Research on the supply guarantee system of orphan drugs in South Korea from the perspective of accessibility and its enlightenment / 中国药房

OBJECTIVE To systematically introduce the supply guarantee system of orphan drugs in South Korea， and to provide reference for improving the accessibility of orphan drugs in China. METHODS The basic characteristics and practical experience of supply guarantee system of orphan drugs in South Korea were summarized by studying the marketing incentive mechanism， reserve supply mechanism and emergency use mechanism. Then， based on the research on the current situation and existing problems of orphan drug supply in China， specific suggestions were put forward to improve the accessibility of orphan drugs in China. RESULTS & CONCLUSIONS South Korea has effectively improved the accessibility of orphan drugs through orphan drug identification channels and supporting incentive policies， relying on the reserve supply mechanism and the import route for emergency use. Therefore， it is suggested that China should guarantee the normal supply of orphan drugs from three aspects： improving the recognition and incentive policy of orphan drugs， building a full-time management department of orphan drugs， and optimizing the temporary import path.

Disease burden of benign prostatic hyperplasia in China, Japan and South Korea from 1990 to 2019: a comparative study / 现代泌尿外科杂志

【Objective】 To analyze the disease burden of benign prostatic hyperplasia (BPH) in China, Japan and South Korea from 1990 to 2019, so as to provide scientific basis for rational allocation of health resources. 【Methods】 Data were obtained from the Global Burden of Disease Study 2019. The incidence, prevalence and years lived with disability(YLD)were used to analyze the burden, and the average annual percent change and annual percent change were calculated. 【Results】 The incidence, prevalence and YLD rate in China were much higher than those in Japan and South Korea. The crude incidence in China, Japan and South Korea increased by 2.56%, 1.49% and 3.59% per year from 1990 to 2019, the crude prevalence rate increased by 2.70%, 2.34% and 4.03%, and the crude YLD rate increased by 2.68%, 2.33% and 4.04%. After age standardization, the disease burden in China decreased with time, but the trend was not significant, and the standardized rate in Japan and Korea increased significantly with time. The disease burden of BPH increased with age, and those aged 60 to 84 years had the highest burden. In addition, the disease burden increased with the increase of socio-demographic index (SDI) in all three countries. 【Conclusion】 The disease burden of BPH was very heavy in China, Japan and South Korea, especially in China. Males aged 60 to 84 years were the high-risk group. Targeted intervention should be adopted for these population.

Mercury concentration in shark meat from traditional markets of Gyeongsangbuk-do, South Korea

Positive Effects of the National Cigarette Price Increase Policy on Smoking Cessation in South Korea / 결핵

Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study / 가정의학회지

BACKGROUND: Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data. METHODS: This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted. RESULTS: The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P < 0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P < 0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P < 0.001), Clinical Dementia Rating Sum of Box (P < 0.001), Global Deterioration Scale score (P < 0.001), abnormality of free T4 level (P < 0.001), anemia (P < 0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers. CONCLUSION: Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.

Beliefs about Tic Disorders and Tourette's Syndrome in South Korea: An Online Panel Survey

OBJECTIVES: This study investigates lay beliefs about the etiology and treatments of tic disorder and Tourette's syndrome, as well as identifying sociodemographic and personality variables affecting these beliefs among South Koreans. METHODS: In total, 673 participants (mean age 41.77±12.03 years) completed an online survey regarding their beliefs about tic disorder and Tourette's syndrome. The factors related to their lay beliefs about the disorders were analyzed, and the correlates were investigated. RESULTS: Results indicated that lay people in South Korea held strong beliefs that the causes of tic disorder and Tourette's syndrome lie within the parenting/psychological and neurological/biological categories, compared to the dietary/environmental one. Among the sociodemographic variables, sex, age, and levels of subjective mental health knowledge were primarily associated with the aforementioned beliefs. Familiarity with tic disorder and Tourette's syndrome was also associated with these beliefs. Among the personality traits investigated, extraversion and conscientiousness had significant influences on the beliefs people had about tic disorder and Tourette's syndrome. CONCLUSION: The results suggest that both policy makers and mental health service providers should adopt a strategic approach for developing and implementing health education interventions about tic disorder and Tourette's syndrome because individual sociodemographic variables, familiarity with the disorders, and personality traits are all associated with the beliefs about these disorders.

Malaria Incidence of the Regions Adjacent to the Demilitarized Zone in the Democratic People's Republic of Korea, 2004–2016

BACKGROUND: Vivax malaria reemerged in the Korean peninsula in 1990s beginning from the western border area and spread across both Koreas rapidly with its peak incidences reported on the early 2000s. There have been few reports on the malaria incidence in the Democratic People's Republic of Korea (North Korea) that provides detailed epidemiological features. The purpose of this study was to describe the time trends and spatial distribution of malaria in North Korea with comparison to those in South Korean regions across the border. METHODS: The incidence of malaria in each province of North Korea from 2004 to 2016 was estimated based on data from domestic and international health authorities. Consistency of the data was evaluated by calculating the ratio of malaria cases in each province to the total cases each year. We also compared the changes in malaria incidence over time in South and North Korea adjacent to the demilitarized zone. RESULTS: In North Korea, the incidence of malaria in the three provinces adjacent to the demilitarized zone was the highest (52.1−315.3 per 100,000), followed by Pyeonganbuk-do (14.7−113.5 per 100,000), where railways and road networks were connected to northern China. The incidence of malaria in each province of North Korea reported after 2011 was more consistent than when compared with previous annual data, and there was also a positive correlation between changes in incidence over time when compared with malaria incidence in South Korea (r = 0.855, r = 0.596). CONCLUSION: The malaria report of North Korea was relatively consistent in its spatiotemporal tendency since 2011, suggesting improvement of the quality of the surveillance data. The strong correlation between North and South Korean malaria incidence at regional level suggests that collaboration between both sides are essential for the successful elimination of malaria in the Korean peninsula.

Disaster preparedness for earthquakes in hemodialysis units in Gyeongju and Pohang, South Korea

In 2016 and 2017, there were earthquakes greater than 5.0 in magnitude on the Korean Peninsula, which has previously been considered an earthquake-free zone. Patients with chronic kidney disease are particularly vulnerable to earthquakes, as the term “renal disaster” suggests. In the event of a major earthquake, patients on hemodialysis face the risk of losing maintenance dialysis due to infrastructure disruption. In this review, we share the experience of an earthquake in Pohang that posed a serious risk to patients on hemodialysis. We review the disaster response system in Japan and propose a disaster preparedness plan with respect to hemodialysis. Korean nephrologists and staff in dialysis facilities should be trained in emergency response to mitigate risk from natural disasters. Dialysis staff should be familiar with the action plan for natural disaster events that disrupt hemodialysis, such as outages and water treatment system failures caused by earthquakes. Patients on hemodialysis also need to be educated about disaster preparedness. In the event of a disaster situation that results in dialysis failure, patients need to know what to do. At the local and national government level, long-term preparations should be made to handle renal disaster and patient safety logistics. Moreover, Korean nephrologists should also be prepared to manage cardiovascular disease and diabetes in disaster situations. Further evaluation and management of social and national disaster preparedness of hemodialysis units to earthquakes in Korea are needed.

Mental Health Literacy of Autism Spectrum Disorder in Korea: Recognition, Etiology, Treatment

OBJECTIVE: The objective of this study was to investigate the Korean public’s recognition of autism spectrum disorder (ASD), revealing underlying factors regarding perception relative to etiology and treatment of ASD, and examining variables related to those factors. METHODS: An online survey was held to investigate mental health literacy (MHL) on ASD of the general public in Korea. A total of 673 adults participated and completed questionnaires on socio-demographic characteristics and if they know someone with ASD. Next, participants were provided with a vignette describing a child with ASD. Only those that recognized there was a problem with the child moved to the next part which asked their perception regarding etiology and treatment of ASD. RESULTS: According to our study, approximately 25% of participants correctly recognized the child in the vignette as having ASD. Perception regarding etiology and treatment of ASD varied among socio-demographic characteristics. Participants acquainted with someone with ASD and correctly recognized ASD held mixed perception regarding cause and treatment. CONCLUSION: This study investigated MHL of ASD in Korea. The result reveals there is much room for improvement relative to raising awareness on MHL of ASD. Intervention considering socio-demographic characteristics and acquaintance with ASD are needed.

Design and Methods of the Korean National Investigations of 70,000 Suicide Victims Through Police Records (The KNIGHTS Study)

OBJECTIVE: The suicide rate in South Korea was the second highest among the Organization for Economic Cooperation and Development countries in 2017. The purpose of this study is to understand the characteristics of people who died by suicide in Korea from 2013–2017 and to better prevent suicide. METHODS: This study was performed by the Korea Psychological Autopsy Center (KPAC), an affiliate of the Korea Ministry of Health and Welfare. According to the Korea National Statistical Office, the number of suicide victims nationwide was estimated to reach about 70,000 from 2013 to 2017. Comprehensive suicide records from all 254 police stations in South Korea were evaluated by 32 investigators who completed a 14-day didactic training program. Then, we evaluated the characteristics of suicide victims in association with disease data from the National Health Insurance Database (NHID), which is anonymously linked to personal information of suicide victims. RESULTS: Thirty-one of 254 police stations in the Seoul metropolitan area were analyzed by August 10, 2018. Findings showed that the characteristics of suicide victims differed according to the nature of the region. CONCLUSION: Our results suggest that different strategies and methods are needed to prevent suicide by regional groups.

Determinants of North Korean Refugees' Trust in South Korea Health Service / 보건행정학회지

BACKGROUND: The purpose of this study was to investigate the determinants of North Korean refugees' trust in South Korea health service. METHODS: This study surveyed 168 North Korean refugees aged 19 and over living in Seoul, Gyeonggi, Incheon, and Gangwon. The collected data were analyzed by frequency analysis, t-test, analysis of variance, and hierarchical regression analysis to analyze the effect on the trust of refugees. RESULTS: The difference analysis showed statistically significant difference according to duration of residence and employment status. The determinants of North Korean refugees' trust in South Korea health services were duration of residence, basic communication skills, health communication skills, and experience of health service. CONCLUSION: In order to increase the trust of North Korean defectors in South Korea medical services, it is necessary to resolve communication problems and improve the satisfaction of health services. For this, the interpreter service should be activated. And specific education should be given to the North Korean refugees about the health care system and the utilization methods of health service in Korea.

Changing Disease Trends in the Northern Gyeonggi-do Province of South Korea from 2002 to 2013: A Big Data Study Using National Health Information Database Cohort

OBJECTIVES: To investigate the chronological patterns of diseases in Northern Gyeonggi-do province, South Korea, and compare these with national data. METHODS: A National Health Insurance cohort based on the National Health Information Database (NHID Cohort 2002–2013) was used to perform a retrospective, population-based study (46,605,433 of the target population, of which 1,025,340 were randomly sampled) to identify disease patterns from 2002 to 2013. Common diseases including malaria, cancer (uterine cervix, urinary bladder, colon), diabetes mellitus, psychiatric disorders, hypertension, intracranial hemorrhage, bronchitis/bronchiolitis, peptic ulcer, and end stage renal disease were evaluated. RESULTS: Uterine cervix cancer, urinary bladder cancer and colon cancer had the greatest rate of increase in Northern Gyeonggi-do province compared with the rest of the country, but by 2013 the incidence of these cancers had dropped dramatically. Acute myocardial infarction and end stage renal disease also increased over the study period. Psychiatric disorders, diabetes mellitus, hypertension and peptic ulcers showed a gradual increase over time. No obvious differences were found for intracranial hemorrhage or bronchitis/bronchiolitis between the Northern Gyeonggi-do province and the remaining South Korean provinces. Malaria showed a unique time trend, only observed in the Northern Gyeonggi province, peaking in 2004, 2007 and 2009 to 2010. CONCLUSION: This study showed that the Northern Gyeonggi-do province population had a different disease profile over time, compared with collated data for the remaining provinces in South Korea. “Big data” studies using the National Health Insurance cohort database can provide insight into the healthcare environment for healthcare providers, stakeholders and policymakers.

Characteristics of South Korean Patients with Hereditary Transthyretin Amyloidosis

BACKGROUND AND PURPOSE: This retrospective cross-sectional study included 18 patients from unrelated families harboring mutations of the transthyretin gene (TTR), and analyzed their characteristics and geographical distribution in South Korea. METHODS: The included patients had a diagnosis of systemic amyloidosis, clinical symptoms, such as amyloid neuropathy or cardiomyopathy, and confirmation of a TTR gene mutation using genetic analysis recorded between April 1995 and November 2014. RESULTS: The mean age at disease onset was 49.6 years, and the mean disease duration from symptom onset to diagnosis was 3.67 years. Fifteen of the 18 patients were classified as mixed phenotype, 2 as the neurological phenotype, and only 1 patient as the cardiac phenotype. The most-common mutation pattern in South Korea was Asp38Ala, which was detected in eight patients. Thirteen patients reported their family hometowns, and five of the eight harboring the Asp38Ala mutation were from the Gyeongsang province in southeast Korea. The other eight patients exhibited a widespread geographical distribution. A particularly noteworthy finding was that the valine at position 30 (Val30Met) mutation, which was previously reported as the most-common TTR mutation worldwide and also the most common in the Japanese population, was not detected in the present South Korean patients. CONCLUSIONS: South Korean patients with hereditary TTR amyloidosis exhibited heterogeneous TTR genotypes and clinical phenotypes. The findings of this study suggest that the distribution of TTR amyloidosis in South Korea is due to de novo mutations and/or related to the other countries in East Asia.

New Species and New Record of Genus Chrysothrix (Chrysotrichaceae, Arthoniales) from South Korea and Chile

The genus Chrysothrix is very common around the world and easy to be recognized by its bright yellowish granular thallus. In this study, investigations of lichen mycota in South Korea and Chile from 2010 to 2017 have been done, and some Chrysothrix specimens were collected, based on the morphological and chemical study on these specimens, five species were confirmed in this study, including one new species from Chile, Chrysothrix chilensis D. Liu & J.-S Hur, and one new record from South Korea, C. xanthina (Vain.) Kalb. Meanwhile, detail description and illustration for each species were present in this study.

Study on the Quality of Life of Chinese Residents from Different Countries' Perspective: Based on the EQ-5D Value Set of China, Britain, Japan and Korea / 中国卫生经济

Objective:To study the characteristics of EQ-5D-3L value set in China,UK,Japan and Korea,and conduct the evaluation of health-related quality of life in China from multiple perspectives.Methods:Based on the 5th national health service survey data,Pearson correlation coefficient was used to study the relationship between health quality of life of residents in China based on different utility value system.Results:The upper limit of utility values in China,Britain,Japan and South Korea were 1,the lower limit were-0.149,-0.594,-0.171 and-0.106.From the perspectives of the four countries,the average values of China's residents were 0.9588,0.9130,0.9499 and 0.9643.Conclusion:China,Japan and South Korea were more consistent in their preferences for health assessment and more concerned about the health effects of general problems and self-care,while the UK was more concerned about extreme problems and the impact of pain.From the perspective of China and South Korea,the attitude towards the quality of life of Chinese residents was optimistic.UK and Japan were relatively pessimistic about the health status of the elderly and low-income people aged 65 and above.

The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity / 예방의학회지

OBJECTIVES: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. METHODS: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. RESULTS: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. CONCLUSIONS: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

The Genus Chlorociboria, Blue-Green Micromycetes in South Korea

The species of the genus Chlorociboria Seaver are very common on the forest floor, and can be easily distinguished by small and numerous blue-green fruitbody, especially the blue substrate dyed with xylindein produced by this group. This genus has rather high species diversity in the Southern Hemisphere, while a little attention was paid to this group in East Asia area. During a field survey in South Korea, several Chlorociboria specimens were collected. Based on morphological and phylogenetic analyses, three species of Chlorociboria were reported, including one new record in South Korea and one new record in Jeju Island. The key to the species of Chlorociboria from South Korea is provided.

Cryptothecia austrocoreana (Arthoniales, Arthoniaceae), a New Species from South Korea

Cryptothecia austrocoreana is a new lichen species from South Korea. The species is characterized by the presence of a heteromerous thallus and faveolate ascigerous area (ascomata) immersed in a slightly raised thallus. The species has muriform ascospores, (4)6–8–spored 8–11 × 3–4 septate, (34)36–48(51) × (17)19–23(25) μm. Atranorin, chloroatranorin, and barbatic acid are present. In the phylogenetic tree, C. austrocoreana belongs to the arthonioid clade in Arthoniaceae.

Concept and Development of Resident Training Program for General Competencies / 의학교육논단

Resident training programs in South Korea lag far behind that of advanced countries. Given the problems the current system in South Korea has, it is time to consider a new resident training system, resident training for general competencies. Training for the general competencies was practiced in medical fields in advanced countries such as the USA, Canada, and the UK as early as 20 years ago. This system has rendered itself a key component of resident training. Although a few theoretical procedures on general competencies have been practiced in South Korea, the awareness of this concept is still very weak, and the application of the theory to actual training is a long way off from becoming effective. It is urgent for South Korea to adopt competency- and outcome-based training for general competencies. To this end, the knowledge of the concept of this type of training should be improved. Also, the system should be carefully designed to cover a doctor's whole career, and be applied immediately. The competency- and outcome-based training for general competencies is a system that assures high level qualifications. It reflects the needs of our society under the recognition that a professional organization should be committed and accountable in order to respond to social demands. As the benefits of the new training system reach the public and medical care consumers, training-related expenses should be borne by social costs.

Phylogeographical characterization of H5N8 viruses isolated from poultry and wild birds during 2014–2016 in South Korea

During 2014–2016 HPAI outbreak in South Korea, H5N8 viruses have been mostly isolated in western areas of the country, which provide wintering habitats for wild birds and have a high density of poultry. Analysis of a total of 101 Korean isolates revealed that primitive H5N8 viruses (C0 group) have evolved into multiple genetic subgroups appearing from various epidemiological sources, namely, the viruses circulating in poultry farms (C1 and C5) and those reintroduced by migratory birds in late 2014 (C2 and C4). No C3 groups were detected. The results may explain the possible reasons of the recent long-term persistence of H5N8 viruses in South Korea, and help to develop the effective measures in controlling HPAI viruses.