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"A straight-forward, detailed overview of pathophysiology, providing nursing students with clear and simple explanations of the basic principles that underpin health and illness, and the main causes of disease. The book uses person-centred nursing as its guiding principle (in-line with the new NMC standards) to encourage students to develop a more detailed understanding of specific disorders and learn how to apply the bioscience theory to nursing practice and patient care." -- Provided by publisher"

"Penelitian ini bertujuan untuk mengetahui karakteristik gambaran pada mamografi dengan keganasan pada hasil histopatologi serta kesesuaian BI-RADS mamografi dengan hasil histopatologi. Penelitian ini menggunakan desain potong lintang dengan data sekunder yaitu 85 pasien perempuan dengan kelainan jinak/ganas pada payudara yang menjalani mamografi dan biopsi bedah atau core biopsy di RS kanker Dharmais Januari 2011 sampai Desember 2012. Hasil penelitian menunjukkan terdapat kesesuaian antara kecurigaan tingkat keganasan berdasarkan kategori BI-RADS mamografi dengan hasil pemeriksaan histopatologi. Mamografi memiliki sensitifitas 100% dan spesifitas relatif 88,9%, nilai duga negatif 100% dan nilai duga positif 97,1%. Mamografi berperan penting dalam mendiagnosis kelainan payudara.

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This study aims to investigate the characteristics of the mammography findings with malignancy on histopathology results and the association of the BI-RADS mammography with histopathological results. This study used a cross-sectional design with secondary data of 85 female patients with benign /malignant breast abnormality who underwent mammography and surgical biopsy or core biopsy at Dharmais cancer hospital in January 2011 until December 2012. The results showed there is association between the level of suspicion of malignancy based on the BIRADS category mammography with histopathological examination. Mammography had a sensitivity rate 100% and a relative specificity rate 88.9%, negative predictive value 100% and a positive predictive value 97.1%. Mammography plays an important role in the diagnosis of breast abnormalities."

"Tujuan: AmpIifikasi dan over-ekspresi c-erbB2 and MRP1 ditemukan pada beberapa tumor dan merupakan hal yang panting daiam menentukan perilaku karsinoma. Tujuan penelitian ini untuk mengevaluasi hubungan antara ekspresi protein c-erbB-2 dan MRPI dengan derajat keganasan karsinoma payudara duktal invasif dan respon kemoterapi neoajuvan CAF.Cara kerja: Ekspresi protein c-erB2 and MRP1 dianalisa secara imunohistokimia pada 27 blok paraffin dari pasien yang telah didiagnosa sebagai karsinoma payudara duktal. Hasilnya dihubungkan dengan derajat keganasan dan respon kemoterapi. Hubungan antara beberapa variabel dianalisa dengan uji analisa statistik non-parametrik Kendall,Hasil: Ekspresi protein C-erbB-2 positif pada 33,3 % tumor. Ekspresi protein MRP1 negatif pads 25,9 %, positif lemah pada 11,1 %, positif sedang pads 37,1 % dan positif kuat pada 25,9 %. Terdapat hubungan yang bermakna antara ekspresi protein C-erbB-2 dengan MRP1 (p=0,020, r=0,370). Tetapi, tidak ada hubungan yang bermakna antara ekspresi protein C-erbB-2 dengan derajat keganasan (p= 0,210) dan respon kemoterapineoajuvan CAF (p=0,168). Tidak ada hubungan yang bermakna antara ekspresi proteinMRPI dengan derajat keganasan (p= 0,144) dan respon kemoterapi neoajuvan CAF (p=0,056). )_ Tidak ada hubungan yang bermakna antara ekspresi protein MRP1 dengan derajat keganasan dengan respon kemoterapi neoajuvan CAF (p-,I30).Kesimpulan: Terdapat hubungan yang bermakna antara ekspresi protein c-erbB-2 dengan MRP1. Tidak ada hubungan yang bermakna antara ekspresi protein c-erbB2 dan MRPI dengan derajat keganasan dan respon kemoterapi. Tetapi, ada kecenderungan bahwa ekspresi protein MRP berhubungan searah dengan derajat keganasan dan respon kemoterapi. Tidak ada hubungan yang bermakna antara derajat keganasan dengan respon kemoterapi.

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Aims: Amplification and over-expression of c-erbB2 and MRP1 gene has been demonstrated in several tumors and thought to be important determinant of behaviors of carcinoma. In this study, correlation between c-erbB-2 and MRPI protein expression with histological grade of invasive ductal carcinoma of the breast and CAF neoadjuvant chemotherapy response were evaluated.

Methods: Paraffin-embedded tissue section from 27 patients who diagnosed as invasive ductal carcinoma of the breast were analyzed immunohistochemically for the expression of c-erbB2 and MRPI. The result was compared with histological grade and CAF neoadjuvant chemotherapy response. The correlation between several variable were analyzed by non-parametric statistical analysis correlation of Kendall.

Result: C-erbB-2 protein expression were positive in 33.3 % of the tumours. MRP1 protein expression were negative in 25.9 %, weak positive in 11.1 %, moderate positive in 37.1 % and strong positive in 25.9 %. There was significant correlation between C-erbB-2 with MRPI protein expression (p(_020, r0.370). However, there was no significant correlation between C-erbB-2 protein expression with histological grade (p= 0.210) and chemotherapy response (p=0.168). There was no significant correlation between MRP I protein expression with histological grade (p= 0.144) and chemotherapy response (p-0.056). There was no significant correlation between histological grade with chemotherapy response (p.41130).

Conclusion C-erbB-2 and MRPI protein expression were weakly correlated with each other. There was no significant correlation among both of the c-erbB2 and MRP I protein with histological grade and CAF neoadjuvant chemotherapy response_ However, there was a tendency that the expression of MRPI protein was related to histological grade and CAF neoadjuvant chemotherapy response. There was no significant correlation between histological grade and CAF neoadjuvant chemotherapy response."

"Penelitian ini telah berhasil melakukan modifikasi pada tepung terigu dengan metode heat moisture treatment (HMT) dan ikat silang menggunakan asam sitrat. HMTdilakukan dengan memvariasikan waktu pemanasan dan ikat silang dilakukan dengan memvariasikan konsentrasi dari asamsitrat yang digunakan. HMT menghasilkan perubahan atau penyusunan ulang struktur kristral yang diidentifikasi menggunakan mikroskop. Ikat si- lang menambahkan ikatan kovalen antar rantai pati yang dapat diidentifikasi menggunakan FTIR. Setelah modifikasi, diamati perubahan dari sifat fisikokimia dari pati. Kecenderungan yang terjadi setelah modifikasi adalah penurunan swelling power dan kelarutan, penurunan viskositas pasta,pen- ingkatan ketahanan termal. Daya cerna pati mengalami penurunan yang sig- nifikan pada pati dengan modifikasi secara tunggal maupun ganda.

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This study was succesfully modifying wheat flour with heat mois- ture treatment (HMT) methode and crosslinking with citric acid. HMT is conducted by varying the heating time and crosslinking is conducted by var- ying concentration of citric acid used. HMT will generate rearrangement on starch crystal structure and could be indetified with microscope while cross- linking will generate new covalent bond on starch chain and could be iden- tified with FTIR. After modification changes in physicochemical properties are observed. The trend of alteration are decrease in swelling power and solubility, decrease paste viscosity, and increasing thermal resistance. Di- gestibility of starch also observed as significant decrease on single and dual treated starch."

"Latar Belakang: Dalam dekade terakhir, insidensi kanker usus halus telah meningkat lebih dari empat kali lipat. Insidensi ini diperkirakan akan terus meningkat akibat perubahan pola hidup. Terapi definitif dan utama saat ini adalah reseksi radikal segmen yang terserang kanker, dengan risiko yang cukup signifikan selama dan setelah terapi. Kemoterapi dan terapi neoadjuvan yang tersedia tidak menghasilkan efek yang diinginkan. Lunasin, peptida yang terkandung dalam kacang kedelai, dikenal dapat meningkatkan kesehatan sel secara epigenetik dan mengurangi inflamasi. Berangkat dari hal tersebut, ada kemungkinan bahwa ekstrak lunasin dapat menjadi terapi neoadjuvan yang efektif untuk kanker usus halus.Metode: Sebanyak 20 ekor mencit jenis Balb/c dibagi ke dalam empat kelompok. Semua mencit diinduksi dengan azoxymethane dan dextran sodium sulfat. Selama enam minggu setelahnya, mencit akan diberi ekstrak lunasin dalam konsentrasi yang berbeda (0, 20, 30, dan 40 mg/ kgBB). Delapan minggu setelah induksi, mencit akan dikorbankan. Sel usus halus mencit akan diproses dan diwarnai dengan hematoxyllin-eosin, kemudian jumlah hiperplasia, displasia, angiogenesis, fokus inflamasi, dan sel goblet akan diamati di bawah mikroskop.Hasil: Terdapat perbedaan yang signifikan dalam jumlah displasia (p=0,000) dan angiogenesis (p=0,009) dalam kelompok-kelompok dengan perlakuan yang berbeda. Namun, tidak ditemukan adanya perbedaan yang signifikan dalam jumlah hyperplasia, fokus inflamasi, dan sel goblet di antara kelompok-kelompok dengan pemberian lunasin dengan konsentrasi berbeda.Kesimpulan : Pemberian ekstrak lunasin dapat meningkatkan hasil jumlah dysplasia dan angiogenesis secara non dose-dependent, namun tidak mempengaruhi faktor-faktor yang lain dalam proses karsinogenesis usus halus.

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Background : Within the last decade, incidence of small bowel cancer has increased by more than fourfold. It is predicted that due to shift in diet and lifestyle, the numbers of incidence will steadily rise. The primary and only definite therapy for small intestine cancer is radical segmental resection, which carries side effects and risks during and after surgery. At the moment, available chemotherapy and neoadjuvant therapy do not exert significant result. Lunasin, a novel peptide originated from soybean, is believed to promote cellular health epigenetically and reduce inflammation. Thus, there is possibility that the lunasin extract may come off as a new and effective adjuvant therapy for small intestine malignancies.

Method: A total of 20 Balb/c mice were divided into four groups. The mice were induced with azoxymethane and dextran sodium sulfate. For the next six weeks, each group was given different concentration of lunasin extract. After eight weeks since the induction, the mice were sacrificed and the small intestinal tissue was harvested and stained using hematoxyllin-eosin. After that, the amount of hyperplasia, dysplasia, angiogenesis, inflammatory foci, and goblet cells will be observed under the microscope.

Results: There is significant difference in the amount of dysplasia (p=0.000) and angiogenesis (p=0.009) among the groups that receive different concentrations of lunasin. However, there is no effect of lunasin administration to the amount of hyperplasia, inflammatory foci, and of goblet cells.

Conclusion: Non dose-dependent administration of lunasin extract improves dysplasia and angiogenesis, but not other factors in small intestine carcinogenesis."

"Latar belakang: Kanker payudara merupakan kanker terbanyak dengan insiden 40,3 per 100.000 perempuan dan angka mortalitas sebesar 16,6 per 100.000 perempuan di Indonesia. Pada stadium awal I-II, penentuan terapi operatif mastektomi seringkali membutuhkan pemeriksaan potong beku intraoperatif untuk menilai keganasan, namun sering tidak tersedia di banyak rumah sakit. Tripel diagnostik pemeriksaan fisik, ultrasonografi dan fine needle aspiration biopsy merupakan metode diagnostik preoperatif yang juga dinilai akurat dan mudah dilakukan. Studi ini menilai kesesuaian tripel diagnostik dengan histopatologis khususnya pada benjolan yang curiga ganas di RSCM dan RSUPP selama Februari 2016-Agustus 2017. Metode: Subjek dengan benjolan payudara curiga ganas pada stadium awal yang memenuhi kriteria inklusi di RSCM dan RSUPP dilakukan tripel diagnostik preoperatif, kemudian dilakukan pemeriksaan potong beku intraoperatif dan histopatologi pasca operasi. Menggunakan desain studi diagnostik statistik, dilakukan analisis kesesuaian tripel diagnostik maupun potong beku dibandingkan dengan histopatologi yaitu sensitivitas, spesifisitas, nilai prediksi positif NPP, nilai prediksi negatif NPN dan akurasi. Hasil Didapatkan 33 subjek kanker payudara stadium awal prevalensi 4,3 dengan rerata umur 49,6 tahun dengan kelompok umur terbanyak di atas 40 tahun 78,8. Sekitar 63,6 subjek memiliki ukuran tumor 2-5 cm dan jenis histopatologi terbanyak berupa karsinoma invasif 84,8. Dibandingkan hasil histopatologi: a Potong beku memiliki sensitivitas 96,8, spesifisitas 100, NPP 100, NPN 66,7, dan akurasi 97,0 ; dan b Tripel diagnostik mempunyai sensitivitas 77,4, spesifisitas 100, nilai prediksi positif tinggi 100, nilai prediksi negatif 22,2 dan akurasi 78,8 p = 0,016. Kesimpulan: Tripel diagnostik merupakan metode diagnostik yang cukup akurat pada kanker payudara stadium awal sehingga dapat digunakan sebagai metode diagnostik alternatif di fasilitas pelayanan tipe C dan D di Indonesia di saat potong beku tidak tersedia.

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Background: Breast cancer is the most common cancer with incidence rate 40.3 per 100.000 women and mortality rate 16.6 per 100.000 women in Indonesia. In early stage, decision for operative therapy mastectomy requires intraoperative frozen section to assess its malignancy, which is often unavailable in many hospitals. Triple diagnostic physical examination, breast ultrasonography and fine needle aspiration biopsy is an accurate and easily performed preoperative diagnostic method. This study assesses the suitability of triple diagnostic with histopathology results in suspicious malignant breast lumps at Ciptomangunkusumo and Persahabatan hospital during February 2016 August 2017.

Method: Subjects with supicious malignant breast lump that met the inclusion criteria underwent preoperative triple diagnostic, intraoperative frozen section and postoperative histopathology examination. With statistic diagnostic study design, the suitability of triple diagnostic and frozen section were assesed in comparation to histologic examination sensitivity, specificity, positive predictive value PPV, negative predictive value NPV and accuracy.

Result: 33 subjects with early stage breast cancer were obtained prevalence 4.3 with average mean of age of 49.6 years, were above 40 years 78.8. Around 63.6 had tumor size between 2 5 cm, and most histopathologic types were those with invasive carcinoma 84.8. When compared to histopathologic result a Frozen section has 96.8 sensitivity, 100 specificity, 100 PPV, 66.7 NPV and 97.0 accuracy and b Triple diagnostic has 77.4 sensitivity, 100 specificity, high PPV 100, 22.2 NPV and 78.8 accuracy. p 0.016.

Conclusion: Triple diagnostic is a relatively accurate diagnostic method in early stage breast cancer, hence, can be used as an alternative diagnostic method at type C and D heatlhcare facilities in Indonesia whenever frozen section is unavailable. "