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Journal : journal of internal medicine

KESULITAN DIAGNOSIS DAN TERAPI PADA LIMFOMA PANKREAS DISERTAI SINDROMA KAUDA EQUINA Ridwan, Muhammad; Dharmayuda, Tjokorda Gde
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Lymphoma, part of non-Hodgkin?s lymphoma, is a rare malignancy in pancreas. Its clinicalpresentations and supporting laboratory and imaging results are similar to those of pancreas adenocarcinoma.Apart from pancreas, extranodal type of non-Hodgkin can involve many other organs including bone marrows,nervous system, and kidneys. Treatment should be focused on emergency priority and the underlying cause. Inthis case report, we have documented a 44 year-old man who initially presented jaundice and abdominal massand then diagnosed with pancreas tumor. However, pathology anatomy and histochemistry examinations ofperipancreas tissue biopsy and indicated a non-hodgkin lymphoma of pancreas, in form of diffuse large B celllymphoma, intermediate grade. The patient was developing cauda equina syndrome a week after laparotomy.Discussion among team suggested that both conditions may have the same root: lymphoma. The patient wasthen put on CHOP regiments of chemotherapy program and later, also underwent a spinal decompressionprocedure. Overall, jaundice, abdominal mass and other related symptoms subsided, and quality of lifeimproved, although some cauda equina symptoms remained.
PENGARUH INSULIN TERHADAP FUNGSI KARDIOVASKULAR Ridwan, Muhammad; Gotera, Wira
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Abstract

Insulin is an anabolic hormone responsible for regulation of glucose metabolism and signals for storage and usage ofmany fundamental nutrients such as glucose, amino acids, and fatty acids. Its effects on cardiovascular function, reveal widerearly-known insulin actions, are based on the balance between its NO-dependent vasodilator action and endothelin-1-dependentvasocontriction action regulated by signals through phosphatidylinositole 3-kinase (PI3K) and mitogen-activated protein kinase(MAPK)-dependent pathways on vascular endothelial cells. On insulin resistance setting, signal perturbances of PI3K pathwayand enhanced signals through MAPK pathway are conditions underlying link between metabolic disorders and cardiovasculardiseases. Insulin also has antiinflammatory effects by suppressing expression of ICAM-1, MCP-1, NF-kB, MMP-9 and CRP. Onthe heart, insulin increases contractility and plays important roles in maximazing heart glucose uptake particularly in stress states.In addition, insulin plays a role in physiologic heart growth through Akt pathway. However, chronic exposure of insulin isassociated with ventricular disfunction. In term of cardiovascular function, insulin is known to increase peripheral blood flow danto decrease peripheral resistance, so that results in enhanced cardiac output without significant changes in blood pressure.Not only can improved insulin action repair glucose metabolism, but also improve risks underlying atherosclerosis andcardiovascular complications of diabetes. In 2007, European Cardiac Society (ESC) has recommended intensive insulin usage totightly control blood glucose in order to improve adult critically ill and heart surgery patient mortality and morbidity
Co-Authors - Sulaiman ., Hartutiningsih ., Mardawati Abdul Munir Achmad Fudholi Achmar Mallawa Ade Aditia Armi Adi Syahfutra Adnan Sauddin, Adnan Adrian Novigasa, Adrian Agung Mahar Rani Aidil Darma Setiadi, Aidil Darma Al Aziiz, Arief Nur Rahman AL IKHLAS " Alfikar " Amanah, Ulfah Nurul Amila Gadri Arlina Prima Putri, Arlina Prima Armayani, Hanifa Ayu Auradian Marta Bambang Pramono Baskoro, Galih Wahyu Darmawati Darwis Denny Sagita Rusdianto Diana Ningrum, Diana Ediyono, Suryo Elviza " ENDANG TRI MARGAWATI Eneng Tita Tosida Fadil Oenzil Fadil, Jazuli Fadil, Jazuli Faisal . Farid Lubis, Mahbud FATHONI, RIZAL Fatihah, Ishma Febry, Muhamad Fernandes Pakpahan, Fernandes Fitriningsih, Fitriningsih Galih Ujiantoro, Galih Haeriyyah, Haeriyyah Haq, Ramiz Ansharil Harahap, Isnaini Harahap, Pangeran Hardianti, Ratih Hasyim, Putri Resky Hatuwe, Massad Hayyu Dwi Putri Helda Yenni, Helda Henki Bayu Seta, Henki Bayu Herdi Sahrasad Ichwann Hastona, Ichwann Ilham Wahyudi Ilyas Ilyas Indradjaja, Indradjaja Indriawati, Indriawati Indriawati, Indriawati Indriyati Eko Purwaningsih, Indriyati Eko Iqbal Maulana, Iqbal Iqbal Wahid, Iqbal Irfan Taufik, Irfan Iriani, Dian Irmayanti Irmayanti, Irmayanti Irwan, Muh. Isril " Junizan " Kamal " Kasman Kasman Khairiah, Hanifa Khairul Anwar Kholik, Kholik Laode Muh. Golok Jaya, Laode Muh. Golok Lokaria, Aldian Mulyanto Lubis, Kamaluddin M. Banda Selamat, M. Banda Mahardeka Tri Ananta, Mahardeka Tri Mahmudah, Qonitatul Mallawa, Achmar Mallawa1 Mandala, Eka Praja Wiyata Marya Ulfa Masnani, Sitti Wahidah Mauli Kasmi, Mauli Miftah Ardhillah Fajri, Miftah Ardhillah Mitriani, Shelmia Muhammad Firdaus Muhammad Muhammad Muhammad Rizki Muhammad Walihuddin Mukhtar Mukhtar mukti Zainuddin Munawir, Ahmad Mursalin, Muhammad Mursalin, Muhammad Musbir Musbir Musta'in, Musta'in Mustakim Mustakim N. Ira Sari Nadya Vinandari Natsir, Andi Baso Adil Nawir Rasidi Nida’uljanah, Hanifah Novi Triayanti Noviarni ., Noviarni Noviarni, . nugraha, noviyanti Nugroho, Edy Prasetyo Nur Rahmah Nur, Mujadilah Nurdin Nurdin Nurhuda, Yeni Agus Nurul Muslihat, Nurul Okfalisa Okfalisa Oktari, Ahmad Rezha Pangestu, Danang Aji Pramuda N.S, Muhammad Prita D. S, Septarina pujowati, penny Puspa Arum, Enggar Diah Putri, Andi Rani Sahni Putri, Andi Rani Sahni Putri, Dewi Eka Rachmat Hidayat Rahayu Rahayu Rahmat Hidayat Ramadhani, Siti Reno Efaldi Reristiani Jantia Reski Lestari Ria Azizah Tri Nuraini Richo Rahgia Syahputra Riki Syaputra, Riki Risnawati Ibnas, Risnawati Rizki Ananda Rizky, Said Muhammad Rizky, Said Muhammad Rizona, Firnaliza Robby Setiawan Robiatun Adawiyah, Robiatun Roesyandi Nan Arief, Roesyandi Nan Rosdianwinata, Eka Rudi Febrianda, Rudi Rusdiansyah Rusdiansyah S. Sudarno, S. safruddin Safruddin, safruddin Safruddin, . Sahat Siagian Sahni Putri, Andi Rani Samsul Bahri Santoso, Kukuh Aris Saptono Hadi, Saptono Saputra, Dede Saputra, Rifaldi Sarip Hidayat, Sarip Seniorita, Seniorita Sofian, Sofian Sri Rahayu St. Aisjah Farhum, St. Aisjah Sugianto Sugianto Surya Fernando, Surya Suryono Suryono Suryono, Ryan Randy Sutardi Sutardi Syamsuri Syamsuri Telanai, Yudi Theresia Wati, Theresia Tjokorda Gde Dharmayuda Tohari, M Imam Tria Febrina Triyanti Nurul Hidayati Try Azisah Nurman vito siregar, Akbar ihza Wahjoeno, Dipo Wira Gotera Yandri Pratama Yulianto Yulianto Zainal Arifin Zainuddin, Mukti Zainuddin1 Zamira Ulfa Zuhriah Zuhriah, Zuhriah ZURAIDAH ZURAIDAH