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Abstrak :
Artritis reumatoid AR adalah penyakit autoimun yang saat ini telah diketahui menunjukkan manifestasi klinis bukan hanya intraartikular, tetapi juga ekstraartikular. Kejadian kardiovaskular baik subklinis maupun klinis ditemukan lebih tinggi pada penderita AR. Mediator inflamasi aterogenik pada AR seperti interleukin-6 IL-6 diduga menjadi salah satu faktor risiko nontradisional kardiovaskular yang berkontribusi meningkatkan penanda disfungsi endotel seperti E-Selectin. Penelitian ini bertujuan mengetahui peran mediator inflamasi dalam kejadian disfungsi endotel, khususnya korelasi IL-6 dan E-selectin, pada pasien artritis reumatoid tanpa faktor risiko kardiovaskular. Studi potong-lintang dilakukan pada 40 pasien AR di Poliklinik Reumatologi RSUPN Dr. Cipto Mangunkusumo, Indonesia, pada bulan September-November 2017. Pemeriksaan IL-6 dan E-Selectin dilakukan dengan teknik enzyme-linked immunosorbent assay ELISA. Analisis korelasi bivariat dilakukan untuk menemukan korelasi kedua penanda tersebut. Rerata usia subjek penelitian ini adalah 44,9 13,1 tahun dan median durasi sakit adalah 36 bulan. Korelasi kadar IL-6 dengan kadar E-Selectin memiliki kekuatan korelasi lemah tetapi tidak bermakna secara statistik r = 0.232, p=0,149. Tidak terdapat korelasi antara IL-6 dengan E-Selectin pada pasien AR tanpa faktor risiko tradisional kardiovaskular. ......Rheumatoid arthritis RA is an autoimmune disease which has recently been recognized to manifest as not only intraarticular but also extraarticular symptoms. Cardiovascular events, presented either subclinically or clinically, were discovered more in AR patients. Atherogenic inflammatory mediator in AR including interleukin-6 IL-6 was thought to be one of nontraditional cardiovascular risk factor contributing to increase the endothelial dysfunction biomarker such as E-Selectin. This study was purposed to determine the correlation between inflammatory mediator and endothelial dysfunction event, especially between IL-6 and E-Selectin, in RA patient without traditional cardiovascular risk factor. A cross-sectional study was performed to 40 RA patients of Rheumatology Clinic of Cipto Mangunkusumo National General Hospital, Indonesia from September to November 2017. Measurement of the level of IL-6 and E-Selectin were performed using enzyme-linked immunosorbent assay ELISA. Bivariate correlation analysis was performed to determine the correlation between those two biomarkers. The mean age of this study subjects was 44.9 13.1 years and median of disease duration was 36 months. This study showed weak correlation between IL-6 and E-Selectin level, but not statistically significant.232, p=0.149 . There is no correlation between IL-6 and sE-Selectin in rheumatoid arthritis patient without traditional risk factor cardiovascular.

Abstrak :
Perubahan pola makan yang tidak sehat dapat menyebabkan low grade inflammation dan berkontribusi terhadap resistensi insulin. Namun, penelitian tentang efek peradangan yang disebabkan oleh diet masih tidak konsisten. Tujuan penelitian ini untuk mengetahui hubungan antara potensi kadar inflamasi pada makanan yang diukur dengan Dietary Inflammatory Score (DII) dan kadar serum TNF-alfa. Tesis ini merupakan studi potong lintang pebandingan yang dilakukan pada 210 orang dewasa usia 18-55 tahun kelompok status gizi normal (normoweight) dan obesitas. Rerata dari skor DII pada kelompok normoweight (n=76) adalah -0,20±2,20 sedangkan pada kelompok obes (n=134) adalah 0,05±1,99 (p=0,407) dari nilai maksimal skor DII 6,35 dan nilai skor DII minimal adalah -,55. Analisa pada 72 subsample menunjukkan bahwa skor DII tidak berhubungan dengan serum TNF-α setelah penyesuaian untuk kovariat (ß = 0,001, p = 0,895). Namun, jika skor DII diklasifikasikan ke dalam kelompok status gizi normal dan kelompok obesitas, skor DII pada normoweight (n=34) berhubungan signifikan dengan serum TNF-α setelah penyesuaian kovariat (ß = 0,013, p = 0,036), tetapi tidak pada kelompok obesitas. Kesimpulannya, Skor DII secara keseluruhan tidak berhubungan dengan kadar TNF-α serum tetapi hubungan positif terlihat pada kelompok dengan status gizi normal menunjukkan adanya potensi inflamasi dari diet yang terukur dengan skor DII dan berhubungan peningkatan inflamasi jaringan adiposa lebih terlihat pada kelompok status gizi normal. Program promotif dan preventif perlu ditingkatkan dengan sedini mungkin untuk meningkatkan kualitas diet dan kesehatan individu dan masyarakat. ...... Accumulating evidence identifies dietary intake may triggers chronic low-grade inflammation as potential mechanisms contributing to insulin resistance. However, studies regarding dietary inflammatory were inconsistent. The study aimed to observe the relationship between the inflammatory potential in foods as measured by the Dietary Inflammatory Score (DII) and TNF-alpha serum levels among the normal body mass index (normoweight) and obese adults. A cross-sectional comparative study was conducted involving adults aged 18-55 years. The mean DII score in the normoweight group (n=76) was -0.20 ± 2.20, while in the obese group (n=134) was 0.05 ± 1.99 (p = 0.407). Our of maximum DII score was 6,35 and minimum DII score was -7,55. Analysis of 72 subsample showed that the overall DII score was not associated with serum TNF-α after adjustment for covariates (ß = 0.001, p = 0.895). However, if the DII score was classified into the normoweight and the obese group, the DII score in the normoweight group (n=34) was significantly associated with serum TNF-α after covariate adjustment (ß = 0.013, p = 0.036), but not in the obese group. In conclusion, overall DII score was not associated with serum TNF-α level. However, the positive association suggesting the inflammatory nature of diet in regulating adipose tissue inflammation was observed and more suitable in normal nutritional state. Promotive dan preventive program should be encouraged as earliest possible to improve individual and community diet quality and health status.

Abstrak :
ABSTRACT
Background: the aging process causes decreasing in the function of various organs. Skletal muscle is one of the organs affected by aging process. It is known as sarcopenia. Sarcopenia is defined as a syndrome characterized by progressive loss of muscle mass and strength. The handgrip strength examination is often applied as a sarcopenia filtering technique. This study aimed to determine the relationship between age, nutritional status, and chronic diseases such as stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD), and chronic obstructive pulmonary disease (COPD) with handgrip strength. Methods: a cross-sectional study to determine factors related to the handgrip strength in elderly patients was conducted in Geriatric outpatient clinic of Cipto Mangunkusumo Hospital and Mohammad Hoesin Hospital from August to October 2015. There were 352 eligible subjects in this study recruited with consecutive sampling. The independent variables in the study consisted of age, sex, nutritional status, chronic disease (stroke, hypertension (HT), diabetes mellitus (DM), coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD)), waist circumference while the dependent variable was handgrip strength. Results: age of more than 75 years old and malnutriton were risk factors that affected hangrip strength. Age of >75 years increase the risk for having low handgrip strength by 2,3-fold. Malnutrition increased risk for low handgrip strength for 1,9-fold. Conclusion: ages of >75 years old and malnutrition will increase the risk of low handgrip strength in elderly patients.

Abstrak :
Latar Belakang: Ikterus obstruktif merupakan salah satu komplikasi tersering keganasan sistem bilier. Keadaan ini akan memicu pelepasan sitokin proinflamasi. Terdapat kontroversi mengenai pengaruh drainase bilier terhadap perubahan kadar sitokin proinflamasi pada penderita kanker pankreatobilier. Tujuan: Untuk mengetahui kadar Tumor Necrosis Faktor alfa (TNF-alfa) dan Interleukin 6 (IL6) sebelum dan sesudah Endoscopic Retrograde Cholangio Pancreatography (ERCP) atau Percutaneus Transhepatic Biliary Drainage (PTBD) pada penderita ikterus obstruksi etiologi kanker pankreatobilier. Metode: Desain penelitian adalah one group before after study. Pemilihan sampel secara consecutive sampling. Sampel darah diambil sebelum dan lima hari sesudah ERCP atau PTBD. Pengukuran kadar TNF-alfa dan IL-6 dengan cara Enzyme Linked Immunosorbed Assay (ELISA). Hasil: Terdapat 40 orang responden yang diikutsertakan dalam penelitian ini, 22 laki laki dan 18 perempuan dengan usia rata rata 55,3 tahun. Berdasarkan imaging dan endoskopi, ditegakkan diagnosis kolangiokarsinoma sebanyak 22 orang, tumor ampula Vateri 10 orang, dan tumor pankreas 8 orang. Kadar rata-rata TNF- alfa sebelum tindakan 4,81 (2,91) pg/ml dan sesudah tindakan 8,05 (6,7) pg/ml, terdapat peningkatan yang bermakna setelah tindakan drainase bilier (p:0,02). Kadar rata-rata IL-6 sebelum tindakan 7,79 (1,57) pg/ml dan sesudah tindakan 7,75 (1,76) pg/ml, tidak terdapat perbedaan yang bermakna setelah tindakan drainase bilier (p:0.52). Kadar rata-rata bilirubin sebelum tindakan 15,5 mg% dan sesudah tindakan 11,3 mg%. Simpulan: Terjadi peningkatan kadar rata-rata TNF-alfa secara bermakna setelah drainase. Tidak ada penurunan yang bermakna kadar rata-rata IL-6.

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Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. Objective: The present study was designed to determine levels of Tumor Necrosis Factor Alpha (TNF-Alpha) and Interleukin 6 (IL-6) in preprocedure of either Endoscopic Retrograde Cholangio Pancreatography (ERCP) or Percutaneus Transhepatic Biliary Drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer. Methods : The study method is before- and- after case study design with consecutive sampling. Blood was collected five days prior to either Endoscopic Retrograde Cholangio Pancreatography (ERCP) procedure or Percutaneus Transhepatic Biliary Drainage (PTBD) procedure and five days after either of them. Enzyme Linked Immunosorbed Assay (ELISA) was used to determine TNF-Alpha and IL-6. Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The mean age was 55.3 years old. According to the results of imaging and endoscopy procedure, twenty two (22) people were diagnosed cholangi carcinoma, ten (10) people were diagnosed ampulla varteri and eigth (8) people were diagnosed pancreatic tumor. In preprocedure, the mean of TNF-Alpha concentration was 4.81 (2.91) pg/mL, the mean of IL-6 concentration was 7.79 (1.57) pg/mL and the mean of bilirubin concentration was 15.5 mg%. In postprocedure, the mean of TNF-Alpha concentration was 8.05 (6.7) pg/mL, there was significant increase in TNF-Alpha concentration (p:0.02). However, the mean of IL-6 concentration was 7.75 (1.76) pg/mL, there was not any significant chance in IL-6 concentration (p:0.52). The mean of bilirubin concentration was 11.3 mg%. Conclusions: On one hand, there was significant increase in mean concentration value of TNF-Alpha after biliary drainage procedure. On the other hand there was not any significant decrease in mean concentration value of IL-6 after biliary drainage procedure.

Abstrak :
ABSTRAK
Kanker kolorektal merupakan salah satu jenis kanker yang paling banyak menyebabkan kematian di dunia dan berada di peringkat tiga terbanyak setelah kanker paru dan kanker payudara. Inflamasi merupakan predisposisi kanker kolorektal melalui berbagai mediator proinflamasi dan antiinflamasi yang dihasilkan sel-sel inflamasi. Pengobatan kanker kolorektal secara konvensional dengan terapi bedah, kemoterapi maupun radioterapi belum dapat memberikan hasil yang memuaskan karena angka kekambuhan kanker yang tinggi dan terjadinya inflamasi akibat terapi. Annona muricata Linn. (AML), atau sirsak memiliki zat aktif asetogenin,yang selain bersifat anti-oksidan, antiinflamasi juga memiliki efek sitotoksik karena mampu menginduksi apoptosis dengan mengurangi kadar cAMP dan cGMP pada sel-sel kanker manusia. Dua puluh lima subyek penderita kanker kolorektal yang sudah direseksi dibagi menjadi dua kelompok dan mendapatkan tambahan terapi berupa ekstrak etanol daun AML atau maltosa selama 8 minggu, dan dilakukan pemeriksaan kadar TNF-α, IL-10, IFN-γ, COX-2 serta cleaved caspase CK18 melalui serum subyek sebelum dan setelah terapi selesai dilakukan. Pemberian ekstrak etanol AML tidak menimbulkan perubahan signifikan dari kelima parameter dibandingkan antara kelompok perlakuan dan kontrol. Terdapat korelasi bersifat positif yang signifikan antara mediator proinflamasi TNF-α dan IL-10 setelah perlakuan yaitu 0,641 (p = 0,009) dan juga korelasi positif antara TNF-α dan ccCK18 yaitu 0,817 (p = 0,002). Berdasarkan hasil di atas ekstrak etanol AML memiliki peran untuk meregulasi homeostasis proinflamasi dan antiinflamasi serta berperan dalam proses apoptosis.

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ABSTRACT
Colorectal cancer is one type of cancer which causes the most deaths in the world and is the third highest after lung cancer and breast cancer. Inflammation is one of colorectal cancer predispotition, mediated by a variety of inflammatory cytokine produced by inflammatory cells. Treatment of colorectal cancer include surgical therapy, chemotherapy or radiotherapy had not given a satisfactory result for the high recurrence rate of cancer, even resulted inflammation as a side effect of therapy. Annona muricata Linn. (AML), or soursop has asetogenin as one of its active substances, which have antioxidant potency, anti-inflammatory and cytotoxic effect because it can induce apoptosis by reducing levels of cAMP and cGMP in human cancer cells. Twenty-five post-resection colorectal cancer patients divided into two groups and get ethanol fraction of leaves of AML or maltose as an additional therapy for 8 weeks. Levels of TNF-α, IL-10, IFN-γ, COX-2 and caspase cleaved CK18 serum subjects before and after treatment was examined. Ethanol fraction of AML did not make a significant change from the five parameters which were compared between treatment and kontrol groups. TNF-α and IL-10 serum after treatment had a positive correlation with R= 0,641 (p = 0.009). TNF-α and ccCK18 also had positive correlation with R = 0.817 (p = 0.002). Based on results the ethanol fraction of AML plays a role to homeostasis of proinflammatory and antiinflammatory as well as apoptosis regulation.

Abstrak :
Epithelial Mesenchymal Transition (EMT) adalah salah satu mekanisme resistensi Sorafenib pada kanker hepatoseluler. Alfa Mangostin diketahui dapat menurunkan aktifitas jalur TGF-βpada hepatic stellate cells. Penelitian ini dilakukan untuk mengetahui pengaruh Alfa Mangostin pada Epithelial Mesenchymal Transition (EMT), HepG2 yang tahan terhadap Sorafenib melalui jalur TGF-β/SMAD. Sel lestari kanker hati, HepG2 dibagi menjadi enam kelompok perlakuan, yaitu kelompok DMSO 0,01%, Alfa Mangostin20μM, Sorafenib10μM, Sorafenib10μM+Sorafenib10μM, Sorafenib10μM-Alfa Mangostin20μM, dan Sorafenib10μM +Sorafenib10μM - Alfa Mangostin20μMselama 24 jam. Sel dihitung menggunakan trypan blue exclusion method. Kadar TGF-β medium diukur menggunakan ELISA. Ekspresi TGF-β,TGF-βRI, SMAD3, SMAD7, E-cadherin dan Vimentin diukur dengan qRT-PCR. Pemberian Alfa Mangostin pada sel HepG2 yang tahan terhadap Sorafenib dapat menurunkan jumlah sel hidup. Namun terdapat peningkatan ekspresi TGF-β, kadar TGF-β1 aktif, TGF-βRI, SMAD3, dan Vimentin serta penurunan ekspresi SMAD7 dan E-cadherin setelah pemberian Sorafenib dan Alfa Mangostin. Alfa Mangostin menurunkan jumlah sel hidup namun tidak menghambat EMT melalui jalur TGF-β/SMAD pada sel HepG2 yang tahan terhadap Sorafenib.  Epithelial Mesenchymal Transition (EMT) is one of resistance mechanism through Sorafenib in hepatocellular carcinoma. Alpha Mangosteen is known to have reduced TGF-β/SMAD pathway in hepatic stellate cells. This research purpose is to explore the effect of Alpha Mangosteen on Epithelial Mesenchymal Transition (EMT) on human hepatoceluller carcinoma HepG2 cells surviving Sorafenib via TGF-β/SMAD pathways. Immortalized HCC cell line, HepG2 cells, were divided into 6 groups: DMSO0,01% group, Alpha Mangosteen 20μMgroup, Sorafenib10μM group, Sorafenib 10μM-Sorafenib10μM group, Sorafenib10μM +  Alpha Mangosteen 20μM group, dan Sorafenib10μM + Sorafenib10μM - Alpha Mangosteen 20μMgroup for 24 h. Cells were harvested and counted by trypan blue exclusion method. TGF-β medium concentration was evaluated by ELISA. Expression of TGF-β,TGF-βRI, SMAD3, SMAD7, E-cadherinand Vimentin measured by qRT-PCR. Alpha Mangosteen administration on HepG2 surviving Sorafenib cells reduced mean live cells. However, the expression of TGF-β, TGF-β1 active concentration, TGF-βR, SMAD3, and Vimentin were elevated. Alpha Mangosteen also decreased SMAD7 dan E-cadherin expression. Alpha Mangosteen reduced live cells but did not have effect on preventing EMT activation through TGF-β/SMAD pathways on HepG2 surviving Sorafenib cells. 

Abstrak :
Pendahuluan : GERD dapat menurunkan kualitas hidup yang dapat dipicu dan dieksaserbasi dengan stres. Tujuan penelitian ini adalah untuk mengetahui hubungan antara stres kerja dengan kejadian GERD. Metode : Penelitian ini merupakan penelitian potong lintang pada Januari hingga April 2021 terhadap 100 guru SD di Cipondoh, Kota Tangerang yang dipilih melalui metode multistage cluster random sample. Para guru mengisi kuesioner melalui google form. Kuesioner GERDQ digunakan untuk mendiagnosis GERD, sementara stres kerja dinilai menggunakan Teacher Stress Inventory (TSI). Seluruh faktor risiko yang mungkin ada dianalisa. Data yang didapat diolah dengan menggunakan analisis bivariat. Hasil : Mayoritas guru adalah perempuan, berusia dibawah 40 tahun, mengajar sekolah swasta, dan memiliki pengalaman mengajar lebih dari lima tahun. Guru yang mengalami stres rendah sebanyak 77% dengan beban kerja sebagai stresor utama. Prevalensi GERD didapatkan sebanyak 23%. Dari hasil penelitian ini, tidak didapatkan hubungan yang bermakna antara stres kerja pada guru dengan kejadian GERD (p=0,69). Faktor resiko yang bermakna secara statistik ialah merokok (p = 0,037; OR : 11,4). Karakteristik guru, obesitas, diet tinggi lemak, kafein serta peristiwa hidup yang stressful bukan merupakan faktor resiko yang bermakna. Kesimpulan : Tidak terdapat hubungan yang bermakna antara stres kerja dengan GERD ......GERD can reduce the quality of life and it can triggered and exacerbated by stress. The aim of this study is to find a relationship between occupational stress and GERD. Method: This is a cross-sectional study, held in September 2020-July 2021. This study were involving 100 elementary teacher in Cipondoh, Kota Tangerang, whom selected by multistage cluster random sample method, and completing the questionnaire using google form application. The GERDQ Questioner were used to diagnose GERD, while occupational stress assessed using the Teacher Stress Inventory (TSI). All possible risk factors were analysed. Results were analysed using bivariate analysis. Results: Most of the subject were female, under 40 years old, work in private school, and have more than five years experiences of teaching. They are having a low occupational stress (77%), workload being the most stressor. The prevalence of GERD was 23%. The result of this study failed to indicate a significant relationship between occupational stress among the teachers and GERD (p = 0,69). We found that the statistically significant risk factors of GERD is smoking (p = 0,037; OR = 11,4). Characteristic subject, obesity, fat dietary, caffein, and (stressful) life events were not a significant risk factors of GERD. Conclusion: We didn’t find any significant relationship between teacher stress and GERD.

Abstrak :
Efek lunasin sebagai anti-inflamasi, antioksidan, anti kanker dan anti metastasis telah lama diketahui. Lunasin melalui motif RGD pada strukturnya dapat berikatan dengan integrin dan menghambat jalur persinyalan FAK/Src/ERK/NFkB sehingga aktivasi NF-kB menurun. Hal ini akan menyebabkan penurunan aktifitas proliferasi dan peningkatan apoptosis. Penelitian ini bertujuan untuk mempelajari efek lunasin dalam menghambat karsinogenesis kolorektal dan mempelajari protein-protein yang terlibat dalam mekanisme tersebut. Penelitian ini menggunakan bahan biologi tersimpan (BBT) blok parafin jaringan kolon mencit BALB/c yang diinduksi AOM dan DSS yang terdiri dari 6 kelompok yaitu kelompok normal yang tidak diinduksi dan diberi perlakuan, kelompok kontrol negatif yang hanya diinduksi AOM dan DSS, kelompok kontrol positif yang diinduksi dan diberi aspirin, kelompok lunasin dosis rendah, sedang dan tinggi masing-masing yang diinduksi dan diberi lunasin 75, 150 dan 200 mg/BB. Jaringan kolon hewan diambil dan dilakuan pulasan hematoksilin eosin dan imunohistokimia untuk mengukur ekspresi Ki67, C-myc dan Bcl-2. Kuantifikasi ekspresi Ki67, C-myc dan Bcl-2 dari hasil pulasan imunohistokimia dilakukan dengan menggunakan metode H-score. Data H-score diolah dan dianalisa menggunakan uji statistik Kruskall Wallis. Ekspresi Ki67, C-myc dan Bcl-2 berbeda signifikan pada setiap kelompok (p=0,000). Lunasin dapat menurunkan ekspresi Ki67, C-myc dan Bcl-2 pada kolon model hewan karsinogenesis kolorektal yang diinduksi AOM dan DSS. ...... The effects of Lunasin as anti-inflammatory, antioxidant, anti-cancer and antimetastatic effects have long been known. Lunasin through the RGD motive on its structure can bind to integrins and inhibit the FAK/Src/ERK/NF-kB signaling pathway and supress NF-kB activation. It causes decreasing of proliferative activity and increasing of apoptosis. This study aims to study the effect of lunasin in inhibiting colorectal cancer carcinogenesis and investigate the proteins involved in this mechanism. This study used stored biological material (BBT), paraffin blocks, colon tissue of BALB/c mice induced by AOM and DSS which consisted of 6 groups, the normal group that was not induced and treated, the negative control group that was only induced by AOM and DSS, the positive control group. who were induced and given aspirin, the low, medium and high dose lunasin groups were induced and given lunacin 75, 150 and 200 mg/kgBW, respectively. Colon tissue was taken and stained with hematoxylin eosin and immunohistochemistry to measure the expression of Ki67, C-myc and Bcl-2. The quantification of Ki67, C-myc and Bcl-2 expressions from the results of immunohistochemical stains was done using the H-score method. The H-score data were processed and analyzed using the Kruskall Wallis statistical test. Expressions of Ki67, C-myc and Bcl-2 were significantly different in each group (p = 0.000). Lunasin can decrease the expression of Ki67, C-myc and Bcl-2 in colon animal models of AOM and DSS-induced colorectal cancer.

Abstrak :
Gastroesophageal reflux disease (GERD) adalah suatu kondisi kembalinya cairan lambung ke esofagus. Terapi akupunktur tanam benang telah menjadi salah satu terapi yang digunakan untuk alternatif terapi. Penelitian ini bertujuan untuk mengetahui perubahan kadar Nitrit Oksida (NO) serum setelah terapi akupunktur tanam benang dan medikamentosa. Uji acak tersamar tunggal dilakukan pada 50 responden dengan GERD yang di bagi kepada kelompok akupunktur tanam benang dan medikamentosa dibandingkan dengan kelompok akupunktur sham dan medikamentosa. Pemeriksaan kadar NO menjadi parameter yang dinilai pada saat sebelum perlakuan dan 30 hari setelah 2 kali terapi dengan durasi 15 hari sekali. Hasil penelitian menunjukkan terjadi kenaikan kadar NO pada kelompok perlakuan dibandingkan kelompok sham namun tidak ada perbedaan bermakna antara kedua kelompok. Kesimpulan penelitian ini akupunktur tanam benang belum terbukti secara statistik mempengaruhi kadar NO pada pasien GERD. ......OksidaGastroesophageal reflux disease (GERD ) is a condition that causes the return of gastric fluid into the esophagus. Catgut embedding acupuncture has become one of the therapies used for alternative therapies. This study aimed to determine changes in serum Nitric Oxide (NO) levels after catgut embedding acupuncture therapy and conventional medicine. Single -blind randomized trials is used on 50 respondents with GERD were divided to group catgut embedding acupuncture therapy and conventional medicine compared with sham acupuncture group and medicine. The level of NO into the parameters assessed at the time before treatment and 30 days after treatment with 2 times the duration of 15 days. The results showed increased levels of NO in catgut embedding acupuncture therapy and conventional medicine group compared with sham acupuncture group and medicine but there was no significant difference between the two groups. The conclusion of this study catgut embedding acupuncture has not been proven statistically in influencing the levels of NO in patients with GERD.

Abstrak :
[Latar Belakang Transplantasi ginjal adalah modalitas terapi pengganti ginjal yang paling baik bagi pasien dengan Penyakit Ginjal Tahap Akhir (PGTA). Saat ini di Indonesia transplantasi ginjal dengan donor hidup mulai semakin sering dilakukan, terutama di RSUPN Cipto Mangunkusumo, di mana dalam beberapa tahun terakhir lebih dari 50% kasus transplantasi ginjal di Indonesia dilakukan di rumah sakit ini. Walaupun demikian, data mengenai hasil transplantasi di Indonesia, baik kesintasan 1 tahun graft maupun pasien, serta faktor yang diduga mempengaruhinya masih belum ada. Diharapkan hasil transplantasi di rumah sakit ini dapat menggambarkan hasil secara keseluruhan di Indonesia. Metode Studi kohort retrospektif pada resipien transplantasi ginjal di RSUPN-CM dari Januari 2010 hingga Mei 2014. Data didapatkan dari penelusuran rekam medis serta menghubungi pasien secara langsung. Masing-masing resipien diikuti sejak tanggal transplantasi hingga kematian atau Mei 2015. Proporsi kesintasan graft dan pasien pada 1 tahun post transplantasi dan pada akhir studi didokumentasikan. Kurva Kaplan-Meier digunakan untuk menggambarkan kesintasan pasien secara keseluruhan. Studi deskriptif dilakukan dengan melihat perbedaan proporsi variabel serta perbedaan rerata atau median pada pasien yang mengalami kegagalan graft 1 tahun serta tidak, serta pasien yang bertahan hidup atau meninggal. Hasil Berdasarkan hasil consecutive total sampling didapatkan 157 resipien yang menjalani transplantasi ginjal di RSUPN-CM, 137 resipien di antaranya memenuhi kriteria penelitian, seluruhnya mendapatkan ginjal dari donor hidup. Usia resipien rata-rata adalah 47,9 ± 13,9 tahun, rerata IMT 22,8 ± 3,7 kg/m2, dan proporsi resipien dengan diabetes 35,8%. Didapatkan 7 pasien mengalami disfungsi graft primer (kegagalan transplantasi), sehingga 130 pasien diikuti untuk melihat kesintasan jangka panjang. Pada akhir tahun pertama, didapatkan angka death-censored graft survival adalah 95,4%, all-cause graft survival 85,4%, kesintasan pasien 88,5%, dan death with a functioning graft sebesar 10%. Pada akhir studi, didapatkan angka kesintasan tersebut berturut-turut adalah 94,6%, 80%, 82,3%, dan 14,6%, dengan median waktu pengamatan 24 bulan (1 ? 64 bulan). Kurva Kaplan Meier menunjukkan angka mortalitas tertinggi didapatkan pada bulan-bulan awal post transplantasi. Kegagalan graft dan kematian didapatkan lebih banyak pada resipien yang berusia lebih tua, mengidap diabetes melitus, serta memiliki indeks komorbiditas yang tinggi. Penyebab kematian utama adalah infeksi (11,5%) diikuti dengan kejadian kardiovaskular (3,8%). Simpulan Death-censored graft survival 1 tahun resipien transplantasi ginjal di Indonesia sudah sangat memuaskan. Angka death with functioning graft masih cukup tinggi, sehingga menurunkan all-cause graft survival dan kesintasan pasien 1 tahun. Walaupun demikian, secara keseluruhan hasil ini masih sebanding dengan negara-negara berkembang lainnya.;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries, Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 – 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries]