South Korea's health care non-governmental organizations (NGOs) have played a crucial role in South-North relations, for a formal intergovernmental relationship is difficult to establish and also easily breaks down. Humanitarian assistance by NGOs in the health care sector is an area that receives wide support from South Korean society for its urgency and for its appeal to humanity. This humanitarian assistance started in the late 1990's and continued to grow until the late 2000's. This assistance continued throughout the tension between the two administrations that resulted in a radical decrease in overall assistance from South Korea to North Korea. However, concerns remain about the transparency and efficiency of NGO activities. In this article, the NGOs and their major activities are delineated, and South Korean legislation is examined. A current act, the Law on the Development of South and North Korean Relations serves as a basis for governmental regulation and support of NGO's. Humanitarian assistance in the healthcare area is directly related to the health of the North Korean people, and it should not be influenced by political changes. Long-term planning and close discussions between NGOs, their North Korean counterparts, and the South Korean government are needed. NGOs need to overcome their shortcomings such as a lack of expertise and shortage of financial support. For this, NGOs must improve their administration transparency and professionalism.
Delivery of Health Care ; Democratic People's Republic of Korea ; Financial Support ; Health Care Sector ; Humans ; Jurisprudence ; Republic of Korea

PURPOSE: This study aimed to examine the factors related to the bone mineral density (BMD) in male and female adults aged 50 years or older. The factors included were socio-demographics, body mass index (BMI), blood pressure, blood lipids, and health habits. METHODS: As a secondary data analysis, this study used raw data from the 5th Korean National Health and Nutrition Examination Survey, and selected 2,295 adults aged over 50 years who participated in the survey and had BMD values. The T-score of the femoral neck was evaluated for BMD. Data were analyzed using descriptive statistics, ANOVA and multiple regression. RESULTS: The factors influencing the BMD in men were age (β=−.029, p<.001), BMI (β=.100, p<.001), triglyceride (β=−.001, p=.001), and calcium (β=.001, p=.003), and the suggested regression equation explained 25.6% of the variance in BMD (F=16.32, p<.001). The factors related to BMD in women were age (β=−.060, p<.001), BMI (β=.091, p<.001), total cholesterol (β=−.002, p=.028), HDL cholesterol (β=.009, p=.001), and calcium (β=.001, p=.004), and the suggested regression equation explained 47.0% of the variance in BMD (F=61.72, p<.001). CONCLUSION: Based on the findings of this study, the modifiable factors, such as BMI, blood cholesterol, and calcium, should be targeted to improve the BMD in both men and women.
Adult* ; Blood Pressure ; Body Mass Index ; Bone Density ; Calcium ; Cholesterol ; Cholesterol, HDL ; Female ; Femur Neck ; Humans ; Male ; Miners* ; Nutrition Surveys* ; Osteoporosis ; Sex Characteristics ; Statistics as Topic ; Triglycerides

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE).RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.CONCLUSION: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.
Dyspnea ; Exercise ; Humans ; Intention ; Lung Neoplasms ; Lung ; Motor Activity ; Non-Randomized Controlled Trials as Topic ; Nursing ; Patient Education as Topic ; Quality of Life ; Self Efficacy ; Walking

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE). RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. CONCLUSION The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

OBJECTIVES: The association between smoking and obesity is a significant public health concern. Both are preventable risk factors of cardiovascular disease and a range of other conditions. However, despite numerous previous studies, no consensus has emerged regarding the effect of smoking on obesity. We therefore carried out a novel study evaluating the relationship between smoking and obesity. METHODS: A total of 5,254 subjects aged 19 years or older drawn from the 2010-2013 Korea National Health and Nutrition Examination Survey were included in this cross-sectional study. Smoking was examined both in terms of smoking status and the quantity of cigarettes smoked by current smokers. Multiple logistic regression analysis was used to assess the association between smoking and obesity. Overall obesity was defined as a body mass index (BMI) ≥25 kg/m2, and central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. We adjusted for the possible confounding effects of age, sex, physical activity, alcohol consumption, and the presence of hypertension or diabetes. RESULTS: A statistically significant difference in central obesity according to smoking status was identified. Current smokers were more likely to be centrally obese than never-smokers (adjusted odds ratio,1.30; 95% confidence interval, 1.02 to 1.67). However, no significant association was found between smoking and obesity defined by BMI. Moreover, among current smokers, no statistically significant association was found between the daily amount of smoking and obesity or central obesity. CONCLUSIONS: Smoking was positively associated with central obesity. Current smokers should be acquainted that they may be more prone to central obesity.
Alcohol Drinking ; Body Mass Index ; Cardiovascular Diseases ; Consensus ; Cross-Sectional Studies* ; Female ; Humans ; Hypertension ; Korea* ; Logistic Models ; Male ; Motor Activity ; Nutrition Surveys* ; Obesity* ; Obesity, Abdominal* ; Public Health ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products ; Waist Circumference

Objectives: This study aimed to describe the characteristics and risk factors for severe disease in pregnant women infected with coronavirus disease 2019 (COVID-19) from the early days of the COVID-19 epidemic in Korea to the predominant period of the Delta variant. Methods: A retrospective cohort study was conducted among pregnant women diagnosed with COVID-19 between February 2020 and December 2021. Logistic regression analysis was performed to compare severe and mild cases after adjusting for pregnant women’s age, nationality, infection route, outbreak area, infection period, symptoms, underlying disease, smoking status, trimester, and COVID-19 vaccination status. Results: In total, 2,233 pregnant women were diagnosed with COVID-19 by December 2021. Among these, 96.7% had mild symptoms, 3.3% had severe symptoms, and 0.04% died. The risk factors for severe disease in pregnant women with confirmed COVID-19 were being in the age group of 35 to 45 years, having hyperlipidemia, being in the second or third trimester of pregnancy at the time of COVID-19 diagnosis, being infected during the Delta-predominant period, and having a fever (≥38 °C) at diagnosis. Furthermore, 47.1% of patients in the mild group and 84.9% of patients in the severe group had 3 or more risk factors. Conclusion Pregnant women with COVID-19 mainly experienced mild symptoms, but those with risk factors were at a higher risk of developing severe symptoms. Therefore, treatment and follow-up management should be thoroughly implemented.

A 68-year-old woman was admitted to our hospital with obstructive jaundice. Abdominal CT scan demonstrated a mass at the head of the pancreas. The patient was diagnosed as having obstructive jaundice caused by pancreatic cancer. We tried to relieve the bile duct obstruction by ERCP (endoscopic retrograde cholangiopancreatography). After several cannulation attempts, we thought that we had achieved deep cannulation of the bile duct and tried to place a biliary plastic stent. During ERCP, however, we noticed massive air in the portal venous system, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography revealed air in the portal venous system. Fortunately, there were no subsequent complications. The air in the portal vein had disappeared, ascertained by CT scan taken 5 days later. The patient underwent surgical resection for pancreatic cancer. Isolated portal vein cannulation per se does not usually result in mortality or serious morbidity.
Aged ; Bile Ducts ; Catheterization* ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholestasis ; Female ; Head ; Humans ; Jaundice, Obstructive ; Mortality ; Pancreas ; Pancreatic Neoplasms ; Plastics ; Portal Vein* ; Stents ; Tomography, X-Ray Computed

Orthostatic hypotension (OH) is defined by a 20-mm Hg difference of systolic blood pressure (dtSBP) and/or a 10-mm Hg difference of diastolic blood pressure (dtDBP) between supine and standing, and OH is associated with a failure of the cardiovascular reflex to maintain blood pressure on standing from a supine position. To understand the underlying genetic factors for OH traits (OH, dtSBP, and dtDBP), genome-wide association studies (GWASs) using 333,651 single nucleotide polymorphisms (SNPs) were conducted separately for two population-based cohorts, Ansung (n = 3,173) and Ansan (n = 3,255). We identified 8 SNPs (5 SNPs for dtSBP and 3 SNPs for dtDBP) that were repeatedly associated in both the Ansung and Ansan cohorts and had p-values of <1 x 10(-5) in the meta-analysis. Unfortunately, the SNPs of the OH case control GWAS did not pass our p-value criteria. Four of 8 SNPs were located in the intergenic region of chromosome 2, and the nearest gene (CTNNA2) was located at 1 Mb of distance. CTNNA2 is a linker between cadherin adhesion receptors and the actin cytoskeleton and is essential for stabilizing dendritic spines in rodent hippocampal neurons. Although there is no report about the function in blood pressure regulation, hippocampal neurons interact primarily with the autonomic nervous system and might be related to OH. The remaining SNPs, rs7098785 of dtSBP trait and rs6892553, rs16887217, and rs4959677 of dtDBP trait were located in the PIK3AP1 intron, ACTBL2-3' flanking, STAR intron, and intergenic region, respectively, but there was no clear functional link to blood pressure regulation.
Actin Cytoskeleton ; Autonomic Nervous System ; Blood Pressure ; Case-Control Studies ; Chromosomes, Human, Pair 2 ; Cohort Studies ; Dendritic Spines ; DNA, Intergenic ; Genome-Wide Association Study ; Hypotension, Orthostatic ; Introns ; Neurons ; Polymorphism, Single Nucleotide ; Reflex ; Rodentia ; Supine Position

PURPOSE: The purpose of this study was to demonstrate the prognostic significance of changes in body composition in patients with newly diagnosed hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Patients (n=178) newly diagnosed with HCC participated in the study between 2007 and 2012. Areas of skeletal muscle and abdominal fat were directly measured using a three-dimensional workstation. Cox proportional-hazards modes were used to estimate the effect of baseline variables on overall survival. The inverse probability of treatmentweighting (IPTW) method was used to minimize confounding bias. RESULTS: Cutoff values for sarcopenia, obtained from receiver-operating characteristic curves, were defined as skeletal muscle index at the third lumbar vertebra of ≤ 45.8 cm/m2 for males and ≤ 43.0 cm/m2 for females. Sarcopenia patients were older, more likely to be female, and had lower body mass index. Univariable analysis showed that the presence of sarcopenia and visceral to subcutaneous fat area ratio (VSR) were significantly associatedwith prognosis. The multivariable analyses revealed that VSR was predictive of overall survival. However, in the multivariable Cox model adjusted by IPTW, sarcopenia, not VSR, were associated with overall survival. CONCLUSION: The presence of sarcopenia at HCC diagnosis is independently associated with survival.
Abdominal Fat ; Bias (Epidemiology) ; Body Composition ; Body Mass Index ; Carcinoma, Hepatocellular* ; Diagnosis ; Female ; Humans ; Intra-Abdominal Fat ; Liver* ; Male ; Methods ; Muscle, Skeletal ; Prognosis* ; Sarcopenia* ; Spine ; Subcutaneous Fat

Objectives: On November 5, 2021, Pfizer Inc. announced Paxlovid (nirmatrelvir+ritonavir) as a treatment method that could reduce the risk of hospitalization or death for patients with confirmed coronavirus disease 2019 (COVID-19). Methods: From February 6, 2022 to April 2, 2022, the incidence of COVID-19 and the effects of treatment with Paxlovid were analyzed in 2,241 patients and workers at 5 long-term care facilities during the outbreak of the Omicron variant of severe acute respiratory syndrome coronavirus 2 in South Korea. Results: The rate of severe illness or death in the group given Paxlovid was 51% lower than that of the non-Paxlovid group (adjusted risk ratio [aRR], 0.49; 95% confidence interval [CI], 0.24−0.98). Compared to unvaccinated patients, patients who had completed 3 doses of the vaccine had a 71% reduced rate of severe illness or death (aRR, 0.29; 95% CI, 0.13−0.64) and a 65% reduced death rate (aRR, 0.35; 95% CI, 0.15−0.79). Conclusion Patients given Paxlovid showed a lower rate of severe illness or death and a lower fatality rate than those who did not receive Paxlovid. Patients who received 3 doses of the vaccine had a lower rate of severe illness or death and a lower fatality rate than the unvaccinated group.