OBJECTIVES: The purpose of this study was to investigate important therapeutic factors in encounter group and compare these therapeutic factors with those in long-term outpatient group psychotherapy, to understand the content and process in real cases for facilitation of interpersonal learning which is important for long-term outpatient group psychotherapy, and to acquire basic data of long-term outpatient group psychotherapy on the basis of this understanding. METHODS: The subject was 7 encounter groups, composed of 41 persons. We used short form of Yalom's Q-sort to find important therapeutic factors in encounter group. We selected 2 cases for analyzing the process and content in these cases. RESULTS: Three of the most important therapeutic factors were existential factors','self understanding', and 'interpersonal teaming(input)'. CONCLUSION: We suggest that interpersonal learning is the most important therapeutic factor in encounter group.
Humans ; Learning ; Outpatients ; Psychotherapy, Group* ; Q-Sort ; Sensitivity Training Groups

OBJECTIVES: We compared resorbable plates with titanium plates for treatment of combined mandibular angle and symphyseal fractures. MATERIALS AND METHODS: Patients with mandibular angle and symphysis fractures were divided into two groups. The control (T) group received titanium plates while the experimental (R) group received resorbable plates. All procedures were carried out under general anesthesia using standard surgical techniques. We compared the frequency of wound dehiscence, development of infection, malocclusion, malunion, screw breakage, and any other technical difficulties between the two groups. RESULTS: Thirteen patients were included in the R group, where 39 resorbable plates were applied. The T group consisted of 16 patients who received 48 titanium plates. The mean age in the R and T groups was 28.29 and 24.23 years, respectively. Primary healing of the fractured mandible was obtained in all patients in both groups. Postoperative complications were minor and transient. Moreover, there were no significant differences in the rates of various complications between the two groups. Breakage of 3 screws during the perioperative period was seen in the R group, while no screws or plates were broken in the T group. CONCLUSION: Resorbable plates can be used to stabilize combined mandibular angle and symphysis fractures.
Anesthesia, General ; Humans ; Malocclusion ; Mandible ; Mandibular Fractures ; Perioperative Period ; Postoperative Complications ; Sensitivity Training Groups ; Titanium* ; Wounds and Injuries

BACKGROUND: During ophthalmologic surgery, a variety of anesthetic induction techniques are used in an attempt to prevent the rise of intraocular pressure (IOP). This study compared the effects of etomidate, a new intravenous anesthetic agent, on the changes in IOP with those of thiopental sodium and propofol. METHODS: Forty-five patients were randomly allocated and divided into three groups to be injected intravenously with etomidate 0.2-0.3 mg/kg (E-group, n = 15), propofol 2-3 mg/kg (P-group, n = 15) or thiopental sodium 4-5 mg/kg (T-group, n = 15). Systolic arterial pressure (SAP), heart rate (HR) and intraocular pressure (IOP) were measured at 1, 2 and 3 minutes after the administration of the induction agents. During the induction of anesthesia, the incidence of IV injection pain, myoclonus, hiccup and a decrease in SAP of more than 30% were investigated. RESULTS: At 1, 2 and 3 min following the induction of anesthesia, the SAP in the P-Group decreased significantly more than that in the other two groups (P < 0.05). After the induction, heart rate in the T-Group increased significantly more than that in the other two groups (P < 0.05). The three intravenous agents induced a significant decrease in IOP after an injection (P < 0.05). Comparing the three groups, the IOP in the E- and P-Group decreased significantly more than that in the T-Group (P < 0.05). CONCLUSIONS: Etomidate may be used as a choice of intravenous induction agent to reduce intraocular pressure in ophthalmologic operations especially in an emergency situation, geriatric and hypovolemic patients.
Anesthesia* ; Arterial Pressure ; Emergencies ; Etomidate* ; Heart Rate ; Hiccup ; Humans ; Hypovolemia ; Incidence ; Intraocular Pressure* ; Myoclonus ; Propofol* ; Sensitivity Training Groups ; Thiopental*

BACKGROUND: The purpose of this study was to independently evaluate the beneficial effects of a high dose of transamine administrated prior to CPB on the postoperative hematologic aspect and bleeding. MATERIALS AND METHODS: This study included randomly selected groups of 40 adult patients undergoing OHS with CPB. All patients were divided into 2 groups: transamine group (T-group, n=20) and placebo group (P-group, n=20). The T-group received a high-dose of transamine (10 g) before and during CPB. The P-group received normal saline at the same times and served as a control group. RESULTS: The results of comparative studies between the 2 groups in the same hematologic variables were summarized as follows. (1) During CPB, the fibrinogen concentrations and platelet counts were significantly lower in the P-group than in the T-group (p<0.01). (2) During CPB, production of D-dimer occurred in 18 patients (90%) in the P-group and did not occur in the T-group (0%) (p<0.0001). (3) At CPB-off, the % concentration of fibrinogen (70.2+/-3.9%) and the % platelet counts (72.4+/-4.5%) of the T-group were significantly higher than those (54.5+/-3.8%, 64.3+/-2.9%) of the P-group (p<0.01). (4) Postoperative values of PT (14.0+/-0.03 sec.) and aPTT (27.6+/-0.1 sec.) of the T-group were significantly lower than those (16.0+/-0.02sec., 30.1+/-0.1sec.) of the P-group (p<0.05). (5) Postoperative bleeding and requirement of whole blood and other blood products were significantly less in the T-group than in the P-group (p <0.05). (6) There were no significant hypercoagulability signs such as cerebral em bolism, myocardial infarction, pulmonary embolism, or any other neurological prob lems in either group. CONCLUSIONS: We concluded that a high dose of transamine administered prior to CPB prevents the activation of fibri nolytic system and has beneficial effects of reducing the postoperative bleeding t endency without apparent hypercoagulability signs.
Adult ; Cardiopulmonary Bypass* ; Fibrinogen ; Hemorrhage ; Humans ; Myocardial Infarction ; Platelet Count ; Pulmonary Embolism ; Sensitivity Training Groups ; Thrombophilia ; Tranexamic Acid* ; Tranylcypromine*

The aim of this article is to understand group psychotherapy. In group psychotherapy, psychoanalytic theory and cognitive-behavioral theory have been accepted as perennial effective therapeutic modalities. But nowadays, all theories give the group psychotherapy vitality and liveness as a therapeutic modality in practical setting. The orders of the group psychotherapy that current therapists prefer according to their theoretical background are as follows: psychodynamic/psychoanalytic, group as a whole/systems, transactional analysis/gestalt/redecision, interpersonal/interactional, cognitive/behavioral, object relations, group analysis, psychodrama, existential/humanistic, and self psychology. The practice of group psychotherapy includes four therapy group, encounter group, training group, and education group or self-help group. Therapy group has the goal of symptom relief and personality reconstruction for patients. Encounter group has the goal of self growth and self realization for non-patients. Training group has the goal of training in human relationship and self maturation for mental health personnels. Self help group has the goal of education and support for patient families and patients. Group psychotherapy has been accepted as a therapeutic modality that are equally effective as individual psychotherapy although group psychotherapy has been derived from individual psychotherapy. Recently, individual psychotherapy has been less practiced yearly because of the pressure of economic difficulties of medical insurance in developed countries. Therefore, the importance of group psychotherapy with its therapeutic effectiveness and cost-efficiency is uprising.
Developed Countries ; Education ; Humans ; Insurance ; Mental Health ; Object Attachment ; Psychoanalytic Theory ; Psychodrama ; Psychotherapy ; Psychotherapy, Group* ; Self Psychology ; Self-Help Groups ; Sensitivity Training Groups

Train-of-four (TOF) fade is a characteristic of the nondepolarizing neuromuscular blocking agents, but the degree of TOF fade has been shown to vary for different nondeplarizing relaxants. In the present study we measured the degree of fade of four nondepolarizing muscle relaxantsatracurium, vecuronium, pancuronium, and d-tubocurarine-during spontaneous recovery of neuromuscular blockade. Forty ASA class 1 or 2 adult patients were studied. All patients were premedicated with glycopyrrolate 0.2 mg and nalbuphine 10 mg IM, 1 hour before induction. After induction with pentothal sodium 5-6 mg/kg IV, neuromuscular monitoring was carried out by stimulaton of the ulnar nerve at the wrist with supramaximal stimuli at a frequency of 2 Hz repeated every 20 seconds using an ABM (Anesthesia and Brain activity Monitor, Datex Co.). The electromyographic response of hypothenar muscles was recorded. Following stabilization of control twitch height, the nondepolarizing relaxant was injected as a bolus dose, and tracheal intubation was performed when the first twich height of the train (T(1)) was 5% of the control. Anesthesia was maintained with O2-N2O (50%) -enflurane. Patients were divided into four groups according to use of relaxant: atracurium 0.4 mg/kg (n=10: group A), vecuronium 0.08 mg/kg (n=10; group V), pancuronium 0.08 mg/kg (n=10; group T), and d-tubocurarine 0.4 mg/kg (n= 10: group T). T(4) ratios at T(1) of 25, 50 and 75% recovery of T(1) and recovery index in each group were measured. The results were as follows: 1) The T(4) ratio was decreased significantly in P and T groups, as compared to A and V group. There were no significant differences between P and T groups, and between A and V groups (except 25% recovery of T(1)). 2) The recovery index was 14.8+/-2.36 min in A group, 16.4+/-1.85 min in V group, 51.2+/-4.17 min in P group, and 93.4+/-7.31 min in T group.
Adult ; Anesthesia ; Atracurium ; Brain ; Glycopyrrolate ; Humans ; Intubation ; Muscles ; Nalbuphine ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Neuromuscular Monitoring ; Pancuronium ; Sensitivity Training Groups ; Sodium ; Thiopental ; Tubocurarine ; Ulnar Nerve ; Vecuronium Bromide ; Wrist

BACKGROUND: Sternal fractures are relatively rare, and caused mainly by blunt anterior chest wall trauma. In most cases, sternal fractures are treated conservatively. However, if the patient exhibits problematic symptoms such as intractable chest wall pain or bony crepitus due to sternal instability, surgical correction is indicated. But no consensus exists regarding the most appropriate surgical method. We analyzed the results of surgical fixation in cases of sternal fracture in order to identify which surgical method led to the best outcomes. METHODS: We retrospectively reviewed the medical records of patients with sternal fractures from December 2008 to December 2011, and found 19 patients who underwent open reduction and internal fixation of the sternum with a longitudinal plate (L-group) or a T-shaped plate (T-group). We investigated patients' characteristics, clinical details regarding each case of chest trauma, the presence of other associated injuries, the type of open reduction and fixation, whether a combined operation was performed, and postoperative complications. RESULTS: Of the 19 patients, 10 patients (52.6%) were male, and their average age was 56.8 years (range, 32 to 82 years). Seven patients (36.8%) had isolated sternal fractures, while 12 (63.2%) had other associated injuries. Seven patients (36.8%) were in the L-group and 12 patients (63.2%) were in the T-group. Three patients in the L-group (42.9%) showed a loosening of the fixation. In all patients in the T-group, the fracture exhibited stable alignment. CONCLUSION: Open reduction and internal fixation with a T-shaped plate in sternal fractures is a safer and more efficient treatment method than treatment with a longitudinal plate, especially in patients with a severely displaced sternum or anterior flail chest, than a longitudinal plate.
Bone Plates ; Consensus ; Flail Chest ; Fracture Fixation ; Humans ; Male ; Medical Records ; Methods ; Postoperative Complications ; Retrospective Studies ; Sensitivity Training Groups ; Sternum ; Thoracic Injuries ; Thoracic Wall ; Thorax

OBJECTIVES: Group psychotherapy is more economic than individual psychotherapy and effective to adolescents especially. Group psychotherapy with adolescents will be used widely when adolescents problems are becoming more important so that government focuses on them. This article aims for the readers to understand group psychotherapy easily. METHODS: This article is based on reviewing lots of articles related to adolescent group psychotherapy published at home and abroad and our researches and practical experiences in regard with inpatient and outpatient group with adolescents for a long time. This article is described in order of history, theory, model, development stage, and therapeutic factor. RESULTS: Theories of group psychotherapy have been affected by about 200 psychotherapy theories. Among a lot of theories, psychoanalytic theory and cognitive-behavioral theory have been accepted as a perennial effective therapeutic modality. In Korea, structuralized cognitive-behavioral group therapy is currently pervaded in Youth Counselling Center or General Social Welfare Center. But because that is generally consist of skill training and problem solving centered approach, it is difficult to achieve therapeutic goal of ultimate behavioral change in basis of genetic insight. On the contrary, it is known that psychoanalytic group therapy has more benefit to raise adolescent universal value, group norms, group rules, confidentiality, and community consciousness for adolescents. and that group therapy provides adolescents with more secure and caring conditions. Here and now, adolescent group therapists apply wide theories and various techniques with flexible attitudes to go together with unapproachable adolescents. Models of group psychotherapy have various mode related to age, disorders, functional level, developmental level, clinical environment, structural modalities, and intervention goal. Developmental stages of the group psychotherapy consist of formal stage, conflictual stage, normal stage, and performing stage. And then those are divided with the first stage, middle stage, and the last stage in an adolescent group. Therapeutic factors of an adolescent group are as follows. Interpersonal learning, catharsis, existential factor, and group cohesiveness are highly evaluated in an encounter group and a long-term group for personality change. And catharsis, universality, identification, and group cohesiveness are highly evaluated in a short-term group. To handle the adolescent group, therapist capability is very critical. Special knowledge, technique, and endurance are needed for the group therapist to lead an adolescent group. Even though some therapist lead the adult group for a long time, they have to get special training and supervision to lead the adolescent group. CONCLUSIONS: Group psychotherapy has been formally accepted as one of therapeutic modalities that must be as equally effective as individual psychotherapy even if it derives from individual psychotherapy. Adolescent group psychotherapy is currently accepted as one of the most important therapeutic modalities although it is not highlighted as same as adult group psychotherapy. Group therapy is the most desirable therapeutic method for adolescents because they go through a transitional critical time for change and they are especially affected by peer group.
Adolescent* ; Adult ; Catharsis ; Confidentiality ; Consciousness ; Humans ; Inpatients ; Korea ; Learning ; Organization and Administration ; Outpatients ; Peer Group ; Problem Solving ; Psychoanalytic Theory ; Psychotherapy ; Psychotherapy, Group* ; Sensitivity Training Groups ; Social Welfare

To investigate the clinical effect of cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment in the treatment of pregnancy with otitis externa mycotica.From May 2015 to May 2017,16 cases of pregnant patients(19 ears)with otitis externa mycotica were divided into two groups:pure cleaning up group and cleaning up combined with medication group.In the pure cleaning up group,external auditory canal were only cleaned up under otoendoscope conventionally in 9 patients(11 ears),while in the cleaning up combined with medication group,Clotrimazole Ointment was topically applied after cleaning up the external auditory canal under otoendoscope in 7 patients(8 ears).After treatment of 2 weeks,the clinical curative effect,adverse reaction and average time interval to take effect were compared at the end of treatment.The total effective rate(100%)in cleaning up combined with medication group's was significantly better than that in pure cleaning up group's(81.81%)(<0.05);The average time interval to take effect in cleaning up combined with medication groupwas significantly shorter than that in pure cleaning up group's[(2.71±0.70)d vs(5.40±1.96)d,<0.05].After the two-week treatment,there was a four-week follow-up.Only one patient in pure cleaning up group relapsed.After two-week treatment by Clotrimazole Ointment,this patient was cured.Cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment is effective and safe for the treatment of otitis externa mycotica in pregnant women.The addition of topical application of Clotrimazole Ointment further improve the therapeutic efficacy,as compared to the conventional method of cleaning up the external auditory canal under otoendoscope.We suggest clinical application of this method.
Anti-Infective Agents, Local ; therapeutic use ; Clotrimazole ; therapeutic use ; Ear Canal ; Female ; Humans ; Mycoses ; therapy ; Otitis Externa ; therapy ; Pregnancy ; Pregnancy Complications, Infectious ; therapy ; Sensitivity Training Groups

BACKGROUND: Osteolytic metastasis is a common destructive form of metastasis, in which there is an increased bone resorption but impaired bone formation. It is hypothesized that the changed mechanical properties of tumor affected bone cells could inhibit its mechanosensing, thus contributing to differences in bone remodeling. METHODS: Here, atomic force microscopy indentation on primary bone cells exposed to 50% conditioned medium from Walker 256 (W) carcinoma cell line or its adaptive tumor (T) cells was carried out. Nitric oxide levels of bone cells were monitored in response to low-magnitude, high-frequency (LMHF) vibrations. RESULTS: A stronger sustained inhibitive effect on bone cell viability and differentiation by T cells as compared to that of its cell line was demonstrated. This could be attributed to the higher levels of transforming growth factor-β1 (TGF-β1) in the T-conditioned medium as compared to W-conditioned medium. Bone cell elastic moduli in W and T-groups were found to decrease significantly by 61.0% and 69.6%, respectively compared to control and corresponded to filamentous actin changes. Nitric oxide responses were significantly inhibited in T-conditioned group but not in W-conditioned group. CONCLUSIONS: It implied that a change in cell mechanical properties is not sufficient as an indicator of change in mechanosensing ability. Moreover, inhibition of phosphoinositide 3-kinase/Akt downstream signaling pathway of TGF-β1 alleviated the inhibition effects on mechanosensing in T-conditioned cells, further suggesting that growth factors such as TGF-β could be good therapeutic targets for osteoblast treatment.
Actins ; Bone Neoplasms ; Bone Remodeling ; Bone Resorption ; Cell Line ; Cell Survival ; Culture Media, Conditioned ; Elastic Modulus ; Intercellular Signaling Peptides and Proteins ; Microscopy, Atomic Force ; Neoplasm Metastasis ; Nitric Oxide ; Osteoblasts ; Osteogenesis ; Sensitivity Training Groups ; T-Lymphocytes ; Vibration ; Walkers