍정적인 영향을 미치는 것으로 나타났고 감정조절(부정적)에 부정적인 영향을 미치는 것으로 나타났다. 이상의 결과를 종합해 볼 때, 대학 축구선수의 기분 상태는 출전선수와 비출전선수와 차이를 입증하였으며, 선수의 기분 상태의 변화가 경쟁 불안을 조절할 수 있는 역할을 할 수 있을 것이다. 또한 출전 여부 유/무에 따라 비출전선수의 스포츠 경쟁 불안이 높을수록 인지적 신체적 불안이 높고, 출전선수는 상태 자신감 부분에서 높게 측정되었다. 마지막으로 스포츠 경쟁 불안 상태의 하위요인인 상태 자심감과 인지적 불안이 스포츠 수행 전략의 하위요인 컨디션 조절, 심상 목표 설정, 자기조절, 긴장 풀기, 감정조절에 영향을 미치는 것을 입증하였다. The purpose of this study is to compare the pre-game mood state of Korean college soccer players and classify the sub-factors of the questionnaire according to demographic characteristics and participation status to determine whether sports competition anxiety affects sports strategy analysis. For the purpose of this study, a survey was conducted by distributing questionnaires to 114 soccer players belonging to domestic university soccer teams in order to determine whether athletes' competitive anxiety status has an empirical effect on sports performance strategies, that is, performance. The analysis method used the SPSS program to conduct frequency analysis, exploratory factor analysis, reliability analysis, paired samples t-test, independent sample t-test, correlation analysis, and multiple regression analysis, and the following conclusions were drawn. First, there was no difference in the mood state of college soccer players depending on whether they participated or not a week before the game and immediately before the game, but non-playing players were measured to have higher vitality than participating players according to sub-factors, and the vitality of non-playing players was measured depending on whether they played or not. A week before and just before the game, there was a significant difference in depression and vitality for participating players, and in anxiety, depression, anger, vitality, fatigue, and confusion, which were sub-factors of mood state for non-playing players. Second, although there was no difference in sports competition anxiety depending on the grade and position of college soccer players, non-players had higher cognitive and physical anxiety depending on whether they participated or not, and the confidence level was higher for participating players. Third, the higher the cognitive anxiety, a subfactor of sports competition anxiety, the lower the subfactors of sports performance strategy, conditioning and relaxation, and the higher the cognitive anxiety, the higher the emotional control (negative). The higher the physical anxiety, a subfactor of sports competition anxiety, the lower the relaxation, a subfactor of sports performance strategy, and the higher the physical anxiety, the higher the emotional regulation (negative). Lastly, it was found that the higher the self-confidence in sports competition anxiety, the higher the self-regulation, mental goal setting, conditioning, and relaxation, and the lower the emotional control. Fourth, state confidence, which is a sub-factor of sports competition anxiety, was found to have a positive effect on self-regulation, conditioning, mental goal setting, and relaxation, which are sub-factors of performance strategies, and was found to have a negative effect on emotion regulation (negatively).

블랙커민씨드오일의 구강 미세생태계 바이오필름 성숙 억제 효과

조아현 가천대학교 메디컬캠퍼스 보건대학원 2024 국내석사

최근 구강질환의 원인인 바이오필름을 관리하기 위해 부작용이 적은 천연 물질에 대한 관심이 증가하고 있다. 그 중 블랙커민씨드오일(black cumin seed oil, BCSO)은 광범위한 항균 활성을 갖으며, Streptococcus mutans와 같은 단일종 바이오필름에 대한 항균 효과가 증명된 바 있다. 그러나 구강질환을 관리하기 위한 방법을 모색하기 위해서는 실제 바이오필름과 유사한 다종 바이오필름 모델을 적용하여 항균효과를 검증하는 것이 중요하다. 본 연구는 실제 구강 환경을 가장 비슷하게 재현하는 구강 미세생태계 바이오필름(oral microcosm biofilm) 모델을 사용하여 BCSO의 효과를 평가하였다. 두 가지 성숙도의 바이오필름(2일 및 6일)을 형성하여 0.5% BCSO, 0.5% Dimethyl sulfoxide(DMSO) 및 0.12% chlorhexidine gluconate(CHX)를 하루에 한 번 1분 동안 처치하였다. 6일 동안 처치를 반복한 후, quantitative light-induced fluorescence- digital(QLF-D) 카메라로 촬영한 형광이미지의 붉은형광강도(RatioR/G), 공초점 레이저 주사 현미경으로 관찰한 extracellular polysaccharide(EPS)와 살아있는 세균의 양 및 내산성세균의 집락수(CFUs/mL)를 비교, 분석하였다. 본 연구 결과, 2일 및 6일 성숙 바이오필름에 대한 0.5% BCSO 처치군의 RatioR/G 는 0.12% CHX 처치군과 통계적으로 유의한 차이가 없었다(p > 0.05). EPS의 양 또한 2일 및 6일 성숙 바이오필름 모두 0.5% BCSO 처치군과 0.12% CHX 처치군이 모두 통계적으로 유의한 차이를 보이지 않았다(p > 0.05). 2 일 성숙 바이오필름에서 살아있는 세균은 0.5% BCSO를 처치군이 가장 적게 나타났으며(p < 0.001), 6일 성숙 바이오필름에서는 0.5% BCSO 처치군과 0.12% CHX 처치군의 유의한 차이가 없었다(p > 0.05). 2일 성숙 바이오필름에 대한 0.5% BCSO 처치군의 내산성균의 집락수는 0.12% CHX 처치군과 유의한 차이가 없었으며(p > 0.05), 6일 성숙 바이오필름에 대한 내산성균의 집락수는 모든 군에서 통계적으로 유의한 차이가 없었다(p > 0.05). 본 연구 결과, 0.5% BCSO는 두 가지 성숙도의 바이오필름에 대해 0.12% CHX과 유사하거나, 더 좋은 효과로 바이오필름의 병원성을 감소시켰다. BCSO 는 천연 유래 물질로서 살균 작용과 더불어 바이오필름 내 축적되는 EPS의 합성을 억제하고, 세균의 응집을 파괴하는 새로운 항균 메커니즘을 보여주었다. 이를 바탕으로 BCSO가 CHX를 포함한 기존의 화학요법제의 부작용을 보완할 수 있는 새로운 항균 물질로써 활용될 수 있음을 제안한다.

대학생의 미래지향시간관과 진로준비행동의 관계에서 진로적응성과 자기통제의 조절된 매개효과

조아현 이화여자대학교 대학원 2025 국내석사

본 연구는 진로발달의 전환점에 속해 있는 대학생의 진로준비행동에 미래지향시간관이 미치는 영향을 알아보고자 하였다. 구체적으로는 미래지향시간관이 진로준비행동에 미치는 영향에서 진로적응성의 매개효과를 검정하고 자기통제가 그러한 매개효과를 조절하는지 확인하고자 하였다. 이를 위해 만 19세 이상 만 29세 이하의 성인 남녀 350명을 대상으로 온라인 설문조사를 실시하였으며 Mahalanobis 이상치를 제거한 348명의 자료를 이용하였다. 수집된 자료는 SPSS 23.0을 통해 주요 변인 간 기술통계 및 상관분석을 실시하였으며, PROCESS Macro v.4.2를 이용하여 매개효과 및 조절된 매개효과의 유의성을 검정하였다. 본 연구의 주요 결과는 다음과 같다. 첫째, 미래지향시간관과 진로준비행동 간에 직접 경로가 유의하게 나타나지 않았다. 둘째, 미래지향시간관과 진로준비행동의 관계를 진로적응성이 매개하는 것으로 나타났다. 셋째, 미래지향시간관과 진로준비행동의 관계에서 진로적응성의 매개효과를 자기통제가 조절하는 것으로 확인되었다. 대학생의 미래지향시간관이 진로적응성을 통해 간접적으로 진로준비행동을 예측하였으며, 진로적응성의 매개효과가 자기통제를 통해 조절되는 것으로 나타났다. 구체적으로 자기통제 수준이 높을수록 미래지향시간관이 진로적응성에 미치는 정적인 영향이 강화됨을 확인할 수 있었다. 자기통제가 높을수록 개인은 미래에 대한 가치를 인식하고, 현재와 미래의 연결성을 고려하여 현재 시점에 선택과 결정을 내린다. 이는 곧 개인이 진로영역에 더욱 잘 적응하도록 돕게 되고, 결국 실제적인 진로준비행동으로 이어지게 된다. 한편 미래지향시간관과 진로준비행동 간의 직접적인 관계는 살펴볼 수 없었다. 이는 한국의 경제 저성장으로 인해 위축된 취업시장에서 대학생들이 보다 적극적인 진로준비행동을 할 수 있도록 단순히 미래에 가치를 두는 것뿐만 아니라 직면한 어려움에 대처할 수 있는 심리사회적 자원이 필요함을 시사하는 결과이기도 하다. 이를 바탕으로 대학생들의 진로 적응 및 준비행동에 있어 미래지향시간관과 자기통제를 다루는 개입의 필요성을 확인하였다는 점에서 의의가 있다. The purpose of this study is to examine the mediating effect of career adaptability moderated by self-control on the relationship between future time perspective and career preparation behavior among undergraduate students in South Korea. Undergraduate students, at a critical juncture in their career development, often face challenges stemming from Korea’s competitive job market and economic stagnation. An online survey was conducted among 350 undergraduate students aged 19 to 29 from four-year universities in South Korea. After removing Mahalanobis outliers, data from 348 participants were analyzed. Measures included scales assessing future time perspective, career adaptability, self-control, and career preparation behavior. Data were analyzed using SPSS 23.0 and PROCESS Macro v4.2. The key findings of this study are as follows: First, the direct effect of future time perspective on career preparation behavior was not statistically significant. Second, career adaptability fully mediated the relationship between future time perspective and career preparation behavior. Third, self-control moderated the mediating effect of career adaptability, such that the positive influence of future time perspective on career adaptability was stronger for individuals with higher levels of self-control. These findings suggest that future time perspective influences career preparation behavior indirectly through career adaptability and that self-control regulates this pathway. Specifically, students with higher self-control are better able to recognize the value of the future and make decisions that enhance their adaptability, ultimately leading to more active career preparation behaviors. Alternatively, no statistically significant relationship was identified between future time perspective and career preparation behavior. The results suggest that in the context of Korea’s economic stagnation and challenging job market, psychological and social resources that enable individuals to cope with present difficulties are essential for active career preparation behavior. The study underscores the need for counseling interventions that address both future time perspective and self-control to enhance career adaptability and preparation behaviors among college students. Additionally, it highlights the importance of understanding individual differences in time perspective when providing career-related guidance.

한국 흑산도산 쥐노래미(Hexagrammos otakii)의 연령과 성장

조아현 국립군산대학교 2025 국내석사

The age and growth of the Hexagrammos otakii sampled from Heuksando were determined from 412 otolith from January to December 2023. Age of Hexagrammos otakii was determined from the rings on the otolith. The relationship between total length (TL) and total weight (TW) by the equation : Female TW = 5×10-6 TL3.1486 (r2 = 0.95), Male TW = 9×10-6 TL3.0387 (r2 = 0.95). The relationship between total length (TL) and otolith radius (R) was expressed by the following equation : Female TL = 213.69 R –110.12 (r2 = 0.75), Male TL = 212.18 R –107.85 (r2 = 0.84). The spawning period estimated January and February through gonadosomatic index (GSI) analysis. The relationship between total length and ring radius of otoliths in each ring group was expressed as a regression line. There is a correspondence in each ring formation. Based on the monthly variations in the marginal index (MI) of the otolith, it is assumed that the ring of this species was formed once a year during the period of October and November. Growth curves for total length (TL) and total weight (TW) fitted to the von Bertalanffy’s equation were expressed as follows : Combined:L _{t} =581.427(1-e ^{-0.1604(t+1.0191)} ) Female:`L _{t} =592.028(1-e ^{-0.1572(t+0.9882)} ) Male:`L _{t} =579.684(1-e ^{-0.1587(t+1.0760)} ) Combined:W _{t} =2,603.665(1-e ^{-0.1604(t+1.0191)} ) ^{3.1002} Female:`W _{t} =2,675.540(1-e ^{-0.1572(t+0.9882)} ) ^{3.1484} Male:`W _{t} =2,304.808(1-e ^{-0.1587(t+1.0760)} ) ^{3.0430} The von Bertalanffy growth curve had an additive error structure and growth parameters estimated from non-linear regression were female L∞=592.028 ㎜, k=0.1572/year and t0=-0.9882 year. And male L∞=579.684 ㎜, k=0.1587/year and t0=-1.0760 year.

Development and Characterization of a Fully Human Antibody Targeting Siglec-15, Restoring Immune Function in Colorectal Cancer

조아현 국민대학교 일반대학원 2024 국내석사

Activation of high-sensitivity C-reactive protein and endothelial markers at chronic phase of stroke according to stroke subtypes

조아현 울산대학교 2007 국내박사

High-sensitivity CRP (hsCRP) 는 심혈관 질환뿐 아니라 뇌졸중의 새로운 위험인자로 최근 대두되고 있다. 그러나 뇌졸중과 CRP level 에 관련한 보고는 많이 있으나 정확한 뇌졸중의 아형 분류를 하여 분석한 보고는 거의 없다. 게다가 뇌졸중의 각 아형별 분포가 인종별로 다르다고 알려져 있다. 이에 저자들은 자세한 뇌혈관 상태에 대한 검사를 바탕으로 한 뇌졸중의 아형을 분류하고 이에 따른 염증인자 및 혈관 내피세포인자의 활성상태에 대하여 알아보았다. 서울아산병원 신경과에 내원하는 뇌졸중 환자들 대상으로 혈액 검사를 실시하여 염증 인자뿐 아니라 혈관내피세포인자를 측정하여 뇌졸중 아형 별로 이들이 미치는 영향에 대해 알아보고자 하였다. 신경과 외래를 내원하는 환자들 중, 뇌졸중의 진단과 아형이 확실한 환자들을 대상으로 동의서를 받은 후 혈액 검사를 하였다. hsCRP, intercellular cell adhesion molecule, vascular cell adhesion molecule, E-selectin 을 검사하였다. 뇌졸중 아형의 분류는 TOAST 분류법을 통해, 대혈관 질환 (large vessel disease), 소혈관 질환 (small vessel disease), 심인성 뇌경색 (cardioembolism), 뇌출혈 (intracerebral hemorrhage) 로 분류하였다. 혈관 검사가 완벽히 된 환자들을 대상으로 증상유무에 관계없이 뇌혈관 질환의 양상도 함께 분류하였는데 정상 뇌혈관, 뇌내 뇌혈관 질환, 뇌외 뇌혈관 질환, 뇌내외 뇌혈관 질환으로 분류하였다. 총 401 명의 환자가 동의하여 혈액 검사가 시행되었다. 대뇌혈관 질환 환자가 175 명 (43.6%), 소혈관 질환 환자가 120 명 (29.9%) 으로 가장 많았다. 각 아형 별로 CRP 수치의 차이는 없었다. 혈관질환의 양상 별로 분류한 경우, 뇌 내 혈관 질환이 있는 환자에서, 당뇨와 statin 사용 유무를 보정하였을 때 hsCRP 가 높은 환자들에서 뇌 내혈관 질환이 보다 많이 관찰되었다. (OR, 2.94, 95% CI, 1.15-7.54, p=0.025) 뇌백질증, 미세 출혈을 함께 동반한 환자와 그렇지 않은 환자 간의 CRP 수치의 차이는 없었다. hsCRP levels 이 각 뇌졸중의 아형별로 차이가 나지는 않았다. 하지만 혈관상태에 따른 뇌졸중 환자의 분류에서 뇌내 혈관 질환이 있는 환자군에서 그렇지 않은 환자군에 비하여 hsCRP levels 가 유의하게 높은 결과는 뇌내 혈관 질환이 발생하는 데 있어 염증인자의 역할이 중요함을 시사해 주는 것으로 생각된다. C-reactive protein (CRP) has been recently identified as a novel risk marker in stroke as well as coronary artery disease. Although there are many reports on CRP levels in stroke patients, few studies have analyzed the relationship between the CRP and specific stroke subtypes assessed by MRI and MRA results. Stroke is a heterogeneous disease with various pathogenic mechanisms in different subtypes, and the prevalence of each subtype is different among ethnicities. With these regards we aimed to investigate the role of inflammation and endothelial activation according to different stroke subtypes with detailed analysis of arterial disease patterns. We consecutively included patients with stroke in the chronic (>3 months) stage and divided the stroke subtypes with MRI and angiographic findings. Stroke subtypes were classified as large vessel disease (LVD), small vessel disease (SVD), cardioembolism (CE), and intracerebral hemorrhage (ICH). Arterial disease patterns according to the vessel studies were arbitrarily defined as intracranial disease, extracranial disease, no large vessel disease (no LVD) and intracranial disease with extracranial disease regardless of the stroke subtype. Age and sex matched normal persons were included as control group (n=21). High-sensitivity CRP (hsCRP), intercellular adhesion molecule, vascular cell adhesion molecule, and E-selectin were tested in the patients and control subjects. Among total 401 patients, LVD was most common (n, %; 175, 43.6%), followed by SVD (120, 29.9%), CE (60, 15.0%) and ICH (44, 11.0%). hsCRP level was not different among different stroke subtypes. Regarding arterial disease patterns, 186 (50%) patients had no LVD, 118 (32%) had intracranial disease, 39 (10.6%) had both intracranial and extracranial diseases, and 26 (7%) had extracranial disease. The CRP level was significantly higher in patients with intracranial disease than in those with arterial patterns (no LVD, extracranial disease) after adjustment for diabetes mellitus and use of statin which were associated with the presence of intracranial disease (Odds ratio 2.94, 95% CI 1.15-7.54, p=0.025). The E-selectin level was also higher in patients with intracranial disease than in the control group (p=0.048). In conclusion, we could not find significant differences in hsCRP levels among different stroke subtypes. However, the higher hsCRP levels and E-selectin in patients with intracranial stenosis suggests that inflammation may play a more significant role in intracranial arterial diseases than in other vascular lesions in stroke patients.

음성명료도 평가를 통한 국내 초등학교 저학년 교실의 음향성능 기준에 관한 연구

조아현 충북대학교 2022 국내석사

A school classroom is a space where the transmission of a teacher's speech is very important. Speech intelligibility is a element in judging the acoustic performance of the classroom. The reverberation time and background noise are important acoustic factors in evaluating the speech intelligibility. According to classroom use, volume, and students’ age, in the UK and United States, the standards for reverberation time and background noise have been established. However, in South Korea, the reverberation time and background noise standards ​​for middle and high school classrooms have been presented excepted to elementary school. Children 14 years or older have the ability to recognize speech equal to that of adults, but children under 14 have lower speech recognition performance compared to adults because their hearing is still under developed. In particular, children aged 9 years or less have markedly lower speech recognition ability. Therefore, to consider the speech recognition ability of children aged 9 years or less, standards for acoustic performance in lower grade elementary school classrooms are needed. This study aims to derive the appropriate standards for the acoustic performance of lower grade elementary school classroom. In this study, the actual conditions of the acoustic performance of lower grade classrooms of elementary schools were investigated, and then, speech intelligibility tests according to reverberation time and signal-to-noise ratios were evaluated with lower grade elementary school students and adults in South Korea. Through the evaluation results, as the reverberation time became longer, the speech intelligibility scores of lower grade elementary school students decreased, and the scores were highest when the reverberation time was 0.6 sec. In addition, for the lower grades of elementary school to be well figure out speech in a noise environment, the signal-to-noise ratio must be at lest 20 dB(A). This means that the background noise of the classrooms should not exceed 30 dB(A), given that the minimum speech level of the teacher is 50 dB(A). In conclusion, the lower grade elementary school classrooms must meet the acoustic performance standards of 0.6 sec of reverberation time and 30 dB(A) or less for background noise. Thus, the lower grade elementary school classrooms to which the acoustic performance standards proposed in this study are applied can have a clearer and calmer environment.