The Korean government’s strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

PURPOSE: The aim of this research was to identify the relationships between occupational stress, ethical dilemma, burnout and turnover intention and the factors influencing turnover intention in hospital nurses. METHODS: The participants, 215 nurses, were recruited from two university hospitals located in two provinces of Korea. Data were collected through self-report questionnaires. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression with SPSS/WIN 22.0. RESULTS: Participants' scores for occupational stress, ethical dilemma, burnout and turnover intention were 3.96±0.45, 2.60±0.39, 3.71±0.70, and 3.50±0.90 respectively. The results show that the higher the score for occupational stress, ethical dilemma, and burnout the higher the score for turnover intention. The most important factor influencing turnover intention was burnout (β=.42, p < .001), followed by position (β=.21, p=.001), educational level (β=.21, p=.007), ethical dilemma (β=.13, p=.020) in that order. These factors explained 43.5% of total variance in turnover intention (F=19.34, p < .001). CONCLUSION: Changes in hospital structural management systems and support strategies should be developed and operated, taking into account burnout, ethical dilemma, and personal characteristics of clinical nurses in order to reduce turnover.
Ethics ; Hospitals, University ; Humans ; Intention ; Korea ; Personnel Turnover

BACKGROUND/AIMS: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV), a novel bunyavirus. As yet, there is no effective antiviral therapy for SFTS. Ribavirin is a broad-spectrum antiviral agent, which has been tried for treatment of SFTS. In this study, antiviral activity of ribavirin against SFTSV has been investigated. METHODS: Vero cell-grown SFTSV strain Gangwon/Korea/2012 was treated with ribavirin at various concentrations. Antiviral activity of ribavirin was evaluated by inhibition of the SFTSV cytopathic effect in Vero cells and quantification of viral RNA load in culture supernatant using one-step real-time reverse transcription polymerase chain reaction. Cytotoxicity of ribavirin was determined by a tetrazolium-based colorimetric method. RESULTS: Ribavirin reduced SFTSV titers in a dose-dependent manner, with a half-maximal inhibitory concentration ranged from 3.69 to 8.72 μg/mL. Cytopathic effects were reduced as ribavirin concentration increased. No significant cytotoxicity was detected at ribavirin concentrations of ≤ 31.3 μg/mL. CONCLUSIONS: Ribavirin exhibited inhibitory activity against SFTSV replication in vitro, which suggests that ribavirin can be used as a potential antiviral agent for SFTS.
Antiviral Agents ; Bunyaviridae Infections ; Communicable Diseases, Emerging ; Fever* ; In Vitro Techniques* ; Methods ; Orthobunyavirus ; Phlebovirus ; Polymerase Chain Reaction ; Reverse Transcription ; Ribavirin* ; RNA, Viral ; Thrombocytopenia* ; Vero Cells

Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.
Abdominal Pain ; Acute Kidney Injury ; Agaricales ; Alopecia ; Anti-Bacterial Agents ; Colony-Stimulating Factors ; Digestive System ; Disseminated Intravascular Coagulation ; Education ; Emergency Service, Hospital ; Fruit ; Fungi ; Gastric Lavage ; Granulocytes* ; Humans ; Male ; Mycotoxins ; Nausea ; Pancytopenia* ; Reishi ; Skin* ; Vomiting

Several studies have suggested that a positive lymphocyte cross-matching (XM) is associated with low graft survival rates and a high prevalence of acute rejection after adult living donor liver transplantations (ALDLTs) using a small-for-size graft. However, there is still no consensus on preoperative desensitization. We adopted the desensitization protocol from ABO-incompatible LDLT. We performed desensitization for the selected patients according to the degree of T lymphocyte cross-match titer, model for end-stage liver disease (MELD) score, and graft liver volume. We retrospectively evaluated 230 consecutive ALDLT recipients for 5 yr. Eleven recipients (4.8%) showed a positive XM. Among them, five patients with the high titer (> 1:16) by antihuman globulin-augmented method (T-AHG) and one with a low titer but a high MELD score of 36 were selected for desensitization: rituximab injection and plasmapheresis before the transplantation. There were no major side effects of desensitization. Four of the patients showed successful depletion of the T-AHG titer. There was no mortality and hyperacute rejection in lymphocyte XM-positive patients, showing no significant difference in survival outcome between two groups (P=1.000). In conclusion, this desensitization protocol for the selected recipients considering the degree of T lymphocyte cross-match titer, MELD score, and graft liver volume is feasible and safe.
ABO Blood-Group System/immunology ; Adult ; Antibodies, Monoclonal, Murine-Derived/therapeutic use ; Desensitization, Immunologic/*methods ; End Stage Liver Disease/surgery ; Female ; Graft Rejection/immunology ; Graft Survival/*immunology ; Histocompatibility Testing ; Humans ; Liver/surgery ; *Liver Transplantation ; Living Donors ; Male ; Middle Aged ; Plasmapheresis ; Preoperative Care ; Retrospective Studies ; Severity of Illness Index ; Survival Rate ; T-Lymphocytes/*immunology ; *Transplant Recipients

PURPOSE: The purpose of this study was to identify health knowledge, health promoting behavior and factors influencing health promoting behavior of North Korean defectors in South Korea. METHODS: Participants in this study were 410 North Korean defectors, over 20 years of age residing in Seoul. They were recruited by snowball sampling. Data were collected from April to June, 2010. Health knowledge, health promoting behavior, self-efficacy, perceived barriers to health promoting behavior and social support were measured by structured questionnaires, and perceived physical and mental health status were measured by one item with 10-point numeric rating scale. The data were analyzed using t-test, ANOVA, and multiple regression. RESULTS: Health knowledge, health promoting behavior, and perceived barriers to health promoting behavior were moderate while self-efficacy and social support were high. Factors influencing health promoting behavior of the participants were found to be self-efficacy, social support and perceived barrier to health promoting behavior. CONCLUSION: The results of this study indicate that nursing intervention programs enhancing self-efficacy, social support and reducing perceived barriers to health promoting behavior need to be developed for North Korean defectors in South Korea.
Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; *Attitude to Health ; Democratic People's Republic of Korea ; Female ; *Health Behavior ; *Health Promotion ; Humans ; Male ; Middle Aged ; Questionnaires ; Refugees/*psychology ; Republic of Korea ; Self Efficacy ; Social Support ; Stress, Psychological

BACKGROUND: Urine cytology is an important test in the screening of urothlelial neoplasms. The conventional smear (CS) method of testing urine samples has a low sensitivity, approximately 50% result accuracy for detecting urothelial carcinomas, while liquid-based cytology (LBC) has much improved diagnostic accuracy, sensitivity, and specificity. The aim of this study was to compare the morphologic features and diagnostic efficacy of CellprepPlus(R) LBC with those of CS for urine cytology. METHODS: A total of 713 cases of urine specimens collected from November 2009 to September 2010 were included. All specimens were divided equally for the preparation of CellprepPlus(R) LBC and CS for each case. RESULTS: CellprepPlus(R) revealed more cellularity, a cleaner background and better cytomorphologic features, but it showed a less intact architectural pattern compared to that of CS. Of the 88 histologically confirmed cases, the diagnostic sensitivity for CellprepPlus(R) was 50% and higher than the 37.5% for CS. The specificity of both preparations was 100%. CONCLUSIONS: The CellprepPlus(R) showed an improved quality of slides and provided better diagnostic accuracy, thus CellprepPlus(R) could be a first-line screening tool in urinary tract cytology.
Mass Screening ; Sensitivity and Specificity ; Urinary Bladder Neoplasms ; Urinary Tract

PURPOSE: The purpose of this study was to identify exercise environments and social support associated with exercise behaviors in middle-aged women. METHOD: Subjects were 207 women aged between 41 and 59 yr in an urban community. The research instruments utilized in this study were exercise stages, exercise environments, exercise partners and social support scale. Subjects were given a self-report questionnaire. Data was analyzed using the SPSS Win program. RESULT: The subjects were in the stages of precontemplation (3.4%), contemplation (25.1%), preparation (40.6%), action (5.8%), and maintenance (25.1%). Subjects who engaged in regular exercise were 30.9%. The mean score of the exercise environment was 6.34. The mean score of social support was 21.28, and 65.7% of subjects had exercise partners. The score of the exercise environment was significantly associated with the exercise stage (p=.01). The number of exercise partners of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support of regular exercise groups was significantly greater than that of non-regular exercise groups (p=.00). The score of social support was significantly associated with the exercise stage (p=.00). CONCLUSION: Exercise environments and social support need to be considered in planning exercise programs to improve exercise behavior among middle-aged women.
Adult ; Attitude to Health ; *Exercise ; Female ; *Health Behavior ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Questionnaires ; *Social Support ; Urban Population ; Women's Health

Choledochocele, classified as choledochal cyst: type III, is a rare cystic or diverticular dilatation of the terminal biliary tree that causes abdominal pain, recurrent pancreatitis, and obstructive jaundice. It is the rarest of the choledochal cysts and has lower malignant potential than any other type of choledochal cyst. Although its anatomic structure does not fit the criteria for pancreatobiliary maljunction, pancreaticobiliary reflux may occur in patients with choledochocele. Herein, we report the case of a 63-year-old woman with recurrent episodes of acute pancreatitis that were caused by a choledochocele with two parapapillary diverticula. She was successfully treated by endoscopic needle-knife sphincterotomy without severe complications and remained asymptomatic at the 6-month follow-up.
Abdominal Pain ; Biliary Tract ; Choledochal Cyst* ; Dilatation ; Diverticulum* ; Female ; Follow-Up Studies ; Humans ; Jaundice, Obstructive ; Middle Aged ; Pancreatitis* ; Sphincterotomy, Endoscopic

The calcinosis, dystrophic soft tissue calcification, occurs in damaged or devitalized tissues normal calcium/phosphorus metabolism. It is the subcutaneous tissues of connective tissues disease ?primarily systemic lupus erythematosus, scleroderma, or dermatomyositis - and may involve a relatively localized area. The calcinotic accumulations may result in muscle atrophy, joint contractures, and skin ulceration complicated by recurrent episodes of local inflammation and infection. Calcinosis may be the source of both pain and disability in connective tissue disease patients. While various therapeutic modality have been used, no treatment has convincingly prevented or reduced calcinosis. We report two cases of calcinosis cutis combined with rheumatic disease.
Calcinosis* ; Connective Tissue ; Connective Tissue Diseases ; Contracture ; Dermatomyositis ; Humans ; Inflammation ; Joints ; Lupus Erythematosus, Systemic ; Metabolism ; Muscular Atrophy ; Rheumatic Diseases ; Skin Ulcer ; Subcutaneous Tissue