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.

Peripheral ossifying fibroma (POF) is a benign tumor characterized by dystrophic calcification or ossification within the gingiva, primarily affecting the anterior maxilla of females and young adults. Its pathogenesis is unclear but linked to local irritants such as trauma, biofilm, dental calculus, and poorly fitting prostheses. In this study, a 63-year-old male presented at Dankook University Dental Hospital with a large nodular lesion on the left maxillary bucco-palatal gingiva. Preoperative imaging, including panoramic radiography and cone-beam computed tomography, was performed. Surgical excision and histological examination confirmed POF with specific morphological characteristics, including mineralized tissue with varied deposition patterns, mature and immature bone, cementum-like tissue, and dystrophic calcification. In conclusion, POF is a rare oral tumor, more common in younger females, typically presenting asymptomatically on the anterior maxilla. Histopathological analysis is crucial for diagnosis. Standard treatment involves conservative local resection, but recurrence rates range from 8% to 20%, necessitating continuous follow-up. This report aims to enhance understanding of POF by presenting a rare case of a large POF in the maxillary posterior bucco-palatal gingiva of an elderly male.

Peripheral ossifying fibroma (POF) is a benign tumor characterized by dystrophic calcification or ossification within the gingiva, primarily affecting the anterior maxilla of females and young adults. Its pathogenesis is unclear but linked to local irritants such as trauma, biofilm, dental calculus, and poorly fitting prostheses. In this study, a 63-year-old male presented at Dankook University Dental Hospital with a large nodular lesion on the left maxillary bucco-palatal gingiva. Preoperative imaging, including panoramic radiography and cone-beam computed tomography, was performed. Surgical excision and histological examination confirmed POF with specific morphological characteristics, including mineralized tissue with varied deposition patterns, mature and immature bone, cementum-like tissue, and dystrophic calcification. In conclusion, POF is a rare oral tumor, more common in younger females, typically presenting asymptomatically on the anterior maxilla. Histopathological analysis is crucial for diagnosis. Standard treatment involves conservative local resection, but recurrence rates range from 8% to 20%, necessitating continuous follow-up. This report aims to enhance understanding of POF by presenting a rare case of a large POF in the maxillary posterior bucco-palatal gingiva of an elderly male.

Peripheral ossifying fibroma (POF) is a benign tumor characterized by dystrophic calcification or ossification within the gingiva, primarily affecting the anterior maxilla of females and young adults. Its pathogenesis is unclear but linked to local irritants such as trauma, biofilm, dental calculus, and poorly fitting prostheses. In this study, a 63-year-old male presented at Dankook University Dental Hospital with a large nodular lesion on the left maxillary bucco-palatal gingiva. Preoperative imaging, including panoramic radiography and cone-beam computed tomography, was performed. Surgical excision and histological examination confirmed POF with specific morphological characteristics, including mineralized tissue with varied deposition patterns, mature and immature bone, cementum-like tissue, and dystrophic calcification. In conclusion, POF is a rare oral tumor, more common in younger females, typically presenting asymptomatically on the anterior maxilla. Histopathological analysis is crucial for diagnosis. Standard treatment involves conservative local resection, but recurrence rates range from 8% to 20%, necessitating continuous follow-up. This report aims to enhance understanding of POF by presenting a rare case of a large POF in the maxillary posterior bucco-palatal gingiva of an elderly male.

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.

Background: Although the consumption of vitamin beverages has increased because of the recent interest in health and beauty, guidelines addressing appropriate consumption habits are lacking. Thus, the aim of this study was to investigate the erosive potential of several vitamin beverages and to propose guidelines for the appropriate intake of these drinks. Methods: Five vitamin beverages were selected after a pre-investigation of the current beverage market. Coca-Cola and mineral water were selected as the control beverages. The pH of the beverages was measured with a calibrated pH meter, and the titratable acidity (TA) was determined by using 1 M sodium hydroxide to reach pH 5.5 (TA5.5) and 7.0 (TA7.0). The screening method suggested by the International Organization for Standardization was used to measure pH variation (pH) by using an under-saturated hydroxyapatite solution to determine the difference between the initial and final pH of the screening solution. All measurements were performed in triplicate. Results: All vitamin beverages tested in this study exhibited a low pH (2.53∼2.99), similar to Coca-Cola, which is known to be a highly acidic beverage. The highest TA5.5 and TA7.0 values of the vitamin beverages were 7.03 ml and 8.81 ml, respectively. The largest change in pH determined by using the screening solution was found in Bacchus D (pH 1.44±0.05). The mean pH of the vitamin beverages was 1.12±0.29, which was higher than that of Coca-Cola (positive control, pH 0.58±0.05). Conclusion Vitamin beverages exhibited an erosive potential capable of damaging enamel surfaces. Therefore, the frequency of vitamin beverage intake should be limited, and individuals consuming these drinks should try to restore normal oral pH as quickly as possible.

BACKGROUND: Hemodynamic and functional evaluation with Doppler and tissue Doppler study as a part of comprehensive echocardiography is essential but normal reference values have never been reported from Korean normal population especially according to age and sex. METHODS: Using Normal echOcaRdiographic Measurements in a KoreAn popuLation study subjects, we obtained normal reference values for Doppler and tissue Doppler echocardiography including tricuspid annular velocities according to current guidelines and compared values according to gender and age groups. RESULTS: Mitral early diastolic (E) and late diastolic (A) velocity as well as E/A ratio were significantly higher in women compared to those in men. Conversely, mitral peak systolic and late diastolic annular velocity in both septal and lateral mitral annulus were significantly lower in women compared to those in men. However, there were no significant differences in both septal and lateral mitral early diastolic annular (e') velocity between men and women. In both men and women, mitral E velocity and its deceleration time as well as both E/A and E/e' ratio considerably increased with age. There were no significant differences in tricuspid inflow velocities and tricuspid lateral annular velocities between men and women except e' velocity, which was significantly higher in women compared to that in men. However, changes in both tricuspid inflow and lateral annular velocities according to age were similar to those in mitral velocities. CONCLUSION: Since there were significant differences in Doppler and tissue Doppler echocardiographic variables between men and women and changes according to age were even more considerable in both gender groups, normal Doppler echocardiographic values should be differentially applied based on age and sex.
Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Female ; Hemodynamics ; Humans ; Male ; Reference Values

PURPOSE: While the Trastuzumab for Gastric Cancer (ToGA) trial demonstrated the efficacy and safety of trastuzumab-based chemotherapy in HER2-positive metastatic gastric cancer, the overall survival (OS) benefit was not found in Asian and diffuse-type cancer patients. The aim of the study is to investigate predictive markers for trastuzumab-based chemotherapy. MATERIALS AND METHODS: Data of patients with HER2-positive gastric cancer treated with trastuzumab-based chemotherapy were analyzed retrospectively. RESULTS: A total of 168 Asian patients were included. The median age was 60 years (range, 27 to 85 years) and the male:female ratio was 118 (70.2%):50 (29.8%). Fourteen (8.3%), 63 (37.5%), 75 (44.6%), and 11 (6.5%) patients had well, moderately, poorly-differentiated tubular adenocarcinoma and signet ring cell carcinoma, respectively. With 14 complete responses and 73 partial responses, the response rate was 50.6%. The median progression-free survival (PFS) was 10.2 months (95% confidence interval [CI], 8.7 to 11.7), and the median OS was 18.5 months (95% CI, 16.4 to 50.6). Next, we investigated the effect of poorly-differentiated histology (PDH, poorly-differentiated tubular adenocarcinoma+signet ring cell carcinoma) on clinical outcomes. The median PFS (8.9 months vs. 11.5 months, p=0.16) was slightly inferior in PDH patients, and the median OS was significantly shorter in PDH patients (14.6 months vs. 19.0 months, p=0.025). CONCLUSION: While subset analysis of the ToGA trial demonstrated that trastuzumab-based chemotherapy may not be beneficial for Asians and patients with PDH, our data may suggest that even in Asian patients and patients with PDH, trastuzumab-based chemotherapy could be associated with improved clinical outcomes in patients with HER2-positive gastric cancer.
Adenocarcinoma ; Asian Continental Ancestry Group ; Carcinoma, Signet Ring Cell ; Disease-Free Survival ; Drug Therapy* ; Ethnic Groups ; Humans ; Receptor, erbB-2 ; Retrospective Studies* ; Stomach Neoplasms*

BACKGROUND: It is important to understand the distribution of 2-dimensional strain values in normal population. We performed a multicenter trial to measure normal echocardiographic values in the Korean population. METHODS: This was a substudy of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL) study. Echocardiographic specialists measured frequently used echocardiographic indices in healthy people according to a standardized method at 23 different university hospitals. The strain values were analyzed from digitally stored images. RESULTS: Of a total of 1003 healthy participants in NORMAL study, 2-dimensional strain values were measured in 501 subjects (265 females, mean age 47 ± 15 years old) with echocardiographic images only by GE echocardiographic machines. Interventricular septal thickness, left ventricular (LV) posterior wall thickness, systolic and diastolic LV dimensions, and LV ejection fraction were 7.5 ± 1.0 mm, 7.4 ± 1.0 mm, 29.9 ± 2.8 mm, 48.9 ± 3.6 mm, and 62 ± 4%, respectively. LV longitudinal systolic strain (LS) values of apical 4-chamber (A4C) view, apical 3-chamber (A3C) view, apical 2-chamber (A2C) view, and LV global LS (LVGLS) were −20.1 ± 2.3, −19.9 ± 2.7, −21.2 ± 2.6, and −20.4 ± 2.2%, respectively. LV longitudinal systolic strain rate (LVLSR) values of the A4C view, A3C view, A2C view, and LV global LSR (LVGLSR) were −1.18 ± 0.18, −1.20 ± 0.21, −1.25 ± 0.21, and −1.21 ± 0.21(−s), respectively. Females had lower LVGLS (−21.2 ± 2.2% vs. −19.5 ± 1.9%, p < 0.001) and LVGLSR (−1.25 ± 0.18(−s) vs. −1.17 ± 0.15(−s), p < 0.001) values than males. CONCLUSION: We measured LV longitudinal strain and strain rate values in the normal Korean population. Since considerable gender differences were observed, normal echocardiographic cutoff values should be differentially applied based on sex.
Echocardiography* ; Female ; Healthy Volunteers ; Heart Ventricles* ; Hospitals, University ; Humans ; Male ; Methods ; Multicenter Studies as Topic ; Reference Values ; Specialization

BACKGROUND: Measurement of the cardiac chamber is essential, and current guidelines recommend measuring and reporting values for both sides of the cardiac chamber during echocardiographic evaluation. Normal echocardiographic reference values have been suggested previously, but detailed information about right-sided chambers and values according to gender was not included. METHODS: This is a prospective multicenter (23 centers) study evaluating normal Korean adult subjects using comprehensive echocardiography. We included normal adult subjects (age; 20-79 years old) who had no significant cardiac disorders or illnesses, such as hypertension or diabetes, which could affect cardiac structure and function. We measured the cardiac chamber including both right and left ventricles as well as atria according to current echocardiography guidelines and compared values according to gender and age groups. RESULTS: A total of 1003 subjects were evaluated and the mean age was 48 +/- 16 years. Left ventricular (LV) dimensions increased, but LV volume decreased in older subjects. Right ventricular (RV) area decreased in women and older subjects, and the RV long-axis dimension showed a similar trend. Left atrial (LA) volume increased in men but there were no differences in LA volume index between men and women. The dimension of great arteries increased in men and older subjects. CONCLUSION: Since there were considerable differences between men and women and in the different age groups, and the trends differed significantly between different echo variables, normal echocardiographic cutoff values should be differentially applied based on age and gender.
Adult ; Arteries* ; Echocardiography* ; Female ; Heart Ventricles ; Humans ; Hypertension ; Male ; Prospective Studies ; Reference Values