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.

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

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

Dendritic cells (DCs), which are regarded as the most potent antigen-presenting cells, are involved in innate and adaptive immunity. Upon uptake of pathogens, DCs express cell surface markers and secrete cytokines. In this study, we analyzed production of cytokines and found that interleukin (IL)-10 and transforming growth factor (TGF)-beta production significantly increased in bone marrow-derived DCs and a mouse DC line, DC2.4, after treatment with crude antigen (CA) from liver fluke, Clonorchis sinensis. However, expression patterns of several activation molecules did not change. In addition, following treatment of DC2.4 cells with antigen from the lung fluke, Paragonimus westermani, production of IL-10 and TGF-beta significantly increased compared with groups treated with other parasite antigens, Spirometra erinacei plerocercoid CA and Echinococcus granulosus hydatid cystic fluid. We also found that treatment of DC2.4 cells with C. sinensis CA resulted in rapid and significant phosphorylation of extracellular signal-regulated kinase 1/2, a mitogen-activated protein kinase. Following treatment of DC2.4 cells with C. sinensis CA, treatment with an inhibitor specific to an extracellular signal-regulated kinase inhibited production of IL-10 and TGF-beta. Our results suggest that CA from C. sinensis has a role in the anti-inflammatory function of DC cells by inducing IL-10 and TGF-beta through activation of extracellular signal-regulated kinase 1/2.
Animals ; Antigens, Helminth/*pharmacology ; Cells, Cultured ; Clonorchis sinensis/*immunology ; Dendritic Cells/drug effects/*metabolism ; Interleukin-10/genetics/*metabolism ; MAP Kinase Signaling System ; Mice ; Transforming Growth Factor beta/genetics/*metabolism

Tuberculous aortitis is a very rare disease. Furthermore, it is all the more rare for it to be complicated by the development of an aortic aneurysm or the formation of aorto-bronchial fistula. If it is complicated by rupture of the aorta, mortality is very high. If the patient didn't contract tuberculosis, but was expectorating blood, we would have to carry out a chest CT promptly, in order to make a rapid and accurate diagnosis of this disease. A 46-year-old male patient was admitted due to the sudden onset of intermittent hemoptysis and chest discomfort. CT scans of the chest showed an aneurysmal change to the descending thoracic aorta, and the formation of an aorto-bronchial fistula, which originated from this aneurysm and communicated with its left lower lobe. We operated with an artificial vessel graft interposition of the descending thoracic aorta and a left lower lobectomy. Because the diagnosis was of tuberculosis, we started anti-Tbc medication and long term anti-Tbc medication was recommended.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Aortitis ; Bronchial Fistula ; Contracts ; Fistula ; Glycosaminoglycans ; Hemoptysis ; Humans ; Male ; Middle Aged ; Rare Diseases ; Rupture ; Thorax ; Transplants ; Tuberculosis

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

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

Elective surgical repair has traditionally been considered to be the treatment of choice for the exclusion of isolated iliac artery aneurysms (IAAs). Recently, endovascular repair has evolved as an alternative to surgical repair, especially in patients at high surgical risk. However, in the absence of sufficient proximal necks, iliac artery aneurysms are not suitable for direct deployment of a tubular-shaped endograft. Here we report two cases of IAAs with short proximal necks that were excluded using an endovascular bifurcated stent-graft. The bifurcated stent-graft was successfully deployed with complete exclusion of the aneurysm. In neither case was there evidence of procedural failures. There were no signs of significant complications. We conclude that endovascular repair of IAAs with short proximal necks is feasible and efficient using an endovascular bifurcated stent-graft.
Aneurysm ; Angioplasty ; Humans ; Iliac Aneurysm ; Iliac Artery ; Neck ; Stents

BACKGROUND: The safety and efficacy of arterial composite grafts for total arterial revascularization have been demonstrated. The saphenous vein (SV) is a widely used graft because of its accessibility, sufficient length, and ease of manipulation. Our aim was to compare mid-term outcomes of saphenous vein Y-grafts with radial artery Y-grafts joined by anastomosis to the left internal thoracic artery. MATERIALS AND METHODS: Records of off-pump coronary artery bypass grafting with composite Y-grafts based on the left internal thoracic artery technique in 552 patients were analyzed retrospectively. After propensity score matching, 79 radial arterial (RA) composite grafts (RA group) and 79 saphenous vein composite grafts (SV group) were compared. The duration of mean follow-up was 24.6+/-14.6 months (range, 1 to 55 months). RESULTS: There were no differences in surgical mortality, all-cause mortality, or morbidity among the groups. Rates of 4-year survival were 91.7% and 96.3% in the RA and SV groups, respectively (p=0.519). The coronary reintervention-free survival rate and freedom from major adverse cardiovascular or cerebrovascular events were similar in the two groups (p=0.685, p=0.564). CONCLUSION: Construction of composite Y-grafts using the radial artery or saphenous vein showed similar mid-term results. Long-term follow-up and randomized trials will be needed to confirm our present conclusions.
Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Follow-Up Studies ; Freedom ; Humans ; Mammary Arteries ; Propensity Score ; Radial Artery ; Retrospective Studies ; Saphenous Vein ; Survival Rate ; Transplants