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Faktor Risiko Terjadinya Metastasis Jauh pada Pasien Kanker Payudara Juli Jamnasi; Soehartati Argadikoesoema Gondhowiardjo; Zubairi Djoerban; Nurjati C Siregar; Evert D.C Poetiray; Anna Puspita Tunggono
Radioterapi & Onkologi Indonesia Vol 7, No 2 (2016): Volume 7 No.2 Juli 2016
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (858.542 KB) | DOI: 10.32532/jori.v7i2.46

Abstract

Tujuan: Mengetahui faktor risiko yang berpengaruh dan lokasi tersering metastasis jauh pada pasien kanker payudara (KPD). Metodologi: Total 1.289 pasien kanker dari periode bulan Januari 2001 sampai Desember 2010 diteliti secara retrospektif. Dari 913 pasien yang memenuhi kriteria inklusi dikelompokan menjadi tiga kelompok. Faktor risiko  dengan uji Chi-square pada kelompok dengan metastasis (Kelompok I+II) dibandingkan dengan kelompok bebas-metastasis (Kelompok III); dan uji Cox-regression untuk mengidentifikasi kesintasan bebas metastasis (DMFS) Hasil: Status T3-T4, pN positif dan subtipe triple-negative secara signifikan berhubungan dengan kejadian metastasis jauh di kelompok metastasis dibandingkan kelompok bebas-metastasis (p<0.05). Status pN positif (HR: 2,51; IK95%: 1,65–3,83) dan derajat histopatologis grade-3 (HR: 1,67; IK95%: 1,06–2,64) secara bermakna berhubungan dan dapat memprediksikan DMFS untuk 5 dan 10 tahun. Lokasi tersering metastasis pada Kelompok I adalah: tulang (n=73; 64,6%), paru (n=33; 29,2%), hati (n=24; 21,2%), otak (n=1; 0,8%) dan payudara kontralateral (n=5; 0,8%). Sedangkan lokasi metastasis pada Kelompok II adalah tulang (n=76; 62,3%), paru (n=34; 27,9%), payudara kontralateral (n=26; 21,3%), hati (n=22; 18%), dan otak (n=13; 10,7%). Kesimpulan: Status  T3 – T4, status pN positif, dan subtipe triple-negative yang bermakna secara statistik pada metastasis jauh (p<0.05). Lokasi tersering metastasis adalah tulang.
Faktor-Faktor yang Memengaruhi Penurunan Body Mass Index Sebelum dan Sesudah Radioterapi pada Pasien Kanker Kepala Leher Putri Elisabet Sinaga; Juli Jamnasi; Sumihar MR Pasaribu; Hendriyo -
Radioterapi & Onkologi Indonesia Vol 10, No 2 (2019): VOLUME 10 NO.2 JULI 2019
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (686.727 KB) | DOI: 10.32532/jori.v10i2.101

Abstract

Latar Belakang: Kanker Kepala Leher (KKL) merupakan suatu istilah yang digunakan untuk menggambarkan semua jenis keganasan yang berasal dari saluran aerodigestif atas. Modalitas pengobatan yang efektif untuk pasien KKL adalah radioterapi. Namun demikian, modalitas tersebut berkontribusi terhadap penurunan nilai Body Mass Index (BMI) pasien KKL akibat dari efek samping radioterapi khususnya pada rongga mulut.Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi penurunan BMI   sebelum dan sesudah menjalani radioterapi pada pasien KKL.Metode Penelitian: Analitik, dengan pendekatan quasi experimental dan rancangan penelitian pre and post design. Penelitian ini melibatkan 26 pasien KKL yang menjalani radioterapi di Rumah Sakit Murni Teguh Medan (RSMT).Hasil Penelitian: Pasien KKL mengalami rata-rata penurunan BMI sebanyak 2,10 poin sampai minggu terakhir radioterapi. Rata-rata penurunan berat badan BB yang dialami pasien sampai minggu terakhir radioterapi adalah sebesar 5,22 kg. Penurunan BMI paling besar terjadi pada minggu ketiga ke minggu keempat radioterapi. Pasien dengan terapi kemoradiasi mengalami penurunan BMI yang lebih besar dibandingkan pasien yang menerima radiasi saja. Hasil analisis menunjukkan terdapat hubungan yang signifikan antara mukositis (p= 0.046) terhadap penurunan BMI. Namun, tidak terdapat hubungan yang signifikan antara disfagia (p=0.548), dan kandidiasis (p=0.235) sebagai efek samping radioterapi yang muncul terhadap besar penurunan BMI pada pasien KKL.Kesimpulan: Dalam penelitian ini, ditemukan adanya hubungan yang signifikan antara mukositis sebagai efek samping radioterapi terhadap besar penurunan BMI pada pasien KKL
AFATINIB MONOTHERAPY FOR DOUBLE-PRIMARY LOCALLY ADVANCED NON-SMALL CELL LUNG CANCER EXON-21 L861Q MUTATION WITH HISTORY OF COLORECTAL CANCER Jamnasi, Juli; Yeoh, Rudiyo; Sudibio, Sudibio; Hendrik, Hendrik
Radioterapi & Onkologi Indonesia Vol 15, No 1 (2024): Vol.15, No. 1(2024): Volume 15 No. 1 January 2024
Publisher : Perhimpunan Dokter Spesialis Onkologi Radiasi Indonesia (PORI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32532/jori.v15i1.164

Abstract

Introduction: Uncommon mutation exon-21 L861Q is a rare type Non-Small Cell LungCancer (NSCLC). Despite the limited data regarding this type of mutation, Afatinib as one of the oral tyrosine kinase inhibitors (TKI) shows good anti-tumor activity.Clinical Features: A 50-year-old woman with a history of post-operative colorectal cancer (2014) without undergoing chemotherapy and radiotherapy; came in October 2020 with severe dyspnea due to massive pleural effusion with a right lower lung bulky mass. Histopathology in 2014 was a low-grade adenocarcinoma colorectal cancer, while the biopsy of the right lung mass in 2020 was a mucinous adenocarcinoma, ALK-negative, TPS 1.75, and exon-21 L861Q mutation.Intervention and Outcomes: The patient underwent thorax drainage to evacuate pleural effusion fluid. Through multidisciplinary discussions, the patient was recommended to take the oral drug TKI Afatinib 40 mg OD in January 2021. On the 2nd week of taking Afatinib, the patient complained of painful swallowing, mouth sores, sore tongue, and joint pain throughout the body; confirmed to be the side effects of the drug. Complaints diminished with supporting drugs, however, did not resolve completely. CT scan in April 2021 showed a significant reduction in lung mass. Due to severe side effects and drastic weight loss, the Afatinib dose was reduced to 20 mg OD. Radiotherapy was incorporated in her treatment session with IMRT to cover the whole tumor.Discussion: Determining the best treatment to treat the patient was initially difficult due to the raising doubt regarding the correlation between the current lung cancer with her previous history of colorectal cancer. Treating the newer lung mass as primary cancer was obviously different rather than treating lung metastatic colorectal cancer. This issue could then be resolved by incorporating more thorough NGS examination. With the finding of exon-21 L861Q mutation in this patient, Afatinib monotherapy is considered the therapy of choice.
PENYULUHAN PEMBERDAYAAN MASYARAKAT DALAM PENCEGAHAN STUNTING DESA AJIJULU, KABUPATEN KARO Siahaan, Jekson Martiar; Silitonga, Hendrika Adriana; Lim, Hadyanto; Pasaribu, Sumihar M. R.; Tarigan, Menang Bastanta; Jamnasi, Juli; Sinatra, Jadeny; Simanjuntak, Salomo Garda Utama; Sembiring, Budi Darmanta; Pakpahan, Edwin Anto; Hutagalung, Sanggam B.; Sinurat, Suryati; Br. T. Tambun, Gita Sradha; Hakim, Enggrek Pelita
Jurnal Pengabdian Pada Masyarakat METHABDI Vol 3 No 1 (2023): Jurnal Pengabdian Pada Masyarakat METHABDI
Publisher : Universitas Methodist Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46880/methabdi.Vol3No1.pp11-14

Abstract

Community Service (PKM) conducted by the Faculty of Medicine at the Indonesian Methodist University provides counseling on stunting prevention. PKM was held on April 14-16 2023 in Ajijulu Village, Tigapanah District, Karo Regency, North Sumatra. Lectures, discussions and motivations are used as orientation methods. Question and answer discussions were held with the aim of gaining insight, understanding and solutions to solve the problems and limitations faced by the local community. The results of the PKM suggestions and research are very effective, considering that there are still many people who are ignorant of stunting prevention. This counseling increases public awareness about stunting prevention. Residents of Ajijulu must be aware and know the importance of preventing stunting, starting from the time of pregnancy and the first 1000 days of life for toddlers.
PENYULUHAN KONTROL HIPERTENSI DAN DIABETES SEJAK DINI KEPADA JEMAAT GEREJA HKBP GEDUNG JOHOR RESORT, KECAMATAN MEDAN JOHOR Anto, Endy Juli; Hutasoit, Eka Samuel P.; Siahaan, Jekson M.; Rimbun, Surjadi; Manullang, Frengky S.; Tiji, Widjaya Taufik; Tambunan, Ronald Tunggul Hotmarojahan; Lim, Hadyanto; Pasaribu, Sumihar Maurist Rantos; Tarigan, Menang Bastanta; Jamnasi, Juli; Sinatra, Jadeny; Silitonga, Hendrika Adriana
Jurnal Pengabdian Pada Masyarakat METHABDI Vol 3 No 2 (2023): Jurnal Pengabdian Pada Masyarakat METHABDI
Publisher : Universitas Methodist Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46880/methabdi.Vol3No2.pp128-132

Abstract

Community Service (PKM) in the form of health education conducted by lecturers at the Faculty of Medicine, Indonesian Methodist University provides outreach about the benefits of controlling hypertension and diabetes mellitus from an early age. PKM was held on August 5 2023 at the HKBP church, Medan Johor District, North Sumatra. Lectures, question and answer discussions and motivation are used as orientation methods. A question and answer discussion was held with the aim of gaining insight and understanding to avoid complications from hypertension and DM. The results of PKM's socialization and work are very effective considering that there are still many people who have not received information about the benefits of vaccination through the basic immunization program. This education makes people more aware of the importance of routine control of health services. The HKBP church community must be aware and know the importance of early control in avoiding complications.
Penyuluhan Program SPA (Sekolah Bebas Ispa) Kepada Siswa SD Galilea Hosana Kids School Lumban Raja, Alex Maruli Tua; Siahaan, Dwi Lunarta Doderina; Jamnasi, Juli; Mega, Juli Yosa; Jeffrey, Jeffrey; Lim, Hadyanto; Herlen, Aldo; Gultom, Helmida; Koswara, Caroline; br. Sembiring, Rehulina; Sihite, Fiorella Natalia Kinanti; Dohude, Priscilla Putri Derlian; Brar, Dylan Amrirtraj; Fransella, Kezia; Panggabean, Kristina Dameria
Jurnal Pengabdian Pada Masyarakat METHABDI Vol 4 No 1 (2024): Jurnal Pengabdian Pada Masyarakat METHABDI
Publisher : Universitas Methodist Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46880/methabdi.Vol4No1.pp23-26

Abstract

RTI (Respiratory Tract Infection) is an acute upper and lower respiratory tract inflammation caused by infectious agents, namely infections of microorganisms or bacteria, viruses, without or accompanied by lung parenchyma. RTI disease in Indonesia is on the 10th list of most common diseases in hospitals. PKM FK-UMI aims to bring the SPA (RTI-Free School/Sekolah Bebas ISPA) program, increase knowledge about RTI, and prevent and reduce the occurrence of RTI to Galilea Hosana Kids Elementary School. The method used is to deliver material about the definition, symptoms, how to get RTI, and how to prevent it. The results of the activity show that Galilea Hosana Kids Elementary School students still do not understand the meaning of RTI, the signs and symptoms of decreased body immunity, how to increase body immunity, and how to prevent the spread of RTI. Counseling for elementary school students at Galilea Hosana Kids Elementary School was very effective in educating students about RTI.
Histopathological Transformation in Medullary Thyroid Carcinoma (MTC) With Poorly Differentiated Thyroid Carcinoma (PDTC): a Case Study of Aggressive Thyroid Cancer in An 18-Year-Old Female Jamnasi, Juli; Bangun, Jonas A.; Tambunan, Ronald T. H.; Mega, Juli Yosa; Lumban Tobing, Paul S.; Fauzi, Tengku M.
Majalah Ilmiah METHODA Vol. 15 No. 2 (2025): Majalah Ilmiah METHODA
Publisher : Universitas Methodist Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46880/methoda.Vol15No2.pp221-224

Abstract

Medullary Thyroid Carcinoma (MTC) is a type of thyroid cancer originating from C cells, while Poorly Differentiated Thyroid Carcinoma (PDTC) is a more aggressive form with poor differentiation. The transformation between these two types can affect prognosis and treatment strategies. This study analyzes an 18-year-old female patient presenting with neck swelling and difficulty swallowing. The initial diagnosis of MTC was established through fine-needle aspiration biopsy (FNAB), and after surgical resection, histopathological analysis was conducted to evaluate any transformation to PDTC. Histopathological findings revealed MTC areas with high calcitonin-producing C cells. However, there were also areas exhibiting characteristics of PDTC, including increased mitotic activity, necrosis, and loss of calcitonin expression. This transformation indicates a shift from a more indolent cancer form to a more aggressive one. The transformation from MTC to PDTC in a young patient underscores the importance of careful monitoring and thorough histopathological evaluation. Appropriate management and understanding of these changes are crucial for improving treatment outcomes. Further studies are needed to elucidate the molecular mechanisms underlying this transformation.