Pingkan Siregar - Academia.edu (original) (raw)

Uploads

Papers by Pingkan Siregar

Research paper thumbnail of Induction of Hepatocellular Carcinoma in Conventional Domestic Swine Using N-Diethylnitrosamine and Phenobarbital

Cancer management and research, Mar 1, 2024

Large animal models are still used in many studies because of their likeness to humans. It has no... more Large animal models are still used in many studies because of their likeness to humans. It has not been documented that regular-sized conventional farm-breed pigs, generally bred for meat production, can be used to generate hepatocellular carcinoma (HCC) animal models. The goal of this study was to investigate how N-diethylnitrosamine (DENA) and phenobarbital (PB) together can generate HCC in ordinary farmed pigs. Materials and Methods: Conventional domestic swine (Sus scrofa domesticus) were used. DENA 15 mg/kg was intraperitoneally injected weekly for 12 weeks, while PB tablets (4 mg/kg) were also administered through food for 16 weeks. Blood testing and ultrasonography evaluation were performed to monitor the progress. Subsequently, computed tomography was conducted in cases with suspected nodules, followed by histopathological examination to confirm the diagnosis. Results: Ten swine (seven males, three females; age: 2 months; weight: 9-15 kg) were included in the study and followed up for 25 months; nine were experimental, and one was control for ethical considerations. The maximum weight of animals during this study reached 162-228 kg. The weight gain seen in the intervention swine was predominantly lower than that documented in the control. The laboratory analysis revealed no notable abnormalities in liver function markers but did demonstrate statistically significant changes in urea (p = 0.028) and creatinine (p = 0.003) levels. Ultrasonography and computed tomography showed multiple liver nodules with characteristics resembling HCC. Serial imaging screening and more extended observations revealed that all animals eventually developed tumors. Histopathological confirmation at 15-22 weeks post-induction revealed that all intervened swine developed multiple nodules of well-differentiated HCC and some with hepatic angiosarcoma. Conclusion: This study successfully generated HCC in conventional domestic swine with a DENA and PB combination. This investigation required at least 15 months to develop tumors. This model will be beneficial for future investigations of HCC in large animals.

Research paper thumbnail of Histopathological and biomarker complete response after neoadjuvant chemotherapy of advanced stage yolk sac tumor of the ovary: A case report and literature review

International Journal of Surgery Case Reports

Research paper thumbnail of Diagnostic Challenge: Distinguishing Uterine Fibroid with Cystic Degeneration vs. Ovarian Cystic Malignancy. A Case Report

Journal of Radiology Case Reports

Our case is a 24-year-old woman who has had abdominal enlargement for eleven months. She had an a... more Our case is a 24-year-old woman who has had abdominal enlargement for eleven months. She had an abdominal mass with an elevated level of CA-125 and imaging studies showed a pelvic cystic mass with a solid part, and thus malignancy was considered in the differential diagnosis. A laparotomy myomectomy was performed. Postoperative histopathological examination results revealed no signs of malignancy. In this case, both ultrasonography and magnetic resonance imaging could not visualize both ovaries and the stalk of the pedunculated fibroid on the posterior uterine corpus. On physical examination and imaging, cystic degeneration of uterine fibroid may present like an ovarian mass. Preoperative diagnosis is challenging. A definitive diagnosis is only feasible postoperatively following histological examination.

Research paper thumbnail of Isolated pancreatic tuberculosis with splenic tuberculosis mimicking lymphoma malignum: A case report

Radiology Case Reports

Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents... more Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents in the lungs, but it may also appear within the abdomen, such as in the pancreas. There can be challenges in diagnosing isolated pancreatic tuberculosis as it may mimic other diseases radiologically. We present a 33-year-old female with intermittent abdominal pain and weight loss. Chest x-rays showed normal findings while noncontrast abdominal computed tomography (CT) showed a solid cystic mass in the pancreas and in the spleen. Contrast-enhanced CT showed an inhomogeneous cystic mass in the body and tail of the pancreas with peripheral rim enhancement. A laparotomy procedure was performed, and tuberculosis was confirmed histopathologically. In this case report, we highlight the challenging nature of diagnosing isolated pancreatic and splenic tuberculosis due to its presentation, which is similar to other neoplastic processes.

Research paper thumbnail of Ultrasonography findings in diabetes and diabetes gastroparesis: A meta-analysis

F1000Research

Background: The gold standard for diagnosis of diabetes gastroparesis (DG) is with gastric emptyi... more Background: The gold standard for diagnosis of diabetes gastroparesis (DG) is with gastric emptying scintigraphy (GES) examination. However, GES is not available in every healthcare center worldwide and the examination cost is rather expensive, unlike ultrasonography (USG) examination. This study aims to evaluate gastric changes monitored with USG in diabetes mellitus (DM) and DG. Methods: We performed searches from Google Scholar, PubMed, Science Direct, Proquest, and Scopus in April 30 – May 6, 2022. Random-effect approach on outcomes, standardized mean-difference (SMD) and 95%-confidence interval (CI) was assessed. Results: Compared to healthy control; (1) Antral cross-sectional area (CSA) in DM is bigger in fasting (SMD=1.25cm2; 95%CI, 0.79 to 1.71, I2=81%, P<0.05) and postprandial (SMD=3.70 cm2; 95%CI, 1.45 to 5.34, I2=85%, P<0.05). (2) Gastric emptying time (GET) is longer with DG (SMD=75.44min; 95%CI, 31.61 to 119.27, I2=97%) and in DM (SMD=35.54min; 95% CI, 11.49 to 5...

Research paper thumbnail of Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review

Research paper thumbnail of Mucinous ovarian cancer metastasis to cervix: a rare case report

Contents and immune checkpoint inhibitor, but predictive biomarkers are lacking. We performed gen... more Contents and immune checkpoint inhibitor, but predictive biomarkers are lacking. We performed genomic profiling and characterized specific genes associated with an increased tumor mutational burden (TMB) in Chinese patients with ovarian cancer (OC). OC accounts for high rates of relapse and mortality among people with solid tumors worldwide. As traditional treatments are limited and often intolerant for patients with advanced ovarian cancer, PARP inhibitors and immunotherapy may breakthrough therapies patients immunotherapy could be a better option. In order to explore the potential use of immunotherapy biomarkers, our study aimed to assess gene alteration and its correlations with microsatellite instability (MSI), TMB and tumor neoantigens burden (TNB) in Chinese CLC populations. Methods: A total of 201 female Chinese patients with OC (including primary peritoneal cancer and fallopian tube cancer) were involved from February 2020 to July 2021. All paired specimens were detected by OncoDrug-Seq™ 603-gene panel assay through next generation sequencing using Illumina NovaSeq 6000. Results: TP53 (62.7%) was the gene with highest mutation frequency, followed by BRCA1 (18.9%), KRAS (11.9%), ARID1A (9.5%), PIK3CA (9.0%), NF1 (6.0%), and BRCA2 (6.0%). Further analysis showed that TP53 alterations (84.6%, n=11/13) were significantly more common in high-grade serous carcinoma than other histological subtypes. Variations detected included fusions (1.4%), duplication (4.5%), and deletion (4.0%). Among them the fusions were RET-CCDC6, BRAF-KIAA1549, NRG1-DIP2B, ERBB2-MACROD2, especially, the latter 2 fusions occurred simultaneously in one patient. Mutational incidences of significant pathway were also analyzed. Five signal pathways, including JAK-STAT (1.4%), MAPK (74.6%), EGFR (28.9%), WNT (63.7%), and TGFB (1.0%) were related to mutational incidences. Correlation analysis between TMB and mutation status in OC (n=110) showed that the OC with RAD50 (n=4) or PALB2 (n=3) mutation patterns had higher TMB (mean values 20.3, 25.5, respectively, p<0.05), while the MSI status showed no significant difference (p>0.05). Conclusion: The landscape of mutation patterns and MSI, and TMB among Chinese OC populations in this study will further assist the utilization of these biomarkers to immunotherapy strategies.

Research paper thumbnail of Additional diagnostic value of digital radiology in plantar fasciitis diagnosis

Medical Journal of Indonesia, 2017

Research paper thumbnail of Recurrent cervical carcinoma presenting as periumbilical abdominal wall mass treated with wide excision followed by reconstruction using surgical mesh: a rare case report

Proceedings of the 7th Biennial Meeting of Asian Society of Gynecologic Oncology, 2021

Aims: Catheter ablation should be considered in patients with atrial fibrillation (AF) and with h... more Aims: Catheter ablation should be considered in patients with atrial fibrillation (AF) and with heart failure (HF) with reduced ejection fraction (EF; HFrEF) to improve survival and reduce heart failure hospitalization. Careful patient selection for AF ablation is key to achieving similar outcome benefits. However, limited data exist regarding predictors of recovered ejection fraction. We aimed to evaluate the predictors of recovered ejection fraction in consecutive patients with HF undergoing AF ablation. Methods and Results: A total of 156 patients [67.3% men, median age 63 (11)] with AF and HF underwent initial catheter ablation between September 2017 and October 2019 in the First Affiliated Hospital of Dalian Medical University. Overall, the percentage of recovered ejection fractions was 72.3%. Recovered EFs were associated with a 39% reduction in all-cause hospitalization compared to non-recovered EFs at the 1-year follow-up [23.8 vs. 62.8 (odds ratio) OR 2.09 (1.40-3.12), P < 0.001]. Univariate analysis for recovered EFs showed that diabetes (P = 0.083), prevalent HF (P = 0.014), prevalent AF (P = 0.051), LVEF (P = 0.022), and E/E ′ (P = 0.001) were associated with EF improvement. Multivariate analysis showed that the only independent predictor of EF recovery was E/E ′ [OR 1.13 (1.03-1.24); P = 0.011]. A receiver operating characteristic analysis determined that the suitable cutoff value for E/E ′ was 15 (sensitivity 38.7%, specificity 89.2%, the area under curve 0.704). Conclusions: Ejection fraction (EF) recovery occurred in 72.3% of patients, associated with a 39% reduction in all-cause hospitalization compared to the non-recovered EFs in our cohort. The only independent predictor of recovered EF was E/E ′ < 15 in our series.

Research paper thumbnail of Rare case of huge vulvar angiomyofibroblastoma in a young female

Gynecologic Oncology Reports, 2021

Highlights • Huge angiomyofibroblastoma of the Vulva.• Differential diagnosis between vulvar angi... more Highlights • Huge angiomyofibroblastoma of the Vulva.• Differential diagnosis between vulvar angiomyofibroblastoma and vulvar aggressive angiomyxoma.• Comprehensive approach diagnosing and therapy of vulvar angiomyofibroblastoma.

Research paper thumbnail of Peran Magnetic Resonance Imgaging Dalam Diagnosis Dan Prognosis Cedera Medula Spinalis Akut

ABSTRACTSpinal cord injury is a common type of injury that can be highly fatal. Clinically, spina... more ABSTRACTSpinal cord injury is a common type of injury that can be highly fatal. Clinically, spinal cord injury can be assessed using standardized physical examination scoring from International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients, which is the American Spinal Injury Association (ASIA) impairment scale or often called as AIS. The results of this scoring will then be combined with magnetic resonance imaging (MRI) examination to determine the diagnosis and prognosis

Research paper thumbnail of Adult granulosa cell tumor with minor foci of juvenile granulosa cell tumor in postmenopausal woman: A rare case report

International Journal of Surgery Case Reports

Research paper thumbnail of Induction of Hepatocellular Carcinoma in Conventional Domestic Swine Using N-Diethylnitrosamine and Phenobarbital

Cancer management and research, Mar 1, 2024

Large animal models are still used in many studies because of their likeness to humans. It has no... more Large animal models are still used in many studies because of their likeness to humans. It has not been documented that regular-sized conventional farm-breed pigs, generally bred for meat production, can be used to generate hepatocellular carcinoma (HCC) animal models. The goal of this study was to investigate how N-diethylnitrosamine (DENA) and phenobarbital (PB) together can generate HCC in ordinary farmed pigs. Materials and Methods: Conventional domestic swine (Sus scrofa domesticus) were used. DENA 15 mg/kg was intraperitoneally injected weekly for 12 weeks, while PB tablets (4 mg/kg) were also administered through food for 16 weeks. Blood testing and ultrasonography evaluation were performed to monitor the progress. Subsequently, computed tomography was conducted in cases with suspected nodules, followed by histopathological examination to confirm the diagnosis. Results: Ten swine (seven males, three females; age: 2 months; weight: 9-15 kg) were included in the study and followed up for 25 months; nine were experimental, and one was control for ethical considerations. The maximum weight of animals during this study reached 162-228 kg. The weight gain seen in the intervention swine was predominantly lower than that documented in the control. The laboratory analysis revealed no notable abnormalities in liver function markers but did demonstrate statistically significant changes in urea (p = 0.028) and creatinine (p = 0.003) levels. Ultrasonography and computed tomography showed multiple liver nodules with characteristics resembling HCC. Serial imaging screening and more extended observations revealed that all animals eventually developed tumors. Histopathological confirmation at 15-22 weeks post-induction revealed that all intervened swine developed multiple nodules of well-differentiated HCC and some with hepatic angiosarcoma. Conclusion: This study successfully generated HCC in conventional domestic swine with a DENA and PB combination. This investigation required at least 15 months to develop tumors. This model will be beneficial for future investigations of HCC in large animals.

Research paper thumbnail of Histopathological and biomarker complete response after neoadjuvant chemotherapy of advanced stage yolk sac tumor of the ovary: A case report and literature review

International Journal of Surgery Case Reports

Research paper thumbnail of Diagnostic Challenge: Distinguishing Uterine Fibroid with Cystic Degeneration vs. Ovarian Cystic Malignancy. A Case Report

Journal of Radiology Case Reports

Our case is a 24-year-old woman who has had abdominal enlargement for eleven months. She had an a... more Our case is a 24-year-old woman who has had abdominal enlargement for eleven months. She had an abdominal mass with an elevated level of CA-125 and imaging studies showed a pelvic cystic mass with a solid part, and thus malignancy was considered in the differential diagnosis. A laparotomy myomectomy was performed. Postoperative histopathological examination results revealed no signs of malignancy. In this case, both ultrasonography and magnetic resonance imaging could not visualize both ovaries and the stalk of the pedunculated fibroid on the posterior uterine corpus. On physical examination and imaging, cystic degeneration of uterine fibroid may present like an ovarian mass. Preoperative diagnosis is challenging. A definitive diagnosis is only feasible postoperatively following histological examination.

Research paper thumbnail of Isolated pancreatic tuberculosis with splenic tuberculosis mimicking lymphoma malignum: A case report

Radiology Case Reports

Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents... more Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents in the lungs, but it may also appear within the abdomen, such as in the pancreas. There can be challenges in diagnosing isolated pancreatic tuberculosis as it may mimic other diseases radiologically. We present a 33-year-old female with intermittent abdominal pain and weight loss. Chest x-rays showed normal findings while noncontrast abdominal computed tomography (CT) showed a solid cystic mass in the pancreas and in the spleen. Contrast-enhanced CT showed an inhomogeneous cystic mass in the body and tail of the pancreas with peripheral rim enhancement. A laparotomy procedure was performed, and tuberculosis was confirmed histopathologically. In this case report, we highlight the challenging nature of diagnosing isolated pancreatic and splenic tuberculosis due to its presentation, which is similar to other neoplastic processes.

Research paper thumbnail of Ultrasonography findings in diabetes and diabetes gastroparesis: A meta-analysis

F1000Research

Background: The gold standard for diagnosis of diabetes gastroparesis (DG) is with gastric emptyi... more Background: The gold standard for diagnosis of diabetes gastroparesis (DG) is with gastric emptying scintigraphy (GES) examination. However, GES is not available in every healthcare center worldwide and the examination cost is rather expensive, unlike ultrasonography (USG) examination. This study aims to evaluate gastric changes monitored with USG in diabetes mellitus (DM) and DG. Methods: We performed searches from Google Scholar, PubMed, Science Direct, Proquest, and Scopus in April 30 – May 6, 2022. Random-effect approach on outcomes, standardized mean-difference (SMD) and 95%-confidence interval (CI) was assessed. Results: Compared to healthy control; (1) Antral cross-sectional area (CSA) in DM is bigger in fasting (SMD=1.25cm2; 95%CI, 0.79 to 1.71, I2=81%, P<0.05) and postprandial (SMD=3.70 cm2; 95%CI, 1.45 to 5.34, I2=85%, P<0.05). (2) Gastric emptying time (GET) is longer with DG (SMD=75.44min; 95%CI, 31.61 to 119.27, I2=97%) and in DM (SMD=35.54min; 95% CI, 11.49 to 5...

Research paper thumbnail of Magnetic resonance imaging pitfalls in determining myometrial invasion in stage I endometrial cancer: A case report and literature review

Research paper thumbnail of Mucinous ovarian cancer metastasis to cervix: a rare case report

Contents and immune checkpoint inhibitor, but predictive biomarkers are lacking. We performed gen... more Contents and immune checkpoint inhibitor, but predictive biomarkers are lacking. We performed genomic profiling and characterized specific genes associated with an increased tumor mutational burden (TMB) in Chinese patients with ovarian cancer (OC). OC accounts for high rates of relapse and mortality among people with solid tumors worldwide. As traditional treatments are limited and often intolerant for patients with advanced ovarian cancer, PARP inhibitors and immunotherapy may breakthrough therapies patients immunotherapy could be a better option. In order to explore the potential use of immunotherapy biomarkers, our study aimed to assess gene alteration and its correlations with microsatellite instability (MSI), TMB and tumor neoantigens burden (TNB) in Chinese CLC populations. Methods: A total of 201 female Chinese patients with OC (including primary peritoneal cancer and fallopian tube cancer) were involved from February 2020 to July 2021. All paired specimens were detected by OncoDrug-Seq™ 603-gene panel assay through next generation sequencing using Illumina NovaSeq 6000. Results: TP53 (62.7%) was the gene with highest mutation frequency, followed by BRCA1 (18.9%), KRAS (11.9%), ARID1A (9.5%), PIK3CA (9.0%), NF1 (6.0%), and BRCA2 (6.0%). Further analysis showed that TP53 alterations (84.6%, n=11/13) were significantly more common in high-grade serous carcinoma than other histological subtypes. Variations detected included fusions (1.4%), duplication (4.5%), and deletion (4.0%). Among them the fusions were RET-CCDC6, BRAF-KIAA1549, NRG1-DIP2B, ERBB2-MACROD2, especially, the latter 2 fusions occurred simultaneously in one patient. Mutational incidences of significant pathway were also analyzed. Five signal pathways, including JAK-STAT (1.4%), MAPK (74.6%), EGFR (28.9%), WNT (63.7%), and TGFB (1.0%) were related to mutational incidences. Correlation analysis between TMB and mutation status in OC (n=110) showed that the OC with RAD50 (n=4) or PALB2 (n=3) mutation patterns had higher TMB (mean values 20.3, 25.5, respectively, p<0.05), while the MSI status showed no significant difference (p>0.05). Conclusion: The landscape of mutation patterns and MSI, and TMB among Chinese OC populations in this study will further assist the utilization of these biomarkers to immunotherapy strategies.

Research paper thumbnail of Additional diagnostic value of digital radiology in plantar fasciitis diagnosis

Medical Journal of Indonesia, 2017

Research paper thumbnail of Recurrent cervical carcinoma presenting as periumbilical abdominal wall mass treated with wide excision followed by reconstruction using surgical mesh: a rare case report

Proceedings of the 7th Biennial Meeting of Asian Society of Gynecologic Oncology, 2021

Aims: Catheter ablation should be considered in patients with atrial fibrillation (AF) and with h... more Aims: Catheter ablation should be considered in patients with atrial fibrillation (AF) and with heart failure (HF) with reduced ejection fraction (EF; HFrEF) to improve survival and reduce heart failure hospitalization. Careful patient selection for AF ablation is key to achieving similar outcome benefits. However, limited data exist regarding predictors of recovered ejection fraction. We aimed to evaluate the predictors of recovered ejection fraction in consecutive patients with HF undergoing AF ablation. Methods and Results: A total of 156 patients [67.3% men, median age 63 (11)] with AF and HF underwent initial catheter ablation between September 2017 and October 2019 in the First Affiliated Hospital of Dalian Medical University. Overall, the percentage of recovered ejection fractions was 72.3%. Recovered EFs were associated with a 39% reduction in all-cause hospitalization compared to non-recovered EFs at the 1-year follow-up [23.8 vs. 62.8 (odds ratio) OR 2.09 (1.40-3.12), P < 0.001]. Univariate analysis for recovered EFs showed that diabetes (P = 0.083), prevalent HF (P = 0.014), prevalent AF (P = 0.051), LVEF (P = 0.022), and E/E ′ (P = 0.001) were associated with EF improvement. Multivariate analysis showed that the only independent predictor of EF recovery was E/E ′ [OR 1.13 (1.03-1.24); P = 0.011]. A receiver operating characteristic analysis determined that the suitable cutoff value for E/E ′ was 15 (sensitivity 38.7%, specificity 89.2%, the area under curve 0.704). Conclusions: Ejection fraction (EF) recovery occurred in 72.3% of patients, associated with a 39% reduction in all-cause hospitalization compared to the non-recovered EFs in our cohort. The only independent predictor of recovered EF was E/E ′ < 15 in our series.

Research paper thumbnail of Rare case of huge vulvar angiomyofibroblastoma in a young female

Gynecologic Oncology Reports, 2021

Highlights • Huge angiomyofibroblastoma of the Vulva.• Differential diagnosis between vulvar angi... more Highlights • Huge angiomyofibroblastoma of the Vulva.• Differential diagnosis between vulvar angiomyofibroblastoma and vulvar aggressive angiomyxoma.• Comprehensive approach diagnosing and therapy of vulvar angiomyofibroblastoma.

Research paper thumbnail of Peran Magnetic Resonance Imgaging Dalam Diagnosis Dan Prognosis Cedera Medula Spinalis Akut

ABSTRACTSpinal cord injury is a common type of injury that can be highly fatal. Clinically, spina... more ABSTRACTSpinal cord injury is a common type of injury that can be highly fatal. Clinically, spinal cord injury can be assessed using standardized physical examination scoring from International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients, which is the American Spinal Injury Association (ASIA) impairment scale or often called as AIS. The results of this scoring will then be combined with magnetic resonance imaging (MRI) examination to determine the diagnosis and prognosis

Research paper thumbnail of Adult granulosa cell tumor with minor foci of juvenile granulosa cell tumor in postmenopausal woman: A rare case report

International Journal of Surgery Case Reports