흰쥐에서 Iodine-131-Iododeoxyadenosine 의 생체분포 및 유방암 영상화에 관한 연구

김혜원,원종진,최시성,이현철,김창근,김선구,Yang, David J,이강무,민병철,이종덕,Kim, E Edmund 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4

Purpose: I-131 labeled (2'-deoxy-2-iodo-β-D-arabinofuranosyl) adenine (IAD) may be involved in DNA synthesis during active proliferation of tumor cells. We conducted this study to find out the biodistribution of IAD and its feasibility for scintigraphic tumor imaging. Materisls and Methods: Tosyl acetyl-adenosine was dissolved in acetonitrile, and I-131-NaI was added and heated to synthesize IAD. Female Fisher 344 rats innoculated with breast tumor cells were injected witb 0.27 MBq of IAD. Rats were sacrificed at 0.5, 1, 2, 4, 24h and the % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy, rats bearing breast cancer were administered with 1.11 MBq of IAD and imaging was perforrned after 2 and 24h. Then, rat body was fixed and rnicrotomized slice was placed on radiographic film for autoradiography, Results: %ID/g of tumor wa.' 0.74 (0.5h), 0.73 (1h), 0.55 (2h), 0.38 (4h), and 0.05 (24h), respectively. At 1h after injection, %ID/g of tumor was higher than that of heart (0.34), liver (0.42), spleen (0.47), kidney (0,69), muscle (0.14), bone (0.33) and intestine (0.51). However, %1D/g of tumor was lower than blood (1.06), lung (0.77), and thyroid (177.71). At 4h, %ID/g of tumor in comparison with other tissue did not change. Tumor contrast expressed by tumor to blood ratio was 0.69 and tumor to muscle ratio was 5.11 at 1h. However, these ratios did not improve through 24h. On autoradiogram and scintigraphy at 2 and 24 hour, the tumor was well visualized. Conclusion: This results suggest that Ial) may have a potential for tumor scintigraphy. However, further work is needed to improve localization in tumor tissue. (Korean J Nucl Med 1998;32:374-81)

Role of bicarbonate and volume therapy in the prevention of acute kidney injury in rhabdomyolysis: a retrospective propensity score-matched cohort study

김혜원,Kim Sejoong,Ohn Jung Hun,Kim Nak-Hyun,Lee Jong-chan,김은선,Lim Yejee,Cho Jae Ho,박희선,류지원,Kim Sun-wook 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.3

Background: Although bicarbonate has traditionally been used to treat patients with rhabdomyolysis at high risk of acute kidney injury (AKI), it is unclear whether this is beneficial. This study compared bicarbonate therapy to non-bicarbonate therapy for the prevention of AKI and mortality in rhabdomyolysis patients. Methods: In a propensity score-matched cohort study, patients with a creatine kinase (CK) level of >1,000 U/L during hospitalization were divided into bicarbonate and non-bicarbonate groups. Patients were subgrouped based on low-volume (<3 mL/kg/hr) or high-volume (≥3 mL/kg/hr) fluid resuscitation in the first 72 hours. Logistic regression analyses were used to identify the impacts of bicarbonate use and fluid resuscitation on AKI risk and need for dialysis. The Kaplan-Meier method was used to estimate survival. Volume overload and electrolyte imbalances were assessed. Results: Among 4,077 patients, we assembled a cohort of 887 pairs of patients treated with and without bicarbonate. Bicarbonate group had a higher incidence of AKI, higher rate of dialysis dependency, higher 30-day mortality, and longer hospital stay than the non-bicarbonate group. Further, patients who received high-volume fluid therapy had worse renal outcomes and a higher mortality than those who received low-volume fluids regardless of bicarbonate use. Bicarbonate use, volume overload, and AKI were associated with higher mortality. Volume overload was significantly higher in the bicarbonate group than in the non-bicarbonate group. Conclusion: Bicarbonate or high-volume fluid therapy for patients with rhabdomyolysis did not reduce AKI or improve mortality compared to non-bicarbonate or low-volume fluid therapy. Limited use of bicarbonate and adjustment of fluid volume may improve the short- and long-term outcomes of patients with rhabdomyolysis.

허혈성 심질환(Ischemic heart disease) 환자(患者)의 사상(四象) 처방(處方) 투여 1례(例)에 대한 임상보고(臨床報告)

김혜원,송정모,김정호,Kim, Hye-Won,Song, Jeong-Mo,Kim, Jeong-Ho 사상체질의학회 2002 사상체질의학회지 Vol.14 No.2

An ischemic heart disease(IHD) is a anemic state of heart caused by disproportion between heart's demand and supply of oxygen. A patient who has this IHD feels serious chest pain called angina pectoris. In a keen condition it leads to a necrosis of heart muscles, known as myocardial infarction. In an ischemic heart disease the ECG waves gives us useful information of patients' heart. And CK(creatine kinase) in serum and Troponin T are the principal factors in diagnosis of IHD. In this study, the IHD patient classified by Sasang Constitutional Medicine had a notable medical effects. The symptoms of patient are disappeared and waves of ECG is closed to normal. The result of CK in serum is also recovered. So we report the healing process and results of this patient in this study.

Functional Defect and Its Possible Mechanism of Diabetic Cardiomyopathy

김혜원,이희란,장연진,박형섭,박소영,Kim, Hae-Won,Lee, Hee-Ran,Jang-Yang, Yeon-Jin,Park, Hyoung-Sup,Park, So-Young The Korean Society of Pharmacology 1993 대한약리학잡지 Vol.29 No.2

Oxidative modification of cellular proteins and lipids may play a role in the development of diabetic complications. Diabetic cardiomyopathy has been suggested to be caused by the intracellular $Ca^{2+}$ overload in the myocardium, which is partly due to the defect of calcium transport of the cardiac sarcoplasmic reticulum (SR). In the present study, the possible mechanism of the functional defect of cardiac SR in diabetic rats was studied. Both of the maximal $Ca^{2+}$ uptake and the affinity for $Ca^{2+}$ were decreased in the diabetic rat SR in comparison with the control. To investigate whether the functional defect of the cardiac SR in streptozotocin-induced diabetic rat is associated with the oxidative changes of cardiac SR proteins, the carbonyl group content and glycohemoglobin levels were determined. The increase in carbonyl group content of cardiac SR (2.30 nmols/mg protein, DM; 1.78, control) and in glycohemoglobin level $(13{\sim}17%,\;DM;\;3{\sim}5%,\;control)$ were observed in the diabetics. The extent of increase in calcium transport by phospholamban phosphorylation was greater in the diabetic cardiac SR membranes than that in the control. The phosphorylation levels of phospholamban, as determined by SDS-PAGE and autoradiography with $[{\gamma}^{32}P]ATP$, were increased in diabetic cardiac SR. These results suggest that the impaired cardiac SR function in diabetic rat could be a consequence of the less-phosphorylation of phospholamban in the basal state, which is partly due to the depleted norepinephrine stores in the heart. Furthermore, the oxidative damages in cardiac SR membranes might be one of the additional factors leading to the diabetic cardiomyopathy. 스트렙토조토신으로 당뇨를 유발시킨 쥐의 심근 근장그물에서 칼슘이동이 저하됨을 볼 수 있었다. 칼슘이동의 저하는 최대칼슘 uptake의 감소와 칼슘에 대한 affinity의 감소로 나타났다. 이러한 심근 근장그물의 기능저하가 나타나는 작용기전이 심근 근장그물 단백의 산화성 손상과 관계가 있는지를 살펴보았다. 당뇨쥐에서는 glycohemoglobin과 carbonyl group의 양이 현저히 증가됨을 볼 수 있었다. 한편으로 cyclic AMP 의존성 protein kinase의 catalytic subunit에 의한 phospholamban 인산화에 의해 심근 근장고물 칼슘이동의 증가를 보였고, 이 증가는 대조군에 비하여 당뇨군에서 훨씬 현저하게 나타났다. SDS-polyacrylamide를 이용한 전기영동후 autoradiogram을 통하여 확인한 phospholamban 인산화는 당뇨군에서 진한 band로 나타남이 확인되었다. 이상의 결과로 미루어 당뇨군의 심근 근장그물 기능저하는, 기초상태에서 아마도 심근내 저하된 norephinephrine 양으로 인하여 phospholamban 인산화 정도가 적으므로 근장그물 $Ca^{2+}-ATPase$ 억제가 나타남을 제시해 주며, 근장그물 단백의 산화성 손상도 당뇨성 심근질한을 일으킬 수 있는 또 다른 요인 중의 하나로 생각된다.

'2005국제우수전기제품대전' 유공자 포상식에서

김혜원,Kim hye-won 한국제품안전협회 2005 제품안전 Vol.12 No.-

연세대학교 의과대학 학습공동체 교육과정 개발 및 운영 분석

김혜원,안신기,Kim, Hae Won,An, Shinki 연세대학교 의과대학 2021 의학교육논단 Vol.23 No.3

Learning communities in medical education have demonstrated favorable outcomes in terms of students' learning, professional development, and wellness. Despite these strengths and the widespread adoption of learning communities in US medical schools, there has been little interest in medical learning communities in Korea. In this context, the present study examined the development and implementation of the Yonsei Medical Learning Community (YMLC) and analyzed its outcomes and areas of improvement. The Yonsei University College of Medicine has operated a learning community as part of the undergraduate medical education curriculum since 2014. The YMLC is the first program of its type in Korea. The overall structure of the YMLC consists of four distinct communities (pillars), which are named after four distinguished alumni, and each pillar is organized into five learning community classes. Each class is vertically integrated across students in different medical school years, and one faculty advisor is matched to about 30 students. As the YMLC focuses on fostering reflective practice in students and providing them with opportunities to build teamwork and experience social relatedness, two educational approaches have been adopted: reflective writing and mentoring and community activities. In this study, we obtained and analyzed second-year students' feedback on the YMLC curriculum and identified its achievements, merits, and areas that need improvement. The results have shown that over 75% and 60% of respondents reported satisfaction with reflective writing and mentoring and community activities, respectively. The educational activities of the learning community helped students regularly reflect on their learning and progress and establish close relationships with faculty advisors. However, several areas of improvement regarding content, format, and logistical issues were also identified. The present findings may provide valuable information for other institutions to develop learning communities relevant to their own context.

성인여성(成人女性)의 사상체질(四象體質)과 골밀도(骨密度)의 상관성(相關性)에 대한 연구(硏究)

김혜원,송정모,Kim, Hye-weon,Song, Jeong-mo 사상체질의학회 2001 사상체질의학회지 Vol.13 No.3

Purposes : As the population of old people has increased by the improvement of medical techniques, the concern on degenerative diseases has increased gradually. Especially the researches of osteoporosis have been carried out in view of prevention and treatment. But there wasn't any research related with Sasang Constitution. So we investigated the relation between Sasang Constitution and BMD(bone mineral density). Methods : Authors measured BMD and BMI(body mass index) of healthy women. We devided our subjects into Young age group and Old age group, and analyzed the data of Sasang Constitution subgroup. Results : 1. BMD of Taeumin was higher than those of Soyangin and Soeumin in Lumbar spine and Femoral neck in both Young and Old age group. In Old age group, there were significant differences in Taeumin vs Soeumin, and Soyangin vs Soeumin in BMD of Lumbar spine 2. BMI of Taeumin was higher than those of Soyangin and Soeumin in both Young and Old age group. In Young age group, there were significant differences in Taeumin vs Soyangin and Taeumin vs Soeumin. In Old age group, there were significant differences in Taeumin vs Soyangin, Taeumin vs Soeumin and Soyangin vs Soeumin. Conclusion : BMD and BMI of Taeumin was higher than those of Soyangin and Soeumin.

A Study on the Mechanism of Calcium Binding Inhibition of Cardiac Sarcoplasmic Reticulum by Oxygen Free Radicals

김혜원,정명희,김명석,박찬웅,Kim, Hae-Won,Chung, Myung-Hee,Kim, Myung-Suk,Park, Chan-Woong The Korean Society of Pharmacology 1985 대한약리학잡지 Vol.21 No.2

심근 세포의 칼슘 조절에 중요한 역할을 하는 sarcoplasmic reticulum (SR)의 칼슘운반 능력이 허혈 심근에서 현저히 억제됨이 알려져 있다. 이와같은 허혈 심근에서의 SR 칼슘운반승력 저하에 유독성 산소 대사물이 관여할 것으로 생각되고 있으나 그 기전에 관하여는 아직 알려진 바 없다. 본 연구에서는 그 기전의 일단을 규명하기 위하여 산틴 산화효소계에 의하여 발생된 유독성 산소대사물긴 돼지 심실근에서 추출한 sarcoplasmic reticulum의 칼슘흡수 및 막지질 과산화, sulfhydryl group 그리고 단백질 변성에 미치는 영향을 관찰하여 다음과 같은 결과를 얻었다. 1) 산틴 산화 효소계와 반응시킨 sarcopl smic reticulum의 칼슘흡수는 반응시간 경과에 따라 현저히 억제되었다. 2) sarcoplasmic reticulum 막지질 과산화는 산딘 산화 효소계에 의하여 현저히 증가되었다 3) 항산화제 ${\beta}$-phenylenediamine은 막지질 과산화의 증가는 효과적으로 억제하였으나, 칼슘흡수 억제는 부분적으로 회복시켰다. 4) 산틴 산화 효소계에 의하여 SH-group은 현저히 감소되었으며, 항산화제 첨가에 의하여 그 감소가 일부 억제되었다. 5) sarcoplasmic reticulum을 DTNB로 처리하여 SH-group을 산소 대사물에 의한 산화반응으로부터 보호했을 경우 칼슘흡수의 억제가 부분적으로 방지되었다. 6) Sephadex G-200 크로마토그라피 상에서 산틴 산화효소계와 반응시킨 sarcoplasmic reticulum의 단백질분해가 관찰되었다. 7) 단백질의 polymerization은 관찰되지 않았으며, 아울러 polymerization을 억제하는 semicarbazide로 칼슘흡수 감소를 방지하지 못하였다. 이상의 결과에서 유독성 산소대사물에 의한 sarcoplasmic reticulum의 칼슘흡수 억제는 sarcoplasmic reticulum의 막지질 과산화, SH-group의 산화 및 막 반백절의 분해 등으로 초래되는 복합적인 기전으로 추정되었다. Mechanism of calcium transport inhibition of cardiac sarcoplasmic reticulum (SR) by oxygen free radicals was examined. Effects of oxygen free radicals generated by xanthine/xanthine oxidase (X/XO) system on isolated porcine ventricle SR were studied with respect to its calcium binding, lipid peroxidation, SH-group content and alteration of membrane protein components. The results are as follows. 1) Calcium binding of isolated SR was markedly inhibited by X/XO. 2) During the incubation of sarcoplasmic reticulum with xanthine/xanthine oxidase, there were marked inclose in lipid peroxidation and reduction of SH-group content. 3) An antioxidant, p-phenylenediamine effectively prevented the lipid peroxidation but partially prevented the calcium binding inhibition of X/XO treated SR. 4) The reduction of SH-group content of SR treated with X/XO was partially prevented by p-phenylendiamine. 5) When modifying SH-group of SR by treatment with DTNB, the inhibition of calcium binding activity was partially prevented. 6) On gel-permeation chromatography of X/XO-treated sarcoplasmic reticulum, there was an increase of small molecular weight products, probably protein degradation products. 7) Semicarbazide, which prevents the cross-linking reaction of protein components, did not affect the calcium binding inhibition of X/XO-treated SR. From these results, it is suggested that the inhibition of calcium binding of SR by oxygen free radicals results from the consequence of multiple changes of SR components, which are lipid peroxidation, SH-group oxidation and degradation of protein components.

의과대학생을 위한 죽음교육이 말기환자 돌봄 태도에 미치는 영향에 대한 예비연구

김혜원,박중철,Kim, Hae Won,Park, Joong Chul 연세대학교 의과대학 2018 의학교육논단 Vol.20 No.3

End-of-life care competencies have been perceived as important and essential, so it has been suggested that end-of-life care be studied in undergraduate medical education. However, end-of-life care curriculum has mostly focused on acquisition of knowledge and skills rather than attitudes. Therefore, we aimed to explore whether education about death affects medical students' attitudes towards care for dying patients and perception of death anxiety, meaning in life, and self-esteem. A total of 15 first- or second-year medical students were surveyed with questionnaires before and after completing a 6-week death education course. Paired data analysis showed that participants' attitudes towards caring for terminally ill patients and their caregivers improved significantly (t=-2.84, p=0.013) with an effect size of 0.73. In contrast, no significant changes were found in death anxiety, meaning in life, or self-esteem. All participants agreed that formal teaching about death and dying must be encouraged in medical schools. Our results suggest that death education may positively influence attitudes towards end-of-life care. Although replication with larger samples is necessary, this preliminary finding may support the importance of developmentally appropriate end-of-life care education in medical schools.

산욕초기 초산모의 모성 정체성과 영아돌보기 활동 자신감에 관한 연구

김혜원,황문숙,홍경자,Kim, Hae-Won,Hwang, Moon-Sook,Hong, Kyung-Ja 한국여성건강간호학회 1998 여성건강간호학회지 Vol.4 No.1

In this study the levels and influencing characteristics of maternal identity and self confidence for caring the baby were identified during the immediate postpartum period. 114 primiparous women who delivered vaginally normal baby participated in the survey from August 1 to October 31, 1996. SD scale was to measure maternal identity which consisted of 11 items for mother and 6 items for baby. Likert scale was to measure self confidence for caring the baby (38 items). Cronbach's alphas for evaluating internal consistency as follows : .86 for maternal identity and .96 for self confidence scale for caring the baby. The study showed these results : 1. Mean score of maternal identity(82.03 : 52.65 for mother, 29.38 for baby) was considered relatively low. 2. Mean score of self confidence for caring the baby(113.91) was considered relatively low. 3. There were significant influencing characteristics of primiparous to maternal identity : age(total ; F=3.53, p=.0329, for mother ; F=2.60, p=.0719, for baby ; F=3.12, p=.0481), prenatal infant care preparation(total ; t=2.31, p=.0306, for mother ; F=2.62, p=.0160), knowledge about infant care during the hospitalization(for baby ; F=3.94, p=.02222), colostrum feeding(total ; t=1.95, p=.0541, for baby ; t=2.71, p=.0080), frequency of breast feeding during the hospitalization(for baby ; F=3.91, p=.0228)and feeding type after discharge(for baby ; F=3.18, p=.0456). 4. There were significant influencing characteristics of primiparous to self confidence for caring the baby : routine husband support(F=6.09, p=.0031), prenatal infant care preparation(t=2.04, p=.0574), knowledge about infant care during the hospitalization(F=3.15, p=.0467), education of breast feeding during the hospitalization(t=-1.79, p=.0850). 5. Correlation between maternal identity and self confidence for caring the baby was r=.37608(p=.0001). This study implies that special education programs for primipara are needed. For the future, this study suggest that maternal role variables need to be monitored through the home visiting follow up. Also intervention programs related to prenatal care, discharge education, home visiting follow up need to be developed and then evaluated their effectiveness.