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"Telah dilakukan simulasi radioterapi paru-paru untuk verifikasi dosis kalkulasi TPS dengan pengukuran. fantom IMRT CIRS yang terdiri dari material jaringan lunak, paru-paru, dan tulang belakang digunakan sebagai objek dalam simulasi ini. Dosimeter yang digunakan dalam pengukuran adalah, bilik ionisasi Farmer tipe PTW 30013 dan NE 2571, serta Thermoluminisence Dosimeter (TLD). Fantom diradiasi menggunakan sinar-X 10 MV, ukuran lapangan 15 x 15 cm2 dengan 2 lapangan plane parallel metode Anterior-Posterior dan Posterior-Anterior (AP/PA) dan oblig Medio-Lateral dan Lateral-Medial (ML/LM) teknik SAD (Source to Axis Distance) 100 cm. Dosis pada jaringan lunak, paru-paru, dan tulang belakang dikalkulasi mengikuti protokol IAEA TRS 277 khusus untuk pengukuran dengan bilik ionisasi, sedangkan untuk pengukuran dengan TLD kalkulasi dosis pada ketiga medium menggunakan hasil kalibrasi. Dari 27 data deviasi antara hasil pengukuran dan kalkulasi TPS yang dievaluasi, untuk metode AP/PA diperoleh 18 data (66,67%) berada pada daerah antara -4 % sampai 6% dan 9 data (33,33%) berada diluarnya. Sedangkan untuk metode ML/LM, 20 data (74,07%) mempunyai deviasi berada dalam daerah ±6%, selebihnya 7 data (25,93%) memiliki deviasi lebih dari ±6%. Dalam penelitian ini, diperkirakan faktor koreksi ketidakhomogenan pada TPS kurang akurat terutama untuk jaringan paru.

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A radiotherapy simulation of the lung for TPS verification dosage has been conducted by measurement. An IMRT CIRS phantom, that consisted of soft tissue, lung, and spine material, was used for this simulation. The dosimetry that were used in measurements are 30013 PTW Farmer-type and NE 2571 ionization chamber and also Thermoluminisence Dosimeter (TLD). Phantom was irradiated using a 10 MV X-ray with plane dimensions of 15 x 15 cm2 using 2 plane parallel field Anterior-Posterior method and oblique Lateral-Medial (ML/LM) technique where SAD (Source to Axis Distance) is 100 cm. Dosage at soft tissue, lung, and spine were calculated following the IAEA TRS 277 protocol specifically for ionization chamber measurement while measurements using TLD, dosage for those three areas was calculated using calibration result. Out of 27 deviation datas regarding the evaluation of measurements and TPS calculation, for AP/PA method 18 datas (66.67%) were between -4% and 6%, while 9 datas (33,33%) were beyond it. Whereas for ML/LM method, 20 data (74,07%) have deviation between ±6%, remainder 7 data (25,93%) deviation have more than ±6%. In this study it is estimated that inhomogeneity correction factor for the TPS is not accurate especially for lung tissue."

"Kalor adalah suatu bentuk perpindahan energi dari suatu zat ke zat yang lain akibat adanya perbedaan suhu diantara keduanya. Bila suatu kumparan konduktor dialiri oleh arus maka akan menghasilkan suatu energi dalam bentuk panas yang ditandai dengan perubahan temperatur pada kumparan konduktor tersebut. Jika kumparan konduktor dimasukkan kedalam suatu bejana yang berisi minyak transformator maka akan mengakibatkan adanya perpindahan energi panas dari kumparan konduktor ke minyak transformator dan bejana yang selanjutnya akan dilepaskan ke udara. Kalor yang terjadi pada sistem tersebut sangat bergantung pada minyak transformator yang digunakan.Untuk mengetahui aliran kalor yang terjadi pada kumparan konduktor dilakukan dua buah pengujian pada medium udara bebas dan medium minyak transformator. Minyak transformator yang digunakan yaitu minyak transformator baru, bekas, dan bekas yang telah ditembus oleh tegangan tinggi.Kenaikan temperatur yang terjadi pada medium udara bebas lebih tinggi daripada medium minyak transformator. Kenaikan temperatur minyak transformator bekas tembus lebih tinggi daripada minyak transformator bekas dan baru. Perbedaan kenaikan temperatur pada medium minyak transformator disebabkan oleh kalor jenis minyak transformator baru lebih tinggi daripada minyak transformator bekas dan bekas tembus."

"[Latar Belakang : Sesak napas merupakan keluhan utama pada kanker paru. Obatgolongan opioid seperti morfin dapat digunakan untuk mengurangi keluhan sesaknapas. Penelitian ini bertujuan untuk menetapkan efek pengurangan sesak napasdengan pemberian morfin oral lepas lambat 2x10 mg dan 2x30 mg, serta efeksamping yang ditimbulkan. Metode : Penelitian uji klinis dengan subjek pasien kanker paru denganmembandingkan keluhan sesak napas sebelum dan sesudah pemberian morfin oral2x10 mg selama 2 hari dan dilanjutkan dengan 2x30 mg selama 2 hari. Derajatsesak dinilai dengan menggunakan skor sesak modified Borg?s dyspnea scale danVisual Analog Scale (VAS) untuk sesak. Efek samping dipantau selamapemberian obat. Hasil : Tiga puluh tiga peserta penelitian dengan 27 laki-laki (81,8%), jeniskanker paru adenokarsinoma 25 orang (75,8%). Terdapat perbaikan keluhan sesaknapas setelah morfin 2x10 mg pada 18 dari 33 peserta (54,5%) dengan penurunanrata-rata skor sesak Borg dan VAS sebanyak 0,70 dan 6,72 dengan p <0,001dibanding skor awal. Setelah pemberian morfin 2x30 mg perbaikan sesak napasdidapat pada 26 dari 33 peserta (78,8%) dengan penurunan rata-rata skor sesakBorg dan VAS sebanyak 1,64 dan 16,06 dengan p <0,001 dibanding skor awal.Terdapat perbedaan bermakna antara pemberian morfin 2x10 mg dan 2x30 mg (p<0,001). Efek samping yang didapat setelah morfin 2x30 mg yaitu 33,3%mengeluh konstipasi, 42,4% mengantuk, dan 12,1% mual. Tidak ada pasien yangmengalami depresi pernapasan berat. Kesimpulan : Terdapat perbaikan keluhan sesak napas setelah pemberian morfinoral lepas lambat 2x10 mg dan dan perbaikan yang lebih baik dengan 2x30 mg. Tidak ada efek samping yang berat setelah pemberian morfin oral.;Background: Dyspnea is a major complaint in lung cancer. Opioids drugs such as morphine is known to be used to reduce dyspnea. This study aims to determinewhether there is an improvement of dyspnea by titrating morphine sustainedrelease tablet 2x10 mg and 2x30 mg in lung cancer patient, and the side effectsthat appear. Methods: The study is a clinical trial with the subject of lung cancer patients bycomparing dyspnea before and after administration of 2x10 mg morphine tabletsfor 2 days, followed by 2x30 mg for 2 days. The degree of dyspnea assessed usingthe modified Borg's dyspnea scale and the Visual Analog Scale (VAS) fordyspnea. Side effects are observed during administration of the drug. Results: Thirty-three study participants with predominantly 27 men (81.8%) and25 participants with adenocarcinoma (75.8%). There were improvements indyspnea after morphine 2x10 mg in 18 of the 33 participants (54.5%) with anaverage improvements of Borg and VAS scores for 0.70 and 6.72 with p <0.001compared to the initial score. After administration of morphine 2x30 mgimprovements in dyspnea were obtained in 26 of the 33 participants (78.8%) withan average improvements of Borg and VAS scores for 1.64 and 16.06 with p<0.001 compared to the initial score. There were significant differences betweenthe administration of morphine 2x10 mg and 2x30 mg (p <0.001). Side effectswere obtained after 2x30 mg morphine such as 33.3% complained of constipation,drowsiness in 42.4%, and nausea in 12.1%. No patients experienced severerespiratory depression. Conclusion: There is dyspnea improvement after administration of sustainedreleasemorphine tablet 2x10 mg and better improvement with 2x30 mg. No severe side effects after administration of oral morphine., Background: Dyspnea is a major complaint in lung cancer. Opioids drugs such as morphine is known to be used to reduce dyspnea. This study aims to determinewhether there is an improvement of dyspnea by titrating morphine sustainedrelease tablet 2x10 mg and 2x30 mg in lung cancer patient, and the side effectsthat appear. Methods: The study is a clinical trial with the subject of lung cancer patients bycomparing dyspnea before and after administration of 2x10 mg morphine tabletsfor 2 days, followed by 2x30 mg for 2 days. The degree of dyspnea assessed usingthe modified Borg's dyspnea scale and the Visual Analog Scale (VAS) fordyspnea. Side effects are observed during administration of the drug. Results: Thirty-three study participants with predominantly 27 men (81.8%) and25 participants with adenocarcinoma (75.8%). There were improvements indyspnea after morphine 2x10 mg in 18 of the 33 participants (54.5%) with anaverage improvements of Borg and VAS scores for 0.70 and 6.72 with p <0.001compared to the initial score. After administration of morphine 2x30 mgimprovements in dyspnea were obtained in 26 of the 33 participants (78.8%) withan average improvements of Borg and VAS scores for 1.64 and 16.06 with p<0.001 compared to the initial score. There were significant differences betweenthe administration of morphine 2x10 mg and 2x30 mg (p <0.001). Side effectswere obtained after 2x30 mg morphine such as 33.3% complained of constipation,drowsiness in 42.4%, and nausea in 12.1%. No patients experienced severerespiratory depression. Conclusion: There is dyspnea improvement after administration of sustainedreleasemorphine tablet 2x10 mg and better improvement with 2x30 mg. No severe side effects after administration of oral morphine.]"

"[Telah dilakukan penelitian dalam mengevaluasi pengaruh material homogen dan inhomogen pada teknik IMRT (Intensity Modulated Radiotherapy) menggunakan modalitas Fan Beam CT (FBCT) dan Cone Beam CT (CBCT) terhadap Gamma Index (GI). Perencanaan ulang dilakukan untuk 5 pasien kanker paru kanan pada modalitas FBCT dan CBCT menggunakan TPS Phillips Pinnacle energi foton 6 MV. Menggunakan Teknik IMRT 30 segmen, 50 segmen, dan 70 segmen untuk perencanan terapi. Calculation Grid Resolution (CGR) 0.2 cm dan 0.4 cm digunakan sebagai resolusi dalam perhitungan dosis. Serta kalibrasi bilangan CT (KBC) FBCT, CBCT, dan linear dipergunakan sebagai koreksi CT density number. Pengukuran plannar dose untuk evaluasi Gamma Index (DD 2% / DTA 2 mm, passing rate 90%) dilakukan pada SAD 100 cm dengan material homogen dan inhomogen pada kedalaman 1.5 cm, 5 cm, dan 10 cm. Didapatkan deviasi nilai rata-­‐rata GI antara CGR 0.2 cm dengan 0.4 cm material homogen modalitas FBCT dan CBCT berturut-­‐tutut ≤1.46% dan ≤ 1.13%. Serta deviasi pada material inhomogen sebesar ≤ 2.54% (FBCT) dan ≤ 1.74% (CBCT). Deviasi Nilai rata-­rata GI antara FBCT dengan CBCT dengan CGR 0.2 cm berturut-­turut ≤ 1.95% (homogen) dan ≤ 2.36% (inhomogen). Dan deviasi Nilai rata-­‐rata GI antara material homogen dan material ekuivalen homogen sebesar ≤ 0.80%. Dari hasil penelitian yang didapat, bahwa evaluasi Gamma Index dapat dipengaruhi oleh jumlah segmen, modalitas CT, kalibrasi bilangan CT, Calculation Grid Resolution, dan kedalaman material.

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These Studies have been carried out to evaluate the effect of a homogeneous and inhomogeneous material on IMRT Technique (Intensity Modulated Radiotherapy) using Fan Beam CT (FBCT) and Cone Beam CT (CBCT) for the Gamma Index (GI). The Phillips Pinnacle treatment plan was used to replan 5 patients on right side of lung cancer. Photon 6 MV was applied to this technique with 30 segments, 50 segments, and 70 segments, repectively. Using Calculation Grid Resolution (CGR) 0.2 cm and 0.4 cm for resolution in the calculation of the dose. As well as the calibration of CT numbers (CCN) FBCT, CBCT, and the linear density are used as a correction CT number. The planar measurement for the evaluation of Gamma Index (DD 2% / DTA 2 mm, the passing rate of 90%) carried out at 100 cm SAD with the homogeneous and inhomogeneous material at a depth of 1.5 cm, 5 cm, and 10 cm, respectively. We obtained deviation average value of GI between CGR 0.2 cm and 0.4 cm using the homogeneous material on FBCT and CBCT modality ≤1.46% and ≤ 1:13%, respectively. As well as the material inhomogeneous deviation of ≤ 2.54% (FBCT) and ≤ 1.74% (CBCT). The deviation of the average GI value between FBCT with CBCT with CGR 0.2 cm respectively ≤ 1.95% (homogeneous) and ≤ 2.36% (inhomogeneous). Finally, the deviation of the average GI value between homogeneous and equivalent of homogeneous material is ≤ 0.80%. From the results obtained, that the Gamma Index can be influenced by the number of segments, modalities of CT, calibration of CT numbers, calculation grid resolution and depth of material.

, These

Studies

have

been

carried

out

to

evaluate

the

effect

of

a

homogeneous

and

inhomogeneous

material

on

IMRT

Technique

(Intensity

Modulated

Radiotherapy)

using

Fan

Beam

CT

(FBCT)

and

Cone

Beam

CT

(CBCT)

for

the

Gamma

Index

(GI).

The

Phillips

Pinnacle

treatment

plan

was

used

to

replan

5

patients

on

right

side

of

lung

cancer.

Photon

6

MV

was

applied

to

this

technique

with

30

segments,

50

segments,

and

70

segments,

repectively.

Using

Calculation

Grid

Resolution

(CGR)

0.2

cm

and

0.4

cm

for

resolution

in

the

calculation

of

the

dose.

As

well

as

the

calibration

of

CT

numbers

(CCN)

FBCT,

CBCT,

and

the

linear

density

are

used

as

a

correction

CT

number.

The

planar

measurement

for

the

evaluation

of

Gamma

Index

(DD

2%

/

DTA

2

mm,

the

passing

rate

of

90%)

carried

out

at

100

cm

SAD

with

the

homogeneous

and

inhomogeneous

material

at

a

depth

of

1.5

cm,

5

cm,

and

10

cm,

respectively.

We

obtained

deviation

average

value

of

GI

between

CGR

0.2

cm

and

0.4

cm

using

the

homogeneous

material

on

FBCT

and

CBCT

modality

≤1.46%

and

≤

1:13%,

respectively.

As

well

as

the

material

inhomogeneous

deviation

of

≤

2.54%

(FBCT)

and

≤

1.74%

(CBCT).

The

deviation

of

the

average

GI

value

between

FBCT

with

CBCT

with

CGR

0.2

cm

respectively

≤

1.95%

(homogeneous)

and

≤

2.36%

(inhomogeneous).

Finally,

the

deviation

of

the

average

GI

value

between

homogeneous

and

equivalent

of

homogeneous

material

is

≤

0.80%.

From

the

results

obtained,

that

the

Gamma

Index

can

be

influenced

by

the

number

of

segments,

modalities

of

CT,

calibration

of

CT

numbers,

calculation

grid

resolution

and

depth

of

material.

Key

words

:

Calculation

Grid

Resolution,

Calibration

of

CT

Numbers,

Cone]"

"Berkendara dalam kegiatan operasional PT XYZ merupakan kejadian utama kecelakaan. Setiap tahun bahkan cenderung mengalamai kenaikan rate kecelakaan. Belajar dari kejadian kecelakaan berkendara di tahun 2016 dan 2017, PT XYZ berkewajiban untuk menurunkan tingkat rate kecelakaan, oleh karena itu di tahun 2018 diperkenalkan sebuah program Journey Management System (JMS) yang bertujuan untuk membentuk karakter pengemudi yang selamat guna mencapai penurunan jumlah kecelakaan berkendara di PT XYZ. Desain penelitian ini adalah survei menggunakan metode penelitian deskriptif dengan pendekatan semikuantitatif. Tujuannya adalah untuk mengetahui hubungan antara penerapan JMS dan jumlah kecelakaan sekaligus menilai perubahan perilaku pengemudi sebelum dan sesudah penerapan JMS ini. Aplikasi pengolahan data statistik (Statistical Product and Service Solution/ SPSS) dengan metode Correlation untuk mengetahui hubungan antara implementasi JMS dan perilaku mengemudi dan jumlah kecelakaan berkendara. Dari hasil penelitian ini disimpulkan bahwa JMS memiliki hubungan dengan perilaku mengemudi di PT XYZ, Akan tetapi JMS tidak memiliki hubungan dengan jumlah kecelakaan berkendara di PT XYZ.

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Driving in PT XYZ's operational activities is the main incident of accidents. Every year it even tends to experience an increase in the accident rate. Learning from the incidents of driving accidents in 2016 and 2017, PT XYZ is obliged to reduce the rate of accidents, therefore in 2018 a Journey Management System (JMS) program was introduced which aims to shape the character of safe drivers to achieve a reduction in the number of driving accidents in PT XYZ. The research design was a survey using descriptive research methods with a semi-quantitative approach. The aim is to determine the relationship between the implementation of the JMS and the number of accidents as well as to assess changes in driver behavior before and after the implementation of this JMS. Statistical data processing application (Statistical Product and Service Solution / SPSS) with the Correlation method to determine the relationship between JMS implementation and driving behavior and the number of driving accidents. From the results of this study it is concluded that JMS has a relationship with driving behavior at PT XYZ, however JMS has no relationship with the number of driving accidents at PT XYZ."