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Malang Respiratory Journal Department of Pulmonology Respiratory Medicine Universitas Brawijaya mrj@ub.ac.id
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Malang Respiratory Journal
Published by Universitas Brawijaya
ISSN : 27457842     EISSN : 27226492     DOI : https://doi.org/10.21776/ub.mrj
Core Subject : Health, Science, Education,
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other
Malang Respiratory Journal is the official open-access journal of Department of Pulmonology Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. It publishes articles two times per year. It is a peer reviewed publication of Indonesian Pulmonology and Respiratory journals and accepting articles for publication from around the world. MRJ only publishes articles in the English version. The objective of this journal is publishing the selected clinical and basic research relevant to Pulmonology and Respiratory. It covers the following topics such as infection, thoracic oncology, asthma and COPD, interventional pulmonology and respiratory emergency, occupational and environmental pulmonology, and clinical immunology. It is an international journal dedicated to provide new information that could give a new insight for alternative solutions, diagnosis, therapy and prevention for researchers and practitioners in Pulmonology Respiratory Medicine.
Arjuna Subject : Kedokteran - Kedokteran Paru dan Pernafasan
Articles 66 Documents
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Successful Of Embolization Therapy On Recurrent Massive Hemoptysis because of TB Sequelae Ratih Dwi ary Merdekawati; Suryanti Dwi Pratiwi; Ahmad Bayhaqi
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (515.146 KB) | DOI: 10.21776/ub.mrj.2020.002.02.4

Abstract

AbstractBackground: Haemoptysis is one of vascular lesions in TB sequelae, with incidence of 28% from 919 cases. It may be recurrent, massive and might cause mortality if left untreated. Embolization procedure with glue and coil can be an alternative to treat patient with recurrent hemoptysis.Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a 34 years old male with intermittent massive haemoptysis. Chest X-ray examination showed Lung Tb far advanced lesion with no acid bacilli found on microbiological examination. Transthoracic FNAB revealed chronic suppurative inflammation, with Cytology sputum Class II. Chest CT Angiography showed Lung TB Far advanced lesions accompanied by mediastinal lymphadenopathy with unsuspecting complications of left supreme intercostal artery aneurysm dd pseudoaneurysm, suggestion embolization. Examination results confirmed the diagnosis of recurrent massive haemoptysis and intercostal artery aneurysm with the history of TB. Embolization procedure was then performed.Conclusion: Angiography CT Scan has better detail in evaluating condition, source, amount, and tract of artery in chest cavity. Bronchial artery embolization as an alternative therapy was found to give better effect of occlusion.Keywords: Massive haemoptysis, chest CT angiography, embolization.
Tuberculosis Management in Renal Transplant Recipient Rezki Tantular
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2019.001.01.4

Abstract

Background: Tuberculosis (TB) is a major global health problem and South-East Asia was the leading contributor of TB cases globally. Treatment regimen of TB for an individual patient depends on multiple factors, and one of them was patient’s comorbidities. Comorbidities such as renal failure or concurrent use of immunosuppressant drugs post renal transplantation will influence pharmacological aspect of anti-tuberculosis drugs.Case: A 38-year-old male with a history of chronic renal failure who had undergone routine hemodialysis was diagnosed with pulmonary tuberculosis and was scheduled for a renal transplantation procedure. During the administration of anti-tuberculosis drugs in this patient, the physician mustconsider the kidney function, and possible drug interactions between anti-tuberculosis drugs especially rifampicin with immunosuppressant drugs used after renal transplantation. The initialregimen used in this patient was RHE which was followed by RH, but after using immunosuppressant drugs, rifampicin was replaced with moxifloxacin to avoid suboptimal effect of immunosuppressant drugs to prevent donor rejection, which is the biggest contributor ofmortality in transplant recipients in the first year post-transplantation.
Chemotherapy Resistance in Remutation of Epidermal Growth Factor Receptor Wild Type Becomes a Positive Type and Back Becomes a Wild Type in A Patient with Lung Adenocarcinoma Kristo Kurniawan; Yani Jane Sugiri; Ngakan Putu Parsama Putra; Handy Setyo Yudhanto
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (201.575 KB) | DOI: 10.21776/ub.mrj.2021.003.01.5

Abstract

Introduction: Lung cancer is the most common type of cancer worldwide (11.6%) and the leading cause of death due to cancer throughout the world. One type of lung cancer that is often found is Adenocarcinoma, 35-40%. Mutations in EGFR often occur in patients with pulmonary Adenocarcinoma, especially in Asia. Chemotherapy selection for pulmonary adenocarcinoma patients based on the status of their EGFR mutations. Positive EGFR mutations can get treatment with Tyrosine Kinase Inhibitors. Giving chemotherapy can affect changes in EGFR mutation status. Patients with chemotherapy treatment can experience resistance to chemotherapy either primary or acquired resistance through a variety of mechanisms.Case Description: we reported one case of a 56-year-old man with pulmonary adenocarcinoma who had a positive change in EGFR-type from wild type mutations and then returned to a wild type. Patients were initially diagnosed with wild-type pulmonary adenocarcinoma from EGFR examination of tissue biopsy and given conventional chemotherapy. During the evaluation, progression occurred so that the status of the EGFR mutation was examined using ct-DNA and the result was mutation deletion exon 19 so that the patient obtained Gefitinib. Due to progressive return, the patient again examined EGFR status from tissue biopsy obtained using pleuroscopy and obtained an EGFR wild type. Patients again get conventional chemotherapy.Discussion Changes in the status of EGFR mutation in pulmonary adenocarcinoma patients and chemotherapy resistance can occur in patients with chemotherapy treatment. 
Well Differentiated B3 Thymoma complicated with Vena Cava Superior Syndrome undergo Debulking and Chemotherapy Wayan Wahyu Semara Putra; Iin Noor Chozin; Kenty Wantry; Artono Isharanto; Rachma Dini Erawati
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.4

Abstract

Background: Thymoma is a rare neoplasm. This incident is comparable to 390 new cases reported per year. Genetic factors are believed to be one of the factors of B3 thymoma and thymus carcinoma. Multimodality of thymoma therapy (surgery, radiation and chemotherapy) gives better results.Case Report: Mr A, 29 years old, with initial diagnosis of stage IV thymoma (according to Masaoka) with SVKS then undergo debulking, followed by chemotherapy with a regimen of Cisplatin + Vincristin, Cyclophospamid, Doxorubicin, Prednison every 21 days as much as 6 times. Subjective responses indicated by reduced complaints of chest pain and loss of swelling of the right arm. Semisubjective response indicated by increase of body weight. Objective response is progressive, so can be continued with second line chemotherapy or radiotherapy.Conclusion: The prognosis of patient with well differentiated thymic carcinoma stadium iv (thymoma b3) complicated with vena cava superior syndrome was poor because of the objective response of the chemotherapy was progressive, and the relapse case was higher.
Adhesiolysis and Decortication for Reccurent Hydropneumothorax Associated with Pleural Tuberculosis Muhamad Yusuf Musthafa; Yani Jane Sugiri; Imam Suseno Bayuadi
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (201.21 KB) | DOI: 10.21776/ub.mrj.2021.003.02.2

Abstract

Introduction: Pleural tuberculosis is a pleural infection of tuberculosis caused by Mycobacterium tuberculosis which commonly manifests as hydropneumothorax. Initial treatment with anti-tuberculosis drugs is aimed to prevent progression of the disease and relieve patient’s symptoms. Indication of adhesiolysis and decortication is to remove layer of fibrous tissue and allow the lung to reexpand.Case: A 60 year old woman with shortness of breath, cough, and right-sided chest pain. She had a history of treatment with first-line anti-tubercular drugs for a year stop in September 2016. She was identified with recurrent right-sided hydropneumothorax by chest imaging and thorax CT-scan. Adhesiolysis and decortication were performed on her. Two months later she was diagnosed again with recurrent right-sided hydropneumothorax. VATS (Video-Assisted Thoracoscopic Surgery) revealed fistula involving inferior lobe of the lung. Then, she was treated with second-line anti tuberculosis drugs. After four times reccurent hydropneumothorax, patient showed significant improvement in clinical condition, radiology finding, and lung function test after she finished the tuberculosis treatment.Discussion: Definitive diagnosis of pleural tuberculosis is by the finding of mycobacterium tuberculosis in pleural biopsy, or Mtb culture, and it was difficult to perform. In this case pleural fluid analysis revealed that cause of recurrent right-sided hydropneumothorax was tuberculosis infection.Summary: A 60 year old woman with four times reccurent right-sided hydropneumothorax, and the pleural fluid analysis suggested it was tuberculosis infection. Providing anti-tuberculosis medication based on clinically diagnosed tuberculosis based on flowchart of tuberculosis diagnosis from national tuberculosis programmed are essential to prevent progression of the disease.
The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female Patient frenky hardiyanto; Suryanti Dwi Pratiwi; Dini Rachma Erawati; Artono Isharanto; Diah Prabawati Retnani; Herwindo Pudjo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1427.792 KB) | DOI: 10.21776/ub.mrj.2020.002.02.5

Abstract

Title: The Role of CD3, CD20, CD30, and Ki67 Immunohistochemistries in Establishing  Mediastinal Gray Zone Lymphoma Diagnosis in 24-years-old Female PatientAuthor: Frenky Hardiyanto, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Suryanti Dwi Pratiwi, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Diah Prabawati R, MD, Patology Anatomy Specialist, Herwindo P, MD, Internal Medicine Specialist.Introduction:. A woman with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x-rays and ct thorax revealed a mass in mediastinum.Case Description: Patient is a 24 years old female with complaints of shortness of breath, cough, fever, night sweating, decrease of body weight and swelling in face, neck and right arm. Chest x rays and CT thorax revealed a mass in mediastinum. Open biopsy on right neck mass and transthoracic FNAB resulting of chronic inflammation, so the patient was diagnosed with glandular tuberculosis and Mediastinal Tumor. Patient was getting worse after one month consuming OAT. Patient was consulted to Cardiovascular and thorax Surgery Department. Patient was performed thoracotomy and debulking. Anatomical pathology was examined from debulking mass, the result of immunohistochemistry was found nodular mediastinal gray zone lymphoma.Discussion: this case it is very difficult to enforce the diagnosis. Patients have done neck FNAB, transthoracic FNAB, open biopsy right neck mass and FOB have not been able to establish diagnosis. Until finally done thoracotomy and debulking in this patient, from immunohistochemistry results obtained nodular sclerosis Hodgkin lymphoma. Collaboration from pulmonologist, radiologist, cardiovascular and thorax surgeon, and patology anatomy specialist  is needed to confirm the diagnosis in these patients.Keywords: mediastinal tumor, mediastinal gray zone lymphoma
Multilocular Thymic Cyst with Superior Cava Vein Syndrome Complication Rahadi Widodo
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (661.867 KB) | DOI: 10.21776/ub.mrj.2019.001.01.5

Abstract

Background: Thymic cysts are uncommon, only comprising 1-3% of all mediastinal masses and 5-28% of the mediastinal cysts. Usually benign entities representing remnants of persistent thymopharyngeal duct or cystic degeneration of Hassall corpuscles. Unilocular thymic cysts are probably of congenital origin (derived from embryologic thymic tissue) and without inflammation, while multilocular thymic cysts are predominantly acquired, resulting from inflammation or neoplasm, have thick walls and contain dark-brown fluid.Case: A 51-year-old male with complaint of pain on his neck, shoulder, and right chest, accompanied with swelling of right arm and vena ecstasis on his neck and chest wall. The patient was diagnosed as anterior mediastinal tumor with complication vena cava superior syndrome. He underwent surgical treatment with approach median sternotomy and wide excision of tumor. Histopathologic examinaton of the tumor reveals a multilocular thymic cyst. Pneumonia occured after surgery and could be overcome by aggresive combination antibiotic treatment. There was right pleural effusion and right phrenic nerve paralysis after surgery. In this patient, also there is a mass in right posterior pleural cavity which has not been removed by surgical treatment.
The Role of Bronchoscopy for Successful Removal of A Chronic Aspirated Foreign Body After Twenty Years Abdul Haris; Ngakan Putu Parsama Putra
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.096 KB) | DOI: 10.21776/ub.mrj.2021.003.02.5

Abstract

Title: The Role of Bronchoscopy for Successful Removal of A Chronic Aspirated Foreign Body After Twenty YearsAuthor: Abdul Haris, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Parsama Putra, MD, Pulmonologist Consultant, Introduction:. A Man with complaints of chronic cough, and shortness of breath, with history of inhaled metal bullet 20 years ago. Chest x-ray thorax revealed a foreign body and pleural effusion.Case Description: Patient is a 58 years old male with complaints chronic cough and shortness breath, he had inhaled  metal bullet in 20 years ago. Chest x ray revealed a foreign body and pleural effusion dextra. Fiber optic bronchoscopy shon corpus alienum metal bullet in medial lobus dextra, and its was retrieved using basket forcepDiscussion: the diagnosis of foreign body aspiration as some patients may not offer a clear history of aspiration or may present late. In addition, malignancy, lung tuberculosis, chronic pneumonia can be misdiagnosed to patients, fiber optic bronchoscopy has been secure and effective procedure in the therapy of foreign body in the airway
Successful Therapy on Patients with Yolksac and Embrional Carcinoma by Surgery and Chemotherapy Fahmi Adhi Prasetya; Susanthy Djajalaksana; Diah Prabawati Retnani; Artono Isharanto; Indrastuti Normahayu; Shinta Okta
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.5

Abstract

Background: Malignant mixed germ cell tumors account for 13-25% of all non seminoma germ cell tumors, almost all cases were found in males (85%), increased in the third decade, and had an average survival rate of 40-45%. With modern management the average 5-year survival rate can be over 80%.Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an malignant epithelial tumor derived from mediastinal or lung. The CT scan of the chest showed an lobulated solid mass of iso-hipodens on the anterior superior mediastinum, mass encompassing the aortic arch, left pulmonalis artery, subclavian artery. The result from transthoracic FNAB with USG guidance showed an malignant epithelial tumor derived from mediastinal or lung, impression of an adeno squamous carcinoma. The AFP, LDH, and NSE serum level was elevated. Patient underwent a surgical sternotomy and tumor debulking. The biopsy showed an malignant mixed germ cell tumor (yolksac and embrional carcinoma). These were confirming the diagnosis of malignant mixed germ cell mediastinal tumor (yolksac and embrinonal carcinoma). Patient received a combination bleomycin, etoposid, cisplatin 3 series chemoteraphy  and evaluated.Conclusion: Some procedures like biopsy, tumor marker, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining surgical therapy (surgical sternotomy and tumor debulking) with chemotherapy could increase the survival rate of patients.
Foreign Body Extraction of a Push-pin nail with Granulation Tissue Complication on a Thirteen Years Old Male umi fatma octavia; Ngakan Putu Parsama Putra
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (284.854 KB) | DOI: 10.21776/ub.mrj.2021.003.01.2

Abstract

Background : Foreign body aspiration is common in children (80% in children under 5 years old) and elderly. The ratio in men is higher than in women. Flexible bronchoscopy is often used as a primary procedure in such cases because of its high sensitivity and specificity. However, in some cases, rigid bronchoscopy might be superior. This is a case report about a patient who came with complaints of bloody cough and chest pain after the ingestion of a push-pin nail. The patient underwent both bronchoscopic procedures.Case : A 13-year-old male presented with complaints of sudden bloody coughing accompanied by chest pain in the middle area. Physical examinations were unremarkable, but images of spikes suggestive of a foreign object on the left hilus were found at the chest x-ray. A flexible fiberoptic bronchoscopy was performed immediately. A push-pin nail, located the left main bronchus with a sharp tip embedded in the mucosa and covered by granulation tissue, was identified. Evacuation attempts were unsuccessful. Rigid bronchoscopy was then performed and evacuation was carried out successfully. The patient was then discharged after forty-eight hours of close monitoring.Conclusion: There are two types of bronchoscopy, flexible and rigid. Both have their respective advantages in the handling of patients with foreign bodies.  Acquiring skills in operating both types of bronchoscopy are important for a bronchologist.Keywords: Foreign body, Aspiration, Granulation tissue, Bronchoscopy

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