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Abstrak :
The development and progression of cancer and the experimental reversal of tumorigenicity are companied by complex changes in the pattern of gene expression. DNA micro-array technology is used to profile complex disease and discover novel disease-related genes. This technique has been successfully used to investigate gene expression in processes as complex as inflammatory disease, tumor suppression and to identify heat shock in human T cell. DNA micro-arrays or DNA-chip technology allows expression monitoring of hundreds and thousands of genes simultaneously and provide a format for identifying genes as well as changes in their activity. The DNA micro-array helps us study genome-wide expression patterns in complex biological systems. These tools have shown great promise in finding the meaning of complex diseases such as cancer. There is some interest in the potential application of DNA micro-array analysis for gene expression profiling in human cancers. Micro-arrays of DNA provide a powerful tool for studying the development and progression of cancer phenomena. It might be useful for tumor classification, for the elucidation of regulatory networks that are disturbed in tumor cells and for the identification of genes that might be of use for diagnostic purposes or as therapeutic targets.

Abstrak :
Esophageal polyp can be found by chance during endoscopic examination. Polyps can be formed by changes in the esophageal mucosa due to reflux esophagitis. We report a case of multiple esophageal polyp in a patient with complaints of recurrent regurgitation without heartburn. Endoscopy demonstrated multiple polyps at the distal esophagus. Anatomic pathology evaluation of the polyp demonstrated mucosa lined with squamous epithels demonstrating elongation of the papilla and deposition of acute and chronic inflammatory cells, indicating chronic esophagitis with hyperplastic epithels. In this case, we conducted recurrent ligation of the multiple polyps. Evaluation at 2 weeks after the final ligation demonstrated no polyp remains, and the post-ligation ulcer was found. Evaluation at 1 month following treatment found diminished complaints. From this case, we can conclude that endoscopy is an important investigation modality to establish the diagnosis in cases of chronic gastrointestinal complaints. Ligation is a choice for the management of esophageal polyps

Abstrak :
Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding. Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005. Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade HI in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), > 60 years (305 cases; 36.2%), < 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age > 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%). Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage HI. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study.

Abstrak :
Dyspepsia is one of numerous general complaints, which is commonly encountered by doctors of various disciplines. In daily practice, the complaint is not only limited for gastroenterologists. Knowledge on pathophysiology of dyspepsia have been developing continuously since a scientific investigation has been started in 1980s, which considers Helicobacter pylori as one of key factor in managing dyspepsia, either it is associated with ulcer or non-ulcer. The management of dyspepsia cannot be separated from the management of H. pylori and there is an additional new knowledge associated with definition, pathophysiology, diagnosis and treatment of both dyspepsia and H. pylori infection. This consensus document on the management of dyspepsia and H. pylori infection in Indonesia has been developed using the evidence-based medicine principles; therefore, it can be used as a reference for doctors in dealing with dyspepsia and H. pylori infection cases in their daily practice. It is expected that with the new consensus, doctors can provide greater service to their patients who have dyspepsia and H. pylori infection.

Abstrak :
Tujuan Pengobatan untuk eradikasi H pylori dengan kombinasi PPI dan Amoksisilin 1000 mg atau Clarithromycin 500 mg yang diberikan 2 kali sehari selama 2 minggu telah terbukti efektif. Kebanyakan penelitian menyebutkan bahwa pengobatan 7 dan 10 hari sama efektif. Tujuan dari penelitian ini adalah untuk membandingkan terapi eradikasi H pylori selama 5 dan 7 hari. Metode Penelitian ini dilakukan secara prospektif pada 60 pasien yang terinfeksi H pylori, pemeriksaan dilakukan dengan endoskopi dan biopsi saluran cerna bagian atas di 6 (enam) rumah sakit di Indonesia. Diagnosis H pylori ditegakkan berdasarkan pada 2 pemeriksaan rapid urea test (Pronto Dry) dan pemeriksaan histopatologi atau adanya urea breath test (UBT) yang positif. Kemudian secara terbuka pasien akan dibagi menjadi 2 kelompok, kelompok pertama mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 5 hari dan kelompok kedua mendapatkan pengobatan oral amoksisilin 1000 mg 2 kali sehari, clarithromycin oral 500 mg 2 kali sehari, rabeprazole 10 mg 2 kali sehari selama 7 hari. Empat minggu kemudian, pasien dievaluasi dengan UBT untuk memastikan keberadaan H pylori. Hasil Pada penelitian ini didapatkan 60 pasien yang terdiri dari 42 laki-laki dan 18 perempuan dengan rata-rata (usia+SD) 47.63+13.93 tahun, rentang usia 21-74 tahun. Kelompok pengobatan 5 hari terdiri dari 25 (41,7%) pasien dan kelompok pengobatan 7 hari terdiri dari 35 (58.3%) pasien. Setelah kelompok pengobatan 5 hari didapatkan 18 (72%) pasien H Pylori negatif, dan setelah pengobatan 7 hari didapatkan 32 (91.4%) pasien H Pylori negatif. Kegagalan eradikasi ditemukan pada kelompok pengobatan 5 hari sebesar 7 (28%) pasien dan pada kelompok pengobatan 7 hari sebesar 3 (8.6%) (p=0,077). Kesimpulan Penelitian ini menunjukkan bahwa eradikasi H pylori dengan pengobatan tripel dengan rabeprazole pada kelompok 7 hari masih lebih baik daripada kelompok pengobatan 5 hari. Perbedaan yang tidak bermakna secara statistik ini mungkin karena jumlah sampel tidak mencukupi.

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Aim A combination of PPI and 1000 mg amoxicillin/500 mg clarithromycin twice daily for 2 weeks has been proven effective in the eradication of H. pylori. Most studies suggested that treatment for 7 and 10 days may be equally effective. Few data are available on the effi cacy of 5-day triple therapy. Aim of this study was to compare 5-day and 7-day rabeprazole triple therapy for eradication of H. pylori infection. Methods We prospectively studied 60 consecutive H. pylori-infected patients who came to hospitals in six centres in Indonesia and who underwent upper endoscopy and biopsy. H. pylori infection was confi rmed if two rapid urease tests (Pronto Dry) and histology or urea breath test were positive. Patients were assigned to either an open-labelled 5-day or 7-day course of oral amoxicillin 1000 mg b.i.d., clarithromycin 500 mg b.i.d., and rabeprazole 10 mg b.i.d. (RAC).Four weeks after therapy, all patients had a repeated UBT for evaluation of the presence of H. pylori. Results Of the 60 patients (42 males and 18 females) with mean age (± SD) 47.63 ± 13.93 years, range 21?74 years, 25 patients (41.7%) had 5-day treatment and 35 patients (58.3%) had 7-day treatment. With 5-day treatment, 18 patients (72%) and with 7-day treatment 32 patients (91.4%) became negative for H. pylori infection. The eradication failure was found on 7 patients (28.0%) in 5-day reatment and 3 patients (8.6%) in 7-day treatment. Conclusions The study showed that the eradication of H. pylori infection by triple rabeprazole-based treatment in 7-day is still better than in 5-day.