Intracranial ependymoma is an uncommon central nervous system neoplasma which happens in all age groups but has higher incidence occurring in the posterior foassa in infants and children. The location of the tumor is in the ventricle system, especially the fourth ventricle. Depending on its position to tentorium, the tumors can be divided into supratentorial and infratentorial. Hydrocephalus and calcifications usually occur in both types of tumors. Ependymomas have unspecific and varied appearance in density on computed tomography examination, but most of them are isodense. The supratentorial ependymoma tends to be hypodense, cystic-like lesion and enhanced (homogenous and nonhomogenous) after contrast injection. The infratentorial ependymoma are mostly hypodense and similar enhancement to supratentorial tumor. Treatments consist of surgical resection and radiotherapy, but the overall results are not very effective.
Nitric Oxide (NO) is a vasodilator that regulates vascular smooth muscle tone. Low levels of NO can cause vasoconstriction andhemodynamic disturbances. In stroke the levels of NO are increased. Endothelial nitric oxide synthase gene polymorphism (eNOS) isbelieved to reduce levels of NO in blood. NO levels decreased in stroke patients with G894T polymorphisms of eNOS gene. Mortality rateof hemorrhagic stroke are increased in case with increased peri focal edema volume. The mechanism of the increased of peri focal edemavolume completely unknown yet, suspected genetics factor. This study was conducted to know the correlation between the NO and perifocal edema volume in stroke with eNOS gene G894T polymorphism by determination. The study was conducted by comparing the levelsof NO and edema volume of intra cerebral hemorrhagic stroke of 46 subjects from Neurology department of dr. Zainoel Abidin generalhospital in Banda Aceh from September 2014 through January 2015 with comparison to ischemic stroke patients the same amount.NO levels checked with Cayman Systems kit following the protocol Griess. G894T polymorphism was determined by PCR-RFLP method.The volume of edema was measured with semi-automatic CT volumetry. Chi Square test was used for comparison of two variables andSpearman correlation test to assess the relationship between the NO and perifocal edema volume. The result is significant, if p valuewas <0.05. The results of these study were levels of NO decreases if there were polymorphism (p=0.001). Peri focal edema volume wasincreased if there were G894T polymorphism (p=0.038). The correlation between low levels of NO and increase of edema volume wasobtained p=0.040 and R=0.304. The researchers concluded that in intra cerebral hemorrhagic stroke the level of NO were decreasedand peri focal edema volume increased if there was G894T polymorphism of eNOS gene. There was a less correlation between low levelsof NO and peri focal edema volume.
Oral cancer is a malignant neoplasia on the lip and oral cavity. It is generally late-detected, locally invasive, and it has a high propensity for cervical lymph node metastases as well as blood-borne distant metastases. Diagnostic imaging for oral cancer is generally performed using conventional radiography, Cone Beam Computed Tomography (CBCT), Computed Tomography (CT), ultrasonography (USG), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Single-Photon Emission Computed Tomography (SPECT), and bone scintigraphy. This review provides a general overview of oral cancer imaging and basic principles of interpretation for oral cancer using several imaging modalities. The selection of imaging modalities for oral cancer must be based upon clinical condition, availability of imaging modalities, and cost effectivity. Despite the limited availability of modern imaging modalities in Indonesia, understanding on the major concept of various oral cancer imaging and its interpretation are certainly required by the dentists. Imaging and its interpretation are required to assist the diagnosis and determine the most appropriate treatment plan. Thus, the survival rate can be improved.
Intracranial ependymoma is an uncommon central nervous system neoplasms which happens in all age groups but has higher incidence occurring in the posterior fossa in infants and children. The location of the tumor is in the ventricle system, especially the fourth ventricle. Depending on its position to tentorium, the tumors can be divided into supratentorial and infratentorial. Hydrocephalus and calcifications usually occur in both types of tumors. Ependymomas have unspecific and varied appearance in density on computed tomography examination, but most of them are isodense. The supratentorial ependymoma tends to be hypodense, cystic-like lesion and enhanced (homogenous and nonhomogenous) after contrast, injection. The Infratentorial ependymoma are mostly hypodense and similar enhancement to supratentorial tumor. Treatments consist of surgical resection and radiotherapy, but the overall results are not very effective. Keywords : ependymoma - infratentorial tumor - supratentorial tumor - contrast enhancement
Background: Hepatocellular carcinoma (HCC) is a primary liver malignancy with high prevalence rate, associated primarily with the Hepatitis B Virus. HCC is the third leading cause of death worldwide. The prevalence in Indonesia is estimated at 100 per100,000 inhabitants. Treatment is generally ineffective as patients are already at advanced stages when diagnosed. Trans-arterial Chemoembolization (TACE) is a promising treatment, and β-Glucan combined therapy is expected to treat HCC more efficiently. This study evaluated the treatment response of TACE in HCC combined with β-Glucan orally. Methods: A randomized clinical trial was conducted on 63 patients with HCC. The subjects of the study were randomly assigned into two groups: 32 administered TACE plus β-Glucan, and 31 with TACE plus placebo. Results: In the β-Glucan group, there were four patients (12.50%) with complete response, 16 (50%) partial response, 3 (9.38%) no response, and 9 (28.12%) in deteriorated response. In the placebo group, there were 0 complete response, 11(35.48%) partial, 2(6.45%) no response, and 18 (58.07%) deteriorated response. The survival rate of the β-Glucan group was longer (median 39 weeks) than the placebo group (median 26 weeks). CD4, CD8 and IL-2 post-TACE increased significantly (p<0.05). The placebo group had 4.143 times, significantly higher hazard risk (p<0.05).Conclusion: HCC therapy with a combination of TACE and β-Glucan is beneficial to increase the therapeutic response, immunity and survival rate.
Background : Peritumoral brain edema (PTBE) of meningioma causes morbidity, poor clinical outcomes and complicates surgery. Tumor size correlates with the incidence of PTBE. However, the threshold value for tumor size that cause PTBE in meningioma has not been widely studied. Objective: To determine the threshold value for meningioma size that can predict the incidence of peritumoral edema in general and based on specific intracranial locations on pre-operative head MRI.Methods: This is a cross sectional study on patients with intracranial meningioma who had undergone head MRI imaging at Dr.Sardjito Hospital in the period of 2018-2022 retrospectively. An analysis was carried out to find the threshold value for meningioma size and the prevalence ratio to predict the incidence of PTBE. Results: The cut-off volume for intracranial meningioma was >44 cm3 with RP of 3.61 (p=0.01) in general. Simultaneously, large tumor volume (≥44 cm3) has the strongest correlation to the incidence of peritumoral edema (p=0.01). The cut-off volume for meningioma in supratentorial non-skull base was >22 cm3 with RP of 2.54, while in supratentorial skull base was >54 cm3 with RP of 23.33 (p=0.01). The cut off volume for meningioma in infratentorial region was >19.75 cm3 with RP 3.0 (p=0.52). Conclusion: The cut-off value for intracranial meningioma volume to predict the incidence of peritumoral edema is 44 cm3. There are differences in the cut-off values of meningioma volume and prevalence ratios based on specific intracranial locations to predict the incidence of PTBE in meningioma.
