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Abstrak :
Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials & Methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 [ig El/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 [ig El/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p > 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency (< 200 fig El/g stool) than in dyspepsia (control) (>_ 200 fj,g El/g stool, p < 0.001). The mean fecal elastase-1 result in chronic diarrhea and in dyspepsia were 316.29 ±_ 195.44 vs. 475.93 +. 65.33 fig El/g stool (p < 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea.

Abstrak :
Kaitannya dengan ekspresi protein MLH1, MSH2, dan SMAD4, dan membandingkannya dengan pasien kanker kolorektal usia di atas 60 tahun. Metode: Data rekam medis pasien kanker kolorektal usia di bawah 40 tahun dan usia di atas 60 tahun , dikumpulkan dari 3 rumah sakit: Jakarta, Makasar, dan Bandung. Kelompok etnis dipilih dari suku bangsa Jawa, Makasar (Sulawesi Selatan, dan Minangkabau (Sumatera Barat) yang dikonfirmasi berdasarkan kuesioner. Pada spesimen tumor dilakukan pemeriksaan histopatologi, gradasi tumor, serta pemeriksaan imunohistokimia untuk penentuan ekspresi protein MLH1 dan MSH2 untuk menilai mutasi instabilitas mikrosatelit. Ekspresi protein SMAD4 diperiksa untuk memastikan bahwa jaringan tumor tidak berasal dari instabilitas mikrosatelit. Hasil: Telah dikumpulkan 121 penderita kanker kolorektal dari etnis Sunda, Jawa, Makasar, dan Minangkabau. Derajad keganasan antara pasien muda dan pasien tua berbeda secara bermakna (p = 0.001). Pewarnaan imunohistokimia untuk protein MSH2 dan MLH1 yang dilakukan pada masing-masing 92 dan 97 pasien, menunjukkan tidak terdapat perbedaan bermakna dalam hal ekspresi MLH1 dan MSH2 dan gradasi tumor, yang berarti tidak ada hubungan antara instabilitas mikrosatelit dan derajad tumor. Kesimpulan: Karakter kliniko patologi kanker kolorektal pada penduduk asli Indonesia, tidak berbeda antara pasien usia muda (< 40 tahun) dan pasien usia tua (>60 tahun) pada kelompok etnis yang sama. Juga tidak terdapat perbedaan dalam ekspresi protein MSH2 dan MLH1, yang merupakan indikator instabilitas mikrosatelit.

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Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older. Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities ? Jakarta, Makassar, and Bandung - were reviewed. The ?native? ethnic groups were selected from those originating from Java, Makassar (South Celebes), Miinangkabau (West Sumatra). Ethnicity of 121 colorectal carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin. Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study. Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability.

Abstrak :
Bayi dengan berat badan lahir rendah dan retardasi perkembangan intrauterin masih merupakan masalah khususnya di Indonesia, karena menunjukkan angka kejadian yang tinggi dan perlu diturunkan. Malnutrisi pada anak kurang dari 1 tahun terbanyak pada bayi dengan berat badan lahir rendah. Pada penelitian menggunakan hewan coba, didapatkan nutkosa usus halus hipotmfi dan normoplasi pada tikus maltmtrisi. Keadaan ini memperlihatkan bahwa mukosa usus halus dapat mempertahankan jumlah selnya dalam menghadapi pembatasan nutrien, dan memberi petunjuk akan dapat berkembang bila mendapatkan masukan nutrien yang cukup. Apakah realimentasi dapat memulihkan mukosa yang hipotrofi normoplasi menjadi normofrofi nonnoplasi ? Penelitian ini bertujuan untuk menjawab peitanyaan itu. Penelitian experimental dengan desain post text-control group dilakukan dengan menggunakan 40 ckor anak tikus jantan jcnis Sprague-Dawiey, yang diberikan makanan baku yang latim digunakan untuk penelitian. Penelitian dibagi dalam lahap induksi malnutrisi pranatal dilanjutkan dengan tahap realimentasi. Didapatkan berat badan, tebal mukosa, tinggi vilus, kedalaman kripta, nisbahi vilus/kripta, jumlah vilus, kandungan protein, dan nisbali protein/DNA mukosa usus tikus malnutrisi pranatal yang direalimentasi lebih linggi dari tikus malnultrisi pranatal yang tidak dircalimtmuisi, tetapi lebilt rendah dari tikus kontrol. Aktivitas disakaridttse nmkosa usus halus tikus malntttmi pranatal yang direalimentasi lebih tinggi dari tikus malnutrisi pranatal yang tidak direalimentasi, tetapi lebih rendah dari tikus kontrol. Disimpulkan bahwa manultrisi pranatal tidak menguranigi populasi enterosit usus halus tikus. Realiinentasi pada tikus malnutrisi pranatal dapat memperbaiki hipotrofi mukosa usus halus dan meningkatkan aktivitas diaakaridase namun lidak mencapai nilai normal. Realimentasi pada tikus inalnutrisi pranatal dapat memperbaiki inatnritas mukosa usus halus tetapi tidak mencapai nilai normal. Informasi ini dapat bermanfaal dalam menetapkan kebijakan pengelolaan malnutrisi maternal. (Med J Indones 2006; 15:208-16)

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Low birth-weight infant and intrauterine growth retardation are still a health problem, especially in Indonesia due to high prevalence ami need to be reduced. Malnutrition in infants are most common occur in low birth-weight infants. Malnutrition in nits resulted in hypotrophic and nonnoplastic mucosa of the small intestine. The finding was not only showed that small intestine was able to maintain its cell number in condition with restriction nutrient, however also suggested the posibility of epithelial regeneration if given adequate nutrient intake. Did realimentation recover the hypotrophic nonnoplastic mucosa to norniotrophic. nonnoplastic'.' The study aim to answer that question. Experimental animal study with post test-control group design was performed using 40 male litter of Sprague-Dawley rats, was fed standard chow. The study was divided into phases prenatally-inducccl malnutrition and continued with phase realimentation. The result of this study is the body weight, mucosal thickness, villas height, crypt us depth, ratio of vilus/crypt, number of rilli. protein content, and disaccharidases of rats realimentation group was higher than non-realimentation group, but lower than control group. Prenatally-induced malnutrition did not reduced the population of small intestinal enlem cytes. Realimentalion in rats in prenaially-induced malnutrition was able to improve the hypotrophy of small intestinal mucosa and to increase the distifcharidases activities but did no! reach the normal values. Realimentation in rats in prenatally-induced malnutrition was able to improve the maturity of small intestine mucosa but did not reach the normal values. The information will be helpfull to decide the policy of maternal malnutrition. (Med J Indones 2006; 15:208-16).