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"Gen NANOG berperan dalam pembentukan faktor transkripsi yang memiliki DNA binding domain. Protein yang dibentuk oleh gen ini memiliki kemampuan untuk menimbulkan dan mempertahankan sifat pluripotent dari sebuah sel. Dikarenakan sifat sel tumor yang pluripotent, banyak studi telah dilakukan untuk menilai peran NANOG dalam keganansan tumor. Namun, data mengenai peran NANOG pada keganansan gliom belum cukup untuk mengklarifikasi efek NANOG pada perkembangan glioma. Glioma merupakan tumor otak yang paling dijumpai dalam praktik klinis. Tantangan dalam penanganan glioma terletak pada lokasi tumor yang susah dan beresiko untuk dijangkau. Penanganan glioma, beresiko tinggi untuk mengakibatkan kerusakan pada jaringan otak yang dapat berakibat pada kehilangan fungsi tubuh dan bahkan berakibat pada kematian. Dalam kesempatan ini, studi ini dilakukan untuk meninjau peran NANOG dalam keganasan glioma untuk menunjang penanganan dini dan mengurangi mortalitas dan morbiditas penderita. Studi dilaksanankan melalui kuantifikasi gen dengan metode real-time RT-PCR atas specimen glioma yang diperoleh melalui operasi pengangkatan tumor di Departemen Bedah Saraf FKUI-RSCM. Hasil yang diperoleh menunjukan adanya kecenderungan ekspresi NANOG untuk lebih tinggi di glioma tingkat tinggi dibandingkan glioma tingkat rendah walau tidak signifikan menurut statisitik. Diperlukan studi yang lebih besar untuk menunjang peran NANOG sebagain penanda keganasan pada kasus glioma.NANOG gene codes for a transcription factor with a DNA binding domain that has been found to contribute in maintenance and induction of cell pluripotency. Due to this characteristic, extensive studies have been done to evaluate its function as biomarker of tumor malignancy. However, the role of NANOG in glioma malignancy is not yet elucidated. Glioma, a leading tumor of the brain remains a challenging medical condition due to the location of the tumor. Treatment is complicated due to the high chance of compromising the brain structure which could lead to detrimental effects in body functions. The study conducted is to determine the role of NANOG in glioma malignancy by performing NANOG gene quantification using real-time RT-PCR in low-grade and high-grade glioma samples that was obtained from resection surgery in the Neurosurgery Department of FKUI-RSCM. Statistical analysis, showed that there was not significant difference in NANOG expression between the low-grade and high-grade glioma. Despite the absence of significance, there is a trend for higher expression of NANOG in high-grade glioma compared to low-grade glioma. The result, supports the proposition of NANOG as glioma malignancy biomarker. Further studies need to be conducted with greater sample to bolster the NANOG role in glioma malignancy."

"We report three rare cases of mucosal-associated lymphoid tissue (MALT) lymphoma. Two cases are of gastric MALT lymphoma and one is a case of transverse colon MALT lymphoma. The two cases of gastric MALT lymphoma were diagnosed by endoscopy which demonstrated an ulcer in the cardia and another in the corpus. The first case is in a 62-year-old male. The patients medical history revealed upper GI tract bleeding with melaena in 1993. At the time no diagnosis was made on endoscopy In August 2000, melaena recurred and endoscopy showed an ulcer in the cardio. Histology showed high-grade gastric MALT lymphoma. Based on Ann Arbor classification, the patient was classified as stage IE gastrointestinal lymphoma. H. pylori was negative. The patient received chemotherapy The second case is in a 53-year-old male. He suffered from gastric lymphoma for 3 years. He complained of annually recurring haematemesis before a definitive diagnosis was finally established. He suffered jiom stage IE low-grade well-differentiated lymphocytic MALT lymphoma. H. pylori was negative. Endoscopic procedure after H. pylori eradication showed ulcer regression though histology still showed low-grade MALT lymphoma and H. pylori as positive. The third case is in a 46-year-old male with a complaint of haematochezia. Colonoscopy showed intususception due to tumor in the transverse colon. Histologic examination showed chronic colitis and granulomatosa. lnvagination due to colon tumor was reported. Histologic examination of the biopsy specimen showed low-grade small cell lymphocyte-plasmocytoid lymphoma. "

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif.Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.......Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy. Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study. Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif. Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi. ......Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy. Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study.Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction. Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang: Karsinoma endometrium adalah keganasan pada organ reproduksi wanita yang terjadi umumnya pada wanita pasca menopase. Pemeriksaan radiologi khususnya MRI merupakan penunjang penting dalam menentukan staging dan keterlibatan organ organ rongga panggulyang akan menentukan pilihan terapi. Perkembangan teknik fungsional MRI yakni diffusion weighted imaging (DWI) dan apparent diffusion coefficient (ADC)digunakan untuk membedakan lesi jinak dengan ganas, grading disertai dengan perluasannya, tetapi sayangnya teknik inimemiliki keterbatasanyakni nilai yang dihasilkan pada setiap alat MRI heterogen. Saat ini berkembang teknik baru yang membandingkan nilai ADC jaringan lesi dengan nilai ADC jaringan sehat dengan hasil nilai yang lebih homogen.Tujuan: Tujuan penelitian ini adalah membuktikan nilai rerata rasio ADC memilikihasil lebih homogen dibandingkan dengan nilai rerata ADC.Metode: Penelitian ini menggunakan desain penelitian deskriptif potong lintang menggunakan data sekunder. Penelitian dilakukan mulai bulan Desember 2018 hingga Maret 2019, dengan jumlah sampel sebanyak 21 sampel.Hasil: Median nilai ADC tumor endometrium, urin, dan miometrium adalah 0,58 mm2/s, 3,26 mm2/s, dan 1,52 mm2/s. Berdasarkan coefficient of variation (COV) nilai rasio ADC lebih homogen dibandingkan dengan nilai ADC tumor (nilairasio ADC tumor-urine 35,1%, tumor-miometrium 41,7%, dan ADC tumor 42,2%).Kesimpulan: Nilai rasio ADC memiliki nilai yang lebih homogen dibandingkan dengan nilai ADC, sehingga dapat digunakan sebagai parameter non-invasif dalam mengevaluasi tumor.......Background: Endometrial carcinoma is most common gynecologic malignancy that occurs usually in postmenopausal women. Imaging examination, especially MRI, is important in determining the staging and involvement of intrapelvic organs, which will determine the therapy for the patient. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) can be used to help distinguish benign or malignant lesions, grading and expansion of the lesion, but unfortunately this technique produced heterogeneous values. Currently a new technique is developing that compares the tissue ADC value of lesions with healthy tissue, resulting more homogeneous values.Purpose: The purpose of this study is to prove the average value of the ADC ratio has more homogeneous results than the average value of the ADC.Methods: This study uses a cross-sectional descriptive design, using secondary data. The study was conducted from December 2018 to March 2019, with a total sample of 21.Result: The median ADC value of endometrial, urine, and myometrial tumors was 0.58 mm2 / s, 3.26 mm2 / s, and 1.52 mm2 / s. Based on coefficient of variation (COV) the ADC ratio value is more homogeneous compared to the tumor ADC value (tumor-urine ADC ratio value is 35.1%, myometrial tumor 41.7%, and tumor ADC 42.2%).Conclusion: The ADC ratio value has a more homogeneous value than the ADC value, so it can be used as a non-invasive parameter in evaluating tumors."

"Pendahuluan dan tujuan: Keganasan ginekologis adalah salah satu penyebab kematian tersering pada perempuan. Hidronefrosis atau uropati obstruktif merupakan salah satu temuan tersering pada pasien dengan keganasan ginekologis. Penelitian ini bertujuan menjelaskan profil pasien uropati obstruktif yang disebabkan oleh keganasan ginekologis yang ditatalaksana di Rumah Sakit Cipto Mangunkusumo tahun 2019 sampai 2021 Metode: Dari Januari 2019 sampai Januari 2021, pasien uropati obstruktif dengan keganasan ginekologis yang menjalani prosedur pemasangan DJ stent atau nefrostomi dimasukkan dalam studi prospektif ini. Pasien dengan riwayat diversi urin maupun penyakut lain yang mungkin menyebabkan obstruksi saluran kemih dieksklusi dari penelitian. Hasil: Terdapat 121 pasien keganasan ginekologis dengan uropati obstruktif yang diteliti pada penelitian ini. Persentase pasien dengan pemasangan DJ stent bilateral, kanan, dan kiri adalah 72%, 18%, dan 10%. Mayoritas kasus adalah pasien dengan hidronefrosis grade 3 atau grade 4. Nefrostomi dilakukan pada 69,4% kasus, dan hanya 17% diantaranya yang mengalami episode polyuria. Kesimpulan: Mayoritas kasus uropati obstruktif disebabkan oleh keganasan serviks, dengan dominansi obstruksi bilateral. Nefrostomi adalah metode diversi urin pilihan pada penelitain ini.......Introduction and Objectives: Gynecological malignancies are one of the most common causes of death from cancer in women. Hydronephrosis or obstructive uropathy is the most common finding in patients with gynecological malignancy. This study aimed to describe the profile of obstructive uropathy patients causes of gynecology malignancies treated in our center from 2019 to 2021. Method: From January 2019 to January 2021, obstructive uropathy patients with gynecological malignancies who underwent DJ stent or nephrostomy insertion procedures at Cipto Mangunkusumo Hospital were included in this prospective study. Patients with a history of urinary diversion or other diseases that may cause urinary tract obstruction were excluded. Results: One hundred and twenty-one patients with gynecological malignancies with obstructive uropathy were included. The percentages of bilateral, right-, and left-sided stent positions were 72%, 18%, and 10%, respectively. Most of them were grade 3 or grade 4 hydronephrosis. Percutaneous nephrostomy was mainly used for 69,4%, and only 17% of patients experienced a polyuria episode. Conclusion: Most cases of obstructive uropathy were caused by cervical malignancies, with bilateral obstruction due to cervical cancer occurring in most cases. Nephrostomy is the method of choice for urinary drainage in our center."

"ABSTRAKTumor adrenal insidentaloma memberikan dampak malnutrisi. Hal ini disebabkan oleh adanya interaksi antara tumor-host dan respon inflamasi pada tubuh. Permasalahan gizi pada pasien dengan keganasan yaitu kaheksia atau sindrom anoreksia yang menyebabkan malnutrisi. Jika gizi pasien tidak diperbaiki akan memperburuk status gizi anak dan berisiko terjadinya infeksi dan keterlambatan jadwal terapi yang akan dialami pasien. Karya ilmiah ini bertujuan untuk perbaikan gizi melalui motivasi keluarga supaya anak makan sedikit tapi sering guna untuk meningkatkan asupan kalori pada anak. Hasil dari implementasi dari pemberian motivasi pada keluarga, yaitu anak mampu makan 7/8 dari 1 porsi. Saran dalam pemberian asupan nutrisi pada anak dengan keganasan adalah peningkatan asupan tinggi kalori tinggi protein dengan cara pemberian asupan sedikit namun sering.

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ABSTRACT< br>Adrenal incidentaloma cause malnutrition for children who live with it. This can be happened because of tumor host interaction and inflammatory response from the body. Under severe conditions, there would be symptoms of cachexia or anorexic syndrome which further the problem of malnutrition. If this condition is left untreated it will worsen the nutritional status of the children and add the risk of infection, thus cause delay in the children 39 s therapy schedule. This work intend to show how to use motivational support for families, so even if their children do not eat in the required amount these children would still get a good supply of calories. The result from this strategy is that children can eat 7 8 part of 1 required portion. The author suggests that in terms of supplying nutrition for children with severe condition, the supply of food rich in calories and protein must be increased by giving a fewer portion of food but in frequent manner. "

"Uropati obstruksi yang disebabkan karena keganasan merupakan salah satu kasusyang seringkali ditemukan di bidang urologi. Dilema tersering dalam pemasangannefrostomi perkutan ialah pertimbangan terhadap kualitas hidup pasien dankeuntungannya dalam hal meningkatkan fungsi ginjal pada pasien dengan uropatiobstruksi karena keganasan. Studi ini dibuat untuk mengevaluasi kualitas hiduppasien yang memakai nefrostomi perkutan sebagai tatalaksana untuk obstruksi ureterdi Rumah Sakit Kanker Dharmais, sebagai rumah sakit rujukan utama kanker.Sebanyak 33 pasien yang menjalani prosedur pemasangan nefrostomi perkutan dariperiode januari 2019-maret 2019 diikut sertakan sebagai sampel penelitian. Kualitashidup pasien dievaluasi menggunakan kuisioner Quality of Life-C30 (EORTC QLQC30)pada awal sebelum pemasangan dan 1 bulan setelah pemasangan nefrotosmiperkutan. Skor kualitas hidup awal pada pasien dengan keganasan saluran cernaberkisar antara 87-103 poin, pada pasien dengan keganasan ginekologi berkisar antara74-100, dan untuk pasien dengan keganasan saluran kemih berkisar antara 75-100poin. 1 bulan setelahnya, skor untuk pasien dengan keganasan saluran kemih 87-101poin, pada keganasan ginekologi 73-104 dan keganasan saluran kemih 70-90. Tidakada perbedaan bermakna antara nefrostomi perkutan bilateral maupun unilateral.Nefrostomi perkutan dapat dipilih sebagai tatalaksana uropati obstruktif yangdisebabkan karena keganasan. Meskipun memberikan dampak pada kualitas hiduppasien, nefrostomi perkutan memberikan keuntungan dengan memperbaiki fungsiginjal pasien.

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Obstructive uropathy due to malignancy case has been one of common case found inurology. The most common dilemma regarding percutaneous nephrostomy is aboutpatient quality of life and advantages of this procedure in improving kidney functionin patient with uropathy obstructive due to malignancy. This study was made toevaluate patient quality of life who underwent percutaneous nephrostomy as thetreatment for ureteral obstruction in malignancy case in Dharmais Cancer HospitalJakarta, as the main referral cancer hospital in Indonesia. We selected 33 patient whounderwent percutaneous nephrostomy during January 2019- March 2019. Patientquality of life then being evaluated by using Quality of Life-C30 (EORTC QLQ-C30)questionnaire before and 1 month after nephrostomy procedure. Quality of Life(QOL) scoring in patient with digestive cancer before nephrostomy was 87-103points, 74-100 points for gynecology cancer. And 75-100 points for urinary tract(bladder) cancer. In one months follow up, study found that the Quality of life scorein patient seems decreased some point in digestive, gyenecology, and urinary tractmalignancies ( 87-101, 73-104, 70-90) respectively. There was no difference inquality of life in patient with unilateral or bilateral nephrostomy. Nephrostomy mightbe chosen as the treatment for uropathy obstructive due to malignancy. Despite it willgive impact in patient quality of life, it showed significant improvement in patientkidney function."

"Pendekatan integrasi antara terapi paliatif dan perawatan penyakit kronik dan atau mengancam jiwa telah banyak digunakan dalam beberapa tahun terakhir. Hingga saat ini, masih banyak yang beranggapan bahwa terapi paliatif hanya ditujukan untuk pasien dengan penyakit berat yang sudah berada di stadium terminal atau akhir hidupnya, namun pada kenyataannya banyak pasien mendapatkan manfaat dari terapi paliatif sedini mungkin. Penelitian ini merupakan uji klinis acak terkontrol yang bertujuan untuk mengetahui manfaat integrasi terapi paliatif pada pasien anak dengan penyakit keganasan. Pasien terdiri dari anak  dengan penyakit keganasan usia 2-18 tahun yang dikonsulkan kepada tim paliatif. Pasien dibagi menjadi dua kelompok secara acak, yakni kelompok kontrol (30 anak) dan kelompok intervensi (30 anak). Intervensi berupa kunjungan rumah, komunikasi dua arah antara tenaga terlatih dengan pasien dan orang tua, dibagi menjadi 6 sesi (1 sesi setiap 2 minggu) yang berfokus pada edukasi penyelesaian masalah, manajemen gejala, perawatan diri sendiri, komunikasi, pembuatan keputusan dan pendampingan rencana perawatan lanjutan. Pasien diikuti dan dilakukan penilaian kualitas hidup dengan kuesioner Pediatric Quality of  Life Innitiative (PedsQLTM) modul kanker 3.0, intensitas gejala dinilai dengan Edmonton Symptoms Assesment Score (ESAS), frekuensi kunjungan unit gawat darurat (UGD) pasien anak dengan penyakit keganasan dicatat selama periode penelitian dan dibandingkan dengan sebelum penelitian. Kelompok intervensi memiliki kualitas hidup lebih tinggi bermakna (81,63) dibandingkan kelompok kontrol (62,39), p<0,001. Ranah kualitas hidup yang paling meningkat secara signifikan adalah ranah nyeri, mual, kecemasan prosedur, kecemasan tata laksana, dan khawatir. Intervensi paliatif dapat menurunkan intensitas gangguan tidur (p=0,003) dan anoreksia pada pasien (p<0,001). Intervensi paliatif dapat menurunkan kunjungan UGD sebanyak 4,77 kali pada pasien anak dengan penyakit keganasan (OR 4,77, 95% IK 1,29-17,65; p=0,018).......In these last few years, an integrated approach between palliative care and chronic and/or life-threatening conditions care have been widely used. Many people think that palliative care is only intended for those with end stage of disease or in the end of life period. In fact, many patients had benefit from early palliative integration. This study is aimed to know the role of palliative intervention in child with malignancy. A randomized controlled trial comparing patients who were given palliative care (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 patients. Patients consisted of children with cancer aged 2-18 years old who were consulted to palliative team. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention (report by proxy or self-report). Interventions were given in 6 sessions (1 session every 2 weeks) focusing on problems solving education, symptoms management, self-care, communication, decision making, and long-term care plan assistance. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0. Symptomps intensity were assessed by Edmonton Symptoms Assesment Score (ESAS). Emergency room admissions from the last 3 months were noted before patients were enrolled in the study. During the follow up period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed to see the effect of interventions on outcomes in this study. A significant difference of quality of life was found between the two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). Most significant increased domains were pain, nausea, procedural anxiety, treatment anxiety, and worry. Intensity of sleep disturbance (p=0.003) and anorexia (p<0.001) were decreased significantly in intervention group. Emergency room admissions were reduced by 4.7 times in intervention group (OR 4.77, 95% CI 1.29-17.65; p=0.018)."