Clinical aspects of gastrointestinal stromal tumors / 대한내과학회지

BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The GISTs are immunohistochemically defined as KIT (CD117) positive tumors. To evaluate the prognostic factors for GISTs, we investigated the clinicopathological factors and the patient's survival rate. METHODS: Between 1996 and 2002, 37 patients were diagnosed with GIST at Dong-A University Medical Center, and 34 of these patients with localized GIST underwent surgical resection. For the immunohistochemical staining, we used KIT, CD34, s100 and SMA. RESULTS: The primary tumor site was the stomach (60%), and this was followed by small intestine (40%). The most common tumor morphology was spindle cell (83%) followed by epithelial cell (17%). An immunohistochemical analysis revealed that KIT was expressed 100% and CD34 was expressed in 29 cases (78.4%), SMA in 13 patients (35%), and s100 in 7 patients (18.9%). According to the tumor size and mitotic count, 4 patients were classified as very low, 8 were low, 14 were intermediate and 8 patients were high risk. Nine patients (24.3%) underwent adjuvant chemotherapy. The median follow up duration was 29 months. The 5-year disease free survivalrate was 55.1%, and 5-year overall survival rate was 72.8%. The 5-year disease free survival rates for patients with very low and low risk classifications were 100%, and the intermediate risk and high risk were 76.4% and 38.9%, respectively (p=0.1489). The five year overall survival rates for patients with very low and low risk classification were 100%, and intermediate risk and high risk were 90.0% and 0%, respectively (p=0.0179). However, age, pathologic subtype, adjuvant chemotherapy, and immunohistochemical stain results were not significant prognostic factors. CONCLUSION: These results suggest that risk stratification was the most important prognostic factor in GISTs.

The Analysis of Temporal Bone Pneumatization between Children with Otitis Media with Effusion and Cleft Palate / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A number of studies have documented that the incidence of otitis media with effusion (OME) is greater than 90% in children with cleft palates. The purpose of this study was to evaluate the correlation of OME and mastoid pneumatization in children with cleft palate. SUBJECTS AND METHOD: We studied 175 ears in 95 patients. They were categorized into three groups according to otologic finding:normal children (38 ears), children with OME (89 ears), children with cleft palates (38 ears). The mastoid pnuematization was graded into 5 groups. RESULTS: The masoid pneumatization was relatively good in 76.3% of normal children. The mastoid pneumatization was poor in 40.4% of the children with OME. All children with cleft palate had OME in both ears and their mastoid pneumatizations were very poor, with 16.7% of grade IV and 83.3% of grade V. CONCLUSION: The mastoid pneumatization of children with cleft palate was very poor compared to those without cleft palate. We believe that mastoid pneumatization was influenced by the disease of middle ear and mastoid, environmental factors. Special consideration is needed to deal with otologic problems in children with cleft palate.