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Abstrak :
ABSTRAK
Pengantar: Saat ini, malaria masih menjadi penyakit endemik dan hampir 3.2 milyar orang berisiko terkena malaria, kasus terbanyak terjadi di Asia Tenggara dan Afrika. Indonesia juga merupakan salah satu negara yang memiliki prevalensi tinggi. Terlebih lagi, berkembangnya resistensi terhadap obat anti malaria di Asia Tenggara, khususnya resistensi kloroquin di Indonesia. Sambiloto merupakan obat herbal yang telah digunakan sebagai obat anti malaria dan anti inflamasi. Spirulina juga memiliki fungsi sebagai anti inflamasi. Namun, belum ada penelitian mengenai kombinasi kedua obat ini sebagai obat anti malaria. Tujuan dari penelitian ini untuk mengetahui efek kombinasi dari sambiloto dan spirulina pada perubahan histopatologi di usus halus mencit terinfeksi Plasmodium berghei. Metode: Data diambil dari percobaan pada mencit jantan Swiss Webster yang sudah terinfeksi Plasmodium berghei Anka. Ada empat kelompok perlakuan, kelompok AP yang sudah diobati dengan ekstrak sambiloto, kelompok AP ES yang diberikan ekstrak sambiloto dan ekstrak spirulina, kelompok AP PS yang diobati dengan ekstrak sambiloto dan powder spirulina, serta kelompok DHP sebagai kontrol positif. Hasil: Hasil analisis menggunakan tes one-way ANOVA dan Kruskal-Wallis menunjukkan bahwa tidak ada perbedaan signifikan dalam jumlah fokus inflamasi, sel goblet, dysplasia dan angiogenesis. Namun, dengan pengamatan mikroskopik dan perhitungan rata-rata tiap kelompok, kelompok yang diberikan spirulina memiliki hasil jumlah fokus inflamasi, sel goblet, dysplasia dan angiogenesis yang lebih rendah dibandingkan dengan kelompok perlakuan lainnya. Diskusi: Pada riset ini, sifat anti inflamasi pada sambiloto dan spirulina dikarenakan komponen aktif dari sambiloto yaitu andrographolide dan phycocyanin dari spirulina. Jumlah sel goblet meningkat bersamaan dengan meningkatnya inflamasi, karena fungsi nya sebagai pelindung pada lapisan mucosa. Dysplasia juga berkaitan dengan proses inflamasi terutama dalam perkembangan neoplasma. Beberapa mediator inflamasi juga memiliki sifat angiogenic, yang mendukung terjadinya proses angiogenesis saat mediator- mediator ini direkrut pada proses inflamasi.

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ABSTRACT
Introduction Recently, malaria is still endemic in some area and approximately 3.2 billion people were at risk, most cases happen in South East Asia and African. Indonesia also has high prevalence of malaria. Moreover, high level of antimalarial drug resistance occurs in South East Asia, specifically choloroquine in Indonesia. Sambiloto, one of herbal drugs, has been used as anti malarial drug and also anti inflammatory. Spirulina also has anti inflammatory properties. However, there is no study that prove sambiloto and spirulina combination could be use as anti malarial drug. The purpose of this study is to analyze the effects of sambiloto and spirulina combination to histopathological changes of small intestine from mice that already infected by Plasmodium berghei Method Data is obtained from clinical experiment of Male Swiss Webster mice that already infected with Plasmodium berghei Anka. There are 4 groups of treatment, AP group which has been treated with sambiloto extract, AP ES group treated using sambiloto extract with spirulina extract, AP PS that were treated using sambiloto extract and spirulina powder, and DHP group which is treated with DHP as the positive control group. Results Data analysis using one way ANOVA and Kruskal Wallis shows that there is no significant differences in inflammatory focus, goblet cells, dysplasia and angiogenesis among 4 group of treatment. However, from microscopic field view and mean comparison, addition of spirulina, both extract and powder form, into sambiloto extract decreased inflammatory focus, goblet cells, dysplasia and angiogenesis on the small intestine. Discussion In this research, anti inflammatory properties of sambiloto is due to its bioactive component such as andrographolide and phycocyanin that inhibit pro inflammatory mediators. Goblet cells count increase as inflammation occurs, as it has function as protective part in mucous layer. Dysplasia is also related to inflammation process, especially in neoplasm development. Inflammatory cytokines also have angiogenic properties, as increasing of inflammation process will recruit inflammatory mediators and promote angiogenesis to happen.

Abstrak :
Small intestinal bacterial overgrowth is a condition where the proximal small intestine harbours more than 10 organisms/ml intestinal fluid for a long period. Bacterial overgrowth could be found in patients with certain clinical conditions, such as intestinal anatomical disorders, intestinal motility disorders, and several diseases including liver cirrhosis. It was reported that the prevalence of bacterial overgrowth in patients with liver cirrhosis was around 30%-75%. Small intestinal bacterial overgrowth could induce various clinical conditions from mild to severe cases, therefore it is important to recognise its signs and symptoms, diagnosis, and management. This article will also review the clinical management of small intestinal bacterial overgrowth in liver cirrhosis.

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The abnormality or disease of ihe small intestine may cause chronic diarrhea. The tests required to investigate the abnormality of the small intestine are difficult and expensive. In this study we studied the small intestine in chronic diarrhea cases, to discover any abnormality. The chronic diarrhea patients presenting from 1996 to 2000(5 years) at Cipto Mangunkusumo General Central National Hospital were included in the study. Patients were excluded if unable to co-operate. All of the patients were given blood and stool lexis in addition to colonoscopy, ileoscopy and duodeno-jejunoscopy with biopsy. Small intestinal examination could only be performed on 78patients witii chronic diarrhea. The most frequent characteristic were: aged 30-39 or 50-59 years (25.6% of all canes in the study), male(57.7%), non-bloody non steatorrhoeic tvpe of diarrhea(74.4%), and 4 to 48 weeks-duration of diarrhea(68.0%). Small intestine abnormalities were endoscopically and/or histopathologically found in 65 cases(S2.6%), while the rest of the patients were found to have normal small intestine. The abnormalities were found to he infective non-tuberculosis ileitis (in 20 patients, or 26% of all cases), Infective non-tuberculosis duodenitis(20 or 26%), non-infective jejtinitixf 14, or 18.2%), villous aft phy of the jejunum(3, or 3.9%), lymphoid nodular/follii hyperplasia of the terminal Heutn(l2, or 15.6%) etc. LOT intestinal abnormalities were found in 67 or S3.7% of t chronic diarrhea cases. The frequent small intestinal abnormalities were infe tive ileitis, duodenitis and lymphoid nodular/follicle hype plasiaofthe terminal ileum. The small intestinal abnormal ties were found less than the large intestinal abnormalitie

Abstrak :
Latar Belakang: Dalam dekade terakhir, insidensi kanker usus halus telah meningkat lebih dari empat kali lipat. Insidensi ini diperkirakan akan terus meningkat akibat perubahan pola hidup. Terapi definitif dan utama saat ini adalah reseksi radikal segmen yang terserang kanker, dengan risiko yang cukup signifikan selama dan setelah terapi. Kemoterapi dan terapi neoadjuvan yang tersedia tidak menghasilkan efek yang diinginkan. Lunasin, peptida yang terkandung dalam kacang kedelai, dikenal dapat meningkatkan kesehatan sel secara epigenetik dan mengurangi inflamasi. Berangkat dari hal tersebut, ada kemungkinan bahwa ekstrak lunasin dapat menjadi terapi neoadjuvan yang efektif untuk kanker usus halus. Metode: Sebanyak 20 ekor mencit jenis Balb/c dibagi ke dalam empat kelompok. Semua mencit diinduksi dengan azoxymethane dan dextran sodium sulfat. Selama enam minggu setelahnya, mencit akan diberi ekstrak lunasin dalam konsentrasi yang berbeda (0, 20, 30, dan 40 mg/ kgBB). Delapan minggu setelah induksi, mencit akan dikorbankan. Sel usus halus mencit akan diproses dan diwarnai dengan hematoxyllin-eosin, kemudian jumlah hiperplasia, displasia, angiogenesis, fokus inflamasi, dan sel goblet akan diamati di bawah mikroskop. Hasil: Terdapat perbedaan yang signifikan dalam jumlah displasia (p=0,000) dan angiogenesis (p=0,009) dalam kelompok-kelompok dengan perlakuan yang berbeda. Namun, tidak ditemukan adanya perbedaan yang signifikan dalam jumlah hyperplasia, fokus inflamasi, dan sel goblet di antara kelompok-kelompok dengan pemberian lunasin dengan konsentrasi berbeda. Kesimpulan : Pemberian ekstrak lunasin dapat meningkatkan hasil jumlah dysplasia dan angiogenesis secara non dose-dependent, namun tidak mempengaruhi faktor-faktor yang lain dalam proses karsinogenesis usus halus. ......Background : Within the last decade, incidence of small bowel cancer has increased by more than fourfold. It is predicted that due to shift in diet and lifestyle, the numbers of incidence will steadily rise. The primary and only definite therapy for small intestine cancer is radical segmental resection, which carries side effects and risks during and after surgery. At the moment, available chemotherapy and neoadjuvant therapy do not exert significant result. Lunasin, a novel peptide originated from soybean, is believed to promote cellular health epigenetically and reduce inflammation. Thus, there is possibility that the lunasin extract may come off as a new and effective adjuvant therapy for small intestine malignancies. Method: A total of 20 Balb/c mice were divided into four groups. The mice were induced with azoxymethane and dextran sodium sulfate. For the next six weeks, each group was given different concentration of lunasin extract. After eight weeks since the induction, the mice were sacrificed and the small intestinal tissue was harvested and stained using hematoxyllin-eosin. After that, the amount of hyperplasia, dysplasia, angiogenesis, inflammatory foci, and goblet cells will be observed under the microscope. Results: There is significant difference in the amount of dysplasia (p=0.000) and angiogenesis (p=0.009) among the groups that receive different concentrations of lunasin. However, there is no effect of lunasin administration to the amount of hyperplasia, inflammatory foci, and of goblet cells. Conclusion: Non dose-dependent administration of lunasin extract improves dysplasia and angiogenesis, but not other factors in small intestine carcinogenesis.