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Background: Pulmonary sclerosing hemangioma is rare, but still the second most common benign lung tumor, occurring most1y in middle-aged women. Methods: From January 1985 through April 1993, we experienced eight cases of solitary pulmonary sclerosing hemangioma. Results: Subjects studied were 7 female and 1 male patients. They ranged from 14 to 63 years of age(mean age, 43.8 years) at the time of operation. The patients were frequently asymptomatic and the tumor was often shown to be a large lobulated mass on radiographic examination. The tumor can usually be diagnosed on operation because of its subtle clinical and radiographic presentation. All eight cases were diagnosed intraoperatively. The mean interval between initial radiographic detection and operation was 7.9 months. Out of 8 cases, preoperative impression of benign tumor was made in 4 cases, whereas malignant tumor was suspected in the remaining 4 cases. Enucleation, wedge resection or lobectomy was performed which appropriate in each patient. Conclusion: Surgical removal of the tumor preserving as much lung parenchyma as possible is indicated for proper diagnosis and treatment of this condition.

연구배경 : 만성폐쇄성폐질환에서 혈소판이 활성화되어 있는 근거가 있으며 이 질환의 예후 인자로 잘 알려진 폐동맥 고혈압이 활성화된 혈소판 및 손상된 내피세포가 관여하리라는 보고가 있다. 이에 만성폐쇄성폐질환에서 혈소판 활성화를 알아보고 혈소판 활성화가 폐동맥 고혈압에 미치는 영향을 알아보고자 연구를 시행하였다. 방법 : 대조군 및 만성폐쇄성폐질환의 폐동맥 정상혈압군과 고혈압군을 대상으로 혈소판 응집비 및 혈소판의 alpha-granule에 함유되어 있는 Platelet factor 4와 $\beta$ -thromboglobulin을 측정하여 다음과 같은 결과를 얻었다. 결과: 1) Platelet aggregation ratio (PAR)는 대조군 $0.99{\pm}0.04$ , 폐동맥 정상혈압군 $0.98{\pm}0.05$ , 폐동맥 고혈압군 $0.89{\pm}0.08$ 으로 감소하는 추세를 보였으며, 폐동액 고혈압군에서 대조군보다 통계학적으로 의미 있게 감소 하였다(p $4.7{\pm}1.2$ , 폐동맥 정상혈압군 $18.6{\pm}4.9$ , 폐동맥 고혈압군 $57.2{\pm}12.7$ 으로 만성폐쇄성폐질환에서 대조군보다 통계학적으로 의미 있게 증가 하였으며(p ${\beta}$ -TG, IU/ml)은 대조군 $34.4{\pm}5.8$ , 폐동맥 정상혈압군 $80.4{\pm}18.1$ , 폐동맥 고혈압군 $93.0{\pm}14.0$ 으로 만성폐쇄성폐질환에서 대조군보다 통계학적으로 의미 있게 증가 하였으며(p ${\beta}$ -TG 사이에는 상관 관계가 없었으나 PAR, PF4및 ${\beta}$ -TG 사이에는 통계학적으로 의미 있는 상관관계를 보였다 (Table 3). 결론 : 만성폐쇄성폐질환에서 혈소판이 뚜렷이 활성화되어 있었으며 폐동맥 고혈압군에서 좀더 활성화되는 경향을 보였다. 따라서 만성폐쇄성폐질환에서 혈소판 활성화가 폐동맥 고혈압의 유발 및 유지에 관여할 것으로 사료되며 치료에 대한 연구가 필요할 것으로 사료된다. 【Background: There is evidence that platelet is activated in chronic obstructive pulmonary disease and activated platelet with injured endothelium contribute to the pathogenesis of pulmonary hypertension, prognostic factor of chronic obstructive pulmonary disease. So, we have investigated platelet function further in chronic obstructive pulmonary disease and effect of platelet activation on pulmonary hypertension. Method: We studied platelet aggregation ratio and alpha-granule products such as platelet factor 4(PF4) and beta-thromboglobulin ( ${\beta}$ -TG) in control subjects and COPD without and with pulmonary hypertension subjects. Result: 1) The platelet aggregation ratio (PAR) was $0.99{\pm}0.04$ in control subjects, $0.98{\pm}0.05$ in COPD without pulmonary hypertension subjects and $0.89{\pm}0.08$ in COPD with pulmonary hypertension subjects. The platelet aggregation ratio of COPD subjects was tend to decrease than that of control subjects and the ratio of COPD with pulmonary hypertension subjects was significantly lower than that of control subjects. 2) The platelet factor 4 (PF4, IU/ml) was $4.7{\pm}1.2$ in control subjects, $18.6{\pm}4.9$ in COPD without pulmonary hypertension subjects and $57.2{\pm}12.7$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of control subjects and the level of COPD with pulmonary hypertension subjects was significantly higher than that of COPD without pulmonary hypertension subjects. 3) The beta-thromboglobulin ( ${\beta}$ -TG, IU/ml) was $34.4{\pm}5.8$ in control subjects, $80.4{\pm}18.1$ in COPD without pulmonary hypertension subjects and $93.0{\pm}14.0$ in COPD with pulmonary hypertension subjects. The level of COPD subjects was significantly higher than that of conrtrol subjects and the level of COPD with pulmonary hypertension subjects was tend to increase than that of COPD without pulmonary hypertension subjects. 4) There was no correlation between the clinical parameters and PAR, PF4 and ${\beta}$ -TG but there was significant correlation among PAR, PF4 and ${\beta}$ -TG. Conclusion: The platelet is activated in chronic obstructive pulmonary disease and the platelet of COPD with pulmonary hypertension is tend to be activated more than that of COPD without pulmonary hypertension. So, activated platelet may involve in the pathogenesis and maintenance of pulmonary hypertension in COPD subjects and modulation of platelet activity that might reduce pulmonary hypertension needs to be determined.】

Malignant T cell lymphoma is a morphologically and immunologically distinct subtype of non-Hodgkin's lymphoma. One of the most striking clinical findings is relatively high incidence in males in their twenties or thirties with cervical, supraclavicular and axillary lymphadenopathy (50%), mediastinal mass (50%) or less commonly with extranodal disease. More than 90% of patients present with stage III or IV disease and approximately 60% of patients develop bone marrow infiltration. Clinical trials are needed to optimize therapeutic strategies, since these tumors have a poor prognosis and need to be treated aggressively. A 17-year-old male was admitted to the hospital because of chest pain. Chest PA and CT scan revealed massive pleural effusion and soft tissue masses with destructive change of right third and eighth ribs Histologic diagnosis of pleura and chest wall mass revealed high grade, pleomorphic T cell type, malignant lymphoma.

Objectives: The functional effects of pulmonary resection are dependent on the preexisting function of resected and remaining tissue as well as on the compensatory potential of the remaining tissue. Nowadays, large pulmonary resections are usually applied to lung cancer patients often already compromised by chronic lung disease. It is important to evaluate the pulmonary reserve after lung resection preoperatively in the decision of operability and extent of resection. The aim of this study was to evaluate the changes of pulmonary function after pulmonary resection. Methods: 8 lobectomized and 8 pneumonectomized patients were evaluated. The pulmonary function test was performed preoperatively and in immediate postoperative period and thereafter to 5 years at 3 months interval. Results: 1) The pulmonary function 1 week after operation was significantly low compared with predicted values in, lobectomy and pneumonectomy groups(p

Background: Pulmonary hamartomas are benign tumors that occur in the parenchyma or in the bronchi. They present as a solitary pulmonary nodule(SPN) or as a cause of bronchial obstruction. The incidence, once minimal, is increasing in Korea. To get clinical spectrum about the tumor, we analyzed all the reported cases in Korea since 1964. Methods: We reviewed the clinical, radiological and pathological findings of 13 patients of intrapulmonary or endobronchial hamartomas in Severance Hospital and of 38 reported cases in Korea published in literatures from 1964 to 1992 retrospectively. Results: Including 17 endobronchial hamartomas, 54 cases were studied. There were 25 men and 29 women, with a mean age of 47.2 years; 45.3 years in endobronchial type and 51.3 years in parenchymal type. Pulmonary symptoms were present in 8 patients (22%) of intrapulmonary type and in all patients of endobronchial type: cough (65%), dyspnea (53%), sputum (35%), fever (29%) in order. On chest X-rays, atelectasis was seen in 10 patients (59%) in endobronchial type; but SPN was noted in 36 patients (97%) of intrapulmonary type. Calcification was present in 7 intapulmonary hamartomas (23%); but is in 2 endobronchial hamartomas (12%). The diagnostic yield was 6 out of 14(43%) in endobronchial ones; 4 out of 7(57%) in intrapulmonary ones. Fifty patients underwent operations as follows: lobectomy (28), enucleation (8), resection (8), bilobectomy (4), pneumonectomy (2). The hamartomas were 1.2 times more common in the right lung; mean transverse diameter at the time of operation was 2.3 cm in endobronchial type, 3.8 cm in intrapulmonary ones. Chondroid components were present in 11(65%) of 17 endobronehial ones but in 30(91%) of 33 intrapulmonary hamartomas. No malignant changes were seen perioperative period and up to early 1993. Conclusion: The younger age in endobronchial hamartomas, the preponderance of the female sex and the more incidence in the right lung, and the diagnostic choice of lobectomies were different from the studies of the Western countries.

Background Inflammation plays a significant role in acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM). There may be similar inflammatory changes in non-DM patients with ST elevation myocardial infarction (STEMI) and DM patients with stable angina (SA), and DM patients with STEMI may have more severe changes than the former two groups. The objectives of this study were to investigate whether the level of inflammation was similar in patients with non-DM STEMI and DM SA, and to evaluate whether the changes in the level of inflammation were more severe in patients with DM STEMI compared to the other two groups. Methods and results A variety of inflammatory markers including: highly sensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), IL-18, vascular cell adhesion molecule-1 (VCAM-1), and matrix metallopeptidase-9 (MMP-9) as well as insulin resistance were compared among the three groups: DM STEMI (90 patients), DM SA (91 patients), and non-DM STEMI (76 patients). Inflammatory marker levels were not significantly different between the DM SA and non-DM STEMI groups. However, hsCRP and IL-6 were increased in the DM STEMI compared to the DM SA patients (p = 0.005 and p = 0.004, respectively). In addition, hsCRP, ESR, and IL-18 were increased in the DM STEMI compared to the non-DM STEMI patients (p = 0.017, p = 0.020, and p = 0.033, respectively). Furthermore, the fasting insulin and the homeostasis model assessment were significantly increased in the DM STEMI compared to the DM SA patients (p = 0.04 and p = 0.004, respectively). Conclusions DM SA and non-DM STEMI may have similar inflammatory changes. DM STEMI may be a more severe inflammatory condition compared to patients with DM SA or non-DM STEMI.

The development of drug resistance is the major limiting factor influencing the survival of patients with small cell lung cancer (SCLC). We have thus examined the activity of cyclophosphamide, doxorubicin and vincristine (CAV) alternating with etoposide and cisplatin (EP) in 35 patients with SCLC. The treatment courses were alternated every 3 or 4 weeks. After induction chemotherapy, patients with limited disease (LD) received thoracic radiotherapy (5000 cGy), prophylactic cranial irradiation (3000 cGy) and maintenance chemotherapy and patients with extensive disease (ED) received maintenance chemotherapy only. In this group of 35 patients, 13 had limited disease (LD) and 22 had extensive disease (ED). After completion of the therapy, 100% of the patients with LD achieved complete plus partial remission (CR + PR) and 68% of the patients with ED achieved CR + PR. The median survival time was 66 weeks (15.3 months) in patients with LD and 44 weeks (10.2 months) in patients with ED. The over all survival for patients with LD was superior to that for patients with ED (p less than 0.05). Also, median response duration for patients with LD (35 wks) was longer than that for patients with ED (17 weeks) (p less than 0.05). The primary site was the most vulnerable site to relapse (18 patients). Toxicity was mild to moderate and acceptable, and there were no treatment-related deaths. These results suggest that the alternation of CAV and EP is effective treatment strategy in the management of SCLC. A randomized controlled study will be required to discriminate the actual effect of this alternating regimen.

Background: The correlations between circulating angiogenic cell mobilizations and improvement of microvascular integrity were investigated in patients (n=110) with acute myocardial infarction (AMI) during an 8-month follow up. Methods and Results: Coronary flow reserve (CFR) was measured at baseline and at 8 months by using an intracoronary Doppler wire. Serial changes in the absolute numbers of circulating angiogenic cells such as CD34+, CXCR4+, CD117+, CD133+ and C-met+ were measured at baseline, day 1, day 5 and at 8 months. The absolute numbers of circulating angiogenic cells at day 1 were significantly higher than those at baseline. A positive correlation was found between the numbers of circulating angiogenic cells of CD34+, CXCR4+, CD117+ and CD133+ cells at day 1 and the CFR changes from baseline. The cut-off value of CFR changes at 8 months by a receiver operating characteristic curve between a circulating CD34+ cell at day 1 and changes of CFR at 8 months was 0. Late-loss showed the positive correlation with the absolute number of C-met+ cells and the negative correlation with the absolute number of CXCR4+ cells after AMI. The negative correlation was found between changes in high-sensitive C-reactive protein and soluble intercellular adhesion molecule-1 and changes in CFR at 8 months. Conclusions: The recovery of microvascular integrity after acute ischemic injury was expedited by the increases in circulating angiogenic cell mobilization together with the greater decreases in inflammatory cytokines. The improvement in CFR could be predicted by the measurement of circulating angiogenic cells after AMI. (Circ J 2012; 76: 1213-1221)

Recent studies have reported the existence of resident cardiac stem cells (CSCs) that have potential differentiating into cardiomyogenic and endothelial cell lineage, and therefore promising candidates for cell therapy in cardiovascular field. Mouse CSC lines were transplanted into myocardial