BACKGROUND: Approximately 70–80% of breast cancer express ER-alpha and hormonal therapies, given significant improvements in patient survival. About 50% of ER-positive breast cancer patients with advanced disease insensitive to tamoxifen treatment when diagnosed. Recent studies have shown that ERα-36 is a crucial factor in the resistance of tamoxifen. OBJECTIVE: This study aims to determine the association between ERα-36 expression and de novo resistance of tamoxifen in patients with ER-positive breast cancer. METHODS: This study was an observational study using a cross-sectional method and was conducted at Wahidin Sudirohusodo Hospital and Unhas Hospital. ERα-36 protein expression was assessed using an immunohistochemistry assay. The association of ERα-36 expression and resistance of tamoxifen was tested with the Chi-square test. RESULTS: A total of 50 locally advanced breast cancer cases were included in this study, 22 cases (44%) had overexpression of ERα-36, and 28 cases (56%) had not, 24 cases (48%) had experience resistance to tamoxifen and 26 cases (52%) had not. There was a significant association between ERα-36 expressions and resistance of tamoxifen (p = 0.000). CONCLUSIONS: There was an association between the expression of ER-α36 with de novo resistance of tamoxifen in ER-positive breast cancer. ER-α36 could act as a worth considering biomarker for de novo resistance of tamoxifen in therapeutic strategies.

Introduction.Delayed hospital presentation is a characteristic we found in management of intussusception in our institution. However, with this delayed, surgical intervention is the only option in treatment. Thus, duration of onset is an answered problem. We run a study aimed to find out whether duration is a predictor of bowel resection in management of intussusception. Method. We run retrospective study on idiopathic intussusception managed in period of January 2008 to December 2015 in Cipto Mangunkusumo Hospital, Jakarta. Those other than idiopathic and insufficient data were excluded. Period of onset, signs and symptoms, ultrasound and surgical treatment as well as intraoperative findings were set as the variables and subjected to statistical analysis using χ2 or Fisher's exact test and t-test; significance is met if p value of <0.05. Analysis to find out cut-off point using receiver operating characteristic curve were carried out. Results. There were seventy-three subjects diagnosed as intussusception enrolled in the study. Median age was 7 months (3-48 month). Median period of onset to definitive treatment was 81 hours (15-256 hours). Bloody stools found in 90.4% instead of classic triad (28.7%). All subjects underwent surgical procedure, and out of 73 subjects, 61.6% underwent resection. We found clinical duration was associated to bowel resection (p 0.004) and area under curve 73.7% (p 0.001). The cut-off point as prediction of bowel resection was 78.5 hours with sensitivity of 67.9% and specificity of 71.1%. Conclusion. Surgical intervention is recommended for management of intussusception in those with clinical duration of more than 78.5 hours, instead of non-surgical reduction.

Introduction. Ameloblastoma is a quite rare case but a common odontogenic tumor found, about 11% of all odontogenic tumors. The tumor is locally aggressive odontogenic one with a tendency to have recurrence and may cause severe facial deformity and dysfunction if not treated properly. The slow growing nature of this tumor usually lead to a delay in diagnostic. Recurrence rate of ameloblastoma reported as 15-25% after radical treatment and 75-90% after conservative treatment. This study aimed to find out the characteristics and influencing factors that contributed to postoperative complication. Method. Those diagnosed as ameloblastoma who underwent total mandibulectomy, hemi-mandibulectomy, segmental mandibulectomy, and subtotal mandibulectomy as the first surgery followed by reconstruction using with reconstruction plate or bone graft in dr. Cipto Mangunkusumo general hospital in during January 2008 -December 2012 were reviewed descriptively using cross sectional retrospective study. Results. Twenty-three subjects managed in the oncology surgery division, Department of Surgery, dr. Cipto Mangunkusumo general hospital during such a period. There were 7 males and 9 females aged in ranged of 20-55-year-old. The majority complained painless swelling (9 subjects, 39.1%) for less than 2 years (12 subjects, 52.2%). The most factor found to be related was tooth extraction (8 subjects, 34.8%), following removal of teeth cyst (6 subjects, 26.1%). The most x-ray finding of panoramic view was multilocular (19 subjects, 82.6%) and the most surgical procedure preceded was partial resection of hemi-mandibulectomy (17 subjects, 73.9%). The most histopathological finding was follicular type (8 subjects (34.8%). Morbidity rate was 21.7%, no mortality. The most complication found was plate exposed (3 subjects, 13.08%). Median length of stay was 9 days (ranged of 7-26 days). There was no recurrence found in this study for 1-year postoperative follow-up. No significance relation between characteristics and complication. Conclusion. The postoperative recurrence rate of mandibular ameloblastoma might be be minimized by a wide excision beyond safety margin.