Non-suicidal self-injury (NSSI) and substance addiction have seen a significant rise among adolescents and young adults in re-cent years. This increase is closely linked to digitalization of the modern society, which has dramatically altered how young in-dividuals interact and communicate. Although the use of smartphones, social media, and online interactions has facilitated fast information exchange and increased connectivity, it has also contributed to heightened emotional distress, isolation, and a sense of inner emptiness. NSSI and addiction are seemingly distinct issues. However, they share underlying psychological mecha-nisms such as emotional dysregulation and the reliance on harmful behaviors to cope with psychological pain. These behaviors often serve as attempts to manage unprocessed negative emotions and unresolved inner conflicts. This paper explores NSSI and addiction from a psychoanalytic perspective, focusing on psychological complexities that drive these behaviors. It also exam-ines how the lack of real-object experiences in a digital environment can lead to inner voids that individuals attempt to fill through self-destructive behaviors. The importance of understanding these phenomena from a psychoanalytic standpoint is em-phasized. It provides deeper insight into underlying causes and guides therapeutic approaches. By acting as a developmental ob-ject, a therapist can help patients address unmet developmental needs, mitigate inner conflicts, and establish healthier selfboundaries. This approach is crucial for enabling effective intervention and fostering long-term emotional stability.

PURPOSE: This study aimed to develop and evaluate the lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. METHODS: Thirteen web-sites were searched for eligible clinical practice guidelines (CPGs) and eleven databases were searched to identify evidence to develop a lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment. RESULTS: Based on the inclusion and exclusion criteria, eight CPGs and ninety-six studies, two guidelines and eight studies were identified as evidence. The protocol development group consisted of ten experts who have at least five years' experience in the related area. A lower extremity lymphedema nursing practice protocol for patients following gynecologic cancer treatment was developed including forty-three recommendations in five domains. Significant differences were found in nurses' pre and post knowledge and confidence on lower extremity lymphedema prevention and management. CONCLUSION: Nurses and other professionals could utilize this evidence based lower extremity lymphedema nursing practice protocol and apply it to patients undergoing gynecologic cancer treatment.
Female ; Genital Neoplasms, Female ; Humans ; Lower Extremity* ; Lymphedema* ; Nursing Assessment ; Nursing*

Purpose: This study aimed to investigate the levels of compliance with safe handling of antineoplastic agents, time pressure, knowledge of safe handling of antineoplastic agents, and workplace safety climate, and to identify factors influencing compliance with the safe handling of antineoplastic agents among clinical nurses. Methods: For this cross-sectional study, anonymous written surveys were conducted on a convenience sample of 130 clinical nurses at a university-affiliated hospital between July 10 and 20, 2020. Data were analyzed through descriptive statistics, t-tests, analyses of variance, Pearson’s correlation, and hierarchical multiple regression analysis using SPSS. Results: The average level of compliance with safe handling of antineoplastic agents was 120.81 out of 175. The significant correlates for compliance with safe handling of antineoplastic agents were clinical experience, knowledge of safe handling of antineoplastic agents, and workplace safety climate. These accounted for 38% of the total variance in compliance with the safe handling of antineoplastic agents. Conclusion The findings suggest that to increase compliance with safe handling of antineoplastic agents, workplace safety climate and knowledge of safe handling of antineoplastic agents should be improved. The development and application of an effective training program on the safe handling of antineoplastic agents would lead to improvements in this area.

Purpose: This study aimed to investigate the levels of compliance with safe handling of antineoplastic agents, time pressure, knowledge of safe handling of antineoplastic agents, and workplace safety climate, and to identify factors influencing compliance with the safe handling of antineoplastic agents among clinical nurses. Methods: For this cross-sectional study, anonymous written surveys were conducted on a convenience sample of 130 clinical nurses at a university-affiliated hospital between July 10 and 20, 2020. Data were analyzed through descriptive statistics, t-tests, analyses of variance, Pearson’s correlation, and hierarchical multiple regression analysis using SPSS. Results: The average level of compliance with safe handling of antineoplastic agents was 120.81 out of 175. The significant correlates for compliance with safe handling of antineoplastic agents were clinical experience, knowledge of safe handling of antineoplastic agents, and workplace safety climate. These accounted for 38% of the total variance in compliance with the safe handling of antineoplastic agents. Conclusion The findings suggest that to increase compliance with safe handling of antineoplastic agents, workplace safety climate and knowledge of safe handling of antineoplastic agents should be improved. The development and application of an effective training program on the safe handling of antineoplastic agents would lead to improvements in this area.

No abstract available.
Graft vs Host Disease* ; Liver Transplantation*

No abstract available.
Aged* ; Arm* ; Histiocytoma, Malignant Fibrous ; Humans

OBJECTIVES: The effect of chronic exposure to low levels of n-hexane on peripheral nervous system and the relationship between duration of employment and impairment of peripheral nervous system was studied. METHODS: In 21 workers at two shoe - maker factories and 21 unexposed controls, measurement of exposure of solvents, symptom Questionnaire, physical examination and electrophysiological study were conducted. RESULTS: Mean ages of study subjects in the exposed and the unexposed were 39.9 and 40.1 years old. Mean durations of employment were 15.1 and 10.0 years, respectively. Mean concentraions of urinary 2,5-HD were 2.23 mg/kg creatinine, 0.23 mg/kg creatinine, respectively. Mean concentration of solvents in air were 21.1 ppm of n-hexane, 72.2 rpm of toluene and 0.5 ppm of MEK. There were no differences in the prevalence of subjective symptoms and abnormal neurological signs between the exposed and the unexposed. But vibration extinction time(VAT) of the exposed(8.8 second) was shorter than that of the unexposed(11.9 second)(p < 0.05). Mean values of electrophysiological studies(EPS) of the two groups were within normal limit. However, mean conduction velocity of median motor nerve and median F wave(MMNCV and MFCV), mean amplitude of median sensory action potential(MSAP) were decreased in the exposed(p < 0.05). Moreover, the rate of abnormal finding more than one in sensory nerves wart increased in the exposed than those in the unexposed(p,0.05). Correlation coefficients between duration of employment and mean conduction velocity of median sensory nerve (MSNCV) and between duration of employment and MFCV were -0.57 -0.43, respectively(p < 0.05). CONCLUSIONS: These results showed that chronic (mean 15 years) low level(mean 23 ppm) exposure to n-hexane cause subclinical impairment of peripheral nervous system. These results also suggest that the longer duration of employment, the shorter values of EPB and VAT.
Creatinine ; Employment ; Peripheral Nervous System* ; Physical Examination ; Prevalence ; Questionnaires ; Shoes ; Solvents ; Toluene ; Vibration ; Warts

Hiccups may be considered a form of myoclonus of diaphragm. Valproic acid has been considered the drug of choice in treatment of intractable hiccups; however, its various adverse events limit its use in the clinical basis, especially in elderly or complicated patients. Levetiracetam was known as a safe antiepileptic drug. However, the anti-hiccup property of the levetiracetam has been rarely reported. We report a 69-year old male patient who developed sudden persistent hiccups and was successfully treated with levetiracetam. Levetiracetam should be considered as alternative treatment option in selected patients with intractable hiccups.
Aged ; Diaphragm ; Hiccup ; Humans ; Male ; Myoclonus ; Piracetam ; Valproic Acid

Background: Korea is one of the countries with the highest rate of suicide, while suicidality is known to be closely related to mental illnesses. The study aimed to evaluate the suicide rates in psychiatric patients, to compare it to that of the general population, and to investigate the differences among psychiatric diagnoses and comorbidities. Methods: Medical records and mortality statistics of psychiatric patients at Seoul National University Hospital from 2003 to 2017 were reviewed. The standardized mortality ratio (SMR) for suicide was calculated to compare the psychiatric patients with the general population. The diagnosis-specific standardized mortality rate and hazard ratio (HR) were adjusted by age, sex, and psychiatric comorbidity (i.e., personality disorder and/or pain disorder). Results: A total of 40,692 survivors or non-suicidal deaths and 597 suicidal death were included. The suicide rate among psychiatric patients was 5.13-fold higher than that of the general population. Psychotic disorder had the highest SMR (13.03; 95% confidence interval [CI], 11.23–15.03), followed by bipolar disorder (10.26; 95% CI, 7.97–13.00) and substancerelated disorder (6.78; 95% CI, 4.14–10.47). In survival analysis, psychotic disorder had the highest HR (4.16; 95% CI, 2.86–6.05), which was further increased with younger age, male sex, and comorbidity of personality disorder. Conclusion All psychiatric patients are at a higher risk of suicide compared to the general population, and the risk is highest for those diagnosed with psychotic disorder.