The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

Carcinosarcoma is an uncommon pulmonary malignancy characterized by carcinomatous parenchyma and sarcomatous stroma. Pulmonary carcinosarcoma represented about 1% of the resected lung tumors. The predominant clinical features are productive cough, chest pain, dyspnea, hemoptysis, bronchiectasis, and atelectasis, but alternate atelectasis is rare. We report a case of pulmonary carcinosarcoma associated with alternate atelectasis of the right upper and lower lobe.
Bronchiectasis ; Carcinosarcoma* ; Chest Pain ; Cough ; Dyspnea ; Hemoptysis ; Lung ; Pulmonary Atelectasis*

The pulmonary lymphomas were thought to originate in specialized lymphoid tissue that is associated with bronchial mucosa(bronchus-associated lymphoid tissue(BALT)), and they were categorized as mucosa-associated lymphoid tissue(MALT) lymphoma. MALT lymphoma consists of a monoclonal population of cell, in contrast to reactive lymphoid proliferation, which consists of polyclonal cells. Lymphoma arising from MALT(=MALToma) represents a distinct clinicopathologic features. It is usually localized to their original site for a long time and shows much more favorable prognosis than lymphoma at other site. Some MALT lymphoma could arise simultaneously or successively in different organ or that cells from MALT lymphoma might circulate and give rise to another lymphoma by homing in the MALT of another organ, such as breast, salivary gland, stomach etc, and can be multifocally disseminated or recurred. We report a case of low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue(MALT) of the lung, which was confirmed by open lung biopsy, immunohistochemistry and PCR assay.
B-Lymphocytes ; Biopsy ; Breast ; Immunohistochemistry ; Lung ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Polymerase Chain Reaction ; Prognosis ; Salivary Glands ; Stomach

An aortic aneurysm is described as a permanent localized dilatation of the aorta having a diameter at least 1.5 times that of the expected norrnal diameter of that given aortic segment. Thoracic aortic aneurysms are much less common than are aneurysms of the abdominal aorta. Thoracic aneurysms are classified by the portion of aorta involved, I.e., the ascending, arch, or descending thoracic aorta. We experienced a case of saccular arteriosclerotic aortic aneurysm associated with thrombus in aortic arch in a 78 year-old male who had history of hypertension. He was admitted to Kwangju Veterans Hospital complaining of drowsy mental state and swelling of left foreann. The chest X-ray, chest CT and echocardiogram showed saccular dilatation(maximal diarneter ; 7.67~7.86cm) associated with thrombus in aortic arch. He refused operation because of old age, so he was conservatively rnanaged including propranolol. We report this case of saccular arteriosclerotic aneurysm of aortic arch with a brief review of literature.
Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortic Aneurysm* ; Aortic Aneurysm, Thoracic ; Dilatation ; Gwangju ; Hospitals, Veterans ; Humans ; Hypertension ; Male ; Propranolol ; Thorax ; Thrombosis* ; Tomography, X-Ray Computed

BACKGROUND: Cathepsin D, an aspartic lysosomal proteinase, is believed to be involved in local invasion and metastasis of tumor cells by its proteolytic activity and has been described to be associated with tumor progression and prognosis in some human malignancies including breast cancer. But, its prognostic value for human lung cancer remains to be determined. The purpose of this study is to determine clinicopathological and prognostic significance of cathepsin D expression in non-small cell lung cancer. METHOD: Using a polyclonal antibody, immunohistochemical analysis of cathepsin D was performed on paraffin embedded sections of tumors obtained surgically from 54 patients with non-small cell lung cancer (37 squamous cell carcinoma, 14 adenocarcinoma, 2 large cell carcinoma, and 1 undifferentiated carcinoma). RESULTS: Eighteen patients (33.3%) showed positive immunoreactivities of cathepsin D in tumor cells. No significant correlation of cathepsin D expression in tumor cells was found in p-stage (surgical-pathologic stage), tumor size, tumor factor, nodal involvement, and differentiation. Of 54 patients, 29 (53.7%) patients showed moderate to massive cathepsin D-positive stromal cells within the tumor tissues, while the rest (46.3%) showed few cathepsin D-positive stromal cells within the tumor tissues. Cathepsin D expression n stromal cells was significantly associated with p-stage in non-small cell lung cancer (p=0.031). No significant correlation of the degree of cathepsin D-positive stromal cells was found in tumor size, T-factor, nodal involvement, differentiation. Cathepsin D expression status in tumor cells and stromal cells was not significantly associated with prognosis expressed by survival rate. The results of multivariate analyses of variables possibly associated with progonosis showed that nodal involvement was the only independent prognostic factor in all patients. CONCLUSION: Cathepsin D expression in stromal cells was significantly associated with p-stage in non-small cell lung cancer. However, it was not related to other clinicopathologic features and prognosis, and Cathepsin D expression in tumor was not related to p-stage and prognosis.
Adenocarcinoma ; Breast Neoplasms ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cathepsin D* ; Cathepsins* ; Humans ; Lung Neoplasms ; Multivariate Analysis ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Stromal Cells ; Survival Rate

BACKGROUND: To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. MATERIAL AND METHODS: Thirteen women with tuberculous bronchial stenosis(9cases: left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PFT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. RESULT: 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(l/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. But, significant improvement of PFT was noted in only 25% (1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(l/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. . 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. CONCLUSION: We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery, and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.
Airway Obstruction ; Anesthesia, Local ; Bronchi ; Constriction, Pathologic* ; Cough ; Cryotherapy ; Dilatation* ; Dyspnea ; Female ; Fever ; Humans ; Leukocytosis ; Mediastinal Emphysema ; Mediastinitis ; Pneumothorax ; Respiratory Sounds ; Sputum ; Thorax ; Tuberculosis*

BACKGROUND: To evaluate the effect of the balloon dilatation in tuberculous bronchial stenosis, we performed balloon dilatation in 13 cases which had airway obstruction in main bronchus with the impairment of pulmonary function. MATERIAL AND METHODS: Thirteen women with tuberculous bronchial stenosis(9cases: left main bronchus, 4 cases: right main bronchus) underwent fluoroscopically guided balloon dilatation under the local anesthesia. Among the these patient, 9 cases were active endobronchial tuberculosis, and 4 cases were inactive. Immediate and long term follow-up(average 15.6months) assessments were done focused on change on PFT. The increase of FVC or FEV1 more than 15% after the procedure was considered effective. Complications after dilatation were evaluated in all patients. RESULT: 1) There were an decrease of self-audible wheezing in 75%(6/8), improvement of dyspnea in 62.5%(5/8), improvement of cough and expectoration in 50%(3/6), and improvement of chest discomfort in 50%(l/2). 2) Significant improvement of PFT was noted in 42.9%(3/7) of which respiratory symptoms duration was below 6 months. But, significant improvement of PFT was noted in only 25% (1/4) of which respiratory symptoms duration was above 12 months. 3) Active stage was 69.2%(9/13) and inactive was 30.8%(4/13). There was an significant improvement of PFT in 44.4%(4/9) of active stage, but, only 25%(l/4) of inactive stage was improved. 4) In 61.5%(8/13), FVC and FEV1 were increased to 35.5%, and 22.2% at post-dilatation 7 days. After 1 month later, FVC and FEV1 were increased to 54.7%, and 31.8% in 5 cases(38.5%). 4 cases in which long-term follow-up(average 19.8months) was possible the improvement of FVC, and FEV1 were 30.5%, and 10.1%. . 5) Just after balloon dilatation therapy, transient leukocytosis or fever was noted in 30.8%(4/13), and blood-tinged sputum was noted in 30.8%(4/13). However, serious complication, such as pneumothorax, pneumomediastinum or mediastinitis, was not noted. CONCLUSION: We conclude that tuberculous bronchial stenosis, which is on active stage, and short dulation of respiratory symptoms was more effective on balloon dilatation than inactive stage or long duration of respiratory symptoms. Furthermore, balloon dilatation is easier, much less invasive and expensive than open surgery, and cryotherapy or photoresection. Because of these advantage, we think that balloon dilatation could be the first choice for treating bronchial stenosis and could be done at first in early stage if unresponsiveness with steroid therapy is observed.
Airway Obstruction ; Anesthesia, Local ; Bronchi ; Constriction, Pathologic* ; Cough ; Cryotherapy ; Dilatation* ; Dyspnea ; Female ; Fever ; Humans ; Leukocytosis ; Mediastinal Emphysema ; Mediastinitis ; Pneumothorax ; Respiratory Sounds ; Sputum ; Thorax ; Tuberculosis*

We described a 65-year-old female of 45,X/46,XX Turner's syndrome associated with patent ductus arteriosus who was admitted due to exertional dyspnea and palpitation. This patient had not spontaneous mensturation and had a short stature without webbed neck and a sexual infantilism. Chromosomal aberrations cause primarily structural defects of cardiovascular system, and a variety of structural aberrations involving the X chromosome can cause partial or complete Turner's syndrome. In Turner's syndrome, bicuspid aortic valve or coarctation of aorta is frequently combined, also aortic root dilatation, partial anomalous venous drainage, hypoplastic left heart, ventricular septal defect, atrial septal defect has been reported. However, this patient had not abnormality in aortic valve and whole aorta. Patent ductus arteriosus in 45,X/46,XX Turner's syndrome have not been reported in Korea. We report this case with a brief review of the literature.
Aged ; Aorta ; Aortic Coarctation ; Aortic Valve ; Bicuspid ; Cardiovascular System ; Chromosome Aberrations ; Dilatation ; Drainage ; Ductus Arteriosus, Patent* ; Dyspnea ; Female ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Korea ; Neck ; Sexual Infantilism ; Turner Syndrome ; X Chromosome