The family of an American missionary who was detained in North Korea last year say he is seriously ill and has been moved from a labour camp to hospital.
Kenneth Bae, 45, who was sentenced to 15 years' hard labour for trying to overthrow the government, has an enlarged heart and diabetes.
His sister Terri Chung says he is now too weak to work.
Mr Bae (known in North Korea as Pae Jun-ho) was detained last year after entering North Korea as a tourist. He was sentenced on 2 May this year.
The BBC reports he was said to have used a tourism business to form groups to overthrow the government.
Ms Chung said on Saturday he had recently been visited by a Swedish diplomat and that her brother was now in a hospital.
"We're terribly worried about his health. I think it has been deteriorating," she told a website in the United States.
The US government has appealed to North Korea to release Mr Bae.