Purpose: The purpose of this study was to understand the experience of peer supporters for patients with schizophrenia and identify the meanings of their experiences. Methods: Eleven participants were included in this study. Giorgi’s phenomenological research methodology was used. The data were collected between August, 2022 and January, 2023 through in-depth individual interviews. Results: Four clusters of themes were identified. “Overcoming fear and managing one’s own life”, “A lot of mountains to overcome, but I'm going over them”, “A confident appearance in the world”, and “Being part of the treatment team”. Conclusion Individuals with schizophrenia and peer supporters should be integrated into the treatment team by implementing appropriate policies. Education programs should also be provided accordingly. In addition, it is very important to develop a program that can train peer supporters among schizophrenic patients and expand patient management services that can help them recover from the disorder. These efforts will help patients with schizophrenia achieve vocational and social rehabilitation.

Albizzia julibrissin (AJ) is an herbal medicine that shows low toxicity, promotes promoting blood circulation and mitigates the inflammation and has mild side effects. Benign prostate hyperplasia (BPH) is one of the most common diseases that occurs in older males and often results in lower urinary tract symptoms. This study was conducted to evaluate the protective effect of AJ against BPH using LNCaP cells and Sprague Dawley rats treated with testosterone. Treatment with AJ extract reduced the expression of androgen receptor (AR) and prostate-specific antigen (PSA) in vitro. In vivo, rats were divided into 6 groups: 1 (Normal Control); 2 (Testosterone propionate (TP) alone); 3 (TP + finasteride); 4 (TP + AJ 10 mg/kg); 5 (TP + AJ 50 mg/kg); 6 (TP + AJ 300 mg/kg). The groups treated with AJ showed reduced the relative prostate weights and BPH-related proteins were altered, with decreased AR, PSA and proliferating cell nuclear antigen (PCNA) observed by western blot. Histopathological analysis revealed the therapeutic effect of AJ, with a decreased thickness of epithelial cells and reduced level of PCNA and 5α-reductase type 2. These results suggest that AJ extract could ameliorate testosterone-induced benign prostatic hyperplasia.
Albizzia ; Animals ; Blood Circulation ; Blotting, Western ; Diethylpropion ; Epithelial Cells ; Herbal Medicine ; Humans ; Hyperplasia ; In Vitro Techniques ; Inflammation ; Lower Urinary Tract Symptoms ; Male ; Proliferating Cell Nuclear Antigen ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Rats ; Rats, Sprague-Dawley ; Receptors, Androgen ; Testosterone ; Weights and Measures

PURPOSE: Many recent studies have reported that successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) for chronic total occlusion (CTO) has more beneficial effects than failed CTO-PCI; however, there are only limited data available from comparisons of successful CTO-PCI with medical therapy (MT) in the Korean population. MATERIALS AND METHODS: A total of 840 consecutive CTO patients who underwent diagnostic coronary angiography, receiving either PCI with DESs or MT, were enrolled. Patients were divided into two groups according to the treatment assigned. To adjust for potential confounders, propensity score matching (PSM) analysis was performed using logistic regression. Individual major clinical outcomes and major adverse cardiac events, a composite of total death, myocardial infarction (MI), stroke, and revascularization, were compared between the two groups up to 5 years. RESULTS: After PSM, two propensity-matched groups (265 pairs, n=530) were generated, and the baseline characteristics were balanced. Although the PCI group showed a higher incidence of target lesion and vessel revascularization on CTO, the incidence of MI tended to be lower [hazard ratio (HR): 0.339, 95% confidence interval (CI): 0.110 to 1.043, p=0.059] and the composite of total death or MI was lower (HR: 0.454, 95% CI: 0.224 to 0.919, p=0.028), compared with the MT group up to 5 years. CONCLUSION: In this study, successful CTO PCI with DESs was associated with a higher risk of repeat PCI for the target vessel, but showed a reduced incidence of death or MI.
Coronary Angiography ; Drug-Eluting Stents* ; Humans ; Incidence ; Logistic Models ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Propensity Score ; Stroke

PURPOSE: Angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) are associated with a decreased incidence of new-onset diabetes mellitus (NODM). The aim of this study was to compare the protective effect of ACEI versus ARBs on NODM in an Asian population. MATERIALS AND METHODS: We investigated a total of 2817 patients who did not have diabetes mellitus from January 2004 to September 2009. To adjust for potential confounders, a propensity score matched (PSM) analysis was performed using a logistic regression model. The primary end-point was the cumulative incidence of NODM, which was defined as having a fasting blood glucose > or =126 mg/dL or HbA1c > or =6.5%. Multivariable cox-regression analysis was performed to determine the impact of ACEI versus ARB on the incidence of NODM. RESULTS: Mean follow-up duration was 1839+/-1019 days in all groups before baseline adjustment and 1864+/-1034 days in the PSM group. After PSM (C-statistics=0.731), a total 1024 patients (ACEI group, n=512 and ARB group, n=512) were enrolled for analysis and baseline characteristics were well balanced. After PSM, the cumulative incidence of NODM at 3 years was lower in the ACEI group than the ARB group (2.1% vs. 5.0%, p=0.012). In multivariate analysis, ACEI vs. ARB was an independent predictor of the lower incidence for NODM (odd ratio 0.37, confidence interval 0.17-0.79, p=0.010). CONCLUSION: In the present study, compared with ARB, chronic ACEI administration appeared to be associated with a lower incidence of NODM in a series of Asian cardiovascular patients.
Adult ; Aged ; Angiotensin Receptor Antagonists/*therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use ; Asian Continental Ancestry Group/*statistics & numerical data ; Blood Glucose/analysis ; Diabetes Mellitus/*diagnosis/*epidemiology ; Dose-Response Relationship, Drug ; Drug Monitoring/methods ; Female ; Follow-Up Studies ; Humans ; Hypertension/*drug therapy ; Incidence ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Propensity Score ; Republic of Korea/epidemiology ; Risk Factors

PURPOSE: High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test. MATERIALS AND METHODS: A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels. RESULTS: At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months. CONCLUSION: In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.
Acetylcholine/*metabolism ; Adult ; C-Reactive Protein/*metabolism ; Coronary Vasospasm/*metabolism ; Diabetes Mellitus/metabolism ; Female ; Humans ; Hypertension/metabolism ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. MATERIAL AND METHOD: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7+/-14.9 (range: 20~73) years old. The mean duration of extracorporeal life support system was 5.3+/-3.0 (range: 1~12) days. RESULT: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extracorporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival. CONCLUSION: Although using extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery
Adult ; Emergencies ; Extracorporeal Membrane Oxygenation ; Hemorrhage ; Humans ; Life Support Systems ; Male ; Medical Records ; Renal Insufficiency ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors ; Shock, Cardiogenic ; Survival Rate ; Survivors

BACKGROUND: Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. METHODS: Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. RESULTS: In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.2% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA 'grade A' mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. CONCLUSION: Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adult ; Aged ; Aged, 80 and over ; Anti-Ulcer Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Enzyme Inhibitors/*therapeutic use ; Esophageal Diseases/*pathology ; Female ; Follow-Up Studies ; Gastroesophageal Reflux/drug therapy/epidemiology/*pathology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Omeprazole/*analogs & derivatives/therapeutic use ; Prospective Studies ; Proton-Translocating ATPases/*antagonists & inhibitors ; Treatment Outcome

The conversion of failing Fontan circuit to total cavopulmonary connection(TCPC) is recommended as a therapeutic option in patients with late Fontan complications such as atrial arrhythmia, atrial enlargement, pulmonary venous obstruction, and ventricular dysfunction. Combined TCPC with extracardiac conduit and cryoablation of arrhythmia circuit is preferred for treatment of failing Fontan connection with atrial tachyarrhythmia. We report a case of conversion of atriopulmonary connection to extracardiac conduit Fontan and cryoablation of atrial arrhythmia circuit in a patient with tricuspid atresia, who also had ectopic atrial tachycardia, right atrial thrombi, pulmonary venous obstruction, and ventricular dysfunction. This patient and the parents were Jehovah's Witnesses; therefore, the patient underwent the procedure without blood transfusion.
Arrhythmias, Cardiac* ; Blood Transfusion ; Cryosurgery ; Humans ; Jehovah's Witnesses* ; Parents ; Tachycardia ; Tachycardia, Ectopic Atrial ; Tricuspid Atresia ; Ventricular Dysfunction

BACKGROUND: Pulmonary artery banding (PAB)in the functional univentricular heart (UVH)is a palliative procedure for staging toward the Fontan procedure;however,it is known to be a risk factor. MATERIALS AND METHOD: The records of all 37 patients with functional UVHs who underwent surgical palliation using PAB between September 1989 and August 1999 were reviewed retrospectively.We investigated the aortic arch obstruction,the development and progression of subaortic stenosis after PAB,and risk factor of mortality according to surgical method. RESULT: In 37 neonates and infants with single ventricular physiology,aortic arch obstruction was combined in 7.There were 6 early deaths (16.2%)after PAB and 3 late deaths (8.1%)after Fontan operation.The actuarial overall survival including early mortality at 3 and 5 years were 8 0 .7+/-6.6%,72.2 +/-8.2% respectively. Among 31 patients who survived PAB,27 patients (87.1%)could become candidates for Fontan operation;22 patients(71.0%)completed Fontan operation with 3 deaths and 5 were waiting bidirectional cavopulmonary shunt(BCPS)or Fontan operation (follow-up mean 4.5 year,minimal 2 year). Subaortic stenosis developed in 8 patients after PAB (8/29,27.6%);3 cases in the patients without arch anomaly (3/22,13.6%)and 5 in those with arch anomal y (5/7,71.4%).The subaortic stenosis was managed with Damus-Kaye-Stansel procedure (DKS)in 6 patients without operative mortality and conal septum resection in 2 without long-term survivor. Analysis of risk factors established that aortic arch obstruction was strongly associated with subaortic stenosis (p<0.001).The only risk factor of late mortality was Fontan procedure without staged palliation by BCPS (p=0.001). CONCLUSION: PAB is effective as an initial palliative step in functional UVH.And the high risk group of patients with aortic obstruction can undergo effective short-term PAB as an initial palliative step,with subsequent DKS for subaortic stenosis.This strategy,initial PAB and careful surveillance,and early relief of subaortic stenosis can maintain acceptable anatomy and hemodynamics for later Fontan procedures.
Aorta, Thoracic ; Constriction, Pathologic ; Fontan Procedure ; Heart* ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Mortality ; Pulmonary Artery* ; Risk Factors ; Survivors

BACKGROUND: Reoperations on the aortic root or the ascending aorta are being performed with increasing frequency and remain a challenging problem.This study was performed to analyze the results of reoperations on the ascending aorta and aortic root. MATERIAL AND METHOD: Between May 1995 and April 2001,30 patients had reoperations on the ascending aorta and aortic root and were reviewed retrospectively.The mean interval between the previous repair and the actual reoperation was 56 months(range 3 to 142 months).Seven patients(23.3%)had two or more previous operations.The indications for reoperations were true aneurysm in 7 patients(23.3%),prosthetic valve endocarditis in 6(20%),false aneurysm in 5(16.7%),paravalvular leak associated with Behcet's disease in 4(13.3%),malfunction of prosthetic aortic valve in 4(13.3%),aortic dissection in 3(10%),and annuloaortic ectasia in 1(3.3%).The principal reoperations performed were aortic root replacement in 17 patients(56.7%),replacement of the ascending aorta in 8(26.7%),aortic and mitral valve replacement with reconstruction of fibrous trigone in 2(6.6%),patch aortoplasty in 2(6.6%), and aortic valve replacement after Bentall operation in 1(3.3%).The cardiopulmonary bypass was started before sternotomy in 7 patients and the hypothermic circulatory arrest was used in 16(53.3%).The mean time of circulatory arrest,total bypass,and aortic crossclamp were 20 +/- 12 minutes,228 +/- 56 minutes,and 143 +/- 62 minutes,respectively. RESULT: There were three early deaths(10%).The postoperative complications were reoperation for bleeding in 7 patients(23.3%),cardiac complications in 5(16.7%),transient acute renal failure in 2(6.6%), transient focal seizure in 2(6.6%),and the others in 5.The mean follow-up was 22.8 +/- 20.5 months.There were two late deaths(7.4%).The actuarial survival was 92.6 +/- 5.0%at 6 years. One patient required reoperation for complication of reoperation on the ascending aorta and aortic root(3.7%).The 1-and 6-year actuarial freedom from reoperation was 100%and 83.3 +/- 15.2%,respectively.One patient with Behcet's disease are waiting for reoperation due to false aneurysm,which developed after aortic root replacement with homograft.There were no thromboembolisms or anticoagulant related complications. CONCLUSIONS: This study suggests that reoperations on the ascending aorta and aortic root can be performed with acceptable early mortality and morbidity,and adequate surgical strategies according to the pathologic conditions are critical to the prevention of the reoperation.
Acute Kidney Injury ; Aneurysm ; Aorta* ; Aortic Valve ; Cardiopulmonary Bypass ; Dilatation, Pathologic ; Endocarditis ; Follow-Up Studies ; Freedom ; Hemorrhage ; Humans ; Mitral Valve ; Mortality ; Postoperative Complications ; Reoperation ; Seizures ; Sternotomy ; Thromboembolism