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Articles 41 Documents
Search results for , issue "Vol 48, No 4 (2016)" : 41 Documents clear
Correlation between clinical findings and patient’s survival rate in congenital duodenal obstruction Adipurwadi, Chandra; Makhmudi, Akhmad
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.043 KB) | DOI: 10.19106/JMedSci004804201602

Abstract

Congenital duodenal obstruction (CDO) is one of the most common anomalies in newborns (0-30 days), and accounting for nearly half of all cases of neonatal intestinal obstruction. Although survival in infants with congenital intestinal obstruction has improved, duodenal obstruction continues to present unique challenges. A retrospective correlational study was used in this study, 49 patients with CDO were analyzed within the years of 2004 to 2009. A chi-square test was used to investigate the correlation between clinical findings (age, weight, gestational age, surgical techniques, comorbidity, and early enteral feeding) and patient’s survival rate. None of clinical findings showed a significant correlation with patient’s survival rate, except comorbidity (sepsis) and early enteral feeding showed a significant correlation with patient’s survival rate (p<0.05). In conclusion, this study revealed that comorbidity (sepsis) and early internal feeding correlated with patients’ survival rate.
The Experience of Breast Reconstructive Microsurgery Brahma, Bayu; Haryono, Samuel J
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (93.123 KB) | DOI: 10.19106/JMedScieSup004804201603

Abstract

Autologous techniques in oncoplastic breast surgery may result in graft donor site morbidity. Microsurgery has become a new surgical modality for breast reconstruction; it is a less invasive procedure. In recent experience, we have applied microsurgical technique in oncoplastic breast procedures to minimize morbidity.We reviewed the charts of breast cancer/tumor patients with microsurgical reconstruction.From February 2013 to July 2016, we performed 36 perforator flaps for breast reconstruction. The mean age of the patients was 44.4±6.7 years old, with the median tumor size of 3.7 (1.5-20) cm. No special type of carcinoma (NST) was accounted in 25 (69.4%) cases. Oncoplastic breast conserving surgery (OPS) was the procedure of choice in 17 (47.2%) cases and mastectomy was followed by free flap in 19 (52.8%) patients. In OPS, we used various perforator flaps to cover the defect. Thoracodorsal artery perforator flap (TDAP) was the most common technique used in 8 (22.2%) cases, then lateral intercostal artery (LICAP) flap in 6 (16.7%) cases, anterior intercostal artery (AICAP) flap in 1 (2.8%) cases, and superficial epigastric artery (SEAP) flap in 2 (5.6%) cases. Deep inferior artery perforator (DIEP) free flap was the reconstruction option after mastectomy. During follow-up with the mean time of 12.7±11.4 months, there were 1 local recurrence, 2 regional and systemic metastases, and 1 death due to cerebrovascular disease. There were no flap loss after pedicle perforator reconstruction but total flap necrosis occurred in 5 patients with DIEP free flap. In one patient, we successfully salvaged the flap that had venous congestion. There was no seroma at donor site and no limitation in abdominal wall function after DIEP reconstruction.In our experience, microsurgical reconstruction in breast surgery has been a safe procedure and has less donor site morbidity. Flap failure rate may be improved by refining microsurgical technique
Breast reconstruction Kurnia, Ahmad
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedScieSup004804201601

Abstract

Breast reconstruction is such a unique procedure that might potentially be adjustedin line with time and all advances in technology and instruments (endoscopy,silicone implants, alloderm grafting). In addition, it adapts in accordance to better,more sophisticated knowledge of breast anatomy (vascularization, perforator, andinnervation), breast subunits, and systemic changes. Surgical techniques and thecurrently available list of materials might be utilized to reconstruct the breast insuch a way to yield cosmetic satisfaction. Combination and modification of thosetechniques might be adjusted to the patients’ requests without crossing over thepaths of the disease being corrected (cancer, benign tumor, infection, or otherbreast anomalies).Breast reconstruction’s prerequisite is the absence of cancer approximately 1cm from the edge of incision, adjusted by shape and size of breasts, and sizeof cancer. Several techniques might be applied to conserve and reconstruct thebreasts when the disease has been diagnosed. Oncoplasty applies all techniquesavailable to reaffirm the principles of oncology, by increasing the distance fromthe edges of cancer and proceeding with reconstruction by reduction/mastopexy(volume displacement), or adjacent/distant flaps (volume replacement). Thedisadvantage of BCS/BCT is the short distance from the edge of incision to thetumor due to the risk of post-operative breast deformity, especially when surgeryis followed by adjuvant radiation.
Association between HLA-B alleles and nevirapine-induced allergies among Indonesian HIV patients Pudjiati, Angela Satiti Retno; Oktarina, Dyah Ayu Mira; Soebono, Hardyanto; Sauda, Saihas; Paramita, Dewi Kartikawati; Dwiprahasto, Iwan; Djoerban, Zubairi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (367.093 KB) | DOI: 10.19106/JMedSci004804201604

Abstract

This study aimed to investigate the association between human leukocyte antigen-B(HLA-B) alleles and nevirapine allergy in HIV patients in Indonesia. A case control studywas conducted involving 147 HIV patients comprising of 50 patients with and 97patients without nevirapine allergy as control. The HLA-B allele typing was conducted byusing polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP),followed by sequencing. Bivariate analysis using Chi-square (X2) test and multivariatelogistic regression with significance level at p<0.05 were applied to analysis the data.Among 147 subjects, 34 with HLA-B alleles were identified. Bivariable analysis showedthat HLA-B*58 allele was the most significant risk factor for the nevirapine allergy (OR= 3.67; 95% CI: 1.79 to 7.54), while HLA-B*35 allele was a protective factor (OR =0.18; 95% CI: 0.08 to 0.42). Multivariate logistic regression analysis showed that youngmen and HLA-B*58 allele were the significant risk factors of nevirapine allergy (OR: 4.63;95% CI: 2.02 to 10.61), while older women with the HLA-B*35 was able to reducethe risk of nevirapine allergy approximately 81% (OR: 0.19; 95% CI: 0.08 to 0.49). Inconclusion, young male with the HLA-B*58 allele are the high risk factor for nevirapineallergy in Indonesian HIV patients.
The Expression of hsa-miR-155-5p in Plasma Samples Of Breast Cancer Before And After Chemotherapy Fitria, Meutia Srikandi; Haryana, Sofia Mubarika; Anwar, Sumadi Lukman; Aryandono, Teguh; Tanjung, Dewi Sahfitri; Kartika, Aprilia Indra; Oktriani, Risky; Irianianiwati, .; Sari, Dwi Nur Indah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (93.072 KB) | DOI: 10.19106/JMedScieSup0048042016018

Abstract

Breast cancer has emerged as the most common cancer-related mortality among women worldwide. Therefore, early cancer detection using biomarkers such as microRNA is needed. One of microRNAs that has an important role in breast cancer development is miR-155. Hsa-miR-155-5p is an oncomir that is commonly dysregulated in breast cancer. This study aims to determine the expression of hsa-miR-155-5p in breast cancer patient’s plasma before and after chemotherapy. We collected 64 samples from breast cancer patients admitted to Dr. Sardjito Hospital in Yogyakarta. RNA from plasma was extracted using RNA Isolation Kit miRCURY-Biofluid. cDNA synthesis was performed using cDNA Synthesis kit II and quantification of miR-155-5p using ExiLent SYBR Green master mix (Exiqon). qRT-PCR results were then analyzed with Livak's method and compared (before and after chemotherapy) with t-test. Expression of miR-155-5p in the breast cancer patients’ plasma after chemotherapy was significantly increased (10.59 times) when compared to before chemotherapy (p = 0.001). We concluded that there was upregulated expression of miR-155-5p after chemotherapy than before chemotherapy. There has not been a known, relevant pathway between hsa-miR-155-5p and chemotherapy regimens nor resistance to chemotherapy. Keywords: Breast cancer, plasma, hsa-miR-155-5p, oncomiR, chemotherapy.
Pharmacogenomics and Pharmacogenetics: Some Cases in Oncology Yuliwulandari, Rika
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.773 KB) | DOI: 10.19106/JMedScieSup004804201627

Abstract

ABSTRACTPharmacogenomics and pharmacogenetics plays an important role in understanding how genetic variants influence drug efficacy and toxicity.  In the case of cancer, both efficacy and toxicity of therapeutic agents determine the improvement of survival and quality of life in cancer patients.  Effective treatment of Cancer, one of the most deadly diseases in the world, is importance for extending patient survival. Genetic variation influences the response of an individual to drug treatments that impact the efficacy and toxicity of the drugs. Understanding individual genetic variation is potential to make therapy safer and more effective by determining more appropriate drug selection and drug dosage for each individual patient. In the context of cancer, tumors may have specific disease-defining mutations, but a patient’s germline genetic variation will also affect drug response. Advance research technologies approach such as GWAS and next-generation sequencing technologies, statistical genetics analysis methods and clinical trial design have shown promise for discovery of genetic variants associated with drug response in cancer. Understanding the molecular characteristics of both the tumor and the patient, and establishing their relation with drug outcomes will be critical for the identification of predictive biomarkers and to provide the basis for individualized treatments. Since cancer is also frequent in Indonesia, pharmacogenomics study in oncology and its implementation in the clinical practice is important. Broad collaboration at national and international level could foster the application of personalized medicine in oncology.
Hormonal Contraceptive Use as Risk Factor for Breast Cancer in Young Javanese Women Kusuma, Luna Fitria; Yarso, Kristanto Yuli
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.617 KB) | DOI: 10.19106/JMedScieSup0048042016017

Abstract

Previous study from 351 Indonesian women shown that they had breast cancers at younger age compared with western. In this study we investigate role of hormonal contraceptive as risk factor for Indonesian Javanese young breast cancer cases. However, the presence different life style between ethnic alter their risk as causal factors across populations. Diagnostic and prognostic study findings, including breast cancer prediction rules, must therefore be validated in Asian women. We undertook case-control study to determine population-based distributions of breast cancer among young Javanese people, one of the largest populations in Indonesia (Southeast Asia). A total of 500 women diagnosed with breast cancer participated in this study, divided in to two group young (less 40 years old) and mature breast cancer. Data for hormonal contraceptive, clinico-pathological characteristics and other risk factors were collected. We found that young Javanese women who use hormonal contraceptive for more than 10 years had a 4,67 fold increased risk of being diagnosed with breast cancer in young age (p<0,01). We didn’t found any differences between this two groups in menarche and parity. Interestingly for Javanese women who breast feeding more than 18 months increase 1,74 fold increased risk of being diagnosed with breast cancer in young age (p<0,01). 
Oncoplasty: How to start and experience from Yogyakarta Hardiyanto, Herjuna
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.045 KB) | DOI: 10.19106/JMedScieSup0048042016013

Abstract

AbstractReconstruction surgery after tumor removal is increasingly essential because of changes in patient expectations and demand. With the advance of early screening and detection, our ability to detect early stage cancer is significantly improved. Reconstruction is mostly suitable in patients with early stage cancer. In addition, there is growing ability that that immediate reconstruction in particular selected patients can be performed in a single time operation combining oncological and aesthetic procedures with considerably excellent result.  With the implementation of full coverage insurance by BPJS, most oncological surgery including in breast cancer will be performed by general surgeon in regency hospital. Reconstruction in selected patients usually is performed as delayed procedure by plastic surgeon. With the advance in surgical oncology training, breast surgery should be performed by surgical oncologist with specific oncoplasty training that can offer immediate reconstruction with both extensive removal tumor and reconstruction. Therefore, training in oncoplasty is very important for surgical oncologist. In Yogyakarta, we performed reconstruction after surgery of breast tumor, thyroid cancer, radical neck dissection and facial basal cell carcinoma with relatively excellent results. Further training and innovation are required to improve this early stage oncoplasty practice in Yogyakarta.Keywords : 
Implementation of Medical Genetics in Medical Education Curriculum Aryandono, Teguh
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (70.235 KB) | DOI: 10.19106/JMedScieSup004804201634

Abstract

Primary care physicians should be aware that genomics has arrived at the doorstep of their practice. Genetic knowledge, skills, and attitudes are important to primary care physicians providing support and management to patients and families with (higher risks of) genetic conditions. At least one in ten patients seen in primary care has a disorder with a genetic component, including hereditary cancer.Primary care physicians must be able to advise patients on genetic and genomic manifestations of the associated diseases and disorders, to outline a primary pedigree to deliver the necessary information: the disease which the patients are at risk of, and to decide whether to refer the patients to genetic services.There is more and more evidence to the importance of clinical emphasis in the genetics classes, probably proceeding to a third-year refresher program in the longitudinal curriculum. An enhanced educational experience to improve genetics and genomics knowledge should be better structured in the imminent future.Keywords: primary care physicians, hereditary cancer, genetic curriculum, genetic services
Cytogenetic Analysis for Research and Services Faradz, Sultana MH
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedScieSup004804201631

Abstract

AbstractThat the correct chromosome number in man is 46 was first recognized by Tjio and Levan in 1956. Perhaps few Indonesians know that Tjio was an Indonesian scientist studying in Sweden and then living in the US. Cytogenetic analyses are commonly performed to determine both structural and numerical chromosome aberration, whilst changes in chromosomes can lead to birth defects, syndromes, or even cancer.  Several chromosomal aneuploidy syndromes were identified after the establishment of various chromosome banding techniques in late 1960’s.  Specific cell culture media was found to express fragile site in the beginning of 1970’s and since then, inherited Fragile X Mental Retardation syndrome could be diagnosed.  However, some female permutation cases have been often misdiagnosed. Further molecular analysis has resolved this problem by revealing more CGG repeats in the promoter region FMR1 gene, which is related to the expression of fragile site and the severity of the diseases.In Disorder of Sex Development (DSD), early gender assignment and reconstruction surgery has been challenged because of the dilemma of gender identity development in later life. Cytogenetic analysis for the first-line gender assignment is important in newborn with DSD. Proper diagnosis with hormonal and mutation analysis should be elucidated to avoid medical, psychological, and social aspect in adult life. The most frequent genetic cases in our clinical experiences have been Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia. Female Complete Androgen Insensitivity Syndrome (CAIS) with main symptom primary amenorrhea without cytogenetic analysis has often been diagnosed as inguinal hernia because of testicle location and size.Diagnosis and treatment of several leukemias and lymphomas, as well as some solid tumors, depend on cytogenetic analyses to demonstrate consistent, specific chromosomal aberrations. Chromosome analysis in hematologic malignancy is indicated to support diagnosis, select therapy regimen, and elaborate prognosis. Specific chromosome translocations have been identified for hematologic malignancy. The breakpoints of several of these translocations have been cloned. Several loci of oncogene have been identified and sequenced.  Molecular genetic analysis will replace cytogenetic analysis and shift the requirement for studying metaphase cells. Therefore, chromosome analysis in genetic disease and cancer should be attained with advanced molecular techniques, such as Fluorescence In Situ Hybridization (FISH) and microarray CGH analysis.  Cytogenetic analysis is still useful and applicable in genetic disease diagnosis, sexual assignment, and hematologic malignancy in the laboratory with minimal equipments. Molecular analysis as a part of health care services in Indonesia has been limited in research centers in university setting; therefore, a comprehensive diagnosis with genetic analysis has often been improbable.

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