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All Journal Medical Journal of Indonesia Jurnal Plastik Rekonstruksi The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia
Grace Wangge, Grace
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Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Health Professions Immunology & microbiology Medicine & Pharmacology Other

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Behind and beyond the gatekeepers’ transformation Wangge, Grace
Medical Journal of Indonesia Vol 26, No 2 (2017): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (215.408 KB) | DOI: 10.13181/mji.v26i2.2130

Abstract

[no abstract available]
Comparison of Japanese Classification with the TNM System in the Assessment of Staging in Sigmoid and Rectal Cancer Patients at dr. Cipto Mangunkusumo and Fatmawati General Hospital: A Preliminary Study Putranto, Agi S.; Kristianto, Yusak; Wangge, Grace
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Lymph node metastasis of colorectal cancer is an independent prognostic factor and used as a guideline for adjuvant therapy. Paralleled to this, TNM staging system has been used widely and nowadays referred to a gold standard of colorectal cancer staging. So far, such a system classifies the staging based on the numbers of positive lymph node involvement. Japanese classification was another kind of system do that categorize based on the distribution of lymph nodes involved (i.e. paracolic/rectal, intermediate, root of mesenteric artery). Method. This was a preliminary study analyzed of 15 subjects with sigmoid and rectal cancer underwent surgery at dr. Cipto Mangunkusumo and Fatmawati General Hospital between September and October 2015. We studied the specimen for histopathological evaluation focused on the numbers of positive lymph nodes and the distribution of lymph node metastasis. Staging was carried out using both of TNM system and Japanese classification, and these variables were subjected to agreement analysis. Results. We found more than twelve lymph nodes from each sample. Based on TNM staging system, there are seven subjects on stage II, three subjects with stage IIIb and five subjects with stage IIIc, meanwhile based on Japanese Classification, there were seven subjects with stage II, one subjects with stage IIIa and seven subjects with stage IIIb. Analysis of agreement between both of classifications resulted in coefficient Kappa of 49.3% (moderate category) with p-value of 0.04. Conclusion. Our preliminary study showed that agreement between both of classifications to specify sigmoid and rectal staging is in moderate category. Japanese classification is feasible to be used. Agreement accuracy may be obtained with a bigger sample.
Clinicopathological Predictors of Central Compartment Lymph Node Metastases in cN0 Papillary Thyroid Carcinoma Purnomo, Henricus SW.; Yulian, Erwin D.; Makes, Benyamin; Wangge, Grace
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Prevalence of the lymph node metastases of central neck compartment in papillary thyroid carcinoma (PTC) and its correlation with regional metastatic remains high. There are pros and cons on central neck dissection which is thought to solve the problem. Selection of appropriate patient to undergo central neck dissection is then essential. Thus, predictive factors were very useful in such selection, and we run a study aimed to find out the clinicopathological predictive factors for metastases of central compartment in subjects treated in Cipto Mangunkusumo General Hospital. Method. Data of 62 cN0 papillary thyroid carcinoma (PTC) subjects who underwent central neck dissection were collected consecutively and retrospectively studied. The correlations between clinicopathological factors such as age. Gender, tumor size, extra thyroid extension. Distant metastasis, completeness of resection, histopathology variant, lymphovascular invasion and central compartment metastases were the variables analyzed. Chi square. Fischer exact and stratification test were used. Significance found if p value of <0.05 with 95% confidence interval. Results. In this study, the prevalencein our hospital is 20.9%. The clinicopathological factors that statistically showed significance were the positive lymphovascular invasion (OR=14.40; p<0.05), tall cell variant (OR= 14.00; p <0.05), positive extra thyroid extension (OR=10.44; p<0.05) and age ≥45 years (OR= 9.47; p <0.05). Lymphovascular invasion showed a higher OR (OR=14.40). Conclusion. The lymphovascular invasion, tall cell variant, extra thyroidal extension and age might be the predictors for central compartment lymph node metastases in cN0 PTC patients. However, lymphovascular invasion has the highest risk factor for central neck compartment metastases.
Comparison of Wells Score, D–Dimer and Combination of Wells Score and D–Dimer with Venous Duplex Ultrasonography in Diagnosis of Acute Deep Vein Thrombosis in Lower Extremity Lesmana, Andy; Pratama, Dedy; Wangge, Grace
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Diagnosis of acute deep vein thrombosis (DVT) of lower extremity using available diagnostic tools such as venous duplex ultrasonography (VDUS) encountered problems including cost, time consuming and the operator. A simple and practical tool is required. Thus, we run a study aimed to evaluate the efficacy of Wells score, D–Dimer, or combination of both, compared to VDUS in early detection of acute DVT of lower extremity. Method. A diagnostic study was run using cross–sectional design in Department of Surgery enrolling all adult subjects of which suspected to acute DVT of lower extremity managed in period of January 2014 –December 2015 who met the criteria. The diagnosis was confirmed by VDUS. Those data of medical record were analyzed statistically with diagnostic study to find out the sensitivity and specificity. Results. The study enrolled of 85 subjects. The prevalence of acute DVT of lower extremity was 65.88%. Sensitivity and the highest negative predictive value of 100.00% were found in score combination of II and IV. While as the highest specificity of 89.66% and the highest positive predictive value of 92.68% were found in score combination of III. The score with balanced diagnostic value (sensitivity of 87.50% and specificity of 72.41%) was found in Wells score 3 level I. Conclusion. Wells score and VDUS showed comparable efficacy in detection of acute DVT of lower extremity. Thus, a score could be used as a diagnostic tool.
Risks and Benefits of Central Neck Dissection (CND) in Differentiated Thyroid Carcinoma (DTC) Purnomo, H.S. Wahyu; Yulian, Erwin D; Wangge, Grace
Jurnal llmu Bedah Indonesia Vol 46 No 1 (2018): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v46i1.34

Abstract

Introduction: The role of central neck dissection (CND) remains controversial in differentiated thyroid cancer (DTC). Risk and benefit of CND is necessary to be identified for judging whether CND will be performed or not. Methods: A literature search was performed in MEDLINE (pubmed) using main keywords such as differentiated thyroid carcinoma (DTC), central neck dissection (CND), total thyroidectomy. The literature had inclusion criteria english language literature with risk and benefit of CND. We used qualitative approach to summary descriptive papers result. Results: Sixteen trials were analyzed. There was no increased risk of recurrent laryngeal nerve (RLN) injury (temporary or permanent), permanent hypocalcemia, or locoregional recurrence when CND was performed in addition to TT. Postoperative temporary hypocalcemia was more common after TT with CND than after TT alone. Conclusion: TT alone results in less surgical morbidity in the immediate postoperative period and an identical locoregional recurrence rate compared with TT plus CND.
Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer Darwis, Patrianef; Simanjuntak, Bakti H; Wangge, Grace; Pratama, Deddy; Bakri, Ahmad; Telaumbanua, Rizky
Jurnal llmu Bedah Indonesia Vol 47 No 2 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i2.45

Abstract

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition. Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis. Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p &lt; 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p &lt; 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p &lt; 0.001, OR 8.360, CI 95 % 3.209 – 21.780). Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer. Keywords: Diabetic foot ulcer, Length of stay
Speech Outcome Evaluation Of Cleft Palate Patients Underwent Palatoplasty In Plastic Surgery Division Cipto Mangunkusumo Hospital Indonesia Kreshanti, Prasetyanugraheni; Sari, Vania Aramita; Wangge, Grace; Wahyuni, Luh Karunia
Jurnal Plastik Rekonstruksi Vol. 5 No. 1 (2018): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (934.278 KB) | DOI: 10.14228/jpr.v5i1.248

Abstract

Background: Speech is the primary goal of palatoplasty, however, there is no current data available about the long term speech evaluation after palatoplasty in our hospital which is the national referral hospital that has the only cleft craniofacial center in Indonesia. The initial data of speech outcome is required for further research which assessment should be standardized and applicable to Indonesian children that mostly speak bahasa. This study aims to get initial data by evaluating speech outcome of patients that underwent palatoplasty with adapted perceptual assessment words in Indonesian language, and describe factors influencing speech. Method: This research is a cross-sectional study to evaluate speech outcome of patients underwent palatoplasty in Cipto Mangunkusumo Hospital from October 2010–December 2012 conducted from December 2017 – July 2018. Result: Total 23 samples were measured for articulation rating where 17 (74%) patients had normal production of majority of phonemes, while there were 6 (26%) patients had predominantly distortion of phonemes. The hypernasality rating were normal in 12 (52%) patients, mild in 5 (22%) patients and moderate in 6 (26%) patients. The speech intelligibility rating were dominantly normal which all speech is understood in 17 (74%) patients and the rest of 6 (26%) patients were listeners attention needed. The velopharyngeal competence were good in 16 (70%) patients, fair in 1 (4%) patients and poor in 6 (26%) patients. Conclusion: Management of cleft palate patients will be achieved by well integrated services including speech pathologist and orthodontist. By giving the long term follow up to the patients, the optimal outcomes will be achieved. This research can be used as a reference for speech outcome evaluation in cleft palate patients in Indonesia.
Long Term Evaluation Of Maxillary Growth After ‘The Non Denuded Palatoplasty’ Technique Kreshanti, Prasetyanugraheni; Handayani, Siti; Rachmasari, Maulina; Pancawati, Julieta; Susanto, Amila Jeni; Wangge, Grace; Indania, Alita
Jurnal Plastik Rekonstruksi Vol. 5 No. 2 (2018): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1254.881 KB) | DOI: 10.14228/jpr.v5i2.254

Abstract

Background : Conventional Two Flap Palatoplasty technique will produce lateral defects without any periosteal coverage. These denuded lateral defects are prone to contamination and infection. These will result in wound contraction, scar formation and maxillary growth impairment. In 2011, we studied “The Non Denuded Palatoplasty” technique. This technique precipitated the epithelialization process of the lateral defects. Faster epithelialization is expected to decrease wound contraction and good maxillary growth. Method : This is a case control study to compare the maxillary growth of 2 groups consists of unilateral cleft lip and palate patients repaired with “The Non Denuded Palatoplasty” technique and Conventional Two Flap Palatoplasty. The outcome will be evaluated from cephalometry and the dental cast for each patient is evaluated using GOSLON YARDSTICK method. Data will be analyzed using SPSS version 20. Result : A total of 4 patients in The Non Denuded Palatoplasty group and 10 in the Conventional Two Flap Palatoplasty. The cephalometric SNA, SNB and ANB point showed Class III skeletal jaw relationship or deficient maxilla. Meanwhile the GOSLON yardstick type III are the most common GOSLON on both group with good inter-ratter reliability (p=0.839) based on Mann Whitney test. In these study, there was no correlation between cephalometric variables with GOSLON score. Conclusion: Our results showed that modification (The Non Denuded Palatoplasty) technique made no statistically significant difference to the maxillary growth. However this study has several limitations, one of which being the small sample size due to family, social and other factors that are beyond the control of the investigating team. Also the evaluation was conducted in patients aged 7-9 years, hence the result of this study is not the final outcome. Keywords: maxillary growth evaluation, cephalometry, Goslon Yardstick, two flap palatoplasty
Maxillary Growth Evaluation Of Patients With Unilateral Complete Cleft Lip And Palate After Two Flap Palatoplasty With Honey Oral Drops Kreshanti, Prasetyanugraheni; Handayani, Siti; Fortuna, Forry; Pancawati, Julieta; Susanto, Amila Jeni; Wangge, Grace; Indania, Alita
Jurnal Plastik Rekonstruksi Vol. 5 No. 2 (2018): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2437.533 KB) | DOI: 10.14228/jpr.v5i2.256

Abstract

Background : Honey given as oral drops significantly precipitate epithelialization of the lateral palatal defects post two-flap palatoplasty by 2.1 times. Honey is believed to reduce wound contraction, scar formation, and would contribute as an important factor that will result in a satisfactory maxillary growth. The aim of this study is to evaluate maxillary growth as the long-term effect of rapid epithelialization of the palates treated by honey oral drops. Method : This is a case control study consisting of 2 groups; comparing maxillary growth of the UCCLP patients that were and were not given honey as oral drops following their two-flap palatoplasty in 2011-2012. The cephalometric measurements were recorded and the dental cast are evaluated using GOSLON Yardstick method.Result : This study included a total of 20 patients. Goslon Yardstick type IV are the most frequent GOSLON on both groups (40%) with moderate inter-rater reliability between examiner 1-2 and 2-3 (kappa; 0.583 and 0.512) and substantial between examiner 1-3 (kappa 0.716). Forty-percent of SNA angle in the honey group were considered as normal, while only 20% normal SNA angle were found in the control group.Conclusion: Honey oral drops following two-flap palatoplasty resulted in satisfactory SNA angle. As the completion of maxillary growth occurs at the age of 20, the results of this study would only serve as a preliminary report. Other measures to support maxillary growth should also be taken into account. Further studies are warranted to discover innovations in surgical technique that may be a major contributing factor in maxillary growth. Keywords: Maxillary growth, Two Flap Palatoplasty, honey
Co-Authors Adistra I.T.W.H Satjakoesoemah, Adistra I.T.W.H Bakri, Ahmad Benyamin Makes Candra D.K Wijaya, Candra D.K Darwis, Patrianef Dedy Pratama Fatan Abshari, Fatan Fortuna, Forry Indania, Alita Kreshanti, Prasetyanugraheni Lesmana, Andy Luh Karunia Wahyuni, Luh Karunia Maulina Rachmasari, Maulina Pancawati, Julieta Perdana R Perdana, Perdana R Prahara Yuri Pratama, Deddy Purnomo, H.S. Wahyu Purnomo, Henricus SW. Putranto, Agi S. Sari, Vania Aramita Simanjuntak, Bakti H Siti Handayani Susanto, Amila Jeni Telaumbanua, Rizky Yulian, Erwin D. Yusak Kristianto