Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRACTPurposeThe lymphatic flow along the posterior gastric artery (PGA) is considered of possible clinical importance in terms of lymphatic metastasis; however, little is known about the lymph nodes (LNs) around this artery. The purpose of this study was to establish if LNs exist around the PGA and to evaluate their clinical implications.MethodsWe examined the tissues surrounding the PGA from 21 cadavers to search for LNs. We also investigated the patterns of lymphatic metastases in patients who underwent surgery for gastric neoplasms at our institute to detect their presence along the PGA.ResultsThe PGA was identified in 11 cadavers, and LNs around the PGA were detected microscopically in 2 of these. Lymphatic metastasis directly to the LNs at the splenic artery without any metastases was regarded as skip metastasis along the PGA. Skip metastasis was found in two of ten patients who underwent surgery for remnant gastric cancer.ConclusionsThe existence of LNs around the PGA was confirmed, and based on our findings, lymphatic metastasis through the PGA is possible in patients with remnant gastric cancer."

"Tujuan penelitian ini adalah untuk mengidentifikasi faktor prediktor metastasis kelenjar getah bening (KGB) pada pasien dengan kanker serviks stadium IB dan IIA. Penelitian dilakukan dari bulan Mei 1996 sampai bulan Desember 2001. Ada 183 pasien kanker serviks dengan stadium menurut FIGO IB dan IIA menjalani operasi histerektomi radikal dan limfadenektomi. Dari pasien tersebut 158 pasien yang dapat dinilai, terdiri dari 43 pasien dengan metastasis KGB dan 115 tanpa metastasis KGB. Rancangan penelitian adalah kasus-kontrol. Kasus adalah pasien dengan metastasis KGB dan kontrol pasien tanpa metastasis KGB. Analisis multivariat dilakukan setelah analisis bivariat. Pada analisis bivariat umur < 39 tahun, diameter lesi >4 cm, stadium IIA > 4 cm, histopatologi dengan diferensiasi sedang dan buruk, invasi ke pembuluh darah dan limfa merupakan variabel yang independen terjadinya metastasis KGB dengan nilai p ≤ 0,05. Tetapi pada analisis multivariat yang muncul sebagai variabel independen adalah umur muda, paritas > 4, diameter lesi, histopatologi adenoskuamosa, dan invasi limfo-vaskular dengan nilai p ≤ 0,05. Kesimpulan: Usia muda, paritas > 4, stadium IIA > 4 cm, diameter lesi, histopatologi adenoskuamosa, invasi limfa-vaskular merupakan faktor risiko terjadinya metastasis dan dapat dipergunakan sebagai faktor prediktor metastasis KGB. (Med J Indones 2004; 13: 113-8)

---

The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors. (Med J Indones 2004; 13: 113-8)"

"Frozen section library : lymph nodes highlights the usefulness of techniques such as touch preparation cytology and fine needle aspiration (FNA) cytology, as well as FNA biopsy. This fascicle also suggests proper handling for subsequent ancillary studies, including flow cytometric, cytogenetic, and molecular studies. Special emphasis is given to the limitations of frozen section diagnosis in lymph node pathology. All chapters are written by experts in their fields and include the most up to date scientific information. This book serves as a very useful resource for physicians in the frozen section room and in intra-operative consultation situations dealing with, and interested in, this very complex field of diagnostic pathology. Frozen Section Library: Lymph Nodes is of great value to pathologists, residents, and fellows who diagnose pathologic processes involving lymph nodes."

"PURPOSE: A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T reg cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA.METHODS: The hepatic hilar LNs and PB obtained during the Kasai procedure were analyzed by flow cytometry. The ratios of total and active Tregs to the total CD4+ cells in the PB and the hepatic hilar LNs were compared.RESULTS: In patients with BA, the ratios of both the total and active T reg cells in the hepatic hilar LNs were higher than those in the PB (total T reg cells: PB vs. LN; P < 0.001; active T reg cells: PB vs. LN; P = 0.001). In BA patients, the increase in the ratio of active T reg cells to the CD4 + cells in the LNs in comparison to the PB was greater than that in control patients. The ratio observed in the BA patients was almost double the ratio observed in the control patients. The median LN/PB ratio in the BA patients was 3.1, while that in controls was 1.6 (P = 0.03).CONCLUSION: The present study showed that the ratios of both total T reg cells and active T reg cells were higher in the hepatic hilar lymph nodes of BA patients. This finding could shed light on the pathogenesis of BA."

"ABSTRAKKanker payudara merupakan kanker yang umum terjadi pada wanita baikdi Indonesia ataupun di dunia. Pemeriksan tingkat sebaran sel kanker perludilakukan agar pengobatan yang diberikan tepat. Biopsi jaringan getah bening danpemeriksaan ahli patologi adalah salah satu metode untuk menentukan tingkatpenyebaran kanker. Kendala pada pemeriksaan manual membutuhkan waktu untukmemeriksa bagian perbagian dengan kemungkinan ada bagian yang terlewati,kesalahan dalam klasifikasi dan unsur subjektifitas saat memeriksa. Penggunaankecerdasan buatan dalam prapemeriksaan akan membantu dokter dalam memeriksadan menghilangkan unsur subjektifitas. Proses klasifikasi yang didapat diharapkanmembantu ahli patologi memeriksa dengan lebih cepat dan mengurangi tingkatkesalahan pemeriksaan. Proses dimulai dengan terlebih dahulu menentukan antaradaerah kosong dan daerah yang terdapat jaringan. Selanjutnya menentukan tingkatmetastasis berdasarkan hasil klasifikasi. Metode yang digunakan adalah denganmenggunakan teknik ambang gambar dalam menentukan batas gambar yang berisijaringan. Proses klasifikasi menggunakan jaringan saraf konvolusi (ConvolutionNeural Network (CNN)) dengan banyak klasifikasi sebanyak 5 kelompok selnormal dan 1 kelompok tumor. Hasil dari penggunaan metode ambang adaptifdapat memisahkah antara daerah kosong dan daerah berisi sel-sel. Metode jaringansaraf konvolusi ini dapat mengklasifikasikan dengan hasil sampai 86% dan tesdengan validasi data 80% untuk keseluruhan klasifikasi dan mencapai 93% untuksel tumor dan sel kanker. Hasil dari penentuan tingkat ditentukan oleh akurasi dariproses klasifikasi. Metode ambang gambar adaptif dapat menentukan area kosongdan berisi jaringan sesuai dengan yang diharapkan dan mempercepat prosespemeriksaan. Hasil klasifikasi dan menentukan tingkat dapat ditingkatkan denganmemperbaiki pembagian data-data pada dataset dan mengembangkan konfigurasidari jaringan saraf konvolusi dengan merubah struktur atau menambahkan denganmetode lain.

---

ABSTRACTBreast cancer is the most common cancer in women worldwide and the second mostcommon cancer in Indonesia. Metastasis is the medical term for cancer that spreadsto a different part of the body from where it started. Information from the lymphnode biopsy can help doctor that treatment decisions depend on stage of metastases.Normaly pathologist makes a diagnosis of the prepared sample slide from samplebiopsy with manual visual inspection. Manual diagnosis has the possibility to misssome section not checked, classification errors and subjectivity result. Theclassification process with AI will help the pathologist check faster, reduce the errorlevel and eliminate the subjectivity. The proposed Method using adaptivethresholding method in whole slide image is to determine the area to be processed.And Convolution Neural Network (CNN) for image classification. Adaptivethresholding have ability to separating the blank slide area and tissue area. CNN issuperior in image classification . Classification data for this thesis using 6classification, five class normal cell and one tumor. Adaptive thresholding methodin whole slide image can separate empty tissue and tissue with cell area. The resultCNN Method for overall accuracy 86% and accuracy for tumor cell is 93%.Classification and staging result can be improved by improving dataset for trainingand developing, change the configuration of CNN architecture or adding newmethod."

"Latar Belakang: Karsinoma ovarium merupakan tumor ganas ginekologik yang paling mematikan. Metastasis kelenjar getah bening ditemukan pada 78% kasus stadium lanjut yang dilakukan sampling atau diseksi kelenjar getah bening. Metastasis ini juga ditemukan pada kasus yang secara klinis sesuai dengan stadium I dan II. Faktor risiko terjadinya metastasis kelenjar getah bening pada karsinoma ovarium meliputi tipe histologik serosum, tumor high grade, dan kadar CA125 serum yang tinggi pada saat diagnosis. Pemeriksaan ulang kelenjar getah bening negatif pada kasus keganasan ginekologik lain menunjukkan adanya mikrometastasis hingga 8%- 14%. Tujuan: Penelitian ini dilakukan untuk mengetahui insidensi occult metastasis, baik berupa mikrometastasis maupun isolated tumor cells, pada kelenjar getah bening negatif dengan menggunakan pulasan imunohistokimia sitokeratin AE1/AE3 pada karsinoma ovarium dengan berbagai tipe histologik. Metode: Penelitian retrospektif dengan desain potong lintang pada sediaan kelenjar getah bening negatif dari operasi histerosalpingoovorektomi disertai limfadenektomi kasus karsinoma ovarium di RSCM periode Januari 2016 sampai Desember 2020. Pada seluruh blok parafin berisi kelenjar getah bening negatif berukuran >1 cm dilakukan potong dalam dua kali untuk masing-masing dipulas hematoksilin-eosin dan imunohistokimia sitokeratin AE1/AE3. Data imunoekspresi AE1/AE3 dianalisis untuk menentukan mikrometastasis/isolated tumor cells, dan mengetahui hubungannya dengan tipe histologik serosum. Hasil: Dari 57 sampel yang memenuhi kriteria inklusi dan eksklusi didapatkan rerata usia 49,5 tahun. Tipe histopatologik terbanyak (40,3%) adalah karsinoma sel jernih, 66,7% kasus memiliki tumor high grade, dan 57,9% kasus terdiagnosis pada stadium dini. Occult metastasis didapatkan pada 1 (1,75%) kasus dari seluruh sampel. Tidak ditemukan perbedaan kejadian occult metastasis pada kelompok karsinoma serosum dan non-serosum (p=1). Kesimpulan: Insidensi occult metastasis kelenjar getah bening sebesar 1,75% dari seluruh kasus karsinoma ovarium dalam penelitian ini. Tidak ditemukan perbedaan kejadian occult metastasis pada kelompok karsinoma serosum dan non-serosum.

---

Background: Ovarian carcinoma is the most lethal gynecologic malignant tumor. Lymph node metastases were found in 78% of advanced stage cases that underwent lymph node dissection. These metastases were also found in cases with clinical stage I and II. Risk factors for lymph node metastasis in ovarian carcinoma include serous histologic type, high grade tumor, and high serum CA125 level at diagnosis. Reexamination of negative lymph nodes in cases of other gynecologic malignancies shows micrometastases in up to 8%-14%.

Aim: This study was conducted to determine the incidence of occult metastases, either in the form of micrometastases or isolated tumor cells, in negative lymph nodes by using cytokeratin AE1/AE3 immunohistochemistry in ovarian carcinomas of various histologic types.

Method: A retrospective study with a cross-sectional design on negative lymph node preparations from hysterosalpingoovorectomy surgery accompanied by lymphadenectomy for ovarian carcinoma cases at RSCM January 2016-December 2020. All paraffin blocks containing negative lymph nodes measuring >1 cm were cut in two sections and stained with hematoxylin-eosin and cytokeratin AE1/AE3. AE1/AE3 immunoexpression data were analyzed to determine micrometastases/isolated tumor cells, and their relationship with serous histological type.

Result: Of the 57 samples that met the inclusion and exclusion criteria, the mean age was 49.5 years. The most histopathological types (40.3%) were clear cell carcinomas, 66.7% cases had high grade tumors, and 57.9% cases were diagnosed at an early stage. Occult metastases were found in 1 (1.75%) cases of the entire sample. There was no difference in the incidence of occult metastases in the serous and non-serous carcinoma groups (p=1).

Conclusion: The incidence of occult lymph node metastases was 1.75% of all ovarian carcinoma cases in this study. There was no difference in the incidence of occult metastases in the serous and non-serous carcinoma groups.

"

"The “Abtropfung” theory that nevi develop through the migration of nevus cells from the epidermis to the dermis prevailed for almost a century until the “Hochsteigerung” theory postulated the reverse pattern of migration. Most recently, however, new insights gained from epidemiology, cross-sectional and longitudinal studies of nevi, dermoscopy and confocal microscopy, and cellular and molecular studies have brought into question both of these theories. This book provides a comprehensive guide to current knowledge about nevogenesis by presenting these latest advances and in addition discusses issues yet to be resolved. It will assist practicing physicians in effectively managing patients with a variety of nevi and will also be of great value to researchers in the field. Importantly, since nevi are associated with an increased risk of melanoma, understanding nevogenesis may help to unravel some of the mysteries of melanomagenesis."

"ABSTRAKKanker serviks merupakan keganasan keempat tersering pada perempuan di dunia. Berdasarkan prognosis dan terapi, kanker serviks dibagi menjadi dua kelompok, yaitu stadium awal dan stadium lanjut. Tata laksana standar kanker serviks stadium awal adalah histerektomi radikal dan limfadenektomi. Keterlibatan kelenjar limfe merupakan salah satu faktor yang memengaruhi kesintasan pasien kanker serviks.Penelitian ini bertujuan untuk mengetahui apakah kelenjar limfe dapat dijadikan prediktor kesintasan. Penelitian ini menggunakan desain penelitian kohort retrospektif yang dilakukan di RSUPN dr. Cipto Mangunkusumo pada bulan Agustus 2015 sampai Agustus 2016.Subjek penelitian adalah pasien kanker serviks stadium awal yang dilakukan histerektomi radikal dan limfadenektomi dalam kurun waktu Januari 2011 sampai Desember 2013. Variabel yang diteliti adalah stadium tumor, ukuran tumor, histopatologi, diferensiasi tumor, invasi stroma, invasi limfovaskular, KGB pelvis, batas sayatan, dan invasi parametrium yang dihubungkan dengan kesintasan pasien. Data diolah menggunakan SPSS versi 20 dan dianalisis dengan uji chi square, uji regresi cox metode stepwise, dan Kaplan Meier. Pada penelitian ini diperoleh 123 pasien kanker serviks yang dilakukan histerektomi radikal dan limfadenektomi namun data yang dianalisis adalah 50 pasien yang memenuhi kriteri inklusi dan lolos kriteria eksklusi.Hasilnya, stadium tumor, ukuran tumor, histopatologi, diferensiasi tumor, invasi limfovaskular, KGB pelvis, batas sayatan, dan invasi parametrium tidak berhubungan dengan kesintasan namun invasi stroma dan terapi radiasi berhubungan dengan kesintasan. Jumlah KGB yang diekstraksi tidak berpengaruh terhadap kesintasan namun subjek dengan invasi stroma <2/3 bagian memiliki kesintasan lebih baik. Terapi radiasi juga memberikan kesintasan lebih baik. Perlu dilakukan penelitian lebih lanjut untuk mengetahui faktor prognostik lain pada pasien kanker serviks stadium awal seperti ekspresi faktor-faktor stem cells (SOX4, NANOG dan OCT4).

---

ABSTRACTCervical cancer is the fourth most common cancer in women in the world. Based on the prognosis and therapy, cervical cancer is divided into two groups, which are the early and advanced stages. The standard management of early-stage cervical cancer is radical hysterectomy and lymphadenectomy. The involvement of lymph nodes is one of the factors that affect the survival of cervical cancer patients.This study aims to determine whether lymph nodes can be used as predictors of survival. This study used a retrospective cohort study design conducted at RSUPN Dr. Cipto Mangunkusumo in August 2015 until August 2016.The research subjects were early-stage cervical cancer patients who performed radical hysterectomy and lymphadenectomy in the period January 2011 to December 2013. Variables studied were tumor stage, tumor size, histopathology, tumor differentiation, stromal invasion, lymph-vascular invasion, pelvic lymph nodes, incision border, and parametric invasion associated with patient survival. Data was processed using SPSS version 20 and analyzed by chi square test, cox regression test stepwise method, and Kaplan Meier. In this study 123 patients with cervical cancer were obtained for radical hysterectomy and lymphadenectomy but the data analyzed were 50 patients who fulfilled the inclusion criteria and passed the exclusion criteria.As a result, tumor stage, tumor size, histopathology, tumor differentiation, lymph-vascular invasion, pelvic lymph nodes, incision border, and parametrial invasion were not associated with survival but stromal invasion and radiation therapy were associated to survival. The number of extracted lymph node did not affect survival but subjects with stromal invasion <2/3 of parts had better survival. Radiation therapy also provides better survival. Further research is needed to find out other prognostic factors in early stage cervical cancer patients such as expression of factor stem cells (SOX4, NANOG and OCT4)."