Purpose: This study evaluated the feasibility of radical nephrectomy and thrombectomy without cardiopulmonary bypass (CPB) in patients with renal cell carcinoma (RCC) and level IV venous tumor thrombus, compared with CPB-assisted surgery. Materials and Methods: This retrospective cohort study analyzed patients with RCC and level IV venous tumor thrombus who underwent surgery at a single center between 2014 and 2020. Feasibility of non-CPB surgery was assessed by comparing perioperative safety-related outcomes, overall survival (OS), and progression-free survival (PFS) between the non-CPB and CPB groups. Perioperative outcomes included operative time, blood loss, severe complications (Clavien-Dindo classification grade ≥III), intensive care unit (ICU) stay, and mortality. Kaplan-Meier analysis and generalized Wilcoxon tests were used to compare survival outcomes. Results: A total of 16 patients met eligibility criteria: 5 underwent surgery without CPB, and 11 underwent CPB-assisted surgery. Median operative time was similar between the CPB and non-CPB groups (490 minutes vs. 480 minutes, p=0.650). Compared with the CPB group, blood loss was lower in the non-CPB group (4000 mL vs. 1080 mL, p=0.333). Severe complications occurred in 36.4% of CPB patients and 0% of non-CPB patients (p=0.245). ICU stay was comparable between the non-CPB and CPB groups (2 days vs. 3 days, p=0.356). OS did not differ significantly between groups (p=0.180), whereas PFS was longer in the non-CPB group (p=0.041). Conclusions Radical nephrectomy and thrombectomy without CPB appears feasible and may be associated with lower perioperative morbidity and blood loss without compromising oncologic outcomes. Non-CPB surgery should be considered in selected patients with level IV venous tumor thrombus when technically feasible.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

Background and Objectives: Outcomes of deferring percutaneous coronary intervention (PCI) without invasive physiologic assessment for intermediate coronary lesions is uncertain.We sought to compare long-term outcomes between medical treatment and PCI of intermediate lesions without invasive physiologic assessment. Methods: A total of 899 patients with intermediate coronary lesions between 50% and 70% diameter-stenosis were randomized to the conservative group (n=449) or the aggressive group (n=450). For intermediate lesions, PCI was performed in the aggressive group, but was deferred in the conservative group. The primary endpoint was major adverse cardiac events (MACE, a composite of all-cause death, myocardial infarction [MI], or ischemia-driven any revascularization) at 3 years. Results: The number of treated lesions per patient was 0.8±0.9 in the conservative group and 1.7±0.9 in the aggressive group (p=0.001). At 3 years, the conservative group had a significantly higher incidence of MACE than the aggressive group (13.8% vs. 9.3%; hazard ratio [HR], 1.49; 95% confidence interval [CI], 1.00–2.21; p=0.049), mainly driven by revascularization of target intermediate lesion (6.5% vs. 1.1%; HR, 5.69; 95% CI, 2.20–14.73;p<0.001). Between 1 and 3 years after the index procedure, compared to the aggressive group, the conservative group had significantly higher incidence of cardiac death or MI (3.2% vs.0.7%; HR, 4.34; 95% CI, 1.24–15.22; p=0.022) and ischemia-driven any revascularization. Conclusions For intermediate lesions, medical therapy alone, guided only by angiography, was associated with a higher risk of MACE at 3 years compared with performing PCI, mainly due to increased revascularization.

Background: This study aimed to identify factors that influence the maintenance of long-acting injectable antipsychotics (LAI) for over a year in patients with schizophrenia. Methods: Seventy patients from Naju National Hospital were divided into two groups: those who maintained LAI for over a year (maintaining group, n=39) and those who discontinued (dropout group, n=31). Sociodemographic and clinical factors were compared using medical records and assessments, including the Birchwood Insight Scale (BIS), Drug Attitude Inventory-10 (DAI-10), and World Health Organization Quality of Life assessment instrument. Results: The number of rehospitalizations was significantly lower in the maintaining group (p=0.030). The highest previous Global Assessment of Functioning Scale score within a year of starting LAI was significantly higher in the maintaining group (p=0.002), with a higher number of individuals being employed in this group (p=0.029). The mean BIS (p=0.010) and DAI-10 (p=0.003) scores were higher in the maintaining group. Logistic regression analysis revealed that the DAI-10 (B=0.148, p=0.014) had a significant impact on maintaining LAI. Conclusion Our study suggests that a positive drug attitude is one of the key factors in maintaining LAI treatment, preventing relapses and supporting long-term stabilization in schizophrenia.

Background: This study aimed to identify factors that influence the maintenance of long-acting injectable antipsychotics (LAI) for over a year in patients with schizophrenia. Methods: Seventy patients from Naju National Hospital were divided into two groups: those who maintained LAI for over a year (maintaining group, n=39) and those who discontinued (dropout group, n=31). Sociodemographic and clinical factors were compared using medical records and assessments, including the Birchwood Insight Scale (BIS), Drug Attitude Inventory-10 (DAI-10), and World Health Organization Quality of Life assessment instrument. Results: The number of rehospitalizations was significantly lower in the maintaining group (p=0.030). The highest previous Global Assessment of Functioning Scale score within a year of starting LAI was significantly higher in the maintaining group (p=0.002), with a higher number of individuals being employed in this group (p=0.029). The mean BIS (p=0.010) and DAI-10 (p=0.003) scores were higher in the maintaining group. Logistic regression analysis revealed that the DAI-10 (B=0.148, p=0.014) had a significant impact on maintaining LAI. Conclusion Our study suggests that a positive drug attitude is one of the key factors in maintaining LAI treatment, preventing relapses and supporting long-term stabilization in schizophrenia.

Background: This study aimed to identify factors that influence the maintenance of long-acting injectable antipsychotics (LAI) for over a year in patients with schizophrenia. Methods: Seventy patients from Naju National Hospital were divided into two groups: those who maintained LAI for over a year (maintaining group, n=39) and those who discontinued (dropout group, n=31). Sociodemographic and clinical factors were compared using medical records and assessments, including the Birchwood Insight Scale (BIS), Drug Attitude Inventory-10 (DAI-10), and World Health Organization Quality of Life assessment instrument. Results: The number of rehospitalizations was significantly lower in the maintaining group (p=0.030). The highest previous Global Assessment of Functioning Scale score within a year of starting LAI was significantly higher in the maintaining group (p=0.002), with a higher number of individuals being employed in this group (p=0.029). The mean BIS (p=0.010) and DAI-10 (p=0.003) scores were higher in the maintaining group. Logistic regression analysis revealed that the DAI-10 (B=0.148, p=0.014) had a significant impact on maintaining LAI. Conclusion Our study suggests that a positive drug attitude is one of the key factors in maintaining LAI treatment, preventing relapses and supporting long-term stabilization in schizophrenia.

Background: This study aimed to identify factors that influence the maintenance of long-acting injectable antipsychotics (LAI) for over a year in patients with schizophrenia. Methods: Seventy patients from Naju National Hospital were divided into two groups: those who maintained LAI for over a year (maintaining group, n=39) and those who discontinued (dropout group, n=31). Sociodemographic and clinical factors were compared using medical records and assessments, including the Birchwood Insight Scale (BIS), Drug Attitude Inventory-10 (DAI-10), and World Health Organization Quality of Life assessment instrument. Results: The number of rehospitalizations was significantly lower in the maintaining group (p=0.030). The highest previous Global Assessment of Functioning Scale score within a year of starting LAI was significantly higher in the maintaining group (p=0.002), with a higher number of individuals being employed in this group (p=0.029). The mean BIS (p=0.010) and DAI-10 (p=0.003) scores were higher in the maintaining group. Logistic regression analysis revealed that the DAI-10 (B=0.148, p=0.014) had a significant impact on maintaining LAI. Conclusion Our study suggests that a positive drug attitude is one of the key factors in maintaining LAI treatment, preventing relapses and supporting long-term stabilization in schizophrenia.

Background: This study aimed to identify factors that influence the maintenance of long-acting injectable antipsychotics (LAI) for over a year in patients with schizophrenia. Methods: Seventy patients from Naju National Hospital were divided into two groups: those who maintained LAI for over a year (maintaining group, n=39) and those who discontinued (dropout group, n=31). Sociodemographic and clinical factors were compared using medical records and assessments, including the Birchwood Insight Scale (BIS), Drug Attitude Inventory-10 (DAI-10), and World Health Organization Quality of Life assessment instrument. Results: The number of rehospitalizations was significantly lower in the maintaining group (p=0.030). The highest previous Global Assessment of Functioning Scale score within a year of starting LAI was significantly higher in the maintaining group (p=0.002), with a higher number of individuals being employed in this group (p=0.029). The mean BIS (p=0.010) and DAI-10 (p=0.003) scores were higher in the maintaining group. Logistic regression analysis revealed that the DAI-10 (B=0.148, p=0.014) had a significant impact on maintaining LAI. Conclusion Our study suggests that a positive drug attitude is one of the key factors in maintaining LAI treatment, preventing relapses and supporting long-term stabilization in schizophrenia.