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  • 1
    Online Resource
    Online Resource
    Case Report Mediastinal Teratoma Resembling Vascular Tumor with Rapid Growth Accompanied by Vena Cava Superior Syndrome and Bilateral Paramalignant Pleural Effusion
    Brawijaya University ; 2021
    In:  Malang Respiratory Journal Vol. 2, No. 01 ( 2021-12-07), p. 68-75
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 2, No. 01 ( 2021-12-07), p. 68-75
    Abstract: Background: Teratomas are tumors originate from germ cells, consist of well differentiated tissue from more than one of three layers of embryonic cells: ectoderm, mesoderm and endoderm. Teratomas are generally slow-growing and asymptomatic. Mediastinal teratoma is the most common extra-gonadal germ cell tumor. Superior vena cava syndrome and bilateral paramaligant pleural effusion are complications which can occur in mediastinal teratomas. Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss,  swolen of face, neck, and right arm. Chest x-ray showed mediastinal tumor. However, no mediastinal tumor had been detected by chest x-ray to examine her heart disease 3 years earlier. Chest computed tomography scan showed anterosuperior mediastinal tumor surrounding great blood vessels and bilateral pleural effusion. Computed tomography guided transthoracic fine needle aspiration biopsy revealed  tumor containing mature squamous epithelial component. Patient underwent open biopsy by sternotomy and histological assessment confirmed the diagnosis as mediastinal teratoma with vascular lesions predominantly resembling vascular tumor.Conclusion: Establishing the diagnosis of mediastinal teratoma is challenging and it requires multi modality approaches.  Keywords: Mediastinal teratoma, vena cava superior syndrome, bilateral paramalignant pleural effusion.
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Article
    DOI: 10.21776/ub.mrj.2020.002.01.6
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2021
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  • 2
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    Online Resource
    The Role of Surgical Resection as A Salvage Therapy and Immunohistochemical Stain to Confirm Mediastinal Yolk Sac Tumor
    Brawijaya University ; 2020
    In:  Malang Respiratory Journal Vol. 2, No. 01 ( 2020-04-09), p. 49-55
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 2, No. 01 ( 2020-04-09), p. 49-55
    Abstract: Background: Mediastinal germ cell tumors are uncommon, representing less than 1% of all malignancies. They mostly occur in young men after puberty and have a poor prognosis with over all long term survival rate 42%. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an anterior mediastinum tumor and VCSS The CT scan of the chest showed an anterosuperior mediastinal mass which compress the superior vena cava. The result from transthoracic FNAB with USG guidance showed an extragonadal germ cell tumor which resemble an Embryonal Carcinoma from mediastinum. The AFP serum level was elevated. Patient underwent a radiotherapy and a surgical debulking. The biopsy showed an Endodermal Sinus Tumor (Yolk Sac). Immunohistochemical stain for cytokeratin was positive in the tumor cells while stain for CD30 was negative. These were confirming the diagnosis of primary mediastinal yolk sac tumor. Patient received a combination chemotherapy for a total 6 cycles.Conclusion: Some procedures like biopsy, tumor marker, immunohistochemical stain, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining chemotherapy with surgical therapy or radiotherapy could increase the survival outcome of patients.
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Article
    DOI: 10.21776/ub.mrj.2020.002.01.3
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2020
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  • 3
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    Online Resource
    Successful Of Embolization Therapy On Recurrent Massive Hemoptysis because of TB Sequelae
    Brawijaya University ; 2020
    In:  Malang Respiratory Journal Vol. 2, No. 02 ( 2020-09-09), p. 95-100
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 2, No. 02 ( 2020-09-09), p. 95-100
    Abstract: AbstractBackground: Haemoptysis is one of vascular lesions in TB sequelae, with incidence of 28% from 919 cases. It may be recurrent, massive and might cause mortality if left untreated. Embolization procedure with glue and coil can be an alternative to treat patient with recurrent hemoptysis.Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a 34 years old male with intermittent massive haemoptysis. Chest X-ray examination showed Lung Tb far advanced lesion with no acid bacilli found on microbiological examination. Transthoracic FNAB revealed chronic suppurative inflammation, with Cytology sputum Class II. Chest CT Angiography showed Lung TB Far advanced lesions accompanied by mediastinal lymphadenopathy with unsuspecting complications of left supreme intercostal artery aneurysm dd pseudoaneurysm, suggestion embolization. Examination results confirmed the diagnosis of recurrent massive haemoptysis and intercostal artery aneurysm with the history of TB. Embolization procedure was then performed.Conclusion: Angiography CT Scan has better detail in evaluating condition, source, amount, and tract of artery in chest cavity. Bronchial artery embolization as an alternative therapy was found to give better effect of occlusion.Keywords: Massive haemoptysis, chest CT angiography, embolization.
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Article
    DOI: 10.21776/ub.mrj.2020.002.02.4
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2020
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  • 4
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    Online Resource
    A 30-year-old Woman with Multiple-Sites Metastasis Lung Adenocarcinoma and Coronavirus-19 Disease (COVID-19)
    Brawijaya University ; 2023
    In:  Malang Respiratory Journal Vol. 4, No. 2 ( 2023-03-06), p. 265-274
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 4, No. 2 ( 2023-03-06), p. 265-274
    Abstract: Background: Adenocarcinoma is the most common Non-Small Cell Lung Cancer (NSCLC) in non-smokers in Indonesia. It often metastasizes in multiple sites. Metastasis is a negative predictor for prognosis in lung adenocarcinoma. In this covid pandemic era we present a case of a 30-years-old woman with adenocarcinoma and multiple-sites metastasis, and Coronavirus-19 Disease (COVID-19). Case: A 30-year-old woman came to our hospital with multiple complaints of hearing loss, visual loss, and occasional shortness of breath. The patient had a history of wild-type EGFR adenocarcinoma and has been treated with 4 cycles of gemcitabine. She also presented with a lump in her neck. Further examination revealed multiple metastasis tumours in her brain, right eye, neck, and spine. Pleural fluid examination also showed a malignant pleural effusion. Nasopharyngeal swab using reverse transcriptase-polymerase chain reaction (rt-PCR) method revealed that she also suffers from COVID-19 with positive swab result. Despite adequate treatment, she rapidly deteriorates and passed away in hospital. Discussion: Management in this patient is complex due to multiple complications and limitation of management given in COVID-19 isolation ward. She presented with multiple equally complicated metastasis, in which treatment priority should be carefully assessed. Despite treatment by multiple specialists, her problems still persist and proved to be fatal. Conclusion: Although metastasis is common in adenocarcinoma, multiple metastasis is uncommon, and this case highlights the need of careful management priority in such patients in COVID-19 pandemic setting. Keywords: Adenocarcinoma, Multiple Metastasis, Lung Cancer, COVID-19
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Issue
    URL: Article
    DOI: 10.21776/10.21776/ub.mrj.2022.004.02.01
    DOI: 10.21776/ub.mrj.2022.004.02.5
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2023
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  • 5
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    Online Resource
    Correlation Between CEA Serum Level on NSCLC Patients with EGFR Mutation from Tissue and Plasma Sample
    Perhimpunan Dokter Paru Indonesia ; 2022
    In:  Jurnal Respirologi Indonesia Vol. 42, No. 2 ( 2022-04-13), p. 97-106
    Details
    In: Jurnal Respirologi Indonesia, Perhimpunan Dokter Paru Indonesia, Vol. 42, No. 2 ( 2022-04-13), p. 97-106
    Abstract: Background: Patients with NSCLC can have EGFR mutation and increased level of CEA. EGFR mutation test on NSCLC has very important role for EGFR tyrosine kinase inhibitor (TKI) therapy.CEA is also expected to predict treatment efficiency of EGFR-TKI therapy. Tumor tissue biopsy is an invasive method and has come constraints, despite the golden standard testing. Circulating tumor DNA (ctDNA) is a new and less invasive for detecting EGFR mutation using plasma sample. In this study, we investigated the relationship between serum CEA and EGFR mutations in tissue and plasma in NSCLC patient.Methods: This cross-sectional observational research was conducted in Dr. Saiful Anwar General Hospital Malang from August 2018 until July 2019, 76 NSCLC patients who had undergone test of EGFR mutation from tissue, ctDNA, and serum CEA level. Extracted DNA from plasma and tissue samples from citology or biopsy was checked for the EGFR mutation. The serum CEA levels were analyzed using electrochemical luminescence.Results: EGFR mutation from tissue samples positive detected on 34 subjects and ctDNA detected 19 subjects. Serum level of CEA 〉 5 ng/ml was significantly associated with EGFR mutation from tissue sample (p=0.037) with an odds ratio of 2.778 (95% CI: 1.050-7.348), the area under curve for CEA was 68,8% and cut-off CEA 9.14 ng/ml. Serum level of CEA 〉 5 ng/ml wasalso significantly associated with ctDNA (p=0.015) with an odds ratio of 4.8 (95% CI: 1.259-18.299), the area under curve for CEA was 78,1% and cut-off CEA 14.8 ng/ml.Conclusion: Serum CEA level has poor correlation with mutation of EGFR from tissue and moderate correlation with mutation of EGFR from ctDNA in NSCLC patients. Patients with increased level of CEA 〉 5 ng/ml are 2.778 times more at risk to had EGFR mutation and 4.8 times more at risk to had ctDNA positive mutation.
    Type of Medium: Online Resource
    ISSN: 2620-3162 , 0853-7704
    URL: Article
    DOI: 10.36497/jri.v42i2.299
    Language: Unknown
    Publisher: Perhimpunan Dokter Paru Indonesia
    Publication Date: 2022
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  • 6
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    Online Resource
    EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) AND CARCINOEMBRYONIC ANTIGEN (CEA) RELATIONSHIP OF LUNG ADENOKARSINOMA IN SAIFUL ANWAR HOSPITA MALANG
    Center for Journal Management and Publication, Lambung Mangkurat University ; 2017
    In:  Berkala Kedokteran Vol. 13, No. 2 ( 2017-10-13), p. 173-
    Details
    In: Berkala Kedokteran, Center for Journal Management and Publication, Lambung Mangkurat University, Vol. 13, No. 2 ( 2017-10-13), p. 173-
    Abstract: Abstract: EGFR mutations is associated with sensitivity to tyrosine kinase inhibitors (TKI’s) therapy which are found in Lung Adenocarcinoma. There are some limitations in detecting EGFR mutation. CEA is also expected to predict treatment efficiency of EGFR-TKI's therapy. In this study, we investigated the relationship between serum Carcinoembryonic antigen (CEA) and Epidermal Growth Factor Receptor (EGFR) Mutations in Lung Adenocarcinoma patient. Methods : The research was conducted in Dr. Saiful Anwar General Hospital Malang. From May 2014 to November 2015, 54 lung adenocarcinoma patients who had underwent measurements of EGFR  mutation and serum CEA level were retrospectively recruited. None of them had surgery, radiotherapy, chemotherapy and  targeted therapy. EGFR mutation was detected using PCR, serum CEA levels were analyzed using electrochemical luminescence. Result: Abnormal serum levels of CEA were significantly associated with EGFR mutation (95% CI, P=0,043) with an odds ratio of 3.4 (95% CI: 1.010-11.451). The area under the ROC curve for CEA was 0.558 (95% CI, P=0.078). Conclusion: Serum CEA is associated with mutation of EGFR in lung adenocarcinoma patients.  Keywords : Lung cancer, adenocarcinoma, EGFR, CEA
    Type of Medium: Online Resource
    ISSN: 2338-2198 , 1412-0550
    URL: Issue
    URL: Article
    DOI: 10.20527/jbk.v13i2
    DOI: 10.20527/jbk.v13i2.4073
    Language: Unknown
    Publisher: Center for Journal Management and Publication, Lambung Mangkurat University
    Publication Date: 2017
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  • 7
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    Online Resource
    The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female Patient
    Brawijaya University ; 2020
    In:  Malang Respiratory Journal Vol. 2, No. 02 ( 2020-09-09), p. 101-117
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 2, No. 02 ( 2020-09-09), p. 101-117
    Abstract: Title: The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing  Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female PatientAuthor: Frenky Hardiyanto, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Suryanti Dwi Pratiwi, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Diah Prabawati R, MD, Patology Anatomy Specialist, Herwindo P, MD, Internal Medicine Specialist.Introduction:. A woman with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x-rays and ct thorax revealed a mass in mediastinum.Case Description: Patient is a 24 years old female with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x rays and CT thorax revealed a mass in mediastinum. Open biopsy on right neck mass and transthoracic FNAB resulting of chronic inflammation, so the patient was diagnosed with glandular tuberculosis and Mediastinal Tumor. Patient was getting worse after one month consuming OAT. Patient was consulted to Cardiovascular and thorax Surgery Department. Patient was performed thoracotomy and debulking. Anatomical pathology was examined from debulking mass, the result of immunohistochemistry was found nodular mediastinal gray zone lymphoma.Discussion: this case it is very difficult to enforce the diagnosis. Patients have done neck FNAB, transthoracic FNAB, open biopsy right neck mass and FOB have not been able to establish diagnosis. Until finally done thoracotomy and debulking in this patient, from immunohistochemistry results obtained nodular sclerosis Hodgkin lymphoma. Collaboration from pulmonologist, radiologist, cardiovascular and thorax surgeon, and patology anatomy specialist  is needed to confirm the diagnosis in these patients.Keywords: mediastinal tumor, mediastinal gray zone lymphoma
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Article
    DOI: 10.21776/ub.mrj.2020.002.02.5
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2020
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  • 8
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    Online Resource
    Three Tuberculosis Spondylitis Patients With Resistant Rifampicin From the Transpedicular Debridement Surgery Network
    Brawijaya University ; 2021
    In:  Malang Respiratory Journal Vol. 3, No. 1 ( 2021-12-07), p. 148-156
    Details
    In: Malang Respiratory Journal, Brawijaya University, Vol. 3, No. 1 ( 2021-12-07), p. 148-156
    Abstract: Background: TB spondylitis is a disease that can cause neurological disorders, ranging from 1-2% of the total cases of tuberculosis where the most frequent infection is the spine followed by other large joints such as hips, knees and shoulders. The increase in TB spondylitis associated with MDR TB in 2015 showed 52% or about 32,000 incidences globally.Collaboration of individual alloy MDR TB therapy with surgery in TB spondylitis can reduce patient mortality and morbidity.Case: We report three cases of patients in 2017-2018 in Dr. Saiful Anwar with complaints of back pain and lumps in the back, from the results of anamnesa, physical examination and supporting examination of patients diagnosed with TB spondylitis, patients were given medical management, operative and rehabilitation.Conclusion: This case is interesting because from the results of Molecular Rapid Tests whose samples were obtained from a biopsy of the transpendicular debridement surgery tissue obtained the results of Resistant Rifampicin, all three patients received individualized OAT treatment, the development of the conditions of the three patients improved and quality of life improved.
    Type of Medium: Online Resource
    ISSN: 2722-6492 , 2745-7842
    URL: Article
    DOI: 10.21776/ub.mrj.2021.003.01.6
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2021
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  • 9
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    Online Resource
    Bone metastases tend to increase in non-small cell lung cancer with epidermal growth factor receptor mutation
    Universa Medicina ; 2022
    In:  Universa Medicina Vol. 41, No. 1 ( 2022-01-27), p. 4-10
    Details
    In: Universa Medicina, Universa Medicina, Vol. 41, No. 1 ( 2022-01-27), p. 4-10
    Abstract: BackgroundIncreased understanding in molecular pathology of advanced non-small cell lung cancer (NSCLC) over the past decades has led to personalized treatment approaches being advocated. Epidermal growth factor receptor (EGFR) mutation that often occurs in NSCLC can be identified using immunohistochemical examinations. Moreover, clarifying the relationship between computed tomography (CT) and EGFR mutation of NSCLC might inform therapeutic decision-making. The purpose of this study was to determine the relationship between metastatic sites on primary chest CT-scan and EGFR mutation in NSCLC lung cancer patients. MethodsAn cross-sectional design using secondary data was conducted, involving 76 NSCLC patients. EGFR mutations were determined by immunohistochemical examination and metastatic sites by chest CT-scan with contrast. The collected metastatic sites comprised hilar and mediastinal lymphadenopathy, pulmonary nodules, and bone, liver, spleen and suprarenal metastases. A Chi square test was used to analyze the data. ResultsThis study revealed that the highest NSCLC stage was IVb, found in 39 samples (51.3%), while 34 (44.7%) subjects had EGFR mutation. There was no statistically significant difference between metastatic site and positive EGFR mutation, although positive bone metastases (54.8%) tend to have more numerous positive EGFR mutations compared to negative bone metastases (37.7%) (p=0.142). ConclusionsPatients with positive bone metastases tend to have higher positive EGFR mutation compared to negative bone metastases in NSCLC lung cancer patients. Prospective studies evaluating patients with EGFR mutation for bone metastases should be considered. This can provide information on therapeutic decision-making to obtain good clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 2407-2230 , 1907-3062
    URL: Issue
    URL: Article
    DOI: 10.18051/UnivMed.2022.v41.i1
    DOI: 10.18051/UnivMed.2022.v41.4-10
    Language: Unknown
    Publisher: Universa Medicina
    Publication Date: 2022
    detail.hit.zdb_id: 2907754-0
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  • 10
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    Online Resource
    Relationship of TTF-1 and EGFR on Lung Adenocarcinoma at Dr. Saiful Anwar General Hospital Malang
    Brawijaya University ; 2020
    In:  Jurnal Kedokteran Brawijaya Vol. 31, No. 1 ( 2020-02-29), p. 43-48
    Details
    In: Jurnal Kedokteran Brawijaya, Brawijaya University, Vol. 31, No. 1 ( 2020-02-29), p. 43-48
    Abstract: There is a correlation between mutation of Epidermal Growth Factor Receptor (EGFR) and lung adenocarcinoma. Unfortunately, examination for EGFR mutation is difficult because surgery must be conducted to obtain the best specimen. Thyroid Transcription Factor-1 (TTF-1) is a marker for lung adenocarcinoma. This observational study took place at Dr. Saiful Anwar Hospital from stored biological materials from 2013-2018. Samples were lung adenocarcinoma patients that undergo EGFR examination. Data then analyzed using Fischer's Exact Test to determine the relationship between EGFR and TTF-1. Specificity/sensitivity value is 0.75/0.90, p: 0.617, odds ratio 0.333 (0.032-3.515). However, Receiver Operating Characteristic (ROC) curve of TTF- 1 show AUC 0.614 (95CI, 0.35- 0.878). TTF-1 examination has a moderate strength in determining EGFR mutation on lung adenocarcinoma patients at Dr. Saiful Anwar Hospital.         
    Type of Medium: Online Resource
    ISSN: 2338-0772 , 0216-9347
    URL: Issue
    URL: Article
    DOI: 10.21776/ub.jkb.2020.031.01
    DOI: 10.21776/ub.jkb.2020.031.01.9
    Language: Unknown
    Publisher: Brawijaya University
    Publication Date: 2020
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