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"Latar Belakang: Pulau Langerhans adalah kumpulan sel pernghasil insulin yang tersebar di seluruh pankreas. Resistensi insulin adalah salah satu tanda dari diabetes tipe 2, pada pasien diabetes tipe 2 terjadi penurunan pada ukuran dan jumlah dari pulau Langerhans yang berdampak pada produksi insulin dan menyebabkan pasien dengan kondisi ini memiliki kadar gula darah yang tinggi. Alpha-mangostin diduga berperan dalam proses regenerasi pancreas pada kondisi resistensi insulin. Tujuan dari penelitian ini adalah untuk mengetahui efek dari alpha-mangostin terhadap regenerasi pankreas, baik pada kelenjar endokrin (pulau Langerhans) maupun kelenjar eksokrin. Metode: Tikus jantan galur wistar diacak dan dibagi menjadi 6 kelompok berdasarkan perlakuan yang diterima; Kelompok Normal/Kontrol, Kelompok Normal + Alpha Mangostin 200mg/kgBB, Kelompok Resistensi Insulin (Induksi STZ + HF + HG), Kelompok Resistensi Insulin + Alpha Mangostin 100mg/kgBB, Kelompok Resistensi Insulin + Metformin 200mg/kgBB, Kelompok Resistensi Insulin + Alpha Mangostin 200mg/kgBB. Diameter pulau Langerhans dihitung menggunakan aplikasi ImageJ computer software, sedangkan struktur histologi bagian eksokrin diobservasi dibawah mikroskop cahaya. Hasil: Pemberian alpha mangostin menyebabkan peningkatan pada luas area Langerhans islet secara signifikan. Tidak ditemukan pengaruh signifikan pada pemberian alpha mangostin pada kelenjar eksokrin pulau Langerhans. Kesimpulan: Terdapat hubungan bermakna antara pemberian alpha-mangostin dengan regenerasi pulau Langerhans pankreas pada tikus model insulin resisten. Alphamangostin tidak menyebabkan terjadinya perubahan struktur histologi pada bagian eksokrin pancreas.

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Background: The islets of Langerhans are clusters of insulin-producing cells scattered throughout the pancreas. Insulin resistance is one of the signs of type 2 diabetes, in patients with type 2 diabetes there is a decrease in the size and number of the islets of Langerhans which affects insulin production and causes patients with this condition to have high blood sugar levels. Alpha-mangostin is thought to play a role in the process of pancreatic regeneration in conditions of insulin resistance. The purpose of this study was to determine the effect of alpha-mangostin on pancreatic regeneration, both in endocrine glands (island of Langerhans) and exocrine glands.

Method: Wistar male rats were randomized and divided into 6 groups based on the treatment received; Normal/Control Group, Normal Group + Alpha Mangostin 200mg/kgBB, Insulin Resistance Group (STZ Induction + HF + HG), Insulin Resistance Group + Alpha Mangostin 100mg/kgBB, Insulin Resistance Group + Metformin 200mg/kgBB, Insulin Resistance Group + Alpha Mangostin 200mg /kgBB. The diameter of the islets of Langerhans was calculated using the ImageJ computer software application, while the histological structures of the exocrine sections were observed under a light microscope.

Results: Administration of alpha mangostin caused a significant increase in the Langerhans islet area. No significant effect was found on the administration of alpha mangostin on the exocrine glands of the islets of Langerhans.

Conclusion: There is a significant relationship between the administration of alphamangostin and the regeneration of the pancreatic islets of Langerhans in insulin-resistant rats. Alpha-mangostin does not cause changes in the histological structure of the exocrine pancreas."

"The aim of this research is to find the method for analyze glimepiride and it?s metabolite. Glimepiride is the second generation of antidiabetic oral from the sulphonyl urea that works by stimulating the insulin secretion from beta cells of pancreas. Glimepiride is isolated from plasma the using chloroform. Using the high performance liquid chromatography method which include C18 reversed phase column, using mixture of methanol:water (50:50, v/v) as a mobile phase, flow rate 1.0 ml/minutes, detection at wavelenght 228 nm with photo diode array detector gives retention times of glimepiride in 17 minutes without any interference from endogen component of plasma and from it?s metabolite. Linearity with added internal standard gliclazide was established for the range concentration 100-1000 ng/ml with coefficient of correlation (r) is 0.9977 and give the limit of quantitation of glimepiride in 50 ng/ml. The results of validation method fulfilled for the given criterias."

"ABSTRAKGaya hidup sedenter dan ketidakseimbangan pola konsumsi mengakibatkan masyarakat dunia menghadapi Global Time Bomb Phenomenon. Kecenderungan masyarakat dalam mengkonsumsi makanan tinggi fruktosa dan kolesterol menjadikan sindrom metabolik sebagai bom waktu yang perlu mendapatkan perhatian khusus. Perlemakan pankreas merupakan komorbid yang dapat muncul apabila kondisi hiperlipidemi dan hiperglikemi pada sindrom metabolik tidak mendapatkan intervensi adekuat sedari dini. Gemfibrosil merupakan salah satu pilihan terapi namun efektifitas tunggal regimen ini masih dipertanyakan. Acalypha indica merupakan tanaman herbal yang disinyalir memiliki efek protektif pada kondisi hiperlipidemi dan hiperglikemi. Penelititan ini bertujuan untuk membandingkan efek terapeutik Gemfibrosil G dan Acalypha indica Linn. AI terhadap perlemakan pankreas tikus Sprague-Dawley pasca induksi diet tinggi fruktosa dan kolesterol selama 4 minggu. Tikus yang telah diinduksi dibagi menjadi empat kelompok perlakuan, yaitu kontrol, obat standar Gemfibrosil, ekstrak AI, dan kombinasi AI G. Setiap kelompok mendapatkan perlakuan selama 4 minggu. Hasil uji analisis statistik menggunakan metode One-Way ANOVA dan uji Post Hoc Tukey menunjukkan penurunan perlemakan pankreas yang bermakna antara kelompok kontrol terhadap kelompok yang diadministrasikan Acalypha indica p=0.004, 95 CI: 0.170-0.959 dan kelompok yang diadministrasikan kombinasi Gemfibrosil-Acalypha indica p=0.023, 95 CI: 0.537-0.813 . Efek pankreoprotektif dari Acalypha indica Linn. menunjukkan tumbuhan ini berpotensi sebagai pilihan terapi dalam mengatasi kondisi perlemakan pankreas.

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ABSTRAKSedentary lifestyle and imbalance consumption pattern has made metabolic syndrome as the global time bomb phenomenon in the world. The increasing tendency of people in consuming high amount of fructose and cholesterol food has worsened this issue in the society. Pancreas steatosis become one of the most comorbid when early diagnosis and prompt treatment has not been applied on hyperglycemic and hyperlipidemic condition in metabolic syndrome patient. Gemfibrozil become the drug of choice to prevent this issue, yet the efficacy of this regiment was still questionable. Acalypha indica Linn. is the herb that has protective effect on hyperlipidemic and hyperglycemic condition. This study was aimed to compare therapeutic effect of gemfibrozil G and Acalypha indica Linn. AI on high fructose and cholesterol diet induced pancreas steatosis in Sprague Dawley mice. The post induction mice were divided into four groups control, gemfibrozil, AI extract, and G AI combination regiment. Each group received four weeks intervention. The result of statistical analysis using the One Way ANOVA test and Tukey Post Hoc test showed significant decrease in pancreatic steatosis between the control group and administered Acalypha indica group p 0.004, 95 CI 0.170 0.959 and the group administered with a combination of Gemfibrozil Acalypha indica p 0.023, 95 CI 0.537 0.813 . The protective effect of Acalypha indica Linn. shows that this plant has the potential as therapeutic option in overcoming the condition of pancreas steatosis in metabolic syndrome. "

"LATAR BELAKANG. Progresifitas penurunan sekresi insulin sudah terjadi sebelum individu didiagnosis sebaai DM tipe-2 baru karena kelelahan sel beta pankreas untuk mengatasi resistensi insulin. Efek glukotoksisitas, Iipotoksisitas dan amiloidosis pada sel beta pankreas menyebabkan proses tersebut terus berlanjut walaupun pasien telah diterapi dengan baik. Berbagai penelitian memperlihatkan sebagian besar penyandang DM tipe-2 baru ditemukan dengan fungsi sel beta pankreas yang sudah rendah. Populasi tersebut lebih cepat mengalami kegagalan terapi dibandingkan populasi dengan fungsi sel beta pankreas yang masih baik akibat progresifitas penurunan sekresi insulin yang lebih cepat, sedangkan resistensi insulin dalam tingkatan yang sama. Akibatnya prevalensi kegagalan mencapai kontrol glukosa darah yang baik menjadi tinggi pada populasi tersebut, dan merupakan salah satu penyebab komplikasi makrovaskular maupun mikrovaskular yang semakin meningkat. Di poliklinik diabetes RSCM dan berbagai puskesrnas di Jakarta, sebagian besar penyandang DM tipe-2 sulit untuk mencapai kontrol glukosa darah yang baik dan tingginya prevalensi komplikasi makrovaskular maupun mikrovaskular. Apakah populasi tersebut sudah berada dalam fungsi sel beta pankreas yang rendah? Penelitian ¡ni bertujuan untuk mengetahui gambaran fungsi sel beta pankreas melaluiperhitungan HOMA-B dan resistensi insulin melalui perhitungan HOMA-IR padasubyek penyandang DM tipe-2 baru yang berobat di poliklinik diabetes RSCM.METODOLOGI. Dirancang studi potong lintang dengan analisis deskriptif. Prosedur yang dilakukan adalah subyek dipuasakan selama 10 jam lalu diperiksa konsentrasi glukosa darah puasa dan insulin puasa. Dari hasil tersebut dilakukan penghitungan HOMA-B dan HOMA-IR.HASIL. Telah dilakukan pengambilan data terhadap 100 subyek. Nilai median usia 52 tahun. 51% dan subyek mempunyai riwayat keluarga DM dan sebagian besar subyek adalah obes sebanyak 54%. Sebagian besar subyek dalam kelompok nilai HOMA-B yang sangat rendah yaitu kurang dari 25 pmol/mmol sebanyak 55% dengan nilai median 17,14 pmol/mmol, dan dalam kelompok nilai HOMA-IR yang rendah yaitu kurang dari 3 pmol-mmol/l2 scbanyak 61% dengan niai median 245 pmol-mmol/l2.SIMPULAN. Sebagian besar penyandang DM tipe-2 baru di poliklinik diabetes RSCM adalah obes dan manpunyai riwayat keluarga DM. Sebagian besar subyek berada dalam kelompok fungsi sel beta pankreas dan resistensi insulin yang rendah.

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BACKGROUND. The declining of insulin secretion already happened before the patent diagnosed type 2 diabetic, caused by beta cell pancreas failure in order to compensate insulin resistance. The glucotoxicity and lipotoxicity effect combined with amyloidosis onì beta cell pancreas caused continuing declining process progessiveIy even though the patient has been treated. Most of the previous studies showed that many new type 2 diabetic patients have already had low beta cell finction. This population failed to achieve targeted therapy faster than population with good beta cell function, because faster the declining of insulin secretion. However, innsulin resistance was almost constant. Because of that, prevalence of failed to achieve good blood glucose control were high and one of the mechanisms cause micro and macro vascular complication will increase. Many type 2 diabetic who attended in endocrine metabolic clinic in Cipto Mangunkusumo hospital and Primary Health Care in Jakarta failed to achieve good blood glucose control and there were high incidence of macro and micro vascular complication We hypothesized that many new type 2 diabetIc patients in endocrine metabolic clinic in Cipto Mangunkusumo have already had low beta cells function. We investigated the profile of beta cells function by calculated IIOMA-13 and insulin resistance by calculated ROMA-IR in new type 2 diabetic patients who attenckxl in endocrine metabolic clinic ¡n Cipto Mangunkusumo hospital.METHOD. A descriptive-cross sectional study was conducted. After 10 hours fasting, new type 2 diabetic patients were checked for fasting blood glucose and fasting insulin concentration. Based on those numbei, The HOMA-B and HOMA-IR were calculated.RESULT. Based on the results of 100 patients. Median value of age was 52 years old. 51% of the subjects had family history of diabetic and most of them were obese in 54% subjects. Most of the subjects were in lower HOMA-B value less than 25 Pmol/mmol in 55% of the subiects with median NOMA-B vahe was 17,14 pmol/mmol and wese in lower HOMA-IR less than 3 pmol-mmol,I2 in 61% of the subjects with median HOMA-ER value was 2,45 pmol-mmol/12 groups.CONCLUSION. Many new type 2 diabetic patients, who attended in endocrine metabolic Clinic in Cipto Mangunkusumo hospital, were obese and have already had family history of diabetic. Most of the subjects were in low pancreas beta cell function and insulin resistance groups."

"Pendahuluan: Pembedahan merupakan pilihan tatalaksana kuratif terbaik kanker pancreas, oleh karena itu sangat penting untuk dapat menegakkan diagnosis secara akurat sejak awal. Skor BACAP dan CA 19-9 telah diterima sebagai prediktor resektabilitas kanker pancreas yang cukup baik, dan akurasinya diharapkan akan meningkat apabila keduanya dikombinasikan. Studi ini bertujuan untuk mengetahui keluaran yang dihasilkan oleh kombinasi skor BACAP dan penanda tumor CA 19-9.Metode: Penelitian potong lintang retrospektif ini melibatkan pasien kanker pankreas yang telah menjalani operasi di RSUPN Dr. Cipto Mangunkusumo Indonesia pada periode Januari 2017 hingga April 2023. Data diperoleh dari medical record. Pasien dengan penyakit penyerta seperti jaundice karena obstruksi batu bilier, pankreatitis, sirosis hati, kelainan paru dan pasien dengan neoadjuvant akan diekslusi. Nilai  CA 19-9 diperoleh melalui pemeriksaan Chemiluminescent Immunoassay, titik potong 140,6 dipilih berdasarkan penelitian sebelumnya di RSCM. Nilai skor BACAP melibatkan enam variabel klinis dan radiologis dan dapat diperoleh dengan mengaplikasikan kalkulator yang terdapat pada http://jdlp.fr/resectability/.Hasil: Total 87 pasien yang dilibatkan pada penelitian ini didapatkan keluaran skor BACAP yaitu sensitivitas sebesar 50,0%, spesifisitas 100%; PPV 100%; NPV 73,8%, dan akurasi 75,9% (AUC 94,6%). Sementara modifikasi skor BACAP menghasilkan sensitivitas 83,1%, spesifisitas 85,7%, PPV 70,5%, NPV 92,5%, dan akurasi 83,9% (AUC 89,4%).Kesimpulan: Kombinasi CA 19-9 dan skor BACAP menghasilkan skor modifikasi dengan keluaran yang lebih baik dibandingkan skor BACAP dalam memprediksi resektabilitas karsinoma pankreas.

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Background: Surgery remains the best choice curative treatment for pancreatic cancer. Therefore, it is crucial to establish accurate diagnosis from the beginning. BACAP score and CA 19-9 have been identified as good predictors of pancreatic cancer resectability, and their accuracy is expected to increase when combined. This study aimed to determine the outcomes produced by the combination of the BACAP score and CA 19-9 tumor marker

Methods: This was a retrospective cross-sectional study involved 87 pancreatic cancer patients who underwent surgery between January 2017 and April 2023. The research data was obtained from medical records. The presence of other diseases such as biliary stones, strictures, pancreatitis, liver cirrhosis, or other pulmonary abnormalities, and prior neoadjuvant chemotherapy were excluded. The CA 19-9 value was obtained through a blood examination using the Chemiluminescent Immunoassay method. The cut-off point of 140.6 has been selected and determined based on previous studies at RSCM. The BACAP score, comprising 6 variables (Abdominal pain, weight loss, tumor size, thrombosis, tumor location, and performance status), was applied to the entire research sample using the BACAP score calculator available at http://jdlp.fr/resectability/.

Results: A total 87 patients were included. BACAP score yields a sensitivity of 50.0%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 73.8%, and accuracy of 75.9% (AUC 94.6%). While modified BACAP score yielded a sensitivity of 83.1%, specificity of 85.7%, PPV of 70.5%, NPV of 92.5%, and accuracy of 83.9% (AUC 89.4%).

Conclusion: The combination of CA 19-9 and the BACAP score yields a modified score with better outcomes compared to the BACAP score alone in predicting the resectability of pancreatic carcinoma."

"Pendahuluan: Hiperurisemia sering terjadi pada pasien DM tipe 2, hal ini disebabkan adanya penurunan ekskresi asam urat yang berkaitan dengan resistensi insulin (RI) dan hiperinsulinemia. Tujuan dari penelitian ini adalah untuk mengetahui efek α-mangostin terhadap fungsi ginjal dan kadar asam urat dalam plasma darah tikus model resistensi insulin. Metode: Tikus jantan galur wistar dibagi menjadi 6 kelompok secara acak: normal, normal yang diberi α-mangostin 200 mg/kgBB, RI, RI yang diberi metformin 200 mg/kgBB, RI yang diberi α-mangostin 100 mg/kgBB dan RI yang diberi α- mangostin 200 mg/kgBB. Pemberian α-mangostin dan metformin dilakukan selama 8 minggu dan diberikan secara peroral. Kelompok perlakuan diberi diet tinggi lemak, glukosa 20% dan induksi STZ dosis rendah. Pada akhir penelitian, sampel urin, darah dan ginjal diambil dan diukur proteinuria, BUN, klirens kreatinin, asam urat plasma, transporter URAT1, GLUT9, SGLT2 dan histopatologi ginjal. Hasil: α-mangostin 100 mg/kgBB dan 200 mg/kgBB mampu menurunkan BUN dan asam urat plasma secara signifikan, α-mangostin 100 mg/kgBB dan 200 mg/kgBB cenderung menurunkan proteinuria, meningkatkan klirens kreatinin, menurunkan ekspresi URAT1, GLUT9, SGLT2 serta memperbaiki kerusakan ginjal dibandingkan dengan kelompok RI tanpa pengobatan. Kesimpulan: α-mangostin 100 mg/kgBB dan 200 mg/kgBB mampu menurunkan kadar asam urat plasma dan cenderung memperbaiki fungsi ginjal pada tikus model RI.

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Background: Hyperuricemia often occurs in type 2 diabetes mellitus, this is due to a decrease in uric acid excretion associated with insulin resistance (IR) and hyperinsulinemia. The aim of this study was to analyze the effects of α-mangostin on kidney function and plasma uric acid level of insulin resistance rat model.

Method: Wistar male rats were divided into 6 groups, such as normal, normal + α- mangostin 200 mg/kgBW, IR, IR + metformin 200 mg/kgBW, IR + α-mangostin 100 mg/kgBW and IR + 200 mg/kgBW. -mangostin and metformin were administered by gavage for 8 weeks. To induce IR, treatment groups were given a high-fat diet, glucose 20%, and low-dose injection of STZ. At the end of the study, urine, blood, and kidney tissue were taken and measured proteinuria, BUN, creatinine clearance, plasma uric acid, expressions of URAT1, GLUT9, and SGLT2 as well as kidney histopathology

Results: -mangostin 100 mg/kgBW and 200 mg/kgBW were able to significantly reduce BUN and plasma uric acid levels. -mangostin 100 mg/kgBW and 200 mg/kgBW tended to reduce proteinuria, increase creatinine clearance, reduce the expression of URAT1, GLUT9, SGLT2, as well as improve renal damage compared to that of IR untreated group.

Conclusion: -mangostin 100 mg/kgBW and 200 mg/kgBW were able to reduce plasma uric acid levels dan tended to alleviate renal dysfunction in IR rat model."

"ABSTRAK Latar Belakang dan tujuan: Karsinoma pankreas merupakan keganasan gastrointestinal kedua terbanyak dan merupakan salah satu tumor dengan angka kematian tinggi. Operasi reseksi merupakan satu-satunya terapi kuratif. Kegagalan dalam evaluasi preoperatif dari menyebabkan resiko operasi, terlambatnya pasien mendapat terapi paliatif serta meningkatkan biaya pengobatan. Penelitian ini bertujuan untuk mengevaluasi penilaian resektabilitas karsinoma pankreas pada CT-scan abdomen dibandingkan penemuan operasi serta faktor-faktor yang mempengaruhinya. Metode: Dilakukan pembacaan ulang CT scan pasien karsinoma pankreas pada sistem PACS Departemen Radiologi RSCM dan dibandingkan dengan laporan operasi pada rekam medis. Hasil: Uji statistik McNemar dari hubungan CT-scan dan operasi n=21 menunjukan p > 0,99, dengan nilai R = 0,52 p = 0,017 . Uji McNemar dari hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan teknik pemeriksaan CT-scan p > 0,05.Uji McNemar hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan interval CT-scan dan operasi p > 0,99. Uji McNemar hubungan kesesuaian gambaran CT-scan abdomen dan penemuan operasi dengan lama sakit p > 0,05. Kesimpulan: Terdapat kesesuaian antara gambaran CT-scan abdomen dengan penemuan saat operasi terhadap keterlibatan vaskuler pada karsinoma pankreas. Lama sakit, interval CT-scan dan operasi serta teknik pemeriksaan CT-scan memperlihatkan kecenderungan tidak berhubungan.Kata Kunci: CT-scan abdomen; karsinoma pankreas; laparatomi; resektabilitas ABSTRACT Background and Objective : Pancreatic carcinoma is malignancy in gastrointestinal with high mortality. Surgery is the only curative therapy. Failure evaluation prior to surgery leads to the risk of non-curative surgery, delayed palliative and increased treatment costs. This study aims to evaluate the resectability assessment of pancreatic carcinoma in preoperatif CT-scan compared to surgical findings and the factors that influence it. Methods : Patients with pancreatic carcinoma whose CT scans were in the PACS system of the Radiology Department RSCM reevaluated and compared with surgical reports. Results : McNemar 39;s analysis of the preoperative CT-scan and surgical findings n=21 p>0.99, with R=0.52 p=0.017 . The McNemar analysis conformity relationship between preoperative abdominal CT scan and surgical findings with CT-scan technique p>0.05. McNemar analysis conformity relationship between preoperative abdominal CT-scan and surgical findings with CT-scan interval and surgery p> ?? ??0.99. McNemar analysis conformity relationship between preoperative abdominal CT-scan and surgical findings with prolonged illness p> ?? ??0.05. Conclusion : There is a suitability between preoperative abdominal CT-scan and the surgical findings of vascular involvement in pancreatic carcinoma. Length of prolonged illness, interval between CT-scan and surgery as well as CT-scan technique showed a tendency not to correlate. "

"Latar Belakang: Kanker pankreas adalah penyebab kematian keempat yang berhubungan dengan keganasan di Amerika Serikat, dan diperkirakan akan menjadi penyebab kematian kedua di tahun 2030 di United Kingdom. Indonesia belum memiliki data kesintasan kanker pankreas dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui kesintasan 1 tahun kanker pankreas dan faktor- faktor yang memengaruhinya di RS dr. Cipto Mangunkusumo, Jakarta.Metode: Dilakukan penelitian kohort retrospektif menggunakan data dari rekam medis pasien kanker pankreas RS dr. Cipto Mangunkusumo antara Januari 2012 - Desember 2016. Faktor umur, jenis kelamin, metastasis, stadium, komorbid dan pengobatan dianalisis secara bivariat dan multivariat menggunakan Cox Proportional Hazards Regression untuk mendapatkan Hazard Ratio HR setiap faktor prognosis. Kesintasan kumulatif 1 tahun setelah diagnosis dinyatakan dengan kurva Kaplan- Meier.Hasil: Dari 83 subyek penelitian proporsi laki-laki adalah 62.7, usia ge; 50 tahun 68,7, dengan rentang usia 33-79 tahun, dan rata-rata 55 tahun. Pada analisis bivariat didapati hubungan bermakna secara statistik kesintasan dengan variabel komorbid HR 2,116 IK 95 1,335-3,513 p< 0,002, metastasis HR 3,802 IK 95 1,995-7,249 p

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Background Pancreatic cancer is the fourth leading cause of death associated with malignancy in the United States, and is thought to be the second leading cause of death in 2030 in the United Kingdom. Currently, Indonesia has no data on the survival of pancreatic cancer and the factors that affect it. Aim This study aims to know the 1 year survival of pancreatic cancer and its influencing factors. Methods A retrospective cohort study was performed using data from the medical record of pancreatic cancer patients in dr Cipto Mangunkusumo General Hospital, Jakarta, from January 2012 to December 2016. Age, sex, metastasis, stage, comorbidities, and treatment were analyzed bivariate and multivariate using Cox Proportional Hazards Regression to obtain Hazard Ratio HR for each prognostic factor. The 1 year cumulative survival rate after diagnosis is expressed by the Kaplan Meier Curve.Results Of 83 subjects, the proportion of male was 62,7, age ge 50 years 68,7, with age range 33 79 years, and 55 years on average. In bivariate analysis, there was a statistically significant relationship of survival with comorbidities HR 2.116 95 CI 1.335 3.513 p 0.002, metastasis HR 3.802 95 CI 1.995 7.249 p 0.001, palliative treatment HR 2.108 95 CI 1.077 4.125 p 0.029 and group without treatment HR 2.924 95 CI 1.496 5.716 p 0.002. Multivariate analysis showed that metastasis provided the greatest risk of death with HR 4.306 95 CI 2.125 8.724 p 0.001. Palliative group HR was 2.510 95 CI 1.245 5.061 p 0.010 while the group without treatment gave HR 2.535 95 CI 1.277 5.032 p 0.008. Conclusion The overall survival of 1 year of pancreatic cancer patients was 14, with median survival of 6 months. The presence of metastasis and the decision not to do curative therapy Whipple surgery in patients with pancreatic cancer in dr Cipto Mangunkusumo General Hospital are the primary factors that negatively affect the 1 year survival rate. "

"Iron overload (IO) akibat transfusi darah jangka panjang pada penderita talasemia dapat berdampak fatal pada berbagai organ, termasuk pankreas. Akumulasi besi bebas serta kerusakan akibat stress oksidatif dapat menyebabkan resistensi insulin dan disfungsi sel β pankreas. Tanaman Phaleria macrocarpa yang mengandung mangiferin berpotensi sebagai agen pengkelat besi dan antioksidan. Penelitian ini bertujuan untuk menganalisis efek ekstrak etanol buah Phaleria macrocarpa terhadap kadar besi organ pankreas pada tikus model hemosiderosis. Sejumlah 30 ekor tikus Sprague-Dawley dibagi menjadi kelompok normal, deferiprone 462,5 mg/kgBB, kontrol negatif (IO), mangiferin 50 mg/kgBB, Phaleria macrocarpa 100 mg/kgBB dan 200 mg/kgBB. Injeksi intraperitoneal iron sucrose (15 mg) diberikan 2x seminggu selama 7 minggu untuk seluruh kelompok kecuali normal. Setelah pemberian terapi secara oral selama 4 minggu terakhir, kadar besi diukur dengan Atomic Absorption Spectrometry. Dosis total induksi besi 240 mg selama 7 minggu pada tikus model IO secara signifikan (p < 0,05) meningkatkan kadar besi pankreas sebesar 6 kali dibanding normal. Ekstrak etanol buah Phaleria macrocarpa dosis 100 dan 200 mg/kgBB cenderung menurunkan kadar besi organ pankreas pada tikus. Terdapat perbedaan yang signifikan (p < 0,05) antara kadar besi pankreas pada PM1 dan PM2. Tidak ada perbedaan yang signifikan antara kadar besi pankreas pada PM2 dengan normal.

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Iron overload due to long-term blood transfusion in thalassemia patients can cause fatal impacts on various organs, including the pancreas. Insulin resistance and pancreatic cell dysfunction may result from the accumulation of free iron and oxidative stress damage. Phaleria macrocarpa plants, which contain mangiferin, have potential as iron chelating agents and antioxidants. This study aimed to analyze the effect of Phaleria macrocarpa fruit ethanol extract on pancreatic iron levels in hemosiderosis model rats. Thirty Sprague-Dawley rats were divided into normal, deferiprone 462,5 mg/kgBB, negative control, mangiferin 50 mg/kgBB, and Phaleria macrocarpa extract at 100 and 200 mg/kgBB. 15 mg of iron sucrose was injected intraperitoneally twice a week for 7 weeks into all groups except normal. The iron level in the rat pancreas was assessed using AAS after 4 weeks of oral therapy. The total dose of 240 mg iron induction for 7 weeks in IO model rats significantly (p < 0,05) increased iron level 6x compared to normal. Phaleria macrocarpa ethanol extract at 100 and 200 mg/kgBB doses tended to decrease pancreatic iron level in rats. The difference in pancreatic iron level between PM1 and PM2 is significant (p < 0,05). PM2 and normal don't have significantly different pancreatic iron level."

"ABSTRACTPurpose Adenosquamous carcinoma (ASC) of the pancreas is a rare malignancy, associated with a poor prognosis after surgical resection, with reported median survival times (MSTs) ranging from 4.4 to 13.1 months. We conducted this study to investigate the long-term outcomes of patients after the resection for ASC.MethodsBetween 2002 and 2016, a total of 456 patients underwent resection for ASC or adenocarcinoma (AC) of the pancreas. ASC was confirmed in 17 (3.7%) of these patients. We analyzed the clinicopathological characteristics and survival of these 17 patients in comparison with those of patients with AC of the pancreas.ResultsThe operative procedures performed were pancreaticoduodenectomy (n = 6) and distal pancreatectomy (n = 11). Seven (41.2%) of the 17 patients underwent combined organ resection. R0 resection was achieved in 16 (94.1%) patients. The 5-year overall survival (OS) rate and MST were 40.3% and 20.9 months, respectively. A squamous component of ≥ 60% (P = 0.001) and R1 resection (P < 0.001) were significantly associated with poor OS for patients with ASCConclusionThis study revealed longer survival and a higher R0 resection rate after aggressive combined resection in our ASC patients than those in previous studies. Although this was only a small series, our findings suggest that local control with aggressive resection may be an effective treatment protocol for ASC patients."