Kiki A. Rizki
Divisi Bedah Onkologi Kepala Dan Leher Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

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Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal Setiawan, Jonny; Abdurahman, Maman; Rizki, Kiki A.
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Seroma adalah pengumpulan cairan serous di subkutis dan merupakan komplikasi pascaoperasi kanker payudara yang paling sering dijumpai. Insidensinya mencapai lebih dari 60%. Walaupun tidak mengancam jiwa, namun dapat menimbulkan morbiditas yang serius. Berbagai penelitian dilakukan untuk menentukan faktor risiko untuk mencegah timbulnya seroma. Saat ini, seroma terjadi karena proses inflamasi pascaoperasi. Teori inilah yang mendasari peranan antiinflamasi terhadap pembentukan seroma. Diketahui obat golongan glukokortikoid, memiliki peranan menghambat respons inflamasi. Tujuan penelitian ini untuk menilai efek profilaksis pemberian metilprednisolon perioperatif mastektomi terhadap pembentukan seroma. Penelitian ini merupakan uji klinis secara acak tersamar ganda terhadap 2 kelompok, yaitu antara kelompok karsinoma payudara stadium lokal lanjut yang diberikan metilprednisolon perioperatif mastektomi sebagai kelompok perlakuan dan kontrol. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung, periode April–Juli 2013. Subjek penelitian meliputi 30 wanita yang memenuhi kriteria inklusi dan dibagi menjadi dua kelompok, 15 pasien diberikan metilprednisolon dan 15 pasien sebagai kontrol. Penelitian ini menggunakan uji-t tidak berpasangan dan Mann Whitney. Didapatkan perbedaan rata-rata volume drainase hari ke-1, pada kelompok metilprednisolon sebanyak 104,7 mL dan pada kontrol sebanyak 158 mL, namun secara statistik tidak bermakna (p=0,053). Demikian pula dengan hari-hari selanjutnya dan total seroma, tidak didapatkan perbedaan yang bermakna. Simpulan, pemberian metilprednisolon tidak efektif menurunkan volume drainase seroma pascaoperasi mastektomi. [MKB. 2014;46(2):88–93]Kata kunci: Mastektomi, metilprednisolon, seromaEffectiveness of Methylprednisolone on Post-Operative Seroma Formation Following Radical Modified MastectomySeroma is a collection of serous fluid in the subcutaneous and is the most common complication of breast cancer surgery. The incidence is more than 60%. Although it is not life-threatening but it can cause serious morbidity. Various studies were conducted to determine the risk factors to prevent seroma formation. Currently, seroma occurrs due to postoperative inflammatory processes. This theory underlies the antiinflammatory role for seroma formation. Glucocorticoid drugs is known as playing a role in inhibiting the inflammatory response. The purpose of this study was to assess the prophylactic effect of perioperative administration of methylprednisolone on seroma formation. This study was a double-blind randomized control trial of 2 groups, i.e. a group of locally advanced breast carcinoma which were given methylprednisolone perioperatively as a treatment group and a control group. The research was conducted in Dr. Hasan Sadikin General Hospital Bandung from April to July 2013. Thirty women who met the inclusion criteria were included as subjects who were then divided into two groups: 15 women received methylprednisolone and 15 women serve as controls. This study used independent t and Mann-Whitney tests. There was a difference in the mean volume of drainage on day 1 between the methylprednisolone and control group as much as 104.7 mL and 158 mL, respectively, but not statistically significant (p=0.053). The same situation was also seen for the following days and total seroma, which was no significant difference was found. In conclusion, the use of methylprednisolone is not effective for reducing postoperative seroma drainage volume after mastectomy. [MKB. 2014;46(2):88–93]Key words: Mastectomy, methylprednisolone, seroma DOI:  10.15395/mkb.v46n2.279
Hemimandibulectomy of an extensive complex odontoma in the mandible: a case report Widayanti, Retno; Hardianto, Andri; Hardianto, Andri; Priyanto, Winarno; Rizki, Kiki A.
Journal of Dentomaxillofacial Science Vol 2, No 3 (2017)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v2i3.652

Abstract

Objective: Odontomas are the most common form of odontogenic tumors of the jaw. They constitute 22% of all odontogenic tumors. Odontomas consist of two types, compound and complex. The compound odontomas contain recognizable enamel, dentin and sometimes cementum, shaped in tooth like structures; whereas complex odontomas are composed of irregular masses of dentin and enamel and have no anatomic resemblance to a tooth.Methods: A17-year-old female patient came to Department of Oral and Maxillofacial Surgery with a slow growing and asymptomatic swelling in her left mandible. The panoramic radiograph showed a radioopacity and radiolucent lesion, with well-corticated limits. The radioopaque area was amorphous, circumscribed by a thin and irregular radiolucent halo. An inscisional biopsy confirmed the lesion as a complex odontoma. The surgery performed was hemimandibulectomy followed by a reconstruction using a plate under general anesthesia.Results: Complexodontomas are most likely to be found in the posterior region of the maxilla or the mandible and can be treated with a simple enucleation and curettage. In this case report the hemimandibulectomy was performed due to the extensiveness of the mass.Conclusion: Surgical removal of large complex odontoma with hemimandibulectomy is a rare clinical scenario. The extensiveness of the lesion contributed to its removal technique.
Multiple sialolithiasis of submandibular gland: a case report Nurwahida, Nurwahida; Hardianto, Andri; Rizki, Kiki A.
Journal of Dentomaxillofacial Science Vol 2, No 2 (2017): (Available online: 1 August 2017)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v2i2.530

Abstract

Objective: Sialolithiasis is a common disease of the salivary glands. Sialolithiasis occurs mainly in the submandibular gland (80–90%) and to a lesser extent in the parotid gland (5–20%). Sialoliths may be single or multiple. Multiple sialolith in the submandibular gland are rare. Seventy to 80% of cases feature solitary stones; only about 5% of patients have three or more stones.  Patients commonly experience pain and/or swelling.Methods: A 51-year-old male came to Department of Oral and Maxillofacial Surgery with a swelling and pain at the right submandibular. The panoramic radiograph showed a radiopacity mass with well-defined in right submandibular. The Ultrasonographic interpretation showed hypoechoic inhomogeneous mass with multiple calcification.The submandibular gland removal was performed by extraoral approach.Result:Multiple sialolith in the submandibular gland are rare. A surgical approach for removal of sialolith in the submandibular gland could be intraoral or extraoral. In this case report, we described five stones in the submandibular gland. which were removed by extraoral approach.Conclusion: There are various methods available for the management of salivary stones. In this case report, removal of the submandibular gland with the stone should still be preferred as the gold standard of treatment and could avoid recurrence of this medical condition.
Hemimandibulectomy of an extensive complex odontoma in the mandible: a case report widayanti, retno; Priyanto, Winarno; Rizki, Kiki A.; Hardianto, Andri
Journal of Dentomaxillofacial Science Vol 2, No 3 (2017): (Available online: 1 December 2017)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v2i3.518

Abstract

Objective: Odontomas are the most common form of odontogenic tumors of the jaw, represent a benign hamartoma rather than a true neoplasm. They constitute 22% of all odontogenic tumors. Odontomas are consist of two types, compound and complex. The compound odontomas contain recognizable enalmel, dentin and sometimes cementum, shaped in toothlike structures; whereas complex odontomas are composed of irregular masses of dentin and enamel and have no anatomic resemblance to a tooth.Methods: A17-year-old female patient came to Department of Oral and Maxillofacial Surgery with a slow growing and asymptomatic swelling in her left mandible. The panoramic radiograph showed a radioopacity and radiolucent lesion, with well-corticated limits. The radioopaque area was amorphous, circumscribed by a thin and irregular radiolucent halo. An inscisional biopsy confirmed the lesion as a complex odontoma. The surgery performed was hemimandibulectomy followed by a reconstruction using a plate under general anaesthesia.Results: Complex odontomas are most likely to be found in the posterior region of the maxilla or the mandible and can be treated with a simple enucleation and curettage. In this case report the hemimandibulectomy was performed due to the extensiveness of the mass.Conclusion: Surgical removal of large complex odontoma with hemimandibulectomy is a rare clinical scenario. The extensiveness of the lesion contributed to its removal technique.
Parotid gland tuberculous abscess Bustomi, Ahmad F.; Sylvyana, Melita; Syamsudin, Endang; Rizki, Kiki A.
Journal of Dentomaxillofacial Science Vol 1, No 3 (2016): (Available online: 1 December 2016)
Publisher : DiscoverSys Inc

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/jdmfs.v1i3.314

Abstract

Clinically speaking, parotid gland tuberculosis is a rare case. Its diagnostic values are hard to determine as it has clinical similarities with neoplasms. Mistakes during diagnosis happen quite often thus additional layer of examinations are required to be conducted. An 18-year-old woman was referred from a privately-owned hospital with initial diagnosis of infected parotic sinistra tumor. Physical examination discovered a swelling on her sinistra parotid gland and a lump at the colli sinistra region. Ultrasound scan showed benign hypoechoic areas and cystic regions at the left of submandibular muscle which then expanded towards the neck. Results from the PPD5TU (-), BTA 3X (1X positive) and FNAB pointed out an existing a/r parotid and colli sinistra or Tuberculous abscess. The diagnosis of parotid gland tuberculosis is often established after conducting superficial parotidectomy. During this discussion we will present and elaborate a case of parotid gland tuberculous abscess which was diagnosed with PPD5TU, BTA and FNAB. The patient managed to be cured with OAT distribution and no recurrences were recorded afterward. Parotid gland tuberculous abscess is rarely found in clinics. Tuberculosis examination (including PPD5TU and BTA) and FNAB need to be conducted to prevent unnecessary treatment and medical operations.
Ekspresi Protein B-RAF Mutan pada Karsinoma Tiroid Papilifer yang Bermetastasis ke Kelenjar Getah Bening Regional Achmad, Dimyati; Sebastian, Jeremy; Hernowo, Bethy S.; Rizki, Kiki A.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

AbstrakKarsinoma tiroid papilifer (KTP) dapat tumbuh progresif dan sekitar 33−61% kasus secara klinis telah metastasis ke kelenjar getah bening (KGB) regional pada saat diagnosis ditegakkan. Mutasi gen B-RAF dihubungkan dengan sifat biologis progresivitas KTP. Mutasi gen B-RAF akan mengkode protein B-RAF mutan yang bertindak sebagai regulator sentral pada jalur mytogen activated-pathway kinase (MAPK) dalam proses proliferasi dan dediferensiasi. Mutasi gen B-RAF dapat diidentifikasi pada tingkat deoxyribosenucleic acid (DNA), ribonucleic acid (RNA), dan protein. Masih terdapat kontroversi antara hubungan mutasi B-RAF dan metastasis KGB regional. Tujuan penelitian ini untuk mengetahui hubungan protein B-RAF mutan dengan metastasis ke KGB regional pada KTP. Penelitian ini merupakan penelitian observasional rancangan kuantitatif, studi kasus kontrol berpasangan. Penelitian dilakukan di Subbagian Bedah Onkologi, Kepala dan Leher, Departemen Ilmu Bedah dan Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/ Rumah Sakit Dr. Hasan Sadikin Bandung. Sampel penelitian terdiri atas 38 kasus KTP dengan metastasis dan 38 kasus kontrol tanpa metastasis ke KGB regional yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung pada periode Januari 2003−Desember 2010 dan dipilih berdasarkan proses matching. Masing-masing kelompok diperiksa B-RAF mutan dengan metode imunohistokimia. Hubungan antara tiap variabel bebas dan variabel tergantung diuji menggunakan analisis bivariat Uji McNemar.Hasil penelitian menunjukkan protein B-RAF mutan memiliki hubungan bermakna (p=0,023) dengan metastasis ke KGB regional pada KTP. Terdapat protein B-RAF mutan pada KTP mempunyai risiko untuk metastasis ke KGB regional sebesar 5,92 kali dibandingkan dengan tanpa mutasi B-RAF. Penelitian ini juga menunjukkan prevalensi B-RAF mutan sebesar 65,8% (32 kelompok kasus dan 18 kelompok kontrol). Simpulan, protein B-RAF mutan memiliki hubungan dengan metastasis ke KGB regional pada KTP. [MKB. 2013;45(4):245–50]Kata kunci: Imunohistokimia, karsinoma tiroid papilifer, metastasis ke KGB regional, mutasi B-RAFMutant B-RAF Protein Expression in Regional Lymph Node Metastasized Papillary Thyroid CarcinomaPapillary thyroid carcinoma (PTC) can become progressive and in about 33−61% of cases it has metastasized to regional lymph nodes at diagnosis. Mutation of B-RAF gene correlated with the biological characteristic of lymph node progressivity. Mutation of B-RAF will encode mutant B-RAF protein which acts as the central regulator on mytogen activated-pathway kinase (MAPK) pathway in terms of proliferation and dedifferentiation processes. B-RAF gene mutation can be identified at deoxyribosenucleic acid (DNA), ribonucleic acid (RNA) and protein levels. There are still controversies in corelation between B-RAF mutation and regional lymph node metastasis. The purpose of this study was to discover the correlation between mutant B-RAF protein and regional lymph node metastasis on PTC. This is a quantitative observational paired case-control study. The study was conducted at the Surgical Oncology, Head and Neck Division Departement of Surgery and Pathology Anatomy Departement, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung in April 2011–January 2012. The sample consisted of 38 PTC cases with metastasis and 38 control cases without regional lymph node metastasis treated in Dr. Hasan Sadikin Hospital between January 2003–December 2010 which have been selected based on the matching process. Each group was examined using the immunohistochemistry method. Correlation between each dependent and non-dependent variables were tested using McNemar bivariate analysis. The results showed that mutant B-RAF protein have a significant correlation (p=0.023) with lymph node metastasis in PTC. The risk of metastasis in B-RAF mutant group was 5.92 times higher than without mutation. This study also showed that from 76 PTC cases studied, the prevalence of mutant B-RAF was about 65.8% (32 in cases and 18 in control group). In conclusion, there is a correlation between mutant B-RAF protein and regional lymph node metastasis in papillary thyroid carcinoma. [MKB. 2013;45(4):245–50]Key words: B-RAF mutation, immunohystochemistry, papillary thyroid carcinoma, regional lymph node metastasis DOI: http://dx.doi.org/10.15395/mkb.v45n4.200
PERBEDAAN β-CROSSLAPS SERUM PENDERITA KARSINOMA PAYUDARA PASCAMENOPAUSE ANTARA YANG DIBERIKAN ANASTROZOL DAN TAMOKSIFEN Sebastian, Randy; Abdurahman, Maman; Rizki, Kiki A.
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tamoksifen dan inhibitor aromatase sebagai terapi adjuvan memiliki peranan penting pada karsinoma payudara (KPD) pascamenopause dengan reseptor estrogen positif. Saat ini inhibitor aromatase dapat menggantikan tamoksifen karena memiliki keuntungan yang lebih baik dibanding dengan  tamoksifen. Inhibitor aromatase juga memiliki efek samping meningkatkan penyerapan tulang yang memicu osteoporosis dan fraktur dibanding dengan tamoksifen. Saat terjadi proses penyerapan tulang, matriks tulang yang 90% terdiri atas kolagen tipe I akan terurai sehingga salah satu hasil penguraiannya berupa ?-CrossLaps terdapat dalam darah dan dapat diukur kadarnya. Penelitian ini mengukur perbedaan kadar ?-CrossLaps serum baik pada pasien KPD pascamenopause yang diberikan anastrozol dan tamoksifen di Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari?Juli 2013. Penelitian ini merupakan penelitian potong lintang. Terdapat 32 pasien, yaitu 16 pasien tiap kelompok. Hasil pengolahan data statistik dengan derajat kepercayaan 95% menunjukkan perbedaan yang bermakna kadar ?-CrossLaps serum KPD yang diberikan anastrozol dibanding dengan yang diberikan tamoksifen (p<0,05). Simpulan, kadar ?-CrossLaps rata-rata serum KPD yang diberikan anastrozol lebih tinggi dibanding dengan tamoksifen, artinya  pemberian obat anastrozol pada pasien KPD pascamenopause dalam jangka waktu >6 bulan meningkatan proses penyerapan tulang dibanding dengan yang diberikan tamoksifen. [MKB. 2015;47(4):207?11] DOI: 10.15395/mkb.v47n4.615Kata kunci: Anastrozol, ?-CrossLaps serum, tamoksifenComparison of ?-crosslaps Serum Levels between Postmenopausal Breast Carcinoma Patients Receiving Anastrozol and TamoxifenAbstractTamoxifen and inhibitor aromatases as adjuvant therapy plays an important role in postmenopausal breast cancer patients with positive estrogen receptor. Currently, inhibitor aromatases can replace tamoxifen because it has more advantages than tamoxifen. Inhibitor aromatases also have side effects which is increased bone resorption that triggers osteoporosis and fractures when compared to tamoxifen. During the process of bone resorption, bone matrix, composed of 90% type I collagen, were broken down resulting in ?-crosslaps content in the blood, which is measurable. This study measured the levels of serum ?-crosslaps in postmenopausal breast cancer patients who received anastrozol and tamoxifen in Dr. Hasan Sadikin General Hospital Bandung between January and July 2013. This was a cross-sectional study with comparative analytics to compare the mean levels of serum ?-crosslaps in postmenopausal breast cancer patients between the two groups. There were 32 patients in this study, 16 patients in each group. The results of data processing using statistical tests at 95% confidence level revealed that there was significant differences in serum levels of ?-crosslaps between the group who received anastrozol and those who received tamoxifen (p<0.05). In conclusion, the mean value of ?-crosslaps serum in anastrozol group is higher than in tamoxifen group. This means that postmenopausal breast cancer patients receiving anastrozol for more than 6 months could may experienced a higher degree of bone resorption compared to those receiving tamoxifen. [MKB. 2015;47(4):207?11]Key words: Anastrozol, serum ?-crosslaps, tamoxifen
Plasma Malondialdehid and Histopatology Healing Score Differences in Incised Old and Young Mice Zinc with Zinc Administration Aryantie, Moniq W.; Monica, Rizqy D.; Rezano, Andri; Adi, Sudigdo; Rizki, Kiki A.; Zuhairini, Yenni
Journal of Medicine and Health Vol 2 No 1 (2018)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (371.125 KB) | DOI: 10.28932/jmh.v2i1.743

Abstract

Free radical plays role in wound healing. This study was conducted to determinedifferences in level of plasma malondialdehyde (MDA), and histopathological score of woundhealing by administering zinc in old and young mice. We used 24 old mice and 24 young miceincision wound model, randomized into two groups, with and without zinc administration. Wefound plasma MDA level was lower in old mice with zinc administration but not statisticallysignificant. The plasma MDA level was significantly higher by administering zinc in young mice(p=0.004). The plasma MDA level of young mice was higher than old mice in zincadministration group (p=0.010). Reepitelialization, inflammatory cells, fibroblasts andangiogenesis did not differ by administering zinc both in old mice and young mice.Reepitelialization, inflammatory cells and angiogenesis did not differ between old and youngmice in mice that were given zinc; while fibroblast of young mice is more than old mice(p=0.010). We concluded  plasma MDA level is higher in young mice with zincadministration. Plasma MDA level in young mice is higher than old mice with zincadministration. Young mice with zinc administration have higher fibroblast than oldmice.Keywords: aging, free radical, histopathologic score, malondialdehid, wound healing, zinc
Infected dentigerous cyst due to traumatic injury in impacted of mandible canine: a case report Muhajir, Idawati; Adiantoro, Seto; Hardianto, Andri; Rizki, Kiki A.
Journal of Case Reports in Dental Medicine Vol 1, No 1 (2019)
Publisher : Journal of Case Reports in Dental Medicine

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Abstract

Objective: This case study is a case of infected dentigerous cyst involving all erupted incisor teeth and impacted mandible canine. Diagnosis of results from clinical examination, radiographic and histopathologic.Methods: The initial treatment was antibiotic therapy for 2 week, followed with cyst enucleation, extracted of the all fourth incisors and odontectomy lower left canine, lower premolar and upper right molar through intraoral approach under general anesthesiaResults: The evaluation of 2 weeks post surgery treatment showed the healing was good and the chin region showed no sign of inflammation, the color of the tissue was similar to its surrounding.Conclusion: Last sentence of abstract should be a conclusion or further treatment plan for the case. Histological examination and medical history should be placed before the treatment procedureKeywords: Dentigerous Cyst, Enucleation, Infection.