Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternalewborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

Sphingosine-1-phosphate (S1P), a bioactive sphingolipid metabolite, has various functions to affect many signalling pathways leading to cellular proliferation and differentiation and to regulate of cell migration, invasion, and angiogenesis. However, there are little reports about the relation between trophoblast stem cells and S1P. Thus, the physiologic effects of S1P on trophoblast stem (TS) cells were investigated in this study. S1P was involved in early stage development of trophoblast via upregulation of Eomesodermine mRNA expression and suppressed differentiation of TS cells through activation of extracellular-signal regulated kinase (ERK) activation. Other actions of S1P were the activation of p38 and the induction of Dlx-3 mRNA expression for angiogenesis in TS cells. Interestingly, TS cells cultured with S1P for 4 days in thrombin-fibrinogen gel culture system, specific culture system for endothelial cells, showed good healthy appearance, but TS cells cultured without S1P got severe damages. Taken together, we suggest that S1P has very important roles on placenta such as development of early stage trophoblast, suppression of differentiation, and angiogenesis on placenta.
Cell Movement ; Cell Proliferation ; Endothelial Cells ; Phosphotransferases ; Placenta ; Placentation* ; RNA, Messenger ; Stem Cells ; Trophoblasts ; Up-Regulation

Preeclampsia and fetal growth restriction are conditions associated with placental hypoperfusion and villous hypoxia. The villous response to this environment includes elevated apoptosis. Recently, trophoblast stem (TS) cells had been successfully derived. FGF-4 locates in the inner cell mass (ICM) of blastocyst and TS cells have fibroblast growth factor receptor-2 (FGFR-2). To identify whether FGF-4 protects hypoxia-induced apoptosis in TS cells, this study was carried out. TS cells were cultured up to 48 h in standard (PO2 = 20%) or hypoxic (PO2 = 3%) conditions. TS cells were very vulnerable against exposure to hypoxia for 48 h but embryonic stem (ES) cells were very resistant to hypoxiamediated apoptosis. Death of TS cells bears the typical hallmarks of apoptosis as determined by DNA laddering. FGF- 4 and epidermal growth factor (EGF) protected the hypoxia-mediated cell death of trophoblast but granulocyte-macrophage colony stimulating factor (GMSF) and transforming growth factor-beta (TGF-beta) did not protect. In conclusion, we speculate that the effects of FGF-4 on apoptosis in trophoblasts may play an important role in protecting the placenta from hypoxic injury in pregnancy related with placental hypoperfusion.
Anoxia ; Apoptosis* ; Blastocyst ; Cell Death ; Colony-Stimulating Factors ; DNA ; Epidermal Growth Factor ; Fetal Development ; Fibroblast Growth Factors ; Placenta ; Pre-Eclampsia ; Pregnancy ; Stem Cells* ; Trophoblasts*

This study used survey data to identify the use of salimeters and the prevalence of sodium reduction education in the Gyeonggi region. A survey with 211 dietitians working in school foodservice (106 in elementary schools, 69 in middle schools, and 36 in high schools) was conducted from August 6 to August 17, 2012. The data were analyzed using the SPSS program. Though 86.6% of school kitchens had salimeters, the rate for checking the sodium content of soup or stew was just 62.7% and the rate for checking the sodium content of kimchi and solid food was very low. Since salimeters are mostly used to measure sodium in liquid foods, it is urgent to provide an education and manual on using salimeters and to promote salimetry for kimchi and side dishes. It is also important to provide students with nutritional information by clearly posting the sodium content of food on menus and compelling students to notice them. Sodium reduction education for cooks was conducted in the 70.3% of the kitchens; however, the dietitians perceived that the cooks did not understand the importance of the education. Also, sodium reduction education for students was mostly provided through indirect methods, rather than face-to-face education, resulting in poor educational data (only 36.4% comprehending). By providing detailed guidelines for sodium reduction and labelling accurate content of sodium of the menus, we will be able to enforce practices for sodium reduction in school lunches.
Humans ; Lunch ; Prevalence ; Sodium

PURPOSE: We reviewed our data compiled prospectively for evaluation of post-operative complications and recurrence of laparoscopic inguinal hernia repair. METHODS: Among the 1000 patients (age, > or =20 years old) who were undergone laparoscopic inguinal hernia surgery from January 2007 to July 2011, the age, sex, location, hernia type, operation time, postoperative morbidity, and conversion of 992 patients were analyzed. RESULTS: Among 992 patients, 919 (92.6%) were male and the mean age was 54.2 years (range, 20~90). Operation times (m inutes) for unilateral and bilateral hernia were 40.0 and 53.4, respectively. Mean operation time (minutes) showed a decrease over time, as that for the first half of all cases was 43.5 and that for the second half was 39.7 (p<0.001). Seven cases of conversion (post-radical prostatectomy hernia=7) were recorded to TAPP (n=3) or IPOM (n=4) from TEP. Eleven cases of postoperative catheterization (1.1%), five cases of port site seroma (0.5%), one case of mesh removal due to infection, 24 cases of seroma/hematoma (2.4%), 26 cases of neuralgia (2.6%), and four cases of bleeding with a drop in hemoglobin of more than 3 mg% (0.4%) were also recorded. There were three cases of recurrence (0.35%) at the median follow-up of 46 months (range, 20 to 70 months). CONCLUSION: Laparoscopic inguinal hernia repair can be performed safely, with low rates of complication and recurrence. This technique achieves good results combined with the benefits of minimally invasive surgery. We should be cautious in order to avoid postoperative bleeding, especially in cases of TEP.
Amidines ; Catheterization ; Catheters ; Follow-Up Studies ; Hemoglobins ; Hemorrhage ; Hernia ; Hernia, Inguinal ; Humans ; Male ; Neuralgia ; Prospective Studies ; Prostatectomy ; Pyrazines ; Recurrence ; Seroma

PURPOSE: This study describes our preliminary experience of a single incisional laparoscopic totally extraperitoneal approach (TEP) for inguinal hernia repair, compared to conventional TEP. METHODS: From August 2012 to February 2014, 46 patients underwent inguinal hernia repair using a laparoscopic totally extraperitoneal approach by a single surgeon at Hansol Hospital, Seoul, Korea. Three patients were excluded due to a recurrent inguinal hernia; thus, 43 patients were enrolled in two groups, the single incisional TEP (STEP) group (n=23) and the conventional TEP (CTEP) group (n=20). The mean follow-up period was 15 months. RESULTS: No differences in patient demographics (age, sex, hernia site and type, and body mass index) were detected between the two groups. The operation time in the STEP group was significantly longer than that in the CTEP group (69.7+/-28.5 vs. 51.0+/-16.4 min, p=0.017). No differences in postoperative complications were detected, including chronic pain, voiding difficulties, or the occurrence of a wound seroma (STEP, n=3 vs. CTEP, n=2). Pain scores (STEP, 1.4+/-0.7 vs. CTEP 1.4+/-0.8) and hospital stay duration (STEP, 1.0+/-0.2 vs. CTEP, 1.2+/-0.5 days) also did not differ between the groups. No patient in the STEP group required an additional port. CONCLUSION: Single incisional TEP was technically feasible, although it required a longer operation time. STEP appeared to have better cosmetic results compared with those of CTEP.
Chronic Pain ; Demography ; Follow-Up Studies ; Hernia ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Korea ; Laparoscopy ; Length of Stay ; Postoperative Complications ; Seoul ; Seroma ; Wounds and Injuries

Background: Osteoporosis is a disease that affects the quality of life and imposes a high socioeconomic burden. Studies have reported that statins, a HMG CoA reductase inhibitor, have a positive or negative effect on osteoporosis. The purpose of this study was to analyze the correlation between statins and osteoporosis risk. Methods: We used the total patient sample data of the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the prevalence of osteoporosis in adult patients of Korea who were diagnosed with dyslipidemia and were prescribed statins at the same time. The odds ratio (OR) according to the intensity and type of statin was used to confirming the prevalence. Results: Among the 1,138,899 patients included in the study, 143,895 patients used statins and 27,524 patients (19.13%) were diagnosed with osteoporosis in the statin group. The OR value of statin group was 0.96 (95% CI 0.94-0.98), confirming that the prevalence of osteoporosis decreased, and a significant decrease was seen in all statin intensity. Some of the moderate-intensity statins rather increased the prevalence of osteoporosis, but atorvastatin and rosuvastatin obtained positive results at both medium- and high-intensity doses, and lovastatin, a low-intensity statin, showed the greatest reduction in the prevalence of osteoporosis. Conclusion We found that the prevalence of osteoporosis was reduced in the statin group, and there was a constant correlation regardless of gender or age. However, a large, prospective, double-blind and randomized study is needed for a long period of time to demonstrate the effectiveness of statins.

Purpose: : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods: : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results: : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

PURPOSE: Diallyl disulfide (DADS) is a major organosulfur compound derived from garlic. It has been reported that DADS is able to inhibit the proliferation of several tumor cells. In this study, the effect of DADS was investigated in terms of the proliferation of AGS, gastric adenocarcinoma cell line at various concentrations. METHODS: The viability of cultured cells was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay. To detect the induction of apoptosis, Annexin V-FITC/propodium iodide (PI) staining assay was performed. Analysis of reactive oxygen species (ROS) and the distribution of cells in the cell cycle were measured by a flow cytometer. And using the Western blot analysis, the change of Fas, caspase-3, Bax, Bcl-2 activity was measured. RESULTS: The percentage of live AGS cells was decreased to 23% of that in the control group after 400 microM DADS treatment for 48 hours. The Annexin V positive/PI negative (apoptosis portion) area increased from low concentration of DADS to high concentration. When comparing among the DADS treatment groups, the amount of ROS production increased in a dose dependent manner. The percentage of sub-diploid DNA content increased from 8.71% at 50 microM to 25.74% at 400 microM DADS treatment group. The expressions of Fas, caspase-3, Bax were increased and that of Bcl-2 was decreased in a dose dependent manner. CONCLUSION: DADS decreases the viability of AGS cell lines and induces apoptosis in a dose-dependent manner. But the relationship of the anti-proliferative effect of DADS and related molecular changes were not clearly proportional to the concentration of DADS.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Adenocarcinoma ; Allyl Compounds ; Annexin A5 ; Apoptosis ; Blotting, Western ; Caspase 3 ; Cell Cycle ; Cell Line ; Cells, Cultured ; Disulfides ; DNA ; Garlic ; Reactive Oxygen Species ; Stomach Neoplasms