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"In cases of advanced alveolar bone loss frequently associated with periodontal pockets that may not be accessible by conservative therapy, corrective surgery is often indicated as osseous resective and complete debridement therapy. Transplantation of osseous fill material is often necessary, as a surgical intervention may create an alveolar bone defect. In this reported case of surgery, a cortico-cancellous bone graft taken from the mandibular symphysis was transplanted in a mixture with human mineralized bone from the Dr. Soetomo Hospital Surabaya Bone Bank, expecting for osseous regeneration to reduce the bony defect. Six months after surgery the morphology of the reconstructed alveolar process was satisfactory and showing new growth of bone"

"Primary hyperaldosteronism is an adrenal abnormality in which there is some degree of autonomy of aldosterone secretion. We report a case of thirty three years old Javanese female presented with uncontrolled hypertension, muscular weakness, cramps and progressing shortness of breath during working for 6 years. She had history of hypertension since age 20. Her serum potassium level was always low that associated with inappropriate kaliuresis. Blood gas analysis revealed metabolic alkalosis. Sonography of the adrenal gland showed right hipoechoic architecture; CT scan of the abdomen confirmed an right adrenal tumor measured 4 cm in its greatest dimension. Endocrine evaluation revealed high plasma aldosterone concentration, suppressed plasma renin activity, aldosterone/renin ratio of 112 and confirmed the diagnosis of primary aldosteronism. She underwent unilateral adrenalectomy. Histopathological report from excised adrenal tumor were compatible to benign adrenocortical adenoma. The patient discharge home with well controlled blood pressure and normokalemia. No clinical symptoms was reported in follow-up.

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Hiperaldosteronisme primer merupakan kelainan adrenal dimana sekresi hormon aldosteron terjadi secara otonom. Kami melaporkan sebuah kasus seorang wanita suku Jawa berusia33 tahun yang datang karena hipertensi yang sulit dikendalikan, kelemahan, kram otot, dan sesak nafas saat aktivitas yang memberat dalam kurun waktu 6 tahun belakangan ini. Riwayat hipertensi sudah berlangsung sejak usia 20 tahun. Kadar kalium serum selalu rendah dengan kaliuresis yang berlebihan. Dari analisa gas darah didapatkan metabolik alkalosis. Sonografi abdomen memperlihatkan arsitektur hipoekoik pada daerah suprarenal dekstra; pada CT scan abdomen terdapat tumor adrenal dekstra berukuran 4 cm. Evaluasi endokrin menunjukkan konsentrasi aldosteron plasma yang meningkat, aktivitas renin tersupresi dengan rasio aldosteron/renin 112 dan mengkonfirmasi hiperaldosteronisme primer. Pasien tersebut kemudian menjalani adrenalektomi unilateral. Laporan histopatologi dari tumor adrenal sesuai dengan adenoma korteks adrenal benigna. Pasien kemudian dapat rawat jalan dengan tekanan darah yang lebih terkontrol dengan kalium serum yang normal. Saat ini tidak ada keluhan lagi"

"ABSTRAKPleural effusion is a condition when there is an accumulation of fluid in pleural space. The condition may manifest in breathing impariment by limiting lung expansion space. Pleural effusion is suffered by more than 1.5 million people per year in America. A study held ini Persahabatan Hospital between 2010-2011 found 119 cases of pleural effusion, 42,8% was malignant pleural effusion. Pleural malignancy is the most common indication for thoracocentesis, thus must be considered in massive pleural effusion (MPE). Theraphy for MPE is palliative with the goal being relief of dyspnea. Treatment option for MPA are deteminded by several factors: symptoms and performance status of the patient, the primary tumor type and its response to systematic therapy, and degree of lung re-expansion following pleural fluid removal. In this case, we will present a case of malignant pleural effusion as an illustration in searching of evidence in comparing between pleurodesis and indwelling pleural catheter in management of malignant pleural effusion. "

"Komunikasi antara arteri koroner dan arteri pulmonalis, yang dikenal sebagai fistula arteri koroner ke pulmonal, merupakan sumber pasokan darah yang sangat jarang ke paru-paru pada penyakit atresia pulmonal yang disertai defek septum ventrikel. Seorang anak perempuan berusia 4 tahun dirujuk ke Pusat Jantung Nasional Harapan Kita dengan gejala dan tanda-tanda peningkatan vaskularisasi pembuluh darah paru sejak bayi dan telah dipastikan dengan pemeriksaan foto X-ray toraks. Pemeriksaan fisik jantung ditemukan bunyi jantung I normal, bunyi jantung II keras dan tunggal, dan didapatkan bising ejeksi sistolik pada area pulmonal. Pemeriksaan EKG menunjukkan irama sinus dengan aksis normal serta hipertrofi biventrikel. Pada pemeriksaan ekhokardiografi dicurigai terdapat trunkus arteriosus tipe I dengan defek septum ventrikel perimembran, overriding aorta, dan dilatasi pada pangkal arteri pulmonalis. Namun demikian pada pemeriksaan kateterisasi jantung ditemukan fistula non obstruktif antara arteri koroner kiri dan pangkal arteri pulmonalis yang disertai kelainan defek septum ventrikel. Tindakan bedah telah berhasil dilakukan sekaligus memastikan diagnosis sebelumnya. Walaupun terdapat episode krisis hipertensi paru selama awal perjalanan pasca operasi, pasien tersebut dipulangkan dari perawatan dengan kondisi yang baik. Karena penyakit pembuluh darah paru yang irreversibel bisa terjadi pada fistula koroner ke pulmonal yang tidak restriktif, pengenalan dini terhadap kelainan ini sangat penting untuk mendapatkan hasil tindakan koreksi bedah yang lebih baik. (Med J Indones 2004; 13: 237-40)

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A communication between the coronary and pulmonary arteries, so called coronary to pulmonary fistula, is a rare source of pulmonary supply in pulmonary atresia (PA) with ventricular septal defect (VSD). A 4 year old girl referred to National Cardiovascular Center Harapan Kita, Jakarta with symptoms and signs of increased pulmonary blood flow since infancy and was confirmed by the chest x-rays. Heart examination revealed normal first heart sound with single loud second heart sound and an ejection systolic murmur at the pulmonary area. ECG demonstrated sinus rhythm with normal axis and biventricular hypertrophy. Echocardiography was performed and truncus arteriosus (TA) type I was suspected with perimembranus VSD, overriding of the aorta, and dilated main pulmonary artery. But on cardiac catheterization studies, a non obstructive fistula was found between the left coronary and main pulmonary artery coexisted with PA and VSD. A successful surgery was performed subsequently and confirmed the above diagnosis. Although there were episodes of pulmonary hypertension crisis during early post operative course, she was then discharge from the hospital in a good condition. Since irreversible pulmonary vascular disease may develop in a non restrictive coronary to pulmonary fistula, early recognition of this anomaly is very important for better surgical result. (Med J Indones 2004; 13: 237-40)"

"Ameloblastoma merupakan jenis tumor odontogenik yang umumnya jinak. Namun demikian, kurang dari 2% kasus ameloblastoma mengalami metastasis, terutama ke paru. Kami melaporkan satu kasus ameloblastik karsinoma dengan metastasis di kedua paru setelah 10 tahun pasca reseksi tumor primer dan 2 tahun pasca kemoterapi.

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AbstractAmeloblastoma is a type of odontogenic tumor and generally considered as a benign tumor. However, less than 2% of ameloblastoma were found to have metastases, mostly to the lung. We reported a case of 46-year-old man presenting with an ameloblastic carcinoma with lung metastases 10 years after the primary tumor was resected and 2 years after chemotherapy. Keywords: ameloblastoma, chemotherapy, radiation."

"Periosteal osteosarkoma merupakan tumor ganas tulang yang jarang didapat, dibentuk dari sarkoma tulang dengan didominasi komponen tulang rawan yang berdiferensiasi dan tumbuh pada permukaan tulang. Penelusuran kepustakaan tidak banyak menyebutkan mengenai kasus ini. Laporan kasus ini terakhir dilaporkan oleh Klinik Mayo tahun 1999. Kami laporkan satu kasus periosteal osteosarkoma pada penderita laki-laki berusia 17 tahun. Penderita menjalani tindakan pembedahan berupa prosedur ?limb salvage?, dengan pra dan pasca bedah penderita mendapat kemoterapi (neo-ajuvan dan ajuvan). Tidak ditemukan rekurensi lokal dan metastasis di paru, pada follow up sampai dengan 14 bulan pasca bedah. (Med J Indones 2003; 12: 166-70)

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Periosteal osteosarcoma is a rare type of malignant bone neoplasm, with predominantly cartilaginous component and arising on the bone surface. Reports of the case in the literature were rare. Last case was reported by Mayo Clinic in 1999. We report a case of periosteal osteosarcoma in a 17-year-old male, who was treated surgically with a limb salvage procedure, neoadjuvant and adjuvant chemotherapy were also given to the patient. There was no local recurrence and lung metastases up to 14 months after surgery. (Med J Indones 2003; 12: 166-70)"

"Penganiayaan anak merupakan masalah sosial dan masalah medis yang penting dan dapat menyebabkan kecacatan dan kematian pada anak. Angka kejadian penganiayaan anak dalam setahun diperkirakan sekitar 15 sampai 42 kasus diantara 1000 anak dan terdapat kecenderungan peningkatan. Patah tulang merupakan tanda klinis kedua terbanyak yang ditemukan setelah lesi kulit, dan sekitar sepertiga anak yang teraniaya akan mendatangi ahli bedah tulang. Kami melaporkan seorang anak laki-laki berusia 7 bulan yang diduga mengalami penganiyaan anak. Diagnosis kami didasarkan pada temuan patah tulang multiple, keterlambatan dalam mencari pertolongan medis dan perbedaan antara riwayat perjalanan penyakit dengan temuan klinis. Anak tersebut mengalami patah tulang multipel dengan proses penyembuhan yang bervariasi, termasuk patah tulang pada suprakondilar humerus kiri, radius dan ulna kiri, radius dan ulna kanan, kedua tulang femur, tibia kanan serta tibia dan fibula kiri. Pemeriksaan radiologis merupakan modalitas yang penting dalam menegakkan kemungkinan adanya penganiayaan pada anak tersebut. Anak tersebut telah mendapatkan penanganan medis, proteksi, kelompok konsultasi untuk kedua orang tua dan sedang dalam penyelidikan pihak kepolisian. (Med J Indones 2004; 13: 59-65)

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Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65)."