Publications by authors named "Jufriady Ismy"

4 Publications

  • Page 1 of 1

Female primary urethral carcinoma: A rare case report.

Int J Surg Case Rep 2021 Aug 10;85:106100. Epub 2021 Jun 10.

Urology Department, Faculty of Medicine, Universitas Syiah Kuala, General Hospital dr. Zainoel Abidin, Banda Aceh, Indonesia.

Introduction: Primary tumors of the female urethra are exceedingly rare and account for <0.02% of the malignant disease occurring in women. This disease usually presents late and, hence, has a poor outcome. Early diagnosis is necessary to prevent further metastasis and prevent urinary catheter-dependant. Tumors arising from the distal urethra tend to be early stage and cure rates are high, however lack of knowledge about this disease is notorious, the transmission of knowledge is made only by case reports.

Case Presentation: A 76-years-old woman presented with the chief complaint of lower pelvic pain. The complaintas also accompanied by a burning sensation in the urethra and stranguria, urinary retention, and hematuria. Macroscopic observation revealed the lesion was whitish with vegetative aspect at the urethral meatus, involving the entire urethra. The fragile mass was palpable in distal urethra and external meatus urethra per vaginally and easily bleedings. Laboratory examination of blood chemistry results within normal limit. Urinalysis showed pyuria and hematuria. Urethrocystoscopy findings were whitish lesion with vegetative aspect also fragile mass along the urethra, abnormal bladder neck, and bladder mucous was hyperemis. The histopathological result showed metaplasia squamous cell carcinoma, clear cell carcinoma. She is planned on getting cystouretherectomy (anterior exenteration) later.

Clinical Discussion: The female urethral carcinoma is a disease with low prevalence with urothelial carcinoma (transitional cell) is the most common histological type (Leão et al., 2016; Adolfsson et al., 2012). Symptoms of urethral carcinoma are varied. The carcinoma spreads initially by local invasion into the periurethral tissue, vagina, and vulva and proximally spread to the bladder neck (Leão et al., 2016; Mittal et al., 2020). Distant metastasis is uncommon (Mittal et al., 2020). The most suitable method for collecting material for biopsy is the urethrocystoscopy. MRI is commonly used for staging. For post-surgical staging, the best investigation is the excretory urography (Gourtsoyianni et al., 2011; Picozzi et al., 2012). The management in vogue are surgical such as tumor excision, radical nephro-ureterectomy or anterior pelvic exenteration with radiotherapy or chemotherapy complementary. This cancer is associated with poor outcomes. Therefore, prognostic factors are important to be known.

Conclusion: Although female urethral carcinoma is a rare disease entity, clinicians should have strong suspicion of malignancies in patients to make an exact diagnosis. Early radical surgery can achieve better outcomes, although the standard therapy remains controversial.
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August 2021

Management of cancer pain with analgetic adjuvant and weak opioid in prostate cancer bone metastases: A case series.

Ann Med Surg (Lond) 2020 Dec 9;60:575-578. Epub 2020 Nov 9.

Pain and Headache Division, Neurology Department, Faculty of Medicine, Universitas Syiah Kuala, Zainoel Abidin General Hospital, Banda Aceh, Indonesia.

Background: In cancer patients, cancer pain is the most common cancer complication. About 60-90% of patients with advanced stage cancer experience various levels of pain, and about 30% of patients have been suffering from persistent severe pain. Bones are the most frequent targets of metastases in patients with cancer such as breast, prostate, lung, kidney, and thyroid. In advanced prostate cancer, bone metastasis leads to bone pain, skeletal fracture, and increased mortality. At least 75% of patients with bone metastasis experience bone pain.

Case Description: We report three cases of cancer pain, treated with primary cancer from the prostate metastasis to the spine. All three patients had lower back pain that radiated to the left and right limbs, with mixed pain and bone pain, where early hospital admission shows the Numeric Rating Scale (NRS) pain scale 9-10. Treated with administration of adjuvant therapy (Gabapentin) and weak opioids (injections of Tramadol) as well as injections of Metylprednisolone (for 3 days), the patient's pain scale was evaluated, and the average NRS obtained on days 2-4 was 5-6. On day 5-8, treatment continued with Gabapentin and Tramadol injections, and the pain scale (NRS) decreased to 2-3. All patients on the 8-9 day of treatment also received Biphosphonates to reduce pain, bone damage, fracture risk, and blood calcium levels. Patients can be discharged with an oral Gabapentin prescription only.

Conclusion: A pain scale (NRS) reduction of >50% is obtained from the initial pain scale in cancer pain patients treated using a combination of adjuvant therapy and weak opioids.
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December 2020

The Effect of Exogenous Superoxide Dismutase (SOD) on Caspase-3 Activation and Apoptosis Induction in Pc-3 Prostate Cancer Cells.

Res Rep Urol 2020 27;12:503-508. Epub 2020 Oct 27.

Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.

Background: This study aimed to assess the effects of exogenous SOD administration on prostate cancer cell line (PC-3) apoptosis via the intrinsic pathway by examining the expression of manganese superoxide dismutase (MnSOD), caspase-3, and apoptosis index of the PC-3 cell line.

Methods: We used the prostate cancer cells from secondary prostate cancer cell lines (PC-3) derived from castration refractory prostate cancer (CRPC), cell differentiation grade IV, and had metastasized to the bone from the American Type Culture Collection (ATCC, Rockville, MD, USA). Superoxide dismutase (SOD) is derived from extracts of melon seeds and wheat gliadin biopolymer, and divided into 62.5 mg/mL, 83 mg/mL, 125 mg/mL, and 250 mg/mL doses. Expression of MnSOD was measured by immunohistochemistry (IHC). Expression of caspase-3 was measured using Western Blot method. Apoptotic index is calculated based on the reaction introduction 3OH end of fragmentation of DNA by the enzyme terminal transferase in preparations with TUNEL staining reagents. A one-way ANOVA test and Pearson correlation test were used to determine the relationship between SOD with expression of caspase-3 and apoptotic index.

Results: SOD extract significantly increased the expression of caspase-3 (=0.016) and the apoptotic index (=0.000) (<0.05). There was a correlation between the increased doses of SOD extract and the apoptosis index (=0.015; r=0.679) and between the increased caspase-3 expression and the apoptosis index (=0.015; r=0.682).

Conclusion: Administration of superoxide dismutase (SOD) increased apoptosis in a prostate cancer cell line (PC-3) through the increased expression of caspase-3. Superoxide dismutase (SOD) can be considered as a therapy for late-stage prostate cancer that had been progressed to hormone resistant and metastasized and promote apoptosis in those prostate cancer cells.
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October 2020

Rare case of primary bladder Wilm's tumor in a 1-year old boy.

Urol Case Rep 2019 Jul 26;25:100898. Epub 2019 Apr 26.

Urology Department, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia.

Extrarenal Wilms' tumor (EWRT) is a rare entity, but primary bladder Wilm's tumor is even rarer with only 1 case reported. A 1-year old boy came with chronic urinary retention. Abdominal pelvic CT scan revealed intravesical mass arising from anterior bladder wall extending to the prostate and bladder neck. Initial cystoscopic diagnosis revealed chronic granuloma. We decided to perform partial cystectomy with final pathologic result of bladder Wilms' tumor. EWRT may occur in various organs, but primary bladder Wilms' tumor is extremely rare case.
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July 2019