• Title/Summary/Keyword: general pain

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Analytical Psychology in Psychiatric Clinics (진료현장에서의 분석심리학 : 정신건강의학과 진료실에서 접하는 문제들의 분석심리학적 접근 경험)

  • Sang-Hag Park
    • Sim-seong Yeon-gu
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    • v.35 no.2
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    • pp.85-112
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    • 2020
  • How does analytical psychology help understand patients at general psychiatric clinics? It's necessary to think about how knowledge of analytical psychology can help young psychiatrists who are in training. Patients who come to us bring symptoms(problems). Symptoms can be compared to tickets to a movie theater. Symptoms accompanied by complaints of pain are not only pathological phenomena to be eliminated, but an important pathway to access the patients' inner problems. In terms of seeing the whole, the point of view in analytical psychology is to see the unconscious as well as the consciousness, even the elements the patients do not speak or know of. When determining indications and contra-indications during the initial process of treating a patient, it is more important to acknowledge the therapist's capabilities and limitations than the patient's condition or limitations The approach to complaints of the same symptoms may differ depending on whether the patient is in the first half or the second half of one's life. Analytical psychology is empirical psychology that experiences and it adheres to a phenomenological position that recognizes the phenomenon as true in itself, not logically right or wrong. The analytical psychological view of understanding mental phenomena asks the causal perspective of why the symptoms occurred. At the same time, the therapist, along with the patient, must seek answers to the question of why now and for what purpose. A therapist is a person who experiences the patient's personal development process together. In analytical psychotherapy, the therapist's attitude is more emphasized than the treatment method or technique; it is regarded as of the utmost importance. In this regard, analytical psychology is a practical and useful therapeutic tool, and is a field of study that can be widely used in actual psychiatric clinics. In addition to understanding the patient, it is also the most important discipline for the therapists, especially for the education and growth of those who want to become a treatment tool themselves.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.