OBJECTIVES: Training group with mental health professionals includes didactic process, experience as a member(patient) and a leader(therapist). It is divided into four parts as like 1) lecture, case conference, book reading and seminar about theory and practice, 2) observation, 3) training group(including workshop), and 4) supervision. Among them, the training group and the supervision have been accepted as the most effective methods. Authors have developed and practiced the training group model for mental health professionals including psychiatric residents which aim for the activation of group psychotherapy in mental health area, psychiatrists' initiative in group psychotherapy area, and the training and nurturing of qualified mental health professionals. The objectives of this study are as follows;firstly, we examine the change of defense mechanism and ego function after performing group psychotherapy for mental health professionals;secondly, we analyze the therapeutic factors reported that participants were helped;thirdly, we analyze main features which include group content and process manifested in training group:lastly, we have objectives that the training group is settled down as an effective educational method to foster the personal growth and qualification as a specialist, and also that this study provides a basic research data to set up the training program and the requirements for group psychotherapy. METHODS: This study was performed 5 times from 1997 to 2000. The participants were composed of 37 mental health professionals including psychiatric residents. Among them, 29 participants(male 2, female 27) were chosen as the final subjects except 9 participants dropped out in the process of this study. At first, we take an application of pre-treatment/post-treatment experimental design to evaluate the personality change after performing the training group. EDMT(Ewha Defence Mechanism Test) and EC(Egogram Checklist), the objective questionnaires, were used as the evaluation scale. And 13-therapeutic factor scale and simple subjective questionnaires were performed just after each session and the self-report total assessment questionnaires were performed at the end of this study. RESULTS: To compare mean scores between pre-treatment and post-treatment in EDMT, the mature defense was increased significantly, the immature defense was decreased significantly, and the narcissistic defense and neurotic defense were not changed significantly. To compare mean scores between pre-treatment and post-treatment in EC, Nurturing Parent(NP), Adult(A) and Free Child(FC) were increased significantly. Therapeutic factors ranked highly were interpersonal learning, existential factor, Identification with therapist, catharsis, and socializing technique in order. The total assessment questionnaires reported that the 100% of participants were helped, the 48.3% of participants were changed in their lives, the 89.7% of participants would propose training group to others positively, and the 58.6% of participants had minds to join this kind of program if given again for them. CONCLUSIONS: This result showed that the defense mechanism and ego function of participants were changed. The training group experience makes participants reflect themselves, examine their conflicts and understand others. That also gives them chances of improving insight about group phenomena and understanding about therapeutic factors essential to the mental health professionals, having confidence on the group therapy by learning leadership and techniques, and improving understanding about the psychotherapy on the whole. Therefore, it is needed in the future that the training group would be widely adapted as an educational tool of psychotherapy and group psychotherapy for the mental health professionals as well as psychiatric residents in mental health area.
Catharsis ; Education ; Ego ; Female ; Humans ; Leadership ; Learning ; Mental Health* ; Organization and Administration ; Psychotherapy ; Psychotherapy, Group ; Surveys and Questionnaires ; Research Design ; Specialization

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

As an alternative to group psychotherapy, worked out by Dr. Moreno, the psychodrama is being carried on mainly for a large group of inpatients at 40-50% of the country's psychiatric and training hospitals. The authors have developed a Korean psychodrama model for a group mental health having following characteristics:(1) a one-time treatment, (2) open-group therapy, and (3) structured, large group approach. Korean psychodrama model was proved to be a low cost, highly effective approach in that patients could be dealt with en masse to quite a satisfactory degree: at the same time Korean psychodrama model is easily accessible for any psychiatric doctor or trainee in dealing with a patient. In addition, Korean psychodrama model is highly conducive to experiencing and training related people in psychotherapeutic practice as this model has shown up 79.4% approval rate among patients after treatment. Due to the recent crunch in medical insurance financing, psychotherapy is changing from individual long-term type to a more time-limited type. Despite the mental health law passed in 1995, from the human psychotherapy standpoint, the worsening economic situation has made it difficult for a psychiatrist to deal with patient on a one-to-one basis. As a result, the burden of most psychiatrists, is snowballing day by day. In this context psychodrama seems to be a promising, reliable alternative to group psychotherapy, both medically and economically. It will be a treatment modality for years to come.
Humans ; Inpatients* ; Insurance ; Jurisprudence ; Mental Health ; Psychiatry ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group

OBJECTIVES: This study is designed to develop a large group phychodrama for light delin-quent adolescents (hereinafter called as "Psychodrama") thereby determining therapeutic factors for dealing with them. METHODS: The study was conducted in the program of Seoul Metropolitan Youth Centre called "the class of love" during the period of July through December, 1998. The subjects consisted of a total of 827 young delinquents (759 boys and 68 girls, with the average age of 15.9 years old). To develop "this psychodrama", after we composed of therapeutic team centered by psychiatrists, we prepared from January to June, 1998 by practicing psychodrama with delinquent adolescents and by analyzing the results. "This psychodrama" has three basic steps: (1) warming-up (small group me-eting), (2) action (situation drama and main drama), (3) sharing. A survey of treatments, from a pool of participating adolescents, based on evaluation sheets and 13 therapeutic factors scale followed every session of this psychodrama. RESULTS: "This psychodrama" was helpful for 47.4%, interesting for 49.2%, not helpful for 12.1% and not interesting for 16%. In the whole group of subjects, the important therapeutic factors were existential factor, universality, identification with the therapist and the instillation of hope in the order of rank. When categorized in four different groups (audience, participants in situation drama, auxiliary egos, participants in sharing) the 4 groups displayed different results to one another. First, the therapeutic factors of audience were similar to that of the whole group. Second, participants in situation drama showed a higher catharsis than others. Third, auxiliary egos were leading in the guidance of members and therapists. Fourth, participants in sharing displayed higher group cohesiveness. CONCLUSION: As it is getting harder to find program's suitable for the treatment of increasing number of delinquents due to limited budget and experts, this psychodrama could be more cost-effective than any other measures.
Adolescent* ; Budgets ; Catharsis ; Drama ; Ego ; Female ; Hope ; Humans ; Psychiatry ; Psychodrama* ; Seoul

Melanosis duodeni is an uncommon pathologic condition characterized by diffuse small black spots on the first and second portions of the duodenum. It occurs predominantly in elderly patients and is linked to chronic renal failure, use of antihypertensive drug and oral iron supplementation, and/or presence of gastric hemorrhage. We report a case of melanosis duodeni in a 60-year-old woman diagnosed with hypertension 20 years ago and chronic renal failure 6 years ago. She has taken antihypertensive drugs for many years. On endoscopy, speckled black pigmentation of duodenal mucosa was detected. Microscopically, this duodenal lesions showed numerous coarse pigments in macrophages confined within the lamina propria. By ultrastructural study, macrophages contained electron-dense granules admixed with lipofuscin-like material in residual bodies.
Aged ; Antihypertensive Agents ; Duodenum ; Endoscopy ; Female ; Hemorrhage ; Humans ; Hypertension ; Iron ; Kidney Failure, Chronic ; Macrophages ; Melanosis* ; Middle Aged ; Mucous Membrane ; Pigmentation

OBJECTIVES: The purpose of this research is to help solve adolescent issues involving substance uses, which may become begin to undergo many changes(i. e. practising various roles, thereby leading to independent life styles). More often than not, adolescent drug problems develop into social problems, chiefly behavioral imitations and heavy dependence on medicine. The authors conducted a survey of adolescent substance uses to develop preventive measures against the drug habit prevalent among young people, thereby formulating a policy to deal with problematic community. Funded by a Youth Counselling Center in the city of H. the research was conducted on the following assumptions that there will be:Firstly, a comparison of drug uses by sex and age:Secondly, variance of substance users by family background and peer group:Thirdly, a combination of heavy drinking, smoking and delinquency resulting in the drug habit. METHODS: The survey included a total of 1613 students during 3 days, 12 through 14, July, 1999. The subjects were 833 pupils(51.6%) from 4 middle schools and 780 students(48.4%) from 3 high schools in the city of H with a ratio of 49.5 %(males) and 50.5%(females). RESULTS: 1) Experience of substance use is most referable to drinking(59.4%) and smoking(34.4%) while given to analgesics(33.1%) among medicines, glue(0.7%) among inhalants and philophone(0.4%) among narcotics. 2) High school students found more than double the amount of smoking and drinking as well as uses of hypnotics, stimulants and sedatives by junior high school students. 3) Our resalt showed was significantly noted that non-users had a better relationship with their parents than most users. 4) Smoking and drinking problean could be more easily developing into adolescent substance uses. 5) Alcohol, cigarette, and drug users showed more misconducts than other adolescents. 6) Most adolescents believe that drinking is necessary for making friends(55.0%), while smoking is just for killing time(50.9%). 7) Drinking, smoking, and other substance users were found to develop into more problematic habits. CONCLUSION: The present survey and several others show that adolescent substance uses in Korea are on the rise. Therefore, extensive counter-measures will be necessary followed by nationwide epidemiological survey of the pending issue, with the psychiatrists participating in the campaign.
Adolescent* ; Drinking ; Drug Users ; Financial Management ; Homicide ; Humans ; Hypnotics and Sedatives ; Korea ; Narcotics ; Parents ; Psychiatry ; Smoke ; Smoking ; Social Problems ; Tobacco Products

Assessment of implant mobility is an important and reliable method to clinically evaluate implant stability. PerioTest is a precise and reproducible device that cam dynamically measure the reaction of damping characteristics of peri-implant tissue. The aim of this study is to evaluate the effects of amount of implant surface area, diameter, type, implantation site, degrees of cortical engagement, and length of time in function on PTVs and to find out the most determining factor on PTVs. The results are as follows 1. 5.0mm diameter implants show significantly lower PTV than that of 3.75mm diameter implants. 2. PTV in the mandible is significantly lower than that of the maxilla 3. In the maxilla, there is no significant difference in PTV during the first year of implant function, but during the second year a significant decrease in PTV is noted. 4. In the mandible, there is a significant decrease in PTV during the first and second year of implant function. 5. Implantation site seems to be the most determining factor on PTV among the influencing factors in this study. In conclusion, the amount of implant surface area, type, degrees of cortical engagement had no significant effect on PTV, but installation site and diameter influenced significantly on PTV
Dental Implants* ; Mandible ; Maxilla

Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.
Actins ; Adipose Tissue ; Aged ; Angiomyolipoma* ; Blood Vessels ; Cytoplasm ; Desmin ; Eosinophils ; Epithelioid Cells ; Estrogens ; Female ; Giant Cells ; Glycogen ; Hamartoma ; Humans ; Keratins ; Kidney* ; Melanosomes ; Mitochondria ; Mucin-1 ; Muscle, Smooth ; Receptors, Progesterone ; Tuberous Sclerosis ; Vimentin

BACKGROUND: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination. METHODS: Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale. RESULTS: There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were 13.1 ± 3.85 points and 13.2 ± 3.42 points, respectively, and were not significantly different (p=0.958). CONCLUSIONS: The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated fullthickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.
Collagen ; Decompression ; Humans ; Hyalin ; Rotator Cuff* ; Tears* ; Tendons

OBJECTIVES: Fast change and confusion of the value system in society affect the identity formation of adolescents. So Adolescents' behavioral problems seem to be increasing yearly. It is known that the interpersonal group therapy is the most effective treatment modality among many group programs for adolescents with behavioral problems. Objectives of this study are as follows; first, evaluate therapeutic effects of the interpersonal group therapy for adolescents with behavioral problems second, examine the therapeutic factors; third, analyze the group process; fourth, orgamize the group therapy for adolescents with behavioral problems as an applicable treatment modality. The types of group therapy performed in this study are small, closed, homogeneous, outpatient, time limited, and adolescent group. METHODS: This study was carried out at one of the adolescents mental health services in Uiwang Mental Health Center, from April to June and from September to November in 2000. The subjects were 2nd grade students in K middle school with behavioral proplems. The experimental groups were composed of 4 groups including 2 male groups and 2 female groups (male 11, female 17), and the control groups matched the same conditions as the experimental groups (male 10, female 19). The group therapy was performed weekly in CA (club activity) time, and it took 60-70 minutes at one time. They met total 10 sessions including preparatory meeting and termination meeting. Before and after this program, self-rating scales (behavioral problems, aggression, and impulsivity) were applied for subjects, and the teacher rating scales (behavioral problems, aggression and impulsivity) were performed by teachers in charge. After each session, Yalom's 13 therapeutic factors scale was performed. At the last meeting, total assessment questionnaire was completed. RESULTS: The mean scores of all self-rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) than the control groups, but not significant statistically except the behavioral problem scale of female students. The mean scores of all teacher rating scales (behavioral problem, aggression, and impulsivity) were lower in the experimental groups (both male and female group) in comparison with the control groups, all significant statistically. As faras the therapeutic factors are concerned; first, the mean scores of all therapeutic factors in female students were higher than in male students and the mean scores of all therapeutic factors in the later half sessions were higher than the former half sessions; second, catharsis and existential factor were high in all students and sessions; third, identification with therapist factor was high in all students and sessions; fourth, during the later half sessions, interpersonal input was relatively high in male students and socializing technique was relatively high in female students. Its for the total assessment questionnaires; 100% of male students and 88.2% of female students reported that they were helped by this group therapy; 100% of male students and 82.4% of female students reported that they would participate willingly if future opportunity of the same group therapy is given for them. CONCLUSION: Adolescents with behavioral problems who participated in this study showed the decrease of behavioral problems and the change of aggressive and impulsive attitudes in comparison with the control groups although they had some differences between male and female students. The group therapy with adolescents would be practiced more broadly and extensively though there are several accompanied problems including the difficulty of structuring, the deficit of motivation, and financial problem.
Adolescent* ; Aggression ; Catharsis ; Female ; Group Processes ; Gyeonggi-do ; Humans ; Male ; Mental Health ; Mental Health Services ; Motivation ; Outpatients ; Psychotherapy, Group* ; Surveys and Questionnaires ; Weights and Measures