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"Pendahuluan. Fistula pankreas masih merupakan komplikasi paling sering setelah pankreatikoduodenektomi yang menyebabkan masa rawat lama dan biaya besar.  Fistula ini terjadi sampai 45%.  Kebocoran anastomosis pankreatikojejunostomi merupakan faktor yang paling penting. Belum ada data tentang faktor pankreas yang dapat memengaruhi fistula pankreas di Jakarta, khususnya RS Cipto Mangunkusumo sehingga dilakukan penelitian ini.

Metode.  Penelitian cross sectional ini dilakukan pada 70 orang penderita yang dilakukan pankreatikoduodenektomi. Data dikumpulkan dari data sekunder rekam medis tahun 2016-2019 berupa tekstur pankreas, diameter duktus pankreatikus, teknik anastomosis pankreatikojejunal, dan penggunaan stent pada pankreatikojejunal sebagai variabel bebas. Fistula pankreas sebagai variabel terikat. Data diuji dengan uji Spearman dikarenakan abnormalitas distribusi data.

Hasil.  Didapatkan 70 subjek. Tidak ada kejadian fistula pankreas sebanyak 21,4% dan ada fistula pankreas sebanyak  78,6%. Diameter duktus pankreatikus tidak melebar sebanyak 78,6% dan melebar sebanyak 21,4%. Tekstur pankreas soft sebanyak 22,9% dan hard sebanyak 77,1%. Penggunaan stent sebanyak 21,4% dan tidak ada penggunaan sebanyak 78,6%. Tipe anastomosis pankreatikojejunal dunking atau invaginasi sebanyak 82,9% dan duck to mucosa sebanyak 17,1%.  Faktor risiko yang bermakna pada analisis bivariat adalah diameter duktus pankreatikus (p=0,007). 

Kesimpulan. Penilaian diameter duktus pankreatikus intraoperatif mempunyai hubungan bermakna dalam memperkirakan kejadian fistula pankreas pascaoperasi pankreatikoduodenektomi.

 

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Introduction. Pancreatic fistula is the most common complication after pancreaticoduodenectomy that cause longer hospital stay and higher cost. It happens 45%. Pancreaticojejunostomy anastomosis leakage is the most important factor. No data about pankreas’ factor that can influence pancreatic fistula in Cipto Mangunkusumo hospital so this study is held.

Method. This cross sectional study was done for 70 patients. Data was collected from medical record in 2016-2019.   The data are pancreatic texture, pancreatic duct diameter, pancreaticojejunal anastomotic technique, and use of  stent in pancreaticojejunal as the independent variables. Pancreatic fistula as the dependent variable.   We analyzed  using Spearman test due to abnormality data distribution.

 

Results. There are 70 subjects enrolled. Subjects with no pancreatic fistula about 21,4% and with pancreatic fistula 78,6%.   No dilated pancreatic duct diameter about 78,6% and dilated about 21,4%. Soft texture pancreas about 22,9% and hard 77,1%. Use of stent about 21,4% and no stent 78,6%. Pancreaticojejunal anastomotic type of dunking or invaginating about 82,9% and duck to mucosa about 17,1%.  The significant risk factor in bivariate analysis is diameter of the pancreatic duct (p=0,007). 

Conclusion. Intraoperative assessment of the pancreatic duct diameter associated significantly in predicting pancreatic fistula after pancreaticoduodenectomy.

 

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"[ABSTRAKLatar Belakang : Pada kanker pankreas dapat terjadi obstruksi pada duktus pankreatikus yang menghambat transfer enzim dan bikarbonat ke duodenum yang menyebabkan aktifitas enzim tidak cukup adekuat untuk mempertahankan proses pencernaan secara normal yang disebut sebagai pancreatic exocrine insufficiency (PEI), yang dapat dideteksi dengan pemeriksaan kadar fecal elastase 1.Tujuan : Mengetahui proporsi dan derajat PEI, proporsi steatore pada kanker pankreas, perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable dan perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas.Metode : Penelitian ini adalah studi potong lintang untuk menentukan perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable. Penelitian ini dilakukan di Rumah Sakit Cipto Mangunkusumo, beberapa rumah sakit jejaring RSCM, dan RS Wahidin Sudirohusodo Makasar dari bulan November 2014 sampai dengan Mei 2015. Uji statistik yang digunakan untuk menilai perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable adalah Mann Whitney dan untuk menilai perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas adalah Kruskal Wallis.Hasil : Sebanyak 48 subyek kanker pankreas diikutkan dalam penelitian, dengan kategori resectable sebanyak 19(39,6%) subyek, dan 29(60,4%) subyek yang unresectable. Proporsi pasien kanker pankreas yang mengalami PEI sebanyak 75% (IK 95% 0,63-0,87) dan proporsi pasien kanker pankreas yang memberikan gejala steatore sebanyak 68,8% (IK 95% 0,557-0,819). Tidak ada perbedaan kadar fecal elastase 1 yang bermakna (P=0,738) antara kelompok resectable dan unresectable dengan nilai median pada kelompok resectable adalah 38,0(15-500) μg/g dan pada kelompok unresectable adalah 35,0(15-500) μg/g. Tidak ada perbedaan bermakna (p=0,767) kadar fecal elastase 1 berdasarkan stadium kanker pankreas dengan nilai median(rentang) pada stadium IB 36(15-100) μg/g, stadium IIA 62(15-500) μg/g, stadium III 15(15-500) μg/g, dan stadium IV 36(15-500) μg/g.Kesimpulan : Pada penelitian ini didapatkan proporsi PEI dan steatore yang tinggi pada kanker pankreas. Tidak ditemukan perbedaan bermakna kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable. Tidak terdapat perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas.

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ABSTRACTBackground : In the pancreatic cancer can occur obstruction of the pancreatic duct that inhibit the enzyme transfer and bicarbonate into the duodenum which causes the enzyme activity is not quite adequate to maintain normal digestive process referred to as pancreatic exocrine insufficiency (PEI) that can be detected by measurement of fecal elastase 1 level.Objective : Knowing the proportion and the degree of PEI, the steatore proportion in pancreatic cancer, the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer and differences between the mean levels of fecal elastase 1 based on the stage of pancreatic cancer.Methods : A cross-sectional study to determine the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer. This research was conducted at Cipto Mangunkusumo hospital, some satellite of Cipto Mangunkusumo hospital, and Wahidin Sudirohusodo Makasar hospital at November 2014 until May 2015. The statistical test used to assess differences in the levels of fecal elastase 1 between resectable and unresectable pancreatic cancer is Mann Whitney and to assess the differences between the mean levels of fecal elastase 1 based on staging pancreatic cancer is the Kruskal Wallis.Results : A total of 48 subjects with pancreatic cancer were participated in this study, with resectable category were 19 (39.6%) subjects, and 29 (60.4%) subjects who unresectable. The proportion of patients with pancreatic cancer that experienced PEI are 75% (CI 95% 0.63 - 0.87) and the proportion of patients with pancreatic cancer which provide steatore symptoms are 68.8% (CI 95% 0.557 - 0.819). There is no significant difference levels of fecal elastase 1 (P = 0.738) between the resectable and unresectable where the resectable group median value is 38.0 (15-500) μg / g and in unresectable group was 35.0 (15-500) μg / g. There is no significant difference (p = 0.767) levels of fecal elastase 1 based on the stage of pancreatic cancer with median (range) in stage IB 36 (15-100) pg / g, stage IIA 62 (15-500) pg / g, stage III 15 (15-500) μg / g, and stage IV 36 (15-500) μg / g.Conclusion : This study found a high proportion of PEI and steatore in pancreatic cancer. there is no significant difference fecal elastase 1 levels between the resectable and unresectable pancreatic cancer. There is no significant difference between mean levels of fecal elastase 1 based on the stage of pancreatic cancer., Background : In the pancreatic cancer can occur obstruction of the pancreatic duct that inhibit the enzyme transfer and bicarbonate into the duodenum which causes the enzyme activity is not quite adequate to maintain normal digestive process referred to as pancreatic exocrine insufficiency (PEI) that can be detected by measurement of fecal elastase 1 level.Objective : Knowing the proportion and the degree of PEI, the steatore proportion in pancreatic cancer, the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer and differences between the mean levels of fecal elastase 1 based on the stage of pancreatic cancer.Methods : A cross-sectional study to determine the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer. This research was conducted at Cipto Mangunkusumo hospital, some satellite of Cipto Mangunkusumo hospital, and Wahidin Sudirohusodo Makasar hospital at November 2014 until May 2015. The statistical test used to assess differences in the levels of fecal elastase 1 between resectable and unresectable pancreatic cancer is Mann Whitney and to assess the differences between the mean levels of fecal elastase 1 based on staging pancreatic cancer is the Kruskal Wallis.Results : A total of 48 subjects with pancreatic cancer were participated in this study, with resectable category were 19 (39.6%) subjects, and 29 (60.4%) subjects who unresectable. The proportion of patients with pancreatic cancer that experienced PEI are 75% (CI 95% 0.63 - 0.87) and the proportion of patients with pancreatic cancer which provide steatore symptoms are 68.8% (CI 95% 0.557 - 0.819). There is no significant difference levels of fecal elastase 1 (P = 0.738) between the resectable and unresectable where the resectable group median value is 38.0 (15-500) μg / g and in unresectable group was 35.0 (15-500) μg / g. There is no significant difference (p = 0.767) levels of fecal elastase 1 based on the stage of pancreatic cancer with median (range) in stage IB 36 (15-100) pg / g, stage IIA 62 (15-500) pg / g, stage III 15 (15-500) μg / g, and stage IV 36 (15-500) μg / g.Conclusion : This study found a high proportion of PEI and steatore in pancreatic cancer. there is no significant difference fecal elastase 1 levels between the resectable and unresectable pancreatic cancer. There is no significant difference between mean levels of fecal elastase 1 based on the stage of pancreatic cancer.]"

"ABSTRAKLatar Belakang dan tujuan: Pemeriksaan MRI T2 pankreas merupakan pemeriksaan yang lebih akurat dalam menilai hemosiderosis pankreas, namun memiliki keterbatasan karena hanya tersedia di kota-kota besar. Penelitian ini bertujuan untuk mengetahui korelasi nilai T2 pankreas dengan kadar glukosa darah, karakteristik T2 pankreas dan kadar glukosa darah subyek penelitian, serta pengaruh letak ROI terhadap nilai T2 pankreas. Metode: Penelitian menggunakan desain potong lintang pada 52 subyek anak dan 12 subyek dewasa antara September 2015-Juni 2016. Hasil: Nilai T2 pankreas anak antara 2,71-48,77 ms dan dewasa 6,49-41,82 ms. Kadar glukosa darah puasa anak rerata 87,31 11,01 mg/dL dan dewasa 88,00 10,27 mg/dL. Korelasi nilai T2 pankreas terhadap kadar glukosa darah puasa anak r=0,198 p=0,160 dan dewasa r=0,004 p=0,991 . Hubungan nilai T2 pankreas dengan letak ROI didapatkan p=0,105. Kesimpulan: Tidak terdapat korelasi nilai T2 pankreas dengan kadar glukosa darah puasa pada anak dan dewasa. Tidak terdapat perbedaan signifikan nilai T2 pankreas menurut letak ROI.

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ABSTRACTBackground and Objective T2 MRI examination is more accurate in assessing pancreatic hemosiderosis but lack of availability to be used routinely in daily practice. This study aimed to determine the correlation value of T2 pancreas with blood glucose levels in thalassemic children and adults. Methods Cross sectional study that held in September 2015 June 2016, involving 52 children and 12 adults. Results Pancreatic T2 values of children are 2.71 to 48.77 ms and values of adults are from 6.49 to 41.82 ms. Mean of fasting blood glucose levels in children are 87.31 11.01 mg dL and mean of adults are 88.00 10.27 mg dL. Correlation r between value of pancreatic T2 against children rsquo s fasting blood glucose levels was 0.198 p 0.160 and adults was 0.004 p 0.991 . Significancy value p of relationship between pancreatic T2 and ROI of pancreas was 0.105. Conclusion There was no significant correlation between pancreatic T2 values with fasting blood glucose levels in children and adults, nor significant difference in T2 values according to ROI of pancreas."

"Latar Belakang: Kanker pankreas adalah penyebab kematian keempat yang berhubungan dengan keganasan di Amerika Serikat, dan diperkirakan akan menjadi penyebab kematian kedua di tahun 2030 di United Kingdom. Indonesia belum memiliki data kesintasan kanker pankreas dan faktor-faktor yang memengaruhinya.Tujuan: Mengetahui kesintasan 1 tahun kanker pankreas dan faktor- faktor yang memengaruhinya di RS dr. Cipto Mangunkusumo, Jakarta.Metode: Dilakukan penelitian kohort retrospektif menggunakan data dari rekam medis pasien kanker pankreas RS dr. Cipto Mangunkusumo antara Januari 2012 - Desember 2016. Faktor umur, jenis kelamin, metastasis, stadium, komorbid dan pengobatan dianalisis secara bivariat dan multivariat menggunakan Cox Proportional Hazards Regression untuk mendapatkan Hazard Ratio HR setiap faktor prognosis. Kesintasan kumulatif 1 tahun setelah diagnosis dinyatakan dengan kurva Kaplan- Meier.Hasil: Dari 83 subyek penelitian proporsi laki-laki adalah 62.7, usia ge; 50 tahun 68,7, dengan rentang usia 33-79 tahun, dan rata-rata 55 tahun. Pada analisis bivariat didapati hubungan bermakna secara statistik kesintasan dengan variabel komorbid HR 2,116 IK 95 1,335-3,513 p< 0,002, metastasis HR 3,802 IK 95 1,995-7,249 p

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Background Pancreatic cancer is the fourth leading cause of death associated with malignancy in the United States, and is thought to be the second leading cause of death in 2030 in the United Kingdom. Currently, Indonesia has no data on the survival of pancreatic cancer and the factors that affect it. Aim This study aims to know the 1 year survival of pancreatic cancer and its influencing factors. Methods A retrospective cohort study was performed using data from the medical record of pancreatic cancer patients in dr Cipto Mangunkusumo General Hospital, Jakarta, from January 2012 to December 2016. Age, sex, metastasis, stage, comorbidities, and treatment were analyzed bivariate and multivariate using Cox Proportional Hazards Regression to obtain Hazard Ratio HR for each prognostic factor. The 1 year cumulative survival rate after diagnosis is expressed by the Kaplan Meier Curve.Results Of 83 subjects, the proportion of male was 62,7, age ge 50 years 68,7, with age range 33 79 years, and 55 years on average. In bivariate analysis, there was a statistically significant relationship of survival with comorbidities HR 2.116 95 CI 1.335 3.513 p 0.002, metastasis HR 3.802 95 CI 1.995 7.249 p 0.001, palliative treatment HR 2.108 95 CI 1.077 4.125 p 0.029 and group without treatment HR 2.924 95 CI 1.496 5.716 p 0.002. Multivariate analysis showed that metastasis provided the greatest risk of death with HR 4.306 95 CI 2.125 8.724 p 0.001. Palliative group HR was 2.510 95 CI 1.245 5.061 p 0.010 while the group without treatment gave HR 2.535 95 CI 1.277 5.032 p 0.008. Conclusion The overall survival of 1 year of pancreatic cancer patients was 14, with median survival of 6 months. The presence of metastasis and the decision not to do curative therapy Whipple surgery in patients with pancreatic cancer in dr Cipto Mangunkusumo General Hospital are the primary factors that negatively affect the 1 year survival rate. "

"Latar Belakang: Adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri, tanpa melihat gambaran episentrum tumor, sulit dibedakan secara histopatologi. Gejala klinis tidak spesifik sehingga kasus yang ditemukan seringkali tidak memenuhi kriteria resectable. Gambaran radiologi juga tidak spesifik, padahal terapi dan prognosis keduanya berbeda. Adenokarsinoma duktal pankreas memiliki angka kesintasan rendah dibanding adenokarsinoma ampula vateri. Penentuan asal tumor, berasal dari duktal pankreas atau ampula vateri, sangat penting. SMAD4 diduga dapat menjadi salah satu panel diagnostik imunohistokimia. Penelitian ini dilakukan dengan melihat perbandingan ekspresi SMAD4 di adenokarsinoma ampula vateri dan adenokarsinoma duktal pankreas.Tujuan: Mengetahui perbandingan ekspresi SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri.Metode: Penelitian analitik observasional, desain potong lintang pada sediaan reseksi adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri, periode Januari 2013 hingga September 2021. Pengambilan sampel dilakukan secara total sampling. Adenokasinoma ampula vateri dengan subtipe pankreatobiliar dieksklusi. Pemeriksaan imunohistokimia menggunakan antibodi primer SMAD4. Data imunohistokimia dianalisis untuk melihat adakah perbedaan ekspresi SMAD4 pada adenokarsinoma di ampula vateri dan adenokarsinoma duktal pankreas.Hasil: Loss of SMAD4 didapatkan pada 12 kasus (60 %) adenokarsinoma duktal pankreas dan 8 kasus (44,4 %) adenokarsinoma ampula vateri. Tidak didapatkan hubungan loss of SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri (p=0,338).Kesimpulan: Tidak terdapat hubungan bermakna loss of SMAD4 pada adenokarsinoma duktal pankreas dan adenokarsinoma ampula vateri. Namun terdapat trend loss of SMAD4 lebih tinggi pada adenokarsinoma duktal pankreas dibanding adenokarsinoma ampula vateri subtipe intestinal dan mixed type dominansi intestinal.

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ackground: Differentiating pancreatic ductal adenocarcinoma and ampullary adenocarcinoma without knowing the epicenter of the tumor is difficult. The clinical symptoms are non-specific. The cases found usually do not meet the operable criteria. Radiological examination is also non-specific, although the treatment and prognosis are different. Pancreatic ductal adenocarcinoma has lower survival rate than ampullary adenocarcinoma. It is very important to determine the origin of the tumor from pancreatic ductal or ampulla of Vater. SMAD4 is expected to be one of immunohistochemical diagnostic panel for the pancreatic ductal adenocarcinoma. This study compares the SMAD4 expression in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma.

Objective: Knowing the comparison of SMAD4 expression in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma.

Methods: Observational analytical study with cross sectional design, total sampling was performed on the resection specimens of pancreatic ductal adenocarcinoma and ampullary adenocarcinoma, period January 2013 to December 2021. Ampullary adenocarcinoma with pancreatobilliary subtype was excluded. Immunohistochemical examination using SMAD4 primary antibody. Immunohistochemical data will be analyzed to see SMAD4 expression difference between pancreatic ductal adenocarcinoma and ampullary adenocarcinoma.

Results: Loss of SMAD4 was found in 12 cases (66,7 %) of pancreatic ductal adenocarcinoma and 6 cases (44,4 %) of ampullary adenocarcinoma. There was no significant relationship between loss of SMAD4 in pancreatic ductal adenocarcinoma and ampullary adenocarcinoma (p=0,338).

Conclusions: There was no significant relationship between loss of SMAD4 in pancreatic ductal adenocarcinoma and adenocarcinoma of the ampulla of vater. However, there was a trend of higher SMAD4 loss in pancreatic ductal adenocarcinoma than ampullary vater adenocarcinoma of intestinal subtype and mixed type with intestinal dominance."

"Diabetes melitus adalah sindrom metabolik yang banyak diderita oleh masyarakat di Indonesia. Diabetes melitus dapat terjadi karena gangguan sekresi insulin atau gangguan pada reseptor insulin. Gangguan sekresi insulin pada diabetes melitus disebabkan oleh kerusakan pankreas, yang terjadi salah satunya akibat penumpukan stres oksidatif. Daun Tectona grandis adalah salah satu bahan herbal yang dikatakan memiliki efek antidiabetik. Penelitian mengenai pengaruh ekstrak daun Tectona grandis dengan histopatologi pankreas belum pernah dilakukan. Penelitian ini adalah penelitian eksperimental dengan total sampel sebanyak 30 sampel yang dibagi menjadi 6 kelompok, yakni kelompok kontrol normal (tanpa perlakuan), kontrol positif (diabetes dengan metformin), kontrol negatif (diabetes tanpa perlakuan), perlakuan 1 (diabetes dengan pemberian ekstrak daun jati 200 mg/kgBB), perlakuan 2 (diabetes dengan pemberian ekstrak daun jati 400 mg/kgBB), dan perlakuan 3 (diabetes dengan pemberian ekstrak daun jati 800 mg/kgBB). Organ pankreas akan dibaca di bawah mikroskop dengan perbesaran 100 dan 200 kali untuk diamati jumlah pulau Langerhans, ukuran pulau Langerhans, dan sel yang mendominasi pulau Langerhans. Hasil uji Kruskal-Wallis menunjukkan tidak adanya pengaruh signifikan antara pemberian ekstrak etanol daun Tectona grandis dengan histopatologi organ pankreas (p>0.05).

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Diabetes mellitus is a metabolic syndrome that is suffered by many people in Indonesia. Diabetes mellitus can occur due to impaired insulin secretion or insulin receptor disorders. Impaired insulin secretion in diabetes mellitus is caused by damage to the pancreas, one of which occurs due to accumulation of oxidative stress. Tectona grandis leaf is one of the herbal ingredients that are said to have antidiabetic effects. Research on the effect of Tectona grandis leaf extract on pancreatic histopathology has never been done. This research is an experimental study with 30 samples divided into 6 groups, normal control group (without treatment), positive control (diabetes with metformin), negative control (diabetes without treatment), treatment 1 (diabetes with extract 200 mg/kgBW), treatment 2 (diabetes with extract 400 mg/kgBW), and treatment 3 (diabetes with extract 800 mg/kgBW). The pancreas organ will be read under a microscope with 100 and 200 times magnification to observe the number of islets of Langerhans, the size of the islets of Langerhans, and the cells that dominate the islets of Langerhans. The results of the Kruskal-Wallis test showed that there was no significant effect between the administration of the ethanolic extract of the leaves of Tectona grandis and the histopathology of the pancreas (p>0.05)."

"CA 19-9 merefleksikan derajat keparahan adenokarsinoma kaput pankreas ditunjukkan oleh beberapa studi berhasil menemukan korelasi peningkatan CA 19-9 dengan resektabilitas adenokarsinoma kaput pankreas. Penelitian ini bertujuan melakukan evaluasi hubungan dan nilai diagnostik CA 19-9 dalam memprediksi resektabilitas adenokarsinoma kaput pankreas. Penelitian dilakukan secara potong lintang mengambil data dari rekam medis Rumah Sakit dr. Cipto Mangunkusumo tahun 2016–2019. Pasien terdiagnosis adenokarsinoma kaput pankreas secara histopatologis atau pencitraan abdomen, berusia ≤65 tahun, dan memiliki catatan pemeriksaan kadar CA 19-9 diikutsertakan dalam penelitian ini. Selain kadar CA 19-9, peneliti juga menilai factor terkait operabilitas. Tercatat 54 subjek dengan rerata usia 53,78±11,13 tahun. Ditemukan adanya korelasi positif (0,850) dan signifikan antara tingginya kadar CA 19-9 dengan resektabilitas tumor kaput pankreas. Untuk operabilitas, ditemukan perbedaan bermakna kadar CA 19-9, albumin, dan skor Karnofsky pada kelompok pasien tumor kaput pankreas resectable dan unresectable. Titik potong kadar CA 19-9 tercatat sebesar 140,65 U/mL, dengan sensitivitas sebesar 82,76% (64,23%–94,15%), spesifisitas sebesar 72,00% (50,61%–87,93%), dan AUC sebesar 0,784. CA 19-9 berhubungan secara signifikan dengan resektabilitas tumor kaput pankreas. CA 19-9 memiliki nilai diagnostik yang baik dalam mempredisksi resektabilitas tumor ini.

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This study would like to evaluate the relationship and diagnostic value of CA 19-9 in predicting the resectability of pancreatic head carcinoma. The cross-sectional study took data from the medical records at dr Cipto Mangunkusumo Hospital in 2015–2019. Patients diagnosed with pancreatic head carcinoma based on histopathologic or abdominal imaging, aged ≤75 years, and who had a recorded CA level of 19-9 were enrolled in the study. The investigators also assessed parameters of operability. Of 54 patients with similar characteristics were enrolled, with a mean age of 53.78 ± 11.13 years. It was found that there was a positive (0.850) and significant correlation between high levels of CA 19-9 and unresectable pancreatic head carcinoma. We found significant differences in levels of CA 19-9, albumin, and Karnofsky score in the resectable and unresectable groups of pancreatic head carcinoma. The cut-off point for CA 19-9 levels was 140.65 U / mL, with a sensitivity of 82.76% (64.23%-94.15%), specificity of 72.00% (50.61%-87.93 %), and AUC of 0.784. CA 19-9 was significantly associated with the pancreatic head carcinoma resectability. CA 19-9 has a good diagnostic value in predicting the resectability of these tumors."

"Iron overload (IO) akibat transfusi darah jangka panjang pada penderita talasemia dapat berdampak fatal pada berbagai organ, termasuk pankreas. Akumulasi besi bebas serta kerusakan akibat stress oksidatif dapat menyebabkan resistensi insulin dan disfungsi sel β pankreas. Tanaman Phaleria macrocarpa yang mengandung mangiferin berpotensi sebagai agen pengkelat besi dan antioksidan. Penelitian ini bertujuan untuk menganalisis efek ekstrak etanol buah Phaleria macrocarpa terhadap kadar besi organ pankreas pada tikus model hemosiderosis. Sejumlah 30 ekor tikus Sprague-Dawley dibagi menjadi kelompok normal, deferiprone 462,5 mg/kgBB, kontrol negatif (IO), mangiferin 50 mg/kgBB, Phaleria macrocarpa 100 mg/kgBB dan 200 mg/kgBB. Injeksi intraperitoneal iron sucrose (15 mg) diberikan 2x seminggu selama 7 minggu untuk seluruh kelompok kecuali normal. Setelah pemberian terapi secara oral selama 4 minggu terakhir, kadar besi diukur dengan Atomic Absorption Spectrometry. Dosis total induksi besi 240 mg selama 7 minggu pada tikus model IO secara signifikan (p < 0,05) meningkatkan kadar besi pankreas sebesar 6 kali dibanding normal. Ekstrak etanol buah Phaleria macrocarpa dosis 100 dan 200 mg/kgBB cenderung menurunkan kadar besi organ pankreas pada tikus. Terdapat perbedaan yang signifikan (p < 0,05) antara kadar besi pankreas pada PM1 dan PM2. Tidak ada perbedaan yang signifikan antara kadar besi pankreas pada PM2 dengan normal.

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Iron overload due to long-term blood transfusion in thalassemia patients can cause fatal impacts on various organs, including the pancreas. Insulin resistance and pancreatic cell dysfunction may result from the accumulation of free iron and oxidative stress damage. Phaleria macrocarpa plants, which contain mangiferin, have potential as iron chelating agents and antioxidants. This study aimed to analyze the effect of Phaleria macrocarpa fruit ethanol extract on pancreatic iron levels in hemosiderosis model rats. Thirty Sprague-Dawley rats were divided into normal, deferiprone 462,5 mg/kgBB, negative control, mangiferin 50 mg/kgBB, and Phaleria macrocarpa extract at 100 and 200 mg/kgBB. 15 mg of iron sucrose was injected intraperitoneally twice a week for 7 weeks into all groups except normal. The iron level in the rat pancreas was assessed using AAS after 4 weeks of oral therapy. The total dose of 240 mg iron induction for 7 weeks in IO model rats significantly (p < 0,05) increased iron level 6x compared to normal. Phaleria macrocarpa ethanol extract at 100 and 200 mg/kgBB doses tended to decrease pancreatic iron level in rats. The difference in pancreatic iron level between PM1 and PM2 is significant (p < 0,05). PM2 and normal don't have significantly different pancreatic iron level."

"Latar belakang dan tujuan : Hemosiderosis jantung dan pankreas merupakan komplikasi transfusi pada pasien thalassemia mayor. Evaluasi hemosiderosis pankreas dan jantung dilakukan dengan pemeriksaan MRI sekuens T2*. Kedua organ tersebut mempunyai kesamaan dalam penyimpanan besi dan tehnik pemeriksaan T2* pankreas lebih mudah dan cepat dibandingkan tehnik pemeriksaan jantung, sehingga diharapkan evaluasi hemosiderosis jantung dipermudah dengan menghitung nilai T2* pankreas.Metode : Uji korelatif dengan pendekatan potong lintang pada nilai T2* pankreas dan nilai T2* jantung dihitung menggunakan perangkat lunak CMRtools™ pada 30 subjek thalassemia mayor.Hasil : Tidak terdapat korelasi antara nilai T2* pankreas dengan nilai T2* jantung (R = 0,05, p = 0,798).Kesimpulan : Tidak terdapat korelasi antara nilai T2* pankreas dengan nilai T2* jantung pada pasien thalassemia mayor.

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Background and objective : Cardiac and pancreatic hemosiderosis are transfusion complication in major thalassemia patients. Evaluation of cardiac and pancreatic hemosiderosis assessed by MRI T2* examination. Both organs have same iron deposition, pancreatic T2* examination easier and faster than cardiac. Pancreatic T2* score can be used to evaluate cardiac hemosiderosis.

Method : A cross sectional correlation study between pancreatic and cadiac T2*score calculated with CMRtools™ software conducted in 30 major thalassemia patients.

Result : There is no correlation between pancreatic and cardiac T2* score (R = 0,05, p = 0, 79)

Conclusion : There is no correlation between pancreatic and cardiac T2* score in major thalassemia patients."

"ABSTRAKGaya hidup sedenter dan ketidakseimbangan pola konsumsi mengakibatkan masyarakat dunia menghadapi Global Time Bomb Phenomenon. Kecenderungan masyarakat dalam mengkonsumsi makanan tinggi fruktosa dan kolesterol menjadikan sindrom metabolik sebagai bom waktu yang perlu mendapatkan perhatian khusus. Perlemakan pankreas merupakan komorbid yang dapat muncul apabila kondisi hiperlipidemi dan hiperglikemi pada sindrom metabolik tidak mendapatkan intervensi adekuat sedari dini. Gemfibrosil merupakan salah satu pilihan terapi namun efektifitas tunggal regimen ini masih dipertanyakan. Acalypha indica merupakan tanaman herbal yang disinyalir memiliki efek protektif pada kondisi hiperlipidemi dan hiperglikemi. Penelititan ini bertujuan untuk membandingkan efek terapeutik Gemfibrosil G dan Acalypha indica Linn. AI terhadap perlemakan pankreas tikus Sprague-Dawley pasca induksi diet tinggi fruktosa dan kolesterol selama 4 minggu. Tikus yang telah diinduksi dibagi menjadi empat kelompok perlakuan, yaitu kontrol, obat standar Gemfibrosil, ekstrak AI, dan kombinasi AI G. Setiap kelompok mendapatkan perlakuan selama 4 minggu. Hasil uji analisis statistik menggunakan metode One-Way ANOVA dan uji Post Hoc Tukey menunjukkan penurunan perlemakan pankreas yang bermakna antara kelompok kontrol terhadap kelompok yang diadministrasikan Acalypha indica p=0.004, 95 CI: 0.170-0.959 dan kelompok yang diadministrasikan kombinasi Gemfibrosil-Acalypha indica p=0.023, 95 CI: 0.537-0.813 . Efek pankreoprotektif dari Acalypha indica Linn. menunjukkan tumbuhan ini berpotensi sebagai pilihan terapi dalam mengatasi kondisi perlemakan pankreas.

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ABSTRAKSedentary lifestyle and imbalance consumption pattern has made metabolic syndrome as the global time bomb phenomenon in the world. The increasing tendency of people in consuming high amount of fructose and cholesterol food has worsened this issue in the society. Pancreas steatosis become one of the most comorbid when early diagnosis and prompt treatment has not been applied on hyperglycemic and hyperlipidemic condition in metabolic syndrome patient. Gemfibrozil become the drug of choice to prevent this issue, yet the efficacy of this regiment was still questionable. Acalypha indica Linn. is the herb that has protective effect on hyperlipidemic and hyperglycemic condition. This study was aimed to compare therapeutic effect of gemfibrozil G and Acalypha indica Linn. AI on high fructose and cholesterol diet induced pancreas steatosis in Sprague Dawley mice. The post induction mice were divided into four groups control, gemfibrozil, AI extract, and G AI combination regiment. Each group received four weeks intervention. The result of statistical analysis using the One Way ANOVA test and Tukey Post Hoc test showed significant decrease in pancreatic steatosis between the control group and administered Acalypha indica group p 0.004, 95 CI 0.170 0.959 and the group administered with a combination of Gemfibrozil Acalypha indica p 0.023, 95 CI 0.537 0.813 . The protective effect of Acalypha indica Linn. shows that this plant has the potential as therapeutic option in overcoming the condition of pancreas steatosis in metabolic syndrome. "