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"Background: Some studies suggested that colorectal cancer at young age had a distinct biological characteristic: more advanced stage at time of diagnosis, poorer differentiated, and consisted of large proportion of mucin producing tumors.Aim of the study: To analyze clinical and histopathological differences between young aged colorectal cancer patients (< 40 years old) and the older patientsMethods: A cross-sectional retrospective study was conducted among our colorectal cancer patients in a general hospital between 1999-2004, using C.I8, C.I9, C20 ICD X code in medical record searching. It was requested that the patients had surgical treatment in Dr. Sardjito General Hospital. An inconclusive clinical staging and/or histological data were among the exclusion criteria. Chi-square, Fisher's exact test, T-test, and Mann Whitney U-test was performed to analyze the difference between patients < 40 years old and 40 years old, in respect to diagnostic staging, histological type, histological grade (differentiation), CEA level, hemoglobin, albumin, tumor location, and chief complain. With p < 0.05 was considered as significant.Results: Sixteen young aged (< 40 years old) and 72 older patients had been identified. No differences in gender proportion and mean of symptoms to diagnosis period between two groups. No statistical differences between young aged and the older patients in diagnostic staging, histological grade and type, CEA level, and hemoglobin. Young aged patients had higher albumin value at presentation (p = 0.014), all had left sided tumors (p = 0.035), more complain of anal pain (p < 0.001), and less change of bowel habits complain (p = 0.009)Conclusion: The study results had failed to confirm the difference in respect to diagnostic staging, histological type and grade, CEA level, and hemoglobin. Most of our young aged patients had left sided tumors with chief complain of anal pain, and less complain of change of bowel habits"

"Kaitannya dengan ekspresi protein MLH1, MSH2, dan SMAD4, dan membandingkannya dengan pasien kanker kolorektal usia di atas 60 tahun.Metode: Data rekam medis pasien kanker kolorektal usia di bawah 40 tahun dan usia di atas 60 tahun , dikumpulkan dari 3 rumah sakit: Jakarta, Makasar, dan Bandung. Kelompok etnis dipilih dari suku bangsa Jawa, Makasar (Sulawesi Selatan, dan Minangkabau (Sumatera Barat) yang dikonfirmasi berdasarkan kuesioner. Pada spesimen tumor dilakukan pemeriksaan histopatologi, gradasi tumor, serta pemeriksaan imunohistokimia untuk penentuan ekspresi protein MLH1 dan MSH2 untuk menilai mutasi instabilitas mikrosatelit. Ekspresi protein SMAD4 diperiksa untuk memastikan bahwa jaringan tumor tidak berasal dari instabilitas mikrosatelit.Hasil: Telah dikumpulkan 121 penderita kanker kolorektal dari etnis Sunda, Jawa, Makasar, dan Minangkabau. Derajad keganasan antara pasien muda dan pasien tua berbeda secara bermakna (p = 0.001). Pewarnaan imunohistokimia untuk protein MSH2 dan MLH1 yang dilakukan pada masing-masing 92 dan 97 pasien, menunjukkan tidak terdapat perbedaan bermakna dalam hal ekspresi MLH1 dan MSH2 dan gradasi tumor, yang berarti tidak ada hubungan antara instabilitas mikrosatelit dan derajad tumor.Kesimpulan: Karakter kliniko patologi kanker kolorektal pada penduduk asli Indonesia, tidak berbeda antara pasien usia muda (< 40 tahun) dan pasien usia tua (>60 tahun) pada kelompok etnis yang sama. Juga tidak terdapat perbedaan dalam ekspresi protein MSH2 dan MLH1, yang merupakan indikator instabilitas mikrosatelit.

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Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.

Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities ? Jakarta, Makassar, and Bandung - were reviewed. The ?native? ethnic groups were selected from those originating from Java, Makassar (South Celebes), Miinangkabau (West Sumatra). Ethnicity of 121 colorectal carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.

Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.

Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability."

"To distinguissh the expression of NF-kB and COX-2 between young, and older older groupof sporadic colorectol cancer patients...."

"Saat ini kanker kolorektal menjadi lebih umum terjadi pada orang usia muda (yang didefinisikan sebagai diagnosis pada pasien berusia kurang dari 50 tahun). Beberapa faktor telah diyakini menjadi pemicu terjadinya kanker kolorektal pada usia tua namun faktor apa saja yang berhubungan dengan kejadian kanker kolorektal pada usia dini atau usia muda (Young-Onset) masih terus menjadi perdebatan dan masih terus dilakukan penelitian oleh beberapa ahli. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan peningkatan kejadian Kanker Kolorektal pada usia muda (Young-Onset). Penelitian ini adalah penelitian kuantitatif dengan desain cross-sectional retrospektif dan strategi yang digunakan adalah metode survey yang melibatkan 144 responden. Analisis data menggunakan Mann Whitney, Chi Square, Fisher dan regresi logistik. Hasil penelitian menunjukkan terdapat hubungan antara jenis kelamin (p=0,001) dan pekerjaan (p=0,017) dengan kejadian kanker kolorektal usia muda, dimana pekerjaan merupakan faktor yang paling dominan berhubungan dengan kejadian kanker kolorektal usia muda (95%CI:0,039;0,796). Namun tidak terdapat hubungan antara penghasilan (p=0,181), jam tidur malam (p=0,978), penyakit penyerta medis (p=0,320), daging olahan (p=0,539), Indeks Massa Tubuh (IMT) (p=0,521), merokok (p=0,696), alkohol (p=0,275), sedentary behavior (p=1,000), gorengan (p=0,220), makanan siap saji (p=0,124), dan riwayat kanker dalam keluarga (p=0,140) dengan kejadian kanker kolorektal usia muda. Diharapkan perawat dapat melakukan tindakan promotif dan preventif untuk mencegah peningkatan kejadian kanker kolorektal pada usia muda berdasarkan faktor yang paling dominan berhubungan yaitu pekerjaan, yaitu dengan memberikan edukasi pencegahan dini melalui pemeriksaan darah tinja maupun kolonoskopi pada masyarakat yang aktif bekerja karena kemungkinan skrining tersebut diabaikan akibat kesibukan di tempat kerja.

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Currently, colorectal cancer is becoming more common in young people (defined as a diagnosis in patients aged less than 50 years). Several factors are believed to trigger the occurrence of colorectal cancer in old age, but what factors are associated with the incidence of colorectal cancer at an early or young age (Young-Onset) is still being debated and research is still being carried out by several experts. This study aims to analyze factors associated with an increase in the incidence of Colorectal Cancer at a young age (Young-Onset). This research is a quantitative study with a retrospective cross-sectional design and the strategy used is a survey method involving 144 respondents. Data analysis used Mann Whitney, Chi Square, Fisher and logistics regression. The results of the study showed that there was a relationship between gender (p=0.001) and occupation (p=0.017) with the incidence of colorectal cancer at a young age, where occupation was the most dominant factor associated with the incidence of colorectal cancer at a young age (95% CI: 0.039; 0.796) . However, there was no relationship between income (p=0.181), hours of sleep at night (p=0.978), medical comorbidities (p=0.320), processed meat (p=0.539), Body Mass Index (BMI) (p=0.521), smoking (p=0.696), alcohol (p=0.275), sedentary behavior (p=1.000), fried foods (p=0.220), fast food (p=0.124), and family history of cancer (p=0.140) with the incidence young colorectal cancer. It is hoped that nurses can take promotive and preventive actions to prevent an increase in the incidence of colorectal cancer at a young age based on the most dominant factor related to work, namely by providing early prevention education through fecal blood tests or colonoscopies in people who are actively working because the possibility of screening is neglected due to busy schedules. at workplace."

"Latar belakang : Beberapa data dari luar negri menunjukkan kanker kolorektal predominan terjadi pada populasi usia yang lebih tua (lebih dari 60 tahun). Kanker kolorektal yang terjadi pada usia lebih muda (kurang dari 40 tahun) hanya berkisar antara 3-6%. Dari penelitian terdahulu dilaporkan bahwa kanker kolorektal pada pasien usia muda cenderung memiliki gambaran perilaku tumor yang agresif dengan prognosis buruk. Pada beberapa penelitian, progresivitas dan prognosis yang buruk pada kanker kolorektal, dikaitkan dengan peristiwa angiogenesis. VEGF merupakan salah satu sitokin poten yang terlibat dalam proses angiogenesis seh.ingga tingginya kadar ekspresi VEGF berhubungan dengan progresivitas penyakit yang 1ebih tinggi dan prognosis yang burnk. Cancer-associated stroma mengalami perubahan-perubahan dinamis yang menyerupai reaksi penyembuhan luka, disebut sebagai reaksi desmoplastik. Reaksi ini didukung terutama oleh aktivasi "myofibroblas;'. Beberapa penelitian menunjukkan bahwa myofibroblas mempuuyai peran untuk roemfasilitasi tumorigenesis dan progresi beberapa karsinoma, dan dikenal sebagai suatu petanda penting yang potensial untuk diagnosis, pengobatan dan prognosis kanker. Hasil : Pada penelitian ini terlihat ekspreSi VEGFA tidak berbeda, namun terdapat perbedaan yang bennakna pada reaksi desmoplastik usia muda dibanndingkan pada usia tua. Nampak pula hubungan yang sejaJan antara ekspresi VEGF-A positif kuat dengan reaksi desmoplastik yang keras pada kanker kolorektal usia muda. Hal ini menyokong hepotesa kedua dan ketiga dari penelitian ini. Kesimpulan : Progresivitas penyakit yang lebih tinggi dan prognosis yang buruk pada pasien kanker kolorektal usia muda kemungkinan disebabkan oleh faktor-faktor lain selain VEGF, yang masih memerlukan penelitian lebih lanjut. "

"Colon polyp is a term used for abnormality from bulging tissue above surrounding colonic mucosal layer. Adenoma polyp was the commonly found polyp that progress to colorectal cancer. Most of those patients was asymptomatic. Undetected and unmanaged polyp was a risk factors of colorectal cancer even."

"Lupus nephritis (LN) is involvement of the kidney in patient with systemic lupus erythematosus (SLE) and one of the most common target organ in SLE. The diagnosis of LN will significantly impact the clinical outcome and therapy of the patient. Therapy regiment of LN is divided into two stages, induction and maintenance treatment. The main objective of the induction therapy is to achieve complete or partial remission as soon as possible since it is correlated with better prognosis and fewer relapse incidence. In the maintenance stage, the main aim of the therapy is to maintain the remission status and avoid future relapse. It is also important to evaluate the effectiveness of the therapy as it will affect the duration and the regiment therapy being used. Corticosteroid, cyclophosphamide, mycophenolate mofetil, azathrioprine, cyclosporine and tacrolimus are example of drugs used in LN therapy. Currently, studies are being conducted to evaluate and develop targeted drug therapy to further add treatment options for LN.

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efritis lupus (NL) adalah keterlibatan organ ginjal pada pasien lupus eritematosus sistemik (LES) dan merupakan salah satu keterlibatan organ yang paling sering ditemukan. Ditemukannya NL pada pasien LES akan berdampak besar baik secara prognosis dari pasien maupun dalam pengobatan itu sendiri. Pengobatan NL dibagi menjadi dua tahap, induksi dan rumatan. Target dari pengobatan tahap induksi adalah untuk secepatnya mencapai remisi, baik parsial ataupun komplit, karena akan memberikan prognosis yang lebih baik dan kejadian relapse yang lebih rendah. Pada tahap rumatan, target yang ingin dicapai adalah untuk mempertahankan status remisi dan mencegah terjadinya relapse. Evaluasi keberhasilan dari masing-masing tahap juga sangat penting karena akan berpengaruh pada kelanjutan pengobatan. Kortikosteroid, siklofosfamid, mikofenolat mofetil, azatioprin, siklosporin dan takrolimus adalah obat-obat yang biasa dipakai dalam pengobatan NL. Berbagai target pengobatan baru juga terus berkembang guna memberikan pilihan yang lebih luas dalam menangani kejadian NL."

"ABSTRACTPurposeLysophosphatidylcholine (LPC), which is generated from phosphatidylcholine (PC) and metabolized by autotaxin (ATX), modulates immune responses via its anti-inflammatory property. We investigated the association between LPC and postoperative complications (POCs) after colorectal cancer surgery (CRC).MethodsThe subjects of this study were 43 patients who underwent surgery for CRC. Peripheral blood samples were collected preoperatively and immediately after surgery, and on postoperative days (PODs) 1, 3, 5, and 7. Patients were divided into a No-POC group (n = 33) and a POC group (n = 10). Blood LPC, IL-6, PC, and ATX levels were measured by specific enzymatic assays or ELISA.ResultsThe postoperative to preoperative LPC ratios were lowest on POD 1 in both groups. The POC group had significantly lower LPC ratios throughout the perioperative period than the No-POC group. The LPC ratios were inversely correlated with IL-6. The predictive impact of LPC ratios on POCs was demonstrated by ROC analysis (cut-off 51.2%, AUC 0.798) and multivariate analysis (OR 15.1, P = 0.01). The postoperative PC ratios decreased more after surgery in the POC group. ATX levels did not change significantly in either group.ConclusionsDecreased postoperative LPC is associated with increased postoperative inflammatory response and POCs. The decreased PC supply to the circulation is a mechanism of the postoperative LPC decrease."

"Crolm's disease encompasses a spectrum of clinical and pathological patterns, affecting the gastrointestinal (GI) tract with potential systemic and extraintestinal complications. The disease can affect any age group, but the onset is most common in the second and third decade. Lower Gi bleeding is one of its clinical features. Surgical intervention is required in up to two-thirds of patients to treat intractable hemorrhage, perforation, obstruction or unresponsive fulminant disease.

We reported a case of Crohn's disease in young male who suffered from severe lower Gi bleeding (hematochezia) as the clinical features. Lower GI endoscopy revealed ulceration at the distal ileum surrounded by fibrotic tissue as a source of bleeding and a tumor mass at mesocolon. Upper GI endoscopy was unremarkable. Histopathologyc examination concluded multiple ulceration with chronic ischemic condition, appropriate to Crohn's disease. The patient underwent emergency surgical intervention (subtotal colectomy and ileustomy), and his condition was improved."