Background: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. Methods: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. Results: Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465). Conclusion Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.

Background: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. Methods: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. Results: Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465). Conclusion Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.

Background and Objectives: In chronic heart failure (HF), natriuretic peptide (NP) levels are higher in atrial fibrillation (AF) compared to sinus rhythm (SR). However, due to the loss of atrial contraction, AF patients are prone to hemodynamic decompensation at earlier stages.Since NP levels reflect disease severity, acutely decompensated AF patients may exhibit lower NP levels compared to SR patients, who retain greater hemodynamic reserve. Methods: We analyzed 5,048 patients with acute HF from the Korea Acute Heart Failure registry with available NP data. NP levels and echocardiographic parameters were compared between AF and SR patients. The association of NP levels with in-hospital and one-year mortality was also assessed according to cardiac rhythm. Results: Brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured in 2,027 and 3,021 patients, respectively. NP levels were lower in AF than in SR (median BNP, 740 vs. 1,044 pg/mL; median NT-proBNP, 4,420 vs. 5,198 pg/mL), particularly in HF with reduced or mildly reduced ejection fraction. A similar trend was observed regardless of HF onset or etiology. AF patients had smaller left ventricular (LV) end-diastolic diameter and larger left atrial size compared to SR patients. Higher NP tertiles were associated with increased in-hospital and one-year mortality in both groups. Conclusions In acute HF, NP levels are lower in AF than in SR. AF patients also exhibited smaller LV chamber sizes. Nevertheless, NP levels remain strong predictors of outcomes in both AF and SR patients.

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: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. Methods: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. Results: Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465). Conclusion Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.

Background: Shortage of organ donors in the Republic of Korea has become a major problem. To address this, it has been questioned whether heart transplant (HTx) allocation should be modified to reduce priority of older patients. We aimed to evaluate post-HTx outcomes according to recipient age and specific pre-HTx conditions using a nationwide prospective cohort. Methods: We analyzed clinical characteristics of 628 patients from the Korean Organ Transplant Registry who received HTx from January 2015 to December 2020. Enrolled recipients were divided into three groups according to age. We also included comorbidities including ambulatory status. Non-ambulatory status was defined as pre-HTx support with either extracorporeal membrane oxygenation, continuous renal replacement therapy, or mechanical ventilation. Results: Of the 628 patients, 195 were < 50 years, 322 were 50–64 years and 111 were ≥ 65years at transplant. Four hundred nine (65.1%) were ambulatory and 219 (34.9%) were nonambulatory. Older recipients tended to have more comorbidities, ischemic cardiomyopathy, and received older donors. Post-HTx survival was significantly lower in older recipients (P = 0.025) and recipients with non-ambulatory status (P < 0.001). However, in contrast to non-ambulatory recipients who showed significant survival differences according to the recipient’s age (P = 0.004), ambulatory recipients showed comparable outcomes (P = 0.465). Conclusion Our results do not support use of age alone as an allocation criterion. Transplant candidate age in combination with some comorbidities such as non-ambulatory status may identify patients at a sufficiently elevated risk at which suitability of HTx should be reconsidered.

Objective: This study aimed to investigate the effect of three-dimensional (3D) printed clear aligners (CA) with different designs on the extrusion of mandibular premolars using a force/moment measurement system and digital image correlation (DIC). Methods: The forces and moments applied to the mandibular canines, first and second premolars were measured using a multi-axis force/ moment transducer when an extrusion of 0.5 mm was planned, assuming the mandibular first premolars were intruded by 1 mm. In addition, displacement and strain changes in the CA were analyzed using the DIC method. CA designs were categorized based on the presence of first premolar attachment and subdivided into equigingival margins, 1-mm extended margins, equi-margins with 1-mm thickness and height, and equi-margins with 1-mm reduced buccolingual width.The CA was printed directly at a thickness of 0.5 mm, and the experiments were conducted at 37°C. Results: The results showed that attachment played an important role in the extrusion of first premolars in both the force/moment measurement system and the DIC method. Intrusion was observed without attachment, even though extrusion was planned. CA designs apply greater force to the cervical region by extending the margin or reducing the buccolingual width, thereby improving extrusion efficiency. Conclusions Force and moment changes in direct 3D printed CA are complex and difficult to predict; however, modifying aligner designs, such as extending the margin or reducing buccolingual width, and using appropriate attachments could minimize unwanted tooth movement, optimize planned treatment, and increase treatment predictability.

Objective: This study aimed to investigate the effect of three-dimensional (3D) printed clear aligners (CA) with different designs on the extrusion of mandibular premolars using a force/moment measurement system and digital image correlation (DIC). Methods: The forces and moments applied to the mandibular canines, first and second premolars were measured using a multi-axis force/ moment transducer when an extrusion of 0.5 mm was planned, assuming the mandibular first premolars were intruded by 1 mm. In addition, displacement and strain changes in the CA were analyzed using the DIC method. CA designs were categorized based on the presence of first premolar attachment and subdivided into equigingival margins, 1-mm extended margins, equi-margins with 1-mm thickness and height, and equi-margins with 1-mm reduced buccolingual width.The CA was printed directly at a thickness of 0.5 mm, and the experiments were conducted at 37°C. Results: The results showed that attachment played an important role in the extrusion of first premolars in both the force/moment measurement system and the DIC method. Intrusion was observed without attachment, even though extrusion was planned. CA designs apply greater force to the cervical region by extending the margin or reducing the buccolingual width, thereby improving extrusion efficiency. Conclusions Force and moment changes in direct 3D printed CA are complex and difficult to predict; however, modifying aligner designs, such as extending the margin or reducing buccolingual width, and using appropriate attachments could minimize unwanted tooth movement, optimize planned treatment, and increase treatment predictability.

Objective: This study aimed to investigate the effect of three-dimensional (3D) printed clear aligners (CA) with different designs on the extrusion of mandibular premolars using a force/moment measurement system and digital image correlation (DIC). Methods: The forces and moments applied to the mandibular canines, first and second premolars were measured using a multi-axis force/ moment transducer when an extrusion of 0.5 mm was planned, assuming the mandibular first premolars were intruded by 1 mm. In addition, displacement and strain changes in the CA were analyzed using the DIC method. CA designs were categorized based on the presence of first premolar attachment and subdivided into equigingival margins, 1-mm extended margins, equi-margins with 1-mm thickness and height, and equi-margins with 1-mm reduced buccolingual width.The CA was printed directly at a thickness of 0.5 mm, and the experiments were conducted at 37°C. Results: The results showed that attachment played an important role in the extrusion of first premolars in both the force/moment measurement system and the DIC method. Intrusion was observed without attachment, even though extrusion was planned. CA designs apply greater force to the cervical region by extending the margin or reducing the buccolingual width, thereby improving extrusion efficiency. Conclusions Force and moment changes in direct 3D printed CA are complex and difficult to predict; however, modifying aligner designs, such as extending the margin or reducing buccolingual width, and using appropriate attachments could minimize unwanted tooth movement, optimize planned treatment, and increase treatment predictability.

The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer. The median age of women diagnosed with breast cancer was 53.4 years, with the highest incidence occurring in the 40–49 age group. The most common molecular subtype was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative, accounting for 69.1% of cases, while HER2-positive subtypes comprised 19.3%. During the coronavirus disease 2019 pandemic, the national breast cancer screening rate declined. However, the incidence of early-stage breast cancer (stages 0 and I) continued to increase, accounting for 65.6% of newly diagnosed cases in 2021. Our results showed that the overall survival rate for patients with breast cancer has improved, primarily due to a rise in early-stage diagnoses and advancements in treatment.