OBJECTIVES: The aims of this study were to evaluate the interaction of topotecan with adriamycin, etoposide, 5 fluorouracil (5 FU) and mitomycin C in the established four ovarian cancer cell lines and three cervical cancer cell lines and to establish whether the combination of topotecan with other antitumor drugs would be a synergism for chemotherapy in patients with ovarian and cervical cancer, METHODS: Five antitumor drugs were tested for synergism and antagonism in combination studies in four ovarian cancer cell lines (A2780, A2780 cisplatin resistant variant, A2780 taxol resistant variant, SKOV3) and three cervical cancer cell lines (HeLa, SiHa, ME180). Cytotoxic effects were determined by MTT assay. Synergic interaction was calculated by the median effect principle in which combination index (CI) of less than one suggest a synergic interaction. RESULTS: Dm value of topotecan against SKOV3 (2.07 ug/ml), HeLa (3.32 ug/ml), SiHa cell lines (2.5 ug/ml) were above peak plasma concentration of topotecan (0.5 ug/ml) but most antitumor drugs tested in combinations index were within clinically relevant range. Combination with topotecan showed a synergic effect (CI<1) in seven cancer cell lines at a intermediate or high level of cytotoxicity especially with mitomycin C (6/7), etoposide (6/7), 5 FU (6/7) and adriamycin (4/7). Most striking findings were that a synergic effect was shown in all ovarian cancer cell lines to topotecan/mitomycin C, topotecan/5 FU and topotecan/esoposide combination showed a synergic effect in all cervical cancer cell lines. Topotecan/adriamycin combination showed synergism at an intermediate or high level of cytotoxicity in cisplatin or Taxol resistant ovarian cancer cell lines (A2780CP, A2780TX, SKOV3). CONCLUSION: These results suggested that topotecan showed a synergic effect with a wide range of antitumor drugs: adriamycin, etoposide, 5 FU, mitomycin C in ovarian and cervical cancer cell lines. Combinations of topotecan/mitomycin C, topotecan/5 FU and topotecan/adriamycin for ovarian cancer and a combination of topotecan/etoposide for cervical cancer seemed worthy of consideration for clinical application.
Antineoplastic Agents* ; Cell Line ; Cisplatin ; Doxorubicin ; Drug Therapy ; Etoposide ; Fluorouracil ; Humans ; Mitomycin ; Ovarian Neoplasms ; Paclitaxel ; Plasma ; Strikes, Employee ; Topotecan* ; Uterine Cervical Neoplasms

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

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

In Korea Mental Heath Law came into operation in 1997, and the management of the mentally ills has become an important issue and it is inevitable to train mental health workers for the management of the mentally ills. The purpose of the management seems not only to care the patients' symptoms but also to improve the quality of life. Nowadays, in the best approach of treatment and management it is difficult that one to one management is used because of the cost limitation and management efficacy. So it is highly recommended that the group approach should be used. Hence 'the activation of group psychotherapy' is very important for the effective treatment and efficient management of the mentally ills. And therapists should know group psychotherapy well and to use it properly. In these viewpoints, we first introduced various types of group psychotherapy generally, including Yalom's group psychotherapy which focus on the interpersonal relationship and is the representative type of group psychotherapy. And then we classified group psychotherapy simply, describe the concepts of practical application of group psychotherapeutic approach. And last on the basis of understanding group psychotherapy in this paper, we explored the necessity of its activation on the practical setting and the surrounding circumstances.
Jurisprudence ; Korea ; Mental Health ; Psychotherapy, Group* ; Quality of Life

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

Group psychotherapy is an important therapy far inpatient treatment. A lot of studies proved the effect of inpatient group psychotherapy. Therefore it is necessary to use group psychotherapy actively for inpatient treatment. There are many models of inpatient group psychotherapy made in foreign counties. But It is difficult to apply those models themselves directly in Korean inpatient unit, and so it is an urgent issue to make an inpatient group psychotherapy model that fits Korean inpatient unit setting. According to this need we made our paper in order to introduce an effective model of group psychotherapy for Korean inpatients in detail, and then to provide opportunity for effective inpatient treatment. The characteristics of this inpatient group psychotherapy model are as follows. 1) This model of group psychotherapy give a field in which a therapist encounter inpatients as a human being. 2) This model is easy to perform generally, and helpful to a comprehensive therapeutic approach for inpatients. 3) In this model heterogeneous inpatients participate in a same one group, therefore this model is able to apply various inpatients. 4) This model makes the basis of continuous outpatient treatment or day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 5) Group functions as a social microcosm, and so reveals patient's interpersonal relationship and gives the opportunity to treat it. Therefore group helps patients to be adapted well to inpatient unit and society. 6) In this model, social workers, nurses, or students in practice play a role of healthy egos or observers, and so they can activate group psychotherapy. And this model co be used as a practical and useful tool of the education for psychiatric residents, medical students, social workers, and other students. Psychiatrists seem to be less interested in group psychotherapy than other mental heath practitioners. But it may be appropriate for well trained psychiatrists to use group psychotherapy with individual psychotherapy.
Education ; Ego ; Humans ; Inpatients* ; Outpatients ; Psychiatry* ; Psychotherapy ; Psychotherapy, Group* ; Social Workers ; Students, Medical

In this paper, first of all we compared psychoanalysis with psychodrama by a historical point of view. Next, we reviewed group Psychotherapy generally and considered the position of psychodrama through the comparison with various types of soup psychotherapy On the basis of this consideration, we compared Yalom's group psychotherapy as a typical type of group psychotherapy with psychodrama. Lastly, we discussed the application of group psychotherapy and psychodrama to each other. Psychoanalysis, psychodrama, and group psychotherapy developed separately at similar times in different fields. finally, these three fields met with one another in the field of psychiatry. Each of these three fields changed itself as a result of absorbing various things from one another. Therefore, nowadays these fields became to have a close relation with one another. Psychodrama is in a position as a type of group psychotherapies, so it is important to understand group Psychotherapy generally for understanding Psychodrama. Psychodrama has similar aspects to other group psychotherapies, but also has different aspects from other group psychotherapies. When we understand these aspects, we can conduct therapeutic works effectively in practice. Psychodrama's methods can be applied to group psychotherapy and group psychotherapy's theories can applied to psychodrama. When psychodrama and group psychotherapy takes good points from the other side they can make progress.
Psychoanalysis ; Psychodrama* ; Psychotherapy ; Psychotherapy, Group*

OBJECTIVES: The long-term outpatient group psychotherapy with the chronically ill is an effective, expedient therapeutic modality that makes patients maintain medication and improve their symptoms, helps patients resolve emotional conflict, and corrects their maladaptive interpersonal relationship. Therefore, we performed weekly the semi-opened, heterogeneous, long-term(open-ended), outpatient group psychotherapy to be applicable effectively for the chronically ill. The objectives of this study are as follows; first, we introduce therapeutic principles and management methods of the group psychotherapy to be applicable in the clinical environment with the chronically ill; second, we examine the therapeutic factors in each group development stage which are helped by participants, and analyze the characteristics showed in the process of study; third, we verify the appropriateness and the validity of this group psychotherapy and then establish the base of the effective long-term outpatient therapy for the chronically ill that will be settled down as a applicable treatment modality economically and efficiently in the present medical environment of Korea. METHODS: This study was performed in the subject of the chronically ill who attended at the day care program of Community Mental Health Center in Hanam city from January 1998 to June 1999. The participants were 27 patients, but we dropped 7 patients who attended under 6 months because of long-term group. So the last subjects were 20 patients (12 males and 8 females) who attended for 18 months. The 13 therapeutic factors scale was filled out by participants just after each session and the self-report total assessment questionnaire was performed at the time of study-termination and patient-termiation. RESULTS: The ranks of 13 therapeutic factors scale are as follows: in the forming stage, the upper ranks of therapeutic factors were existential factor, guidance of therapists, instillation of hope, altruism, and catharsis in order. And in the storming stage, the upper ranks of therapeutic factors were existential factor, instillation of hope, guidance of therapists, catharsis, and group cohesiveness in order. Lastly in the norming stage, the upper ranks of therapeutic factors were existential factor, altruism, corrective recapitulation, interpersonal learning, and catharsis in order. According to the total assessment questionnaire about group psychotherapy reported by the participants 90% of them were helped, 80% of them had an idea to recommend this program to other patients actively, and 75% of them had an opinion to attend again this program if given for them. And they evaluated positively about the structure of this program and the therapist. CONCLUSIONS: The long-term outpatient group psychotherapy would be applicable effectively to the chronically ill as a economic, efficient therapeutic modality for rehabilitation. It is much more effective for therapist to perceive in detail the therapeutic factors in each group develop-ment stage when he perfoms the group psychotherapy.
Altruism ; Catharsis ; Chronic Disease ; Day Care, Medical ; Gyeonggi-do ; Hope ; Humans ; Korea ; Learning ; Male ; Mental Health ; Mentally Ill Persons* ; Outpatients* ; Psychotherapy, Group* ; Surveys and Questionnaires ; Rehabilitation

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

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