Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

Vertebral compression fractures are the most common type of osteoporotic fractures. In addition to osteoporosis, however, it can occur secondary to primary malignant conditions or non-skeletal primary neoplasm. Multiple myeloma is a neoplastic disease of a B cell origin in which malignant plasma cells accumulate in the bone marrow. Bone involvement is common, most commonly affecting the spine. These vertebral compression fractures account for the most common cause of increased mortality and morbidity in multiple myeloma patients.This paper reports a case in which unsuspected multiple myeloma was diagnosed by bone biopsy during percutaneous kyphoplasty in a patient with multiple vertebral compression fractures.

Vertebral compression fractures are the most common type of osteoporotic fractures. In addition to osteoporosis, however, it can occur secondary to primary malignant conditions or non-skeletal primary neoplasm. Multiple myeloma is a neoplastic disease of a B cell origin in which malignant plasma cells accumulate in the bone marrow. Bone involvement is common, most commonly affecting the spine. These vertebral compression fractures account for the most common cause of increased mortality and morbidity in multiple myeloma patients.This paper reports a case in which unsuspected multiple myeloma was diagnosed by bone biopsy during percutaneous kyphoplasty in a patient with multiple vertebral compression fractures.

Vertebral compression fractures are the most common type of osteoporotic fractures. In addition to osteoporosis, however, it can occur secondary to primary malignant conditions or non-skeletal primary neoplasm. Multiple myeloma is a neoplastic disease of a B cell origin in which malignant plasma cells accumulate in the bone marrow. Bone involvement is common, most commonly affecting the spine. These vertebral compression fractures account for the most common cause of increased mortality and morbidity in multiple myeloma patients.This paper reports a case in which unsuspected multiple myeloma was diagnosed by bone biopsy during percutaneous kyphoplasty in a patient with multiple vertebral compression fractures.

A 67-year-old female patient was admitted with posterior neck pain, motor weakness in the right upper extremity, and gait disorder.The patient had a history of Sjogren’s syndrome but no history of rheumatoid arthritis or other specific histories. The finding of cervical myelopathy was confirmed by cervical magnetic resonance imaging. As atlanto-axial instability was observed on the cervical radiography, both posterior fusion and laminectomy were performed. After surgery, the pain decreased and neurological symptoms improved immediately. Thus, in Sjogren’s syndrome, we should pay attention to the presence of atlanto-axial instability in the cervical radiograph.

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.

Purpose: Fertility preservation (FP) is an important issue for young survivors of breast cancer. Although international guidelines recommend pre-treatment fertility counseling for women with breast cancer, there is no standardized protocol or referral system for FP in South Korea. There are also barriers to discussing FP that make patient-centered decision making difficult. This study aimed to develop a shared decision making program for FP and compare the rates of FP procedures between the usual care and shared decision making groups. We hypothesized that multidisciplinary shared decision making for FP would increase the rate of FP procedures and patient satisfaction. Methods The multidisciplinary shared decision making for FP in young women with breast cancer (MYBC) is a multicenter, clustered, stepped-wedge, randomized trial. A total of 1100patients with breast cancer, aged 19–40 years, from nine hospitals in South Korea, will be enrolled. They will be randomized at the institutional level and assigned to usual care and shared decision making groups. Four institutions, each of which can recruit more than 200 patients, will each become a cluster, whereas five institutions, each of which can recruit more than 50 patients, will become one cluster, for a total of five clusters. The shared decision making groups will receive multidisciplinary programs for FP developed by the investigator. The primary outcome is the rate of FP procedures; secondary outcomes include fertility results, satisfaction, and quality of life. Outcomes will be measured at enrollment, treatment initiation, and the 1-, 3-, and 5-year follow-ups after starting breast cancer treatment.Discussion: A multidisciplinary shared decision making program for FP is expected to increase fertility rates and satisfaction among young patients with breast cancer. This study will provide the evidence to implement a multidisciplinary system for patients with breast cancer.

PURPOSE: This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS: One-hundred sixty-five monolithic zirconia specimens (16.3 mm x 16.3 mm x 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (DeltaE*(ab)) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: There were significant differences in CIE L* between Subgroup 0 and other subgroups in all groups. CIE a* increased (0.523.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R2>0.89, P<.001). CONCLUSION: Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.
Ceramics* ; Prosthesis Coloring

Excessive occlusal wear causes loss of tooth structure, occlusal plane disharmony, impaired function and esthetic problems. Although the decrease of occlusal vertical dimension may be compensated by the growth of alveolar bone and tooth eruption, minimal increase of occlusal vertical dimension may be required for esthetics and retention of prosthesis. In this case, a 44-year-old male patient visited Seoul National University Dental Hospital with chief complaint of severe tooth wear and shade disharmony. Based on assessment of diagnostic wax-up, 3 mm increase of occlusal vertical dimension was determined. Removable occlusal splint and interim prosthesis was used to ascertain patient's comfort and adaptation. After the adaptation period, definitive prosthesis fabricated with full-contour monolithic zirconia were delivered and the patient was recommended to wear a nightguard device for prosthesis protection. This report presents a case of full mouth rehabilitation with the elevation of patient's occlusal vertical height, resulting in satisfactory esthetics and functions.
Adult ; Dental Occlusion ; Dentition* ; Esthetics ; Humans ; Male ; Mouth Rehabilitation* ; Mouth* ; Occlusal Splints ; Prostheses and Implants* ; Seoul ; Tooth ; Tooth Attrition ; Tooth Eruption ; Tooth Wear ; Vertical Dimension

The maxillary defects lead to anatomical and functional deformity of the maxillofacial region. As far as functions are concerned, such defects can produce difficulty in speech, mastication, and deglutition. Obturator prostheses play a very important role in functional recovery for post-maxillectomy patients. To achieve rigidity of the obturator, appropriate retention should be given, and the weight of the prosthesis be reduced. There are two types of hollow bulb obturator: open and closed. A closed type has many advantages. Nevertheless, some problems, including complexity of fabrication and water leakage into the bulb, have the closed hollow obturator not be widely used. The one-step polymerization technique described in this case overcomes the shortcomings by easily constructing a small hollow bulb with two thermoplastic resin sheets.
Congenital Abnormalities ; Deglutition ; Humans ; Mastication ; Polymerization* ; Polymers* ; Prostheses and Implants ; Rehabilitation* ; Water