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Gambaran Radiologis Karsinoma Sel Skuamosa Mediastinum -, Biddulth; Wulani, Vally; Tanurahardja, Budiana; -, Wuryantoro
Cermin Dunia Kedokteran Vol 43, No 4 (2016): Adiksi
Publisher : PT. Kalbe Farma Tbk.

Dilaporkan sebuah kasus jarang, yaitu karsinoma sel skuamosa di mediastinum. Seorang laki-laki berusia 63 tahun, dengan benjolan di dinding dada yang makin membesar dalam 1 tahun terakhir. Pasca-biopsi, dilakukan radiasi eksterna untuk menghentikan perdarahan. Pada CT scan, didapatkan massa mediastinum, menginvasi struktur sekitar dan pembuluh darah. Pada pemeriksaan skintigrafi tulang, didapatkan tanda-tanda metastasis osteopeni. Pada pemeriksaan histopatologi biopsi didapatkan karsinoma sel skuamosa.

PENGARUH NILAI FRACTIONAL ANISOTROPY (DIFFUSION TENSOR IMAGING) PADA TERAPI IMPLANTASI KOKLEA DALAM KLINIS SENSORINEURAL HEARING LOSS (SNHL) Purnawati, Heny; Amanda, Mega; Wulani, Vally; Serfina Fajarini, Eunike
JRI (Jurnal Radiografer Indonesia) Vol. 3 No. 1 (2020)
Publisher : Perhimpunan Radiografer Indonesia (PARI)

Background: Diffusion Tensor Imaging (DTI) on current MRI cochlear examination able to support the diagnosis and help determine implantation therapy. The DTI line can show the cochlea tract and fractional anisotropy (FA) values with reference to the control reference value. DTI can visualize white matter in the cochlear tract that can be mapped in the FA of the entire cochlear image using directions. The FA value on the MRI cochlear examination can be used to determine the continuation of implant placement in the patient by using the FA-DTI value in the case of sensorineural hearing loss (SNHL). Method: Data were taken from September 2018 to August 2019. The MRI sequences used were Axial T2 5mm, Coronal T2 2mm, Axial T2 2mm, Axial 3D Fiesta-C 0.4mm and DTI 2mm. The total time of examination was 20 minutes using post processing Functool on the 2mm DTI results, measuring the region of interest (ROI) to obtain FA values â€‹â€‹in several segments, namely region Trapezoid Body (rTB), region Superior Olivary Nucleus (rSON), region Inferior Colliculus (rIC), region Medial Geniculate (rMG), region Auditory Radiation (rAR). Result:The results of the DTI image are very sensitive to produce a diagnosis in the form of nerve fibers. DTI which is supported by the results of the FA score is able to provide quantitative information. Conclusion: There is an effect on the FA-DTI value in SNHL cases for cochlear implant therapy.

Radiological anatomy analysis of uncinate process, concha bullosa, and deviated septum in chronic rhinosinusitis Retno Sulistyo Wardani; Arroyan Wardhana; Endang Mangunkusumo; Vally Wulani; Brent Anthony Senior
Oto Rhino Laryngologica Indonesiana Vol 47, No 1 (2017): Volume 47, No. 1 January - June 2017
Publisher : PERHATI-KL

Background: Risk factors of chronic rhinosinusitis include epithelial disease related to disturbanceof mucociliary transport system, anatomical variations obstructing the ostiomeatal complex anddysfunction of neural regulation.Purpose: To find the prevalence of deviated septum, concha bullosa andlateral deflection of the uncinate process in ipsilateral chronic rhinosinusitis.Methods: A retrospectivestudy of computed tomographic (CT) scans of chronic rhinosinusitis patients who were not cured by6 weeks of maximal medical treatment of rhinosinusitis. Pneumatization of the middle turbinate anddeviation of the septum were evaluated on coronal slices, while lateral deflection of the uncinate processwas also assessed by calculating the angle using Osirix software (Pixmeo, Geneva, Switzerland).Results:One hundred ninety-three CT scans comprising 386 nasal sides were analyzed. The prevalence of thecombination of deviated septum, concha bullosa and lateral deflection of the uncinate process occurringconcurrently with ipsilateral maxillary sinusitis was found to be 32,9% (p=0.01, OR=9.1, 95% CI=1.2-69.7). The prevalence of deviated septum with concha bullosa was found in 40.9% with ipsilateral maxillarysinusitis (p=0.03, OR=3.8, 95% CI=1.1-13.3). One single anatomical variation of lateral deflection ofthe uncinate process had a proportion of 71.5% in ipsilateral maxillary sinusitis (p=0.03, OR=2.7 95%CI=1.1-6.9).Conclusion: Deviated septum, concha bullosa and lateral deflection of the uncinate processwere frequently present in the existence of ipsilateral chronic maxillary rhinosinusitis. It suggested greaterassociation compared to one or a combination of two anatomical variation in the role of local factorscontributing to sinonasal epithelial dysfunction.Keywords: chronic rhinosinusitis, deviated septum, concha bullosa, lateral deflection of uncinate process ABSTRAKLatar belakang: Rinosinusitis kronis adalah penyakit inflamasi yang mengakibatkan gangguankeseimbangan homeostasis fungsi hidung dan sinus paranasal. Patofisiologinya terjadi melalui kombinasigangguan transpor sistim mukosiliar, variasi anatomi yang menyempitkan kompleks ostiomeatal sertagangguan regulasi persarafan sensorik, simpatis dan parasimpatis. Tujuan: Untuk mengidentifikasiprevalensi septum deviasi, konka bulosa dan prosesus unsinatus defleksi lateral, serta hubungannya denganrinosinusitis kronik yang terjadi pada sisi yang sama (ipsilateral). Metode: Penelitian retrospektif potonglintang pada tomografi komputer (TK) pasien dengan rinosinusitis kronik yang tidak sembuh dengan terapimedikamentosa maksimal selama 6 minggu. Pneumatisasi konka media dan deviasi septum dievaluasipada potongan koronal, sedangkan defleksi prosesus unsinatus ke lateral dinilai dan diukur sudutnyadengan menggunakan piranti lunak Osirix (Pixmeo, Geneva, Switzerland). Hasil: Analisis dilakukanpada 193 TK yang terdiri dari 386 sisi hidung. Prevalensi kombinasi septum deviasi, konka bulosa danprosesus unsinatus defleksi lateral yang terjadi bersamaan dengan sinusitis maksila ipsilateral adalah 32,9% (p=0,01, OR=9,1, 95% CI=1,2-69,7). Prevalensi septum deviasi dengan konka bulosa ditemukanpada 40.9% sinusitis maksila ipsilateral (p=0,03, OR=3,8, 95% CI=1,1-13,3). Variasi anatomi tunggalyaitu prosesus unsinatus defleksi lateral memiliki proporsi 71,5% pada sinusitis maksila ipsilateral.(p=0,03, OR=2,7 95% CI=1,1-6,9). Kesimpulan: Septum deviasi, konka bulosa dan prosesus unsinatusdefleksi lateral sering ditemukan bersamaan dengan kejadian sinusitis maksila ipsilateral. Kombinasitiga variasi anatomi yang menyempitkan kompleks ostiomeatal (KOM) lebih kuat daripada hanya satuvariasi anatomi atau kombinasi 2 variasi anatomi, sebagai faktor lokal yang berkontribusi terhadapdisfungsi epitel sinonasal serta gagalnya resolusi inflamasi kronik.Kata kunci: Rinosinusitis kronis, septum deviasi, konka bulosa, prosesus unsinatus defleksi lateral

Gambaran Radiologis Karsinoma Sel Skuamosa Mediastinum Biddulth -; Vally Wulani; Budiana Tanurahardja; Wuryantoro -
Cermin Dunia Kedokteran Vol 43, No 4 (2016): Adiksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i4.47

Dilaporkan sebuah kasus jarang, yaitu karsinoma sel skuamosa di mediastinum. Seorang laki-laki berusia 63 tahun, dengan benjolan di dinding dada yang makin membesar dalam 1 tahun terakhir. Pasca-biopsi, dilakukan radiasi eksterna untuk menghentikan perdarahan. Pada CT scan, didapatkan massa mediastinum, menginvasi struktur sekitar dan pembuluh darah. Pada pemeriksaan skintigrafi tulang, didapatkan tanda-tanda metastasis osteopeni. Pada pemeriksaan histopatologi biopsi didapatkan karsinoma sel skuamosa.

Skoring Risiko Mortalitas pada Pneumonia Komunitas Sedang-Berat Kusuma, Ni Nyoman Indirawati; Singh, Gurmeet; Wulani, Vally; Rumende, Cleopas Martin Martin; Fauzar, Fauzar; Kamelia, Telly; Koesnoe, Sukamto; Susilo, Adityo; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Community Acquired Pneumonia (CAP) is a lung parenchyma infection acquired outside of the hospital and is significantly associated with morbidity and mortality rates. Identifying patients with moderate-severe CAP at high risk of mortality through a combination of these variables is expected to serve as a basis for prompt and appropriate intervention, ultimately improving clinical outcomes for CAP patients. This study aimed to develop a scoring system using clinical characteristics, radiological findings, and serum biomarkers to assess the mortality risk in patients with moderate-severe CAP. Methods. This study employs a retrospective cohort design with moderate-severe CAP patients treated at Dr. Ciptomangunkusumo Hospital, Jakarta. The sample data were secondary, derived from medical records of patients diagnosed with moderate-severe CAP between January 2022 and December 2023. Predictor variables for mortality risk were obtained through multivariate analysis using Cox regression. Results. The study included 277 subjects, with 124 (44.77%) deaths and 153 (55.23%) survivors. Predictor variables consistently influencing mortality risk in moderate-severe CAP patients were low BMI (HR 1.609, 95% CI 1.047 – 2.472), procalcitonin (HR 1.778, 95% CI 1.200 – 2.634), and lactate levels (HR 1.451, 95% CI 0.994 – 2.119). The prediction model’s performance, based on the ROC curve analysis, showed moderate predictive ability (AUC = 0.641), and calibration performance, as assessed by the Hosmer-Lemeshow test, showed good validation (p = 0.082). Conclusions. There is an association between BMI, procalcitonin, and lactate levels with the mortality risk in moderate-severe CAP patients. A mortality risk scoring model for moderate-to-severe CAP patients has been established.

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