Maranatha, Daniel
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, University Of Airlangga, General Hospital Dr. Soetomo, Jl. Mayjen Prof. Dr. Moetopo No. 6-8 Surabaya

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Triple Mutation Epidermal Growth Factor Receptor (EGFR) Exon 18 (G719S), 20 (T790M) and 21 (L858R) in a Male Patient with Lung Adenocarcinoma: A Case Report Nur Marleta Riza; Daniel Maranatha
Jurnal Respirasi Vol. 6 No. 1 (2020): January 2020
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (670.147 KB) | DOI: 10.20473/jr.v6-I.1.2020.13-20

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Background: Lung cancer is one of the deadliest cancers in the world. The percentage of non small cell lung cancer (NSCLC) is about 80% of the incidence of lung cancer. The type of NSCLC, adenocarcinoma, is usually found in the presence of epidermal growth factor receptor (EGFR) mutations.Case. A male patient aged 70 years, an active smoker, works as a farmer. He has complained of shortness of breath, and chest pain for three months. There was no family history of suffering from malignancy. The cytology result of the right pleural fluid indicated adenocarcinoma. He was diagnosed with pulmonary adenocarcinoma (D) stage IV positive mutation of EGFR exon 18 (G719S), 20 (T790M) and 21 (L858R) carnofsky score 70. He could survive for more than 11 months with the treatment of EGFR TKI, and received a good therapeutic response. Initially, for the first six months it was such a progressive disease, and for the next eleven months it became stable.Conclusion: In addition to the exon mutations found in this case, the cells in the tumor will continue to grow and develop into new mutants that are immune such drugs and rapidly split themselves into new, different forms. The therapy for complex mutations is still being developed. EGFR TKI therapy in this patient had a relatively good response. Further understanding of the molecular biology of lung cancer is seriously required.
Perbandingan Pola Kuman dan Kadar Biomarker Inflamasi Penderita Severe Pneumonia dengan Penderita Non-severe Pneumonia : [Bacterial Pattern and Inflammatory Biomarker in Severe Pneumonia Compared to Non-Severe Pneumonia Patient] Daniel Maranatha; Mawardi Mawardi
Jurnal Respirasi Vol. 5 No. 2 (2019): Mei 2019
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.811 KB) | DOI: 10.20473/jr.v5-I.2.2019.29-33

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Background: Severe pneumonia is still a serious problem with high mortality rate. The cause of severe pneumonia due to high inflammation or different microbial pattern compared to non-severe pneumonia is still unknown. Methods: An analytic observational study with cross-sectional design was performed in patients with severe pneumonia and non-severe pneumonia treated in intensive care unit (ICU), intensive observation room (ROI), and all inpatient wards of Dr. Soetomo General Hospital Surabaya for a period of 1 year from September 2017 to September 2018. Patients with pneumonia accompanied by active pulmonary tuberculosis (TB), lung tumors, and acute infections other than pulmonary organs were excluded from this study. All study subjects were taken for sputum samples for aerobic sputum culture and blood samples for biomarker examination of C-reactive protein (CRP) and procalcitonin (PCT). Results: The total subjects were 64. Mean value of CRP and PCT levels severe pneumonia was 143.8 mg/L and PCT levels 23.1 ng/ml, respectively. Mean value of CRP and PCT levels non-severe pneumonia was 75.0 mg/L and PCT level 8.08 ng/ml, respectively. There was a significant difference in CRP and PCT levels of severe pneumonia and non-severe pneumonia patients (p < 0.05), whereas no meaningful difference in microbial patterns in both groups. Conclusion: Since inflammation responses of severe pneumonia were more massive than nonsevere patients, it will produce higher CRP and PCT levels.
Problema Diagnostik dan Respons Kemoterapi pada Seorang Penderita Classical Limfoma Hodgkin Tipe Mixed Cellularity dengan Temporary Spontaneus Regression: [Difficult Case of Classical Hodgkin Lymphoma Mixed Cellularity Type with Temporary Spontaneous Regression] Daniel Maranatha; Bintang Bestari
Jurnal Respirasi Vol. 3 No. 1 (2017): Januari 2017
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (639.529 KB) | DOI: 10.20473/jr.v3-I.1.2017.7-11

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Background: Mixed cellularity classical hodgkin lymphoma (MCCHL) is the secound subtype of classical hodgkin lymphoma (cHL) which often happens. MCCHL is aggressive but has a relatively high recovery rate. The diagnosis of cHL is sometimes difficult. Spontaneous regression can occur in cHL but is very rare, temporary or permanent. CHL including diseases with a fairly high cure rate, about 80% of patients recover with first-line chemotherapy. Case: Male age 26 years, 9 months cough, shortness of breath, chest pain 8 months, 6 months fever disappear with enlargement of right supraclavicular lymph nodes appearing at 11 days before admission. Chest X-ray shows the presence of mediastinal mass supported by contrast thoracic CT scan. FNAB has been done three times with no meaningful results. In one of the chest radiographs and CT scan of the thoracic with contrast evaluation showed a reduction in tumor size. Open thoracotomy biopsy is performed with Hodgkin’s lymphoma results. On immunohistochemical examination obtained MCCHL. Chemotherapy with ABVD regimen was administered for three cycles with partial remission and was continued with 6 cycles with stable disease outcomes. Conclusion: Spontaneous temporary regression in cases with mediastinal tumor suspicion may occur in cHL and may cause difficulties in diagnosing. Open biopsy is required as a gold standard and has to be supported by immunohistochemical test. First-line chemotherapy response in cHL is good.
Pneumonitis Akut dan Gagal Napas Setelah Mendapatkan Injeksi Silikon Cair di Payudara: [Acute Pneumonitis and Respiratory Failure after Breast Silicon Injection: A Case Report] Cut Diana Laili; Daniel Maranatha
Jurnal Respirasi Vol. 1 No. 2 (2015): Mei 2015
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (179.959 KB) | DOI: 10.20473/jr.v1-I.2.2015.48-52

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Background; Liquid silicone is a synthetic polymer incorporating oxygen and the semimetallic element silicon. It is widely  used in plastic and reconstructive surgery as it displays little change in physical characteristicswith temperature and age, is poorly  immunogenic, and is not carcinogenic. Case; We report a case of a 27-year-old woman presented to the hospital with the chief complain  progressive shortness of breath, pleuritic chest pain, productive cough, hemoptysis and fever after liquid silicone injections to the  mammae for cosmetic augmentation. Physical examination: tachycardia, tachypneu, hypertermia and diffuse rhonchi throughout the  lungs. Abnormalities laboratory tests gave leuchositosis, granulositosis, increasing trassaminase serum, D-dimer elevation, Arterial  blood gas analysis results respiratory disstres tipe 1. Chest radiograph showed difus bilateral infiltrates, CT angiography was negative  for an acute embolus but demonstrated infiltrates in superior lobus dextra, segment lateral lobus medius dan segment apicoposterior  Sinistra. Conclusion;  Patients with diagnosis of acut pneumonitis and respiratory disstres syndroma after liquid silicone injection to  the mammae, supportive therapy with O2 Ventilator and methylprednisolon low dose gives satisfactory result with radiological and  clinical.
Seorang Penderita dengan Retrosternal Goiter: [A Patient with Retrosternal Goiter: A Rare Case] Mawardi Mawardi; Daniel Maranatha
Jurnal Respirasi Vol. 2 No. 1 (2016): Januari 2016
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (623.876 KB) | DOI: 10.20473/jr.v2-I.1.2016.14-23

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Background: Retrosternal goiter of the thyroid gland is the inclusion of 50% or more into the thoracic cavity. Many terms are used to describe the entry of the thyroid gland into the thoracic cavity include: substernal goiter, intrathoracic goiter, retrosternal goiter and mediastinal goitre. Case: We report the case of a woman with retrosternal goiter initially suspected as a tumor in the mediastinum. Patients present with chest pain and no visible enlargement of the thyroid gland in the neck. On examination thoracic CT scan and found an enlarged thyroid gland in the chest cavity is then performed total thyroidectomy surgery and sternotomy. Conclusion: This case illustrates retrosternal goiters should be differentiated from other mediastinal masses by appropriate work-up, while computed tomography is the most valuable technique and surgical management is mandatory.
Seorang Laki-Laki dengan Tumor Mediastinum Posterior (Malignant Peripheral Nerve Sheath Tumor): [Malignant Peripheral Nerve Sheath Tumor in a Man: A Case Report] Daniel Maranatha; Shinta Karina Yuniati
Jurnal Respirasi Vol. 2 No. 3 (2016): September 2016
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2366.771 KB) | DOI: 10.20473/jr.v2-I.3.2016.82-90

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Background: Malignant tumors arising from peripheral nerves or displaying differentiation along the lines of the various elements of the nerve sheath are referred to Malignant peripheral nerve sheath tumors (MPNST) and also called malignant schwannomas or neurofibrosarcomas. The common sites of involvement are head, neck, extremities and thorax. This case was discussed due to its rare incidence, namely less than 5% of soft tissue malignant tumor. The overall five year survival rate is approximately 50% in patients with resectable tumor. Case: We report a case of MPNST arising from mediastinum, the patient was a male, 41-years-old, with chief complaint are chest pain and mass in the back. Contrast enhanced chest CT Scan showed a solid mass (10.02 × 6.97 × 10.53 cm) in the right side of the posterior mediastinum. On microscopic examination with hematoxylin eosin imunostaining, of the mass on mediastinum showed typical features of MPNST, which were positive for S-100 imunostaining. Based on convensional histopathologic and imunostaining, this case was concluded as Malignant peripheral nerve sheath tumors (MPNST). Conclusion: The treatment of chest wall MPNSTs is multimodality, including wide local excision, adjuvant radiotherapy, and chemotherapy. In our case, we performed direct excision due to the infiltrating mass to the surrounding tissue, so the prognosis for this case was good. This case indicates the role of chemotherapy in treatment of advanced MPNST. Studies shows the superiority of the doxorubicin–ifosfamide regimen. As in this case the patient showed complete respons after surgery and adjuvant chemotherapy.
Pemphigus Paraneoplastik pada Timoma : [Pemphigus Paraneoplastic in Thymoma: A Rare Case] Herley Windo Setiawan; Daniel Maranatha
Jurnal Respirasi Vol. 4 No. 1 (2018): Januari 2018
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (645.973 KB) | DOI: 10.20473/jr.v4-I.1.2018.5-11

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Thymomas are mediastinal primary tumour of the mediastinum and associated with a variety of autoimmune disorders often linked to T-cell mediated autoimmunity. Paraneoplastic pemphigus (PNP) is an immunologically mediated skin disease characterized by epidermal blisters that may occur in association with thymic or non thymic neoplasms. Case: 21 years old man came to the hospital with vesicles and ulcer in oral cavity and extended to whole body since 3 weeks before. Patient was diagnosed with Pemphigus vulgaris and thymomas since 2 years. Patient was hospitalized for 3 times with same cases. Patient underwent chemotherapy Carboplatin-Etoposide 6 series and Radiotherapy 25 series and no response had been documented. Patient was suggested to undergo a resection of thymoma to prevent the exacerbation of pemphigus but he refused. The medication given was only aimed for reducing the exacerbation of Pemphigus. Discussion: PNP is characterized by the production of autoantibodies against various target antigens, mainly plakin family proteins and desmogleins. PNP results from an antitumor immune response cross-reacting with the normal epithelial proteins and thereby inducing autoimmunity by molecular mimicry. PNP sera bind to homologous region within carboxyterminus of members of the plakin gene family. There are also involvement of dysregulation of T-cell development. Conclusion: Pemphigus is rarely associated with Thymomas, but the fact there is an association between Thymomas and pemphigus. According to this fact, every patients with pemphigus should be suspected with malignancies especially thymomas until it was ruled out.
Seorang Wanita dengan TB Paru Kasus Baru dan TB Ekstra Paru Multiple : [New Case of Pulmonary and Multisite Extrapulmonary Tuberculosis in a Woman: A Case Report] Gandhi Estrada Atmanto; Daniel Maranatha
Jurnal Respirasi Vol. 5 No. 1 (2019): Januari 2019
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (721.485 KB) | DOI: 10.20473/jr.v5-I.1.2019.10-14

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Background; Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis (Acid-Fast Bacilli/AFB) that still be a world burden. Extra Pulmonary TB occurred when there were infection and development of Mycobacterium tuberculosis outside lungs, which about 10% cases was Milliary TB. There will be reported case with Lung TB New Case coexistence with Multiple Extra Pulmonary TB. Case; A female, 39 y.o., came to the Soetomo General Teaching Hospital with chief complaint body weakness since 12 months ago following with cough, decrease of appetite, decrease of body weight, low grade fever, and night sweating. The cough was on and off, not productive, and didn`t improve with usual therapy. Her other complaint were painless mass at the left supraclavicular area, swollen and pain at the right knee, and pain at the backbones. Patient had subsequently given Anti Tuberculosis Drugs (ATD) with Streptomycin injection based on clinical judgement. Discussion;  In several cases, Primary Focus as the result of AFB infection in the lung can spread to the other organs. The diagnosis had been made from comprehensive summary of clinical aspects, radiology data, laboratory data, and Histopathology data. Consideration of ATD choice based on grouping of TB diseases (Pulmonary/Extra Pulmonary), severity level of Extra Pulmonary TB and clinical judgement Conclusion; Had reported female patient diagnosed with Lung TB New Case, Osteomyelitis TB, Spondilitis TB, and Lymphadenitis TB. Based on therapeutic evaluation there was improvement condition of the patient after administration of ATD and injection of Streptomycin.
RELATIONSHIP BETWEEN LEVEL OF SERUM ADIPONECTIN AND FRAILTY IN ELDERLY PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE Marfiani, Erika; Ichwani, Jusri; Widajanti, Novira; Maranatha, Daniel; Amin, Muhammad
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 2 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i2.16027

Abstract

Elderly are especially prone to the adverse health effects of chronic obstructive pulmonary disease (COPD). COPD is a typical aging disease which is found to be about 12% in the age group more than 64 years old. Frailty is an important geriatics syndrome, while adiponectin is an important adipokine that regulate homeostasis of energy. Adiponectin is affected by age, especially in males. Adiponectin levels increases as subcutaneous fat cells in older men decreases. Increased adiponectin can lead to muscle wasting which will further reduce body weight and body mass index (BMI), which indirectly also increases the degree of frailty. Until now the relationship between adiponectin with frailty degree in advanced COPD is still unknown.The aims of this study was to investigate the relationship between plasma adiponectin level and frailty in COPD elders. This was an observational analytic cross-sectional study. All anthropometric parameters, including weight, height, and body mass index (BMI), were measured. Adiponectin was measured by ELISA methods obtained from venous blood samples. Aged more than or equal to 60 years old, the patients underwent spirometry to determine the degree of airflow limitation and the degree of frailty defined by the Fried criteria. Statistic analysis used Rank Spearman. Thirty-eight male COPD patients became the subject of the study. The average age was 70-74 years, with a total of 13 robust, 12 prefrails and 13 frail patients. Level of adiponectin (mean and SD) in robust, prefrail, and frail were 6.84+ 2.66 , 6.58 + 4.27, and 11.62 + 4.90 respectively, p=0.015. Further analysis showed that level of adiponectin rose progresively with an increasing number of components of frailty. The degree of obstruction mostly with mild (42.1%), and no subjects with very severe. There were an increase in serum adiponectin levels in all subjects. In conclusion, level of adiponectin serum correlates positively with the degree of frailty.
Terapi Montelukast pada Asma Alfian Nur Rosyid; Arief Bakhtiar; Daniel Maranatha; Muhammad Amin
MEDICINUS Vol. 37 No. 1 (2024): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/51tkjy13

Abstract

Asthma is a chronic inflammatory respiratory condition caused by various inflammatory mediators, including those from the arachidonic acid pathway, which serves as a precursor for leukotrienes and prostaglandins. Leukotriene receptor antagonists (LTRAs) have been approved since 1998 as a treatment for asthma. Montelukast is one of the LTRAs that is useful for asthma control, including cases that accompanied by allergic rhinitis. A daily dose of 5-10 mg is recommended for persistent asthma as the preferred controller. LTRAs are not recommended for acute asthma exacerbation due to their relatively slow onset, but they are beneficial in preventing exacerbations. They are also indicated for exercise-induced asthma (EIA), and can be taken 2 hours prior to exercise. Montelukast can be administered as monotherapy or added to LABA-ICS therapy. It is suitable for adults, children, and infants over 1 year of age, preferably taken at night to prevent symptoms in the early morning. Possible side effects include respiratory tract infections, abdominal pain, diarrhea, and neuropsychiatric disorders. Montelukast is considered safe for use during pregnancy and breastfeeding. Physicians should provide comprehensive education for patients regarding medication compliance and the potential risks of side effects. Regular daily use of montelukast is beneficial in preventing acute exacerbations in asthma patients.