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"Pendahuluan. Penelitian ini merupakan penelitian lanjutan untuk melakukan pengkajian nilai batasan bloodflow rate BFR intraoperatif menggunakan ultrasonografi Doppler dalam memprediksi maturitas fistula brakiosefalika dengan sampel yang lebih besar dan lebih spesifik untuk mendapatkan nilai dengan tingkat error dan bias lebih rendah, sehingga nantinya dapat dijadikan referensi di divisi Bedah Vaskular RSCM. Metode. Dilakukan studi potong lintang analitik di Divisi Vaskular Departemen Ilmu Bedah FKUI-RSCM, Jakarta yang melibatkan semua penderita gagal ginjal stadium 4-5 akibat nefropati diabetik yang akan dihemodialisis dengan akses vaskular fistula brakiosefalika. Hasil. Terdapat 71 subjek dengan rerata BFR 249,15 86,86 mL/menit, rerata diameter arteri 3,3 mm 2,0-7,4 mm dan rerata diameter vena 3 mm 2,1-5,6 mm. Analisis statistik menunjukkan bahwa hanya BFR yang berhubungan bermakna dengan maturitas AVF p80.

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Introduction. This research is a follow-up study to determine the value limits of bloodflow rate BFR intraoperative using Doppler ultrasound to predict maturity of brachiocephalic fistula with a larger sample and to obtain lower level of error and bias, so it can be used as a reference in the Vascular Surgery division, Cipto Mangunkusumo Hospital.

Methods. Cross-sectional design with analytic fashion conducted at Division of Vascular Surgery Department of the Faculty of medicine - Cipto Mangunkusumo Hospital, Jakarta with all patients with stage IV-V CKD, due to diabetic nephropathy who planned to get vascular access for hemodialysis brachiocephalic fistula.

Result. Total subject are 71 with mean bloodflow rate is 249.15 86.86 mL / min, mean arterial diameter is 3.3 mm 2.0 to 7.4 mm and the mean diameter of the vein is 3 mm 2.1 to 5.6 mm . Only BFR associated significantly with maturity AVF p

BFR intraoperatif, maturitas AV fistula, brakiosefalika, sensitivitas, spesifisitas"

"In this paper, I consider why Japan's household saving rate was so high in the past and why it has shown a downward trend in more recent years and based on this analysis, I project future trends in Japan's household saving rate...."

"ABSTRAKThe scarcity of blood that is still happening today is the result of a combination of high blood needs and the difficulty of recruiting and maintaining donors. There is no research discover the substitute that can replace the role of blood, therefore the only source is from donations or blood donors. Approximately 80% of total blood donations collected by American Red Cross are come from blood drive events. Because blood has 6-hour spoilage time, donated blood at various donation locations must be collected and sent to a blood center for processing in less than 6 hours. This research study the Maximum Blood Collection Routing Problem (MBCRP). This problem is the extension of Vehicle Routing Problem with Time-Window (VRPTW) by considering the spoilage time limitation in blood. A mathematical model with objective to maximize total blood collection is built to cope with this problem. The mathematical model will be tested for verification and validation. The model is written in a computer programming language using AMPL software and is solved using the CPLEX solver. Furthermore, the results of verification and validation tests will be evaluated to see the applicability of the model."

"Latar belakang. Timbulnya stasis darah dan pembesaran atrium kiri menyebabkan peningkatan angka kejadian trombus di atrium kiri dan apendiks atrium kiri (Left Atrial Appendage-LAA) pada SM. Diameter atrium kiri yang membesar disebutkan sebagai faktor terjadinya pembentukan LASEC dan meningkatkan angka kejadian tromboemboli. Selain itu adanya stasis darah yang dibuktikan dengan penurunan ejeksi fraksi LAA dan kecepatan aliran darah LAA dapat mencetuskan timbulnya trombus. Perubahan moluker adhesi sICAM-1 dan sVCAM-1 berhubungan dengan kejadian tromboemboli. Tetapi apakah terdapat hubungan antara peran hemodinamik, terutama terhadap diameter, fraksi ejeksi dan kecepatan aliran darah pada LAA dengan kadar molekul adhesi seperti sICAM-1 dan sVCAM-1 belum terjawab. Metode. Pasien SM derajat sedang-berat (tanpa adanya regurgitasi mitral signifikan) yang menjalani pemeriksan ekokardiografi transesofageal diikutsertakan secara konsekutif sejak Januari-April 2014. Penilaian fungsi apendiks atrium kiri dilakukan dengan pemeriksaan transesofageal ekokardiografi. Kadar sICAM-1 dan sVCAM-1 dari vena perifer diukur dengan teknik enzyme-linked immunosorbent assay. Hasil. Sebanyak 26 subyek penelitian dengan rerata usia 38,92±11,93 tahun, 65,3% berjenis kelamin perempuan, dan 46,1% memiliki irama fibrilasi atrium. Dengan sampel tersebut, didapatkan tidak ada hubungan antara komponen fungsi apendiks atrium kiri, baik diameter, ejeksi fraksi, dan kecepatan aliran darah LAA dengan kadar sICAM-1. Tidak terdapat hubungan antara fungsi LAA pada variabel diameter dengan kadar sVCAM-1. Terdapat hubungan terbalik antara ejeksi fraksi LAA dengan kadar sVCAM-1 (-0,21, p=0.038, 95%KI -0,41- -0,01) dan hubungan terbalik antara kecepatan aliran darah LAA dengan kadar sVCAM-1 (-0,29, p=0,048, 95%KI -0,59- -0,003). Kesimpulan. Semakin rendah ejeksi fraksi dan kecepatan aliran darah LAA maka semakin tinggi kadar sVCAM-1.

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Background: Blood stasis and left atrial enlargement increase the incidence of thrombus in the left atrium and left atrial appendage (LAA). Enlargement of left atrial diameter is a factor for LASEC formation and increase the incidence of thromboembolism. Blood stasis which evidenced by a decrease in ejection fraction and LAA blood flow velocity can trigger the presence of thrombus. Changes in soluble adhesion molecules sICAM-1 and sVCAM-1 associated with thromboembolic events. But relationship between the role of hemodynamics, especially the ejection fraction and blood flow velocity in the LAA with the levels of adhesion molecules such as sICAM-1 and sVCAM-1 is not well understood.

Methods: Patient with moderate-severe Mitral Stenosis (in the absence of significant mitral regurgitation) underwent transesophageal echocardiography from January to April 2014. Levels of sICAM-1 and sVCAM-1 from peripheral vein were measured by enzyme-linked immunosorbent technique assay.

Results: A total of 26 subjects with a mean age of 38.92 ± 11.93 years, 65.3% female, and 46.1% had atrial fibrillation. We found no association between components of left atrial appendage function: diameter, ejection fraction and blood flow velocity of LAA with sICAM-1 levels. There was no relationship between the LAA function in the variable diameter of LAA with sVCAM-1 levels. There is an inverse relationship between ejection fraction of LAA and levels of sVCAM-1 (-0.21, p = 0.038, 95% KI -0,41- -0,01) and an inverse association between LAA blood flow velocity and levels of sVCAM-1 (-0 , 29, p = 0.048, 95% KI -0.59 - 0.003).

Conclusion: Low ejection fraction of LAA is associated with higher the levels of sVCAM-1. Low LAA blood flow velocity is associated with higher the levels of sVCAM-1."

"Ièlth dilakukan suatu penelitian "Cross sectional study" pada para akseptor yang telah rnenggunakan kontrasepsinya antara 1 - 4 tahun dibandingkan dengan wanita yang baru akan menggunakan p11. Ada 3 golongan subyek penelitian, .yaitu akseptor KB yang telah menggunakan p11 oral kombinasiberisi mestranol 0,05 mg dan noretindron 1 mg secara terusrnenerus, akseptor KB yang telah menggunakan AKDPL tipe Lippes Loop secara terus menerus dan wanita yang baru akan menggunakan pil dan minimal 3 bulan sebéluinnya tidak menggunakan alat kontrase p si apaun. Masing-masing golongan terdiri darf 30 orang, berusia 20 - 35 tahun.Penentun kadar, kolesterol total den-an metode Siedel dkk. Kolesterol-HDL ditentukan dengan metode Burstein dkk.Trigliserida ditentukan dengan metode Wahlefeld dkk. Sedangkan kolesterol-LDL ditentukan secara tidak langsung dengan menggunakan rumus Friedewald; kesemuanya dilakukan denganmenggunakan Kits Boehringer Mannheim.Dengan uji statistik Anova satu arah dan tes "q", didapatkan hal-hal berikut Kadar rata-rata kolesterol total. dan kolesterol-LDL pada akseptor p11 oral lebih tinggl bermakna dari wanita yang tidak menggunakan alat kontrasepsi (p < 0,05). Sedangkanpada akseptor p11 oral lebih tinggi dari AKDR, tetapi perbedaannya tidak berrnakna pada "level significance" 5%.Kadar rata-rata trigliserida pada akseptor pil oral lebih tinggi bermakna dan. akseptor AKDR dan wanita yang tidak menggunakan alat kontrasepsi ( p < O ,05). Kadar rata-rata klesterol total, kolesterol-LDL dan tnigliserida pada akseptorAKDR leblh tinggi dari wanita yang tidak menggunakan alat kontrase p si, tetapi perbedaannya tidak bermakna pada "level significance" 5%. Tidak terdapat perbedaan bermakna dari kadar rata-rata kolestero1-HDL dan berat badan antara akseptorp11 oral, AKDR dan wanita yang tidak menggunakan alat kontrasepsi. Usia rata-rata akseptor p11 oral dan AKDRlebib tinggi bermakna dari wanita yang tidak menggunakan alatkontrasepsi (P-< 0,05), sedangkan akseptor AKDR lebih tinggi dari p11 oral, tetapi perbedaannya tidak bermakna pada "level significance" 5%.Wanita yang tidak menggunakan alat kontrasepsi tidak mempunyaikeluhan apapun, sedangkan akseptor AKDR mempunyailebih banyak keluhan subyektif yang menyangkut adanya faktor mekanis dalam saluran reproduksi daripada akseptor pil oral.

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A cros sectional study was done on acceptors who -

have been using their contraception between 1 - LI years.It

was compared with women who will have used of the pill. -

There were 3 groups of subject acceptors who have been -

using combination oral contraceptives (0,05 mg mestranol +

I mg noretindrone ) continuously, acce ptors who have been -

using Intrauterine Device (IUD) continuously, and women who

will have used of the pill and they were not using contraception

(minimum 3 months before treatment).

P1 thod of Siedel et al. was used to measure the to -

tal Cholesterol levels; and Burstein et al. to measure the

HDL-Cholesterol; and ahlefeld et al. to measure the Tn -

glyceride. Indirect method of Fniedewald was used to estimate

the LDL-Cholesterol. The Boehringer MannheimKits were

used for this purposes.

By using the "One way analysis of variance" and test

"q", it was found that

The man levels of total Cholesterol and LDL-Choles

terol in oral pill acceptors were significantly higher -

than nonusers (p < 0 ,05). Oral pill acceptors were higherthan

IUDs, but not significant ( p > 0 , 0 5) . The mean level -

of Tniglyceride in oral pill acceptors was significantly -

higher than IUDs and nonusers (P< 0,05). The mean levels of total Cholesterol, LDL-Cholesterol and Triglyceride in-

IUD acceptors were higher than nonusers, but not signifi -

cant (P> 0 ,05). There were significant different of the -

mean level of HDL-Cholesterol and body weight between oral

pill, IUD acceptors and nonusers. The mean ages of oral -

pill and IUD acceptors were significantly higher than nonu

sers (p < 0,05). IUD acceptors was higher than oral pill,-

but not siificant (P> 0,05).

No corrlaint was found for nonusers; and IUD accep -

tors had more subjective complaint than oral gills in rela

tion with mechanic factor in the reproductive tube."

"Stenosis adalah penyempitan abnormal yang dapat menyerang arteri. Para peneliti menyatakan bahwa stenosis dipengaruhi oleh efek fluida non-Newtonian yaitu darah yang viskositasnya dipengaruhi oleh shear stress dinding pembuluh darah. Simulasi CFD dilakukan dengan software ANSYS Fluent Student dan dapat digunakan untuk menganalisis aliran di dalam arteri yang tersumbat pada kasus stenosis pada pembuluh darah yang berbentuk Y junction. Model viskositas yang dipakai untuk studi ini adalah model Carreau karena model ini dapat digunakan untuk berbagai rentang nilai shear rate dan model ini cukup umum digunakan untuk mensimulasikan aliran darah. Karena karakteristik aliran darah dipengaruhi oleh beberapa parameter, maka metode yang dapat digunakan adalah 2k faktorial. Variabel respon yang akan digunakan dalam percobaan adalah velocity, wall shear stress, velocity, dan oscillatory shear index dengan tiga faktor yaitu besar sudut, diameter inlet, dan diameter outlet. Skenario terbaik untuk mencegah terjadinya aterosklerosis adalah dengan memilih faktor desain percabangan level rendah diameter inlet level tinggi dan diameter outlet level rendah sehingga diperoleh variabel respon terbaik dengan nilai velocity yang tinggi, wall shear stress > 0,5, dan OSI < 0,2.

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Stenosis is an abnormal narrowing that can attack the arteries. The researchers stated that stenosis is influenced by the effect of non-Newtonian fluids, namely blood whose viscosity is affected by shear stress on the walls of blood vessels. The CFD simulation was carried out with the ANSYS Fluent Student software and can be used to analyze the flow in a blocked artery in the case of stenosis in a Y-shaped vessel. The viscosity model used in this study is the Carreau model because this model can be used for a wide range of shear rate values and this model is quite commonly used to simulate blood flow. Because the characteristics of blood flow are influenced by several parameters, the method that can be used is 2k factorial. The response variables that will be used in the experiment are velocity, wall shear stress, velocity, and oscillatory shear index with three factors: angle size, inlet diameter, and outlet diameter. The best scenario to prevent atherosclerosis is to choose a low-level branching design factor, high-level inlet diameter and low-level outlet diameter so that the best response variable is obtained with a high velocity value, wall shear stress > 0.5, and OSI < 0.2."