Christian Manginstar - Academia.edu (original) (raw)

Papers by Christian Manginstar

e-Clinic: Jurnal Ilmiah Kedokteran Klinik, Feb 19, 2024

Primary breast lymphoma is rare and it accounts for around 0.5% of malignant breast neoplasms. Sm... more Primary breast lymphoma is rare and it accounts for around 0.5% of malignant breast neoplasms. Small lymphocytic lymphoma (SLL) is a subtype of non-Hodgkin lymphoma originating from a B-cell lineage. This report presents a case of primary SLL of the breast with lung metastasis that had excellent clinical response. We reported a 67-year-old female complained a right breast mass that suddenly appeared after she got massage on her right left arm. The mass was swollen and painless with no systemic complications. The specimen was submitted to histopathology department and it revealed small diffuse lymphocytic lymphoma. Chest X-ray showed a lung metastasis. The patient was then treated with CHOP regimens (Cyclophosphamid, Doxorubicin, Vincristin, and Prednison) and the clinical result was excellent. The side effects of the medication were minimal. In conclusion, primary breast lymphocytic lymphoma is rare and this case highlights the differential diagnosis for a painless breast mass. The treatment must be individualized and multimodal, with chemotherapy being the most accepted treatment.

e-Clinic: Jurnal Ilmiah Kedokteran Klinik, Feb 15, 2024

Burn is caused by exposure to high-temperature substances such as hot, solid liquids or gases suc... more Burn is caused by exposure to high-temperature substances such as hot, solid liquids or gases such as smoke, steam, engines, stoves, radiators and objects that emit heat energy. In severe burns, there is an excessive neutrophil inflammatory response that triggers SIRS, where there is an excessive increase in pro-inflammatory mediators such as TNF-α and IL-6. Propolis contains a number of compounds, such as flavonoids, CAPE, phenol compounds, arginine, ferulic acid and albumin which play a good role in healing burns. This study aimed to find out the effect of propolis on TNF-α expression through in-vivo testing in cases of superficial dermal burns. This was an experimental and laboratory study to assess the bioactive compounds contained in Trigona Sp propolis. Descriptive analysis was performed on the bioactive composition of Trigona Sp propolis and experimental effectiveness of propolis on TNF-α expression in superficial dermal burns. The study was conducted at the laboratory of experimental animals "Alike Quality System", Manado. The results showed that the group treated with propolis had smaller burn areas compared to the groups treated with 1% silver sulfadiazine or with 0.9% NaCl. Granulation had been formed throughout all wounds, however, macroscopically, burns with propolis treatment showed reddish wound appearance while treated wounds with 1% silver sulfadiazine and 0.9% NaCl were darker in color and had thicker crust formation. The one-way ANOVA test showed no significant difference between propolis and 1% silver sulfadiazine on TNF-α expression in dermal superficial burns (p=0.666) meanwhile the effect of propolis compared with NaCl 0.9% on TNF-α expression in dermal superficial burns, showed significant differences (p=0.006 and p=0.040). In conclusion, administration of propolis can reduce the expression of TNF-α in superficial dermal burn.

Phytotherapy Research, Dec 11, 2023

Medical Scope Journal (MSJ), Sep 12, 2023

Medical Scope Journal (MSJ), Feb 1, 2024

Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to... more Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to the conventional thyroidectomy, without any scar as the advantage. This study aimed to present the feasibility and safety of patients with solitary or multinodular goitre and or papillary thyroid carcinoma using TOETVA. This was a case series using 12 patients recorded undergoing TOETVA procedure. Eleven patients' specimen obtained through FNAB resulted as benign nodule. In one patient, the nodule was malignant and unilateral, therefore, endoscopic isthmolobectomy was performed. Outcomes and measures included conversion to open conventional surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue scores, and postoperative complications. The results showed a total of 12 patients; all were women, aged 33-64 years. The size of thyroid nodules ranged from 2 cm to 7 cm. One patient got converted to open isthmus lobectomy. In this series, none of the patients were noted to have mental nerve injury but two patients developed anterior neck chin skin bruise. The mean postoperative VAS measurements were 2, 1, and no pain or 0, on the first, second, third, and seventh postoperative days, respectively. In conclusion, endoscopic thyroidectomy is feasible, safe, and comparable to open thyroidectomy and yields excellent aesthetic results.

Acta Chirurgica Belgica, 2007

Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in t... more Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in the literature. We report a case of a 40-year-old male patient with nodular goitre with the suspicion of malignancy in Fine Needle Aspiration Biopsy. Total thyroidectomy was performed. The histopathological examination revealed a well-differentiated thyroid liposarcoma. The patient recovered uneventfully. Postoperatively, radiotherapy was given to the neck region. During a 2-year follow-up period, no recurrence of the disease occured.

JBN (Jurnal Bedah Nasional)

Tujuan: Untuk menilai hubungan antara jumlah limfosit, monosit, dan neutrofil darah tepi pada pas... more Tujuan: Untuk menilai hubungan antara jumlah limfosit, monosit, dan neutrofil darah tepi pada pasien kemoterapi neoadjuvan kanker payudara stadium lanjut lokal dengan pemberian vitamin D. Metode: Desain penelitian ini berupa single-blind, randomized placebo-controlled trial yang melibatkan 14 sampel dengan 7 sampel sebagai kelompok percobaan yang diberi vitamin D 600 IU/hari dan kelompok kontrol yang diberi plasebo. Dilakukan pengukuran kadar vitamin D, limfosit, monosit, dan neutrofil masing-masing 1 minggu pasca kemoterapi. Penelitian ini dilakukan dari bulan Oktober 2019-Maret 2020 di RSUP Prof. Dr. RD Kandou Manado. Analisa data dilakukan dengan uji ANOVA. Hasil: Kadar vitamin D pada kelompok percobaan mengalami peningkatan yang signifikan dibanding kelompok kontrol. Peningkatan kadar limfosit pada kelompok percobaan sebanyak 11% dibanding kelompok kontrol (p<0,05). Kadar monosit juga meningkat 2% pada kelompok percobaan dibanding kelompok kontrol (p<0,05), namun be...

Medical Scope Journal

Fibrocystic breast tumor is the most common benign type of breast diseases that affects millions ... more Fibrocystic breast tumor is the most common benign type of breast diseases that affects millions of women worldwide. Fibrocystic breast changes are classified as non-proliferative, proliferative without atypia, or proliferative with atypia. We reported a 34-year-old woman presented with a right breast evaluation of breast tumors since one year before admission. On examination, a solid and hard breast tumor measuring 15x10 cm was palpable, well-defined, tender, mobile, and no nipple discharge. The patient underwent two times of core biopsy and the results were fibrocystic changes. Although clinically the breast tumor had a malignant appearance, but the results of core biopsy examinations revealed fibrocystic changes. The patient was managed by wide excision of the evaluated breast tumor with preservation of the breast skin and nipple areolar complex to maintain its function and aesthetic. In conclusion, evaluation of breast tumors must go through a triple diagnostic procedure namely clinical, imaging, and histopathological examinations. Fibrocystic breast tumor can be managed with wide excision of the tumor with preservation of the skin structure and nipple areolar complex of the breast to achieve a natural aesthetic.

JBN (Jurnal Bedah Nasional)

Tujuan: Untuk menganalisa hubungan kadar monosit sel darah tepi pada sebelum dan sesudah terapi p... more Tujuan: Untuk menganalisa hubungan kadar monosit sel darah tepi pada sebelum dan sesudah terapi pada penderita kanker payudara. Metode: Penelitian ini merupakan studi analitik observasional dengan pendekatan kohort prospektif, untuk menganalisa kadar monosit darah tepi sebelum dan sesudah terapi pada penderita kanker payudara. Kriteria inklusi penelitian ini, yaitu: pasien wanita dengan diagnosa kanker payudara stadium lanjut, umur 35-75 tahun dan pasien menyetujui untuk diikutsertakan dalam penelitian. Adapun kriteria eksklusinya adalah pasien wanita dengan diagnosa kanker payudara stadium dini, adanya keganasan atau kelainan hematologi sebelumnya, dan pasien yang meninggal selama waktu penelitian. Hasil: Pada penelitian ini didapatkan sebelum terapi median monosit adalah 5% (IQR 3-10%) dan sesudah pasien mendapatkan pengobatan mediannya turun menjadi 3% (IQR 1,0-7,7 menjadi lebih nyata dan bermakna (p<0,001). Analisis regresi linear dilakukan dalam analisis data orisinil dan da...

Breast Disease

BACKGROUND: Breast cancer (BC) is the most common cancer among women worldwide and a leading caus... more BACKGROUND: Breast cancer (BC) is the most common cancer among women worldwide and a leading cause of death in Indonesia. The primary treatment of locally advanced BC is neoadjuvant chemotherapy (NAC). The rapid proliferation of tumor cells in a neoplastic microenvironment is largely due to hypoxia, which also encourages the development of chemoresistant BC. The master regulator of the hypoxia response is hypoxia-inducible factor-1α (HIF-1α). The response evaluation criteria in solid tumors (RECIST) is an objective response metric that demonstrates the efficacy of a NAC based mostly on the size of the tumor. Ca15-3 is the protein product of the MUC1 gene and is the most widely used serum marker in BC. The purpose of this study is to investigate the relationship between HIF-1α and RECIST and between Ca15-3 and RECIST and to assess the relationship among all of them in BC. METHODS: This observational study used the prospective cohort method included 11 patients with histopathologicall...

e-CliniC, 2021

Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally a... more Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally advanced breast cancer. Therapeutic response can be objectively assessed with RECIST and Ca 15-3 could be used to monitor response to breast cancer (BC) treatment. This study was aimed to prove the relationship between Ca 15-3 and response to neoadjuvant chemotherapy in locally advanced BC. The study was carried out at the Departement of Surgery Prof. Dr. R. D. Kandou Hospital Manado using a single-arm pre-post trial. Each patient would be performed Ca 15-3 test and clinical assessment (RECIST) pre and post chemotherapy for two sessions. There were 11 BC patients with invasive ductal carcinoma. The average age was 60 years old and the majority had anemia and lymphocytopenia. There was a decrease in Ca 15-3 in each patient by a baseline of 21.8 U/mL pre-treatment and a decrease in the lesion size by 30.3 mm using RECIST. The results showed that changes in RECIST and Ca 15-3 level were correlated with each unit change in RECIST was associated with a decrease in Ca 15-3 level by 0.03 units (p=0.019). In conclusion, there was a decrease in Ca 15-3 level in response to chemotherapy, followed by a decrease in RECIST. There was a relationship between Ca 15-3 level and chemotherapy response assessed with RECIST after the second chemotherapy.

Medical Scope Journal, 2021

Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been u... more Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been used as a substitute for scalpels but has not been accepted as standard due to burns and injuries. Patient and observer scar assessment scale (POSAS) is a subjective scar assessment of the patient as well as the observer. This study was aimed to compare post-skin-incision scarring of monopolar electrosurgery and scalpel, and evaluate the appropriateness of scar assessments of the observer and the patient by using POSAS. This was a self-controlled trial design. Post-incision scar tissue assessment was carried out simultaneously by the observer and the patient in the third month after the operation was completed. The paired t test or Wilcoxon rank sum test showed that the differences of assessments of either patient or observer or both were not significant (p=0.05). The correlation test between the total POSAS scores of the patient and observer assessments showed a moderate linear relationship (r=0.51; p<0.001). In conclusion, the use of monopolar electrosurgery and scalpel in performing skin incisions resulted in the formation of equally good scar tissues. The POSAS assessments of patient and observer showed a moderate degree of similarity.

Annals of Medicine and Surgery

Annals of Medicine and Surgery

e-Clinic: Jurnal Ilmiah Kedokteran Klinik, Feb 19, 2024

Primary breast lymphoma is rare and it accounts for around 0.5% of malignant breast neoplasms. Sm... more Primary breast lymphoma is rare and it accounts for around 0.5% of malignant breast neoplasms. Small lymphocytic lymphoma (SLL) is a subtype of non-Hodgkin lymphoma originating from a B-cell lineage. This report presents a case of primary SLL of the breast with lung metastasis that had excellent clinical response. We reported a 67-year-old female complained a right breast mass that suddenly appeared after she got massage on her right left arm. The mass was swollen and painless with no systemic complications. The specimen was submitted to histopathology department and it revealed small diffuse lymphocytic lymphoma. Chest X-ray showed a lung metastasis. The patient was then treated with CHOP regimens (Cyclophosphamid, Doxorubicin, Vincristin, and Prednison) and the clinical result was excellent. The side effects of the medication were minimal. In conclusion, primary breast lymphocytic lymphoma is rare and this case highlights the differential diagnosis for a painless breast mass. The treatment must be individualized and multimodal, with chemotherapy being the most accepted treatment.

e-Clinic: Jurnal Ilmiah Kedokteran Klinik, Feb 15, 2024

Burn is caused by exposure to high-temperature substances such as hot, solid liquids or gases suc... more Burn is caused by exposure to high-temperature substances such as hot, solid liquids or gases such as smoke, steam, engines, stoves, radiators and objects that emit heat energy. In severe burns, there is an excessive neutrophil inflammatory response that triggers SIRS, where there is an excessive increase in pro-inflammatory mediators such as TNF-α and IL-6. Propolis contains a number of compounds, such as flavonoids, CAPE, phenol compounds, arginine, ferulic acid and albumin which play a good role in healing burns. This study aimed to find out the effect of propolis on TNF-α expression through in-vivo testing in cases of superficial dermal burns. This was an experimental and laboratory study to assess the bioactive compounds contained in Trigona Sp propolis. Descriptive analysis was performed on the bioactive composition of Trigona Sp propolis and experimental effectiveness of propolis on TNF-α expression in superficial dermal burns. The study was conducted at the laboratory of experimental animals "Alike Quality System", Manado. The results showed that the group treated with propolis had smaller burn areas compared to the groups treated with 1% silver sulfadiazine or with 0.9% NaCl. Granulation had been formed throughout all wounds, however, macroscopically, burns with propolis treatment showed reddish wound appearance while treated wounds with 1% silver sulfadiazine and 0.9% NaCl were darker in color and had thicker crust formation. The one-way ANOVA test showed no significant difference between propolis and 1% silver sulfadiazine on TNF-α expression in dermal superficial burns (p=0.666) meanwhile the effect of propolis compared with NaCl 0.9% on TNF-α expression in dermal superficial burns, showed significant differences (p=0.006 and p=0.040). In conclusion, administration of propolis can reduce the expression of TNF-α in superficial dermal burn.

Phytotherapy Research, Dec 11, 2023

Medical Scope Journal (MSJ), Sep 12, 2023

Medical Scope Journal (MSJ), Feb 1, 2024

Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to... more Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to the conventional thyroidectomy, without any scar as the advantage. This study aimed to present the feasibility and safety of patients with solitary or multinodular goitre and or papillary thyroid carcinoma using TOETVA. This was a case series using 12 patients recorded undergoing TOETVA procedure. Eleven patients' specimen obtained through FNAB resulted as benign nodule. In one patient, the nodule was malignant and unilateral, therefore, endoscopic isthmolobectomy was performed. Outcomes and measures included conversion to open conventional surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue scores, and postoperative complications. The results showed a total of 12 patients; all were women, aged 33-64 years. The size of thyroid nodules ranged from 2 cm to 7 cm. One patient got converted to open isthmus lobectomy. In this series, none of the patients were noted to have mental nerve injury but two patients developed anterior neck chin skin bruise. The mean postoperative VAS measurements were 2, 1, and no pain or 0, on the first, second, third, and seventh postoperative days, respectively. In conclusion, endoscopic thyroidectomy is feasible, safe, and comparable to open thyroidectomy and yields excellent aesthetic results.

Acta Chirurgica Belgica, 2007

Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in t... more Primary liposarcoma of the thyroid gland is exceedingly rare with only five previous reports in the literature. We report a case of a 40-year-old male patient with nodular goitre with the suspicion of malignancy in Fine Needle Aspiration Biopsy. Total thyroidectomy was performed. The histopathological examination revealed a well-differentiated thyroid liposarcoma. The patient recovered uneventfully. Postoperatively, radiotherapy was given to the neck region. During a 2-year follow-up period, no recurrence of the disease occured.

JBN (Jurnal Bedah Nasional)

Tujuan: Untuk menilai hubungan antara jumlah limfosit, monosit, dan neutrofil darah tepi pada pas... more Tujuan: Untuk menilai hubungan antara jumlah limfosit, monosit, dan neutrofil darah tepi pada pasien kemoterapi neoadjuvan kanker payudara stadium lanjut lokal dengan pemberian vitamin D. Metode: Desain penelitian ini berupa single-blind, randomized placebo-controlled trial yang melibatkan 14 sampel dengan 7 sampel sebagai kelompok percobaan yang diberi vitamin D 600 IU/hari dan kelompok kontrol yang diberi plasebo. Dilakukan pengukuran kadar vitamin D, limfosit, monosit, dan neutrofil masing-masing 1 minggu pasca kemoterapi. Penelitian ini dilakukan dari bulan Oktober 2019-Maret 2020 di RSUP Prof. Dr. RD Kandou Manado. Analisa data dilakukan dengan uji ANOVA. Hasil: Kadar vitamin D pada kelompok percobaan mengalami peningkatan yang signifikan dibanding kelompok kontrol. Peningkatan kadar limfosit pada kelompok percobaan sebanyak 11% dibanding kelompok kontrol (p<0,05). Kadar monosit juga meningkat 2% pada kelompok percobaan dibanding kelompok kontrol (p<0,05), namun be...

Medical Scope Journal

Fibrocystic breast tumor is the most common benign type of breast diseases that affects millions ... more Fibrocystic breast tumor is the most common benign type of breast diseases that affects millions of women worldwide. Fibrocystic breast changes are classified as non-proliferative, proliferative without atypia, or proliferative with atypia. We reported a 34-year-old woman presented with a right breast evaluation of breast tumors since one year before admission. On examination, a solid and hard breast tumor measuring 15x10 cm was palpable, well-defined, tender, mobile, and no nipple discharge. The patient underwent two times of core biopsy and the results were fibrocystic changes. Although clinically the breast tumor had a malignant appearance, but the results of core biopsy examinations revealed fibrocystic changes. The patient was managed by wide excision of the evaluated breast tumor with preservation of the breast skin and nipple areolar complex to maintain its function and aesthetic. In conclusion, evaluation of breast tumors must go through a triple diagnostic procedure namely clinical, imaging, and histopathological examinations. Fibrocystic breast tumor can be managed with wide excision of the tumor with preservation of the skin structure and nipple areolar complex of the breast to achieve a natural aesthetic.

JBN (Jurnal Bedah Nasional)

Tujuan: Untuk menganalisa hubungan kadar monosit sel darah tepi pada sebelum dan sesudah terapi p... more Tujuan: Untuk menganalisa hubungan kadar monosit sel darah tepi pada sebelum dan sesudah terapi pada penderita kanker payudara. Metode: Penelitian ini merupakan studi analitik observasional dengan pendekatan kohort prospektif, untuk menganalisa kadar monosit darah tepi sebelum dan sesudah terapi pada penderita kanker payudara. Kriteria inklusi penelitian ini, yaitu: pasien wanita dengan diagnosa kanker payudara stadium lanjut, umur 35-75 tahun dan pasien menyetujui untuk diikutsertakan dalam penelitian. Adapun kriteria eksklusinya adalah pasien wanita dengan diagnosa kanker payudara stadium dini, adanya keganasan atau kelainan hematologi sebelumnya, dan pasien yang meninggal selama waktu penelitian. Hasil: Pada penelitian ini didapatkan sebelum terapi median monosit adalah 5% (IQR 3-10%) dan sesudah pasien mendapatkan pengobatan mediannya turun menjadi 3% (IQR 1,0-7,7 menjadi lebih nyata dan bermakna (p<0,001). Analisis regresi linear dilakukan dalam analisis data orisinil dan da...

Breast Disease

BACKGROUND: Breast cancer (BC) is the most common cancer among women worldwide and a leading caus... more BACKGROUND: Breast cancer (BC) is the most common cancer among women worldwide and a leading cause of death in Indonesia. The primary treatment of locally advanced BC is neoadjuvant chemotherapy (NAC). The rapid proliferation of tumor cells in a neoplastic microenvironment is largely due to hypoxia, which also encourages the development of chemoresistant BC. The master regulator of the hypoxia response is hypoxia-inducible factor-1α (HIF-1α). The response evaluation criteria in solid tumors (RECIST) is an objective response metric that demonstrates the efficacy of a NAC based mostly on the size of the tumor. Ca15-3 is the protein product of the MUC1 gene and is the most widely used serum marker in BC. The purpose of this study is to investigate the relationship between HIF-1α and RECIST and between Ca15-3 and RECIST and to assess the relationship among all of them in BC. METHODS: This observational study used the prospective cohort method included 11 patients with histopathologicall...

e-CliniC, 2021

Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally a... more Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally advanced breast cancer. Therapeutic response can be objectively assessed with RECIST and Ca 15-3 could be used to monitor response to breast cancer (BC) treatment. This study was aimed to prove the relationship between Ca 15-3 and response to neoadjuvant chemotherapy in locally advanced BC. The study was carried out at the Departement of Surgery Prof. Dr. R. D. Kandou Hospital Manado using a single-arm pre-post trial. Each patient would be performed Ca 15-3 test and clinical assessment (RECIST) pre and post chemotherapy for two sessions. There were 11 BC patients with invasive ductal carcinoma. The average age was 60 years old and the majority had anemia and lymphocytopenia. There was a decrease in Ca 15-3 in each patient by a baseline of 21.8 U/mL pre-treatment and a decrease in the lesion size by 30.3 mm using RECIST. The results showed that changes in RECIST and Ca 15-3 level were correlated with each unit change in RECIST was associated with a decrease in Ca 15-3 level by 0.03 units (p=0.019). In conclusion, there was a decrease in Ca 15-3 level in response to chemotherapy, followed by a decrease in RECIST. There was a relationship between Ca 15-3 level and chemotherapy response assessed with RECIST after the second chemotherapy.

Medical Scope Journal, 2021

Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been u... more Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been used as a substitute for scalpels but has not been accepted as standard due to burns and injuries. Patient and observer scar assessment scale (POSAS) is a subjective scar assessment of the patient as well as the observer. This study was aimed to compare post-skin-incision scarring of monopolar electrosurgery and scalpel, and evaluate the appropriateness of scar assessments of the observer and the patient by using POSAS. This was a self-controlled trial design. Post-incision scar tissue assessment was carried out simultaneously by the observer and the patient in the third month after the operation was completed. The paired t test or Wilcoxon rank sum test showed that the differences of assessments of either patient or observer or both were not significant (p=0.05). The correlation test between the total POSAS scores of the patient and observer assessments showed a moderate linear relationship (r=0.51; p<0.001). In conclusion, the use of monopolar electrosurgery and scalpel in performing skin incisions resulted in the formation of equally good scar tissues. The POSAS assessments of patient and observer showed a moderate degree of similarity.

Annals of Medicine and Surgery

Annals of Medicine and Surgery