Gambaran Tingkat Depresi Lansia di Panti Sosial Lanjut Usia Tulungagung

The process of aging is a process of gradual disappearance of the network’s ability to improve. Depression is one of the most common disorders in the elderly who need handling holistic and balanced in the physical, mental and social. The research aim was to indentify the grade of depression elderly people in Blitar society service of elderly people at Tulungagung. The research design used descriptive research. The population of this research was all of elderly at Blitar society service of elderly people at Tulungagung. The sampel size was 45 elderly (21 men elderly and 24 women elderly) with porposive sampling. The research held on 21 febuary 2014 at Blitar society service of elderly people at Tulungagung. In this research, data was preserved in descriptive analysis with fequency table and radian diagram by percentage and narration. From the research result got the elderly had no depression amount 17,8%, the next elderly with light depression amount 22,2%, the next elderly with medium depression amount 22,2% and elderly with heavy depression amount 37,8%. From the results of researches are expected to managers elderly people in Blitar society service of elderly people at Tulungagung. improve services for the prevention of cases of depression in the elderly

Palatine Tonsil Stenting of the Airway as Determined by Drug-Induced Sleep Endoscopy

Objective. To demonstrate lateral pharyngeal wall collapse and increased apnea-hypopnea index in a child posttonsillectomy. Background. Some children have worsening of their sleep symptoms after tonsillectomy for obstructive sleep apnea. This case report demonstrates an open airway on drug-induced sleep endoscopy (DISE) in a child with tonsillar hypertrophy followed by more pronounced airway obstruction related to lateral pharyngeal wall collapse after tonsillectomy. Case Presentation. A 7-year- old boy presented with obstructive sleep apnea and underwent workup with DISE. Following adenotonsillectomy and subsequent lingual tonsillectomy with epiglottopexy, the patient’s sleep apnea symptoms and polysomnogram results worsened. Subsequent DISE showed a more narrowed oropharyngeal airway space as compared to his preoperative DISE. Discussion. Palatine tonsillar tissue may splint open the airway and prevent airway obstruction in a subset of pediatric patients. Further clinical studies are necessary to determine which children experience this phenomenon. Clinical examination using DISE can be useful in making clinical decisions prior to tonsillectomy

Negative-Pressure Wound Therapy for Ludwig’s Angina: A Case Series

Summary: Negative-pressure wound therapy (NPWT) is a well-established therapeutic approach for various complex wound classes. There is currently limited information on the use of NPWT for the scope of head and neck wounds. However, NPWT has been used successfully in some cases, including malignancy, infection, and trauma. In West Virginia, the incidence of dental-related infections leading to Ludwig’s Angina is high due to lack of access to dental care. Our case series describes the application of vacuum-based therapy in conjunction with antibiotic therapy for quick, effective closure of deep tissue infections before definitive complex wound repair via graft and flap reconstructions. Over a period of 3 months, 2 patients with submental infections extending to the lateral neck demonstrated clean, efficient wound closure with NPWT for less than 14 days while hospitalized at West Virginia University Medicine. Outpatient follow-up with these patients demonstrated excellent cosmetic outcomes with minimal contracture or hypertrophy of healing tissue. NPWT promotes wound healing through decreased edema, improved perfusion, and increased granulation of tissue based on our findings. Our series encourages the use of NPWT for initial closure of complex wounds secondary to deep neck infections

Application of Backscattered Electron Imaging and Lectin-Gold Cytochemistry to Visualize the Distribution of Glycoconjugates in a Basal Lamina

Basement membranes generally appear in transmission electron microscopy as thin, cross-sectioned profiles. Face-views are difficult to obtain particularly when their contours are curved or undulated. Such preparations are suited for the study of the distribution of basement membrane constituents through thickness but are limited for examining their spatial distribution. Scanning electron microscopy offers the potential of visualizing surface views. We have applied this approach to examining the three-dimensional distribution of glycoconjugates in a basement membrane. Large, face-views of the basal lamina related to maturation ameloblasts in the region where enamel of the rat incisor is EDTA soluble were exposed. Glycoconjugates were then revealed by incubating the segments in lectin-gold complexes and binding sites were visualized by backscattered electron imaging. This basal lamina was found to contain fucose, mannose and to be extremely rich in N-acetyl-D-galactosamine. The abundance of glycoconjugates containing the latter sugar residue may impart on this basal lamina selective properties which could regulate the movement of material into, and out of, the enamel layer

Remarkable Presentation: Anaplastic Thyroid Carcinoma Arising from Chronic Hyperthyroidism

Background. Undifferentiated anaplastic carcinoma rarely develops from chronic hyperthyroidism. Although acute hyperthy- roidism can develop prior to anaplastic transformation, chronic hyperthyroidism was thought to be a protective measure against thyroid malignancy. Methods. A 79-year-old female presented acutely to the hospital with dyspnea. She had been taking methimazole for chronic hyperthyroidism due to toxic thyroid nodules, previously biopsied as benign. Upon admission, imaging showed tracheal compression, requiring a total thyroidectomy with tracheostomy for airway management. Results. Pathology demonstrated undifferentiated anaplastic thyroid carcinoma. The patient passed away shortly after hospital discharge. Despite treatment with methimazole for many years, abrupt enlargement of her toxic multinodular goiter was consistent with malignant transformation. Chronic hyperthyroidism and toxic nodules are rarely associated with thyroid malignancy, with only one previous report documenting association with anaplastic thyroid carcinoma. Conclusion. Progressive thyroid enlargement and acute worsening of previously controlled hyperthyroidism should promote concern for disease regardless of baseline thyroid function

High-Resolution Scanning Electron Microscopy of Rat Incisor Ameloblasts

The internal three-dimensional organization of secretory and maturation stage ameloblasts was examined using field emission scanning electron microscopy. Particular attention was given to the structure of the Golgi apparatus, the distribution of smooth membrane tubulo-vesicular elements and their relationship with endosomal/lysosomal components. Rat incisors were fixed by intracardiac perfusion with glutaraldehyde, decalcified and divided into segments. The tissues were cryoprotected with glycerol and freeze-fractured. They were then macerated in osmium, and after conductive staining with osmium/tannic acid, the samples were critical-point dried and sputtered with gold. High-resolution scanning electron microscopy showed that ameloblasts contain a well-developed Golgi apparatus, even in the maturation stage where cells are generally believed not to be actively involved in protein secretion. Smooth tubulo-vesicular structures formed a complex network which extended throughout the cell. In secretory stage ameloblasts, this network reached into Tomes\u27 process and consisted of small and large tubules, and distended portions. The smaller tubules radiated from a central core of organelles towards the plasma membrane. Numerous lysosomal/endosomal elements were observed in the Golgi region, and in some cases smooth tubular portions were seen at the surface of multivesicular bodies. These data show that high-resolution scanning electron microscopy can be applied to correlate three-dimensional structural detail with the secretory and resorptive functions of ameloblasts

Tracheocutaneous Sinus following Tracheocutaneous Fistula Repair: Management Strategies in a Pediatric Patient

Objective. To present a rare case of a pediatric tracheocutaneous sinus years after repair of a tracheocutaneous fistula and to review management strategies. Background. A tracheocutaneous fistula is a common sequela of pediatric tracheostomy and can occur in as many as one in three pediatric patients. There is debate in the literature regarding optimal surgical management. Case Presentation. An 8-year-old girl presented to the emergency department with swelling and erythema over the anterior neck. Clinical exam and diagnostic imaging revealed an underlying tracheocutaneous sinus. Discussion. Complications following pediatric tracheostomy are common and range in complexity from stomal granulation to tracheocutaneous fistula. There is some debate regarding the optimal surgical management of children with tracheocutaneous fistula following tracheostomy. This report discusses the management of a pediatric child with an unusual tracheocutaneous sinus and reviews the various surgical techniques which have been described for definitive repair

Eustachian Tube Foreign Body with Endoscopic-Assisted Surgical Removal

Abstract Objectives. Foreign bodies of the external and middle ear are not uncommon; however, foreign bodies in the eustachian tube are rare. Here we describe the presentation, imaging, and endoscopic-assisted surgical management of a case of eustachian tube foreign body. Methods. A 34-year-old male was seen for evaluation of foreign body of the left eustachian tube while working with metal at a machine shop. Imaging and surgical management are highlighted and review of available literature regarding foreign bodies of the eustachian tube is presented. Results. A CT scan revealed a foreign body present approximately 1 cm into the bony eustachian tube. The patient underwent middle ear exploration which required endoscopic assistance to adequately visualize the foreign body. The foreign body was unable to be removed and required the creation of a bony tunnel lateral to the eustachian tube for visualization and access to the foreign body. Conclusions. This report presents a rare case of eustachian tube foreign body. Use of the endoscope during the surgical removal greatly enhanced the ease and safety of removal. This report also highlights the importance of ear protection with any machining and welding work