Introduction.Pulmonary contusions can cause a progressive inflammatory response. Activation of TNF-α cytokines and reactive oxygen species (ROS) can cause pulmonary cell death. Antioxidants can have the potential to neutralize ROS. The purpose of this study is to determine the effectiveness of antioxidant administration in maintaining pulmonary cell function in wistar rats that have been induced to experience pulmonary contusions through caspase-3 levels. Methods.This study was an in vivo experimental study conducted on thirty male wistar rats and divided into five groups (n = 6): control, pulmonary contusion + asthaxanthine 5 mg/kgBW, pulmonary contusion + vitamin C and E 50 mg/kgBW, pulmonary contusion + vitamin C and E 100 mg/kgBW, pulmonary contusion + vitamin C and E 200 mg/kgBW. The value of Caspase-3 is evaluated by the IHC. All data analyzes used SPSS 18. Results. Low doses of antioxidants have the potential to reduce pulmonary cell death in wistar rats induced by pulmonary contusions.Conclussion. Vitamin C and E effective to reduce polmonary cell death in pulmonary contusion.Keywords: antioxidants, vitamin C, vitamin E, pulmonary contusions animal model, apoptosis, caspase-3

Introduction: Incidence of lung cancer highest in Indonesia and the fifth most abundant in female after breast cancer. Lung cancer is first cause of cancer related mortality in male (21.8%) and second cause of cancer related mortality in female (9.1%) after breast cancer (21.4%). The result of study in 100 hospitals in Jakarta showed that lung cancer was the most abundant in male and forth in female. The sputum cytology in lung cancer is an initial examination for diagnosis. The sputum cytology examination is a simple, accurate, cheap and non-invasive for initial diagnosis of lung disease including lung cancer. Methods: This study targeted lung malignancy suspect patient with sputum cytology examination in Dr. Mohammad Hoesin Hospital Palembang. The inclusion criteria were patients who will have a surgery and histopathology examination, patient >17 years old, patient that willingly take part in this research. The exclusion criteria were patient with sputum that can’t be retrieved. This study was using Cross Sectional method. The measurement of sensitivity and specificity of sputum cytology to histopathology examination calculated with Thornier-Remain formula. Results: The lung cancer patient found most in category of > 40 years (63.6%), male and smoking (77.3%). The sputum cytology’s result highest in non-malignancy (86.4%) and the histopathology examination’s result highest in malignancy (72.7%). Sensitivity of sputum cytology in this study is 28.75% and the specificity 100% Conclusion: The sensitivity of sputum cytology in 28.75% shown accuracy of sputum cytology method and specificity in 100% shown how often the sputum cytology method diagnoses the malignancy

Introduction: Thoracic trauma has mortality rates varying from 10% to 60%. Various scoring frameworks have been created for prognostic value in thoracic trauma patients, including the chest trauma score (CTS). This has not been studied in Indonesian patients. The authors decided to study the picture of CTS in thoracic trauma patients in the Indonesian subpopulation, especially in our hospital. Methods: This research is an analytical observational study at dr. Mohammad Hoesin (RSMH) Palembang in January-June 2020. Our research variables are age, lung contusions, number of rib fractures, bilateral rib fractures, and Chest Trauma Score (CTS). 37 cases could be analyzed with the length of stay, ICU care, mortality, and surgery option. Results: The most common thoracic trauma occurred at the age between less than 45 years, the highest degree of lung contusions was unilateral minor lung contusions. The most common rib fractures were <3 rib fractures. Chest Trauma Score in this study were less than 5. The CTS score had a significant relationship with length of stay and the need of ICU, but was not significantly associated with mortality and surgery option. Conclusion: Chest trauma score can be used to consider the length of treatment and priority needs of the ICU which will be prepared for the management of thoracic trauma patients, especially the young who are accompanied by lung contusions and rib fractures.

Background: Acute mediastinitis is an infection of the connective tissue of the interpleural mediastinal space. The infection may spread through the cervical spaces to the mediastinum, via negative intrathoracic pressure and gravity.1 Management of DNM with minimally invasive drainage, namely video-assisted thoracic surgical drainage (VATS),6 mediastinoscopy,7 and percutaneous catheter drainage,8,9 have been widely used. During early 1920s, data showed subsequent to broad-spectrum antibiotics, the mortality rate was about 40%.12 Furthermore, without prompt diagnosis and aggressive surgery, the mortality rate can reach up to 60%.13 Methods: This retrospective study has a descriptive research design. The number of samples is 19 subjects. Results: From January 1, 2019 to November 30, 2020 there were 19 DNM patients. In this study, most DNM patients were male, average age of 39 years, dental abscesses as the most common source of infection, neck exploration and sternotomy were the most common treatment option, most common outcome death, and the most common result of culture was Acinetobacter baumannii. Conclusion: Good non-operative and operative management can reduce mortality rate.

Background: Thoracotomy can cause postoperative impairment of respiratory function and highly risk turns as Postoperative Pulmonary Complication (PPC). One of strategies to decrease risk of PPC in preoperative evaluation is lung expansion maneuvers include Incentive Spirometry (IS). Incentive Spirometry was breathing technique that sustained maximal inspiration, using device which give visual feedback. This study aims to know effectiveness of using preoperative IS in reducing incidence of PPC in thoracotomy patients. Methods: Experimental study with post test only design. Comparing emerged PPC with Melbourne Group Scale Version 2 (MDG-2) criteria in elective posterolateral thoracotomy patients who given IS and non IS preoperative. Data were analyzed using chi square test. Results: Total samples was 32 patients. There was 11 patients had PPC, which 6 recieved IS preoperatively. There was no relation between PPC with age, sex, height, smoking history proportion (p value>0,05). Chi square test showed there was no relation between using IS preoperative and PPC incidence(p>0,710). Conclusions: IS preoperative was not effective in preventing PPC in elective thoracotomy patients.

Cardiac myxoma is the most frequent primary tumor of the heart, considered a benign, slowly proliferating neoplasm. The incidence of cardiac myxoma is low, with approximately 0.5-1 cases per 1,000,000 individuals per year. Cardiac myxoma can be present at any age but most often in 30-60 years old, with female predominance (1.5:1). Serious complications include neurological symptoms, heart failure, arrhythmias, and pericardial effusion. Ischemic stroke complications associated with atrial myxoma due to embolus. Aims: to describe the features, complications and management of left atrial myxoma. Case summary: A 31-year-old woman with the chief complaint of sudden diplopia and syncope since 4 days before admission to the hospital. Patient also had history of recurrent vertigo in the last month. Her vital sign was normal. Neurological examination showed eyeball muscles paralysis (OD: nerve VI, IV and III inferior oblique paralysis; OS: nerve III medial and superior paralysis), flat right nasolabial plica (nerve VII right perifer paralysis) and tongue deviation to the right (nerve XII right central paralysis). A Head MRI showed subacute multiple infarcts in bilateral thalamus and bilateral centrum semiovale with infarcts in left cerebellum. Echocardiography showed a pedunculated mass in left atrium attached to the interatrial septum, which was suggestive of left atrial myxoma. Patient diagnosed a left atrial myxoma with ischemic stroke. Results: Excised left atrial myxoma was performed with cardiac surgery and cardiopulmonary bypass procedures. After treatment procedures, the patient have clinical improvement without any complications. Histopathological examination revealed cardiac myxoma. Follow-up echocardiography showed no residual tumors in left atrial. Conclusions: Echocardiography should be done in all cases of stroke as a screening tool to rule out any intracardiac mass, such as cardiac myxoma. Early diagnosis and urgent surgical excision of the cardiac myxoma remains the definitive treatment that will be given excellent results.

Abstract Introduction. Extensive pneumothorax with a long duration of symptoms can be dangerous. Broad pneumothorax can cause hypoxemia which can cause increased production of free radicals in the lung tissue (pulmonary oxidative stress). Oxidative stress in the lungs can indicate the degree of damage or disruption of cells in the lungs due to hypoxia. Methods. There were 4 groups each consisting of 6 mice: 24-hour pneumothoric group (A), 48-hour pneumothoric (B), 72-hour pneumothoric (C) and control (D). Pneumothorac is made by air injection into the right chest pleural cavity, then on an X-ray. All samples were examined for PaO2 to ascertain their level of hypotension. After that, the rats were examined for their lungs malondialdehyde (MDA) levels to find out their stress oxidation stress levels. Results. All groups of pneumothorac mice experienced hypoxemia. The average MDA level was higher in the pneumothorac group, but it was statistically significant only in the 72 hour (C) group with p = 0.031. MDA levels in each group were 1.601 ± 0.739 (A), 1.585 ± 0.714 (B), 2.256 ± 0.513 (C), 1.243 ± 0.162 (D). Conclusion. Pneumothorax can cause pulmonary oxidative stress if the pneumothorac is large in volume and the duration of symptoms reaches 72 hours. MDA can be a marker of cell disruption or injury in cases of pneumothorax who have experienced hypoxemia.