Griseofulvin(GF) has become the drug of choice as an antifungal agent for patients who suffer from many kinds of fungal infection. In order to clarify hepatic injury by griseofulvin(GF) overload and the effect of UDCA on GF-induced hepatic injury, the authors carried out biochemical, histologic, and ultrastructural studies of liver following treatment with griseofulvin and ursodeoxycholic acid(UDCA) in mice. Urine porphobilinogen excretion in the group treated with GF alone was significantly increased and reached the highest level in the 4th week and declined thereafter. Biochemical studies of the liver function showed no remarkable changes of serum bilirubin levels throughout the experimental period in all groups, except for SGPT and alkaline phosphatase activities which were significantly elevated and reached the highest level in the second week. Then they slightly decreased in GF treated groups(GF alone and GF plus UDCA) in comparison with the control group. Pathologic findings in the group treated with GF alone include focal liver cell necrosis(esp, zone 3), Mallory bodies in hepatocytes(esp, zone 1), Kupffer cell activation, and brown protoporphyrin pigments in the hepatocytes, bile canaliculi and interlobular bile ducts with a marked inflammatory cell infiltration in the portal tracts. Under the polarizing light microscope, bile ductular and canalicular thrombi showed a "Maltese cross" birefringence in mice treated with GF alone. There is no definite finding of fatty change in hepatocyte. Under the microscope, the liver appeared normal with an intact lobular architecture in the GF plus UDCA treated group. Electron microscopically, GF-induced changes include swelling of mitochondria, globular protoporphyrin crystals in the hepatocyte cytoplasm, markedly dilated bile cannaliculi and bile ducts and the formation of a Mallory hyaline bodies in the hepatocytes. There were no noticeable structural changes in the GF plus UDCA-treated group. Therefore the results suggest that GF causes hepatic injury, namely porphyria and cholestasis, and the treatment of UDCA may have cytoprotective and choleretic effects on GF-induced hepatic injuries.
This phenomenological study was done to identify clinical nurses' experiences of safety management with older patients. Methods: Data were analyzed using Colaizzi's phenomenological six step method. Data collected from July 27 to December 1, 2017, were from face-to-face in-depth interviews with seven nurses who had worked at one general hospital for more than five years. Data collection was done until data saturation was reached. Results: This study results were comprised of four categories and nine clusters of themes. The four categories were: "Increasing burden in the management of older patients", "Unsettling feelings of fear and guilt from unexpected safety accidents", "Shift to active coping", and "Expectations regarding improvement of safety management for older patients" Conclusion: The results of this study show that for clinical nurses to provide safety management for older patients, it is necessary to have a sufficient number of nursing staff, to understand the unique characteristics of elders, and to establish facilities that older patients can use safely and conveniently. In addition, this study is significant for the nursing community as it provides an improved understanding of safety management for older patients from the nurses' point of view and thereby, suggests that there is a need for education and improvement in the work capability to provide care to elders. Furthermore, the study results are also politically significant as evidence to establish standards for expanding the number of nursing staff and safety management infrastructure.
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This study aimed to understand the experiences of married North Korean women's child-rearing, working lives, and their home and work environment in depth. Methods: This study adopted van Manen's hermeneutic phenomenological method to qualitatively analyze data. The participants were 8 married North Korean women defectors. Data were collected through in-depth interviews and observations from July 4 to August 20, 2018. Results: Nine essential themes emerged: more personal challenges after overcoming a life-threatening crisis; hopes of firmly settling in this land; the wound from the north, which chased them here; a body that becomes stronger through hardship; being stuck in a past full of anxiety and pain; the present is full of hope; hope for the future; sense of alienation from coworkers that cannot be overcome; and sense of power to endure an exhausting work life. Conclusion: This study provided a broader understanding of the life and experiences of married women from North Korea. It highlights the need for nurses to recognize their importance in nursing care. The study also suggests that academic and practical approaches for nursing, and basic data for a nursing intervention for married women from North Korea be provided. The study findings can be used as a basis for preparing a national policy that will help North Korean defectors to find employment and gain stability.
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