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All Journal e-CliniC Medical Scope Journal (MSJ) Blantika : Multidisciplinary Journal
Tandililing, Sherly
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Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Nursing Public Health

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Korelasi antara Kadar Kalsidiol (25-Oh) dan Rasio Netrofil-Limfosit dengan Keganasan Nodul Tiroid Bogar, Bryan D.; Lumintang, Nico; Tandililing, Sherly; Wariki, Windy M.
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.48492

Abstract

Abstract: Thyroid malignancy has shown the highest annual incidence rate. Vitamin D deficiency (serum 25-hydroxyvitamin D levels) is one of the risk factors for thyroid malignancy. The neutrophil-lymphocyte ratio (NLR) reflects the balance between pro-tumor inflammatory response and anti-tumor immune response. This study aimed to investigate the relationship between serum 25-hydroxyvitamin D levels, NLR, and thyroid nodule malignancy. This was an observational and analytical study with cross-sectional design. Samples were patients with thyroid nodules admitted to Prof. Dr. R. D. Kandou Hospital, Manado, form August 2022 to March 2023. The results obtained a total of 46 patients with thyroid malignancy that  met the inclusion criteria. The patient characteristics were predominantly female (82.6%), with a mean age of 50.2 ± 14.74 years, normal thyroid hormone status (82.6%), mean serum 25-hydroxyvitamin D levels of 32.25 ng/mL, mean NLR of 5, and papillary carcinoma as the most common malignancy (43.48%). Spearman's correlation analysis revealed a significant association between thyroid malignancy and serum 25-hydroxyvitamin D levels (r =-0.501, p=0) as well as NLR (r 0.376, p=0.01). In conclusion, serum 25-hydroxyvitamin D levels and NLR can be used as indicators for predicting thyroid nodule malignancy. Keywords: thyroid malignancy; 25-hydroxyvitamin D; neutrophil-lymphocyte ratio   Abstrak: Keganasan tiroid mengalami peningkatan angka kejadian tertinggi pertahun. Kekurangan vitamin D (kadar kalsidiol) merupakan salah satu faktor risiko terjadinya keganasan tiroid. Rasio netrofil limfosit (RNL) mencerminkan keseimbangan antara respon inflamasi protumor dan respon imun antitumor. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar 25-hydroxyvitamin D serum dan RNL dengan keganasan nodul tiroid. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel penelitian ialah pasein dengan nodul tiroid yang dirawat di RSUP Prof. Dr. R. D. Kandou Hospital, Manado, sejak Agustus 2022 s/d Maret 2023. Hasil penelitian mendapatkan 46 pasien dengan keganasan tiroid yang memenuhi kriteria. Karakteristik sampel tebanyak ialah jenis kelamin perempuan (82,6%), rerata usia (50,2±14,74 tahun), status hormon tiroid normal (82,6%), rerata kadar 25-hydroxyvitamin D 32,25 ng/mL, rerata RNL 5, dan jenis keganasan karsinoma papiler (43,48%). Uji analisis Spearman menunjukkan keganasan tiroid secara bermakna berhubungan dengan kadar kalsidiol (r=-0,501, p=0), dan RNL (r=0,376, p=0,01). Simpulan penelitian ini ialah kadar 25-hydroxyvitamin D serum dan RNL dapat digunakan sebagai indikator untuk memrediksi keganasan nodul tiroid. Kata Kunci: keganasan tiroid; 25-hydroxyvitamin D; rasio netrofil-limfosit
Fraktur Komunitif Angulus – Korpus Mandibula dengan Pemasangan Titanium Miniplate dan Srew: Laporan Kasus Sitompul, Riston R.; Lumintang, Nico; Tandililing, Sherly
e-CliniC Vol. 12 No. 3 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i3.51821

Abstract

Abstract: Communitive fracture of the mandible is quite complicated to achieve good results with the use of titanium miniplates and screws. The challenges faced start from tips and tricks for placing non-rigid miniplate and screw fixation. There are two methods in performing mandibular communitive fracture surgery, namely closed reduction and open reduction. We reported a case of a 19-year-old male referred to Prof. Dr. R. Kandou Hospital, Manado, with open right mandible fracture. The patient was diagnosed with mild head injury, cerebral edema, skull base fracture, communitive fracture of mandibular angulus and corpus, non-displaced maxillary zygoma fracture, and palatal dental sagittal fracture. The patient underwent open reduction surgery with internal fixation using titanium miniplates and screws, and was re-evaluated in the first week after surgery up to three weeks after surgery. The patient's functional chewing and mouth opening were within normal limits. There were no complications such as infection or nerve lesions. In conclusion, communitive mandibular fracture using an open reduction technique with titanium miniplate and screw internal fixation gives satisfactory result. Keywords: communitive mandibular fracture; open reduction; dental occlusion   Abstrak: Fraktur komunitif mandibula merupakan kasus yang cukup rumit untuk mencapai hasil yang baik dengan penggunaan titanium miniplate dan screw. Tantangan yang dihadapi mulai dari tips dan trik penempatan fiksasi miniplate dan screw yang tidak rigid. Terdapat dua metode dalam melakukan operasi fraktur komunitif mandibula, yaitu reduksi tertutup dan reduksi terbuka. Kami melaporkan kasus seorang laki-laki 19 tahun dirujuk ke RSUP Prof. Dr. R. Kandou, Manado dengan patah tulang dagu kanan terbuka. Pasien didiagnosis dengan cedera kepala ringan, edema serebri, fraktur basis krani, fraktur angulus - korpus mandibula dekstra komunitif, fraktur zigoma pars maksilaris dekstra non-displaced, dan fraktur sagital dental palatal. Pasien dilakukan operasi reduksi terbuka dengan fiksasi internal. Evaluasi dilakukan pada minggu pertama paska operasi, hingga tiga minggu paska operasi. Didapatkan fungsional mengunyah dan membuka mulut pasien ini dalam batas normal, serta tidak didapatkan komplikasi seperti infeksi maupun lesi saraf. Simpulan kasus ini ialah fraktur mandibula komunitif dengan teknik reduksi terbuka dan fiksasi internal titanium miniplate dan screw memberikan hasil yang memuaskan. Kata kunci: fraktur mandibula komunitif; reduksi terbuka; oklusi dental
Cangkok Aurikular Kondrokutaneus Komposit sebagai Alternatif untuk Rekonstruksi Defek Dorsum Nasal dengan Ketebalan Penuh Ketika Septal Hinge Flap Tidak Tersedia: Laporan Kasus Lumintang, Nico A.; Tandililing, Sherly; Akmal, Nuzly Q.
Medical Scope Journal Vol. 7 No. 1 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i1.54926

Abstract

Abstract: Nose is an important structure of the face because it is centrally located and prominent, however, it is also weak and vulnerable to trauma. Nasal trauma, if not treated properly, can lead to functional and esthetic deformities. A full-thickness defect in dorsum nasal and septal area, caused by a traffic accident, can present a challenging reconstruction scenario. We present a case of a 21-year-old male with full-thickness defect in the dorsum nasal and septal area due to a traffic accident. The septal hinge flap is a common option for cartilage and lining reconstruction, but it may not always be available. Considering the complexity of the defect, we decided to perform a reconstruction using an auricular chondrocutaneous graft. A series of post-operative follow-ups were carried out from two months to four months postoperatively to evaluate in depth the function and aesthetic aspects of the patient. The results of the evaluation conducted showed that the patient had achieved a high level of satisfaction related to the restoration of his function and aesthetic appearance. This evaluation was essential to ensure that the interventions carried out had been functionally and aesthetically successful. Keywords: nasal fracture; nasal reconstruction; full-thickness graft; auricular graft; septal hinge flap    Abstrak: Hidung merupakan struktur penting pada wajah karena letaknya di tengah dan menonjol, namun, struktur ini juga lemah dan rentan terhadap trauma. Trauma hidung, jika tidak ditangani dengan baik, dapat menyebabkan kelainan bentuk baik fungsional maupun estetika. Defek dengan hilangnya ketebalan penuh pada area dorsum hidung dan septum, yang disebabkan oleh kecelakaan lalu lintas, dapat menghadirkan skenario rekonstruksi yang menyulitkan. Kami menyajikan laporan kasus seorang laki-laki berusia 21 tahun dengan defek ketebalan penuh pada area dorsum nasal dan septum akibat kecelakaan lalu lintas. Septal hinge flap ialah pilihan umum untuk rekonstruksi tulang rawan dan lapisannya, tetapi mungkin tidak selalu tersedia. Dengan mempertimbangkan kompleksitas defek tersebut, diputuskan untuk melakukan rekonstruksi menggunakan cangkok aurikular kondrokutaneus. Serangkaian tindak lanjut pasca-operasi dilakukan sejak dua bulan hingga empat bulan pasca operasi untuk mengevaluasi secara mendalam aspek fungsi serta estetik pada pasien. Hasil evaluasi menunjukkan bahwa pasien telah mencapai tingkat kepuasan tinggi terkait dengan pemulihan fungsi dan penampilan estetiknya. Evaluasi ini sangat penting untuk memastikan bahwa intervensi yang dilakukan telah berhasil secara fungsional dan estetis. Kata kunci: fraktur nasal; rekonstruksi hidung; full-thicknes graft; auricular graft; septal hinge flap
Cervical Approach for Retrosternal Struma: A Case Report Tandililing, Sherly; Sipayung, Edwin Z.
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.58670

Abstract

Abstract: Retrosternal struma is the inclusion of the thyroid gland into the thoracic cavity. Combined access with a neck incision and chest incision or only a neck incision to free the tumor from the chest cavity and avoid damage to surrounding tissues, makes treatment of substernal struma a challenge both preoperatively and during surgery. Systematic technique minimizes the need for sternotomy, even in patients with significant intra thoracic components, and keeps severe complication rates at levels comparable to those of conventional thyroidectomy. We reported a 46-year-old woman complaining of lumps on the right and left neck for six years. The masses were found on the right side of the neck (10x6cm) and on the left side of the neck (4x3cm), which were hard consistency, well-defined, immobile, skin-colored, painless, and moving when swallowing. CT-scan showed a solid mass struma that had entered the superior thoracic aperture. Total thyroidectomy was performed through cervical approach with a good outcome. In conclusion, total thyroidectomy through a cervical approach is able to remove the entire thyroid gland tissue extending to the retrosternal region with a good outcome without performing a sternotomy. Keywords: retrosternal struma; thyroidectomy; cervical approach
Comprehensive Reconstruction of Facial Defects: A Case Study Utilizing Combined Skin Flap Techniques and Composite Graft Chondrocutaneus Reksoprawiro, Sunarto; Lumintang, Nico; Tandililing, Sherly; Papea, Melky Rendy
Blantika: Multidisciplinary Journal Vol. 3 No. 6 (2025): Special Issue
Publisher : PT. Publikasiku Academic Solution

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57096/blantika.v3i6.362

Abstract

Post-operative defects of skin tumor removal in the facial area, especially the nasal area, are very common. Reconstruction of defects in the nasal, presents a great challenge for surgeons where the presence of asymmetric conditions, changes in skin color and texture will be easily visible and cause changes in facial shape. In addition, to maintain and restore the function of the defective part that will be reconstructed, it requires high precision and expertise to obtain good results aesthetically and functionally. In this article, we present 3 cases of the combined use of auricular chondrocutaneous composite graft and paramedian forehead flap in defect reconstruction full tickness nasal ala after tumor excision. Two cases were unilateral reconstruction and 1 other case was bilateral reconstruction. Previously, the patient had been educated about the choice of surgical technique, risks and benefits of the surgical technique to be used and the patient had agreed to it. The reconstruction results in all three cases showed excellent results both aesthetically and functionally. The shape and contour of the thin auricular cartilage are very suitable for forming the nasal ala without the need for surgical molding as in other cartilage graft donors. The thin skin attached to the cartilage not only forms liningwhich is perfect but also forms a wide nostril space. The weakness of the auricular chondrocutaneous composite graft in terms of vascularization supply can be overcome with paramedian forehead flap, which is also a large skin donor with contours and skin color that are most similar to the skin of the nasal. This procedure provides excellent results in terms of aesthetics and functionality, as well as minimal complications and donor mobility, so it can be the procedure of choice for reconstruction of large defects in the nasal after tumor removal.
Co-Authors Akmal, Nuzly Q. Bogar, Bryan D. Edwin Z. Sipayung Lumintang, Nico A. Nico Lumintang Papea, Melky Rendy Reksoprawiro, Sunarto Sitompul, Riston R. Wariki, Windy M. V.