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Malang Respiratory Journal

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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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Myastehenia Gravis is Caused by the Thymoma in Anterosuperior Mediastinum Sinistra and Posteroinferior Sinistra Ferdy Syah Irfan; Susanthy Djajalaksana
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Background: Thymoma is the most common thymus tumor; it covers 30% of the anterior mediastinum mass in adult. Almost half of thymoma does not present with any symptom and is found by accident. In 40% of patients have symptom of myasthenia gravis; other symptoms include chest pain, symptoms of bleeding and compression to other mediastinumâ€™s structures. Ninety percent of thymoma is located in anterior mediastinum.Case: A 42-year-old woman came to Saiful Anwar Hospital with a complaint of difficulty in swallowing since three months before admission. We performed physical examination and chest X-ray APâ€™ and the result was within normal limit. In USG examination, there was no abnormality. From the laboratory examination, we found leucocytosis and from the CT-scan imaging, we found pocketed pleural effusion sinistra at the postero-inferior part.Based on these findings, we diagnosed (pre-operation diagnosis) this patient as anterosuperior mediastinum tumor: suspect thymoma. The pulmonologist consulted to Surgical Department for surgery. The surgeon performed sternotomy-tumor excision. The result from the vries coup and histopathogical examination was thymoma. FOB after the surgery showed an edema at the right vocal cord (post-extubation). Post-operative chest X-ray showed no mass in antero-superior mediastinum.

Lung Adenocarcinoma Metastases to Mediastinal with Malignant Pericardial Effusion Andri Andri; Ngakan Putu Parsama Putra; Djanggan Sargowo; Dini Rachma Erawati; Diah Prabawati Retnani
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Lung adenocarcinoma with malignant pericardial effusion and also metastases to mediastinum has great impact on morbidity and mortality of patient and it is rare case. Most adenocarcinoma in the mediastinum are metastases from the lung, gastrointestinal tract, pancreas, kidney or even the pituitary gland. Cardiac metastases in lung cancer may occur due to retrograde lymphatic spread or by hematogenous dissemination of tumour cells. Pericardium is frequently involved in direct cardiac invasion by adjacent lung cancer. Pericardial effusion, pericarditis, and tamponade are common and life threatening presentation in such cases. A 42-years-old male with superior mediastinal mass has malignant pericardial effusion, cytology shows adenocarcinoma. The patient undergo transthoracic fine needle aspiration biopsy. The result from biopsy is adenocarcinoma. This is a rare case, patient with primary lung adenocarcinoma and malignant pericardial effusion also metastases to mediastinum. To determine the diagnosis requires a comprehensive clinical evaluation and multidisciplinary approach.

Immunocytochemistry as a Diagnostic Procedure of Pleural Mesothelioma Asih Trimurtini; Triwahju Astuti; Hendy Setyo Yudhanto; Dini Rachma Erawati
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Background: Mesothelioma is a primary malignant tumor arising from the mesothelial surface of the pleura, peritoneal, tunica vaginalis, and pericardium. Most cases of mesothelioma originate from the pleura. Most patients have a history of asbestos exposure. A common diagnostic problem is distinguishing mesothelioma from adenocarcinoma since both tumors invade the pleura. Immunocytochemistry of calretinin and TTF-1 can be used to establish the diagnosis of mesothelioma.Case: Male, 56 years old presented with chest pain, shortness of breath, cough, and weight loss since 5 months before hospitalization. The patient had a history of occupational exposure to asbestos for 30 years. The movement and breath sounds were decreased as well as dull upon percussion at the right chest. A chest X-ray revealed a right lung tumor with pleural effusion. Thorax CT scan suggested pleural mass in right hemithorax, infiltration to intercostal muscles, and destruction of the 7th right rib, right perihilar lymphadenopathy, right pleural effusion, and liver nodules according to mesothelioma T4N1M1 Stage IV. Infiltrative stenting of the right and inferior lobe of the right lung, infiltrative and obstructive stenting of the medius lobe suggestive of a chronic malignancy and inflammation were found on FOB. Cytologic examination of pleural fluid, sputum, and Washing-and-brushing of FOB were a class II (no malignant cells). USG-guided transthoracic FNAB revealed adenocarcinoma with differential diagnosis of mesothelioma. Immunocytochemistry with calretinin showed positive results and TTF-1 showed a negative result. These confirmed the diagnosis of pleural mesothelioma T4N1M1 Stage IV. The patient showed a stable response from carboplatin/gemcitabine treatment.Keyword : Mesothelioma, Immunocytochemistry, TTF-1, Calrenitin

Meningitis Tuberculous with Miliary Tuberculosis and Thoracic Vertebrae Level 11-12 Tumor showing Neurofibroma Patterns: A Case Report Andi Wijayanto; Nunuk Sri Muktiati; Farhad Balâ€™afif; Sri Budhi Rianawati
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Background: Tuberculosis is an infectious disease that develop from systemic infection caused by bacterium Mycobacterium tuberculosis complex. Generally, M.tuberculosis spread from one person to another through nuclear droplet air transmission. Although TB has a lower transmission rate compared to another infectious disease, TB still become a global health problem. It is estimated that approximately one third of the worldâ€™s population is infected by tuberculosis. Every year it is estimated that there are nine million new cases and close to two million death cases caused by tuberculosis.Case: A 24-year-old female was admitted to the hospital complaining of could not move both of her legs and could not urinate. One month before admission, she was diagnosed with meningitis TB; miliary TB; and meningioma at thoracic vertebrae T11-12 based on physical examination, laboratory examination, Chest X-Ray, Head CT Scan without contrast, and thoracolumbal MRI. When admitted to the hospital, the patient already treated with Fixed Dose Combination of antituberculosis Drugs first category for one and a half month from Turen Primary Healthcare. Then the patient underwent bronchoscopy examination. The result of the anatomical pathology examination showed class two. Then the patient underwent a laminectomy surgery and tumor excision at thoracic vertebrae T11-12. The result of postoperative Anatomical Pathology examination showed a neurofibroma pattern. After surgery, the Physical Medicine and Rehabilitation Department placed thoracic lumbosacral orthoses (TLSO) to the patient. Postoperative evaluation up to three months showed that the patientâ€™s general condition was quite good but still cannot move both of her legs and cannot urinate.

HIGH ALTITUDE PULMONARY EDEMA (HAPE) mariyatul khiptiyah; Teguh Rahayu Sartono; Indrastuti Normahayu; Wiwi Jaya
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Â Introduction:Â High altitudeÂ pulmonary edema (HAPE) is one of the acute, severe, non-cardiogenic disease that could be life threatening,Â occurs upon either the first or subsequent exposure to high altitude. It is triggered by a shortage of oxygen after ascending high altitude. The most effective therapeutic approach for HAPE is to immediately descend from high altitude and to give oxygenation, maintaining arterial saturation over 90%, as well as letting the patient rest from strenuous physical activity. The use ofÂ portable hyperbaric chamberÂ is also deemed effective in certain circumstance, and nifedipine can also be used to treat HAPE, even as additional treatment in condition that the patients had yet to descend and oxygenation is still not administrable.Â Case Report: We reported a case at Rs. Dr. Saiful Anwar, a 23-year old male with High Altitude Pulmonary Edema (HAPE). Diagnosis established from anamnesis, physical examination, and laboratory tests. Patient complained shortness of breath when climbing Mt. Semeru, in which the patient reached an altitude of 2700 mdpl in 2 days. Physical examination showed oxygen saturation 46-49% with NRBM 10 lpm, and rhonchi breath sound in all lung areas. Laboratory examination showed leukocytosis, blood gas analysis showed hypocarbia,Â severe hipoxemia,Â metabolic acidosis, and type I respiratory failure. Ches XRay showed wide, irregular infiltrate in both lungs. Based on those, the patient was diagnosed with HAPE. In this case, the patient was given oxygenation.Conclussion: In this case, the patient was diagnosed with HAPE based on anamnesis, physical examination, and laboratory tests. Oxygenation given to the patient improved his condition.Key words: High altitude disease, Acclimatization, Pathophysiology, Management and treatment

2018-2019 Antimicrobial Resistance Pattern in Bacterial Pneumonia at Dr. Soedarsono Hospital Pasuruan Felicia Susanto; Catur Elvi Purnamawati; Devvi Riasari
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Pneumonia is the ninth most common disease in dr. Soedarsono Pasuruan Region General Hospital. The resistance of Klebsiella pneumoniae to third-generation Cephalosporins and Streptococcus pneumonia to Penicillin were the topics discussed on World Health Organizationâ€™s (WHO) global report for antimicrobial resistance. This study purpose is to analyze the microbial pattern and antimicrobial resistance of bacterial pneumonia from sputum culture. This is a descriptive retrospective study with a total of 59 requests for sputum culture which included a clinical diagnosis of pneumonia. There are 37 male (63%) and 22 female (37%) with the most age group was adult (18-59 years) 39 people (66%) included in this study. Gram-negative bacteria are more common as the cause of pneumonia than gram-positive. Gram-negative bacteria that caused pneumonia in this study are Klebsiella pneumoniae (25.4%), Acinetobacter baumannii (15.3%), dan Enterobacter cloacae complex (15.3%). Gram-positive are Staphylococcus haemolyticus (11.9%), Staphylococcus aureus (8.5%), and Staphylococcus epidermidis (8.5%). The most antimicrobial resistance in gram-negative bacteria is Ampicillin (94.3%) and gram-positive bacteria are Benzylpenicillin (94.1%). The number resistance of Penicillin in gram-negative and gram-positive was high; therefore empirical therapy for pneumonia still uses broad-spectrum antimicrobial like beta-lactam.

Patient with Infiltrating Ductal Cell Carcinoma Mammae with Lung Tuberculosis and Nontuberculous Mycobacteria Fitri Indah Sari; Yani Jane Sugiri; Dwi Yuni Nurhidayati
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Introduction:. Infection caused by NTM has a prevalence which varies between 4.1 and 14.1 per 100,000 patients per year. Female has a higher prevalence of NTM disease than male, which is increasing with age, and more common in Western and Southeast Asian countries.Case Description: A 42-year-old female patient has the clinical symptoms of hemoptysis, asphyxia, angina, fever, nocturnal hyperhidrosis, loss of weight and appetite for nearly 10 years. Based on the physical examination, radiology, microbiology and anatomic pathology, this patient has been diagnosed with Ca mammae with Pulmonary TB, and currently is infected by recurrent NTM.Discussion: Symptoms of nonspecific NTM often complicate the diagnosis of TNM. General symptoms such as chronic cough, increased sputum production, dyspnea, fever that is not too high, weakness, weight loss so that it overlaps with other pulmonary symptoms. In NTM, radiologicalmanifestations generally show bronchiectasis, nodular lesions, cavitary lesions and parenchymal consolidation. The choice of therapy in disease caused by NTM depends on three factors: the type of clinical presentation, the species of NTM causing the disease and the immune status of the patient.

Elderly Male Patient with Fibrotic Non Spesific Instertitial Pneumonia from Lung Biopsy by Video Assisted Thoracoscopy Santony santony; Susanthy Djajalaksana; Iin Nur Chozin; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Background: NSIP is a rare disease, the incidence rate ranges from 1 to 9 per 100,000 population, where most cases of NSIP are idiopathic. NSIP definitive diagnosis is very difficult because it must be with a multidisciplinary approach and confirm from a pulmonary biopsy. On the course of his illnesses the possibility of Connective tissue diseases (CTDs) arising in NSIP during follow up period was about 10% of cases.Case Report: We reported one case at RS Dr. Saiful Anwar, an old adult male smoker, age 64 with fibrotic type Non Spesific Instertitial Pneumonia (NSIP). From clinical patients including anamnesis, physical examination and laboratory results and X-Ray chest, ILD suspicion was found. Bodypletstimography results show a corresponding decrease in DLCO with ILD. CT-Scan results obtained by crazy paving with pulmonary bronchiectasis traction in accordance with ILD susp Sussection NSIP and enforced from VATS biopsy results with conclusions according to NSIP description. Patients received corticosteroid therapy for 4 weeks and showed clinical improvement.Conclusion: In these patients the diagnosis of fibrotic NSIP has gone through a multidisciplinary approach including the pulmonology, radiologist and pathologist sections. Corticosteroid therapy in these patients gives good results and the patient is in stable condition. Periodic monitoring is necessary because of the risk of exacerbations and the incidence of CTD complications..

Provision of Gefitinib as Targeted Therapy in Lung Adenocarcinoma with EGFR Mutation and Brain Metastatic Komang Sri Rahayu Widiasari
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Adenocarcinoma is a malignant epithelial tumor with glandular differentiation or mucin production. Adenocarcinoma covers 30% of lung cancers in Europe and America. This report described a case of an unusual chronic headache since 3 years ago without any complementing symptom except for nausea. The primary tumor was detected with Thorax CT scan and confirmed by histopathology examination. Patient treated with gefitinib (1 x 250 mg) and showed a satisfying result. Gefitinib, as first-line therapy for patients with epidermal growth factor receptor ( EGFR) mutation, was effective and well-tolerated in this patient.

Sarcomatoid Carcinoma Of The Mediastinal : A Rare Case of Giant Mass Thymic Carcinoma Subtype Agus Andreas Santoso; Ngakan Putu Parsama Putra; Ungky Agus Setiawan; Artono Isharanto; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

ABSTRACTTitle:Â Sarcomatoid CarcinomaÂ Of The Mediastinum: AÂ Rare Case of Giant MassÂ Thymic CarcinomaÂ SubtypeAuthor: Agus Andreas Santoso, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Persama Putra, MD, Pulmonologist Consultant, Ungky Agus Setiawan, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Hendy Setyo Yudhanto, MD, Pathology Anatomy Specialist.Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, mostÂ patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description:Â A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlargingÂ lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patientÂ hadÂ Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma.Â Discussion:Â Sarcomatoid carcinoma is a type of thymic carcinomaÂ that hasÂ both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This caseÂ wasÂ interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in thisÂ patient.Â

Page 2 of 7 | Total Record : 66

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