This study aimed to characterize the seasonal abundance of hard ticks that transmit severe fever with thrombocytopenia syndrome virus from April to November 2019 and 2020 on Ganghwa-do, Incheon Metropolitan City, Korea. The ticks were collected at grassland, grave site, copse and mountain road using a collection trap method. The ixodid hard ticks comprising three species (Haemaphysalis longicornis, H. flava, and Ixodes nipponensis) collected were 6,622 in 2019 and 3,811 in 2020. H. longicornis was the most frequent (97.9% in 2019 and 96.0% in 2020), followed by H. flava (2.0% and 3.0% in 2019 and 2020, respectively) and I. nipponensis (less than 0.1%). Our study demonstrated that seasonal patterns of the tick populations examined for two years were totally unsimilar. The hard ticks tested using RT-qPCR were all negative for severe fever with thrombocytopenia syndrome virus.

This study aimed to characterize the seasonal abundance of hard ticks that transmit severe fever with thrombocytopenia syndrome virus from April to November 2019 and 2020 on Ganghwa-do, Incheon Metropolitan City, Korea. The ticks were collected at grassland, grave site, copse and mountain road using a collection trap method. The ixodid hard ticks comprising three species (Haemaphysalis longicornis, H. flava, and Ixodes nipponensis) collected were 6,622 in 2019 and 3,811 in 2020. H. longicornis was the most frequent (97.9% in 2019 and 96.0% in 2020), followed by H. flava (2.0% and 3.0% in 2019 and 2020, respectively) and I. nipponensis (less than 0.1%). Our study demonstrated that seasonal patterns of the tick populations examined for two years were totally unsimilar. The hard ticks tested using RT-qPCR were all negative for severe fever with thrombocytopenia syndrome virus.

BACKGROUND AND OBJECTIVES: Identification of coronary sites susceptible to progression or nonprogression might provide additional information to select medical or surgical treatment and furthermore for appropriate timing for percutaneous transluminal coronary angioplasty or coronary artery bypass graft. METHODS: We reviewed serial coronary arteriograms of 50 patients with coronary artery disease retrospectively. Patients were managed with standard treatment including anti-hypertensives, antiplatelets, lipid-lowering agents and other risk factor management by attending physician's decision. Patients who received percutaneous transluminal angioplasty, coronary artery bypass graft or thrombolysis were excluded. Cononary arteriographies were undertaken with average 33 months interval. Criteria for the progression and regression were the changes of the luminal diameter narrowing of the arterial segment by 20% or more reduction or increase, respectively. Results: Patients show progressive change, regressive change or no significant interval change in 50%, 12% and 30% of total 50 patients, respectively. Male gender, angiographic interval were the significant predictor of progressive change. In terms of coronary segment, stable segments are most frequent 52.2% (72/138) and progression in 40.2% (74/184), regression in 27.5% (38/138). Initial coronary lesions with low grade stenosis (less than 50%) have a tendency to progress than that of high grade stenosis (70% or more) Percentage diameter stenosis of new lesion are not related linearly with the interval between two sequential angiographies. CONCLUSION: Number of patients with progressive coronary arteriogram are more frequent than the patients with regressive change or no interval change. Progression and regression are frequent finding of serial coronary arteriography in usual clinical practice. Progression and regression are found frequently in the same patient at different coronary branches (16 patients). It suggested that the local factors may play an important role in the pathogenesis of coronary artery disease as well as systemic risk factors.
Angiography* ; Angioplasty ; Angioplasty, Balloon, Coronary ; Antihypertensive Agents ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Humans ; Male ; Phenobarbital ; Retrospective Studies ; Risk Factors ; Transplants

Percutaneous transluminal coronary angioplasty (PTCA) is a relatively safe and effective procedure in the treatment of coronary artery disease, but complications related to dilating catheters and guide wires such as coronary artery dissection, spasm, rupture, and perforation can be. Pericardial tamponade is a rare complication of cardiac catheterization, and prompt diagnosis and proper management are important in lifesaving. We report 4 patients who developed pericardial tamponade following PTCA, presumably from coronary artery or right ventricular perforation. All 4 patients received heparin during PTCA and temporary pacemaker was placed in the right ventricle. Pericardial tamponade was recognized in the catheterization laboratory in 1 patient, within 3 hours after leaving the laboratory in 3 patients. Emergent pericardiocentesis was performed in all patients. Three patients recovered and one patient died.
Angioplasty, Balloon, Coronary* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Tamponade* ; Catheterization ; Catheters ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Heart Ventricles ; Heparin ; Humans ; Pericardiocentesis ; Rupture ; Spasm

BACKGROUNG AND OBJECTIVES: There were numerous reports for clinical characteristics and prognosis of patients with variant angina (VA) but little information is available for patients with VA who presented as acute myocardial infarction (AMI). The purpose of this study is to determine the clinical and angiographic predictors for initial development of AMI in patients with VA and prognosis of patients with VA who presented as AMI. MATERIALS AND METHODS: The study group comprised 166 patients with VA:forty one (25%) of whom presented as AMI (Group A;Male 32, mean age 50 years) and 125 presented as typical VA or unstable angina (Group B;Male 73, mean age 54 years). The diagnosis of VA was made by spontaneous spasm and ergonovine or acetylcholine (only Group B) provocation. RESULTS: 1)Male gender (78% vs. 58%, p<0.05), smoking (74% vs. 53%, p<0.05), and disease duration (18+/-5 vs. 7+/-1 month, p<0.0001), and ST-segment elevation during chest pain (71% vs. 23%, p<0.05) were significantly higher in group A than in Group B. 2)Prevalence of fixed stenosis of 50% or greater was higher in Group A than in group B (12% vs. 2%, p<0.05) and the percent stenosis after nitroglycerin injection was also greater in group A than in group B (43+/-5% vs. 28+/-2, p<0.01), but the disease activity such as frequency of resting angina, spontaneous spasm, and multivessel spasm were not different between two groups. 3)During clinical follow-up at a mean duration of 2.7 years, three patient (2%) in group B died of a cardiac cause. Non-fatal MI occurred 1 (2%) and 3 patients (2%) in group A and B, respectively. CONCLUSIONS: Our data show that male gender, smoking, duration of disease, ST-segment elevation during chest pain, and a fixed stenosis of 50% or greater are predictors for initial development of AMI in patients with VA. The prognosis in group A is excellent and this may be associated with less severe atherosclerotic disease and a high rate of medication with calcium channel blocker or nitrate compared with those in previous studies.
Acetylcholine ; Angina, Unstable ; Calcium Channels ; Chest Pain ; Constriction, Pathologic ; Diagnosis ; Ergonovine ; Follow-Up Studies* ; Humans ; Male ; Myocardial Infarction* ; Nitroglycerin ; Prognosis ; Smoke ; Smoking ; Spasm

Infective endocarditis is still one of the important fatal diseases, especially with systemic embolic manifestations. Infective endocarditis is often misdiagnosed because of variability of systemic embolic manifestations. We have experienced 3 cases of infective endocarditis with systemic embolic manifestations who were initially misdiagnosed as other infectious diseases. Case 1 is a 66 year-old man, who was admitted to our hospital with dyspnea , fever and petechia. His chest X-ray showed rapid decrease of cardiomegaly and pulmonary congestion in two days. At 1 week after discharge he was readmitted for recurrent fever. On the follow-up echocardiography, mitral regurgitation was newly detected. Case 2 is a 75 year-old man, who was admitted to neurology department with sudden left hemiplegia and headache, in whom it was initially difficult to differentiate from ischemic brain infarction. Case 3 is a 29 year-old man, who was admitted to neurosurgery department with fever and back pain, in whom it was initially difficult to diffrentiate from tuberculous spondylitis in early radiologic study. All 3 cases were treated effectively with appropriate antibiotic therapy and discharged with improvement of symptoms. We report 3 cases of systemic embolic manifestations complicated by infective endocarditis with a brief review of literatures.
Adult ; Aged ; Back Pain ; Brain Infarction ; Cardiomegaly ; Communicable Diseases ; Dyspnea ; Echocardiography ; Embolism ; Endocarditis* ; Estrogens, Conjugated (USP) ; Fever ; Follow-Up Studies ; Headache ; Hemiplegia ; Humans ; Mitral Valve Insufficiency ; Neurology ; Neurosurgery ; Spondylitis ; Thorax

Vancomycin, one of glycopeptide antibiotics, has been used in recent years with the emergence of methicillin- resistant staphylococcus aureus (MRSA), coagulase negative staphylococci (CNS) as important hospital pathogens. A 75 years male patient receiving vancomycin 1g intravenously as twice daily dose for treatment of bacterial endocarditis, suffered from high fever, generalized diffuse erythematous maculopapular eruption, itching and eosinophilia, during course of 16th day of vancomycin therapy for treatment of bacterial endocarditis. This delayed hypersensitivity reaction was resolved with discontinuation of the drug and treatment with antihistamine. Awareness of vancomycin associated delayed hypersensitivity reactions is necessary during the treatment in patients with long-term infusion of vancomyin despite of delayed cutaneous reaction and fever associated with vancomycin therapy is not common.
Anti-Bacterial Agents ; Coagulase ; Endocarditis, Bacterial* ; Eosinophilia ; Fever ; Humans ; Hypersensitivity, Delayed* ; Male ; Pruritus ; Staphylococcus aureus ; Vancomycin*

The Eisenmenger syndrome is characterized by severe irreversible pulmonary hypertension and right-to-left shunting of blood through the pulmonary-systemic communication. The resultant right-to-left shunt leads to clinical cyanosis and secondary manifestations of chronic hypoxemia. Clinical features include dyspnea on exertion, fatigue, palpitation, hemoptysis, syncope, chest pain and predisposition to brain abscess and cerebrovascular accident. Brain abscess is a serious complication of cyanotic congenital heart disease and major cause of death. We report a patient with Eisenmenger syndrome in whom the presence of right-to-left shunt and paradoxical embolism appears to be critical for the development of brain abscess.
Anoxia ; Brain Abscess* ; Brain* ; Cause of Death ; Chest Pain ; Cyanosis ; Dyspnea ; Eisenmenger Complex* ; Embolism, Paradoxical ; Fatigue ; Heart Defects, Congenital ; Hemoptysis ; Humans ; Hypertension, Pulmonary ; Stroke ; Syncope

There are many various complications associated with coronary artery stenting, in cluding thrombotic and hemorrhagic complications, in-stent restenosis, side branch occlusion, stent embolization. The retention of equipment components is the uncommon, unexpected and often problematic situations that can arise requiring ingenuity, skill, and creativity. We reports on a patient in whom an sleeve marker ring of a stent balloon catheter retained within the lumen of the coronary artery following coronary stenting. The sleeve marker ring was extracted by dilatation and withdrawal of balloon catheter which readvanced over a guidewire positioned in the center of ring.
Catheters ; Coronary Vessels* ; Creativity ; Dilatation ; Humans ; Stents*

The presence of pre-existing intracoronary thrombus has consistently been shown to be among the strongest predictors of unsuccessful angioplasty and abrupt vessel closure. Abciximab, platelet glycoprotein IIb/IIIa receptor antagonist, through prevention platelet aggregation and coronary thrombosis, has shown promise in helping to decrease the incidence of complications of PTCA when prophylatically administered in patients presenting with unstable angina or complex lesion morphology for PTCA and in lower risk patients as well. However, the cost of abciximab and its associated increased risk of bleeding may limit its use as a prophylactic treatment. This study was performed to evaluate the effect of the rescue administration of abciximab in seven patients with thrombus containing lesion during angioplasty. Thrombus was disappeared in 4 patients and decreased in 2 patients, and the follow-up angiogram showed normal brisk flow in all 6 patients. There were no death or myocardial infarction on clinical follow-up at a mean of 7 months except one which was developed restenosis at the angioplasty lesion. Dissolution of thrombus and restoration or maintenance of TIMI grade 3 flow were achieved without complications after administration of abciximab when delivered in a rescue manner on thrombus containing lesion during angioplasty. These results showed that failure to give preprocedural proph-ylactic abciximab did not appear to exclude the possibility of a beneficial effect of abciximab, given therapeutically during the early stage of thrombus formation in patients with complicated lesion during angioplasty.
Angina, Unstable ; Angioplasty ; Blood Platelets ; Coronary Thrombosis ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Humans ; Incidence ; Myocardial Infarction ; Platelet Aggregation ; Thrombosis*