Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang. Studi pH lambung pada pasien sirosis hati masih kontroversi Penelitian ini bertujuan untuk mengetahui adanya perbedaan pH lambung pada pasien sirosis hati dengan gastropati hipertensi portal GHP ringan dan berat. Metode Penelitian. Potong lintang dengan cara konsekutif pada pasien yang datang ke poliklinik gastro enterologi dan hepatologi RSCM pada periode Maret - Mei 2014 sebanyak enam puluh dua pasien sirosis hati dengan GHP dilakukan pemeriksaan endoskopi untuk menilai derajat gastropati sesuai klasifikasi McCormack dan pemeriksa pH lambung dengan menggunakan pH meter. Hasil. Dari 62 subjek didapatkan 50 subjek 80 6 berjenis kelamin laki laki dan perempuan 12 subjek 19 4 GHP paling banyak disebabkan oleh hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 dan alkohol 3 2 Rerata pH lambung pada seluruh pasien sirosis hati dengan GHP adalah 2 13 Rerata pH lambung pada pasien sirosis hati dengan GHP ringan 2 00 lebih rendah dibandingkan kelompok GHP berat 2 25 dengan perbedaan yang bermakna.

---

Background. Studies show gastric pH in cirrhosis patient still in controversy Aim of this study to know differences of gastric pH in liver cirrhosis patient withmild and severe portal hypertensive gastropathy

Methods. Cross sectional method with consecutive to all liver cirrhotic patientwho came to gastroenterology and hepatology clinic in Ciptomangunkusumo hospital Sixty two liver cirrhosis patients with portal hypertensive gastropathyunderwent endoscopy to measure degree of gastropathy based on McCormack classification and measured mean basal gastric pH with pH metry.

Result. There are 50 male subject 80 6 and 12 female subject 19 4 participating in this research Portal hypertensive gastropathy mostly caused by hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 and alcohol 3 2 Mean of gastric pH in all liver cirrhosis patient with portal hypertensive gastropathy was 2 13. The mean gastric pH in liver cirrhosis patient with mildportal hypertensive gastropathy 2 00 mEq L lower than the gastric pH in severeportal hypertensive gastropathy 2 25 mEq L with significant differences."

"Bile reflux: gastropathy is a disease caused by reflux of duodenal fluid to the gaster: This fluid contains pancreatic juices and duodenal secretion. The manifestations that occur depend on the frequency amount, and duration of reflux. This disorder is quite rarely recognized in daily clinical practice. Endoscopy of the upper gastrointestinal tract is required to establish the diagnosis of this disorder: This paper will give a brief view ofthe pathogenesis and diagnostic method for this disorder."

"Latar Belakang: Hipertensi pada kehamilan diketahui menyebabkan morbiditas dan mortalitas ibu dan bayi. Banyak faktor yang memengaruhi, diantaranya asam urat, walau masih banyak perdebatan diantara para ahli. Peneliti ingin mengetahui hubungan luaran ibu dan bayi dengan kadar asam urat darah ibu pada kehamilan dengan gangguan hipertensi. Metode: Studi analitik observasional dengan desain potong lintang. Subjek adalah ibu hamil dengan gangguan hipertensi di Rumah Sakit Umum Pusat Persahabatan, periode Januari 2014 sampai Desember 2018. Luaran ibu adalah tingkat keparahan gangguan hipertensi pada kehamilan dan derajat hipertensi. Luaran bayi adalah usia gestasi saat kelahiran, berat badan lahir bayi berdasarkan kurva Lubchenco dan skor APGAR menit pertama. Hubungan luaran ibu dan bayi dengan kadar asam urat darah ibu diketahui dengan uji Kruskal Willis dan Mann Whitney. Hasil: Sebanyak 704 subjek memenuhi kriteria penelitian dari 880 pasien ibu hamil dengan gangguan hipertensi. Didapatkan perbedaan bermakna kadar asam urat darah ibu (p<0,001) antarkelompok keparahan gangguan hipertensi pada kehamilan (preeklamsia gejala berat 5,7 (2,2–16,0) mg/dL, preeklamsia tanpa gejala berat 5,18 + 1,54 mg/dL, dan hipertensi kronik/hipertensi dalam kehamilan 4,8 (2,2-8,0) mg/dL). Didapatkan perbedaan bermakna kadar asam urat darah ibu antarkelompok derajat hipertensi (hipertensi derajat I 4,8 (2,2–8,0) mg/dL, hipertensi derajat II 5,7 (2,2–16,0) mg/dL, dan krisis hipertensi 5,4 (2,6–9,8) mg/dL). Kelompok usia gestasi aterm saat kelahiran menunjukkan kadar asam urat darah ibu 5,0 (2,2–9,8) mg/dL, lebih rendah bermakna (p<0,001) dibandingkan usia gestasi preterm saat kelahiran 6,3 (2,7–16) mg/dL. Tidak didapatkan perbedaan bermakna antarkelompok berat lahir bayi maupun skor APGAR menit pertama. Simpulan: Didapatkan hubungan bermakna antara luaran ibu yaitu tingkat keparahan gangguan hipertensi dan derajat hipertensi, dan luaran bayi yaitu usia gestasi saat kelahiran, dengan kadar asam urat darah ibu. Tidak didapatkan hubungan bermakna antara berat badan lahir bayi dan skor APGAR menit pertama, dengan kadar asam urat darah ibu.

---

Background: Hypertensive disorders in pregnancy is known to cause maternal and perinatal morbidity and mortality. Many factors influence, including uric acid, although there is still a lot of debate among experts. This study aims to find out the relationship between mother and baby outcomes with mother’s uric acid level, in pregnancy with hypertensive disorders.

Method: Observational analytic study with cross sectional design. Subjects were pregnant women with hypertensive disorders at Persahabatan General Hospital, from January 2014 to December 2018. Maternal outcomes were the severity of hypertensive disorders in pregnancy and the degree of hypertension. The perinatal outcomes were the gestational age at birth, the baby's birth weight based on the Lubchenco curve, and the first minute APGAR score. The relationship between maternal and perinatal outcome and maternal blood uric acid levels was questioned by the Kruskal Willis and Mann Whitney test.

Result: A total of 704 subjects met the criteria of the study of 880 pregnant women with hypertensive disorders. There were significant differences of maternal blood uric acid level (p <0.001) between groups of severity of hypertension (preeclampsia with severe features 5.7 (2.2–16.0) mg/dL, preeclampsia without severe features 5.18 + 1.54 mg/dL, and chronic hypertension / gestational hypertension 4.8 (2.2-8.0 mg/dL). There was a significant difference in maternal blood uric acid level between groups of hypertension stage (hypertension stage I 4.8 (2.2–8.0) mg/dL, hypertension stage II 5.7 (2.2–16.0) mg/dL, and a hypertensive crisis 5.4 (2.6–9.8) mg / dL). The group of term gestational age at birth showed maternal blood uric acid level 5.0 (2.2–9.8) mg/dL, significantly lower (p <0.001) than preterm gestational age at birth 6.3 (2.7–7). 16) mg/dL. There were no significant differences between groups of birth weight and first minute APGAR scores.

Conclusion: There is a relationship between maternal outcomes (the severity of hypertensive disorders and the degree of hypertension) and perinatal outcomes (gestational age at birth) with maternal blood uric acid level. There is no relationship between birth weight and first minute APGAR score with maternal blood uric acid level."

"Pada penelitian ini nanopartikel verapamil hidroklorida dari kitosan dan natrium tripolifosfat melalui proses gelasi ionik dipreparasi, dikarakterisasi, dan dievaluasi secara in vitro dan in vivo untuk penghantaran transdermal sebagai sediaan antihipertensi.Hasil menunjukkan nanopartikel kitosan-tripolifosfat dapat digunakan. Formula D merupakan formula terpilih yang menghasilkan nanopartikel berukuran 62,8 nm, persen efisiensi penjerapan 59,15 %, potensial zeta +25,46 mV, sferis, dan dapat dikonfirmasi dengan FT-IR. Formula ini selanjutnya digunakan pada pembuatan sediaan. Uji penetrasi secara in vitro yang menggunakan sel difusi Franz menunjukkan sediaan gel nanopartikel dengan propilen glikol sebagai peningkat penetrasi memiliki daya penetrasi terbesar dibandingkan dengan gel nanopartikel tanpa peningkat penetrasi dan pembanding dengan fluks secara berturut-turut adalah 148,33 ± 1,17 μg/cm2.jam; 121,88 ± 0,37 μg/cm2.jam; dan 60,93 ± 0,47 μg/cm2.jam. Uji tekanan darah secara in vivo menggunakan tikus jantan Sprague Dawley menunjukkan sediaan gel nanopartikel dengan peningkat penetrasi memiliki efektivitas penurunan tekanan darah sistolik tertinggi daripada gel nanopartikel secara berturut-turut adalah 14,89% dan 5,87%; efektivitas dalam menurunkan tekanan darah diastolik menunjukkan hasil efektivitas tertinggi pada gel nanopartikel saja sebesar 4,18%; dan efektivitas penurunan tekanan darah arteri rata-rata didapatkan hasil yang sama pada gel nanopartikel dan gel nanopartikel dengan peningkat penetrasi yaitu sebesar 20,61%, semuanya dibandingkan dengan gel pembanding.

---

In this research, verapamil hydrochloride nanoparticle from chitosan and sodium tripolyphosphate using ionic gelation method had been prepared, charaterized, and evaluated in vitro and in vivo for antihipertensive transdermal delivery.The results showed that chitosan-tripolyphosphate nanoparticle could be used. The chosen formula was formula D which has 62.8 nm nanoparticles size, 59.15% entrapment efficiency, +25.46 mV zeta potential, spherical, and confirmed with FT-IR. This formula was made into gel dosage form. In vitro penetration test using Franz diffusion cell showed that nanogel with propylen glicol as an enhancer had the greatest penetration result compared to nanogel without enhancher and standard gel with flux were 148.33 ± 1.17 μg/cm2.hours; 121.88 ± 0.37 μg/cm2.hours; and 60.93 ± 0.47 μg/cm2.hours, respectively. In vivo blood pressure test using Sprague Dawley male rats showed nanogel with enhancher has the highest systolic blood pressure reduction than nanogel were 14.89% and 5.87%, respectively; in lowering diastolic blood pressure showed the highest effectiveness of nanogel amounting to 4.18%; and the same effectiveness of mean arterial blood pressure obtained on nanogel and nanogel with enhancer which equal to 20.61%, all compared to the standard gel."

"The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other dialogic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2, and increased nitric oxyde which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis."

"Background: Thin study aimed to investigate gastric mucosa mucous layer thickness in portal hypertensive gastropathy (PHG) compare to normal mucosa in functional dyspepsia and its correlation with several variables such as child class, severity of esophageal varices and gastropathy.

Materials and Methods: Biopsy specimens were taken from the antrum and corpus from both group of patients with PHG and functional dyspepsia. The specimen was given cryometric for frozen section. Tissue were sliced by sagital section II urn, placed in object glass, fixed and stained to evaluate mucous thickness and giemsa stained to observe Helicobacter pylori. Measurement of mucous thickness was done upward muscularis mucosa started from upper epithelial layer from faveale tip until outer mucous layer on 15 points which were marked randomly and calculate the mean value by micrometer (/jm).

Results: Mean value of antral mucous thickness in PHG was 13.30 ± 6.5 fim, while in the functional dyspepsia it was 25.59 ± 5.66 /an. Statistical analysis for both kinds of mucous thickness was p<0.001. Mean corpus mucous thickness in PHG was 10.6 ± 6.81 /jm, while mucous thickness in dyspepsia was 32.54 ± 6.51 fjm. Statistical analysis revealed p<0.001. This result showed significant difference of mucous thickness of antrum and corpus statistically between PHG and dyspepsia as control group.

Conclusion: The study had proven the presence of decreased gastric mucosa mucous layer thickness in corpus and antrum in PHG. Thus, therapeutic approach to increase mucous thickness must be considered in patients with PHG."

"Latar Belakang: Sindroma dispepsia sering dialami oleh penderita DM. Asam lambung salah satu faktor agresif terjadinya sindroma dispepsia dan tukak lambung. Penelitian ini bertujuan untuk mencari perbedaan pH lambung pada pasien dispepsia DM dengan yang bukan DM dan untuk mengetahui apakah ada korelasi antara pH lambung dengan proteinuria dan HbA1c. Metode: Pasien terdiri dari 30 kelompok DM dan 30 kelompok bukan DM. Masing-masing kelompok dihitung pH lambung basal. pH lambung basal diukur dgn memasukkan elektroda kateter kedalam lambung selama 30 menit kemudian di rekam dgn alat PH Metri merek Digitrapper pH-Z. Beratnya komplikasi DM diukur dengan mikroalbuminuria, sedangkan kendali gula darah diukur dgn HbA1c. Dilakukan uji chi square utk mencari perbedaan pH lambung kelompok DM dgn yg bukan DM, dengan terlebih dahulu menentukan titik potong dgn analisa ROC (Receiver Operating Caracteristic). Dilakukan uji korelasi antara pH lambung basal dengan mikroalbuminuria dan HbA1c pada kelompok pasien DM. Hasil: pH lambung basal pada dispepsia DM vs non DM (2.30±0.83 vs 2.19±0.52). Dgn uji chi square terdapat perbedaan bermakna antara kelompok DM dengan yang bukan DM. Pada uji korelasi antara pH lambung dengan mikroalbuminuria dijumpai r = 0.47 dan p < 0.05, sedangkan HbA1c dijumpai r=0,59 dan p > 0.05. Simpulan: Ada perbedaan bermakna pH lambung basal antara pasien dispepsia DM dengan pasien dispepsia bukan DM. Ada korelasi antara pH lambung basal dengan mikroalbuminuria, sedangkan dengan HbA1c tidak ada korelasi. pH lambung basal pada pasien DM adalah 2.03±0.83 sedangkan pada yang bukan DM adalah 2.19±0.52.

---

Aims: Dyspepsia syndrome often experienced in diabetic patients. Gastric acid was one aggressive factors in dyspepsia syndrome. This aim of this study was to determine differences gastric pH between dyspepsia diabetic and dispepsia without diabetic patients. Also to determine whether there were a correlation between basal gastric pH and microalbuminuria and also HbA1c.

Methods: There were 30 patients diabetic and 30 patients without diabetic. Basal gastric pH was measured with an electrode catheter that inserted into the stomach for 30 minutes. Gastric pH will be recorded with PH Metri Digitrapper pH-Z. Diabetic complications measured by microalbuminuria, while the measured blood sugar control with HbA1c. Chi-square test to determine differences gastric pH between diabetic and without diabetic patients. Correlation test was performed between basal gastric pH and microalbuminuria and also HbA1c.

Results: We found basal gastric pH diabetic and non diabetic patients were (2.30±0.83 vs 2.19±0.52). There was significant differences between diabetic and non diabetic patients. From 30 diabeic patients we found a corelation between basal gastric pH and microalbuminuria (p < 0.05 and r = 0.47) and a no corelation with HbA1c (p > 0.05 and r=0,59).

Conclusions: There was significant differences basal gastric pH between diabetic and non diabetic patients. There was correlation between basal gastric pH and microalbuminuria, and no correlation with HbA1c. Basal gastric pH diabetic patients was 2,30 ± 0.83 and non diabetic patients was 2,19 ± 0,52."

"ABSTRAKLatar belakang dan Tujuan : Varises esofagus merupakan komplikasi sirosis hati dengan mortalitas tertinggi. Pemeriksaan USG Doppler yang bersifat non invasif, tersedia luas dan relatif murah, dipertimbangkan sebagai metode skrining, namun belum ditemukan parameter Doppler splenoportal yang dapat digunakan sebagai indikator varises dengan akurat. Indeks volume aliran vena lienalis terhadap kecepatan aliran vena porta dipikirkan dapat menjadi parameter baru yang akurat.Metode : Studi observasional potong lintang dilakukan pada 28 pasien sirosis hati di Divisi Hepatologi Departemen Ilmu Penyakit Dalam Rumah Sakit Cipto Mangunkusumo dalam kurun waktu November 2015 hingga Februari 2016. Indeks dan parameter Doppler lainnya merupakan data primer. Subjek dibagi menjadi tiga kelompok, yakni kelompok non varises, varises kecil dan besar. Uji komparatif dilakukan untuk membandingkan indeks dan parameter Doppler lainnya diantara ketiga kelompok tersebut. Analisis kurva receiver operating characteristic (ROC) dilakukan pada parameter yang secara statistik bermakna untuk mendapatkan nilai sensitifitas dan spesifisitasnya.Hasil : Nilai tengah indeks pada kelompok non varises 9,60 (4,67 – 15,07), varises kecil 21,18 (8,92 – 25,24) dan varises besar 64,43 (46,67 – 145,88) dengan nilai p<0,001. Pada analisis kurva ROC didapatkan titik potong indeks 15,78 dengan sensitifitas 80% dan spesifisitas 100% untuk membedakan kelompok varises kecil dan non varises, serta titik potong 36,0 dengan sensitifitas dan spesifisitas 100% untuk membedakan kelompok varises besar dan kecil.Kesimpulan : Terdapat hubungan yang bermakna antara indeks volume aliran vena lienalis terhadap kecepatan aliran vena porta secara ultrasonografi dengan derajat varises esofagus secara endoskopi pada pasien sirosis hati dan indeks tersebut dapat digunakan sebagai indikator varises esofagus dengan akurasi tinggi.

---

ABSTRACTBackground and Objective : Esophageal varices is a complication of liver cirrhosis with high mortality. Doppler ultrasound examination is non-invasive, widely available and relatively low cost to be considered as a screening method of varices. Unfortunately, there is still no splenoportal Doppler parameter that can be used as an indicator of varices with high accuracy. Index of splenic vein flow volume to portal vein flow velocity is thought to be a new, more accurate parameter.Methods : A cross-sectional observational study conducted in 28 patients with liver cirrhosis in the Division of Hepatology Department of Internal Medicine Cipto Mangunkusumo Hospital during November 2015 to February 2016. Index and other splenoportal Doppler parameters are the primary data. Subjects were divided into three groups : a group of non varices, small and large varices. The comparative test conducted to compare the mean index and other splenoportal Doppler parameters among the three groups. Analysis of receiver operating characteristic (ROC) curve was performed on parameters that are statistically significant to get the sensitivity and specificity value.Results : Median index in the group of non varices is 9,60 (4,67 – 15,07), 21,18 (8,92 – 25,24) in small varices and 64,43 (46,67 – 145,88) in large varices group with p<0.001. ROC curve analysis generated optimal cutting point index 15,78 which gives 80% sensitivity and 100% specificity to differentiate small and non varices group and the cutoff point of 36.0 which provides 100% sensitivity and specificity to differentiate among the large and small varices.Conclusions : There is a significant association between the index of splenic vein flow volume to portal vein flow velocity by ultrasound with the degree of esophageal varices by endoscopy in patients with liver cirrhosis and this index can be used as indicator of esophageal varices with high accuracy."

"Latar Belakang: Kondisi dekompensata tanpa infeksi bakteri pada pasien sirosis hati dapat meningkatkan kadar prokalsitonin (PCT). Belum ada penelitian yang secara khusus membandingkan kadar PCT berdasarkan kompensasi hati dan ada tidaknya infeksi bakteri. Tujuan: Mengetahui peran PCT dalam membantu menegakkan diagnosis infeksi bakteri pada pasien sirosis hati. Metode: Studi potong lintang dilakukan terhadap pasien sirosis hati yang berobat jalan dan dirawat inap di RSUPNCM Jakarta dari April sampai Mei 2016. Pada pasien dilakukan pemeriksaan PCT dan penentuan ada tidaknya infeksi bakteri berdasarkan pemeriksaan standar sesuai jenis infeksi yang dicurigai. Dilakukan analisis untuk mengetahui perbedaan rerata kadar PCT pada pasien sirosis hati yang tidak terinfeksi bakteri dan yang terinfeksi bakteri, serta pencarian nilai titik potong PCT untuk mendiagnosis infeksi bakteri pada sirosis hati dekompensata dengan menggunakan receiver operating curve (ROC). Hasil: Didapatkan 55 pasien sirosis hati, pria sebanyak 65,5%, dengan rerata usia 55,34±1,308 tahun. Sebanyak 38 (69,1%) pasien sirosis hati dekompensata yang 22 (57,9%) diantaranya tidak terinfeksi bakteri dan 16 (42,1%) terinfeksi bakteri. Pada pasien yang tidak terinfeksi bakteri terdapat perbedaan rerata kadar PCT yang bermakna antara pasien dekompensata (0,738ng/mL±1,185) dibandingkan dengan 17 pasien kompensata (0,065ng/mL±0,022). Rerata kadar PCT pasien dekompensata yang terinfeksi bakteri (3,607ng/mL±0,643) lebih tinggi bermakna dibandingkan dengan yang tidak terinfeksi bakteri(0,738ng/mL±1,185). Dari kurva ROC, kadar PCT pada pasien sirosis hati dekompensata didapatkan area under curve (AUC) 0,933 (IK 0,853-1,014) untuk diagnosis infeksi bakteri. Nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL dengan sensitivitas 87,5% dan spesifisitas 86,4%. Kesimpulan: Pada pasien sirosis hati yang tidak terinfeksi bakteri, kadar PCT pasien dekompensata lebih tinggi dibandingkan dengan yang kompensata. Kadar PCT pasien sirosis hati dekompensata yang terinfeksi bakteri lebih tinggi dibandingkan dengan yang tidak terinfeksi bakteri. Sementara nilai titik potong kadar PCT untuk mendiagnosis infeksi bakteri pada pasien sirosis hati dekompensata adalah 2,79ng/mL.

---

Background: Liver decompensated without bacterial infection may increase procalcitonin (PCT) level in liver cirrhosis patients. Previous studies did not provide conclusive results about the differences of PCT level due to specific liver compensation and bacterial infection.

Objective: To examine the role of PCT in assisting the diagnosis of bacterial infection in liver cirrhosis patients.

Methods: A cross sectional study was conducted in liver cirrhosis patients who were outpatients and admitted to Cipto Mangunkusumo Hospital, Jakarta between April and May 2016. Procalcitonin were examined and bacterial infection were identified using standard criteria for each type of infection being suspected. Analysis were performed to determine differences in the level of PCT among liver cirrhosis patients without bacterial infection and with bacterial infection, also to get cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients using receiver operating curve (ROC).

Results: There were 55 patients with liver cirrhosis, 65,5% male, with mean of age 55,34±1,308 years. A total of 38 (69,1%) patients had decompensated liver cirrhosis, while 22 (57,9%) of them without bacterial infection and 16 (42,1%) with bacterial infection. In the absence of bacterial infection, there was significant difference between PCT level in decompensated patients (0,738ng/mL±1,185) and 17 compensated patients(0,065ng/mL±0,022). Decompensated patients with bacterial infection (3,607ng/mL±0,643) had significantly higher PCT levels than those without bacterial infection(0,738ng/mL±1,185). From ROC, level of PCT for bacterial infection in decompensated liver cirrhosis was area under curve (AUC) 0,933 (IK 0,853-1,014). Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL with a sensitivity of 87.5% and specificity of 86,4%.

Conclusion: In the absence of bacterial infection, PCT levels of decompensated patients was higher than compensated ones. Procalcitonin levels of decompensated liver cirrhosis patients with bacterial infection was higher than those without bacterial infection.Cut off point of PCT for bacterial infection diagnosis in decompensated liver cirrhosis patients was 2,79ng/mL."

"Ultrasonography examination is an one of examination that can be used to see the abnormality of portal vein system. The technology of ultrasonography examination has further developed especially after using of Doppler ultrasonography which could portray haemodynamic changes from portal vein in liver cirrhosis patient. From this examination we also could predict bleeding."