[Clinical nurses' experiences of workplace verbal violence: a phenomenological study]. / 병원 내 ì–¸ì–´í­ë ¥ì— ë ¸ì¶œëœ 임상 간호사의 경험: í˜„ìƒí•™ì  연구.

Purpose: This study aimed to describe clinical nurses' lived experiences of workplace verbal violence through qualitative research using descriptive phenomenology. Methods: Six female Korean nurses who had less than 5 years of clinical experience and had experienced verbal violence in the workplace within the past year participated in the study. Data were collected through one-on-one in-depth interviews with the participants and analyzed using Colaizzi's phenomenological method. Results: A total of 27 codes, eight themes, and four theme clusters were derived from the participants' statements. The four theme clusters of the clinical nurses' experiences of verbal violence in the workplace were as follows: "tip of the iceberg," "beyond me and my control," "fear and resignation," and "personal burden." The participants recognized that nurses experienced verbal violence daily, and that the causes of and responses to verbal violence were determined by external situational factors rather than nurses' individual problems. This suggests that nurses felt that they had no choice but to personally cope with verbal violence and bear the consequences due to systematic indifference and silence about verbal violence experienced by clinical nurses. Conclusion: The findings show that verbal violence was pervasive and unmerited, yet often endured at the cost of a personal burden to nurses. A clear definition of verbal violence and education for employees are needed, and a reporting system should be established to report all forms of violence regardless of the severity of the incident.

[How Should We Approach Nurse Suicide in Korea: With the Aspect of Prevention-Intervention-Postvention Management].

Recently, nurse suicide has emerged as one of the major issues. We tried to review the status of nurse suicide and its management in Korea through inspecting related web sites, news articles, and research. However, there were no sufficient reports or statistics along with the research throughout the country. Moreover, there were no organized nurse suicide management systems or programs including suicide prevention, suicide intervention, suicide postvention management. In other countries, there were various trials and successful experiences about nurse suicide programs, and those have been managed in organized and integrated ways. It gave us a lot of implications. To effectively prevent and manage the nurse suicide in Korea, nursing workforce, nursing managers, and nursing researchers should be concerned about nurse suicide. Furthermore, discussions and the research must be made actively. Based on such efforts, appropriate programs, organized manage systems, and policies must be devised at institution and national level.

Negative pressure wound therapy of chronically infected wounds using 1% acetic Acid irrigation.

BACKGROUND: Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. METHODS: Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. RESULTS: Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). CONCLUSIONS: By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.

Microsurgical training with fresh chicken legs.

PURPOSE: With the increasing use of microsurgical techniques in clinical work, regular laboratory training in these techniques has become essential. Several specialized materials have been used for this purpose. We investigated whether effective training could be provided with greater convenience and less expense using fresh chicken thighs. Also, we present the histologic characteristics of chicken femoral neurovascular structures. METHODS: The femoral neurovascular bundles of fresh chicken thighs were dissected. Microanastomosis of vessels and nerves were performed with the aid of a microscope. Tissue from the midthigh of 8 chickens was examined histologically. RESULTS: It was found to reduce the time taken to perform anastomoses using the chicken thigh model with statistically significance. The mean diameters (± standard deviations) of the arteries, veins, and nerves were 2.04 ± 0.17 mm, 1.45 ± 0.06 mm, and 1.24 ± 0.08 mm, respectively. The observed tunica adventitia to media ratio was 1:1 and multiple nerve fascicles were wrapped in a single epineurium. Microsurgery training with this material provides several advantages: ready availability, minimal expense, no scheduling or location limitations, neurorrhaphy training, no need for special facilities for animal care or anesthesia, and no need for the trimming of adventitia. CONCLUSION: The femoral neurovascular bundles of chicken are an appropriate and effective model for teaching and practicing microsurgery.

Multiple large cysts arising from nevus comedonicus.

Nevus comedonicus is a type of hamartoma that arises from a developmental anomaly of the mesodermal part of the pilosebaceous gland. In most cases of nevus comedonicus, an acne-like skin condition develops. Repeated inflammation can cause a morphological change to the cyst, papule, to abscess. We experienced a case of congenital nevus comedonicus, which led to the formation of large multiple cysts. A 50-year-old man was referred with a 12.5×10 cm lobulated mass on the posterior neck and upper back. The patient had a widespread presence of nevus comedonicus in the region ranging from the right superior chest to the posterior neck. The patient had a 30-year history of six prior excisions. A magnetic resonance imaging review led to a diagnosis of nevus comedonicus. Surgical treatment consisted of excision of the mass and wide excision for the patch type of nevus comedonicus around the neck. On histopathology, multiple masses were diagnosed as typical cysts containing keratinized tissue. The diffuse comedone lesions were diagnosed as nevus comedonicus. This case shows that large, multiple cysts can occur as a long-term complication of nevus comedonicus, and also highlights the importance of radical resection to prevent its further invagination.