“아동ㆍ청소년 정신건강 영역 사례관리 현황과 과제”

오영림 한국정신건강사회복지학회 2015 한국정신건강사회복지학회 학술발표논문집 Vol.2015 No.10

Antenatal Magnesium Sulfate for Neuroprotective Effects In Preterm Infants

오영림 고신대학교(의대) 고신대학교 의과대학 학술지 2014 고신대학교 의과대학 학술지 Vol.29 No.2

Fetal or neonatal brain injury can result in lifelong neurologic disability. Although survival rates for preterm infants have increased dramatically with the advent of modern perinatal and neonatal intensive care, but the rates of neurologic abnormalities in survivors, particularly motor disorders such as cerebral palsy, have not diminished. Antenatal magnesium sulfate may reduce the rates of cerebral palsy in survivors of preterm birth. There are five randomized controlled trials of magnesium sulfate administered to women at risk of preterm delivery before 34 weeks of gestation which have reported neurological outcomes for the child. From meta-analysis of these randomized trials, the rate of cerebral palsy was reduced by magnesium sulfate (RR, 0.69; 95% CI, 0.54-0.87; five trials; 6,145 infants) as did the moderate/severe cerebral palsy incidence (RR, 0.64; 95% CI, 0.44-0.92; three trials; 4387 infants). There was no statistically significant difference between the rates of neonatal adverse outcomes of the magnesium administration group and the control group. In most prospective randomized studies, no significant difference in the severe mother-side side effects between the magnesium sulfate administration group and the control group. Antenatal magnesium sulfate therapy is neuroprotective against motor dysfunction in offspring for the preterm infant; however the possibility of an increase in the fetal or neonatal death rate was not completely excluded.

호르몬 요법 후 비반응군의 빈도와 기저 골밀도에 따른 호르몬대체요법 후 골밀도의 변화

오영림,최종순,정민형,이지영,지용일,정혁,최원준,김흥열 대한골다공증학회 2011 Osteoporosis and Sarcopenia Vol.9 No.1

Objectives: To investigate the incidence of non-responder to hormone therapy (HT) and to evaluate the bone response to HT according to basal bone mineral density(BMD) in postmenopausal women. Methods: A total of 167 postmenopausal women received either continuous combined estrogen- progestogen replacement (n=102) or estrogen replacement (n=65) for 1 years. BMD at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry (DXA) before and 1 year after HT. Results: The incidence of non-responder (women with >3% bone loss per year) to HT was 8.3% in the lumbar spine, and 22.1% in femoral neck. non-responder group had a higher basal BMD at the lumbar spine than responder group, and showed bone loss rate of 7.7% per year. After 1 year of HT, postmenopausal women with osteoporosis showed a higher rate of increase in BMD at the lumbar spine and femoral neck than women with normal BMD or osteopenia. Conclusions: The non-responders to HT have a higher basal lumbar BMD, compared with responders. The higher basal BMD at the lumbar spine is, the less bone conservation effect of HT is.

복강경하 근종절제술을 시행받은 병력을 가진 임신 28주 산모에서의 자연자궁파열 1예

오영림 고신대학교(의대) 고신대학교 의과대학 학술지 2010 고신대학교 의과대학 학술지 Vol.25 No.2

Spontaneous uterine rupture during pregnancy is a very uncommon but resulting in high maternal and neonatal mortality despite of prompt therapy. But it was difficult work in early detection, proper treatment, and prevention. Recently, we experienced a case of uterine rupture without bleeding nor fetal distress in pregnancy at 28 gestation weeks and a healthy infant was successfully delivered by Cesarean section in patient having a previous laparoscopic myomectomy. So we report this case with a brief review of the literature.

복강경하 자궁적출술 후 발생한 질내장탈출증 1예

오영림,김흥열 고신대학교의과대학 2007 고신대학교 의과대학 학술지 Vol.22 No.1

Vaginal evisceration is a rare but life threatening complication of gynecologic surgery. The incidence after laparoscopic hysterectomy is unknown. The incidence of evisceration in the patients undergoing laparoscopic hysterectomy in our hospital was 0.1%. The rapid recovery after laparoscopic hysterectomy, compared with abdominal hysterectomy, is widely acknowledged. Swift return to everyday activities and early resumption of intercourse could predispose to avoid coitus until complete healing of vaginal vault. We described the cases of vaginal evisceration after laparoscopic hysterectomy including a review of the literature.

주의력결핍과잉행동장애를 가지고 있는 청소년이 경험하는 ADHD의 본질과 의미에 관한 현상학적 연구

오영림 한국정신건강사회복지학회 2010 정신보건과 사회사업 Vol. No.

The intent of this study is to identify what problematic activities, which others view as symptoms, mean from the viewpoint of adolescents with the ADHD. It is focused on discussing the change of viewpoint looking at the ADHD activities freshly through essential meaning that the youths themselves experience, as the ADHD-related activities have been perceived as problematic ones only. For this, I used phenomenological research method, conducted in-depth interviews with nine youths who are diagnosed with the ADHD (Attention Deficiency & Hyper Activity), and analysed according to Giorgi's analysis steps. As a result of analysis, the essence of the ADHD activities that are viewed as symptoms to others was "my mind and my body make each different thought," and compositional factors that are derived from the whole context through 18 low compositional factors are consisted of "my mind and my body make each different thought," "Confusion over myself who appears different from others," and "repetitive vicious cycle." The ADHD is a phenomenon in which one's own body and mind are out of control, a difficulty in terms of perception to the ADHD youths. I found that negative responses from the surrounding lead to low self-respect, and this shows a vicious cycle of persecutional mindset and social inadaptability. The understanding of adolescents with the ADHD can present a brandnew viewpoint in intervention for social integration. 이 연구는 주의력결핍과잉행동장애를 경험하는 ADHD청소년들이 타인이 증상이라고 생각하는 문제 행동에 있어서 당사자적 입장에서는 그 행동들이 무엇을 의미하는 것인지 밝혀보고자 하였다. 기존의 관점에서는 ADHD행동이 문제행동으로만 인식되었으므로 당사자들이 경험하는 본질의 의미를 통해서 ADHD행동을 새롭게 바라보는 관점의 전환을 논의하고자 한 것이다. 이를 위해 현상학적 연구 방법을 사용하였고, ADHD로 진단을 받은 청소년 9명을 심층 면접하여, Giorgi의 분석단계에 따라 분석하였다. 분석결과 타인에게 증상이라고 보여지는 주의력결핍과잉행동의 본질은 “몸따로 마음 따로” 였으며, 18개의 하위구성요소를 통해 전체적인 맥락에 따라 도출된 구성요소는 “몸하고 마음하고 따로 노는 불편함”, “남과 다른 자신에 대한 혼란스러움”, “반복되는 악순환”으로 구성되었다. 이러한 기본구조를 통해 주의력결핍과잉행동장애가 ADHD청소년에게는 지각측면의 어려움으로 자신의 몸과 마음이 제어가 안 되는 현상이었으며. 주변의 부정적인 반응들이 ADHD청소년에게 낮은 자아존중감을 만들고 이것은 피해적 생각과 사회부적응의 악순환을 보임을 알 수 있었다. ADHD청소년에 대한 이해는 사회통합을 위한 개입에 있어서 새로운 관점을 제시 할 수 있음을 제언하였다.

아동,청소년 정신건강 사정 및 정신보건 서비스

오영림 한국정신건강사회복지학회 2009 한국정신건강사회복지학회 학술발표논문집 Vol.2009 No.11

폐경 후 자궁 출혈과 내막암에 관한 상관관계

오영림,김흥열,정민형,지용일 고신대학교 의과대학 2011 고신대학교 의과대학 학술지 Vol.26 No.1

OBJECTIVES: To investigate correlation between risk factors of endometrial carcinoma and histopatholgic findings of endometrium. METHODS: We reviewed medical records of 148 postmenopausal women with abnormal uterine bleeding, who underwent endometrial biopsy from January 2009 to April 2010. Women who had hematologic disease, or had non-uterine pelvic diseases were excluded. Hormone therapy was performed in indicated subjects. Age, body mass index (BMI), associated diseases, endometrial thickness checked by transvaginal sonography, whether hormone therapy was used were reviewed according to endometrial histopathology. RESULTS: Mean age of the subjects was 58.9 +/- 8.4years old. Among the endometrial histopathologic findings, atrophic endometrium was the most common finding (32.7%), followed by hyperplastic endometrium (17.8%), endometrial carcinoma (10.4%), and endometrial polyp (9.2%). BMI was not correlation of the prevalence of endometrial carcinoma and endometrial hyperplasia. Mean endometrial thickness was 9.8 +/- 5.56 mm, while it was 14.0 +/- 5.89 mm in endometrial hyperplasia, and 16.0 +/- 6.56 mm in endometrial carcinoma. The prevalence of endometrial cancer was high in those whose endometrial thickness was more than 10 mm (P < 0.001). The prevalence of endometrial hyperplasia in those whose postmenopausal bleeding was related to hormone therapy was higher than of women in whom hormone therapy was not performed. However, there were no statistical significance. CONCLUSIONS: Postmenopausal bleeding must be considered as indicative of malignant disease until proven otherwise. Endometrial biopsy should be performed to exclude endometrial carcinoma in postmenopausal women whose endometrial thickness measured by transvaginal sonography is thick.

아동, 청소년 정신건강을 위한 부모교육의 실제

오영림 한국정신건강사회복지학회 2018 한국정신건강사회복지학회 학술발표논문집 Vol.2018 No.11

은둔형 외톨이, 청소년기의 은둔과 고립 지원을 위한 방안모색

오영림 한국정신건강사회복지학회 2023 한국정신건강사회복지학회 학술발표논문집 Vol.2023 No.11