Active Immunization Study of Colon Cancer Derived 1-8D Peptide in HHD Mice

BACKGROUND: 1-8D gene is a member of human 1-8 interferon inducible gene family and was shown to be overexpressed in fresh colon cancer tissues. Three peptides 1-6, 3-5 and 3-7 derived from human 1-8D gene were shown to have immunogenicity against colon cancer. METHODS: To study tumor immunotherapy of three peptides we established an active immunization model using HHD mice. D(b-/-) x beta2 microglobulin (beta2 m) null mice transgenic for a chimeric HLA-A2.1/D(b-)beta2 m single chain (HHD mice) were challenged with B16/HHD/1-8D tumor cells and were immunized with irradiated peptide-loaded RMA- S/HHD/B7.1 transfectants. In therapy model tumor growth was retarded in HHD mice that were injected with 3-5 peptide-loaded RMA-S/HHD/B7.1. In survival test vaccination with 1-8D-derived peptide protects HHD mice from tumor progression after tumor challenge. RESULTS: These studies show that peptide 3-5 derived from 1-8D gene can be the most effective candidate for the vaccine of immunotherapy against colon cancer and highlight 1-8D gene as putative colon carcinoma associated antigens. CONCLUSION: We demonstrated that RMA-S/HHD/ B7.1 loaded with 1-8D peptides, especially 3-5, immunization generates potent antitumor immunity against tumor cells in HHD mice and designed active immunization as proper immunotherapeutic protocols.

A Large Malignant Insulinoma: Case Report with Endosonographic, Immunohistochemical and Ultrastructural Features

Malignant insulinoma in the beta cells of the pancreatic islet is rare and usually presented as hypoglycemia. We report a case of large malignant insulinoma in a 53-year-old Korean woman. A presumptive clinical diagnosis was made before surgery, based on the high plasma insulin-to-glucose ratio and a large solitary heterogeneous pancreatic mass by abdominal computed tomography and endosonography. The tumor measured 5.8X4.7X4.5 cm in dimension and showed capsular invasions and metastases in two of four peripancreatic lymph nodes. The tumor cells were strongly immunoreactive to insulin and had a high Ki-67 labeling index (13%) and atypical membranous electron-dense granules, ranging from 120 to 400 nm in diameter, in the cytoplasm on electron microscopy. The patient was treated by distal pancreatectomy with splenectomy and rapidly recovered without neurohypoglycemic symptoms. This case showed not only lymph node metastases, the most reliable parameter for malignancy in pancreatic endocrine tumors, but also other valid diagnostic clues, such as high Ki-67 labeling index, heterogeneous enodosonographic findings, capsular invasions with large tumor and pure atypical secretory granules.

Peripheral Artery Aneurysm

Compare to aortic aneurysm, peripheral artery aneurysm is rare but has a tendency of developing multiple arterial aneurysms at the same time. Popliteal artery is the most frequent site of involvement and followed by femoral artery. More than 90% of peripheral artery aneurysms are occurred at these two arteries. Since we have no written nationwide report of peripheral artery aneurysm, we reviewed aneurysms that developed outside of the thoracoabdominal cavity and compared it with western reports. From January 1991 through December 1998, we experienced 19 cases of peripheral artery aneurysms and these included pseudoaneurysms that developed long after vascular trauma. Most frequent ages were 30's and about 3/4 of the patients were male. More than 75% of the patients had symptom of pulsating mass or tender mass when they visited hospital but symptoms associated with mass, such as compression of surrounding structure, were developed in only one patient. Nine cases were developed at femoral arteries and three at popliteal artery and these included 5 cases of pseudoaneurysm. One patient showed multiple arterial aneurysms and 7 patients had atherosclerosis or hypertension. Three cases had Behcet's disease and two of them developed pseudoaneurysm at arterial puncture site and vascular anastomotic site. Most of the aneurysms were excised and performed patch graft, bypass graft or simple closure according to the size of the aneurysm. Three of the patients were died due to myocardial infarction, sepsis and advanced renal failure but aneurysm related mortality was only one who developed sepsis after bypass graft. In summary, we have different incidence of peripheral artery aneurysm in site, multiplicity and presenting symptoms but these are not sufficient because of small limited number of patients. Nationwide report and analysis is necessary.

Seven Cases of Desmoid Tumor of Trunk

BACKGROUND: A desmoid tumor is a rare neoplasm of a mature fibroblast within an extensive collagen matrix. These tumors are classified pathologically as aggressive fibromatosis with local invasiveness, showing recurrences after surgical treatment, although they do not metastasize. Complete surgical excision without leaving a remnant tumor seems to be the primary treatment option, but these tumors often recur after resection. Therefore, alternative treatment strategies, including radiation therapy, nonsteroidal anti-inflammatory agents, anti-estrogen compounds, and cytotoxic chemotherapy, have been employed. METHOD: The authors report the clinical characteristics and prognoses after treatment for seven patients who were diagnosed as having desmoid tumors and who underwent surgical excision for therapy during the ten-year period from 1986 to 1997 at Keimyung University Dongsan Medical Center. RESULTS: There were two males and five females. The most common chief complaint was a slowly growing painless mass. The duration of the symptom before diagnosis was quite different from patient to patient. The locations in the trunk were scattered diffusely: the shoulder, the chest wall, the abdominal wall, the retroperitoneum, and the pelvic cavity. The tumors were well visualized by imaging techniques such as ultrasonograms, CT scans, and MRI. Four of the seven patients experienced recurrent tumors after surgical excision; two are dead. The tumors in the recurrent patients were excised incompletely at initial surgery. CONCLUSION: Although the uncommon, solid desmoid tumors which develop in the musculoaponeurosis of the trunk are benign pathologically, they were recurrent after surgical excision when the resection margin is incomplete. Therefore, complete excision is the only curative therapeutic modality.