OBJECTIVES: Recently, the outpatient group psychotherapy has been changed from traditional long-term therapy to short-term or time-limited therapy. The termination time and session numbers are given from start line in the time-limited therapy while 10 to 40 sessions are needed in the short-term therapy. And therapist and patients come to an agreement of the accomplishable therapeutic goal and work together actively. The time-limited group psychotherapy is being accepted newly as an efficient therapeutic modality because effective therapeutic outcomes within given time have been reported. The objectives of this study are as follows; firstly, we examine the therapeutic outcomes and the therapeutic factors after performing the time-limited group psychotherapy for outpatients in the psychiatric clinic; secondly, we analyze the characteristics showed in the process of study; lastly, we verify the feasibility and the validity of this group psychotherapy and then establish the basis of the effective outpatient therapy that would be settled down as an applicable treatment modality economically and efficiently in the current medical environment of Korea. METHODS: This study was performed weekly in total 12 sessions from July 1999, April 2000 to and each session took 70-80 minutes. The experimental group were composed of the highly-functioning psychotic patients among outpatients in the psychiatric clinic. The control group were composed of the similar patients through one-to-one matching of age, sex, diagnosis, and duration of illness. The participants were 8 patients each. BDI(Beck Depression Inventory), STAI(Spielbergs State-Trait Anxiety Inventory), MMPI(Minnesota Multiphasic Personality Inventory), and EDMT(Ewha Defence Mechanism Test) as the evaluation scales were performed before and after treatment. And 13-therapeutic factors scale was performed just after each session and the self-report total assessment questionnaire was performed only in experimental group at the end of this study. RESULTS: The mean score of BDI was decreased significantly in experimental group in comparison with control group. The mean score of STAI-S was not changed significantly in both group, and the mean score of STAI-T was decreased in experimental group in comparison with control group. The mean score of MMPI was decreased significantly in experimental group in comparison with control group, but the comparison of difference scores(post-treatment score - pre-treatment score) between the experimental and control group was not decreased significantly. This result may come from psychopharmacotherapy and individual supportive psychotherapy given equally to both group. The mean scores of immature defence and neurotic defence in EDMT were decreased significantly in experimental group compared with control group. Comparing the therapeutic factors to divide into the first, middle, and the last stage, existential factor was ranked first, and catharsis, identification with therapist, universality, and group cohesiveness were ranked high in all stages. Interpersonal learning was ranked first in the last stage although being ranked low in the first and middle stage. The total assessment questionnaires about group psychotherapy were reported that 100% of participants were helped, 75% of participants were changed in their lives, and 75% of participants had minds to join this kind of program again if given for them. CONCLUSIONS: This result shows that not only symptom relief but also personality change was achieved when the time-limited group psychotherapy was practiced in addition to simple psychophamarcotherapy and individual supportive psychotherapy for outpatients. The degree of satisfaction for group psychotherapy of participants were evaluated highly. Group psychotherapy has been accepted in public as a therapeutic modality that must be as equally effective as psychotherapy although group psychotherapy derives from individual psychotherapy. In our current medical environment that has been changed suddenly by the separation of medical practice and pharmaceutical dispensing and the decrease of medical fee, group psychotherapy or time-limited therapy would be settled down as low-expense and high-efficiency therapeutic modalities that were as equally effective as individual psychotherapy or long-term therapy.
Anxiety ; Catharsis ; Depression ; Diagnosis ; Fees, Medical ; Humans ; Korea ; Learning ; MMPI ; Outpatients* ; Psychotherapy ; Psychotherapy, Group* ; Surveys and Questionnaires ; Weights and Measures

From January 1995 to December 1997, a total of 219 cases pelviscopic surgery was performed at Il Sin Christian Hospital. To evaluate the safty and efficacy of pelviscopic surgery, we reviewed indication of operation, mean age, parity, history of abdominal operation, type of operation, duration of hospitalization and complication retrospectively. The number of pelviscopic surgery have risen from 33 cases in 1995 to 53 cases in 1996 and 133 cases in 1997. The most common indications were 118 cases for ectopic pregnancy (53.9%) and 42 cases for ovarian cyst (19.2%), 20 cases for infertility (9.1%) in order. Among the ovarian cyst, endometrioma was the most common. The mean age of patients was 31+/-6.7 years old and mean parity was 0.77. In most cases, mean blood loss was lesser than 100 cc except 500 cc in LAVH, 150 cc in CISH, 106.7 cc in ectopic mass removal. The postoperative hospital stay was varied from 0 day to 10 days, but usually 2 days. The 26 cases had complicated and the most common complication was fever above 38degrees C. In conclusion, it is evident that pelviscopic surgery is lesser invasive technique, has lower complication rate and shorter the length of hospitalization. So, we expect the number and indication of pelviscopic surgery will be increased in future.
Endometriosis ; Female ; Fever ; Hospitalization ; Humans ; Infertility ; Length of Stay ; Ovarian Cysts ; Parity ; Pregnancy ; Pregnancy, Ectopic ; Retrospective Studies

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

The study was the clinical analysis of 509 patients with pure ocular injuries who visited to Chonnam University Hospital Emergency center from July 1, 1996 to June 30, 1997 retrospectively. Clinical data survey including sex and age distribution, causes of trauma, injury site, ocular disease, and surgical intervention was done. Most of ocular injury patients were male. 3rd and 4th decade who were socially active were nearly 50%. Direct and indirect injury from foreign body was the most common cause of ocular injuries followed by fist blow, traffic accident, falling down, and sport injury. Cornea was the most common ocular injury site (209 patients, 41.1%). The incidence of the traumatic ocular disease showed corneal erosion (117 patients, 22.9%) and then eyeball perforation, traumatic hyphema etc. by frequency of order. Eyeball perforation was the most common ocular injury which needed a emergency surgical intervention. As a results, emergency physicians have to pay attention to the cornea in case of any type of ocular injuries and eyeball perforation which caused by direct and indirect injury from foreign body.
Accidents, Traffic ; Age Distribution ; Cornea ; Emergencies ; Foreign Bodies ; Humans ; Hyphema ; Incidence ; Jeollanam-do ; Male ; Retrospective Studies ; Sports

PURPOSE: Conventional indomethacin therapy(0.2mg/kg every 12 hours for three doses) has been used for closure of PDA. The effect of prolonged low dose of indomethacin therapy(0.1mg/kg daily for six days)had been reported in foreign country but, nothing had been reported in our country. So we attempted this study to examine effects of these two methods. METHODS: Forty one infants with PDA of prematurity from January 1992 to July 1995 who were admitted in NICU of Il Sin Christian Hospital were included. 27 of these infants received conventional dose of indomethacin therapy and 14 received prolonged low dose of indomethacin therapy, and we examined with closure rate and complication etc. RESULTS: 1) Closure of PDA was observed in 15(55.6%) and relapse was 3(11.1%) in conventional dose therapy group. In prolonged low dose therapy group, closure was 8(57.1%) and relapse was none. 2) Intraventricular hemorrhage was observed in 20(74.1%), 6(42.9%) and gastrointestinal tract bleeding was 6(22.2%), 13(92.2%) in each group. There was statistically significant between the two groups(p<0.05). 3) The rise of serum BUN, creatinine was observed in 9(33.3%), 6(46.2%), bleeding tendency was 9(33.3%), 8(57.1%), necrotizing enterocolitis was 2(7.4%), 0 and retinopathy of prematurity was 8(29.6%), 3(21.4%) in each group.But there was not statistically significant correlation between the two groups. 4) The development of sepsis and broncopulmonary dysplasia was slightly more in prolonged low dose therapy group. 5) The reduction of urine output was observed in 11(40.7%), 2(14.3%) in each group but, absolute oliguria was not observed in both groups. CONCLUSIONS: Though the closure rate of PDA was similar in both groups, prolonged low dose indomethacin therapy can be recommanded with its effectiveness on preventing the relapse of PDA and the accurrence of necrotizing enterocolitis.
Creatinine ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Indomethacin* ; Infant ; Oliguria ; Recurrence ; Retinopathy of Prematurity ; Sepsis

The QTc interval is a complex quantitative trait and a strong prognostic indicator of cardiovascular mortality in general, healthy people. The aim of this study was to identify non-genetic factors and quantitative trait loci that govern the QTc interval in an isolated Mongolian population. We used multiple regression analysis to determine the relationship between the QTc interval and non-genetic factors including height, blood pressure, and the plasma lipid level. Whole genome linkage analyses were performed to reveal quantitative trait loci for the QTc interval with 349 microsatellite markers from 1,080 Mongolian subjects. Among many factors previously known for association with the QTc interval, age, sex, heart rate, QRS duration of electrocardiogram and systolic blood pressure were also found to have influence on the QTc interval. A genetic effect for the QTc interval was identified based on familial correlation with a heritability value of 0.31. In a whole genome linkage analysis, we identified the four potential linkage regions 7q31-34, 5q21, 4q28, and 2q36.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Blood Pressure/genetics ; Body Height/genetics ; Cardiovascular Diseases/*genetics/mortality/pathology/*physiopathology ; Child ; Child, Preschool ; Chromosomes, Human/genetics ; *Electrocardiography ; Female ; *Genome-Wide Association Study ; Heart Rate/genetics ; Humans ; Male ; Microsatellite Repeats/*genetics ; Middle Aged ; Mongolia/epidemiology ; Quantitative Trait Loci/*genetics ; Sex Factors

The authors regret an error in discussion, the authors wrote that "We also performed an additional linkage analysis using only the adult population (> or = 20 years old)(Table 7, Figure 2 and 3)." In this sentence, Table 7 should be changed to Table 6.

BACKGROUND: A small change in venous capacitance significantly alters venous return and thus cardiac output. It is therefore important to know the effects of intravenous anesthetics on venous capacitance, particularly in a hypovolemic state. As ketamine does not suppress sympathetic activity, it has been suggested that ketamine may be the drug of choice for anesthesia during hypovolemia. The purpose of this study was to examine the effects of ketamine or sodium thiopental on venous capacitance and total vascular compliance in dogs. METHODS: Twenty mongrel dogs, weighing 10~15 Kg, were divided into two group (ketamine group: 10, sodium thiopental group: 10) of 10 each. Venous capacitance was assessed before and after drug (ketamine 1 mg/kg or sodium thiopental 5 mg/kg) injection by measuring mean circulatory filling pressure (MCFP) in the normovolemia and hypovolemia. MCFP was measured after arresting the circulation by tightening of superior vena cava and inferior vena cava snares simultaneously. RESULTS: As compared with MCFP in the normovolemia and hypovolemia, MCFP was significantly increased by ketamine in the normovolemia and hypovolemia. As compared with MCFP in the hypovolemia, MCFP was significantly decreased by sodium thiopental in the hypovolemia. The slope of the regression line relating MCFP and blood volume was not significantly altered by ketamine or sodium thiopental, which suggests that ketamine or sodium thiopental did not alter total vascular compliance. CONCLUSIONS: These results suggest that ketamine decreases venous capacitance in the normovolemia and hypovolemia but sodium thiopental increases venous capacitance in the hypovolemia.
Anesthesia ; Anesthetics, Intravenous ; Animals ; Blood Volume ; Cardiac Output ; Compliance ; Dogs* ; Hypovolemia ; Ketamine* ; SNARE Proteins ; Sodium* ; Thiopental* ; Vena Cava, Inferior ; Vena Cava, Superior

Valproic acid-induced hyperammonemic encephalopathy (VHE) is a very rare but serious complication. Discontinuation of valproic acid is the first and critical step for treatment. VHE can occur in people with normal liver function, despite normal doses and serum levels of valproic acid, therefore it is very hard to predict. Recently, we experienced a case of VHE. Here we will present the clinical, laboratory and electroencephalography findings in this patient.
Electroencephalography ; Epilepsy ; Humans ; Liver ; Status Epilepticus ; Valproic Acid

BACKGROUND: A limited number of studies have been conducted on postoperative epidural analgesia in pediatric patients. There have been primarily dealt with spinal or abdominal surgeries where multiple dermatomal segments needed to be blocked and morphine was given either through the caudal approach or by direct catheter placement. This study evaluated the safety and efficacy of postoperative continuous patient controlled epidural analgesia (PCEA) in children undergoing lower extremity surgery using a bupivacaine and fentanyl via lumbar approach. METHODS: The patient population consisted of 40 children ranging in age from 5 to 12 years. Patients were randomly divided into two groups according to postoperative pain relief regimen; the control group received an intramuscular injection of ketorolac 1 mg/kg t.i.d. and meperidine 0.5 mg/kg p.r.n., and the epidural group received PCEA (0.1% bupivacaine + fentanyl 2 microgram/ml) through an epidural catheter positioned at the surgical dermatomal level of the spinal cord. In the epidural group the volume of the initial dose was 1 ml/segment in children 10 years of age. The basal infusion rate was 0.1 ml/kg/hr (bolus: 0.05 ml/kg, lockout time: 30 minutes). Pain scores were measured upon arrival at the ward, and 6 and 24 hours thereafter. RESULTS: The epidural group had significantly lower pain scores and minimal side effects. A significant correlation was observed between the bolus number and the incidence of nausea/vomiting in the epidural group. CONCLUSIONS: This study shows that PCEA targeted at the surgical dermatome is a safer and more effective regimen for postoperative pain relief than conventional postoperative pain relief in pediatric patients undergoing lower extremity surgery.
Analgesia, Epidural* ; Bupivacaine ; Catheters ; Child ; Fentanyl ; Humans ; Incidence ; Injections, Intramuscular ; Ketorolac ; Lower Extremity* ; Meperidine ; Morphine ; Pain, Postoperative ; Spinal Cord