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The Usefulness of Pressure-regulated Volume Control(PRVC) Mode in Mechanically Ventilated Patients with Unstable Respiratory Mechanics (기계 호흡 중 불안정한 호흡역학을 보인 환자에서 압력조절용적조정양식(Pressure-regulated Volume Control Mode)의 효용)

  • Sohn, Jang-Won;Koh, Youn-Suck;Lim, Chae-Man;Shim, Tae-Sun;Lee, Jong-Deog;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1318-1325
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    • 1997
  • Background : Since the late 1960s, mechanical ventilation has been accomplished primarily using volume controlled ventilation(VCV). While VCV allows a set tidal volume to be guaranteed, VCV could bring about excessive airway pressures that may be lead to barotrauma in the patients with acute lung injury. With the increment of knowledge related to ventilator-induced lung injury, pressure controlled ventilation(PCV) has been frequently applied to these patients. But, PCV has a disadvantage of variable tidal volume delivery as pulmonary impedance changes. Since the concept of combining the positive attributes of VCV and PCV(dual control ventilation, DCV) was described firstly in 1992, a few DCV modes were introduced. Pressure-regulated volume control(PRVC) mode, a kind of DCV, is pressure-limited, time-cycled ventilation that uses tidal volume as a feedback control for continuously adjusting the pressure limit However, no clinical studies were published on the efficacy of PRVC until now. 'This investigation studied the efficacy of PRVC in the patients with unstable respiratory mechanics. Methods : The subjects were 8 mechanically ventilated patients(M : F=6 : 2, $56{\pm}26$ years) who showed unstable respiratory mechanics, which was defined by the coefficients of variation of peak inspiratory pressure for 15 minutes greater than 10% under VCV, or the coefficients of variation of tidal volume greater than 10% under PCV. The study was consisited of 3 modes application with VCV, PCV and PRVC for 15 minutes by random order. To obtain same tidal volume, inspiratory pressure setting was adjusted in PCV. Respiratory parameters were measured by pulmonary monitor(CP-100 pulmonary monitor, Bicore, Irvine, CA, USA). Results : 1) Mean tidal volumes($V_T$) in each mode were not different(VCV, $431{\pm}102ml$ ; PCV, $417{\pm}99ml$ ; PRVC, $414{\pm}97ml$) 2) The coefficient of variation(CV) of $V_T$ were $5.2{\pm}3.9%$ in VCV, $15.2{\pm}7.5%$ in PCV and $19.3{\pm}10.0%$ in PRVC. The CV of $V_T$ in PCV and PRVC were significantly greater than that in VCV(p<0.01). 3) Mean peak inspiratory pressure(PIP) in VCV($31.0{\pm}6.9cm$ $H_2O$) was higher than PIP in PCV($26.0{\pm}6.5cm$ $H_2O$) or PRVC($27.0{\pm}6.4cm$ $H_2O$)(p<0.05). 4) The CV of PIP were $13.9{\pm}3.7%$ in VCV, $4.9{\pm}2.6%$ in PVC and $12.2{\pm}7.0%$ in PRVC. The CV of PIP in VCV and PRVC were greater than that in PCV(p<0.01). Conclusions : Because of wide fluctuations of VT and PIP, PRVC mode did not seem to have advantages compared to VCV or PCV in the patients with unstable respiratory mechanics.

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Total Folate Contents of 15 Edible Plants Consumed in Korea Using Trienzyme Extraction Method (국내 소비되는 봄나물의 Trienzyme 추출법을 적용한 엽산 함량 분석)

  • Kim, Bo Min;Kim, So-Min;Oh, Ji Yeon;Cho, Young-Sook;Kim, Se-Na;Choi, Youngmin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.43 no.11
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    • pp.1796-1800
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    • 2014
  • Trienzyme digestion (AOAC Official Method 2004.05) procedure using protease, ${\alpha}$-amylase, and chicken pancreas conjugase was evaluated to determine its usefulness in the microbiological quantitation of total folate in foods. Folate values obtained by alkali hydrolysis (Korean Food Standards Codex) were compared to those obtained by the trienzyme method for four certified reference materials (CRM) representing diverse matrixes. Trienzyme treatment increased measurable folate from most CRM compared to levels found after alkali hydrolysis. The largest increases were observed with CRM 487 (pig liver, 5.8-fold) and CRM 121 (whole meal flour, 3.1-fold) after trienzyme digestion. Using trienzyme digestion method, total folate contents of raw and blanched edible plants were determined. Eleutherococcus senticosus ($146.9{\mu}g/100g$) showed the highest total folate content, followed by Aster glehni F. Schmidt ($142.8{\mu}g/100g$) and Ledebouriella seseloides H. Wolff ($140.4{\mu}g/100g$) on a wet weight basis. Blanching of samples resulted in an insignificant decrease in folate content for five samples and 11~63% reduction for nine samples. Our finding suggests that trienzyme digestion method is accurate for the determination of food folate in leafy vegetables.

Crystallization and Magnetic Properties of Iron Doped La-Ba-Mn-O (Fe이 치환된 LaBaMnO계 산화물의 중성자 회절 및 Messbauer분광학연구)

  • Choi, Kang-Ryong;Kim, Sam-Jin;Shim, In-Bo;Kim, Chul-Sung
    • Journal of the Korean Magnetics Society
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    • v.14 no.1
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    • pp.38-44
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    • 2004
  • The iron doped colossal magnetoresistance materials with La-Ba-Mn-O perovskites structure have been synthesized by chemical reaction of sol-gel methods. Their crystallographic and magnetic properties have been studied with x-ray diffraction, VSM, RBS, Mossbauer spectroscopy, and magnetoresistance measurements. The crystal structure of the La$\_$0.67/Ba$\_$0.33/Mn$\_$0.99/Fe$\_$0.01/ $O_3$ at room temperature was determined to be orthorhombic of Pnma. The lattice parameters a$\_$0/ and c$\_$0/ increased gradually, but b$\_$0/ deceased with increase of iron substitution. The magnetization and coercivity deceased, also the Curie temperature decreased from 360 K as x increased from 0.00 to 0.05. Magnetoresistence measurements were carried out, and the maximum MR ($\Delta$$\rho$/$\rho$(0)) was observed at 281 K, about 9.5 % in 10 kOe. The temperature of maximum resistance (R$\_$MAX/) decreased with increasing substitution of Fe ions and a semiconductor-metal transition temperature (T$\_$SC-M/) decreased too. This phenomena show that ferromagnetic transition temperature decreased by substituting Fe for Mn ions, it decreases double exchange interaction. This result accords with magnetic structure of neutron diffraction. Mossbauer spectra of La$\_$0.67/Ba$\_$0.33/Mn$\_$0.99/Fe$\_$0.01/ $O_3$were taken at various temperatures ranging from 15 to 350 K. With lowering temperature of the sample, two magnetic phases were increased and finally it showed the two sharp sextets of spectra at 15 K. The isomer shift at all temperature range is about 0.3 mm/s relative to Fe metal, which means that both Fe ions are Fe$\^$3+/ states.Fe$\^$3+/ states.

Original expression of the creative chidren's picture-book (창작그림동화의 독창성 연구)

  • 안경환
    • Archives of design research
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    • v.11 no.1
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    • pp.185-197
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    • 1998
  • The domestic publishing market has heen ranked at No.7 in the word publishing market(stastics material in Cultu re and Gymnastics m inistrv )Es pe cia Ill'. publishing quantity of children'book is about to reacb No.3. Such a publishing condition i." showing that Korean publishing world has limit,llion of kind and genre despite of its quant.iative improvement On the ot.her hand. t',reign juvenile publi."hing has multi-publishing form, which is a simultaneous publishing with dolls, audio stuff, game programs and CD-ROM t.itles. Even the animation is considered as of the publication at the planning s tsge. However, when we take a look at domestic condition we come to know that Korean juvenile publishing has been occupied mostly by the studying book. Also, the cautious book selection by the well educated parents in l990's has brought up the change of juvenile publishing world. Such a presen t condition bears of juvenlie publi.,;hing world. Such a present condition bears problem, which is the checking 190 translat.ions among the published picture- books of the last ye ar children's book Nevertheless, there was a sucessful domestic planned creative picture book last year. That is "Puppy s shit", which was sold out 15 000 copies and be st se ller of children's book. Whe n we take a look at the commercial success of "Puppy s shit", it is possible that domestic work holds a position in the publishing market. "Puppy s shit" is the story about valuable nature with Korean styled illustration, which tells the prefemece of Korean book in do mestic pu blis hin f.i market. With the motto "Finding prospect of the Korean creative children's book", this paper was went throu gh. By searchinf.i for creative com ponent.s of picture-book planning such as theme, story, illustration, and edit design through the foreign picture-book "What 1 want. to know from the little mole is who made it on top of his head"-and domestic creative picture/book 'Puppy's shit", this study tried to tell a couple of things like followings publication of Korean creative picture book in t.he world. professional and more artistic inner fabric and originality(the relatio nship be tween stort and illu,tration), improvement of illustration through new formative language with well expressed con ten t, planning improvem ent of Korean creative pictive picture book including literary, artistic and educative component and finally examples of planning, artict and educative component and finally example, of planning the good book with a story and illu,;tration which can in the long run improve the value of life for the children.h can in the long run improve the value of life for the children.

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Extraction of Acetylcholinestrase from the Housefly and Three Other Insect Species for In Vitro Anticholinesterase Screening (In Vitro Anticholinesterase 스크리닝을 위한 집파리 및 3종 곤충으로부터의 Acetylcholinesterase의 추출)

  • 이시혁;이준호;조광연
    • Korean journal of applied entomology
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    • v.30 no.1
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    • pp.18-28
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    • 1991
  • The optimal pH of the extraction buffer was 7.5 considiering AChE stability and its buffer capacity when AChE was isolated and extracted from the housefly(Musca domesitca L.)and three other insect species with 0.01 M sodium phosphate buffer. Also, the optimal pH of the reaction buffer was 7.5 considering enzyme activity and its buffer capacity when AChE activity was measured with the substrate in 0.1 M sodium phosphate buffer. The Potter Elvehjem type homogenizer with Teflon pestle was used to homgenize the tissues. When preparing a AChE suspension by centrifuging the homogenate, 700 g supernatant of adult head for the housefly, 700 g supernatnat of 5th instar nymphal whole body for the brown planthopper, lipid-eliminated 10,000 g supernatant of 5th instar larval whole body for the diamondback moth, and 700 g supernatant of 4th instar larval head for the tobacco cutworm were considered satisfactory as enzyme sources in view of mass preparation, extraction efficiency and stability of enzyme activity during evaluation. When AChE suspensions of 4 insect species were stored at $-18^{\circ}C$, more than 90% of activity was maintained up to 3 weeks. Km values of AChEs of the housefly, the brown planthopper, and the diamondback moth were 0.042, 0.037 and 0.043 mM, respectively and AChE-specific substrate inhibition was observed at high concentration. Km value of the tobacco cutworm ChE was 1.15 mM and BuChE characteristics was observed, though further study is needed. The optimal substrate concentration for the AChE inhibition tests was 0.5 mM for the housfly, the brown planthopper, and the diamondback moth and 12 mM for the tobacco cutworm.

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The Comorbidity of Periodic Limb Movements Disorder in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자에서의 수면중 주기성 사지운동장애의 동반이환율)

  • Yang, Chang-Kook;Son, Choon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1039-1046
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    • 1998
  • Background: Sleep-related breathing disorders(SRBD) and periodic leg movements disorder(PLMD) are both common, and are considered as separate sleep disorders. However, both disorders show high comorbidity. SRBD and PLMD can result in excessive daytime sleepiness and insomnia due to frequent sleep fragmentation. So, it is very important to consider the presence of PLMD, when we are dealing with the diagnosis and management of SRBD. The objectives of this study were to determine the incidence of PLMD in patients with SRBD, and to describe any differences between patients with and without PLMD. Method: The authors reviewed the sleep recordings of 106 patients with a final diagnosis of SRBD(obstructive sleep apnea or upper airway resistance syndrome), who underwent full nocturnal polysomnography, including the monitoring of the anterior tibialis electromyogram. All sleep records were recorded and scored using the standard criteria. The data was analyzed by the student t-test. Result: 106 patients(M=76, F=30) were included in the analysis. Data revealed a mean age of $49.5{\pm}13.6$ years, a respiratory disturbance index(RDI) of $22.3{\pm}25.4$/hour sleep, a lowest oxygen saturation of $84.9{\pm}11.3%$, a maximal esophageal pressure of $-41.0{\pm}19.1cmH_2O$, and PLM index(PLMI) of $13.1{\pm}22.4$movements/hour sleep. Forty four percent(47 of 106 patients) had a PLMI of greater than 5 on this study. The mean age of the patients with PLMD was significantly higher than that of the patients without PLMD(p<0.005). Female patients with SRBD accompanied more PLMD(p<0.05). The apnea index of the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.01). The percentage of stage 1 sleep in the patients with PLMD was significantly lower than that of the patients without PLMD(p<0.05). Conclusion: The prevalence of PLMD in the patients with SRBD was high at 44.3%. The patients with PLMD were older and had more high RDI in comparison to the patients without PLMD, which was consistent with previous findings. The authors recommend that more careful consideration of PLMD is required when diagnosing and treating SRBD.

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Primiparas만 Perceptions of Their Delivery Experience and Their Maternal-Infant Interaction : Compared According to Delivery Method (초산모의 분만유형별 분만경험에 대한 지각과 모아상호작용 과정에 관한 연구)

  • 조미영
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.153-173
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    • 1990
  • One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p=0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p=0.000) but no differences for labor or the bady according to the delivery method(p=0.096, p=0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p=0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p=0.042), 2nd day (p=0.009), and the 3rd day(p=0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F=.3206, p=.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r=.4363, p=.000, r=.2881, p=.012). No correlations between perceptions of labor and maternal-infant interaction were found(p=0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p=0.000) and from the fourth to sixth weeks after birth(P=0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p=0.002) and breast feeding(p=0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p=0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p=0.010), a wanted pregnancy (P=0.030) and her confidence in her role as a mother(p=0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.

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The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

A Study on the Relationships between the Oral Health Activities and Oral Health Conditions of the Elderly (노인의 구강보건행위와 구강건강상태와의 관련성 조사 연구)

  • Gwon, Mi-Young;Young, Jin-Young
    • Journal of dental hygiene science
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    • v.6 no.4
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    • pp.271-276
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    • 2006
  • This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).

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Clinical Characteristics and Prognosis of Gastrointestinal Stromal Tumors of Stomach (위의 위장관 간질 종양의 임상적 특징 및 예후)

  • Kim, Min-Hyung;Hur, Hoon;Kim, Sin-Sun;Kim, Sung-Keun;Jeon, Kyung-Hwa;Song, Kyo-Young;Kim, Jin-Jo;Jin, Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim, Keun-Woo;Jeon, Hae-Myung
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.146-153
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    • 2006
  • Purpose: Gastrointestinal stromal tumorsm (GISTs) are the most common mesenchymal tumors that arise anywhere in the tubular GI tract. The prognosis for GSTIs is important because f GISTs may metastasiwx in the liver or the abdominal cavity in an early stage. For the reason we examined the tumor size, the mitotic number, ki 67, p53, and c-kit mutation as independent prognostic factor for GISTs. Materials and Methods: A retrospective study was conducted in 76 patients who had been re-evaluated for confirmation of diagnosis between Jan 1998 and Dec. 2001. at Catholic University of medicine. Results: There were significant difference between the turner size, mitotic indices, ki 67, c-kit mutations and the 5-years survival rates. Tumor size (${\geq}5\;cm$) and mitotic index (${\geq}5/50\;HPF$) were statistically related to a significantly poor prognosis (P=0.017 and P=0.042, respectively). c-kit mutations in exon 11 were found in 7 cases c-kit mutation was observed more frequently in high risk patients, and there was a significant difference between c-kit mutation and survival (P=0.037). Elevated ki 67 was noted in 34 out of the 76 cases. High risk patients showed elevated ki67 index more frequently and there was significant relation with the survival rate (P=0.0417). Conclusion: We think that tumor size, mitotic index, Ki 67 and c-kit mutation are as independent prognostic factors for GISTs, but more research is needed.

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