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.

Effect of a Phospholamban Peptide on the Skeletal Sarcoplasmic Reticulum $Ca^{2+}$ Transport

김혜원,이희란,Kim, Hae-Won,Lee, Hee-Ran The Korean Society of Pharmacology 1994 대한약리학잡지 Vol.30 No.1

Phospholamban은 심근 근장그물 $Ca^{2+}-ATPase$ 조절단백이다. 조절작용기전은 탈인산화된 phospholamban에 의해 $Ca^{2+}-ATPase$가 억제됨으로 나타나며, 이 phospholamban이 인산화됨으로 $Ca^{2+}-ATPase$에 대한 억제가 반전됨을 보인다. 최근에 phospholamban의 cytoplasmic domain만으로 $Ca^{2+}-ATPase$를 억제하기에는 불충분하다는 보고가 있어 본 실험을 계획하였다. $Ca^{2+}-ATPase$의 활성을 억제하는 phospholamban domain을 밝히기 위하여 합성한 phospholamban 펩타이드(아미노산 1-25)의 $Ca^{2+}$ uptake에 대한 효과를 살펴보았다. 골격근 근장그물에서 $Ca^{2+}-ATPase$를 분리한 후 phosphatidylcholine이나 phosphatidylcholine과 phosphatidylserine을 포함한 liposome에 재조합시켰다. Phospholamban 펩타이드는 phosphatidylcholine을 이용하여 재조합된 vesicles의 초기 $Ca^{2+}$ uptake rate를 억제하고, cAMP 의존성 protein kinase의 catalytic subunit로 인산화시킨 phospholamban 펩타이드는 이 억제를 반전시킴을 보여 주었다. Phosphatidylcholine과 phosphatidylserine을 포함한 제조합 vesicles에서도 같은 양상을 보였다. 이상의 결과로 미루어 볼 때 인산화 sites를 포함하고 있는 phospholamban의 cytoplasmic domain은 그 자체만으로도 근장그물 칼슘펌프를 억제하기에 충분하다고 결론지을 수 있다. Phospholamban is the regulator of $Ca^{2+}-ATPase$ in cardiac sarcoplasmic reticulum(SR). The mechanism of regulation appears to involve inhibition by dephosphorylated phospholamban. Phosphorylation of phospholamban relieves this inhibition. Recently, there has been a report that the cytoplasmic domain (amino acids 1-25) of phospholamban is insufficient to inhibit the $Ca^{2+}$ pump. To explore the domains of phospholamban responsible for $Ca^{2+}-ATPase$ inhibitory activity, we examined the effect of a synthetic phospholamban peptide consisting of amino acid residues 1-25 on $Ca^{2+}$ uptake by reconstituted skeletal SR $Ca^{2+}-ATPase$. The $Ca^{2+}-ATPase$ of skeletal SR was purified and reconstituted in proteoliposomes containing phosphatidylcholine (PC) or phosphatidylcholine: phosphatidylserine (PC:PS). Inclusion of a phospholamban peptide in PC proteoliposomes was associated with significant inhibition of the initial rates of $Ca^{2+}$ uptake at pCa 6.0, and phosphorylation of this peptide by the catalytic subunit of cAMP-dependent protein kinase reversed the inhibitory effect on the $Ca^{2+}$ pump. Similar effects of phospholamban peptide were also observed using PC:PS proteoliposomes. Based on these results, we could conclude that the cytoplasmic domain of phospholamban, containing the phosphorylation sites, by itself is sufficient to inhibit the $Ca^{2+}$ pump of SR.

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.

코로나19 팬데믹 상황에서 국내 의과대학생이 경험한 일상생활 변화, 정신건강 문제 및 스트레스 대처

김혜원,여상희,안신기,Kim, Hae Won,Yeo, Sanghee,An, Shinki 연세대학교 의과대학 2022 의학교육논단 Vol.24 No.3

This study aimed to examine the influence of the coronavirus disease 2019 (COVID-19) pandemic on areas of Korean medical students' lives, assess concerns, and investigate the strategies they used to cope with stress due to the pandemic. An online survey with a total of 53 items on the impact of COVID-19, concerns, and coping strategies was sent to medical students, and responses were collected from April 27, 2021 to May 30, 2021. In total, 1,329 students were included in the study. Analysis was performed using the chi-square test, independent-sample t-test, and one-way analysis of variance, and the post-hoc Scheffé test or Games-Howell test was performed for multiple comparisons. The main negative impacts of the pandemic were on hobbies/leisure activities and mental health, and medical students expressed the highest levels of concern regarding restriction of movement, returning to everyday life, and risk of infection for family and friends. Female students more strongly agreed that COVID-19 had increased their depressed mood and anxiety (p<0.001 and p=0.003, respectively). Furthermore, the negative impacts of the pandemic on different areas of life significantly affected current levels of depressed mood and anxiety. To cope with pandemic-related stress, students used several strategies such as talking with family or friends (91.5%), sleeping (83.1%), exercising (72.8%), using social networking services (60.8%), drinking alcohol (37.8%), and practicing meditation/mindfulness (24.4%); the effectiveness of these strategies ranged from 3.45 to 4.19 on a 5-point Likert-type scale (1-5). The study findings suggest that COVID-19 has influenced the mental health of medical students and raised concerns in many areas of their lives. Students used various strategies to cope with the pandemic-related stress; since the effectiveness of frequently used approaches varied, it is essential to guide medical students to develop effective coping strategies.

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.

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.

중학생을 대상으로 한 Moos 월경증상 척도의 타당도와 신뢰도 검증

김혜원 ( Hae Won Kim ),권미경 ( Mi Kyoung Kwon ) 부모자녀건강학회 2004 부모자녀건강학회지 Vol.7 No.2

오브제적 표현특성을 적용한 결혼예식공간 디자인에 관한 연구

김혜원(Kim, Hae-Won),윤은경(Yun, Yean-Kyung) 한국실내디자인학회 2020 한국실내디자인학회 학술대회논문집 Vol.22 No.1

이야기책을 이용한 기능적 읽기 중재가 언어발달지체아동의 의미관계확장에 미치는 효과

김혜원(Hae-Won Kim),김영태(Young-Tae Kim) 한국언어치료학회 2004 言語治療硏究 Vol.13 No.4

The purpose of this study is to investigate the effects of the functional reading intervention using storybook on children with language delayed in expansion of semantic relations. In this study, 4 young children with language delayed, 3 to 6 years of age, participated. In order to ascertain effects of inter-subject intervention and generalization, a multiple probe baseline design was applied. The realization of the functional reading activities using storybook was observed in this category; semantic relations of the utterance. The treatment was composed of 13-14 sessions and 5 generalizations across situation and among other adults. To examine the maintenance effect, 3 follow-up sessions were conducted three weeks after the intervention completion. The results obtained from the present study are as follow :1. The functional reading intervention using storybook increased the types of semantic relations of all four children with language delayed.2. Increased level of the types of semantic relations through the functional reading intervention using storybook was generalized to free play situation.3. Increased level of the types of semantic relations through the functional reading intervention using storybook was generalized to mothers.4. Increased level of the types of semantic relations through the functional reading intervention using storybook was maintained even three weeks after the treatment. The maintenance of the target children showed that the level was little higher than the intervention level.These results support that the use of the functional reading intervention using storybook in language interventions is an effective naturalistic approach for semantic relations development of children with language delayed.