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Abstrak :
Ruang Lingkup dan Cara Penelitian: DaIam kehidupan sehari-hari penggunaan minyak jelantah berasal dari restoran makanan cepat saji dan hotel, umum digunakan oleh pedagang gorengan. Pemanasan minyak goreng berulang kali menyebabkan oksidasi dan polimerisasi asam lemak yang dikandungnya. Oksidasi Iemak ini akan menghasilkan senyawa peroksida yang merupakan radikal bebas yang akan menyebabkan kerusakan membran sel. Vitamin C dan vitamin E telah diketahui merupakan antioksidan yang berperan dalam melindungi sel terhadap daya destruktif radikal bebas. Penelitian ini dilakukan untuk melihat efek pemberian vitamin C dan vitamin E pada kerusakan. hati, jantung dan aorta yang ditimbulkan akibat pemberian minyak jelantah dengan angka peroksida 125-130 meq/kg, dengan dosis 10 ul/g BB selama 12 minggu pada mencit jantan (Mus musculus L) galur Swiss derived Lima kelompok masing-masing terdiri dari 8 ekor mencit dengan diet standar, yaitu kelompok kontrol (K), kelompok perlakuan dengan minyak jelantah (MJ), kelompok perlakuan dengan minyak jelantah dan suplemen vitamin C 2.5 mg/hr (MJC); kelompok perlakuan dengan suplemen vitamin E 0.1 mg/hr (MJE); kelompok perlakuan dengan suplemen kombinasi vitamin C dan vitamin E (MJCE). Pada minggu ke-13 dilakukan eutanasia dan dilakukan pembedahan untuk melihat perubahan histopatologik hati, jantung dan aorta dengan pulasan HE dan pulasan elastika Verhaeff?s. Hasil dan kesimpulan: Ditemukan perubahan gambaran histopatologik berupa bendungan hati, peningkatan apoptosis, perlemakan, penipisan miokardium dan `hilangnya gelombang tunika elastika aorta. Bendungan hati ditemukan pada semua kelompok, terrnasuk kelompok konrol walaupun derajatnya lebih ringan (Kruskal Wallis, p=0.048). Pelebaran vena sentralis ditemukan pada kelompok perlakuan, walaupun tidak berbeda bermakna. Perlemakan ditemukan pada seluruh kelompok perlakuan dengan derajat yang lebih berat terutama pada kelompok MJE dan MJCE. (Kruskal Wallis, p=0.001), menunjukkan vitamin E tidak memberikan daya proteksi pada hati. Peningkatan derajat apoptosis sel hati terutama di zona 1 menunjukkan berbeda bermakna (Kruskal Wallis, p=0.006). Ditemukan penipisan miokardium yang berbeda bermakna pada seluruh kelompok perlakuan dengan atau tanpa suplemen (Anova,P=0.000) Ditemukan pula korelasi terbalik antara penipisan miokardium dengan pelebaran diameter ventrikel yang berbeda bermakna (Pearson, r = - 0.437). Kelainan dinding aorta berupa ketidak-teraturan putusnya gelombang tunika elastika ditemukan berbeda makna (Kruskal Wallis, p=0..000) antara kelompok kontrol dan kelompok perlakuan baik yang mendapat suplemen maupun tidak, dengan derajat yang lebih berat terutama pada kelompok MJC dan MJCE, menunjukkan vitamin C tidak memberikan proteksi pada aorta. Dari penelitian ini dapat disimpulkan bahwa pencekokan minyak jelantah mengakibatkan perlemakan hati, peningkatan derajat apoptosis zona 1, penipisan miokardium dan hilangnya gelombang sampai putusnya tunika elastika aorta Pemberian vitamin C, vitamin E dan kombinasi keduanya tidak dapat memperbaiki kerusakan akibat pemberian minyak jelantah secara menyeluruh. Daya proteksi vitamin C lebih baik pada jaringan hati dan vitamin E lebih baik pada jantung dan aorta.

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Scope of study and method: In everyday life, re-use cooking oil from hotel or fast food restaurants was commonly used by deep-fried food vendors on the street. Heating of cooking oil caused oxidation and polymerization of its lipid component. This process resulted in lipid peroxide, free radical which produced cell membrane damage. Vitamin C and vitamin E have been known as anti-oxidant that protects cells from free radical destruction. This study was carried to observe the effect of vitamin C and vitamin E or its combination supplementation for 12 weeks on liver, myocardium and aorta from damaging effect of re-use cooking oil intake of 10 ul/g BW with peroxide number 125-130 mEg/kg, in male M musculus strain Swiss-derived. Five groups of 8 mice with standard diet were studied_ control, treated with re-use cooking oil only (MI}, treated with re-use cooking oil with 2.5 mg/day vitamin C supplementation (MJC), treated with re-use cooking oil with 0.1 mg/day vitamin E supplementation (MJE) and treated with combination vitamin C and vitamin E (MICE), in week 13, the mice were sacrificed and histopathological changes in liver, heart and aorta were studied using HE and elastic Verhoeff's staining. Result and Conclusion Histopathological changes of venous congestion, increase of apoptotic rate and steatosis were found in liver. Thinning of myocardium, ventricle dilatation, and disruption of elastic fibers of aorta were found. Liver veins congestion were found in all group although in control it was milder (Kruskal Wallis, p=0.048). Central veins dilatation was found in all groups (Ml, MJC, MIE and MJCE) although it was not significantly different. Steatosis were found in all groups, which were more severe in groups MJE and MJCE (Kruskal Wallis, p=0.001), showing that vitamin E did not give protection to liver. There was significant increase of apoptotic rate in zone 3 in all (Kruskal Wallis, p=0.006). Significant thinning of Myocardial was also found in all groups wit or without therapy (Anova, p= 0.011). Significant inverse correlation was found in heart myocardial thinning and ventricle dilatation (Pearson, r==-0,437). Elastic fibers degradation and break-down were found in control and MJ (Kruskal Wallis, pA31.000). In the other groups (MJC, MJE and MICE) degradation of aorta elastic fibers were also found. From this study, it is concluded that intake of re-use cooking oil contributed to steatosis and increase of zone 3 apoptosis rate in of the liver, and caused thinning of heart myocardium with ventricle dilatation, and degradation of aorta elastic fibers. Vitamin C, vitamin E supplementation or its combination could not protect liver, myocardium or aorta from damaging effect(s) of re-use cooking oil intake.

Abstrak :
Latar belakang: Liposarkoma berdiferensiasi baik (LPSBB) merupakan subtipe liposarkoma yang paling sering ditemui dan kadang sulit dibedakan dengan lipoma karena kemiripan gambaran morfologik. Pada penelitian ini akan dilihat overekspresi dan amplifikasi gen murine double minute 2 (MDM2) sebagai alat bantu diagnostik untuk membedakan kedua entitas tersebut serta hubungannya dengan indeks proliferasi Ki67. Bahan dan cara: Dilakukan pulasan imunohistokimia MDM2 dan Ki67 pada 37 tumor lipomatosa, yang terdiri atas 18 LPSBB dan 19 lipoma, dilanjutkan dengan hibridisasi in situ pada 12 kasus terpilih. Hasil: Overekspresi MDM2 ditemukan pada seluruh LPSBB dan pada 3 (16%) lipoma (p=0,000). Amplifikasi MDM2 ditemukan pada seluruh kasus LPSBB yang diperiksa namun terdapat pula pada 1 lipoma (p=0,200). Terdapat korelasi yang kuat antara overekspresi MDM2 dengan indeks proliferasi Ki67 yang lebih tinggi (r=0,645, p=0,000). Kesimpulan: Overekspresi MDM2 dapat digunakan sebagai alat bantu diagnostik dalam membedakan LPSBB dengan lipoma, serta berhubungan dengan indeks proliferasi sel tumor.

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Background: Well differentiated liposarcoma (WDLPS) is the most common type of liposarcoma and sometimes can be difficult to distinguish from lipoma because of the similar morphology. This study propose to evaluate the expression and amplification of murine double minute 2 (MDM2) and determine its correlation with Ki67 proliferation index. Methods: This study enrolled 37 cases of lipomatous tumors. Eighteen cases of WDLPS and 19 cases of lipoma were stained for MDM2 and Ki67 immunohistochemistry. As an addition, in situ hybridization were done in 12 selected cases. Results: Overexpression of MDM2 overexpression was detected in all WDLPS cases and in 3 (16%) of lipoma cases with significance difference (p=0,000), whereas MDM2 amplification was found in all WDLPS and in 1 of lipoma cases (p=0,200). There is a strong correlation between MDM2 overexpression and higher proliferation index (r=0,645, p=0,000). Conclusion: Evaluation of MDM2 overexpression may be used as a useful adjunct to differentiate WDLPS from lipoma and seem to be related with proliferation index.

Abstrak :
Karsinoma serviks uteri merupakan tumor ganas yang sering ditemukan di Indonesia dan pada umumnya penderita datang dalam keadaan ianjut dimana radioterapi merupakan terapi pilih. Penilaian respon radiasi dapat dipelajari secara klinis maupun secara histopatologik. Secara histopatologik, selama ini penilaian dilakukan secara kasar yaiutu dengan melihat ada tidak sel tumor yang viable. Respon radiasi antara lain dipengaruhi oleh tingkat prolifersi sel, penilaiannya dapat dilakukan dengan berbagai metode antara lain dengan metode Ag NOR. AgNOR merupakan Salah satu cam penilaian proliferasi sel dengan cars menghilung nuclear organizer region (NOR). Pada penelitian ini nilai AgNOR digunakan untuk melakukan hubungannya dengan derajat respon radiasi secara hisropomlogik. Penghitungan nilai AfNOR dilakukan dengan 2 cara yaitu (1) rata-rata nilai AgNOR pada nukleus (mAgNOR) dan persentase AgNOR (PAgNOR). Penilaian derajat respon radiasi secara histopalogik dilakukan menurut metode Shimosato yang membuat derajat respon radiasi dari jaringan yang resisten sampai paling sensitif terhadap radiasi dengan gradasi 1A sampai 4C. Hasil dan kesimpulan, dari 20 kasus karsinoma serviks yang diperiksa, didapatkan 2 kasus dengan derajat respon radiasi 1,5 kasus dengan derajat respon radiasi 4B dan 1 kasus dengan derajat respon radiasi 4C. Karena perbandingan kasus yang tidak seimbang, kasus-kasus ini dikemlompokkan lagi menjadi 2 kelompok yaitu: (1) kelompok denga respon radiasi baik (13 kasus) dan (2) kelompok dengan derajat respon radiasi buruk (7 kasus). Walaupun terlihat kecenderungan nilai mAgNOR yang lebih tinggi ppada kasus dengan derajat respon radiasi lebih tinggi, nilai mAgNOR yang tidak berbeda bermakna pada kelompok-kelompok yang diperiksa, kemungkinan disebabkan karena mAgNOR tidak secara sppesifik mewakili fraksi pertumbuhan yang tinggi sehingga tidak langsung terkait dengan radiosensitifitas jaringan. Dari penelitian ini ditemukan nilapAgNOR yang lebih tinggi secara bermakna pada kelompok dengan responn radiasi baik debandinglan dengan kelompok dengan derajat respon radiasi buruk (p=0,05). Hasil ini menunjukkan bahwa nilai pAgNOR lebih spesifik dan ditelti lebih lanjut dengan digabungkan dengan metoda sehic diharapkan dapat dipakai sebagai salah satu cara untuk memprediksi respon radiaso karsinogen serviks uteri. ......Cervical uterine cancer is one of tlte most common malignant tumors in Indonesia, patients usually presented in an advance stage where radiotherapy is a therapy of choice. Evaluation of radiotherapy is done both clinically and histopathologcally. Ust; histopathologic assessment was done roughly bythe presence of viable tumor cells. Radio response is influenced by cell proliferation rate and the assessment can be done with methods. ie. Ag NOR method. AgNOR is one of cell proliferation marker that cour nuclcolar organizer region (NOR). In this study, AgNOR counts was used to soc corelation with grade ofhistopathological radiation response. AgNOR counts was carried in 2 wajrs: (1) mean of AgNOR counts in the nuclei (mAgNOR0 and (2) percentag AgNOR (PAgNOR). Evaluation of histopathologic radiation response grade was a following Shimosato that made gradation radiation response from radioresistant to alt radiosensitiv tissue in IA to -1C grade. Result and conclusion, from 20 cases of Cervical cancer studied based on Shimosato method. 2 cases were of grade 1, 5 cases of grade ZA. l case of grade 5, 2 cases of grade 49., 9 cases of grade 4B and 1 of gade 4C . Due to unequal number of cases in each group, it was grouped into 2 groups, good radiation response. which is iound in 13 cases and (2) poor radiation response a cases. Altough there is higher number mAgNOR counts irt group with higher grade radiation response. It was not statistically significant, most likely because in mAgNOR is specitically representing high growth fraction, therefore was not correlated directly with tis radiosonsitivitly. From this study, it was showed that pAgNOR counts was hit significantly in group with good radiation response compared to group with poor radia response (p=0.05). The result showed that pAgNOR count is more speciiic, therefore it car used in more research combine with another method make this method will used as one method for the prediction of radiation response in cert-?ical uterine carcinoma.

Abstrak :
Pendahuluan : Disfungsi endotel merupakan awal timbutnya aterosklerosis yang pada kondisi lanjut akan menychabkan penyakit jantung koroner (PJK). Teh hijau dilaporkan mampu memperbaiki disfungsi endotel karena kandungan katekin yang ada di dalamnya. Penelitian menunjukkan teh hijau mampu meningkatkan produksi prostasiklin pada kultur sel aorta babi. Tujuan penelitian : Untuk mcmbuktikan hahwa pemberian teh hijau sekali minum dapat memberi efek terhadap peningkatan produksi 6-ketoprostaglandin Fl-a sebagai metabolic prostasiklin dan penurunan kadar tromboksan B2 sebagai metabolit tromboksan A2 pada penderita PJK. Metode : Penelitian dilakukan pada 25 penderita yang terhukti PJK dari pemeriksaan angiografi koroner. Sampel dibagi menjadi 2 kelompok. Kelompok 1 mendapat teh hijau terlebih dahulu dan Kelompok l1 mendapat plasebolair putih terlebih dahulu. Setelah masa wash-Put selama 1 minggu, dilakukan cross-over. Dihitung kadar 6-ketoprostaglandin Fl-a sebagai metabolit prostasiklin don tromboksan B2 sebagai metabolit tromboksan A2 sebelum dan sesudah pemberian teh hijau dan plasebo. Dllakukan pemeriksaan kadar 6-ketoprostaglandin Fl-a dan tromboksan B2 pada 20 orang sehat usia 18-25 tabula sebagai acuan nilai normal. Hasil : Didapatkan peningkatan kadar 6-ketoprostaglandin Fl-a yang bermakna pada kedua kelompok. Pada kelompok I sebeiuni pemberian tab hijau kadar 6-ketoprostaglandin Fl -a 5.126 (2.808-6.237) menjadi 6.575 (4.788-7.638) ng/ml (p= 0.012). Pada kelompok plasebo tidak didapatkan peningkatan yang bermakna (p= 0.328). Pada kelompok II kadar 6-ketoprostaglandin Fl-ct sebelum teh hijau 6.044 (2.804-11.693) menjadi 7.212 (4.028-11.175) ng/ml (p= 0.011). Pada plasebo tidak didapatkan peningkatan yang bermakna (p= 0.325). Pada pemeriksaan kadar tromboksan B2 tidak didapatkan penurunan yang bermakna balk pada kelompok I maupun pada kelompok II. Pada kelompok I sebelum pemberian teh hijau 0.472 (0.122-0.630) menjadi 0.092 (0.056-0.135) ng/ml (p= 0.68). Pada kelompok l1 sebelum pemberian teh hijau 0.1 11 (0.029-0.630) meningkat menjadi 0.660 (0.018-0.958) ng/ml (p= 0.055). Hadar 6-ketoprostaglandin F1-u pada penderita PJK lehih rendah secara bermakna dibanding orang sehat (p<0.001). Pada pemeriksaan kadar tromboksan B2 pada penderita PJK lehih rendah secara bermakna dibanding prang sehat (p<0.001) Kesimpulan : pemberian teh hijau sekali minum mampu meningkatkan produksi 6-ketoprostaglandin Fl-a yang merupakan metabolit aktif prostasiklin pada penderita penyakit jantung koroner, akan tctapi tidak memberikan efek penurunan kadar tromboksan B2 yang merupakan metabolit aktiFdari tromboksan A2.

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Introduction : Endothelial dysfunction is an early process of atherosclerosis that in long term will cause coronary artery disease. Green tea has been reported to improve endothelial function because of catechin substance in green tea. Study had showed that green tea could increase the prostacyclin production in bovine aorta cell culture. Objective :To gain evidence that one time consuming of green tea may increase 6-ketoprostaglandin Fl-a production as a metabolite of prostacyclin and decrease thromboxane B2 production as a metabolite of thromboxane A2 in coronary artery disease patients. Method : Study has been conducted to 25 patients proven to have coronary artery disease by coronary angiography. Sample was grouped into two groups. Groups I firstly receive green tea and Group II firstly receive placebo (mineral water). After washout period for one week, sample was being cross-overed. The level of 6-ketoprostaglandin Fl-a as a metabolite of prostacyclin and thromboxane B2 as a metabolite of thromboxane A2 were measured before and after green tea and water consumption. We also measure the level of 6-ketoprostaglandin Fl -a and thromboxane B2 in 20 healthy persons aged 18 -25 years old as a normal value. Result : There were significant increasing level of 6-ketoprostaglandin Fl-a of both groups. In Group I, the level of 6-ketoprostaglandin Fl-a before green tea consumption was 5.126(2.808-6.237) and raised up to 6.575(4.788-7.638) ng/ml(p= 0.012). Meanwhile in placebo group there were no significant increase level of 6-ketoprostaglandin Fl-a (p= 0.328). In group II the level of 6-ketoprostaglandin Fl-a before green tea consumption was 6.044(2.804-11.693) and raised up to 7.212(4.028-11.175) ng/ml (p= 0.011). As for placebo group, there were no significant increase level of 6-ketoprostaglandin F l -a (p= 0.325). Thromboxane B2 measurement result shows no significant decrease both in group I and group H. In group I, thromboxan B2 level before green tea consumption was 0.472(0.122-0.630) and raised up to 0.092(0.056-0_l35) ng/ml(p= 0.68). As for group H, thromboxane B2 level before green tea consumption was 0.111(0.029-0.630) and raised up to 0.660(0.018-0.958) ng/ml (p= 0.055). The level of 6-ketoprostaglandin Fl-a in coronary artery disease patients was significantly bellow healthy persons (p<0.001). The level of thromboxane B2 in coronary atery disease patients were also significantly bellows healthy persons (p<0.001). Conclusion : One time green tea consumption can increase 6-ketoprostaglandin Fl-a production as an active metabolite of prostacyclin in coronary artery disease patients but does not decrease thromboxan B2 level, an active metabolite of thromboxan A2.

Abstrak :
ABSTRAK
Pendahuluan: Biopsi jarum inti dianggap memiliki hasil akurasi yang sama dengan biopsi terbuka dan telah menjadi prosedur rutin untuk menegakkan diagnosis lesi muskuloskeletal. Namun demikian uji diagnostik biopsi jarum inti di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN CM) belum dilaporkan. Tujuan dari analisis retrospektif ini adalah untuk mendapatkan nilai ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal. Metode: Dari Januari 2011 hingga Agustus 2015, semua pasien dengan lesi muskuloskeletal di RSUPN CM yang menjalani biopsi jarum inti dan eksisi tumor diidentifikasi dan diambil datanya. Ketepatan diagnosis dianalisis baik untuk kesimpulan histopatologi maupun kesimpulan clinical pathology conference (CPC). Hasil: Sebanyak 86 sampel dikumpulkan dalam penelitian ini. Ketepatan diagnosis biopsi jarum inti dibandingkan dengan spesimen pasca eksisi adalah 74,4%. Setelah dilakukan CPC, nilai ketepatan menjadi 83,7% dengan sensitivitas 98%, spesifisitas 59%, NDP 87%, NDN 93% (p = 0.00). Ketepatan biopsi jarum inti setelah pulasan imunohistokimia naik menjadi 84,9% (p = 0,438). Ketepatan untuk membedakan lesi jinak dan ganas adalah 97,1% (jinak) dan 82,7% (ganas) (p = 0.00). Ketepatan untuk membedakan lesi primer dan metastasis adalah 97,2% (primer) dan 85,7% (metastasis) (p = 0.00). Diskusi: Kami mendapatkan nilai ketepatan biopsi jarum inti yang sedikit lebih rendah karena dalam penelitian ini dituntut untuk membuat diagnosis sampai tingkat morfologi (ICD O dan ICD X). Namun demikian, dengan modalitas lain seperti imunohistokimia dan kesimpulan CPC, ketepatan menjadi meningkat. Ketepatan diagnosis untuk membedakan lesi jinak-ganas dan primer-metastasis tinggi. Biopsi jarum inti direkomendasikan untuk penegakkan diagnosis lesi muskuloskeletal.ABSTRACT
Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions. ;Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions. ;Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.

Abstrak :
Ruang lingkup dan Cara penelitian: Buah merah merupakan tanaman yang kaya akan bahan-bahan antioksidan seperti beta karoten dan alfa tokoferol. Baik buah maupun minyaknya sudah banyak dikonsumsi oleh masyarakat dan diyakini memiliki khasiat dalam pengobatan berbagai penyakit, salah satunya adalah kanker. Meskipun buah merah sudah digunakan secara luas oleh masyarakat, namun penelitian ilmiah tentang khasiat buah merah masih sangat terbatas. Penelitian pengaruh minyak buah merah terhadap karsinogenesis hati pada tikus yang diinduksi N-2-Fluroenilasetamida (FAA) bertujuan untuk menganalisis perlindungan minyak buah merah terhadap karsinogenesis akibat FAA pada tikus. Dalam penelitian ini digunakan 24 ekor tikus jantan galur Wistar, berumur ± 3 bulan dengan berat badan berkisar 150-200 gram, yang dibagi ke dalam 4 kelompok yaitu: kelompok kontrol, merupakan kelompok yang mendapatkan akuades, kelompok BM, adalah kelompok yang diberi minyak buah merah 10μl/gram BB/hari, kelompok FAA, merupakan kelompok yang diinduksi karsinogenesis FAA 40μg/hari dan kelompok BM+FAA, merupakan kelompok yang mendapatkan minyak buah merah dan FAA dengan dosis yang sama dengan kelompok BM dan kelompok FAA Perlakuan diberikan dengan sonde lambung setiap had selama ± 8 minggu. Pada minggu ke 8 tikus dikorbankan kemudian diambil hati dan darab dari jantung. Sebagai parameter karsinogenesis adalah kadar asam sialat, kadar proteasom dan skor karsinogenesis berdasarkan pemeriksaan histopatologis. Disamping itu juga diukur parameter untuk menilai fungsi hati seperti: albumin, protein total dan pola elekroforesis protein plasma serta aktivitas glutamatepiruvate transaminase (GPT) plasma. Data penelitian kemudian diolah secara statistik. Hasil dan kesimpulan: Pada pemeriksaan asam sialat ditemukan bahwa kadar asam sialat hati kelompok FAA secara statistik lebih tinggi dibandingkan kontrol, namun demikian kadar asam sialat plasma belum ditemukan perbedaan yang bermakna. Uji statistik yang dilakukan terhadap kadar proteasom plasma dan jaringan hati menunjukkan tidak ada perbedaan bermakna antar kelompok perlakuan. Sedangkan pemeriksaan histopatologis memperlihatkan skor karsinogenesis kelompok FAA lebih tinggi secara bermakna dibandingkan kontrol. Sementara itu pemeriksaan asam sialat, proteasom maupun histopatologis kelompok BM+FAA tidak berbeda bermakna dibandingkan kelompok FAA. Dari basil-basil tersebut dapat disimpulkan bahwa karsinogenesis yang terjadi masih pada tahap dini dan belum ditemukan perlindungan minyak buah merah terhadap karsinogenesis. Pada penilaian fungsi hati tidak ditemukan perbedaan bermakna kadar protein total, kadar albumin dan pola elektroforesis protein plasma. Hal ini menunjukkan bahwa FAA walaupun sudah menimbulkan karsinogenesis tapi tidak menggangu fungsi hati. Pada pemeriksaan GPT plasma ditemukan aktivilas pada kelompok BM dan FAA Iebih tinggi secara bermakna dibandingkan kelompok kontrol atau kelompok FAA. Hal ini memberikan kesan bahwa minyak buah merah, walaupun tidak menyebabkan karsinogenesis hati namun dapat menimbulkan kerusakan hati. Hal ini didukung oleh pemeriksaan histopatologis jaringan hati yaitu ditemukannya gambaran degenerasi hidropik yang menandai awal kerusakan sel hati.

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Red fruit (Pandanus conoideus Lam) is an endemic plant in Eastern Indonesia especially in Papua. This fruit has been used traditionally since many years ago for various purposes such as daily food consumption, traditional medicine, handycraft etc. As traditional medicine it is believed that this fruit can cure many diseases like cancer, AIDS, arthritis and many others. This advantage might be due to it's rich antioxidant substances such as carotene and a tocopherol. This study was conducted to investigate the effect of red fruit oil on FAA induced carcinogenesis in rat Twenty four male Wistar rats, approximately 3 months old, weighing 150-200 g were equally divided into 4 groups. The first (control) group, received distilled water. The second (BM) group received 10pLIg body weight/day of red fruit oil. The third (FAA) group received 40µg FAAIday. The fourth (BM+FAA) group received red fruit oil as well as FAA with similar dose as BM and FAA group_ The treatments were given for eight weeks and at the end of S~' weeks the animal were sacrificed, liver and the blood were collected. To analyzed liver carcinogenesis, the level of sialic acid, proteasome and histopathological based carcinogenesis score were measured To asses liver function, glutamate-pyruvate transaminase (GPT) activity, albumin and total plasma level protein were measured, and plasma protein electrophoresis pattern were also determined. The data were statistically analyzed using ANOVA and Tukey test. This study showed that liver sialic acid level of FAA rats was significantly higher than those in the control group but there was no statistically difference between sialic plasma level of FAA group compared to the control. The liver and proteasome plasma level found to be similar among the groups. Histopatological finding showed that carcinogenesis scores in FAA group was higher than the control group. Moreover, there were no differences in sialic acid level as well as carcinogenesis scores between BM+FAA group compared to FAA group. The analysis of liver function showed that liver function of all groups were still in normal range. It can be concluded that the FAA induced liver carcinogenesis was still in early stage and red fruit oil supplementation has no protection effect on liver carcinogenesis. Surprisingly, the plasma GPT activity of BM and BM+FAA group were significantly higher than control group or FAA group_ This result showed that red fruit oil supplementation it self, even though couldn't induce carcinogenesis, lead to liver cells changes, a cloudy swelling degeneration, which reflecting an early liver injury.

Abstrak :
ABSTRAK Ruang lingkup, bahan dan cara penelitian : Telah dilakukan penelitian retrospektif di Departemen Patologi Anatomik FKUI RRSUPN CM. Sampel diambil dari Arsip Departemen PatoIogi Anatomik dari tahun 1995 sampai dengan tahun 2003. Gambaran histologik melanoma malignum dinilai uang, yaitu tipe Nodular Melanoma, tipe Superficial Spreading Melanoma dan tipe Acral Lenligineous Melanoma. Dilakukan pewarnaan ulang HE dan imunoperoksidase dengan menggunakan antibodi Ki67. Penghitungan jumlah mitosis dilakukan dengan menghitung jumlah mitosis/kuadrat milimeter pada 10 LPB secara acak. Penilaian ketebalan tumor dilakukan menurut Breslow. Perkalian antara ketebalan tumor dan jumlah mitosis dilakukan untuk penentuan indeks prognosis. Penghitungan positifitas Ki67 pada inti sel yang berwarna coklat tua dilakukan pada 500 sel secara acak. Untuk mengetahui hubungan berbanding terbalik antara ekspresi Ki67 dengan indeks prognosis dilakukan uji korelasi non parametrik 2x2 dengan uji Pearson. Uji korelasi parametrik dilakukan dengan uji Tukey dan Duncan. Hasil dan kesimpulan: Dan 20 kasus MM (11 kasus NM, 5 kasus ALM dan 4 kasus SSM), didapatkan 17 kasus MM (10 kasus NM, 4 kasus ALM dan 3 kasus SSM) yang positif mengekspresikan Ki67, 3 kasus yang tidak mengekspresikan Ki67 terdiri atas 1 kasus NM, 1 kasus ALM dan I kasus SSM. Dua puluh kasus MM menunjukkan 12 kasus dengan Breslow > 4 mm (8 kasus NM dan 4 kasus ALM), sedangkan 8 kasus dengan Breslow < 4 mm (3 kasus NM , 1 kasus ALM dan 4 kasus SSM). Pada 4 kasus SSM 3 kasus mengekspresikan Ki67 positif 1 dan 1 kasus tidak mengekspresikan Ki67. Hasil uji korelasi menunjukkan adanya hubungan bermakna antara ketebalan tumor Breslow dengan indeks proliferasi Ki67. Dari hasil penelitian ini dapat disimpulkan, bahwa antibodi monoklonal Ki67 sebagai petanda proliferasi dapat digunakan sebagai indikator dalam memprediksi prognosis dan kemungkinan terjadinya early metastasis pada penderita MM yang mempunyai nilai ketebalan Breslow rendah, seperti pada jenis SSM.

Abstrak :
ABSTRAK
Jumlah parasitemia pada infeksi malaria yang ada di dalam darah perifer tidak mampu menunjukkan total biomassa parasit malaria. Total biomassa parasit malaria yang diukur dengan pemeriksaan antibodi histidine rich protein HRP dan Plasmodium lactate dehydrogenase pLDH menunjukkan bahwa biomassa parasit malaria lebih tinggi dibandingkan dengan parasitemia di darah perifer. Biomassa parasit malaria berhubungan dengan inflamasi sistemik dan tidak berhubungan dengan aktivasi endotel. Oleh karena itu, biomassa parasit malaria kemungkinan tidak terakumulasi di sel-sel endotel, melainkan di organ non endotel seperti limpa. Penelitian tentang malaria di limpa masih sangat jarang dilakukan, namun ada beberapa yang menunjukkan terdapat perbedaan arsitektur limpa yang terinfeksi oleh P. falciparum dan P. vivax. Perbedaan tersebut diduga karena perbedaan sel inang yang diinfeksi, yaitu eritrosit pada P. falciparum dan retikulosit pada P. vivax. Sebanyak 12 sampel limpa pasien splenektomi digunakan untuk membuktikan apakah limpa manusia merupakan reservoir parasit malaria dan terjadi penghindaran respons imun di limpa. Hasil penelitian menunjukkan bahwa semakin tinggi berat limpa pasien berhubungan dengan tingginya parasitemia, luas pulpa putih dan akumulasi parasit malaria. Akumulasi P. falciparum juga terjadi di limpa dengan tingginya parasitemia di limpa namun stadium hidup yang muda lebih banyak ditemukan di limpa. Hal tersebut berhubungan dengan mekanisme penghindaran respons imun dengan dugaan sekuestrasi di pembuluh darah sehingga menurunkan stadium matang di limpa. Mekanisme penghindaran pada stadium yang lebih muda juga dilakukan dengan cara membentuk rosetting. Akumulasi P. vivax di limpa tidak dapat dideskripsikan di penelitian ini karena jumlah sampel yang sedikit dengan parasitemia rendah. Namun penelitian ini mampu memprediksi kemungkinan akumulasi P. vivax di limpa dengan tingginya retikulosit di limpa.Kata kunci: Limpa, Malaria, P. falciparum, P. vivax, limpa, retikulosit.

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ABSTRACT
The number of parasitemia in malaria infections from peripheral blood was not able to show the total parasite biomass. Total malaria parasite biomass as measured by histidine rich protein HRP and Plasmodium lactate dehydrogenase pLDH antibody test showed higher parasitic biomass than parasitemia in peripheral blood. Total parasite biomass was not correlated with endothelial activation. Therefore parasite biomass was possible to accumulate in non endothelial organ such as the spleen. Research on malaria in the spleen was still very limited, but there were some that showed the differences of splenic architecture in P. falciparum and P. vivax infection. The difference was due to the difference of infected host cell ie red blood cell in P. falciparum and reticulocyte in P. vivax. A total of 12 spleen from splenectomy patients were used to prove whether the human spleen is malaria parasite reservoir and the escaping immune response in the spleen. The results showed that the higher spleen weight was associated with high parasitemia, white pulp area, and accumulation of malaria parasites. P. falciparum accumulation also occurs in the spleen with high parasitemia in the spleen but younger life stages are more common in the spleen. It is related to the mechanism of escaping the immune response with sequestration in the blood vessels thereby decreasing the mature stage in the spleen. The mechanism of escaping immune respons in the spleen at younger stages was also done by forming rosetting. The accumulation of P. vivax in the spleen can not be described in this study because of the limited number of samples with low parasitemia. However, this study was able to predict the possibility of P. vivax accumulation in the spleen with high reticulocytes in the spleen.Keywords Spleen, Malaria, P. falciparum, P. vivax, spleen, reticulocyte.

Abstrak :
ABSTRAK
Tesis ini bertujuan menilai perbandingan efektivitas injeksi intravitreal vorikonazol 100 µg/0.1 mL dengan amfoterisin B 5 µg/0.1 mL pada endoftalmitis akibat Aspergillus flavus di hewan coba kelinci. Uji eksperimental tersamar acak dilakukan pada 15 kelinci albino New Zealand white yang terbagi menjadi tiga kelompok, yaitu kelompok vorikonazol, amfoterisin B, dan kontrol. Parameter yang dinilai adalah perubahan klinis, pemeriksaan mikologi, dan perubahan histopatologi jaringan. Perubahan skor klinis di akhir evaluasi tidak berbeda bermakna antara kelompok vorikonazol dengan amfoterisin B, namun respons klinis cenderung lebih baik pada kelompok vorikonazol. Jumlah koloni jamur terkecil dan berbeda bermakna didapatkan pada kelompok amfoterisin B. Tidak didapatkan perbedaan bermakna pada rerata nilai histopatologi jaringan kedua kelompok, namun derajat inflamasi cenderung lebih ringan pada kelompok vorikonazol.ABSTRACT
The purpose of this study was to compare the efficacies of intravitreal 100 µg voriconazole and 5 µg amphotericin B treatment against Aspergillus flavus in an exogenous endophthalmitis model in rabbit eyes. A randomized, controlledexperimental study was conducted on 15 albino New Zealand white rabbits, which latter allocated into three different treatment group of voriconazole, amphotericin B, and control. Clinical grading were performed at multiple times, while mycology analysis and histopathological examination were performed at 10 days after treatment. No significant change in clinical grading was found between the treatment group, but voriconazole group showed better response tendency. The smallest number of fungal colony forming unit was found significantly in the amphotericin B group. No significant difference was found, however, between the mean histopathological score of the two treatment groups, but the tendency of a lower inflammation score was shown in voriconazole group. ;The purpose of this study was to compare the efficacies of intravitreal 100 µg voriconazole and 5 µg amphotericin B treatment against Aspergillus flavus in an exogenous endophthalmitis model in rabbit eyes. A randomized, controlledexperimental study was conducted on 15 albino New Zealand white rabbits, which latter allocated into three different treatment group of voriconazole, amphotericin B, and control. Clinical grading were performed at multiple times, while mycology analysis and histopathological examination were performed at 10 days after treatment. No significant change in clinical grading was found between the treatment group, but voriconazole group showed better response tendency. The smallest number of fungal colony forming unit was found significantly in the amphotericin B group. No significant difference was found, however, between the mean histopathological score of the two treatment groups, but the tendency of a lower inflammation score was shown in voriconazole group. ;The purpose of this study was to compare the efficacies of intravitreal 100 µg voriconazole and 5 µg amphotericin B treatment against Aspergillus flavus in an exogenous endophthalmitis model in rabbit eyes. A randomized, controlledexperimental study was conducted on 15 albino New Zealand white rabbits, which latter allocated into three different treatment group of voriconazole, amphotericin B, and control. Clinical grading were performed at multiple times, while mycology analysis and histopathological examination were performed at 10 days after treatment. No significant change in clinical grading was found between the treatment group, but voriconazole group showed better response tendency. The smallest number of fungal colony forming unit was found significantly in the amphotericin B group. No significant difference was found, however, between the mean histopathological score of the two treatment groups, but the tendency of a lower inflammation score was shown in voriconazole group. ;The purpose of this study was to compare the efficacies of intravitreal 100 µg voriconazole and 5 µg amphotericin B treatment against Aspergillus flavus in an exogenous endophthalmitis model in rabbit eyes. A randomized, controlledexperimental study was conducted on 15 albino New Zealand white rabbits, which latter allocated into three different treatment group of voriconazole, amphotericin B, and control. Clinical grading were performed at multiple times, while mycology analysis and histopathological examination were performed at 10 days after treatment. No significant change in clinical grading was found between the treatment group, but voriconazole group showed better response tendency. The smallest number of fungal colony forming unit was found significantly in the amphotericin B group. No significant difference was found, however, between the mean histopathological score of the two treatment groups, but the tendency of a lower inflammation score was shown in voriconazole group.

Abstrak :
Latar belakang: Rabdomiosarkoma (RMS) merupakan sarkoma yang banyak ditemukan pada anak dan dewasa muda. Secara histopatologik ada 4 tipe, yaitu embrional, alveolar, spindel, dan pleomorfik. Tipe histologi dan lokasi (favorable dan unfavorable) termasuk faktor yang menentukan prognosis RMS. Terapi kombinasi pada RMS dengan reseksi komplet, kemoterapi, dan radiasi belum meningkatkan kesintasan pasien RMS terutama pada stadium lanjut. Anti terhadap Epidermal growth factor receptor (EGFR) telah dipakai dalam terapi untuk tumor epitelial ganas, sedangkan penggunaannya pada sarkoma masih dalam penelitian. Dalam penelitian ini dibandingkan ekspresi EGFR pada rabdomiosarkoma anak tipe embrional (RMSE) dan alveolar (RMSA) yang memiliki perbedaan prognosis, serta dilihat ekspresi EGFR pada lokasi favorable dan unfavorable. Metode: Penelitian ini menggunakan metode potong lintang dengan pemilihan sampel secara konsekutif. Sampel terdiri atas 17 kasus RMSE dan 13 kasus RMSA di Departemen Patologi Anatomik FKUI/RSCM tahun 2008-2015. Diagnosis RMSE dan RMSA ditegakkan secara histopatologi dan imunohistokimia MyoD1 dan atau desmin positif. Dilakukan pulasan imunohistokimia EGFR pada RMSE dan RMSA dengan penilaian semikuantitatif, membandingkan kedua tipe histologik dan lokasi tumor. Hasil: Ekspresi EGFR pada RMSE lebih tinggi secara bermakna dibandingkan dengan RMSA (53% vs 23%, p=0,029). Bila dihubungkan dengan lokasi, maka ekspresi EGFR pada RMSE lebih tinggi pada lokasi unfavorabe dibanding lokasi favorable (p=0,412). Ekspresi EGFR pada RMSA lebih tinggi pada lokasi favorable dibanding lokasi unfavorable (p=0,592). Kesimpulan: Ekspresi EGFR pada RMSE lebih tinggi dibandingkan pada RMSA, dengan ekspresi EGFR pada RMSE di lokasi unfavorable lebih tinggi dibanding pada lokasi favorable walaupun tidak bermakna secara statistik. ...... Background: Rhabdomyosarcoma (RMS) is the most common sarcoma in children and young adults. Histologically, RMS is divided into 4 types: embryonal, alveolar, spindle, and pleomorphic. Histologic type and location (favorable and unfavorable) are amongst factors that determine prognosis of rabdomyosarcoma. Combined therapies on RMS which consist of complete resection, chemotherapy, and radiation do not increase the survival, especially in advanced stage. Anti-EGFR therapy has been used in epithelial tumor, while its use in sarcoma is still in research. The aim of this study was to compare the expression of EGFR in rhabdomyosarcoma embryonal type (ERMS) and alveolar type (ARMS) which have different prognosis; and comparing EGFR expression in favorable and unfavorable locations. Method: This was a restropective cross sectional study, using consecutive sampling. The cases consist of 17 ERMS and 13 ARMS in Departement of Anatomical Pathology FMUI/RSCM 2008-2015. ERMS and ARMS was diagnosed by histopathology and confirmed by immunostaining, MyoD1 and or desmin positive. EGFR immunostaining was performed and scored semiquantitatively, and compared the 2 histologic types and location. Results: There was differences between EGFR expression on ERMS and ARMS (p=0.029). EGFR expression on ERMS was more frequent in unfavorable location than favorable location (p=0.412). EGFR expression on ARMS was more frequent in favorable location than unfavorable location (p=0.592). Conclusions: Expression EGFR on ERMS was more frequent than ARMSA. RMSE on unfavorable location tented to express EGFR more frequent even did not reach statistical significance.