PROTOZOOLOGI UMUM

Pembagian Protozoa :

1. Rhizopoda
2. Flagellata
3. Cilliophora
4. Sporozoa
5. Tak tergolongkan

Rhizopoda :

1. Entamoeba histolytica
2. Entamoeba coli
3. Endolimax nana
4. Iodamoeba butschii
5. Dientamoeba fragilis

Technorati Tags: protozoa,parasitologi,fk undip,amoeba,entamoeba,flagellata,rhizopoda,histolytica,balantidium coli,giardia lamblia

Flagellata :

1. C heilomastix mesnili
2. Giardia lamblia
3. Trichomonas vaginalis
4. Leishmania donovani ;  L. tropica ;      L. braziliensis
5. Trypanosoa gambiense ;  T. rhodensiense ;  T. cruzi

Sporozoa :

1. Plasmodium vivax
2. Plasmodium falciparum
3. P. malariae
4. P. ovale
5. Isospora hominis
6. Eimeria sp.

Ciliophora :

1. Balantidium coli

Status tak tergolongkan

1. Toxoplasma gondii
2. Pneumocystis carinii

Differential diagnosis on Hearing Loss

Differential diagnosis
Common causes of SNHL include acoustic neuroma, multiple sclerosis, hypothyroidism, vertebrobasilar insufficiency, or stroke, Meniere's syndrome, drug toxicity, and idiopathic hearing loss. CHL is most frequently caused by cerumen impaction, perforation of the TM, middle ear effusion, atelectasis, and otosclerosis. In addition, a variety of tumors (e.g., squamous cell cancer, exostoses, or cholesteatoma) can cause CHL. MHL may be secondary to presbycusis, medications, and noise-induced hearing loss.

Physical examination on Hearing Loss

A simple hearing challenge may confirm hearing loss or detect significant hearing asymmetry. Ask the patient to cover one ear and try to detect soft sounds such as the tick of a watch, the scratching of two fingers rubbed together, or a softly whispered voice. Inspect the canal and TM to rule out the obvious causes of CHL. Cerumen impaction is a remarkably common and easily corrected cause of hearing loss. Pneumatoscopy to check for the normal movement of the TM helps rule out perforation, atelectasis, eustachian tube dysfunction, stiffened TM, ossicular disruption, and middle ear effusion.

Hearing Loss

History
Although patients rarely present with a complaint of decreased hearing, most have no specific hearing concern. Instead they present with depression, confusion, social isolation, or poor job performance, which may be caused or complicated by hearing impairment. Family members note abnormal, slow, or overly loud answers, a sudden tendency to monopolize or disrupt conversation, or to tilt the head in conversation. CHL is often of sudden onset but of a mild degree. Complete occlusion or rapid collection of fluid in middle ear causes an abrupt change in hearing. SNHL can be abrupt and severe (stroke, idiopathic, trauma), or gradual (MeniereTechnorati Tags: CHL, SNHL, Hearing Loss, OSCE's syndrome, acoustic neuroma, hypothyroidism). CHL often affects the quality of hearing first. Described as muffled like a head in a drum,the patient may lose high frequency and voice discrimination; however,
they are still capable of detecting subtle sounds. SNHL, when not associated with tinnitus, can have good quality but diminished hearing usually more profound than CHL.

Recent Report on carcinoma larynx

Recent reports that show promise of practical clinical utility include the following:

The immortalizing enzyme, telomerase, has been linked to carcinogenesis and its confirmed presence in laryngeal
P.1728
cancer specimens may provide a novel molecular marker, especially for diagnosing persistent malignancy after radiation failure (1).
A form of hyaluronidase, PH-20, which is expressed in primary laryngeal cancer tissue, is elevated even more in metastatic lesions, such that it can serve as a useful tumor marker and have prognostic value (2).
Using polymerase chain reaction techniques, herpes simplex virus DNA was found in 75% of laryngeal cancers, but only in 25% of oral cancers and in no control biopsy tissue, suggesting that it may be a cocarcinogen in some patients (3).
Mutations of the p53 gene have been found to correlate with the clinical outcome of patients with laryngeal cancer. The predictive power of p53 gene mutations is an area of high research interest at this time (4).
Retinoblastoma protein expression negativity is associated with a higher likelihood of lymph node metastasis and a significantly lower 5-year survival rate (5).
Low levels of cyclin D1 can be detected by immunohistochemical staining of paraffin-embedded specimens.
Low levels of cyclin D1 correlate with radio-resistant early-stage larynx carcinoma (6).



Technorati Tags: telomerase, hyaluronidase

Radiotherapy for Early Glottic Cancer

The optimal clinical scenario for using XRT in early glottic cancer is diffuse superficial disease (T1b, T2b) in which surgical intervention would disrupt the basic architecture of both vocal folds, the anterior commissure tendon, or the laminae propria.
The disadvantages of XRT include treatment of noncancerous vocal-fold tissue (T1a, T2a), which frequently results in scarring of the mucosa of the normal vocal fold with associated dysphonia (13).
DIAGNOSIS STAGING

• Laryngeal examination and videostroboscopy
• Panendoscopy with biopsy and mapping of the tumor
• Computed tomography scan of the neck with contrast
• Chest x-ray study
• Comprehensive chemistry panel, including liver function tests
• Complete blood count

COMPLICATIONS ON ENDOSCOPY RESECTION

• Hemoptysis subsequent to reconstruction
• Hematoma
• Airway edema
• Airway obstruction
• Dysphonia
• Aspiration
• Positive surgical margins
• Laryngeal stenosis
• Scarring
• Extrusion of Gore-Tex implant

Technorati Tags: carcinoma, glottic, radiotherapy