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.

Purpose: Frequent neutropenia hinders uninterrupted palbociclib treatment in patients with hormone receptor (HR)–positive breast cancer. We compared the efficacy outcomes in multicenter cohorts of patients with metastatic breast cancer (mBC) receiving palbociclib following conventional dose modification or limited modified schemes for afebrile grade 3 neutropenia. Materials and Methods: Patients with HR-positive, human epidermal growth factor receptor 2–negative mBC (n=434) receiving palbociclib with letrozole as first-line therapy were analyzed and classified based on neutropenia grade and afebrile grade 3 neutropenia management as follows: group 1 (maintained palbociclib dose, limited scheme), group 2 (dose delay or reduction, conventional scheme), group 3 (no afebrile grade 3 neutropenia event), and group 4 (grade 4 neutropenia event). The primary and secondary endpoints were progression-free survival (PFS) between groups 1 and 2 and PFS, overall survival, and safety profiles among all groups. Results: During follow-up (median 23.7 months), group 1 (2-year PFS, 67.9%) showed significantly longer PFS than did group 2 (2-year PFS, 55.3%; p=0.036), maintained across all subgroups, and upon adjustment of the factors. Febrile neutropenia occurred in one and two patients of group 1 and group 2, respectively, without mortality. Conclusion Limited dose modification for palbociclib-related grade 3 neutropenia may lead to longer PFS, without increasing toxicity, than the conventional dose scheme.

Objectives: The purpose of this study was to evaluate and report the antibacterial efficacy in relation to oral disease-causing bacteria using a mouthwash containing 0.05% CPC in an in vitro test. Methods: The sterilization test and susceptibility assay of mouthwash containing 0.05% CPC were investigated against Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus acidophilus;Streptococcus sanguinis as oral bacteria related to dental caries; Enterococcus faecalis as apical periodontitis-related bacteria; and Actinomyces israelii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescence, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Filifactor alocis as periodontal disease-related bacteria. Results: In the sterilization test, most of the bacteria had more than 99.99% sterilizing power for all samples but compared to other bacteria, the sterilizing power of these samples was not successful for L. acidophilus and E. faecalis bacteria. When comparing the sterilization power between the samples, sample 3 (0.05% CPC+20% ethanol) was the strongest. Conclusions In the antimicrobial activity test, sample 3 inhibited growth at the lowest concentration overall.

Objectives: The purpose of this study was to evaluate and report the antibacterial efficacy in relation to oral disease-causing bacteria using a mouthwash containing 0.05% CPC in an in vitro test. Methods: The sterilization test and susceptibility assay of mouthwash containing 0.05% CPC were investigated against Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus acidophilus;Streptococcus sanguinis as oral bacteria related to dental caries; Enterococcus faecalis as apical periodontitis-related bacteria; and Actinomyces israelii, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Prevotella nigrescence, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Filifactor alocis as periodontal disease-related bacteria. Results: In the sterilization test, most of the bacteria had more than 99.99% sterilizing power for all samples but compared to other bacteria, the sterilizing power of these samples was not successful for L. acidophilus and E. faecalis bacteria. When comparing the sterilization power between the samples, sample 3 (0.05% CPC+20% ethanol) was the strongest. Conclusions In the antimicrobial activity test, sample 3 inhibited growth at the lowest concentration overall.

PURPOSE: Femoral vein catheterization is often performed using a landmark technique, despite the recommended method of using ultrasound guidance. Although the landmark-based procedure is a well-known, widely adopted method to date, there are insufficient studies validating the effectiveness of this method. Hence, the purpose of this study was to confirm the relationship between femoral artery and vein using an ultrasound, as well as to validate the effectiveness of the femoral vein catheterization method using the landmark technique. METHODS: This was a prospective, repeated measurement study. Using an ultrasound with a 10 MHz transducer, the femoral vein cross-sectional areas on the right side were saved at a distance of 1, 2, 3, and 4 cm from the inguinal ligament with supine and hip abduction-external rotation positions. The width of the femoral vessels, center-to-center distance between the femoral artery and vein(horizontal distance between the center of the femoral artery and vein) and width of exposed femoral vein (not posterior to femoral artery) were measured. RESULTS: The width of the femoral vein, the center-to-center distance between the femoral artery and vein, as well as the width of the exposed femoral vein were significantly decreased as the distance from the inguinal ligament was increased, regardless of the posture change (p<0.001). However, at a distance of 1 cm from the inguinal ligament, only 5.4% of the femoral veins were exposed without disturbance of the femoral artery, and there were also a few cases in which the femoral veins were not exposed at all. CONCLUSION: It appears that an ultrasound-guided femoral vein catheterization is recommended over the conventional landmark technique.
Anatomic Landmarks ; Catheterization* ; Catheters ; Femoral Artery* ; Femoral Vein ; Hip ; Ligaments ; Methods ; Posture ; Prospective Studies* ; Transducers ; Ultrasonography* ; Veins*

PURPOSE: There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation. RESULTS: Thirty-five patients underwent DDLT, and 146 underwent LDLT. The 1-, 3-, and 5-year patient survival rates were 66.7%, 63.0%, and 63.0% in the DDLT group and 86.1%, 82.3%, and 79.5% in the LDLT group (P = 0.024), respectively. After propensity matching, the patient survival curve of the LDLT group was higher than that of the DDLT group. However, there was no statistically significant difference in patient survival between the 2 groups (P = 0.061). Recipient age ≥ 60 years, LDLT, and use of tacrolimus were positively associated with patient survival in multivariate analyses. CONCLUSION: LDLT appears to be suitable for HCV-infected patients if appropriate living donor is available.
Case-Control Studies* ; Consensus ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Immunosuppression ; Liver Transplantation ; Liver* ; Living Donors* ; Multivariate Analysis ; Propensity Score* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tacrolimus ; Tissue Donors

PURPOSE: There is no consensus regarding the difference in outcomes of HCV in patients who receive living donor liver transplantation (LDLT) or compared to deceased donor liver transplantation (DDLT). The aims of this study were to compare characteristics between LDLT and DDLT groups and to identify risk factors affecting patient survival. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent liver transplantation. RESULTS: Thirty-five patients underwent DDLT, and 146 underwent LDLT. The 1-, 3-, and 5-year patient survival rates were 66.7%, 63.0%, and 63.0% in the DDLT group and 86.1%, 82.3%, and 79.5% in the LDLT group (P = 0.024), respectively. After propensity matching, the patient survival curve of the LDLT group was higher than that of the DDLT group. However, there was no statistically significant difference in patient survival between the 2 groups (P = 0.061). Recipient age ≥ 60 years, LDLT, and use of tacrolimus were positively associated with patient survival in multivariate analyses. CONCLUSION: LDLT appears to be suitable for HCV-infected patients if appropriate living donor is available.
Case-Control Studies* ; Consensus ; Hepacivirus ; Hepatitis C* ; Hepatitis* ; Humans ; Immunosuppression ; Liver Transplantation ; Liver* ; Living Donors* ; Multivariate Analysis ; Propensity Score* ; Retrospective Studies ; Risk Factors ; Survival Rate ; Tacrolimus ; Tissue Donors

PURPOSE: HCV-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT. RESULTS: The 1-, 3-, and 5-year overall survival rates were 78.8%, 75.3%, and 73.1%, respectively. Excluding the cases of hospital mortality (n = 23), 169 patients were evaluated for patient survival. Most patients were genotype 1 (n = 111, 65.7%) or genotype 2 (n = 42, 24.9%). The proportion of living donors for LT (n = 135, 79.9%) was higher than that of deceased donors (deceased donor liver transplantation [DDLT], n = 34, 20.1%). The median donor and recipient ages were 32 years and 56 years, respectively. Twenty-eight patients (16.6%) died during the observation period. Seventy-five patients underwent universal prophylaxis and 15 received preemptive therapy. HCV recurrence was detected in 97 patients. Recipients who were older than 60, received DDLT, used cyclosporine, or suffered acute rejection had lower rates of survival. CONCLUSION: Patent survival rates of HCV patients after LT in Korea were comparable with other countries.
Cyclosporine ; Genotype ; Hepacivirus ; Hospital Mortality ; Humans ; Immunosuppression ; Korea* ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Recurrence ; Retrospective Studies ; Survival Rate ; Tacrolimus ; Tissue Donors

BACKGROUND/AIMS: The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR. METHODS: We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers. RESULTS: BPAR occurred in 39 (23.1%) of the HCV-RNA-positive recipients after LT. The 1-, 3-, and 5-year survival rates were 92.1%, 90.3%, and 88.5%, respectively, in patients without BPAR, and 75.7%, 63.4%, and 58.9% in patients with BPAR (P<0.001). Multivariate analyses showed that BPAR was associated with the non-use of basiliximab and tacrolimus and the use of cyclosporin in LT recipients with HCV RNA-positive. CONCLUSION: The results of the present study suggest that the immunosuppression status of HCV-RNA-positive LT recipients should be carefully determined in order to prevent BPAR and to improve patient survival.
Antibodies, Monoclonal/therapeutic use ; Biopsy ; Cyclosporine/therapeutic use ; Drug Therapy, Combination ; Genotype ; Graft Rejection/mortality/*prevention & control ; Hepacivirus/genetics/isolation & purification ; Hepatitis C/drug therapy/*virology ; Humans ; Immunosuppressive Agents/*therapeutic use ; *Liver Transplantation/adverse effects ; Polymerase Chain Reaction ; RNA, Viral/blood ; Recombinant Fusion Proteins/therapeutic use ; Recurrence ; Retrospective Studies ; Survival Rate ; Tacrolimus/therapeutic use

Small cell neuroendocrine carcinoma in the ampulla of Vater is a rare disease and there have only been three cases reported in Korea. In these three cases, the patients had symptoms of abdominal pain and jaundice. A biopsy via endoscopic retrograde cholangiopancreatography confirmed a small cell neuroendocrine carcinoma; thus, each patient underwent surgical treatment. Recently, we experienced a case of small cell neuroendocrine carcinoma in an asymptomatic patient. An ulcerative lesion was identified during screening gastroduodenoscopy. Here, we report this case and review the relevant literature.
Abdominal Pain ; Ampulla of Vater* ; Biopsy ; Carcinoma, Neuroendocrine* ; Cholangiopancreatography, Endoscopic Retrograde ; Duodenoscopy ; Humans ; Jaundice ; Korea ; Mass Screening ; Rare Diseases ; Ulcer