Cellular immunotherapy in multiple myeloma

In multiple myeloma (MM), the impaired function of several types of immune cells favors the tumor’s escape from immune surveillance and, therefore, its growth and survival. Tremendous improvements have been made in the treatment of MM over the past decade but cellular immunotherapy using dendritic cells, natural killer cells, and genetically engineered T-cells represent a new therapeutic era. The application of these treatments is growing rapidly, based on their capacity to eradicate MM. In this review, we summarize recent progress in cellular immunotherapy for MM and its future prospects.

Breast Disease with Skin Thickening: Differential Diagnosis with Mammography & Ultrasonography

Diffuse skin thickening of the breast is produced by lymphedema usually secondary to obstruction of theaxillary lymphatics. On physical examination, the affected breast is, due to increased fluid content, larger,heavier, and of higher overall density. Mammography reveals an increased coarse reticular pattern. Thickening ofthe skin can have many causes. It may be a result of tumor invasion or a tumor in the dermal lymphatics; orbecause of lymphatic congestion through obstruction of lymphatic drainage within the breast, in the axilla, orcentrally in the mediastinum. Further causes may be congestive heart failure, benign inflammation, primary skinprocesses such as psoriasis, or systemic diseases which involve the skin. Mammographic appearance is known to benonspecific. Ultrasound can demonstrate skin thickening directly, but despite some reports suggesting that thecause of skin thickening can be inferred from the results of ultrasound, this is not usually of practicalimportance. The purpose of this study is to review the causes of skin thickening of the breast and to usemammography and US to differentiate the causes.

Thymoma Arising from Aberrant Cervical Thymus

Thymoma is one of the most common neoplasms of the mediastinum, and the most frequent tumor of theanterosuperior compartment. Thymoma developing from arrested undescended thymic cells in the neck is, however,rare. The most common extrathoracic location is the vicinity of the thyroid. Two cases of aberrant cervicalthymoma are presented. Both manifested as mass lesions at the thoracic inlet, with superior displacement of thethyroid. The masses had clinical features similar to those previously reported for cervical thymoma: preponderancein women, and the absence of myasthenic symptoms, but in one case there was malignant transformation.

A Case of Pulmonary Kaposi's Sarcoma in a Patient with Renal

Kaposi's sarcoma accounts for more than 3 % of neoplasms occurring in patients who have undergone atransplant. An epidemiologic study showed that in renal transplanted patients, the incidence of Kaposi's sarcomawas 400 to 500 times higher than in controls of the same ethnic origin. We report a case of Kaposi's sarcomainvolving the lung and skin after immunosuppressive therapy in a patient with renal transplant. A plain chestradiograph showed diffusely increased interstitial opacity with multiple, ill-defined small nodules in both lungfields. HRCT revealed multiple small nodules, predominantly in the peribronchovascular regions, and ill-definedareas of ground-glass opacity and consolidation in both lungs.

The psychological characteristics of functional dyspepsia patients by MMPI

BACKGROUND: The functional dyspepsia gives rise to such a symptom similar to peptic ulcer without showing a noticeable lesion(e.g, gastric or duodenal ulcer) by endoscopy or upper GI serises, and it has been known that this is about twice as many as the peptic ulcer. However, there is no exact theory about its pathophysiology and it is suggested that multiple factors including genetic, physiologic, psychologic, environmental factors are engaged. Especially, in respect to the occurrence of functional dyspepsia and psychological factors, there have been many clinical studies over the world. But, we still need more studies in this country, therefore, this study has been initiated to give help patients of functional dyspepsia, invest.igating their characteristic traits through MMPI. METHODS: From March to September in 1996, the patients who visited the family medicine out-patients department of St. Marys hospital of Catholic Medical College were sampled in this study. There were 46 patients having a similar symptoms to peptic ulcer without showing pathologic lesions by endoscopy. Through an interview and some basic tests, the 41 controls who had no dyspeptic symptoms and were not affected to a noticeable physical or physiological disorders were selected for the normal reference group. The standardized MMPI of our country was applied to the whole object groups to get a result. Then each average value of the measure(mean T-score) was calculated, and the differences of the average value were analyzed by the t-test and chi-square test. And the psychological pattern analysis was done. RESULTS: In demographic aspects, there were no significant differences between the two groups. The mean T score for each measure of the two groups falls within the normal ranges with their values being of between 30 to 70. And the average of L, F, and K measure, known as the validity measure, did not give a significant differences between the two groups. The measure of Hs, D, and Hy have appeared significantly high in the patients group(p<0.01) and the Pd measure, too(p<0.05). While Mf, Pa, and Ma measure have not shown a significant differences, Pt, Sc, and Si measure have very significant differences(p<0.01). CONCLUSIONS: In the patient group with the functional dyspepsia, the measures of Hs, D, and Hy where they indicate a neurotic pattern have shown a very significantly high point as well as those of Pd, Pt, Sc, and Si where they indicate a psychotic pattern. This reveals that in the group of the functional dyspepsia neurotic or psychotic trends to attribute. However, it is very hard to define the characteristics of a group with just one test, so further study with more variable test will be necessary.

CT Differentiation of Adrenal Pheochromocytoma from Primary Carcinoma and Metastasis

PURPOSE: To evaluate the efficacy of CT imaging in differentiating pheochromocytoma from primary adrenalcarcinoma and metastasis. MATERIALS AND METHODS: The authors retrospectively reviewed CT imagings of 24 patients(9 males, 15 females, mean age 49) with 27 surgically or clinically proven adrenal neoplasms larger than 3cm indiameter. These neoplasms included pheochromocytomas(n=11), adrenal carcinomas(n=6), and adrenal metastases(n=10,bilateral : 3). Two radiologists visually inspected CT features with respect to tumor size, shape, intratumoral hypodensity, and calcification, and agreed upon their evalvation. These results were compared with the final histopathologic and clinical diagnosis. RESULTS: Ten of eleven pheochromocytomas(91%) were observed to be round or ovoid; this shape was rarely seen in primary carcinomas(0/6) or metastases(2/10). in contrast, mostcarcinomas(6/6, 100%) were lobulated or irregular in shape, as were most metastases(8/10, 80%). smooth, round orovoid intratumoral hypodensity was noted in all pheochromocytomas. Stellate or linear, irregular intratumoral hypodensity was present in all carcinomas and metastases. However, there were no significant differences in CTdensity of calcification. CONCLUSION: Tumor shape and intratumoral hypodensity are very useful CT findings for differentiating adrenal pheochromocytomas from primary carcinomas and metastases.

Idiopathic fibrosing pancreatitis: a rare cause of chronic obstructive jaundice in childhood

We report a 14-months-old infant who had obstructive jaundice caused by idiopathic fibrosing pancreatitis. Ultrasonography and abdominal computed tomography showed dilatation of the intrahepatic ducts, common bile duct, and the pancreatic duct. Diffuse swelling of the pancreas was also noted on CT. At laparotomy, the head portion of the pancreas revealed a stony hard consistency, and proliferation of fibrotic tissue was confirmed pathologically. Idiopathic fibrosing pancreatitis is a very rare disease entity in childhood, but should be considered in the differential diagnosis of obstructive jaundice in children who demonstrate bile duct and pancreatic duct dilatation and/or diffuse pancreas swelling.