Background: Data on severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) delta variant virulence are insufficient. We retrospectively compared the clinical features of adult coronavirus disease 2019 (COVID-19) patients without risk factors for severe COVID-19 who entered residential treatment centers (RTCs) before and after the delta variant outbreak. Methods: We collected medical information from two RTCs in South Korea. On the basis of nationwide delta variant surveillance, we divided the patients into two groups: 1) the delta-minor group (diagnosed from December 2020–June 2021, detection rate < 10%) and 2) the delta-dominant group (diagnosed during August 2021, detection rate > 90%). After propensity-score matching, the incidences of pneumonia, hospital transfer and need for supplemental oxygen were compared between the groups. In addition, risk factors for hospital transfer were analysed. Results: A total of 1,915 patients were included. The incidence of pneumonia (14.6% vs.9.2%, P = 0.009), all-cause hospital transfer (10.4% vs. 6.3%, P = 0.020) and COVID-19-related hospital transfer (7.5% vs. 4.8%, P = 0.081) were higher in the delta-dominant group than those in the delta-minor group. In the multivariate analysis, the delta-dominant group was an independent risk factor for all-cause (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.16–3.13; P = 0.011) and COVID-19-related hospital transfer (aOR, 1.86; 95% CI, 1.04–3.32; P = 0.036). Conclusion Hospitalization rates were increased in the adult COVID-19 patients during the delta variant nationwide outbreak. Our results showed that the delta variant may be more virulent than previous lineages.

BACKGROUND: The purpose of this study was to evaluate the use of a Fogarty arterial embolectomy catheter (Fogarty catheter) in intraoperative balloon angioplasty of the cephalic vein, in order to determine its effect on the patency of arteriovenous fistulas (AVFs) created for hemodialysis access. METHODS: A total of 156 patients who underwent creation of an AVF were divided into two groups, based whether a Fogarty catheter was used during AVF creation. Group A (89 patients) comprised the patients who underwent balloon angioplasty with a Fogarty catheter during the operation. Group B (67 patients) included the patients in whom a Fogarty catheter was not used during the operation. Patient records were reviewed retrospectively and documented. The patency rate was determined by the Kaplan-Meier method. RESULTS: The records of 156 patients who underwent the creation of an AVF from January 2007 to October 2011 were included. The mean follow-up duration was 40.2+/-19.4 months (range, 1 to 97 months). The patency rates in group A at 12, 36, and 72 months were 83.9%+/-3.9%, 78.3%+/-4.6%, and 76.3%+/-4.9%, respectively, while the corresponding patency rates in group B were 92.5%+/-3.2%, 82.8%+/-0.5%, and 79.9%+/-5.7%, respectively. The patency rates in group B were found to be slightly higher than those in group A, but the difference was not statistically significant (p=0.356). CONCLUSION: Intraoperative balloon angioplasty of the cephalic vein using the Fogarty catheter is a simple and easily reproducible procedure, and it can be helpful in increasing AVF patency in cases of insufficient runoff or a suboptimal cephalic vein.
Angioplasty, Balloon* ; Arteriovenous Fistula* ; Catheters* ; Embolectomy* ; Follow-Up Studies ; Humans ; Renal Dialysis* ; Retrospective Studies ; Vascular Patency ; Veins

Pseudoaneurysm with arteriovenous fistula is a rare complication of arthroscopy, and can be diagnosed by ultrasonography, computed tomography, magnetic resonance imaging, or angiography. This condition can be treated with open surgical repair or endovascular repair. We report our experience with the open surgical repair of a pseudoaneurysm with an arteriovenous fistula in a young male patient who underwent arthroscopy five months previously.
Aneurysm, False* ; Angiography ; Arteries ; Arteriovenous Fistula* ; Arthroscopy* ; Humans ; Knee ; Magnetic Resonance Imaging ; Male ; Ultrasonography

Atypical adenomatous hyperplasia is a premalignant lesion reflecting a focal proliferation of atypical cells. These lesions are usually observed as incidental findings in lungs that have been resected due to other conditions, such as lung cancer. We report the youngest case of atypical adenomatous hyperplasia on record in a 12-year-old girl. In this patient, the lesion was found in association with pneumothorax.
Child* ; Female* ; Humans ; Hyperplasia* ; Incidental Findings ; Lung ; Lung Neoplasms ; Pneumothorax ; Thoracoscopy

Chondrosarcoma is a rare entity of malignant tumor which arises from cartilaginous tissue, and the literatures on this disease are scarce. The first-line of treatment for cardiac chondrosarcoma is surgery. Due to early local recurrence and distant metastasis, the prognosis is poor even after complete surgical excision. We present a case of chondrosarcoma in the left atrium causing functional mitral stenosis which required urgent surgical intervention, and the successful treatment outcome.
Chondrosarcoma* ; Heart Atria ; Heart Neoplasms ; Heart* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Neoplasms, Connective Tissue ; Prognosis ; Recurrence ; Treatment Outcome

No abstract available.

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.
Abdominal Pain ; Carcinoma ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colorectal Neoplasms ; Endoscopy ; Humans ; Ileostomy ; Middle Aged ; Palliative Care ; Stents

BACKGROUND: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. MATERIAL AND METHOD: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. RESULT: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. CONCLUSION: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.
Adenosine ; Angiography ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Heart ; Heart Diseases ; Humans ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon ; Vascular Diseases

A functional single lung caused by lung diseases or pneumonectomy can result in anatomic and physiologic changes that may interfere with the conduct of subsequent coronary artery bypass surgery. Since this type of case is extremely rare, there has not been any report on this in Korea. A 71-year-old female with a history of a destroyed left lung from pulmonary tuberculosis 13 years ago was admitted for evaluation of her increasing chest pain that she'd experienced for 2 weeks. Since coronary angiographies demonstrated 80% stenosis of the left main os, 90~95% stenosis of the p-LAD, 90% stenosis of the m-LCx and 90% stenosis of the RCA, coronary artery bypass surgery (CABG) was planned. Off-pump CABG with vein grafts through a median sternotomy was performed and the patient recovered the same as other CABG patients without complications.
Aged ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Female ; Humans ; Korea ; Lung ; Lung Diseases ; Pneumonectomy ; Sternotomy ; Transplants ; Tuberculosis, Pulmonary ; Veins

PURPOSE: The expression of nerve growth factor-beta (NGF-beta) is related to cardiac nerve sprouting and sympathetic hyper innervation. We investigated the changes of plasma levels of NGF-beta and the relationship to follow-up heart rate variability (HRV) after radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). MATERIALS AND METHODS: This study included 147 patients with AF (117 men, 55.8+/-11.5 years, 106 paroxysmal AF) who underwent RFCA. The plasma levels of NGF-beta were quantified using double sandwich enzyme linked immunosorbent assay method before (NGF-beta(pre)) and 1 hour after RFCA (NGF-beta(post-1hr)). HRV at pre-procedure (HRV(pre)), 3 months (HRV(post-3mo)), and 1 year post-procedure (HRV(post-1yr)) were analyzed and compared with plasma levels of NGF-beta. RESULTS: 1) The plasma levels of NGF-beta significantly increased after RFCA (20.05+/-11.09 pg/mL vs. 29.60+/-19.43 pg/mL, p<0.001). The patients who did not show increased NGF-beta(post-1hr) were older (p=0.023) and had greater left atrial volume index (p=0.028) than those with increased NGF-beta(post-1hr). 2) In patients with NGF-beta(pre) >18 pg/mL, low frequency components (LF)/high-frequency components (HF) (p=0.003) and the number of atrial premature contractions (APCs, p=0.045) in HRV(post-3mo) were significantly higher than those with < or =18 pg/mL. 3) The LF/HF at HRV(post-3mo) was linearly associated with the NGF-beta(pre) (B=4.240, 95% CI 1.114-7.336, p=0.008) and the NGF-beta(post-1hr) (B=7.617, 95% CI 2.106-13.127, p=0.007). 4) Both NGF-beta(pre) (OR=1.159, 95% CI 1.045-1.286, p=0.005) and NGF-beta(post-1hr) (OR=1.098, 95% CI 1.030-1.170, p=0.004) were independent predictors for the increase of LF/HF at HRV(post-3mo). CONCLUSION: AF catheter ablation increases plasma level of NGF-beta, and high plasma levels of NGF-beta(pre) was associated with higher sympathetic nerve activity and higher frequency of APCs in HRV(post-3mo).
Aged ; Atrial Fibrillation/physiopathology/*surgery ; Catheter Ablation/*methods ; Female ; *Heart Rate ; Humans ; Male ; Middle Aged ; Nerve Growth Factor ; Nerve Growth Factors ; Transforming Growth Factor beta/*metabolism ; Treatment Outcome