Case Report: Giant Epidermoid Cyst on the Neck with Hypopharyngeal Propulsion

Introduction: Dermoid cyst is a cystic mass lined with stratified squamous epithelium with skin adnexal structure. Histopathologically dermoid cysts consist of 3 types, namely epidermoid cysts, true dermoid cysts and teratoid cysts. Epidermoid cysts are characterized by masses with a simple squamous epithelial lining. When the cyst ruptures, it releases a cheesy white matter that smells bad. Epidermoid cysts are most commonly found in the age range of 15 and 35 years with almost the same frequency between male and female sexes. Case description: We report a case of a 52-year-old man with a lump on the left side of the neck that has been slowly growing since 1 year and a computer tomography of the neck suspected a cyst in the anterior glottis. The patient was diagnosed as a neck cyst. Management was carried out by excision of the cyst under general anesthesia and histopathological examination with the results of an Epidermoid cyst. Conclusion: Epidermoid cysts can develop in any part of the body, but are very rare on the head and neck. Definitive management of epidermoid cysts with complete excision of the cyst gives satisfactory results Keywords: Giant Epidermoid Cyst, excision, hypopharyngeal propulsio

Penatalaksanaan Kista Teratoid Leher

Kista dermoid merupakan massa kistik subkutan yang terdiri dari epitel dan struktur adneksa. Secara histopatologi terdiri dari tiga jenis yaitu kista epidermoid, dermoid sejati dan teratoid. Kista teratoid merupakan variasi jarang dari kista dermoid. Kista teratoid timbul dari diferensiasi ektodermal sel multipotensial sepanjang proses fusi embrionik. Kista ini lebih sering terjadi pada laki-laki pada usia dekade kedua dan ketiga. Kista dapat terjadi di seluruh tubuh. Dilaporkan kasus seorang laki-laki usia 49 tahun dengan benjolan di leher yang membesar secara perlahan sejak 1 bulan dan hasil Computed Tomography (CT) Scan tiroid dan leher dicurigai sebagai kista tiroglosus dan didiagnosis banding dengan kista dermoid. Dilakukan penatalaksanaan dengan eksisi kista dalam anestesi umum dan dilakukan pemeriksaan patologi anatomi dengan hasil kista teratoid. Kista teratoid dapat berkembang di bagian tubuh manapun, namun sangat jarang pada kepala dan leher. Jika kista teratoid dapat terdiagnosis lebih awal dan ditatalaksana dengan eksisi kista secara komplit, maka prognosisnya lebih baik. Dari ketiga variasi kista dermoid, hanya kista teratoid yang dapat mengalami perubahan kearah keganasan.Kata kunci: eksisi kista, histopatologi, kista teratoi

Hubungan DNA Virus Epstein-Barr, Alel HLA-DRB1 dan Polimorfisme Gen CYP2E1 dengan Kejadian Karsinoma Nasofaring pada Etnik Minangkabau

Karsinoma Nasofaring (KNF) merupakan keganasan yang memiliki pola distribusi yang unik baik berdasarkan geografis maupun kelompok etnik. Penyebab pasti KNF sampai saat ini belum diketahui secara pasti, namun diduga merupakan interaksi dari multi faktor. Infeksi virus Epstein-Barr (EBV) berinteraksi dengan kerentanan genetik dan faktor lingkungan merupakan faktor etiologi utama. Tujuan dari penelitian ini adalah untuk menganalisis hubungan DNA EBV, alel HLA-DRB1*03, HLA-DRB1*11 dan polimorfisme gen CYP2E1 (rs2031920) dengan kejadian KNF pada etnik Minangkabau. Subjek penelitian adalah pasien baru KNF etnik minangkabau, sedangkan sebagai kontrol penelitian adalah orang sehat yang juga etnik Minangkabau. Sebanyak 23 kasus KNF dan 23 kontrol yang dicocokkan jenis kelamin dan umur ±3 tahun. Persetujuan diminta sebelum disertakan dalam penelitian.Untuk pemeriksaan dilakukan pengambilan sampel darah. Load DNA EBV dihitung dengan pemeriksaan real-time quantitative PCR, alel HLA-DRB1 diperiksa dengan PCR sequence specific primers dan untuk pemeriksaan polimorfisme gen CYP2E1 dilakukan PCR sekuensing. Sebanyak 15 laki-laki dan 8 perempuan (rasio 1,87:1) dengan usia rata-rata 46,6±12,89 tahun ikut dalam penelitian. Sebagian besar kasus KNF (91,3%) adalah stadium lanjut (stadium III dan IV), dengan tipe patologi karsinoma tidak berdiferensiasi merupakan kelompok terbanyak (69,6%). Hasil pemeriksaan load DNA EBV didapatkan hasil yang sangat variatif. pada kelompok kasus KNF, 65,2% memiliki load DNA EBV >50.000 copy number/ ml, sementara pada kontrol hanya 34,8%, secara statistik terdapat hubungan antara DNA EBV dengan kejadian KNF. Frekuensi alel HLA-DRB1*03 lebih tinggi pada kontrol (26,1%) dibandingkan dengan kasus KNF (4,3%), namun secara statistik tidak signifikan (p>0,05) . Di sisi lain, frekuensi alel HLA-DRB1*11 ditemukan lebih tinggi pada kelompok kontrol (43,5%) dibandingkan dengan kelompok KNF (4,3%), hubungan ini secara statistik bermakna (p0,05). Penelitian ini menyimpulkan bahwa terdapat hubungan DNA virus Epstein-Barr dan alel HLA-DRB1*11 dengan kejadian karsinoma nasofaring pada etnik Minangkabau. Sementara alel HLA-DRB1*03 dan polimorfisme gen CYP2E1 (rs2031920) tidak berhubungan dengan kejadian karsinoma nasofaring pada etnik Minangkabau. Kata Kunci: DNA EBV, alel HLA-DRB1, polimorfisme CYP2E1, Karsinoma Nasofaring, Minangkabau

Case Report: Ranula and Sublingual Glands Extirpation as Intraoral Ranula Procedures

Ranula is a cystic lesion that develops from saliva extravasation caused by trauma to the sublingual gland or the occurrence of duct blockages. The ranula is divided into intraoral (simple ranula) and plunging ranula. There are several options of methods in the management of ranulas such as sclerotherapy, marsupialization, and extirpation with or without gland removal involved, incision and drainage with intraoral approach, excision lesions with the extra-oral approach. A case of ranula was reported in a girl aged 12 years diagnosed with intraoral ranula (simple ranula). Treatment is done by performing ranula extirpation accompanied by the removal of the sublingual gland and its ducts.  The extirpation of the ranula followed by removal of the involved sublingual salivary gland gave satisfactory results with no recurrence until 1 year of follow-up on the management of intra-oral ranula.   Keywords: ranula, simple ranula, intraoral ranul

Simulation and experimental study of double holes film cooling

In the modern gas turbine, film cooling has been widely used to provide thermal protection for the external surface of the gas turbine blades. Numerous number of geometrical arrangement film cooling have been presented for the past 50 years. The main inspiration of the presented geometrical arrangements film cooling are to minimize the effect of lift off phenomena caused by the formation of the Counter Rotating Vortex Pair (CRVP) which commonly discovered in the Single Cylindrical Hole (SCH) arrangement. In order to reduce the CRVP effects, tremendous efforts from the past researchers have been made including the introduction of the Double Cylindrical Hole (DCH). The present study has made use this DCH along with the employment of several geometrical arrangements including pitch distance (POD), length between holes in streamwise direction (LoD), compound angle and upstream ramp. The evaluation of these parameters involved three different blowing ratios, M and two value of the turbulence intensities, Tu. The diameter of the cooling holes in the present study is 4.75mm which taken based on the previous study. The present study has been divided into two major studies namely experimental study and simulation study. The purpose of the experimental study is to validate the present simulation study which making use of an open end wind tunnel. As the validation process shows a good agreement results, 14 more models have been built and tested using simulation study which the total cases considered are 105. As for the result, all the considered cases of DCH shows improvement in comparison with SCH. Each of the considered geometries and flow parameters have their own effects on the film cooling effectiveness which will be elaborate in details in the further chapter. As conclusion, the simulation is having good agreement with the present experimental study and the previous study which is essential to confirm the reliability of the study. Meanwhile, all DCH shows improvement in term of film cooling effectiveness on each of blowing ratio value