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Abstrak :
ABSTRACT
Pada pasien penyakit ginjal tahap akhir, transplantasi ginjal merupakan pilihan terbaik bagi pasien; akan tetapi, delayed graft function dapat menjadi komplikasi bagi pasien yang dapat berkembang menjadi rejeksi (penolakan) terhadap organ donor, sehingga menggagalkan transplantasi. Tujuan: Mengetahui hubungan antara faktor intraoperatif (warm ischemia time 1, cold ischemia time, warm ischemia time 2, waktu urin keluar, dan kompleksitas pembuluh darah) dan kejadian delayed graft function pada resipien. Metode: Peneliti melakukan studi potong-lintang dengan mengambil 611 data rekam medis pasien dari data rekapitulasi transplantasi ginjal di Departemen Urologi, Rumah Sakit Cipto Mangunkusumo, dari rentang waktu November 2011-September 2018. Peneliti kemudian melakukan analisis bivariat dan multivariat untuk menentukan signifikansi hubungan variabel. Hasil: Dari lima variabel yang diteliti, tidak terdapat satu pun variabel yang memiliki hubungan signifikan (p = 0,996; p = 0,125; p = 0,677; p = 0,332; p = 0,748; secara berurutan) dengan kejadian delayed graft function, dari total 545 pasien yang diteliti. Diskusi: Hubungan variabel yang tidak signifikan dapat dijelaskan oleh jenis donor pada penelitian ini yang sepenuhnya donor hidup, sehingga meminimalkan dampak buruk dari stress iskemik dan reperfusion injury yang disebabkan oleh faktor intraoperatif.

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ABSTRACT
For patients with end-stage renal disease, transplantation is the best option for renal replacement therapy; however, Delayed Graft Function can complicates the transplantation, and even progresses into organ rejection, resulting in a failed transplantation. Objective: The purpose of this study was to determine the association between intraoperative factors (warm ischemia time 1, cold ischemia time, warm ischemia time 2, time of first urine output, and blood vessels complexity) and delayed graft function in transplant recipient. Methods: Researcher used cross-sectional study design by collecting 611 patient data of medical record from data recapitulation of renal transplant by Departemen of Urology, Cipto Mangunkusumo National Referral Hospital, from November 2011-September 2018. Selected patient data were then analyzed using bivariate and multivariate analysis. Results: From five variables in this study, none of them have significant association (p = 0,996; p = 0,125; p = 0,677; p = 0,332; p = 748; respectively) with delayed graft function, from a total of 545 patients. Discussion: The insignificant association of variables may be explained by the type of donor in this study, that is compromised entirely of living donor, which reduce the negative impact of ischemic stress and reperfusion injury caused by the intraoperative factors.

Abstrak :
Latar Belakang: Pemeriksaan dan diagnosis kanker prostat (PCa) diperlukan untuk memberikan manajemen optimal pada tahap awal. Meskipun telah dibahas dalam banyak pedoman, implementasi pemeriksaan dan diagnosis PCa di Indonesia masih belum diketahui. Studi ini bertujuan untuk mengevaluasi pola pemeriksaan dan diagnosis PCa di antara urolog Indonesia serta kepatuhan mereka terhadap pedoman. Metode: Studi potong lintang ini dilakukan antara Februari dan Juli 2019. Responden adalah urolog Indonesia yang terdaftar sebagai anggota Perhimpunan Urologi Indonesia (IUA) dan telah berpraktik selama setidaknya enam bulan. Data dikumpulkan menggunakan kuesioner yang dibagikan dalam simposium urologi nasional dan secara elektronik melalui Google Form. Data disajikan secara deskriptif, dan semua data diproses menggunakan SPSS versi 23. Hasil: Dari 458 urolog, 195 (42,6%) memberikan respons lengkap. Sebagian besar responden, 181 (92,8%) urolog, menggunakan pedoman IUA. Di antara 103 (52,8%) responden yang melakukan pemeriksaan, hampir separuh (42,7%) setuju untuk memeriksa pasien yang berusia ≥ 50 tahun atau ≥ 45 tahun dengan riwayat keluarga PCa. Selain itu, 76,8% akan mengulang pemeriksaan setiap tahun, dan 35,6% akan menghentikannya ketika pasien berusia 70 tahun. Pemeriksaan rektal digital (DRE) sering dilakukan untuk pemeriksaan (74,5%), sementara tes antigen spesifik prostat (PSA) hanya dilakukan dalam 52,3% kasus. Tes PSA tersedia di 74,8% rumah sakit. Reseksi transuretral prostat (TURP) masih digunakan oleh 67,2% responden untuk diagnosis. Hanya 52,3% peserta yang menggunakan biopsi prostat transrektal untuk diagnosis, menggunakan anestesi (78,1%) selama prosedur, dan peningkatan kadar PSA (98%) sebagai indikasi. Namun, USG Transrektal (TRUS) hanya tersedia di 49% rumah sakit. Studi ini menemukan bahwa tingkat kepatuhan urolog Indonesia terhadap pedoman adalah 63,3% (9-100%). Kesimpulan: Pemeriksaan dan diagnosis PCa masih bervariasi di antara urolog Indonesia, yang mungkin disebabkan oleh ketersediaan modalitas diagnostik yang berbeda. ......Background: Prostate cancer (PCa) screening and diagnosis are mandatory to deliver optimal management in the early phase. Even though it has been discussed in many guidelines, the implementation of PCa screening and diagnosis in Indonesia remains unknown. This study aims to evaluate the pattern of PCa screening and diagnosis among Indonesian urologists and their adherence to guidelines. Methods: This cross-sectional study was conducted between February and July 2019. Respondents were Indonesian urologists registered as members of the Indonesian Urological Association (IUA) and had already practiced for at least six months. Data were collected using questionnaires, which were distributed at a national urology symposium and electronically via Google Form. Data were presented descriptively, and all data were processed using SPSS version 23. Result: Of 458 urologists, 195 (42.6%) gave full responses. Most of the respondents, 181 (92.8%) urologists, used the IUA guidelines. Among the 103 (52.8%) respondents who performed screening, nearly half (42.7%) agreed to screen patients aged ≥ 50 years or ≥ 45 years with a family history of PCa. Moreover, 76.8% would repeat screening annually, and 35.6% would stop when the patient's age reached 70 years old. Digital rectal examination (DRE) was frequently performed for screening (74.5%), while prostate-specific antigen (PSA) tests were only performed in 52.3% of cases. The PSA test was available in 74.8% of hospitals. Transurethral resection of the prostate (TURP) was still used by 67.2% of respondents for diagnosis. Only 52.3 % of participants used transrectal prostate biopsy for diagnosis, using anesthesia (78.1%) during the procedure, and increased PSA level (98%) as its indication. However, Transrectal Ultrasound (TRUS) was only available in 49% of hospitals. This study found that Indonesian urologist adherence level toward guidelines was 63.3% (9-100%). Conclusion: PCa screening and diagnosis are still varied among Indonesian urologists, which might arise due to the different availability of diagnostic modalities.

Abstrak :
Strktur uretra adalah kelainan berupa penyempitan lumen uretra akibat terbentuknya jaringan parut (scar) yang melibatkan epitel dan jaringan erektil korpus spongiosum. Proses patofisiologi terjadinya kelainan ini belum sepenuhnya diketahui. Di antara berbagai faktor yang terlibat, diferensiasi miofibroblas merupakan salah satu faktor kunci.Tujuan penelitian ini adalah untuk mengetahui diferensiasi miofibroblas pada proses terjadinya striktur uretra di tingkat selular dan melihat hubungan antara growth factor dan komposisi kolagen dengan diferensiasi miofibroblas. Penelitian ini adalah studi eksperimental pada kelinci New Zealand jantan dewasa yang dibagi menjadi dua kelompok, yaitu kelompok model penyembuhan uretra normal dan model striktur uretra.Dua kelinci pada masing-masing kelompok dilakukan eutanasia pada hari ke-2, 7, 14, 21, 30, 60, dan 90. Dilakukan pemeriksaan adanya sumbatan uretra dengan sondase bougie 8 F, pemeriksaan CRP serum darah, pemeriksaan hematoksilin-eosin, trichrome Masson, picrosirius red, TUNEL, dan RT PCR untuk melihat ekspresi gen α-SMA, TGF β, dan b-FGF. Dari hasil penelitian dijumpai adanya perbedaan dalam apoptosis miofibroblas, komposisi kolagen I/total, kadar TGF β dan b-FGF antara kedua kelompok. Terdapat korelasi positif sedang antara apoptosis miofibroblas dengan ekspresi gen TGF β dan korelasi positif lemah antara apoptosis miofibroblas dan komposisi kolagen tipe I/ kolagen total. ......Urethral stricture is a narrowing urethral lumen due to scar formation involving epithel and corpus spongiosum erectile tissue. Pathophysiology process of this abnormality is not fully understood. Among various factors involved, myofibroblast differentiation is a key factor. The purpose of this study is to investigate the process of myofibroblast differentiation on urethral stricture formation process at cellular level and observe the correlation between growth factors and collagen composition with myofibroblast. The study was an experimental study in adult male New Zealand rabbits, divided into two groups, namely the normal urethral healing model and urethral stricture model. Euthanasia was performed in two rabbits of each group on days 2, 7, 14, 30, 60, and 90. Urethral stricture was confirmed by bougie. Several laboratory examination were done, including CRP blood serum, haematoxylin eosin, trichrome Masson, picrosirius red, TUNEL and RT PCR to look at gene expression of α- SMA, TGF β, b-FGF, dan EGF. The study found a difference in apoptosis myofibroblast, composition of collagen type I/total, TGF β and b-FGF levels between the two groups. There was also a positive moderate correlation between TGF β gene expression and myofibroblast apoptosis proportion and a positive weak correlation collagen type I/ total composition and myofibroblast apoptosis proportion.;Urethral stricture is a narrowing urethral lumen due to scar formation involving epithel and corpus spongiosum erectile tissue. Pathophysiology process of this abnormality is not fully understood. Among various factors involved, myofibroblast differentiation is a key factor. The purpose of this study is to investigate the process of myofibroblast differentiation on urethral stricture formation process at cellular level and observe the correlation between growth factors and collagen composition with myofibroblast. The study was an experimental study in adult male New Zealand rabbits, divided into two groups, namely the normal urethral healing model and urethral stricture model. Euthanasia was performed in two rabbits of each group on days 2, 7, 14, 30, 60, and 90. Urethral stricture was confirmed by bougie. Several laboratory examination were done, including CRP blood serum, haematoxylin eosin, trichrome Masson, picrosirius red, TUNEL and RT PCR to look at gene expression of α- SMA, TGF β, b-FGF, dan EGF. The study found a difference in apoptosis myofibroblast, composition of collagen type I/total, TGF β and b-FGF levels between the two groups. There was also a positive moderate correlation between TGF β gene expression and myofibroblast apoptosis proportion and a positive weak correlation collagen type I/ total composition and myofibroblast apoptosis proportion.