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All Journal Malang Respiratory Journal Journal of Community Health and Preventive Medicine (JOCHAPM)
Dwi Pratiwi, Suryanti
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Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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THE RELATIONSHIP BETWEEN THE LEVEL OF KNOWLEDGE ABOUT THE DANGERS OF CIGARETTES AND CARBON MONOXIDE LEVELS OF BREATHING AIR IN STUDENTS FROM A HIGH SCHOOL IN MALANG Dwi Pratiwi, Suryanti; Agus Setyawan, Ungky; Mafisah, Saidah; Muhammad, Iqbal; Herda Asyari, Claudia; Dini, Zata; Pratiwi, Eka; Lyono, Albert; Delfianto, Dwiroza Delfianto; Nur Hikmah, Naila Nur Hikmah; Suardana, I Made Suardana; Martha , Martha
Journal of Community Health and Preventive Medicine Vol. 4 No. 2 (2024): JOCHAPM Vol. 4 No. 2 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jochapm.2024.004.02.3

Abstract

This study aims to analyze the relationship between the level of knowledge about the dangers of smoking and smoking behavior and exposure to cigarette smoke in high school students. This quantitative descriptive research with a cross-sectional design involved 114 students from one Malang Senior High School, with sampling using a simple random sampling method. Using a CO analyzer, data was collected through questionnaires to measure students' knowledge levels and measurements of carbon monoxide (CO) in breathing air. The study results showed that 62% of the respondents were women and 38% were men, with an average age of 16.8 years. As many as 80% of students do not smoke, while the other 20% are active smokers. The average CO level of the students' breath air was 3.34 PPM, with active smokers showing significantly higher CO levels (7.74 PPM) compared to passive smokers (2.06 PPM) and non-smoking students (2.61 PPM). The ANOVA statistical test showed a significant difference in CO levels between groups (p < 0.05). Although the level of students' knowledge about the dangers of smoking was relatively high (average pretest 124), no significant relationship was found between knowledge and smoking behavior (p = 0.802). The study concluded that although knowledge about the dangers of smoking is moderate, smoking behavior among male students remains high, suggesting the need for more in-depth interventions to address the social and psychological factors that support smoking behavior.
A Rare Case: Adenocarcinoma Bronchogenic Dextra Std IVB on Gefitinib (15 months) accompanied by Decreased Visual Acuity, Bilateral Sensorineural Deafness and Psychiatric Disorders with No Radiological Evidence of Brain Metastasis Ensang Timuda, Caesar; Dwi Pratiwi, Suryanti; Rahmawati, Dessika; Yudhantara, Dearisa; Erawati, Dini; Indrasworo, Dyah; Prayitnaningsih, Seskoati
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.2

Abstract

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease
Rare Case: 65 Year Old Man with Anteromedial Mediastinal Tumor (Thymic Carcinoma) Mimicking Lung Cancer Lyono, Albert; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Isharanto, Artono
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.02

Abstract

Background: Thymic carcinoma are very rare and often accompanied by metastases to other organs, pericardial effusion and pleural effusion where the 5-year survival rate is about 55%. Thymic carcinoma has several subtypes, squamous cell carcinoma and undifferentiated carcinoma. Case Report: A 65-year-old man coincidentally showed a mediastinal tumor on CXR while infected with COVID-19. Spirometry shows mild obstruction and restriction. Thorax CT scan suggests an anterior-middle mediastinal mass with left pleural effusion. The patient underwent a core biopsy followed by VATS tumor excision. Immunohistochemistry CK(+) and Vimentin(-) suggest a solid type adenocarcinoma, then Napsin A(-), TTF1(-), P40(+) suggest squamous cell carcinoma. The patient was diagnosed with left anteromedial mediastinal tumor (Thymic carcinoma: Squamous cell carcinoma) Masaoka stage III, left pleural effusion. The patient was treated with first line chemotherapy Carboplatin-Etoposide 6 series resulting stable disease followed by maintenance chemotherapy etoposide 6 series. The last RECIST suggests a solid malignant mass in the left lung (stable disease). Discussion: Surgery with radiotherapy is treatment for resectable cases but for unresectable cases chemotherapy with or without radiotherapy is preferred. The patient was unresectable case treated with chemotherapy. Thymic carcinoma has a poor response to chemotherapy with overall response rate around 22-36% but this patient has stable disease with chemotherapy. Conclusion: 65 years-old man without respiratory complaints diagnosed with unresectable thymic carcinoma and left pleural effusion, underwent chemotherapy with result stable disease up to 9 months continued maintenance therapy and become a resectable tumor. Keywords: Thymic carcinoma, Squamous Cell Carcinoma
Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma: Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma Adolf Nggay, Andriana; Dwi Pratiwi, Suryanti; Jane Sugiri, Yani; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Elisabeth, Gracelia
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.04

Abstract

Background: Enteric type lung adenocarcinoma is a very rare variant of pulmonary adenocarcinoma, with a prevalence of about less than 1% of all cases(2). Due to the similarity in its symptoms, physical examination findings, and additional tests, it is very difficult to distinguish it from thymic adenocarcinoma, which can lead to delayed diagnosis and treatment(6). Case Report: A 58-year-old male presented with shortness of breath. Chest X-ray revealed a mass in the right suprahilar region, which was subsequently confirmed as a mediastinal tumor by contrast-enhanced chest CT scan. The patient underwent open thoracotomy biopsy, and macroscopic examination suggested thymic carcinoma. Histopathological findings revealed atypical cells with bronchoscopic washing and brushing cytology results classified as class II, and Ultrasound guided TTNA only showed debris cells. Diagnostic confirmation took 1.5 years, with immunohistochemistry results showing CK(+), CD45(-), P40(-), Vimentin(-), Napsin A(-), CK7(+), CK20(+), leading to a final diagnosis of enteric-type lung adenocarcinoma with EGFR exon 21 mutation. Conclusion: An accurate diagnosis of enteric-type pulmonary adenocarcinoma requires a multidisciplinary team approach and specific immunohistochemistry (CK7, CK20) to enable precise treatment planning. Keyword: Enteric Tipe Lung Adenocarcinoma, Thymic Adenocarcinoma, Immunohistochemistry
Rare and challenging case: a young woman with a pulmonary malignant peripheral nerve sheath tumor mimicking mesothelioma Irawan, Ari; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia; Rachma Erawati, Dini
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.03

Abstract

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a rare and highly aggressive tumor that develops from peripheral nerves which is closely related to neurofibromatosis type 1 (NF1). It has a very small percentage of occurrence in the lung. Here, we would like to report a case of pulmonary MPNST mimicking mesothelioma that was treated with cisplatin-pemetrexed. Case Illustrations: A 17-year-old female with no history of NF1, complaints of shortness of breath, and weight loss. A thoracic CT-scan and pathology were initially consistent with suspected mesothelioma. A unique finding in this case, was demonstrated positive vimentin and CD56, also loss of nuclear SOX10 and H3K27me3 expression in spindle cells. After a multidisciplinary board discussion, the diagnosis of MPNST was assumed. She underwent a palliative chemotherapy regimen. Discussion: Pulmonary MPNST with or without NF1 seems infrequent. Its clinical findings are usually nonspecific with a complex histological appearance. Establishing the diagnosis of MPNST is challenging, therefore pathological examination and immunohistochemistry (IHC) become the gold standard. The expression of SOX10 has poor sensitivity, also the loss of S100 expression may indicate de-differentiation of Schwann cells, hence, it may be less specific for MPNST diagnosis. Nevertheless, the loss of H3K27me3 marker has a great diagnostic value. The most effective treatment is complete surgical resection to achieve negative margins. However, in our case, the tumor has metastasized and is unresectable, so she was treated with the cisplatin-pemetrexed chemotherapy regimen and obtained stable disease results on the RECIST-CT examination after 3-series-chemotherapy. Conclusion: MPNST is a rare case with difficulties in diagnosis due to nonspecific clinical and histological features, therefore, IHC plays an important role in providing its diagnosis. Chemotherapy might be a good approach for treating an unresectable MPNST, but, still, there is no gold standard for palliative care guidelines.
Co-Authors Adolf Nggay, Andriana Agus Setyawan, Ungky Ari Irawan Delfianto, Dwiroza Delfianto Dini, Zata Eka Pratiwi Elisabeth, Gracelia Ensang Timuda, Caesar Erawati, Dini Herda Asyari, Claudia Indrasworo, Dyah Iqbal Muhammad Isharanto, Artono Jane Sugiri, Yani Kusuma Wardhana, Koernia Lyono, Albert Mafisah, Saidah Martha , Martha Nur Hikmah, Naila Nur Hikmah Rachma Erawati, Dini Rahmawati, Dessika Seskoati Prayitnaningsih Setyo Yudhanto, Hendy Suardana, I Made Suardana Yudhantara, Dearisa