Penile granuloma caused by liquid silicone injection

Various alloplastic injectable implants have been developed for soft tissue augmentation withoutsurgery. Silicone is a polymer from a family of chemically related organo-silicone compounds that mayexist in any state from a fluid to a solid. Injectable liquid silicone has been used for various cosmetictreatments, mainly for soft tissue augmentation, for example lip, cheek, breast, buttock, and penile. Liquidsilicone has been implicated in variety of adverse inflammatory reactions, sometimes resulting in tissuedestruction.We describe an adverse granulomatous reaction after the injection of liquid silicone for penile augmentation.Penile granuloma can occur as an adverse effect of penile enlargement with the injection of high viscositysolution, like silicone (siliconoma), paraffin (paraffinoma), vaseline or mineral oil. Penile granuloma is arare case which needs an accurate management.We found 30-years old man that occurs 5 weeks after non medical injection of liquid silicone. Surgicalmanagement was done with an excision of the granuloma and round incision on the upper penile, exceptthe urethral part. There were no complications following the treatment. Histopathology examination showedthe appearance of silicone-like foreign body granuloma and fibrosis of the preputium. It is concluded that Injection liquid silicone for penile augmentation could cause adverse granulomatous. Surgical management can be done with an excision of the granuloma.Keywords: liquid silicone, penile granuloma, surgical excision

A comparison study on the blood transfusion reaction between the elective and the emergency operation’s patients

Blood transfusion is principally a process of transferring blood or blood components from one individual (the donor) toanother individual (the recipient). Blood transfusion can be either a life saving condition or a life threatening situation dueto the complications happened. Therefore, blood transfusion should be conducted with clear and accurate indication inorder to obtain a condition in which the advantages outweighs the disadvantages. The aim of this study was to evaluatethe differences of the blood transfusion reactions between the patients underwent the emergency surgery with theelective surgery. This was a cross sectional study using data from the medical records from January to December 2009and from the observation on blood transfusion patients from January to May 2010. Data were analyzed using independentt-test, Chi-square test or the logistic regression, with 95% confidence interval (p0.05). In conclusion, blood transfusion reactions happened morefrequently in emergency surgery than elective surgery. The WB also generated transfusion reaction more frequently thanthe PRC. The amount of blood required based on hemoglobin correction formula for most patients was similar to the bloodtransfused.Key words: blood transfusion-type of operation-transfusion reaction - whole blood-haemoboglobin correction formul

Lama tindakan dan kejadian komplikasi pada vasektomi tanpa pisau dibandingkan dengan vasektomi metoda standar

ABSTRACT Background: Punctured Technique of Vasectomy is a simple and refined method of vasectomy. This method was introduced to make fewer complications and to remove the fear of surgical knife. Objective: This study was aimed to assess the ease of procedure, safety, and effectiveness of Punctured Technique of Vasectomy. Methods: A prospective study of 80 acceptors has been done at Dr. Sardjito Hospital Yogyakarta from January 1991 up to Jury 1991. These subjects were randomly distributed into two groups, Punctured Method (39) and Standard Method (41). Duration of operation and complication done during operation was recorded. The follow up for complication was recorded in the second week post-operative, and sperm analyses was done in the tenth week post-operative. Results: Duration of Punctured Method (9,7179 ± 2,9731 minutes) was significantly different (p-value =0,0006) compared to that of Standard Method (12,1951 ± 3,2421 minutes). There were two complications during Punctured Method operation compared to six complications during Standard Method operation (RR =1,5495%Cl: 0,97 - 2,46). In the second post-operative week, there was no complication in the Punctured Method group, while there was one wound infection in the Standard Method group. Sperm analysis both groups showed no active spermatozoon. Conclusion: Punctured Method is easier than Standard Method, and there was no difference of effectiveness in both methods. Key words: punctured vasectomy - complications - sperm - analysis Latar Belakang: Vasektomi Tanpa Pisau (VTP) merupakan penyederhanaan dan penyempurnaan teknik vasektomi. Metode ini diperkenalkan untuk memperkecil komplikasi dan mempermudah pemasyrakatannya terutama ditujukan pada orang yang takut pisau operasi. Tujuan Penelitian: untuk menilai beberapa aspek klinis terutama kemudahan, keamanan, dan efektivitas VTP dibandingkan dengan Vasektomi Metode Standar (VP). Bahan dan cara penelitian: Penelitian prospektif terhadap 80 akseptor Keluarga Berencana Mantap yang menjalani vasektomi baik dengan metode VTP maupun metode VP di Poliklinik Kontrasepsi Mantap RSUP Dr. Sardjito Yogyakarta mulai dari Januari 1991 sampai dengan Juli 1991. Subjek penelitian dibagi dalam dua kelompok secara acak, metode VTP sebanyak 39 orang dan metode VP sebanyak 41 orang. Lama tindakan dan komplikasi yand terjadi dicatat mulai dari pemberian antiseptik pada medan operasi sampai selesai menutup luka vasektomi. Pemeriksaan komplikasi dilakukan pada minggu kedua setelah operasi dan analisis sperma dilakukan pada minggu ke-sepuluh. Hasil penelitian: Rerata lama tindakan metode VTP (9,7179 ± 2,9731 menit) berbeda bermakna (p=0,0006) dibandingkan rerata lama tindakan metode VP (12,1951 ± 3,2421 menit). Kelompok VP mempunyai risiko relatif 1,54 kali dari kelompok VTP untuk terjadinya komplikasi, tetapi uji statistik menunjukkan bahwa tidak ada perbedaan bermakna untuk terjadinya komplikasi pada kedua kelompok (RR =1,5495%CI: 0,97 - 2,46). ..

The effect of human saliva compared to Aloe vera on wound healing of 2nd degree burn injury in animal models

Burn injury is one of the common causes of injury that has relatively high morbidity and mortality. Several studies using herbal and traditional medicine from different countries have been documented in burn injury management. Human saliva that contains antibacterial, antifungal, antiviral and analgesic components as well as growth factors can induce re-epithelialization process in 2nd degree burn injury. Whereas, Aloe vera that influence a physiological moist condition was proven can induce re-epithelialization process lead to faster wound healing. This study aimed to compare topical application of human saliva and A. vera on wound healing process of 2nd degree burn injury. This was an experimental study using post-test only control group design using 27 white rats (Rattus novergicus) of Sprague Dawley strain divided into 3 groups with 9 rats in each group. Group I were applied 1 mL of human saliva, Group II were applied A. vera and Group III as control were applied NaCl. Change in body weight and macroscopic clinical assessment were observed every day for 14 days, whereas histological examination was observed on day 14. The data were presented as mean ± standard error of the mean (SEM) and analyzed using one-way analysis of variance (Anova). The result showed that the wound healing process at each treatment showed different level. The human saliva application tended to show faster wound healing process of 2nd degree burn injury compare with A. vera or NaCl (

Assessment of maximal urinary flow rate (Qmax) of urethral stricture patients three weeks post internal urethrotomy Sachse in Dr. Sardjito General Hospital Yogyakarta

Urethral stricture is a common urologic problem in developing countries including Indonesia dueto its high prevalence. Internal urethrotomy is still the gold standard to return patients to a stateof normal voiding. To evaluate the outcome of the internal urethrotomy, uroflowmetry assessmentcan be conducted with its principal variable of maximal urinary flow rate (Qmax). Since 1985, inDr. Sardjito General Hospital Yogyakarta, the internal urethrotomy has been used as the maintreatment modality to manage the urethral stricture. However, its outcome has not beenevaluated. The aim of this study was to evaluate Qmax of urethral stricture patients postinternal urethrotomy Sachse in Dr. Sardjito General Hospital. This was a cross-sectional studyperformed starting from November 2009 to April 2010. The Qmax was assessed using theuroflowmeter three weeks after internal urethrotomy. The length and the locations of the patients’stricture, as well as its correlation with Qmax were also measured and evaluated. Among 24patients selected, 13 patients who fulfilled the inclusion and exclusion criteria were involved inthis study. The mean of the Qmax of patients was 22.3±6.7 mL/s.The mean of Qmax ofpatients who had the length of urethral stricture of d” 2 cm (14.8±3.8 mL/s) was significantlyhigher than patients who had length of à 2 cm (6.4±2.6 mL/s) (p=0.03), whereas patients whohad the location of urethral stricture on anterior (12.4±5.4 mL/s) were not significantly differentcompared to patients who had those on posterior (8.5±4.9 mL/s) (p=0.398). In conclusion, themajority of patients returned to a state of normal urinary tract function post internal urethrotomy.The Qmax of urethral stricture patients after internal urethrotomy are influenced by the lengthof the stricture but not by its location.Keywords: urethral stricture - urethrography - Sachse - uroflowmetry - Qma

Sepsis risk factor in mount Merapi eruption victims with 2nd or 3rd degree of burn injury

Sepsis is one of the fatal complications of burns. It is the most common cause of death from burns. Burn sepsis usually occurs after a burn injury develops into infection. This study was conducted to determine correlation between age, burn area, inhalation trauma, enteral nutrition start time, escarotomy time, and albumin level of sepsis in patients with 2nd or 3rd degree burn injury. This was a cross sectional study during May to June 2012. The subjects in this study were 39 victims of mount Merapi eruption in 2010 who suffered 2nd or 3rd degree of burns injury. The result showed the correlation between widespread burns, inhalation trauma, time of escarotomy, and albumin levels with sepsis (p < 0.05). In conclusion, the risk factor for sepsis in patients with 2nd or 3rd degree of burns injury are the area of burns (> 50%), inhalation trauma, time of escarotomy (> 72 hours), and albumin levels (<3.5g/dL)

Breast reconstruction with autologous tissue following mastectomy: two case reports of a delayed conventional transverse rectus abdominismyocutaneous (TRAM) and latissimus dorsi myocutaneous (LDM) flap surgery

Breast cancer is the most common malignant tumor and the leading cause of death among females. Most women with breast cancer will undergo breast-conserving surgery (BCS) or lumpectomy, simple or total mastectomy, modified radical mastectomy or bilateral mastectomy. Breast reconstruction solves many of the problems. The goal is to return the patient to a near-normal state so that she is not handicapped in her daily living. Breast reconstruction is also intended to offer psychological benefits to women treated by mastectomy following a diagnosis of possibly terminal cancer. In these case reports, we reported two successful cosmetic reconstruction cases. The first case was a 39-years-old female with non-recurrent breast cancer consulted and was referred by the oncology surgeon to the Plastic Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Dr. Sardjito General Hospital. She wanted to undergo breast reconstruction. We planned to operate three years following mastectomy. She was diagnosed with 3B-stage of right breast cancer before. After the surgery, the patient received six series of chemotherapy. She also underwent radiotherapy 25 times and hormonal therapy. We decided to perform a transverse rectus abdominis myocutaneous (TRAM) flap surgery on her with 22 months follow up. The procedure provided good results, and the patient was satisfied. The second case was a 32-year-old woman who after excision of a phyllodes tumor and wanted breast reconstruction. Reconstruction was performed four years after tumor removal using latissimus dorsi myocutaneous (LDM) flap. The surgery provided good results, and the patient was satisfied. We reported two successful cosmetic reconstruction cases of non-recurrent 3B-stage of right breast cancer post-mastectomy after pedicled TRAM flap surgery and left breast post excision of phyllodes tumor after LDM flap surgery

The effect of mitomycin-c in keloid fibroblast cultures

ABSTRACTKeloid occurs due to hyperactivity of keloid fibroblast (KF) in proliferation, migration, collagen deposition, together with low rates of collagen degradation. These are under the responsibility of TGF-b. Mitomycin C (MC) is used for treating keloid by a topical application during surgery at the level of 0.02% to 0.08%. Unfortunately, the lowest effective level of MC for keloid has not been determined yet. We aimed to determine the lowest effective level of MC in the suppression of KF activities. Various levels of MC diluted in growth medium were administered on KF that were isolated from six patients. After 24 hours and 72 hours of incubation, cellular proliferation, collagen deposition, cellular migration and level of TGF-b, were analyzed. Application of 120 uM MC on KF culture for 24 hours could significantly reduce TGF-b production from 1265.74 ± 274.81 pg/mL to 265.17 ± 12.20 pg/mL; proliferation index from 100% to 84.01 ± 12.91%; inhibit cellular migration to 64.38 ± 3.66%; but reduce collagen depositions from 100% to only 91.13 ± 10.19%. The lowest MC level is on 30 uM or equal with 0.001%. In conclusion, the lowest level of MC can suppress the activities of KF is 0.001%. Moreover, due to low activity in inhibiting collagen deposition, MC would be better as an adjuvant drug for keloid surgery

Tarsoconjunctival-Skin Flap as Another Option in Correcting Ectropion for Oro-Ocular Cleft Reconstruction: Report of 2 Cases

Abstract Facial clefts are rare facial anomalies. Among them, oro-ocular cleft remains a challenging malformation due to ectropion of the inferior palpebra which can constitute an emergency when the patient's globe is exposed leading to exposure keratitis and blindness. Here we report surgical procedures to correct lower eyelid ectropion using tarsoconjunctival-skin flap performed on 2 cases. In conclusion, tarsoconjunctival-skin flap can be provided to effectively correct lower eyelid ectropion and is a better option when nose correction is not involved simultaneously

The occurence of complication in post punctured vasectomy vs standard method

Background: Punctured Technique of Vasectomy is a simple and refined method of vasectomy. This method was introduced to make fewer complications and to remove the fear of surgical knife.Objective: This study was aimed to assess the ease of procedure, safety, and effectiveness of Punctured Technique of Vasectomy.Methods: A prospective study of 80 acceptors has been done at Dr. Sardjito Hospital Yogyakarta from January 1991 up to Jury 1991. These subjects were randomly distributed into two groups, Punctured Method (39) and Standard Method (41). Duration of operation and complication done during operation was recorded. The follow up for complication was recorded in the second week post-operative, and sperm analyses was done in the tenth week post-operative.Results: Duration of Punctured Method (9,7179 ± 2,9731 minutes) was significantly different (p-value =0,0006) compared to that of Standard Method (12,1951 ± 3,2421 minutes). There were two complications during Punctured Method operation compared to six complications during Standard Method operation (RR =1,54; 95%Cl: 0,97 - 2,46). In the second post-operative week, there was no complication in the Punctured Method group, while there was one wound infection in the Standard Method group. Sperm analysis both groups showed no active spermatozoon.Conclusion: Punctured Method is easier than Standard Method, and there was no difference of effectiveness in both methods.Key words: punctured vasectomy - complications - sperm - analysi