BACKGROUND/AIMS: Assessment of malignant potential in gastrointestinal stromal tumor (GIST) is still problematic. The maximum tumor diameter and the mitotic index are generally used as an index of malignancy of GISTs. The Ki-67 labeling index has recently been used as an index of cell growth. The aim of this study was to investigate the prognostic value of Ki-67 in GIST. METHODS: We retrospectively reviewed the medical records of 32 patients with GIST who underwent surgical resection at Inje University Seoul Paik Hospital. We analyzed their Ki-67 expression, histologic finding, and prognosis. RESULTS: According to the tumor size and mitotic count, 4 patients were classified as very low risk, 9 patients as low risk, 14 patients as intermediate risk and 5 patients as high risk. The average Ki-67 index was 5.56+/-4.48%. The median follow-up duration was 35.72+/-29.04 months, and local/distant recurrences were observed in 6 (18.7%) patients. The overall cumulative disease free survival rates in patients with Ki-67 index < or =5% at 1 year, 2 years, and 5 years were 100%, 100%, and 86%, respectively. The overall cumulative disease free survival rates in patients with Ki-67 index >5% were at 1 year, 2 years, and 5 years were 82.1%, 70.3%, and 46.9%, respectively. There was significant relationship between elevated Ki-67 and disease free survival rate (p=0.007). CONCLUSIONS: Our study suggests that Ki-67 index >5% confers a higher risk of relapse in patients with GIST. Future work should focus on standardization of Ki-67 assessment and specification of its role in making treatment decisions.
Adult ; Aged ; Disease-Free Survival ; Female ; Gastrointestinal Neoplasms/*diagnosis/mortality/pathology ; Gastrointestinal Stromal Tumors/*diagnosis/mortality/pathology ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Ki-67 Antigen/*metabolism ; Linear Models ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies

PURPOSE: This study analyzed the effectiveness of poly (lactic-co-glycolic acid) (PLGA) as a tissue recovery agent and determines the in vivo safety and efficacy of microparticle-based PLGA. MATERIALS AND METHODS: Fifteen 3-month-old male white rabbits were used. Allogenic adipose tissue derived stromal vascular fraction (SVF) was cultured and labeled with the fluorescent dye PKH26. The rabbits were divided into 4 groups: the SVF group, the PLGA group, the normal control group, and the disease control group. The right corpus cavernosal tissue of the rabbits was surgically removed in the selected portion, except in the normal control group. The defect space of each rabbit was replaced with 10(6) SVF cells in the SVF group and 0.1 g of biodegradable polymer solution in the PLGA group. Microscopic confirmation and analysis of tissue regeneration were performed after 8 weeks. Using confocal microscopy, the nuclei of the smooth muscle cells and SVF migration were examined. The composition of smooth muscle and fibrosis of the injured corpus cavernosum were compared and analyzed by Masson's trichrome stain. RESULTS: There were no signs of migration or rejection of the injected materials in any of the experimental groups. The mean amount of smooth muscle in the normal control group was 15.25+/-1.34 microm2 (right) and 13.90+/-0.703 microm2 (left); in the disease control group it was 11.10+/-0.87 microm2 (right) and 12.80+/-1.01 microm2 (left); in the SVF group it was 13.82+/-4.10 microm2 (right) and 13.96+/-3.94 microm2 (left); and in the PLGA group it was 12.89+/-1.39 microm2 (right) and 13.24+/-1.43 microm2 (left). Only the disease control group showed significant decreased smooth muscle in the left cavernosum (p<0.05). No significant difference was found between the left and right side of each rabbit's cavernosal smooth muscle in the SVF or PLGA group (p>0.05). Furthermore, no difference was found between any two groups (normal control versus SVF (p=0.705), normal control versus PLGA (p=0.88), SVF versus PLGA (p=0.23). CONCLUSIONS: PLGA microparticles had the same tissue restoring effect when compared with SVF and no adverse effect or migration of particles was found through the injection of PLGA or SVF. PLGA is safe and has the proper tissue recovery effect, saving additional tissue harvesting.
Adipose Tissue ; Fibrosis ; Humans ; Infant ; Lactic Acid ; Male ; Microscopy, Confocal ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Organic Chemicals ; Penis ; Polyglycolic Acid ; Polymers ; Rabbits ; Regeneration ; Rejection (Psychology) ; Tissue and Organ Harvesting

A solitary fibrous tumor (STF) is a relatively unusual neoplasm first described as a distinctive tumor arising from pleura. Some reports have shown that STF also affect extrathoracic regions. A 70-year-old woman was referred to our hospital for surgical treatment of an incidentally discovered thigh mass. We performed complete removal of the tumor. It was a soft tissue tumor with muscle indentation but without invasion to the surrounding muscles. The resected specimen was 7.0x6.3x5.2 cm. Histologically, the tumor was composed of a haphazard proliferation of spindle cells and epitheloid cells with hypercellularity and high mitotic activity. Immunohistochemistry showed positive immunoreactivity for CD34, CD99, bcl-2 protein, CD117, vimentin, smooth muscle actin and epithelial membrane antigen. We report, herein, on a rare case of malignant SFT in the thigh region along with a review of the literature.
Actins ; Aged ; Female ; Humans ; Immunohistochemistry ; Mucin-1 ; Muscle, Smooth ; Muscles ; Pleura ; Solitary Fibrous Tumors ; Thigh ; Vimentin

Cutaneous metastasis from bladder cancer is very rare. A 48-year-old man presented with a 5 month history of a dome-shaped nodule on his scalp. Histopathologic examination of the skin lesion revealed the proliferation of atypical cells, which were similar to those of urothelial carcinoma of the urinary bladder. We herein report on a case of cutaneous metastasis from urothelial carcinoma of the urinary bladder with a review of the Korean literature.
Carcinoma, Transitional Cell ; Humans ; Middle Aged ; Neoplasm Metastasis* ; Scalp ; Skin ; Urinary Bladder Neoplasms ; Urinary Bladder*

Xanthogranuloma is a benign, fibrohistiocytic lesion that presents as a yellowish, cutaneous papule or nodule. Although the head, neck, and trunk are the most common sites for xanthogranuloma, it can appear at any site on the body. We report a rare solitary xanthogranuloma on the palm of 24-year-old man.
Head ; Humans ; Neck ; Young Adult

Granular cell tumor (GCT) of the breast is a rare clinical entity, and is believed to be of schwannian origin and to follow a benign clinical course. A 50-year-old woman presented with a slowly growing mass in the right breast. Fine needle aspiration cytology revealed a cellular smear containing isolated or clustered cells showing round to oval nuclei with abundant oncocytic granular cytoplasm. Nuclei showed a fine granular chromatin pattern and occasional small single nucleoli. Cell boundaries were poorly defined, and naked nuclei were frequently found. Histologically, the tumor showed features of typical GCT, and immunohistochemical staining findings strongly supported the diagnosis. The present study demonstrates that GCT of the breast can mimic malignant lesions of breast both clinically and radiologically. The recognition of its cytologic features and suspicion of this lesion would undoubtedly aid the correct diagnosis of mammary GCT.
Biopsy, Fine-Needle* ; Breast* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Granular Cell Tumor* ; Humans ; Middle Aged

Diffuse infiltrative lymphocytosis syndrome is an autoimmune syndrome that is characterized by the oligoclonal expansion of CD8+ T-lymphocytes in response to human immunodeficiency virus (HIV) antigens. The clinical manifestations include bilateral enlargement of the parotid glands, lymphocytic interstitial pneumonitis, lymphocytic hepatitis, neurological involvement and systemic lymphadenopathies. In addition to a positive HIV test, the diagnostic histopathological findings are CD8+ T-lymphocytic infiltrations in the lymphnodes, liver, lung, muscle and the salivary or lacrimal glands without granulomatous or neoplastic involvement. We report a case of pulmonary involvement of diffuse infiltrative lymphocytosis syndrome that was associated with a human immunodeficiency virus infection.
Hepatitis ; HIV* ; Humans* ; Lacrimal Apparatus ; Liver ; Lung ; Lung Diseases, Interstitial ; Lymphocytosis* ; Parotid Gland ; T-Lymphocytes

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss

Inflammatory pseudotumor (IPT) is an uncommon benign neoplasm of unknown etiology presenting as an incidental mass, fever, malaise, anemia, and weight loss. Generally, IPT in the lung is asymptomatic. A case of pulmonary IPT presenting as prolonged fever in a 59 year old man is presented with clinicopathological findings. The patient had been febrile for three months before admission. Five months before admission, a chest X-ray showed a small left pulmonary mass which was regarded as old tuberculosis. An chest X-ray taken on admission revealed a left pulmonary mass two times the size of the one on the first x-ray. Percutaneous needle aspiration and biopsy were performed, and the microscopic examination revealed a plasma cell reaction with myofibroblastic proliferation, consistent with IPT. As prolonged unexplained fever is a frequent symptom in patients with IPTs, this disease entity should be included in the differential diagnosis of fever of unknown origin.
Anemia ; Biopsy ; Diagnosis, Differential ; Fever of Unknown Origin* ; Fever* ; Granuloma, Plasma Cell ; Humans ; Lung ; Middle Aged ; Myofibroblasts ; Needles ; Plasma Cell Granuloma, Pulmonary* ; Plasma Cells ; Thorax ; Tuberculosis ; Weight Loss

OBJECTIVE: Lower extremity orthoses are important in the rehabilitation of the patients with stroke and traumatic brain injury. But it is unknown how much they are used in the social activity after the discharge from the hospital. This study was carried out to investigate the status of using orthosis in social activity and complaints about orthosis. METHOD: The questionnaires were given to 42 cases with stroke and 17 cases with traumatic brain injury. RESULTS: The user of lower extremity orthosis in social activity were 55.9%, and the causes of disuse were patient's poor condition, improved gait pattern, inappropriate design and defect of orthosis, and patient's refusal. The degree of satisfaction with orthosis for comfort, external appearance and weight were 79.3%, 86.2%, and 72.4%, respectively. CONCLUSION: Physiatrists should give more attention in orthosis at follow-up of patients with stroke and traumatic brain injury and make efforts to improve function and external appearance of orthosis.
Brain Injuries* ; Disulfiram ; Follow-Up Studies ; Gait ; Humans ; Lower Extremity* ; Orthotic Devices* ; Surveys and Questionnaires ; Rehabilitation ; Stroke*