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"Adenoid cystic carcinoma is an extremely rare case of the esophagus. We present a female patient, aged 76 years who present with dysphagia and weight loss for tire last three month. On endoscopy there was a luminal narrowing in the middle third of the esophagus. Diagnosis was challenging due to the stenosis and the tumor size. Histopathological confirmation was obtained by subcarinal fine-needle aspiration biopsy. This type of cancer is very aggressive with short survival time. Further studies are needed to define optimal treatment."

"Perjalanan penyakit Neoplasma Ovarium Kistik (NOK) disebut sillent killer karena seringkali terdeteksi saat sudah membesar. Kista ovarium seringkali muncul sepanjangsiklus hidup perempuan. Kelainan ginekologis dianggap sebagai kondisi yang secara signifikan mempengaruhi kehidupan sehari-hari perempuan, hubungan sosial, seksualitas dan kesehatan psikologis. Penatalaksaan NOK meliputi tindakan konservatif dan suportif dengan pemberian asuhan keperawatan yang komprehesif. Metode yang digunakan adalah studi kasus dengan fokus penerapan teori adaptasi Roy dan teori ketidakpastian Mishel. Aplikasi teori adaptasi Roy dan teori ketidakpastian Mishel efektif diterapkan pada kelima kasus yang berfokus pada kemampuan klien untuk beradaptasi dengan berbagai perubahan fisik maupun psikologis, serta melihat penilaian yang muncul dari kondisi penyakit dan tindakan yang dilakukan serta mampu mengeksplorasi bagaimana mekanisme koping yang digunakan serta respon adaptif yang digunakan oleh klien dengan menggunakan intervensi keperawatan yang sesuai.

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Cystic Ovary Neoplasm (NOK) disease is called the sillent killer because it is detected when it is enlarged. Ovarian cysts appeaed throughout the life cycle of women. Gynecological abnormalities are considered a condition that significantly affects women's daily lives, social relations, sexuality and psychological health. NOK's

management includes conservative and supportive interventions by providing comprehensive nursing care. The method used is a case study with a focus on applying Roy's adaptation theory and Mishel's uncertainty theory. The application of Roy's adaptation theory and Mishel's uncertainty theory is effectively applied to the five cases that focus on the client's ability to adapt to various physical and psychological changes, as well as see the evaluations that arise from disease conditions and actions and are able to explore how coping mechanisms are used and adaptive responses used by clients by using appropriate nursing interventions."

"Tujuan: Mengetahui bahwa indeks morfometrik USG merupakan metode yang baik dalam mendiagnosis keganasan ovarium tipe epitelial. Metode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di Rumah Sakit Cipto Mangunkusumo dengan mengambil data retrospektif dari Januari 2016 hingga Desember 2017. Pasien poliklinik rawat jalan ginekologi dengan kecurigaan memiliki neoplasma ovarium kistik direkrut. Standar baku emas adalah temuan histologi dari massa adneksa yang dioperasi. Karakteristik gambaran pola morfometrik ultrasonografi meliputi bilateralitas, jumlah lokus, regularitas dinding dalam (inner wall), tonjolan papiler (papillary projection), bagian padat (solid part), asites, dan doppler blood flow.  Analisis ROC dilakukan untuk menentukan seberapa baik model ini digunakan sebagai metode diagnostik keganasan ovarium tipe epitelial. Analisis statistik dihitung, untuk mendapatkan nilai akurasi, sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediksi negatif. Hasil: Penelitian ini melibatkan 178 pasien, sebanyak 101 kasus (56.74%) adalah k asusjinak dan 77 kasus (43.25%) adalah kasus ganas. Pola karakteristik USG, papillary projection (p-value = 0.000), solid part (p-value = 0.000), inner wall (p-value = 0.000), asites (p-value = 0.000) dan Doppler blood flow (p-value = 0.000) subjek penelitian memiliki hubungan yang bermakna dengan kejadian keganasan ovarium. Pola morfologi papillary projection memiliki nilai sensitifitas yang paling tinggi (83%), kemudian adanya asites (82%), dan iregularitas dinding (81%). Untuk kategori spesifisitas, didapatkan adanya bagian padat (solid part) memiliki nilai spesifisitas yang paling tinggi (93%).Analisis regresi multinomial digunakan untuk menilai gabungan pola karateristik yang bermakna untuk diagnostik keganasan ovarium tipe epitelial dengan AUC 89.40% (95%CI 84.70%-94.00%), Model ini akurat  secara statistik (p <0,05). Kesimpulan: Indeks morfometrik USG merupakan salah satu metode yang baik dalam memprediksi keganasan ovarium.

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Objective: To know whether the ultrasound morphometric index is a good method to diagnose epithelial ovarian malignancy.

Materials and methods: This study is a diagnostic test conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. All data were taken retrospectively from January 2016 to December 2017. Gynecological outpatient polyclinic patients with suspicion of having cystic ovarian neoplasms were recruited. Characteristics of ultrasound morphometric patterns include bilaterality, number of loci, inner wall regularity, papillary projection, solid part, ascites, and doppler blood flow.

Results: The study involved 178 patients, 101 cases (56.74%) were malignant and 77 cases (43.25%) were malignant cases. The characteristics of ultrasound, papillary projection, solid part, inner wall, ascites and Doppler blood flow patterns of the study subjects had a significant relationship with the incidence of ovarian malignancy. Multinomial regression analysis was used to assess the combined characteristic patterns for the diagnostic epithelial type ovarian malignancy with AUC 89.40% (95% CI 84.70% -94.00%), this model was statistically accurate (p <0.05).

Conclusion: Morphometric index of ultrasound is a good methods in predicting epithelial ovarian malignancy "

"Latar Belakang: Kista dentigerous merupakan hasil pembesaran folikel, berasal dari akumulasi cairan antara epitel email tereduksi dan email gigi impaksi. Mayoritas berhubungan dengan gigi yang paling sering impaksi, seperti molar tiga mandibula, kaninus maksila, molar tiga maksila, dan premolar dua mandibula. Setiap elemen gigi impaksi memiliki potensi yang sama mengalami pembentukan Kista Dentigerous. Untuk mencegah hal tersebut maka dibutuhkan perawatan yang tepat dan pencegahan sedini mungkin sehingga kemungkinan morbiditas lebih lanjut dapat dihindari. Berdasarkan tinjauan di atas, penulis ingin mengetahui data terbaru mengenai distribusi dan frekuensi Kista Dentigerous berdasarkan lokasi kelainan di Poli Gigi RSUPN Cipto Mangunkusumo periode 1 November 2002 - 31 Oktober 2008.Tujuan: Penelitian ini bertujuan untuk mengetahui regio yang paling sering mengalami Kista Dentigerous pada pasien Poli Gigi RSUPN Cipto Mangunkusumo periode 1 November 2002 - 31 Oktober 2008.Metode: Penelitian ini berjenis observasi deskriptif dan merupakan studi retrospektif menggunakan data sekunder berasal dari kartu status pasien Poli Gigi RSUPN Cipto Mangunkusumo periode 1 November 2002 - 31 Oktober 2008 yang di dalamnya tercantum biodata, foto panoramik, dan hasil pemeriksaan histopatologis.Hasil: Didapatkan 49 kasus dan 48 elemen gigi. Distribusi dan frekuensi menggunakan tabel dan pie chart yang menggambarkan berapa banyak kista dentigerous berdasarkan lokasi kelainan yang terjadi.Kesimpulan: Distribusi dan frekuensi kista dentigerous paling banyak disebabkan oleh gigi Caninus maksila impaksi dan lokasi kelainan Kista Dentigerous paling banyak terjadi pada regio kaninus - kaninus maksila.

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Backgroud: Dentigerous cyst is a result of folicle swelling, arise from fluid accumulation between the reduced enamel epithelium and the enamel of the impaction tooth. Most often they involve mandibular third molars, maxillary canines, maxillary third molars, and mandibular second premolars. Every single impaction tooth have same potency to grow a Dentigerous Cyst formation. In order to prevent a Dentigerous Cyts formation, we need a certain treatment and prevention must be done as soon as posible so that probability of next morbidity can be prevent. Based on the theory, the author wants to find the latest data about distribution and frequency of Dentigerous Cyst based on causing tooth element and location of cystic lesion in Poli Gigi RSUPN Cipto Mangunkusumo in period of November 1st 2002 - Oktober 31st 2008.Aim: To know the most region that usually have Dentigerous Cyst formation in Poli Gigi RSUPN Cipto Mangunkusumo patients within Period November 1st 2002 - Oktober 31st 2008.Method: The type of this study is descriptive observation - restrospective study by using secondary data from the dental record of Oral and Maxillofacial Surgery Clinic patients in Poli Gigi RSUPN Cipto Mangunkusumo within November 1st 2002 - Oktober 31st 2008 period, which is the content of the dental records is patient`s demographic data, panoramic radiograph, and the result of histopathologic examination.Results: There are 49 cases and involved 48 teeth. Distribution and frequensy use table and pie chart to describe the number of Dentigerous Cyst based on causing tooth element and location of cystic lesion.Conclusions: In this distribution and frequency of Dentigerous Cyst study, the Dentigrous Cyst is usually involve maxillary canine impaction teeth and most often site of Dentigerous Cyst is canine to canine region on maxilla."

"ABSTRACTAdenoid cystic carcinoma (ACC) is one of the common malignant tumors in salivary glands, and the clinical prognosis is poor with frequent distant metastasis which may lead to death. Expression of the MYB-NFIB chimeric gene in ACC has been reported recently. MYB is an oncogene with transcription regulating functions, and NFIB encodes nuclear transcription factor although detailed functions are unknown. This study investigated whether MYB-NFIB chimeric gene expression affects tumor angiogenesis and proliferation in salivary gland ACC. In 26 salivary gland ACC cases, MYB-NFIB chimeric gene expression was analyzed by RT-PCR and direct sequencing. Immunohistochemical studies for CD31, vascular endothelial growth factor (VEGF) and Ki-67 were performed. Tumor angiogenesis was evaluated by blood vessel (CD31-positive) density and tumor proliferation by Ki-67 labeling index, and the relationship with MYB-NFIB chimeric gene expression was analyzed. MYB-NFIB chimeric gene expression was detected in nine of 26 ACC cases. Blood vessel density was significantly higher in chimeric gene-expressing cases compared to non-expressing cases. VEGF score tended to be higher in chimeric gene-expressing cases than in non-expressing cases, while Ki-67 labeling index was not significantly different. The number of chimeric gene-expressing cases increased with age, peaking in the sixties age group and declining thereafter, while the number of non-expressing cases increased with age continuously. In ACC, blood vessel density was significantly higher in MYB-NFIB chimeric gene-expressing cases compared to non-expressing cases, which may be due to higher VEGF production capability. MYB-NFIB chimeric gene expression may also be related to the onset age of ACC."

"Latar belakang: Complex cystic and solid mass payudara merupakan massa kistik dengan konten anekoik (cairan) dan konten ekogenik (padat), termasuk di antaranya adalah dinding tebal, septasi tebal, massa intrakistik atau mural, dan massa dominan padat dengan komponen kistik. Complex cystic and solid mass payudara yang tergolong sebagai kategori BI-RADS 4, yaitu lesi yang mencurigakan ganas dengan tingkat keganasan 2-95%, sebuah rentang yang sangat lebar. Berdasarkan temuannya complex cystic and solid mass payudara memiliki temuan dibagi menjadi 3 tipe berdasarkan temuannya: tipe 1 adalah lesi dengan penebalan dinding atau septasi interna atau keduanya; tipe 2 adalah lesi dengan massa intrakistik atau massa campuran kistik-padat dominan kistik (komponen kistik >50%); dan tipe 3 adalah lesi dengan massa dominan padat (komponen padat >50%) dengan komponen kistik / fokus kistik eksentrik. Telaah sistematis dan meta-analisis ini dibuat dengan tujuan untuk mendapatkan nilai prediktif positif dari masing-masing temuan tersebut. Metode: Pencarian sistematis dilakukan untuk mengidentifikasi studi yang menilai prediktif positif keganasan berdasarkan temuan USG pada complex cystic and solid mass payudara, dengan referensi baku pemeriksaan patologi. Pencarian dilakukan pada Juni 2022 melalui data dasar Pubmed, Embase, Scopus, Cochrane, GARUDA, dan Indonesian Journal of Cancer, daftar pustaka dari artikel terpilih, dan grey literature. Temuan utama yang diekstraksi dari tiap studi adalah jumlah positif benar dan positif palsu untuk mendapatkan nilai prediktif positif masing-masing temuan USG. Penilaian kualitas metodologi dan kualitas bukti studi dilakukan menggunakan QUADAS-2 dan GRADE. Hasil: 10 studi (255 lesi) yang menilai temuan USG tipe 1, sembilan studi (347 lesi) tipe 2; dan 10 studi ( 277 lesi) tipe 3 diidentifikasi. Dua studi menunjukkan setidaknya satu risiko bias yang tinggi pada salah satu domain. Tujuh studi menunjukkan setidaknya dua risiko bias tidak jelas. Empat studi menunjukkan terdapat satu risiko bias tidak jelas. Pada analisis subgrup studi-studi dengan risiko bias dan penerapan yang relatif rendah, didapatkan PPV tipe 1 13% (95% CI 4-22%), tipe 2 20% (95% CI 12-29%), dan tipe 3 30% (95% CI 13-48%). Kesimpulan: Temuan USG tipe 1 dapat dikategorikan sebagai BI-RADS 4a, sedangkan temuan USG tipe 2 dan 3 dapat dikategorikan sebagai BI-RADS 4b. Kecenderungan peningkatan risiko keganasan ditemukan meningkat sesuai dengan bertambahnya komponen padat. Akan tetapi, penerapan temuan telaah sistematis ini terbatas karena kualitas metodologi studi dan kualitas bukti yang terbatas

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Background: Complex cystic and solid breast masses are cystic masses with anechoic (fluid) and echogenic (solid) content, including thick walls, thick septations, intracystic or mural masses, and predominantly solid masses with cystic components. Complex cystic and solid breast masses is categorized as BI-RADS 4, i.e. suspicious lesions with a malignancy rate of 2-95%, thus a very wide range. Based on ultrasonography findings, complex cystic and solid mass breasts are divided into 3 types: type 1 with wall thickening or internal septation or both; type 2 with an intracystic mass or a mixed cystic-solid mass predominantly cystic (cystic component >50%); and type 3 with a predominantly solid mass (solid component >50%) with a cystic component/eccentric cystic foci. This systematic review are written to obtain a positive predictive value from each of these findings. Methods: Studies that detect predictive positive value of malignancy based on ultrasound findings of complex cystic and solid breast masses, with reference to pathological examinations were identified. The search was conducted in June 2022 through the Pubmed, Embase, Scopus, Cochrane, GARUDA, and Indonesian Journal of Cancer, bibliography of selected articles, and grey literature. Findings extracted from each eligible study included including number of true positives and false positives to obtain the positive predictive value. Methodological quality dan evidence quality were assessed using QUADAS-2. Results: Ten studies in type 1 US features (255 lesions), nine studies in type 2 US features (347 lesions), and ten studies in type 3 US features (277 lesions) were identified. Two studies demonstrated at least one high risk of bias in one domain. Seven studies demonstrated at least two unclear risks of bias. Four studies demonstrated one unclear risk of bias. Subgroup analysis based on risk of bias and applicability was performed, from those studies type 1 US features has PPV 13% (95% CI 4-22%), type 2 has PPV 20% (95% CI 12-29%),a nd type 3 has PPV V type 1 has a range of 3.2% to 30.4%, type 2 has a range of 12.2 to 38.9%, and type 3 has PPV 30% (95% CI 13-48%). Conclusion: Type 1 ultrasound findings can be categorized as BI-RADS 4a, while type 2 and 3 ultrasound findings can be categorized as BI-RADS 4b. The increased risk of malignancy also corresponds to an increase in its solid component. However, the application of the findings of this systematic review is limited due to limited quality of the methodology and evidence quality of studies"