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the (94), #teratoma (82), and (81), saya (79), teratomas (54), are (42), yang (40), tak (30), dan (30), may (27), with (24), malignant (24), edit (22), tumor (20), mature (20), fetus (19), not (18), cell (17), nak (16), germ (16), untuk (14), dah (14), that (14), hari (13), tapi (13), benign (13), often (13), dia (12), from (12), more (12), such (12), this (12), aku (11), dengan (11), macam (11), fetu (11), 2010 (10), ini (10), boleh (10), contain (10), for (10), lagi (9), cuti (9), pun (9), kerana (9), reported (9), usually (9), found (9), cyst (9), surgery (9), non (9), can (9), rohaiza (8), juga (8), banyak (8), apa (8), rasa (8), orang (8), bila (8), allah (8), kita (8), there (8), rare (8), tissues (8), have (8), been (8), other (8), these (8), origin (8), fetiform (8), also (8), tumors (8), cells (8), most (8), grade (8), cystic (8), which (8), blog (7), one (7), posted (7), anak (7), pada (7), kat (7), kawan (7), sakit (7), dalam (7), operation (7), doktor (7), surrounding (7), 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tial surgery 20 a grade 1 immature teratoma that appears to be benign e g because afp is not elevated has a much higher risk of malignancy and requires adequate follow up 21 22 23 24 this grade of teratoma also may be difficult to diagnose correctly it can be confused with other small round cell neoplasms such as neuroblastoma small cell carcinoma of hypercalcemic type primitive neuroectodermal tumor wilm s tumor desmoplastic small round cell tumor and non hodgkin lymphoma 25 edit teratoma with malignant transformation a teratoma with malignant transformation or tmt is a very rare form of teratoma that may contain elements of somatic non germ cell malignant tumors such as leukemia carcinoma or sarcoma 15 of 641 children with pure teratoma nine developed tmt 26 five carcinoma two glioma and two embryonal carcinoma here these last are classified among germ cell tumors edit extraspinal ependymoma extraspinal ependymoma usually considered to be a glioma a type of non germ cell tumor may be an unusual form of mature teratoma 27 edit initial diagnosis teratomas are thought to be present since birth or even before birth and therefore can be considered congenital tumors however many teratomas are not diagnosed until much later in childhood or in adulthood large tumors are more likely to be diagnosed early on sacrococcygeal and cervical teratomas are often detected by prenatal ultrasound additional diagnostic methods may include prenatal mri in rare circumstances the tumor is so large that the fetus may be damaged or die in the case of large sacrococcygeal teratomas a significant portion of the fetus blood flow is redirected toward the teratoma a phenomenon called steal syndrome causing heart failure or hydrops of the fetus in certain cases fetal surgery may be indicated beyond the newborn period symptoms of a teratoma depend on its location and organ of origin ovarian teratomas often present with abdominal or pelvic pain caused by torsion of the ovary or irritation of its ligaments testicular teratomas present as a palpable mass in the testis mediastinal teratomas often cause compression of the lungs or the airways and may present with chest pain and or respiratory symptoms some teratomas contain yolk sac elements which secrete alpha fetoprotein afp detection of afp may help to confirm the diagnosis and is often used as a marker for recurrence or treatment efficacy but is rarely the method of initial diagnosis maternal serum alpha fetoprotein or msafp is a useful screening test for other fetal conditions including down syndrome spina bifida and abdominal wall defects such as gastroschisis edit time of presentation teratomas of germ cell origin usually are found i e present in adult men and women but they may also be found in children and infants teratomas of embryonal origin are most often found in babies at birth in young children and since the advent of ultrasound imaging in fetuses the most commonly diagnosed fetal teratomas are sacrococcygeal teratoma altman types i ii and iii and cervical neck teratoma because these teratomas project from the fetal body into the surrounding amniotic fluid they can be seen during routine prenatal ultrasound exams teratomas within the fetal body are less easily seen with ultrasound for these mri of the pregnant uterus is more informative 28 29 edit complications teratomas are not dangerous for the fetus unless there is either a mass effect or a large amount of blood flow through the tumor known as vascular steal the mass effect frequently consists of obstruction of normal passage of fluids from surrounding organs the vascular steal can place a strain on the growing heart of the fetus even resulting in heart failure and thus must be monitored by fetal echocardiography after surgery there is a risk of regrowth in place or in nearby organs 30 edit treatment edit surgery the treatment of choice is complete surgical removal i e complete resection 31 32 teratomas normally are well encapsulated and non invasive of surrounding tissues hence they are relatively easy to resect from surrounding tissues exceptions include teratomas in the brain and very large complex teratomas that have pushed into and become interlaced with adjacent muscles and other structures prevention of recurrence does not require en bloc resection of surrounding tissues edit chemotherapy for malignant teratomas usually surgery is followed by chemotherapy teratomas that are in surgically inaccessible locations or are very complex or are likely to be malignant due to late discovery and or treatment sometimes are treated first with chemotherapy edit clinical trials the examples and perspective in this article may not represent a worldwide view of the subject please improve this article and discuss the issue on the talk page june 2007 as of 2007 there have been two clinical trials in progress that address germ cell tumors both of which include teratomas 33 34 a predominant theory of reversing or delaying teratomic lymphatic spread was tested by kevin smith incoorporating njd s enzyme with common lymphocyte co stimulators edit follow up although often described as benign a teratoma does have malignant potential in a uk study of 351 infants and children diagnosed with benign teratoma reported 227 with mt 124 with it five years after surgery event free survival was 92 2 and 85 9 respectively and overall survival was 99 and 95 1 35 a similar study in italy reported on 183 infants and children diagnosed with teratoma at 10 years after surgery event free and overall survival were 90 4 and 98 respectively 36 depending on which tissue s it contains a teratoma may secrete a variety of chemicals with systemic effects some teratomas secrete the pregnancy hormone human chorionic gonadotropin βhcg which can be used in clinical practice to monitor the successful treatment or relapse in patients with a known hcg secreting teratoma this hormone is not recommended as a diagnostic marker because most teratomas do not secrete it some teratomas secrete thyroxine in some cases to such a degree that it can lead to clinical hyperthyroidism in the patient of special concern is the secretion of alpha fetoprotein afp under some circumstances afp can be used as a diagnostic marker specific for the presence of yolk sac cells within the teratoma these cells can develop into a frankly malignant tumor known as yolk sac tumor or endodermal sinus tumor adequate follow up requires close observation involving repeated physical examination scanning ultrasound mri or ct and measurement of afp and or βhcg 37 38 edit use in basic research in light of the ethical issues surrounding the source of human stem cells teratomas are being looked at as an alternative source for research since they lack the potential to grow into functional human beings edit teratoma in non humans ovarian teratomas have been reported in mares 39 40 posted by rohaiza at 8 29 pm no comments home sweet home seronok rasanya bila dah balik rumah alhamdulillah ya allah rindunya saya nak menatap anak teruna dan anak dara saya yang gebu tu rindu juga saya nak menyapa ikan ikan dalam akuarium teringat awatif paling suka duduk tepi akuarium dan cakap fish angun angun angun maksudnya bangun tak tau kenapa agaknya dia ingat ikan ikan kt dalam akuarium tu semua tidur kot saya juga rindu pada pokok pokok di halaman pokok tembikai yang saya tanam pokok bunga nasi kerabu bunga telang yg ni org kelantan mesti kenal ni cili yg ayah tanam dan kehijauan rumput carpet semuanya menggamit saya pulang jam 4 30 petang 15 3 2010 saya berjaya melarikan diri dari hospital sungai buloh doktor bagi cuti 6 minggu sampai 28 4 2010 balik je pergi jemput si gebu dan abang alhamdulillah anak anak saya sihat dan selamat alhamdulillah ikan dan pokok2 kesayangan saya juga sihat meliuk lintuk ditiup angin petang bersama pancaran sinaran mentari cantiknya 16 3 2010 memikirkan apa la yang saya nak buat selama 6 minggu ni aduh bosannya saya di rumah sorang sorang abang pegi tuisyen adik lak kena hantar kt nursery sbb mama dilarang keras dukung dia cuma boleh peluk dan cium je saya dok tepi akuarium tengok ikan berenang merenung pokok pokok yang bercahaya disirami mentar pagi boring dok depan saya beralih ke belakang konon nak makan nasi lemak yang abah beli tadi tengok pinggan yang dh berbasuh tapi belum letak dalm kabinet saya tanpa ragu kemaskan pinggan2 tu semua lepas tu masak air tiba tiba rasa sesak nafas penat mencungap cungap saya seketika cepat penat agaknya ini lah yang dirasai oleh orang yang baru lepas operation patutlah orang cakap jangan buat sebarang kerja pun rehat jangan bergerak banyak sangat saya gagahkan diri buat nescafee dan kononya nak bawa nasi lemak makan kat kerusi batu tepi akuarium bersusah nk buka pintu depan dengan sudu dan garfu sebungkus nasi lemak dan muga nescafee tiba2 nescafee panas tertumpah kena tangan dalam kekalutan saya mencari minyak gamat tak jumpa dah la jalan terbongkok2 pergerakan pun lembab saya ambik ubat gigi lega sikit kemudian call abah tanya mana minyak gamat kesian dia yang dalam perjalanan ke pejabat patah balik mungkin kesian kat saya yang mengaduh kesakitan minyak gamat kat tingkat atas pastinya ambik masa yang lama untuk saya menapak keatas dengan keadaan saya yg macam ni alamak ni baru tak sampai suku hari saya kat rumah dah ada tragedi tak apa esok saya kena lebih berhati hati kerana saya dah tak sekuat dulu hmm apa pun bestnya duduk rumah hehe home sweet home posted by rohaiza at 7 31 pm 2 comments sunday march 14 2010 sakit itu menyiksakan selaku manusia hidup dan mati sepatutnya kerana allah s w t sebagaimana firmannya dalam surah al an am ayat 162 yang bermaksud katakanlah sesungguhnya ibadatku hidupku dan matiku hanyalah untuk allah tuhan semesta alam syukur yang teramat pada mu ya allah kerana masih memberi kesempatan untuk hambamu ini bernafas dan melangkah di bumi ini kesakitan ini walau amat menyiksakan namun cukup banyak untuk menginsafkan saya banyak yang saya janjikan dengan diri ini sepanjang sakit ni terutamanya hendak menambah amal ibadat saya tak patut cakap kat sini kan takut tak terbuat keduanya saya hendak taat sepenuhnya pada suami dan kedua ibu bapa saya pas tu saya nak didik anak2 saya betul supaya menjadi seorang muslim dan mslimat yang disayangi allah banyak lagi bla bla bla saya tak boleh utarakan semuanya bahaya tapi itulah hakikatnya saat saya nak dibius saya mengucap dan mohon kemapunan dari allah sebanyak banyaknya manalah tau waktu tu saya terus tidur untuk selama lamanya besar kekuasaanmu ya allah syukur padamu sebelum masuk hospital saya sering bermonolog sendiri kenapa saya yang kena macam ni orang lain boleh hidup riang ria sihat walafiat saya saya sering menyalahkan diri sendiri dan takdir tapi bila dah masuk kat sini macam macam penyakit yang saya jumpa subhanallah satu lagi bila kita sakit ni kita boleh kenal sebenarnya siapa kawan kita yang sebenar benarnya rupanya kawan susah memang payah nak cari terima kasih yang tidak terhingga untuk mira dan nairul korang memang kawan sejati juga kita dapat kenal siapa antara adik beradik yang benar benar sayangkan kita terima kasih untuk adik salma semoga tali silaturrahim kita akan kekal sehingga mati posted by rohaiza at 10 30 pm 1 comment sakit itu menyiksakan hari ni dah masuk hari yang keempat saya kt hospital ni rasa seronok sikt hari ni sebab kawan kawan datang melawat pas tu sbb husband bawakan lap top so boleh lah buka fb untuk menghilangkan sunyi kalau tak dok kira masa je bila la nk balik rumah ni bila sakit ni macam macm yang terkenang selain boleh rasa keinsafan dalam keperitan menanggung kesakitan semakin rasa takut menghadapi hari kematian ini adalah first time saya menghadapi operation walapun dah dua kali bersalin saya tak pernah kena operate rasa lucu pulak bila teringat waktu bersalin kali kedua dulu bila dah rasa tak tahan lagi menaggung sakit saya request dgn doktor untuk operation saya ingat operation lagi senang nasib baik doktor tu halang walaupun doktor tu berbangsa india tapi dia sentiasa ingatkan saya erti kekuatan dan kesabaran balik pada cerita operation ni sebelum operation hati saya dah gundah gulana para doktor pun serius semacam je dah sampai lima enam kali scan tak puas hati kerana ct scan yang saya jalani tak sama dgn pandangan doktor saya jadi takut sendiri setiap saat hanya berdoa supaya allah panjangkan umur saya kerana anak anak saya masih kecil dan saya masih ada kedua org tua yang akan tua yang memerlukan penjagaan saya doktor pun sama mula2 dia org cakap saya akan dibius penuh pas tu cakap pulak separuh dah saya mula ketakutan tapi dalam hati bagus juga bius separuh sbb waktu operate tu saya boleh berdoa pada tuhan tak pun berzikir sebanyak mungkin dan di saat2 akhir bagi tahu pulak bius penuh dan saya tak tahu apa terjadi sehingga 2 jam kemudian iaitu selepas operation dimana saya dikejutkan dan saya alami kesakitan yang amat hmm waktu entry ni ditulis pesakit kt depan saya sedang menangis tak pasti dia sakit apa yg pasti berkaitan dengan kandungannya sian dia saya nk stop la kejap husband datang nk sembang ngan dia posted by rohaiza at 12 21 am 3 comments sunday january 3 2010 selamat tahun baru 2010 sudah lama saya tak up date blog ni tiba tiba hari ni di permulaan tahun 2010 ni keinginan datang mendadak tambahan lagi opis sunyi sangat hari ni sementelah ramai yang cuti menghantar anak memulakan persekolahan bagi saya tugas tu saya serahkan pada en lan je la jadi bermakna saya boleh jimat cuti hmm kepentingan diri la pulak tapi tak pe cuti en lan pun banyak lagi baki cuti tahun lepas campur pulak ngan cuti tahun ni hm mau dekat 50 hari itu la untungnye kerje gomen kan cuti banyak jangan cemburu cuti saya rasanya dekat dengan 80 hari hish tak nak cerita la pasal cuti bukannya menarik pun sebenarnya saya tak tau apa yang nak ditulis kat sini cuma tangan ni je rasa rajin nak menaip itu la orang tulis blog say pun nak tulis blog juga tapi seringkali bila dah menaip sikit saya dah kebuntuan idea tak pandai la nak mengarang macam orang lain saya hairan dengan orang yang boleh up date kan blog dia orang hari hari macam macam cerita yang dipaparkan seronok saya baca blog mereka hmm rasanya cukup la setakat ni sebagai permulaan saya nak tambah lagi tapi tak ada idea la selamat tahun baru 2010 buat semua kawan kawan posted by rohaiza at 4 06 pm 1 comment thursday august 13 2009 opis kl yang aku tinggalkan tanggal 31 7 2009 merupakan last daya aku kerja kt ptk kl siapa sangka kan akhirnya doa aku dimakbulkan tuhan juga sedih juga sapa kata tak sedih nak tinggalkan tempat aku cari makan tapi memangnya jodoh aku dengan ptk kl ni memang nya tak panjang kalau dulu tempat pertama aku posting ialah pejabat ni tapi hanya untuk sebulan sahaja kali ini aku posting lagi ke kl tapi hanya untuk tempoh lebih kurang 8 bulan itupun setelah dicampur dengan kursus 3 bulan bagiamanapun terima kasih yang tidak terhingga kepada semua pegawai dan kakitangan ptk kl yang telah sudi mene...