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.

Endostatin is released during extracellular matrix remodeling and is involved in the development of vascular pathology and cardiovascular (CV) disease. However, the role of circulating endostatin as a biomarker of vascular calcification and CV events in patients undergoing hemodialysis (HD) remains unclear. Methods: A total of 372 patients undergoing HD were prospectively recruited. Plasma endostatin levels were measured at baseline, and their associations with circulating mineral bone disease (MBD) biomarkers and abdominal aortic vascular calcification scores were analyzed. The primary endpoint was defined as a composite of CV and cardiac events. Results: Plasma levels of patients in endostatin tertile 3 were significantly associated with low-density lipoprotein cholesterol levels and predialysis systolic blood pressure in multivariate analysis. However, endostatin levels did not correlate with circulating MBD biomarkers or vascular calcification scores. Patients in endostatin tertile 3 had a significantly higher cumulative event rate for the composite of CV events (p = 0.006). Endostatin tertile 3 was also associated with an increased cumulative rate of cardiac events (p = 0.04). In multivariate Cox regression analyses, endostatin tertile 3 was associated with a 4.37-fold risk for composite CV events and a 3.88-fold risk for cardiac events after adjusting for multiple variables. Conclusion: Higher circulating endostatin levels were independently associated with atherosclerotic risk factors but did not correlate with MBD markers or vascular calcification. Higher circulating endostatin levels were associated with a greater risk of composite CV events in patients undergoing HD, and endostatin is a biomarker that helps to determine the high risk of CV events.

Purpose: This study aimed to analyze the treatment outcomes of combined definitive radiation therapy (RT) and androgen deprivation therapy (ADT) for clinically node-positive prostate cancer. Materials and Methods: Medical records of 60 patients with clinically suspected metastatic lymph nodes on radiological examination were retrospectively analyzed. Eight patients (13.3%) were suspected to have metastatic common iliac or para-aortic lymph nodes. All patients underwent definitive RT with a dose fractionation of 70 Gy in 28 fractions. ADT was initiated 2–3 months before RT and continued for at least 2 years. Biochemical failure rate (BFR), clinical failure rate (CFR), overall survival (OS), and prostate cancer-specific survival (PCSS) were calculated, and genitourinary and gastrointestinal adverse events were recorded. Results: The median follow-up period was 5.47 years. The 5-year BFR, CFR, OS, and PCSS rates were 19.1%, 11.3%, 89.0%, and 98.2%, respectively. The median duration of ADT was 2.30 years. BFR and CFR increased after 3 years, and 11 out of 14 biochemical failures occurred after the cessation of ADT. Grade 2 and beyond late genitourinary and gastrointestinal toxicity rates were 5.0% and 13.3%, respectively. However, only two grade 3 adverse events were reported, and no grade 4–5 adverse events were reported. Patients with non-regional lymph node metastases did not have worse BFR, CFR, or adverse event rates. Conclusion This study reported the efficacy and tolerable toxicity of hypofractionated definitive RT combined with ADT for clinically node-positive prostate cancer. Additionally, selected patients with adjacent non-regional lymph node metastases might be able to undergo definitive RT combined with ADT.

Background: The coronavirus disease-2019 (COVID-19) pandemic has contributed to the change in the epidemiology of many infectious diseases. This study aimed to establish the pre-pandemic epidemiology of pediatric invasive bacterial infection (IBI). Methods: A retrospective multicenter-based surveillance for pediatric IBIs has been maintained from 1996 to 2020 in Korea. IBIs caused by eight bacteria (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Listeria monocytogenes, and Salmonella species) in immunocompetent children > 3 months of age were collected at 29 centers. The annual trend in the proportion of IBIs by each pathogen was analyzed. Results: A total of 2,195 episodes were identified during the 25-year period between 1996 and 2020. S. pneumoniae (42.4%), S. aureus (22.1%), and Salmonella species (21.0%) were common in children 3 to 59 months of age. In children ≥ 5 years of age, S. aureus (58.1%), followed by Salmonella species (14.8%) and S. pneumoniae (12.2%) were common. Excluding the year 2020, there was a trend toward a decrease in the relative proportions of S. pneumoniae (rs = −0.430, P = 0.036), H. influenzae (rs = −0.922, P < 0.001), while trend toward an increase in the relative proportion of S. aureus (rs = 0.850, P < 0.001), S. agalactiae (rs = 0.615, P = 0.001), and S. pyogenes (rs = 0.554, P = 0.005). Conclusion In the proportion of IBIs over a 24-year period between 1996 and 2019, we observed a decreasing trend for S. pneumoniae and H. influenzae and an increasing trend for S. aureus, S. agalactiae, and S. pyogenes in children > 3 months of age. These findings can be used as the baseline data to navigate the trend in the epidemiology of pediatric IBI in the post COVID-19 era.

This was a clinical trial study to aid the recovery of elderly female alcoholic liver disease patients by providing a balanced nutritional supplement comprising soymilk. All patients gave their consent before enrolling. The average demographics of the subjects were age 81.57 years, height 150.43 cm, weight 52.67 kg, and body mass index 24.15 kg/m2 . An increase in the daily consumption of fruits and fruit juice was observed after the patients had started taking the balanced meal as compared to before. Intakes of vitamin A, vitamin C, vitamin E, and cholesterol decreased after consuming soymilk, whereas vitamin B 12, niacin, folic acid, and dietary fiber significantly increased (P<0.05). Blood cholesterol and BUN levels showed a decreasing tendency.Our results indicate that consuming soymilk in a balanced diet for female patients afflicted with alcoholic liver disease helps improve their nutritional status by increasing the nutrients lacking in the body.

A resorbable barrier membrane is commonly used for the repair of perforated sinus membranes during sinus lifting surgeries. However, repairing largescale perforations poses challenges for clinicians as the protection and isolation of graft material remain uncertain. With this technique, we aimed to prevent graft material loss and subsequent sinus-related complications using intra-sinus rigid fixation of the resorbable barrier membrane in cases with a large perforation of the sinus membrane.

Xerostomia is defined as the subjective complaint of dry mouth with or without hyposalivation, which is insufficient salivary secretion from salivary gland. Xerostomia can lead to multiple oral symptoms such as dental caries, halitosis, burning mouth syndrome, and oral candidiasis, which can significantly impact the well-being of patients, especially in geriatric patients who may already have compromised health. Clinical findings of xerostomia include decreased salivary flow and alterations in salivary composition. These changes can lead to various oral health problems such as dental caries, periodontitis, swallowing and speaking difficulties, taste disturbances, halitosis, mucosal diseases, and burning mouth syndrome. Recognizing these clinical manifestations is essential for early diagnosis and appropriate management. Although several reasons and risk factors have been suggested for xerostomia such as aging, chemo-radiation therapy, systemic disease, and Sjögren’s syndrome, the polypharmacy is recently highlighted especially in elderly patients. Understanding the etiology and risk factors associated with xerostomia is crucial for effective management. To manage xerostomia patients, a multidisciplinary guideline should be established beyond dental care. Through this literature review, we summarized consideration for diagnostic, therapeutic, nursing essentials for the clinical guideline. By addressing the underlying causes and implementing appropriate treatment strategies, healthcare professionals can improve the quality of life for individuals suffering from xerostomia.

Background: The primary objective of this study was to assess the clinical effectiveness of fused images obtained from single-photon emission computed tomography (SPECT) and facial computed tomography (CT) for evaluat‑ ing degenerative changes in the mandibular condylar head. This assessment was accomplished by comparing the Technetium-99 m methylene diphosphonate ( 99m Tc-MDP) uptake ratio with the results of clinical and radiographic findings. Methods: The study included 17 patients (3 males and 14 females) with suspected osteoarthritis of the mandibular condyle, totaling 34 temporomandibular joints (TMJs). Based on clinical and radiographic examinations, the TMJs were categorized into four groups: normal (group N), internal derangement (group ID), osteoarthritis (group OA), and osteoarthritis sequelae (group ­OA seq ). For each patient, bone SPECT and facial CT scans were registered and reconstructed to create fused SPECT/CT images. The 99m Tc-MDP uptake levels in the TMJs were statistically com‑ pared among the four groups. Results: The 99m Tc-MDP uptake ratio showed a gradual increase in the order of the following: group N, group OA seq , group ID, and group OA. There was a significant difference observed among groups (pConclusion Fused SPECT/CT image can be an effective tool for evaluating degenerative changes in the mandibular condylar head. The technique demonstrated the ability to differentiate between normal TMJs and those with internal derangement, osteoarthritis, or osteoarthritis sequelae. This approach holds promise as a valuable method in clinical assessments of TMJ degeneration.

Superficial angiomyxoma (SA) is a rare, benign, cutaneous soft tissue tumor. It is composed of myxoid matrix and blood vessels. Herein, we report a case of a solitary SA on the posterior neck of a 6-year-old boy. An analysis of the biopsied specimen showed a prominent myxoid stroma with thin-walled, branching blood vessels, revealing the presence of an SA. SA especially that originating in the posterior neck, is rarely seen and should be considered as a differential diagnosis for a solitary mass in the posterior neck.

Background: Endoscope-assisted surgery is a surgical method that has been used in oral and maxillofacial surgical fields. It provides good illumination, clear, and magnified visualization of the operative field. The purpose of this article is to describe the early clinical experiences to conduct minimally invasive surgery with endoscope-assisted enucleation of cysts on the jaw. It appears that this approach may be a superior alternative to the conventional approach. Methods: In this study, 24 patients (9 females, 15 males, average age 41.5) underwent endoscope-assisted cyst enucleation under general anesthesia. All operations were done by one surgeon. The cases were classified depending on whether bone penetration occurred at the cyst site. The cystic lesions were enucleated using an endoscope with a 0°, 1.9 mm diameter, or a 30°, 2.7 mm diameter. Two bony windows were used for the insertion of a syringe for irrigation, curettes, suction tips, sinus blades, surgical drills, and an endoscope. An additional small channel was made for the insertion of endoscopic instruments. Results: The 24 patients who underwent cyst enucleation were regularly observed for 3 to 12 months to evaluate for complications. Although some patients experienced swelling and numbness, these symptoms did not persist, and the patients soon returned to normal and there was no sign of recurrence. Conclusions The results of this study have suggested the possibility of minimally invasive surgery with endoscopes when it comes to cyst removal in the oral and maxillofacial region. Nevertheless, this study has limitations designed as a preliminary report focusing on the feasibility of endoscope-assisted cyst enucleation in the oral and maxillofacial regions.