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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.

The Interpretaion of the Fairy Tale <The Frog King or Iron Heinrich> in Light of Jungian Psychology : The Unification of Opposites in the Fairytale (민담 <개구리 왕 혹은 충직한 하인리히>의 융심리학적 해석 : 민담에 나타난 대극의 합일)

  • Boseop Lee
    • Sim-seong Yeon-gu
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    • v.36 no.1
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    • pp.55-86
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    • 2021
  • The initial situation in our tale shows that the earth-mother-feminine principle disappeared from the center of the collective consciousness into the collective unconscious. Therefore the heaven-father-masculine principle is dominant, which is represented by the king. And in the king's daughter, who is living without mother, the positive father complex is working. She stays in the heaven-spirit world playing with the golden ball, which can be seen as the state of inflation. She is disconnected from the earth-mother-feminine principle, which is important for a woman to find her genuine feminine identity. This demanded principle approaches her through the frog, a bewitched prince. Psychologically it means that a man is under the power of the negative mother complex. The disgusting, ugly frog is a symbol for the shadow, the earthly animal instincts of the princess. Only with his help she can find her golden ball again, which has fallen into the deep well. Their talk about the rewards to him for his help shows us very well the opposites. The frog wants the feminine value such as relation, earthly eros, but the princess offers the masculine value such as heavenly logos. After the frog brought her the lost ball, i.e. she regained her libido, she completely forgot her promise. Like this the content, which is becoming conscious, here the shadow, is easy to fall back into the unconscious and to be repressed. The frog cannot be with the princess without the help of the king, a father figure, a firm protector of the collective oder. At first unwillingly the princess obeys Logos of her father. But her authentic instinctual urge grows stronger and it causes that her ego is released from the power of her father complex. At just this moment the frog turns into a prince, i.e. he is liberated from the mother complex. The marriage of princess and frog-prince symbolize the unification of the opposites: heaven becomes earthly and earth becomes heavenly. Three iron bands, wrapped around the heart of Heinrich, a young king's servant, are snapped, while he brings the prince and princess back to his kingdom. The heart, the place of earth-mother-feminine consciousness, is now liberated. This principle, which disappeared into the unconscious, emerged into the collective consciousness and the wholeness is recovered. The Self is now leading the collective consciousness, which includes not only the principle of Logos but also Eros.

Establishment of Test Conditions and Interlaboratory Comparison Study of Neuro-2a Assay for Saxitoxin Detection (Saxitoxin 검출을 위한 Neuro-2a 시험법 조건 확립 및 실험실 간 변동성 비교 연구)

  • Youngjin Kim;Jooree Seo;Jun Kim;Jeong-In Park;Jong Hee Kim;Hyun Park;Young-Seok Han;Youn-Jung Kim
    • Journal of Marine Life Science
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    • v.9 no.1
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    • pp.9-21
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    • 2024
  • Paralytic shellfish poisoning (PSP) including Saxitoxin (STX) is caused by harmful algae, and poisoning occurs when the contaminated seafood is consumed. The mouse bioassay (MBA), a standard test method for detecting PSP, is being sanctioned in many countries due to its low detection limit and the animal concerns. An alternative to the MBA is the Neuro-2a cell-based assay. This study aimed to establish various test conditions for Neuro-2a assay, including cell density, culture conditions, and STX treatment conditions, to suit the domestic laboratory environment. As a result, the initial cell density was set to 40,000 cells/well and the incubation time to 24 hours. Additionally, the concentration of Ouabain and Veratridine (O/V) was set to 500/50 μM, at which most cells died. In this study, we identified eight concentrations of STX, ranging from 368 to 47,056 fg/μl, which produced an S-shaped dose-response curve when treated with O/V. Through inter-laboratory variability comparison of the Neuro-2a assay, we established five Quality Control Criteria to verify the appropriateness of the experiments and six Data Criteria (Top and Bottom OD, EC50, EC20, Hill slop, and R2 of graph) to determine the reliability of the experimental data. The Neuro-2a assay conducted under the established conditions showed an EC50 value of approximately 1,800~3,500 fg/μl. The intra- & inter-lab variability comparison results showed that the coefficients of variation (CVs) for the Quality Control and Data values ranged from 1.98% to 29.15%, confirming the reproducibility of the experiments. This study presented Quality Control Criteria and Data Criteria to assess the appropriateness of the experiments and confirmed the excellent repeatability and reproducibility of the Neuro-2a assay. To apply the Neuro-2a assay as an alternative method for detecting PSP in domestic seafood, it is essential to establish a toxin extraction method from seafood and toxin quantification methods, and perform correlation analysis with MBA and instrumental analysis methods.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization (흉벽 및 흉곽 내 장기 손상으로 인한 외상성 혈흉: 전신 동맥 색전술의 임상 결과)

  • Chang Mu Lee;Chang Ho Jeon;Rang Lee;Hoon Kwon;Chang Won Kim;Jin Hyeok Kim;Jae Hun Kim;Hohyun Kim;Seon Hee Kim;Chan Kyu Lee;Chan Yong Park;Miju Bae
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.923-935
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    • 2021
  • Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors (신보강화학요법 후 유방암의 병리학적 완전 관해 예측 및 잔류 암 평가: 유방자기공명영상의 정확도 및 영향인자 분석)

  • Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.654-669
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    • 2021
  • Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

Chest CT Findings of COVID-19 Patients with Mild Clinical Symptoms at a Single Hospital in Korea (경증의 임상 소견을 보이는 COVID-19 환자들의 흉부 CT 소견)

  • Woon Young Baek;Young Kyung Lee;Suhyun Kim;Chorom Hahm;Mi Young Ahn;Dong Hyun Oh;Jae-Phil Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.139-151
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    • 2021
  • Purpose To retrospectively evaluate the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in patients with mild clinical symptoms at a single hospital in South Korea. Materials and Methods CT scans of 87 COVID-19 patients [43 men and 44 women; median age: 41 years (interquartile range: 26.1-51.0 years)] with mild clinical symptoms (fever < 38℃ and no dyspnea) were evaluated. Results CT findings were normal in 39 (44.8%) and abnormal in 48 (55.2%) patients. Among the 48 patients with lung opacities, 17 (35.4%) had unilateral disease and 31 (64.6%) had bilateral disease. One (2.1%) patient showed subpleural distribution, 9 (18.8%) showed peribronchovascular distribution, and 38 (79.2%) showed subpleural and peribronchovascular distributions. Twenty-two (45.8%) patients had pure ground-glass opacities (GGOs) with no consolidation, 17 (35.4%) had mixed opacities dominated by GGOs, and 9 (18.8%) had mixed opacities dominated by consolidation. No patients demonstrated consolidation without GGOs. Conclusion The most common CT finding of COVID-19 in patients with mild clinical symptoms was bilateral multiple GGO-dominant lesions with subpleural and peribronchovascular distribution and lower lung predilection. The initial chest CT of almost half of COVID-19 patients with mild clinical symptoms showed no lung parenchymal lesions. Compared to relatively severe cases, mild cases were more likely to manifest as unilateral disease with pure GGOs or GGO-dominant mixed opacities and less likely to show air bronchogram.

Quantification of the Elastic Property of Normal Thigh Muscles Using MR Elastography: Our Initial Experience (자기 공명 탄성 검사를 이용한 대퇴 근육의 탄성도의 정량화: 초기 경험)

  • Junghoon Kim;Jeong Ah Ryu;Juhan Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1556-1564
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    • 2021
  • Purpose This study aimed to apply MR elastography (MRE) to achieve in vivo evaluation of the elastic properties of thigh muscles and validate the feasibility of quantifying the elasticity of normal thigh muscles using MRE. Materials and Methods This prospective study included 10 volunteer subjects [mean age, 32.5 years, (range, 23-45 years)] who reported normal activities of daily living and underwent both T2-weighted axial images and MRE of thigh muscles on the same day. A sequence with a motion-encoding gradient was used in the MRE to map the propagating shear waves in the muscle. Elastic properties were quantified as the shear modulus of the following four thigh muscles at rest; the vastus medialis, vastus lateralis, adductor magnus, and biceps femoris. Results The mean shear modulus was 0.98 ± 0.32 kPa and 1.00 ± 0.33 kPa for the vastus medialis, 1.10 ± 0.46 kPa and 1.07 ± 0.43 kPa for the vastus lateralis, 0.91 ± 0.41 kPa and 0.93 ± 0.47 kPa for the adductor magnus, and 0.99 ± 0.37 kPa and 0.94 ± 0.32 kPa for the biceps femoris, with reader 1 and 2, respectively. No significant difference was observed in the shear modulus based on sex (p < 0.05). Aging consistently showed a statistically significant negative correlation (p < 0.05) with the shear modulus of the thigh muscles, except for the vastus medialis (p = 0.194 for reader 1 and p = 0.355 for reader 2). Conclusion MRE is a quantitative technique used to measure the elastic properties of individual muscles with excellent inter-observer agreement. Age was consistently significantly negatively correlated with the shear stiffness of muscles, except for the vastus medialis.

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings (대동맥판막치환술 후 발생한 판막하 판누스(Pannus): 시간에 따른 변화 및 심초음파 소견)

  • Mi Yeon Park;Hyun Jung Koo;Hojin Ha;Joon-Won Kang;Dong Hyun Yang
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1151-1163
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    • 2020
  • Purpose This study aimed to evaluate changes of subprosthetic pannus on cardiac CT and determine its relationship to echocardiographic findings in patients with mechanical aortic valve replacement (AVR). Materials and Methods Between April 2011 and November 2017, 17 AVR patients (56.8 ± 8.9 years, 12% male) who showed pannus formation on CT and had undergone both follow-up CT and echocardiography were included. The mean interval from AVR to the date of pannus detection was 10.5 ± 7.1 years. In the initial and follow-up CT and echocardiography, the pannus extent and echocardiographic parameters were compared using paired t-tests. The relationship between the opening angle of the prosthetic valve and the pannus extent was evaluated using Pearson correlation analysis. Results The pannus extent was significantly increased on CT (p < 0.05). The peak velocity (3.9 ± 0.8 m/s vs. 4.2 ± 0.8 m/s, p = 0.03) and mean pressure gradient (36.4 ± 15.5 mm Hg vs. 42.1 ± 15.8 mm Hg, p = 0.03) were significantly increased. The mean opening angles of the mechanical aortic leaflets were slightly decreased, but there was no statistical significance (73.1 ± 8.3° vs. 69.4 ± 12.1°, p = 0.12). The opening angle of the prosthetic leaflets was inversely correlated with the pannus extent (r = -0.57, p < 0.001). Conclusion The pannus extent increases over time, increasing transvalvular peak velocity and the pressure gradient. CT can be used to evaluate the pannus extent associated with hemodynamic changes that need to be managed by surgical intervention.

Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology (확산강조영상에서 미만성 대뇌 백질의 이상을 보이는 신생아 경련 환자에서 구조적 이상이나 대사와 관련된 원인이 없을 경우 임상적 소견과 영상 소견의 특징)

  • Maeran Kim;Jae-Yeon Hwang;Yeoun Joo Lee;Yong-Woo Kim;Shin Yun Byun;Yun-Jin Lee;Jeong A Yeom;Ung Bae Jeon;Ki Seok Choo;Kyung Jin Nam;Storm Nicholas Shaun Reid
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1412-1423
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    • 2020
  • Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

Changes in Fermentation Characteristics and Bacterial Communities of Whole Crop Rice Silage during Ensiling Period (저장기간에 따른 사료용 벼 사일리지의 발효특성 및 미생물상 변화)

  • Mirae Oh;Hyung Soo Park;Bo Ram Choi;Jae Hoon Woo;Seung Min Jeong;Ji Hye Kim;Bae Hun Lee
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.44 no.1
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    • pp.1-5
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    • 2024
  • Understanding changes in fermentation characteristics and microbial populations of forage silage during ensiling is of interest for improving the nutrient value of the feed for ruminants. This study was conducted to investigate the changes in fermentation characteristics and bacterial communities of whole crop rice (WCR) silage during the ensiling period. The chemical compositions, pH, organic acids and bacterial communities were evaluated at 0, 3, 6, and 12 months after ensiling. The bacterial communities were classified at both the genus and species levels. The dry matter content of WCR silage decreased with the length of storage (p<0.05), but there was no significant difference in crude protein and NDF contents. Following fermentation, the pH level of WCR silage was lower than the initial level. The lactic acid content remained at high levels for 3 to 6 months after ensiling, followed by a sharp decline at 12 months (p<0.05). Before fermentation, the WCR was dominated by Weissella (30.8%) and Pantoea (20.2%). Growth of Lactiplantibacillus plantarum (31.4%) was observed at 3 months after ensiling. At 6 months, there was a decrease in Lactiplantibacillus plantarum (10.2%) and an increase in Levilactobacillus brevis (12.8%), resulting in increased bacteria diversity until that period. The WCR silage was dominated by Lentilactobacillus buchneri (71.2%) and Lacticaseibacillus casei (27.0%) with a sharp reduction in diversity at 12 months. Overall, the WCR silage maintained satisfactory fermentation quality over a 12-month ensiling period. Furthermore, the fermentation characteristics of silage were found to be correlated to bacterial microbiome.