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CRANIAL ULTRASOUND: EFFICIENT SCREENING TOOL FOR EARLY DETECTION OF BRAIN INJURY IN PRETERM INFANTS Erawati, Dini Rachma; Yueniwati, Yuyun
Malang Neurology Journal Vol 7, No 1 (2021): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.2

Abstract

Background: Cranial ultrasound becomes an important diagnostic tool to evaluate brain injury in infants. Brain injury is a major complication for preterm birth. The brain injury of preterm infants differs from that of a term infant. Brain injury has correlation with gestational age and mode of delivery.Objective: To analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery and to reveal if cranial ultrasound can be used to detect brain injury in premature infants.Methods: An observational analytic study using cross-sectional design took place in Saiful Anwar Hospital Malang, Indonesia. 38 healthy preterm infants underwent cranial ultrasound examination within the first four day of life. Fisher Exact test was used to analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery.Results:  Most of  the healthy preterm infants (89.5%) were  ≥ 32 weeks gestational age, and 52.6% of samples had caesarean section as their mode of delivery. There were three abnormal findings in cranial ultrasound; increased periventricular echogenic (5.3%), increased parenchym echogenic (5.3%), and indistinguishable of gray-white matter differentiation (5.3%). There was no significant correlation between abnormal cranial ultrasound findings with gestational age and mode of delivery (p= 0.202; p= 0.218).Conclusion: There were abnormal cranial ultrasound findings in some healthy preterm infants despite no significant correlation between ultrasound findings with gestational age and mode of delivery. Cranial ultrasound in preterm infants could become a screening tool for early detection of brain injury.
Lung Adenocarcinoma Metastases to Mediastinal with Malignant Pericardial Effusion Andri, Andri; Parsama Putra, Ngakan Putu; Sargowo, Djanggan; Erawati, Dini Rachma; Retnani, Diah Prabawati
Malang Respiratory Journal Vol 3, No 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.362 KB) | DOI: 10.21776/ub.mrj.2021.003.02.4

Abstract

Lung adenocarcinoma with malignant pericardial effusion and also metastases to mediastinum has great impact on morbidity and mortality of patient and it is rare case. Most adenocarcinoma in the mediastinum are metastases from the lung, gastrointestinal tract, pancreas, kidney or even the pituitary gland. Cardiac metastases in lung cancer may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. A 42-years-old male with superior mediastinal mass has malignant pericardial effusion, cytology shows adenocarcinoma. The patient undergo transthoracic fine needle aspiration biopsy. The result from biopsy is adenocarcinoma. This is a rare case, patient with primary lung adenocarcinoma and malignant pericardial effusion also metastases to mediastinum. To determine the diagnosis requires a comprehensive clinical evaluation and multidisciplinary approach.
Immunocytochemistry as a Diagnostic Procedure of Pleural Mesothelioma Trimurtini, Asih; Astuti, Triwahju; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
Malang Respiratory Journal Vol 2, No 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (795.153 KB) | DOI: 10.21776/ub.mrj.2020.002.02.2

Abstract

Background: Mesothelioma is a primary malignant tumor arising from the mesothelial surface of the pleura, peritoneal, tunica vaginalis, and pericardium. Most cases of mesothelioma originate from the pleura. Most patients have a history of asbestos exposure. A common diagnostic problem is distinguishing mesothelioma from adenocarcinoma since both tumors invade the pleura. Immunocytochemistry of calretinin and TTF-1 can be used to establish the diagnosis of mesothelioma.Case: Male, 56 years old presented with chest pain, shortness of breath, cough, and weight loss since 5 months before hospitalization. The patient had a history of occupational exposure to asbestos for 30 years. The movement and breath sounds were decreased as well as dull upon percussion at the right chest. A chest X-ray revealed a right lung tumor with pleural effusion. Thorax CT scan suggested pleural mass in right hemithorax, infiltration to intercostal muscles, and destruction of the 7th right rib, right perihilar lymphadenopathy, right pleural effusion, and liver nodules according to mesothelioma T4N1M1 Stage IV. Infiltrative stenting of the right and inferior lobe of the right lung, infiltrative and obstructive stenting of the medius lobe suggestive of a chronic malignancy and inflammation were found on FOB. Cytologic examination of pleural fluid, sputum, and Washing-and-brushing of FOB were a class II (no malignant cells). USG-guided transthoracic FNAB revealed adenocarcinoma with differential diagnosis of mesothelioma. Immunocytochemistry with calretinin showed positive results and TTF-1 showed a negative result. These confirmed the diagnosis of pleural mesothelioma T4N1M1 Stage IV. The patient showed a stable response from carboplatin/gemcitabine treatment.Keyword : Mesothelioma, Immunocytochemistry, TTF-1, Calrenitin
Elderly Male Patient with Fibrotic Non Spesific Instertitial Pneumonia from Lung Biopsy by Video Assisted Thoracoscopy santony, Santony; Djajalaksana, Susanthy; Chozin, Iin Nur; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol 2, No 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.507 KB) | DOI: 10.21776/ub.mrj.2020.002.02.3

Abstract

Background: NSIP is a rare disease, the incidence rate ranges from 1 to 9 per 100,000 population, where most cases of NSIP are idiopathic. NSIP definitive diagnosis is very difficult because it must be with a multidisciplinary approach and confirm from a pulmonary biopsy. On the course of his illnesses the possibility of Connective tissue diseases (CTDs) arising in NSIP during follow up period was about 10% of cases.Case Report: We reported one case at RS Dr. Saiful Anwar, an old adult male smoker, age 64 with fibrotic type Non Spesific Instertitial Pneumonia (NSIP). From clinical patients including anamnesis, physical examination and laboratory results and X-Ray chest, ILD suspicion was found. Bodypletstimography results show a corresponding decrease in DLCO with ILD. CT-Scan results obtained by crazy paving with pulmonary bronchiectasis traction in accordance with ILD susp Sussection NSIP and enforced from VATS biopsy results with conclusions according to NSIP description. Patients received corticosteroid therapy for 4 weeks and showed clinical improvement.Conclusion: In these patients the diagnosis of fibrotic NSIP has gone through a multidisciplinary approach including the pulmonology, radiologist and pathologist sections. Corticosteroid therapy in these patients gives good results and the patient is in stable condition. Periodic monitoring is necessary because of the risk of exacerbations and the incidence of CTD complications..
Sarcomatoid Carcinoma Of The Mediastinal : A Rare Case of Giant Mass Thymic Carcinoma Subtype Santoso, Agus Andreas; Parsama Putra, Ngakan Putu; Setiawan, Ungky Agus; Isharanto, Artono; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol 3, No 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (12695.27 KB) | DOI: 10.21776/ub.mrj.2021.003.01.4

Abstract

ABSTRACTTitle: Sarcomatoid Carcinoma Of The Mediastinum: A Rare Case of Giant Mass Thymic Carcinoma SubtypeAuthor: Agus Andreas Santoso, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Persama Putra, MD, Pulmonologist Consultant, Ungky Agus Setiawan, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Hendy Setyo Yudhanto, MD, Pathology Anatomy Specialist.Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, most patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description: A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlarging lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patient had Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma. Discussion: Sarcomatoid carcinoma is a type of thymic carcinoma that has both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This case was interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in this patient. 
Bone metastases tend to increase in non-small cell lung cancer with epidermal growth factor receptor mutation Maleachi, Reginald; Erawati, Dini Rachma; Pratiwi, Suryanti Dwi; Andarini, Sri
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.4-10

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.