The gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors of the gastrointestinal tract. Between the 1990s and early 2000s, GIST was identified as a tumor characterized by KIT or PDGFRA mutations, resulting in imatinib being established as an effective targeted therapy. However, with advances in molecular diagnostics, approximately 10%–15% of GISTs have been reported to harbor alternative mutations, such as those in the succinate dehydrogenase subunit genes and BRAF, leading to the development of additional targeted therapies. GISTs exhibit a wide spectrum of clinical behaviors, ranging from indolent to highly aggressive, prompting the development of diverse risk classification systems. However, multiple systems remain in use, leading to inconsistent pathologic reports. Moreover, the mitotic counting method—a key factor in risk stratification—has become a major source of confusion among pathologists owing to the adoption of digital pathology and discrepancies between updated international guidelines and outdated reimbursement requirements. These inconsistencies have hindered pathologic reporting and communication between pathologists and clinicians. This review comprehensively overviews the historical background, molecular subtypes, and risk classification systems of GIST, focusing on evolving issues in mitotic rate evaluation and the application of risk classification systems in clinical practice.

The tarsus in dogs has a complex structure that makes its evaluation relatively challenging. Because an accurate diagnosis of the tarsus is difficult through basic examinations alone, imaging tests are essential. Previous studies have explored the anatomical and radiological features of the canine tarsus using several imaging modalities. However, the imaging utility of the tarsus across different modalities has not been thoroughly evaluated. This study aimed to visualize the tarsal structures using magnetic resonance imaging (MRI) and ultrasonography, compare their utility, and propose suitable imaging modalities and conditions for evaluating specific tarsal structures. Magnetic resonance imaging and ultrasound scans of the tarsus of four healthy dogs were performed, and two observers rated the utility of each image on a five-point scale. Although MRI is more beneficial for assessing the tarsal structures than ultrasound, ultrasound also appears clinically useful for evaluating the cranial tibialis muscle, deep digital flexor tendon, subcutaneous fat, joint space, and superficial digital flexor tendon. In addition, each structure of interest can be evaluated for optimal visibility using specific ultrasound sections, MRI sequences, and planes. In veterinary clinical practice, an initial assessment using ultrasound imaging with optimal visibility is required and if further evaluation is necessary, MRI examinations with optimal MRI sequences and planes can be performed.

Objectives: This study aims to examine the clinical outcomes of women who underwent a midurethral sling surgery for stress urinary incontinence and compare postoperative urinary symptoms among different body mass index (BMI) groups. Methods: A retrospective cohort study on results after midurethral sling surgery according to BMI was conducted at the institution of the current study from January 2010 to December 2019. The study population was classified into three groups according to patients’ BMI (in kg/m2 ) during surgery: normal weight (BMI < 23.0 kg/m2 ), overweight (BMI, 23.0–24.9 kg/m2 ), and obese (BMI ≥ 25.0 kg/m2 ). The primary outcome was the recurrence of urinary symptoms after surgery. The secondary outcomes were operation time, estimated blood loss, length of hospital stay, and postoperative complications. Results: This study included 376 patients (normal weight, 148; overweight, 74; and obese women, 154) who underwent midurethral sling surgery. No significant difference was noted in urinary symptom recurrence after midurethral sling surgery. Of the patients, 6.8% (n = 10), 9.5% (n = 7), and 7.8% (n = 12) were normal weight, overweight, and obese women, respectively (P = 0.775). Moreover, operation time (P = 0.589), blood loss (P = 0.138), and complication rate (P = 0.865) showed no significant difference. Conclusions Midurethral sling surgery is effective regardless of BMI. Even when midurethral sling surgery was performed as a concomitant surgery, no significant difference in urinary symptom recurrence, operation time, intraoperative blood loss, and complication rate was noted among different BMI groups.

Abortion, Induced ; Abortion, Missed ; Dilatation ; Female ; Gestational Sac ; Humans ; Hysteroscopy ; Pregnancy Trimester, First ; Pregnancy ; Ultrasonography ; Uterus

OBJECTIVE: This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. METHODS: We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5–16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the “Korean Longitudinal Study on Cognitive Aging and Dementia.” The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. RESULTS: The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd–4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). CONCLUSION: Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.
Aged ; Cognition ; Cognition Disorders ; Cognitive Aging ; Cohort Studies ; Confounding Factors (Epidemiology) ; Dementia ; Folic Acid ; Follow-Up Studies ; Humans ; Logistic Models ; Longitudinal Studies ; Prospective Studies ; Reference Values