No abstract

Blount disease is a rare growth disorder of the medial aspect of the proximal tibial physis, with abrupt medial angulation leading to varus angulation of the proximal tibia and medial rotation of the tibia. Multiple factors such as ethnicity, genetics, and mechanical stress are thought to be contributing element to this disease. Treatment depends on the age of the patient and severity of the condition. A diagnosis of Blount disease is based on clinical, laboratory and standing alignment of x-ray. The natural history of untreated Blount disease is progressive and non-resolving varus deformity which produce joint deformity and growth retardation. Proper management of patient with obese and Blount disease is nutritional and surgical procedure. Hereby we presented a six year old girl with juvenile blount disease related to obesity.

Background: Overexpression of VEGF before therapy has been associated with decreased survival and poor prognosis of osteosarcoma patients, but VEGF expression in osteosarcoma patients following receiving neoadjuvant chemotherapy has not been much elucidated. The purpose of this study was to determine the effect of VEGF expression after neoadjuvant chemotherapy on chemotherapy responses (HUVOS), local recurrence, metastases and survival of osteosarcoma patients. Methods: A cross-sectional study was conducted in Jakarta during the 2009-2010 period to 19 osteosarcoma patients at Cipto Mangunkusumo Hospital, Jakarta. Data on patient's characteristics, VEGF expression after chemotherapy, local recurrence, metastasis, Latar Belakang: Ekspresi yang berlebih dari VEGF sebelum terapi telah dihubungkan dengan penurunan survival dan prognosa yang jelek dari pasien osteosarkoma, namun ekspresi VEGF pada pasien osteosakoma setelah mendapat neoadjuvant kemoterapi belum banyak diteliti. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh ekspresi VEGF setelah neoadjuvant kemoterapi terhadap respon kemoterapi (HUVOS), local recurrence, metastase dan survival pasien osteosarkoma. Metode: Penelitian dengan desain potong lintang dilakukan di Jakarta pada periode 2009-2010 terhadap 19 pasien osteosarkoma di RS Cipto Mangunkusumo, Jakarta. Data karakteristik pasien, ekspresi VEGF setelah kemoterapi, local recurrence, metastase, respon kemoterapi dan survival pada pasien osteosarkoma dicatat chemotherapy response and survival in osteosarcoma patients were recorded and analysed using statistical analysis. All data were analysed using SPSS software version 16 for Windows. Results: Most respondents were male (63.2%), age> 14 years (84.2%), stage IIB (94.7%), poor HUVOS (73.7%), size <10 cm (63, 2%), positive VEGF expression (57.9%), negative metastasis (73.7%), and death (73.7%). There was no significant relationship between VEGF expression and all parameters assessed (P> 0.05). Conclusion: VEGF expression by living osteosarcoma cells after neoadjuvant chemotherapy is not significantly related to histological response (HUVOS), local recurrence and metastasis, but has a significant relationship with good survival. dan dianalisis menggunakan uji statistik. Seluruh data dianalisis menggunakan piranti lunak SPSS versi 16 untuk Windows. Hasil: Sebagian besar responden berjenis kelamin laki-laki (63,2%), usia > 14 tahun (84,2%), stadium IIB (94,7%), HUVOS buruk (73,7%), ukuran < 10 cm (63,2%), ekspresi VEGF positif (57,9%), metastasis negatif (73,7%), dan meninggal (73,7%). Tidak terdapat hubungan yang bermakna antara ekspresi VEGF dengan seluruh parameter yang dinilai (P>0,05). Kesimpulan: Ekspresi VEGF oleh sel osteosarkoma yang masih hidup setelah neoadjuvant kemoterapi tidak berhubungan bermakna dengan respon histologi (HUVOS), local recurrence dan metastase, namun memiliki hubungan yang bermakna dengan survival yang baik.