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.

Background: Since the clinical application of flow cytometry, many clinical laboratories have utilized this method for diagnosing hematologic malignancies. However, delays in testing can occur due to various reasons.To address this issue, whole blood fixatives are occasionally administered.Hence, this study aimed to determine the impact of applying whole blood fixative on bone marrow specimens. Methods: Nine samples without lymphoma/leukemia bone marrow involvement were examined. Flow cytometry was performed using 17 common markers. The samples were stored at room temperature (RT) and 4°C without fixative treatment, stored at 4°C after TransFix (Cytomark, UK) treatment, and stored at RT after Cyto-Chex (Streck, USA) treatment.Subsequently, the samples were divided into groups and examined. A total of 13 tests were conducted on each sample for up to 5 days. Results: The neutrophil and monocyte fractions improved when the samples were stored at 4°C, while no significant difference was observed in the lymphocyte fractions. The fluorescence intensity of the markers varied depending on the marker and conditions, with the most stable markers observed when stored in TransFix at 4°C, followed by storage at 4°C, CytoChex RT, and RT. Conclusions The use of fixative on bone marrow specimens maintained the stability of markers during delayed testing. Both fixatives are more effective in preserving marker intensity and cell fractions compared with RT storage.Refrigeration and the use of fixatives may be beneficial for examinations delayed beyond 72 hours.

Background: Disruptions of the intestinal epithelial barrier (IEB) are frequently observed in various digestive diseases, including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). This study assessed the improvement in the IEB during the laxative activity of phlorotannin (Pt) harvested from Ecklonia cava in constipation by examining the changes in the expression of the regulatory proteins for the tight junction (TJ) and adherens junction (AJ), and inflammatory cytokines in Sprague Dawley (SD) rats with loperamide (Lm)-induced constipation after a Pt treatment. Results: The Pt treatment induced laxative activity, including the improvement of feces-related parameters, gastrointestinal transit rate, and histological structure of the mid colon in Lm-treated SD rats. In addition, significant recovery effects were detected in the histology of IEB, including the mucus layer, epithelial cells, and lamina propria in the midcolon of Lm + Pt treated SD rats. The expression levels of E-cadherin and p120-catenin for AJ and the ZO-1, occludin, and Claudin-1 genes for TJ in epithelial cells were improved remarkably after the Pt treatment, but the rate of increase was different. Furthermore, the Pt treatment increased the expression level of several inflammatory cytokines, such asTNF-α, IL-6, IL-1β, IL-13, and IL-4 in Lm + Pt treated SD rats. Conclusions These results provide the first evidence that the laxative activity of Pt in SD rats with Lm-induced constipation phenotypes involve improvements in the IEB.

Purpose: This study was aimed at investigating the incidence and risk factors of dyslipidemia in menopausal women using a Korean community-based longitudinal study. Methods: The subjects were 245 postmenopausal women without dyslipidemia who had participated in the Ansan-Ansung cohort study from 2001~2002 (baseline) to 2015~2016 (seventh follow-up visit). The dyslipidemia incidence was measured as incidence proportion (%) and incidence rate per 100 person-years. The predictors of developing dyslipidemia were analyzed with Cox’s proportional hazard model. Results: The incidence of new dyslipidemia during the follow-up period was 78.4% (192 patients), and 11.9 per 100 person-years. Mean duration from menopause to developing dyslipidemia was 5.3 years in new dyslipidemia cases. The triglyceride/high density lipoprotein (TG/HDL-C) ratio at baseline (hazard ratio = 2.20; 95% confidence interval = 1.39~3.48) was independently associated with developing dyslipidemia. Conclusion Dyslipidemia occurs frequently in postmenopausal women, principally within five years after menopause. Therefore, steps must be taken to prevent dyslipidemia immediately after menopause, particularly in women with a high TG/HDL-C ratio at the start of menopause.

Purpose: This study investigated the incidence and risk factors of cataract in people with diabetes mellitus (DM) using data from Ansan cohort of the Korean Genome and Epidemiology Study (KoGES). Methods: Data from a total of 329 patients with type 2 DM without cataract who participated in Ansan cohort of the KoGES from baseline survey (2001–2002) to fifth follow-up visit (2011–2012) were examined.The characteristics of the subjects were analyzed with frequency and percentage, and mean and standard deviation. Cataract incidence was measured as incidence proportion (%). For risk factors of cataract, hazard ratio (HR) and 95% confidence interval (CI) were obtained using the Cox proportional hazard model. Results: The cataract incidence over a 10-year follow-up period was 19.1% (15.1 in males and 25.8 in females), and mean age at the incidence of cataract was 63.48 years (61.58 years in males and 65.31 years in females). Age (HR=1.09, 95% CI=1.05–1.13) and HbA1c (HR=1.21, 95% CI=1.07–1.37) or the duration of DM (HR=1.05, 95% CI=1.00–1.09) were found to be independently associated with cataract development. Conclusion Cataract development in people with DM is common, and its likelihood increases with age, HbA1c, and the duration of DM. Considering negative effect of cataract on their quality of life and economic burden, nurses should identify people with DM at a higher risk of cataract development, and plan individual eye examination programs to detect cataract development as early as possible.

Background: The study examined the prevalence of suicidal ideation and suicide attempts among registrants of public community healthcare centers and compared between the characteristics of mental and general healthcare center (GHC) registrants. Methods: The study measured lifetime suicidal behaviors, psychosocial variables, psychiatric comorbidities, and suicide related factors. Results: A total of 132 (73.7%) and 126 (42.3%) mental and GHC registrants, respectively, reported a history of suicidal ideation; whereas 64 (35.8%) and 29 (9.7%) of mental and GHC registrants, respectively, reported a history of suicidal attempts. Scores of the Beck Depression Inventory (BDI) for both suicidal ideation groups were above the severe level, although only 2% of GHC group recognized their diagnoses of depressive disorders. Conclusion The study observed high suicidal risk among the mental and GHC registrants. High BDI scores and unevaluated depression under score the need for screening and provision of appropriate early interventions in public community healthcare centers.

OBJECTIVE: To confirm the effects of combined upper limb robotic therapy (RT) as compared to conventional occupational therapy (OT) in tetraplegic spinal cord injury (SCI) patients and to suggest the optimized treatment guidelines of combined upper limb RT. METHODS: After subject recruitment and screening for eligibility, the baseline evaluation for outcome measures were performed. We evaluated the Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), the American Spinal Injury Association upper extremity motor score, grip and pinch strength, and the Spinal Cord Independence Measurement III (SCIM-III). In this study, the pre-tested participants were divided randomly into the RT and OT group. The utilized interventions included combined upper limb RT using ArmeoPower and Amadeo (RT group), or conventional OT (OT group) in addition to daily inpatient rehabilitation program. The participants underwent 40 minutes×3 sessions×5 weeks of interventions. RESULTS: A total of 30 tetraplegic SCI patients completed entire study program. After 5 weeks of intervention, both groups demonstrated increases in GRASSP-strength and SCIM-III. The manual muscle test scores of elbow flexion, elbow extension, 2-5th metacarpophalangeal extension, and SCIM-III subscores of bathing-upper, dressing-upper, and grooming as well as the GRASSP-qualitative prehension score were noted to have been significantly increased in the RT group as evaluated. The OT group showed improvements in the GRASSP-quantitative prehension score and some items in grip and pinch strength. There was no significant difference between the two groups in almost all measurements except for the SCIM-III bathing-upper subscore. CONCLUSION: Combined upper limb RT demonstrated beneficial effects on the upper limb motor function in patients with tetraplegic SCI, which were comparable with conventional OT.
Animals ; Elbow ; Grooming ; Hand Strength ; Humans ; Inpatients ; Mass Screening ; Occupational Therapy ; Outcome Assessment (Health Care) ; Pinch Strength ; Rehabilitation ; Robotics ; Spinal Cord Injuries ; Spinal Cord ; Spinal Injuries ; Upper Extremity

BACKGROUND: Sleep disorder is a precursor to depression, which is one of the psychological factors associated with periodontal disease that, in turn, affects general and periodontal health. This study aimed to investigate the relationship between sleep duration, depression, and periodontitis in older people aged over 65 years. METHODS: A total of 2,002 older adults aged 65 years or older were included in the study. Their general and health aspects, including smoking, drinking, diabetes, hypertension, and depression, were investigated. Periodontitis was examined using the Community Periodontal Index (CPI). Data were analyzed through a complex sampling design method. Frequency and crossover analyses were conducted to investigate the relationship between depression and periodontitis. To investigate the effect of depression on periodontitis, a logistic regression analysis was performed. RESULTS: Regarding depression and participants' general characteristics, statistically significant differences were found in sex, economic activity, smoking habit, and CPI (p<0.05). In the presence of depression, the odds ratio for periodontitis was 1.84, and the adjusted odds ratio for age, sex, economic activity, residence type, household income, education level, smoking habit, drinking, hypertension, and diabetes was 1.72, representing a significant difference (p<0.05). CONCLUSION: This study examined the relationship between depression and periodontitis in older persons and confirmed a significant correlation. As the population of older adults increases, we should pay attention to their mental and oral health as well as systemic diseases. Various programs for the health promotion of older persons need to be implemented to improve the quality of life of older people.
Adult ; Depression ; Drinking ; Education ; Family Characteristics ; Health Promotion ; Humans ; Hypertension ; Logistic Models ; Methods ; Odds Ratio ; Oral Health ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Psychology ; Quality of Life ; Sleep Wake Disorders ; Smoke ; Smoking

OBJECTIVE: The aim of this study is to investigate the effects of cognitive training and cognitive trainer on cognitive function in persons with mild cognitive impairment (MCI). METHODS: A randomized controlled single blind trial with 2 treatment groups was designed and 40 participants were included in this study. They received cognitive training intervention by cognitive professional and non-professional. The cognitive training focused on memory strategies. This cognitive intervention consisted of 8 sessions training and once a week. The effect of program was examined in performance-based measures of cognitive abilities; memory, language, constructional praxis, attention, and working memory. The comparison of effect of trainer was examined by repeated measure analysis of variance. RESULTS: Thirty-six MCI completed the cognitive intervention and was assessed neurocognitive test on pre- and post-intervention. Attention, language inhibition and semantic language were significantly improved compared with baseline in total group. The memory (p=0.003) was significantly improved in Professional Program Group and attention (p=0.007) was significantly improved in Non-Professional Program Group (NPG). Distinctively, Korean version of Short form of Geriatric Depression Scale mean score in NPG was statistically improved from 4.24 to 3.29 (p=0.018) after intervention, but the comparison between groups was not significant. CONCLUSION: This study shows that the cognitive intervention program may improve on memory, attention and language in cognitive functions of MCI. But there is difference in improvement of the domains of cognitive abilities depending on the trainer.
Cognition ; Depression ; Humans ; Memory ; Memory, Short-Term ; Mild Cognitive Impairment ; Semantics

BACKGROUND: Flow cytometry analysis of paroxysmal nocturnal hemoglobinuria (PNH) is significantly affected by the methodology used. The lack of data on the effect of age and refrigeration on PNH clone stability motivated us to study these aspects using flow cytometry. METHODS: Peripheral blood was collected from six patients, of which two presented with PNH. All samples were tested immediately and stored at room temperature (RT, 20–25℃) and at 4℃ for re-analysis at 24, 48, 72 hr and 7 days. Anti-CD59-fluorescein isothiocyanate (Beckman Coulter, USA) and anti-CD235a-phycoerythrin (PE; Beckman Coulter) were used to stain red blood cells (RBCs). Fluorescein-labeled proaerolysin (Cedarlane, Canada), anti-CD15-PE (Beckman Coulter), anti-CD24-PE-cyanin 5 (Beckman Coulter), and anti-CD45-PE-cyanin 7 (Beckman Coulter) were used to stain granulocytes. Flow cytometry was performed using a FC500 flow cytometer (Beckman Coulter). The effects of time and temperature were analyzed using generalized estimating equations. RESULTS: No significant differences in the gated percentage of RBCs and PNH clone size of RBCs were observed between the RT and 4℃ groups up to 7 days of testing. The percentage of gated neutrophils decreased with specimen age (P<0.001) and a better correlation with baseline was obtained at 4℃ than at RT (P=0.014). Neutrophil PNH clones were stable until 48 hr and 72 hr at RT and 4℃, respectively, and could not be analyzed at 7 days. CONCLUSIONS: RBC analysis was successfully performed up to 7 days. For neutrophils, testing within 48 hr is recommended, because the number of gated cells decreases significantly with age.
Clone Cells ; Erythrocytes ; Flow Cytometry ; Granulocytes ; Hemoglobinuria, Paroxysmal ; Humans ; Neutrophils ; Refrigeration