Alveolar rhabdomyosarcoma (RMS) is one of the four subtypes of RMS. Alveolar RMS is the rare type found in adults, with the worse prognosis. We report 2 serial cases of alveolar RMS on extremity which was only treated with subtotal excision or incision biopsy. We further gave a total dose of 70 Gy radiotherapy on the local tumor and 50 Gy prophylaxis dose on regional lymph node after 6 cycles of anthracyclines-based chemotherapy. Postradiotherapy, contrast computed tomography scan revealed no tumor mass left (complete response).
Kanker payudara adalah salah satu kanker yang sering menyebabkan metastasis pada tulang. Nyeri merupakan keluhan terbanyak pada metastasis tulang. Tatalaksana kombinasi diperlukan untuk mengatasi nyeri metastasis tulang. Radiasi adalah pengobatan yang efektif untuk mengurangi nyeri akibat metastasis tulang. Kami melaporkan seorang pasien perempuan yang datang dengan keluhan nyeri hebat pada punggung bawah. Pasien didiagnosis dengan kanker payudara kambuh jauh (metastasis) pada tulang vertebra lumbal ke-2 sampai 4. Dilakukan radiasi paliatif sebanyak 10 fraksi (10 x 3 Gy) pada vertebra lumbal ke-1 sampai 5 dengan dosis total 30 Gy. Didapatkan hasil pengurangan nyeri dari awalnya nyeri berat dengan konsumsi rutin opioid menjadi nyeri ringan dengan konsumsi NSAID bila diperlukan. Respon radiasi adekuat untuk pengurangan nyeri didapatkan pada 1 bulan setelah radiasi.
Nasopharyngeal carcinoma (NPC) is a multifactorial disease that is geographically endemic in the world. Indonesia population is about 225 million people having varied diversity ethnic and has the high incidence rate of NPC approximately 6.2 per 100,000 people per year. EBV infection has been shown to be consistent with the onset of NPC. The pathogenesis of NPC is more directly reflected by carcinoma-specific viral transcriptional activity at the site of primary tumor. Therefore, EBV infection in NPC is also reflected by the expression of EBV latent and lytic gene, particularly in the expression of mRNA LMP1 EBV as a biomarker for EBV latent infection. The aims of this study were to determine the relative expression of mRNA LMP1 EBV in undifferentiated NPC (NPC WHO-III) patient as a biomarker of tumour progressivity in NPC. The samples were the tissue biopsies formalin-fixed embedded paraffin (FFPE) of 28 undifferentiated NPC patients at Pathology Anatomy Departement, R.S.U.D. Prof. dr. Margono Soekarjo, Purwokerto. The relative expression of mRNA LMP1 EBV was determined by RT-qPCR technique and calculated by formula 2-ΔCt. The relative expression of mRNA LMP1 EBV in undifferentiated NPCpatients on advanced staging was approximately start from 5,832.90 to 39,786.70. In undifferentiated NPC patients, the relative expression of mRNA LMP1 EBV in stadium IV (13.619,33 + 4902,3) increased of 1.5 times compared to stadium III (n = 2; 9.299,35 + 6178,9), however it was no significance differences statistically. Therefore, the relative expression of mRNA LMP1 EBV has a potensial biomarker of tumour progressivity in advanced staging undifferentiated NPC. AbstrakKarsinoma Nasofaring (KNF) merupakan penyakit yang bersifat multifaktor dan endemik di dunia. Populasi penduduk Indonesia yang berjumlah 225 juta yang terdiri atas beragam etnis populasi memiliki laju insidensi kasus KNF yang tinggi berkisar 6,2 per 100.000 penduduk pertahun. Infeksi EBV terbukti konsisten dengan perkembangan KNF. Patogenesis KNF lebih nyata terlihat dari aktivitas spesifik transkripsi virus pada tumor primernya. Infeksi EBV pada KNF dapat diamati dari ekspresi gen laten dan litiknya.. LMP1 merupakan onkogen utama dalam tumorigenesis KNF, sehingga ekspresi mRNA LMP1 EBV berperan sebagai petanda biologi infeksi laten EBV. Penelitian ini adalah untuk mengetahui ekspresi relatif mRNA LMP1 EBV berpotensi sebagai biomarka progresivitas tumor pada KNF tidak berdiferensiasi (KNF WHO III) Desain penelitian ini adalah studi cross sectional (seran lintang). Subyek penelitian adalah 28 biopsi jaringan tumor nasofaring yang terfiksasi dalam blok paraffin (formalin-fixed paraffin embedded/FFPE) populasi pasien KNF tidak berdiferensiasi pada Poli Patologi Anatomi R.S.U.D. Prof dr. Margono Soekarjo – Fakultas Kedokteran Unsoed, Purwokerto. Ekspresi relatif mRNA LMP1 EBV ditentukan dengan teknik RT-qPCR dan dihitung dengan rumus 2-ΔCt. Nilai ekspresi relatif mRNA LMP1 EBV pada penderita KNF tidak berdiferensiasi stadium lanjut berkisar 5,832.90 - 39,786.70. Nilai ekspresi relatif mRNA LMP1 EBV pada stadium IV (13.619,33 + 4902,3) meningkat 1,5 kali dibandingkan dengan stadium III (9.299,35 + 6178,9), namun peningkatan ekspresi relatif mRNA LMP1 EBV tidak bermakna secara statistik Ekspresi relatif mRNA LMP1 EBV dari biopsi jaringan tumor FFPE berpotensi sebagai biomarka progresivitas tumor pada stadium lanjut KNF tidak berdiferensiasi.
Background: Erythrodermic psoriasis (EP) is a severe type of psoriasis, a chronic inflammatory disease characterized by general erythematous condition with thick scale all around the body. The treatment of EP consists systemic medications like cyclosporine or methotrexate and biologic agents, which lately suggested related to the development of cutaneous T-cell lymphoma (CTCL) in severe psoriasis patients. Case Report: A 45-year old, Javanese male was diagnosed previously with EP that transformed to CTCL. His previous history, he was histologically confirmed as psoriasis vulgaris since 2014 and was treated regularly with methotrexate. After 5 years, he gradually suffered several episodes of erythrodermic condition and was diagnosed with erythrodermic psoriasis with unusual pruritic hyperkeratotic plaques and ulcers on his trunks without any general lymph nodes enlargement. Peripheral blood smear showed Sezary cell and histopathology result confirmed CTCL. He was treated with combination of radiotherapy, phototherapy and topical regiments with a good result and acceptable. Discussion: Several studies suggested that severe psoriasis had increased the susceptibility of CTCL, especially with the use of cyclosporine, methotrexate or biologic agents as the treatment. In this case, methotrexate might play role in the development of CTCL or enhanced the transformation of EP to CTCL. Combination of localized radiation therapy, NBUVB and topical therapy gave a quiet good result for the skin condition and increased patient’s quality of life. Conclusion: Erythrodermic psoriasis might transform or develop to CTCL which in this case was probably related to the use of methotrexate.
Ionizing radiation, when it hits our bodies, can ionize and excite the atomic nuclei of cells. Ionization and excitation will cause DNA damage either directly or indirectly. DNA damage is direct if ionizing radiation hits DNA, while DNA damage is indirectly through the formation of free radicals (atoms with unpaired electrons) and has a very damaging effect on DNA. Therefore, safety in ionizing radiation, including its use in the medical world, is essential. Protection includes safety avoiding deterministic effects and stochastic effects. To protect against both deterministic and stochastic effects, the role of the radiographer is significant. Heinrich (1980) estimates that (85%) accidents are the result of the contribution of unsafe work behavior (unsafe act). Radiation accidents reported by the United States Energy Atomic Commission from 1960-1968 were caused by operator error (68%), procedural errors (8%), equipment damage (15%), and others (9%). When viewed in detail, the operator's errors were not conducting a radiation survey (46%), not following procedures (36%), not using protective equipment (6%), human error (6%), and calculating radiation exposure errors (6%). Therefore, the radiographer must know and understand ionizing radiation, its dangers, and the application of radiation protection from the results of a survey conducted at Prof. Hospital. Dr. Margono Soekarjo Purwokerto to 22 radiographers showed that the level of understanding of ionizing radiation, the dangers, and the application of radiation protection is still low. Therefore education and training are very much needed for them. Keywords: Radiation Hazard, Radiation Protection, Radiographer Education and Training
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