1.Palliative Care and Hospice for Heart Failure Patients: Position Statement From the Korean Society of Heart Failure
Seung-Mok LEE ; Hae-Young LEE ; Shin Hye YOO ; Hyun-Jai CHO ; Jong-Chan YOUN ; Seong-Mi PARK ; Jin-Ok JEONG ; Min-Seok KIM ; Chi Young SHIM ; Jin Joo PARK ; Kye Hun KIM ; Eung Ju KIM ; Jeong Hoon YANG ; Jae Yeong CHO ; Sang-Ho JO ; Kyung-Kuk HWANG ; Ju-Hee LEE ; In-Cheol KIM ; Gi Beom KIM ; Jung Hyun CHOI ; Sung-Hee SHIN ; Wook-Jin CHUNG ; Seok-Min KANG ; Myeong Chan CHO ; Dae-Gyun PARK ; Byung-Su YOO
International Journal of Heart Failure 2025;7(1):32-46
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.
2.Hypoxia‑inducible factor‑1α‑deficient adipose‑tissue macrophages produce the heat to mediate lipolysis of white adipose tissue through uncoupling protein‑1
Gi‑Sue KANG ; Young‑Eun KIM ; Ho Rim OH ; Hye‑Ju JO ; Seoyeon BOK ; Yoon Kyung JEON ; Gi Jeong CHEON ; Tae‑Young ROH ; Young‑Tae CHANG ; Do Joong PARK ; G‑One AHN
Laboratory Animal Research 2024;40(4):408-423
Background:
Uncoupling protein 1 (UCP1) is a proton uncoupler located across the mitochondrial membrane gener‑ ally involved in thermogenesis of brown adipose tissues. Although UCP1 is known to be strongly expressed in brown adipocytes, recent evidence suggest that white adipocytes can also express UCP1 under certain circumstances such as cold- or β-adrenergic receptor-stimulation, allowing them to acquire brown adipocyte-like features thereby becoming ’beige’ adipocytes.
Results:
In this study, we report that UCP1 can be expressed in adipose-tissue macrophages (ATM) lacking func‑ tional hypoxia-inducible factor-1 (HIF-1) and this does not require cold- nor β-adrenergic receptor activation. By using myeloid-specific Hif-1α knockout (KO) mice, we observed that these mice were protected from diet-induced obesity and exhibited an improved thermogenic tolerance upon cold challenge. ATM isolated from white adipose tissues (WAT) of these mice fed with high fat diet exhibited significantly higher M2-polarization, decreased gly‑ colysis, increased mitochondrial functions and acetyl-CoA levels, along with increased expression of Ucp1, peroxisome proliferator activated receptor-gamma co-activator-1a, and others involved in histone acetylation. Consistent with the increased Ucp1 gene expression, these ATM produced a significant amount of heat mediating lipolysis of cocultured adipocytes liberating free fatty acid. Treating ATM with acetate, a substrate for acetyl-CoA synthesis was able to boost the heat production in wild-type or Hif-1α-deficient but not UCP1-deficient macrophages, indicating that UCP1 was necessary for the heat production in macrophages. Lastly, we observed a significant inverse correlation between the number of UCP1-expressing ATM in WAT and the body mass index of human individuals.
Conclusions
UCP1-expressing ATM produce the heat to mediate lipolysis of adipocytes, indicating that this can be a novel strategy to treat and prevent diet-induced obesity.
3.Evaluation of Radioactivity in Therapeutic Radiopharmaceutical Waste
Jung Ju JO ; Su Hyoung LEE ; Beom Hoon KI ; Ho Jin RYU ; Tae Hwan KIM ; Gi Sub KIM ; Sang Kyu LEE ; Dong Wook KIM ; Kum Bae KIM ; Sangrok KIM ; Sang Hyoun CHOI
Progress in Medical Physics 2024;35(4):163-171
Purpose:
This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices.
Methods:
I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations.
Results:
For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines.
Conclusions
These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.
4.Hypoxia‑inducible factor‑1α‑deficient adipose‑tissue macrophages produce the heat to mediate lipolysis of white adipose tissue through uncoupling protein‑1
Gi‑Sue KANG ; Young‑Eun KIM ; Ho Rim OH ; Hye‑Ju JO ; Seoyeon BOK ; Yoon Kyung JEON ; Gi Jeong CHEON ; Tae‑Young ROH ; Young‑Tae CHANG ; Do Joong PARK ; G‑One AHN
Laboratory Animal Research 2024;40(4):408-423
Background:
Uncoupling protein 1 (UCP1) is a proton uncoupler located across the mitochondrial membrane gener‑ ally involved in thermogenesis of brown adipose tissues. Although UCP1 is known to be strongly expressed in brown adipocytes, recent evidence suggest that white adipocytes can also express UCP1 under certain circumstances such as cold- or β-adrenergic receptor-stimulation, allowing them to acquire brown adipocyte-like features thereby becoming ’beige’ adipocytes.
Results:
In this study, we report that UCP1 can be expressed in adipose-tissue macrophages (ATM) lacking func‑ tional hypoxia-inducible factor-1 (HIF-1) and this does not require cold- nor β-adrenergic receptor activation. By using myeloid-specific Hif-1α knockout (KO) mice, we observed that these mice were protected from diet-induced obesity and exhibited an improved thermogenic tolerance upon cold challenge. ATM isolated from white adipose tissues (WAT) of these mice fed with high fat diet exhibited significantly higher M2-polarization, decreased gly‑ colysis, increased mitochondrial functions and acetyl-CoA levels, along with increased expression of Ucp1, peroxisome proliferator activated receptor-gamma co-activator-1a, and others involved in histone acetylation. Consistent with the increased Ucp1 gene expression, these ATM produced a significant amount of heat mediating lipolysis of cocultured adipocytes liberating free fatty acid. Treating ATM with acetate, a substrate for acetyl-CoA synthesis was able to boost the heat production in wild-type or Hif-1α-deficient but not UCP1-deficient macrophages, indicating that UCP1 was necessary for the heat production in macrophages. Lastly, we observed a significant inverse correlation between the number of UCP1-expressing ATM in WAT and the body mass index of human individuals.
Conclusions
UCP1-expressing ATM produce the heat to mediate lipolysis of adipocytes, indicating that this can be a novel strategy to treat and prevent diet-induced obesity.
5.Evaluation of Radioactivity in Therapeutic Radiopharmaceutical Waste
Jung Ju JO ; Su Hyoung LEE ; Beom Hoon KI ; Ho Jin RYU ; Tae Hwan KIM ; Gi Sub KIM ; Sang Kyu LEE ; Dong Wook KIM ; Kum Bae KIM ; Sangrok KIM ; Sang Hyoun CHOI
Progress in Medical Physics 2024;35(4):163-171
Purpose:
This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices.
Methods:
I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations.
Results:
For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines.
Conclusions
These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.
6.Hypoxia‑inducible factor‑1α‑deficient adipose‑tissue macrophages produce the heat to mediate lipolysis of white adipose tissue through uncoupling protein‑1
Gi‑Sue KANG ; Young‑Eun KIM ; Ho Rim OH ; Hye‑Ju JO ; Seoyeon BOK ; Yoon Kyung JEON ; Gi Jeong CHEON ; Tae‑Young ROH ; Young‑Tae CHANG ; Do Joong PARK ; G‑One AHN
Laboratory Animal Research 2024;40(4):408-423
Background:
Uncoupling protein 1 (UCP1) is a proton uncoupler located across the mitochondrial membrane gener‑ ally involved in thermogenesis of brown adipose tissues. Although UCP1 is known to be strongly expressed in brown adipocytes, recent evidence suggest that white adipocytes can also express UCP1 under certain circumstances such as cold- or β-adrenergic receptor-stimulation, allowing them to acquire brown adipocyte-like features thereby becoming ’beige’ adipocytes.
Results:
In this study, we report that UCP1 can be expressed in adipose-tissue macrophages (ATM) lacking func‑ tional hypoxia-inducible factor-1 (HIF-1) and this does not require cold- nor β-adrenergic receptor activation. By using myeloid-specific Hif-1α knockout (KO) mice, we observed that these mice were protected from diet-induced obesity and exhibited an improved thermogenic tolerance upon cold challenge. ATM isolated from white adipose tissues (WAT) of these mice fed with high fat diet exhibited significantly higher M2-polarization, decreased gly‑ colysis, increased mitochondrial functions and acetyl-CoA levels, along with increased expression of Ucp1, peroxisome proliferator activated receptor-gamma co-activator-1a, and others involved in histone acetylation. Consistent with the increased Ucp1 gene expression, these ATM produced a significant amount of heat mediating lipolysis of cocultured adipocytes liberating free fatty acid. Treating ATM with acetate, a substrate for acetyl-CoA synthesis was able to boost the heat production in wild-type or Hif-1α-deficient but not UCP1-deficient macrophages, indicating that UCP1 was necessary for the heat production in macrophages. Lastly, we observed a significant inverse correlation between the number of UCP1-expressing ATM in WAT and the body mass index of human individuals.
Conclusions
UCP1-expressing ATM produce the heat to mediate lipolysis of adipocytes, indicating that this can be a novel strategy to treat and prevent diet-induced obesity.
7.Evaluation of Radioactivity in Therapeutic Radiopharmaceutical Waste
Jung Ju JO ; Su Hyoung LEE ; Beom Hoon KI ; Ho Jin RYU ; Tae Hwan KIM ; Gi Sub KIM ; Sang Kyu LEE ; Dong Wook KIM ; Kum Bae KIM ; Sangrok KIM ; Sang Hyoun CHOI
Progress in Medical Physics 2024;35(4):163-171
Purpose:
This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices.
Methods:
I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations.
Results:
For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines.
Conclusions
These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.
8.Hypoxia‑inducible factor‑1α‑deficient adipose‑tissue macrophages produce the heat to mediate lipolysis of white adipose tissue through uncoupling protein‑1
Gi‑Sue KANG ; Young‑Eun KIM ; Ho Rim OH ; Hye‑Ju JO ; Seoyeon BOK ; Yoon Kyung JEON ; Gi Jeong CHEON ; Tae‑Young ROH ; Young‑Tae CHANG ; Do Joong PARK ; G‑One AHN
Laboratory Animal Research 2024;40(4):408-423
Background:
Uncoupling protein 1 (UCP1) is a proton uncoupler located across the mitochondrial membrane gener‑ ally involved in thermogenesis of brown adipose tissues. Although UCP1 is known to be strongly expressed in brown adipocytes, recent evidence suggest that white adipocytes can also express UCP1 under certain circumstances such as cold- or β-adrenergic receptor-stimulation, allowing them to acquire brown adipocyte-like features thereby becoming ’beige’ adipocytes.
Results:
In this study, we report that UCP1 can be expressed in adipose-tissue macrophages (ATM) lacking func‑ tional hypoxia-inducible factor-1 (HIF-1) and this does not require cold- nor β-adrenergic receptor activation. By using myeloid-specific Hif-1α knockout (KO) mice, we observed that these mice were protected from diet-induced obesity and exhibited an improved thermogenic tolerance upon cold challenge. ATM isolated from white adipose tissues (WAT) of these mice fed with high fat diet exhibited significantly higher M2-polarization, decreased gly‑ colysis, increased mitochondrial functions and acetyl-CoA levels, along with increased expression of Ucp1, peroxisome proliferator activated receptor-gamma co-activator-1a, and others involved in histone acetylation. Consistent with the increased Ucp1 gene expression, these ATM produced a significant amount of heat mediating lipolysis of cocultured adipocytes liberating free fatty acid. Treating ATM with acetate, a substrate for acetyl-CoA synthesis was able to boost the heat production in wild-type or Hif-1α-deficient but not UCP1-deficient macrophages, indicating that UCP1 was necessary for the heat production in macrophages. Lastly, we observed a significant inverse correlation between the number of UCP1-expressing ATM in WAT and the body mass index of human individuals.
Conclusions
UCP1-expressing ATM produce the heat to mediate lipolysis of adipocytes, indicating that this can be a novel strategy to treat and prevent diet-induced obesity.
9.Evaluation of Radioactivity in Therapeutic Radiopharmaceutical Waste
Jung Ju JO ; Su Hyoung LEE ; Beom Hoon KI ; Ho Jin RYU ; Tae Hwan KIM ; Gi Sub KIM ; Sang Kyu LEE ; Dong Wook KIM ; Kum Bae KIM ; Sangrok KIM ; Sang Hyoun CHOI
Progress in Medical Physics 2024;35(4):163-171
Purpose:
This study aims to systematically analyze the radioactive waste generated from treatments using radioactive Iodine-131 (I-131), Lutetium-177 (Lu-177), and Actinium-225 (Ac-225) to facilitate safe waste management practices.
Methods:
I-131 is primarily used in thyroid cancer treatment, while Lu-177 and Ac-225 are used to treat prostate cancer. Radioactive waste generated after these treatments was collected from patients at the Korea Cancer Center Hospital and categorized into clothing, slippers, syringes, and other items. The radioactivity concentration of each item was measured using a calibrated highpurity germanium detector. Using measurements, the self-disposal date of each waste item was calculated according to the permissible disposal levels defined by the Nuclear Safety and Security Commission (NSSC) under domestic nuclear safety regulations.
Results:
For the I-131 radioactive waste, clothing, towels, and tableware exhibited high radioactivity concentrations, with most items exceeding the permissible self-disposal levels.Conversely, the type and quantity of waste generated from Lu-177 and Ac-225 that were intravenously injected were relatively minimal, with certain items below the self-disposal thresholds, enabling immediate disposal. For Ac-225, no permissible self-disposal concentration is specified by the NSSC, unlike other therapeutic nuclides. Hence, additional studies are required to establish clear guidelines.
Conclusions
These findings provide valuable data for optimizing radioactive waste management, potentially reducing disposal time and costs, minimizing radiation exposure, and enhancing hospital safety practices.
10.Hypoxia‑inducible factor‑1α‑deficient adipose‑tissue macrophages produce the heat to mediate lipolysis of white adipose tissue through uncoupling protein‑1
Gi‑Sue KANG ; Young‑Eun KIM ; Ho Rim OH ; Hye‑Ju JO ; Seoyeon BOK ; Yoon Kyung JEON ; Gi Jeong CHEON ; Tae‑Young ROH ; Young‑Tae CHANG ; Do Joong PARK ; G‑One AHN
Laboratory Animal Research 2024;40(4):408-423
Background:
Uncoupling protein 1 (UCP1) is a proton uncoupler located across the mitochondrial membrane gener‑ ally involved in thermogenesis of brown adipose tissues. Although UCP1 is known to be strongly expressed in brown adipocytes, recent evidence suggest that white adipocytes can also express UCP1 under certain circumstances such as cold- or β-adrenergic receptor-stimulation, allowing them to acquire brown adipocyte-like features thereby becoming ’beige’ adipocytes.
Results:
In this study, we report that UCP1 can be expressed in adipose-tissue macrophages (ATM) lacking func‑ tional hypoxia-inducible factor-1 (HIF-1) and this does not require cold- nor β-adrenergic receptor activation. By using myeloid-specific Hif-1α knockout (KO) mice, we observed that these mice were protected from diet-induced obesity and exhibited an improved thermogenic tolerance upon cold challenge. ATM isolated from white adipose tissues (WAT) of these mice fed with high fat diet exhibited significantly higher M2-polarization, decreased gly‑ colysis, increased mitochondrial functions and acetyl-CoA levels, along with increased expression of Ucp1, peroxisome proliferator activated receptor-gamma co-activator-1a, and others involved in histone acetylation. Consistent with the increased Ucp1 gene expression, these ATM produced a significant amount of heat mediating lipolysis of cocultured adipocytes liberating free fatty acid. Treating ATM with acetate, a substrate for acetyl-CoA synthesis was able to boost the heat production in wild-type or Hif-1α-deficient but not UCP1-deficient macrophages, indicating that UCP1 was necessary for the heat production in macrophages. Lastly, we observed a significant inverse correlation between the number of UCP1-expressing ATM in WAT and the body mass index of human individuals.
Conclusions
UCP1-expressing ATM produce the heat to mediate lipolysis of adipocytes, indicating that this can be a novel strategy to treat and prevent diet-induced obesity.

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