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"Diagnostic, prognostic and therapeutic value of gene signatures provides readers a useful and comprehensive resource about the range of applications of microarray technology in oncological diseases. Topics covered include gene signatures and soft tissue sarcomas, prognostic relevance of breast cancer signatures, gene expression profiling of colorectal cancer and liver metastasis, gene signatures in GISTs, CNVs and gene expression profiles in pancreatic cancer, and gene signatures in head/neck, lung and gastric tumors."

"This book describes both the technologies used in the discovery of melanoma biomarkers and the clinical application of these biomarkers for diagnosis and staging of disease, determination of prognosis, treatment planning, monitoring of response to therapy, identification of novel therapeutic targets and drug development. A broad range of biomarkers (DNA/chromosomal, mRNA, microRNA, mitochondrial DNA, epigenetic and protein) is outlined. As therapies for melanoma become increasingly more target specific, the identification, validation and use of biomarkers will invariably play a greater role in the management of patients with this disease."

"Latar belakang: Sepsis sulit dibedakan dengan respon inflamasi non infeksi secara klinis dan kultur darah yang merupakan gold standar diagnosis sepsis memiliki banyak keterbatasan. Presepsin merupakan suatu biomarker baru namun belum banyak data tentang efektifitas penggunaanya pada anak.Tujuan: Mengetahui nilai diagnostik dan prognostik presepsin dibandingkan dengan leukosit, PCT dan CRP pada pasien anak yang dicurigai sepsis

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Method: The latitude cut study was conducted during March-December 2020 at RSCM Jakarta on 56 patients aged 2 months - 10 years with suspicion of sepsis Diagnosis of sepsis is established based on the criteria of sepsis-3 and blood culture. Biomarker examination and PELOD-2 score are performed at the beginning and after 72 hours, mortality assessment is conducted on day 7. Presepsin levels are checked using the PATHFAST® method.

Result: The median value of precessine levels in the proven sepsis group (1183 pg/ml was higher than that of the unproven group of sepsis (369 pg/ml, p=0.001). Precessine has a good diagnostic value (AUC of 0.862), with a cut of 711 pg/ml having a sensitivity of 75.8%, specificity of 82.6%, positive guess value of 86.2% and negative guess value of 70.4%, better than leukocytes, PCT, and CRP. Presepsin levels increased linearly with the severity of sepsis and were moderately correlated with PELOD-2 scores (r=0.548; p=0.001). Survival analysis showed precessine levels of ≥ 1,250 pg/ml were significantly associated with early mortality (HR 6.31; 95%CI; 1.67-23.83; p=0.007). Presepsin levels after 72 hours of antibiotic therapy decreased significantly in the improved sepsis group and increased in the worsening sepsis group.

Inference: Presepsin is a reliable biomarker and can be used to help diagnose sepsis, predict severity, death and evaluate therapies in tertiary hospital services."

"ABSTRAKTuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them  is in abdominal organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and  absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care."

"ABSTRAKTuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them  is in abdominal organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and  absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care.Tuberculosis was still a global health problem. Beside lung, tuberculosis also manifest in other organs, one among them is in abdominal organs. Abdominal tuberculosis was a complex disease with unspecific sign and symptoms so that its diagnostic procedure was not rarely inconclusive. We reported a 24 years old woman with chief complain of worsening abdominal pain in all region, accompanied by nausea, vomiting, bloating, and  absent bowel movement. She also had a fresh bloody stool. She had an active pulmonary tuberculosis on initiation phase treatment. Physical examination suggest a bowel obstruction sign with distended abdomen and increase bowel sound. Colonoscopy procedure findings was a mass that obstruct bowel lumen in ileocaecal region, suggest for malignancy similar to computerized tomography (CT) scan result, but pathlogic result showed an active colitis without any sign of malignancy. Because of its contradiction, the second colonoscopy was performed and concluded as intestinal tuberculosis, matched with second pathologic examination. Although polymerase chain reaction (PCR) tuberculosis (TB) showed a negative result, a further clinical judgement concluded this as an intestinal tuberculosis case. Patient was finally treated as intestinal tuberculosis with first-line antituberculosis drugs and planned to have colonoscopy evaluation. After general condition was good and obstructive ileus sign was relieved, patient planned for outpatient care."

"From the l9th of July to the l9?' of October 1999, we conducted a study to evaluate the diagnostic capabilities/benefits of the double contrast barium esophagogram in patients with esophagitis. The sample patients were taken from patients with reflux-type dyspepsia who visited the out patient clinic of the Sub-department of Gastroenterology ofthe Department of Internal Medicine of the Faculty of Medicine of the University of indonesia/Cipto Mangunkusumo Hospital, Jakarta. During the duration of study 32 patients fulfilled the criteria for inclusion, and did not fulfill the criteria for exclusion. All of the subjects underwent double contrast barium esophagogram, Bernstein lest, and endoscopy of the upper gastrointestinal tract, as well as biopsy of the lower third esophageal mucosa. The chief complaints for reflux type dyspepsia were found in the following order: pyrosis/heartburn (56.26%), acid/sour taste in the mouth (12.5%), chest pain (9.3 8%), swallowing disturbance (6.25%). breathing difficulties (6.25%), belching (6.25%), and palpitation (3.12%) From the 32 patients with reflux type dyspepsia that underwent double contrast barium esophagogram, 10 patients (3l. 25%) were found positive for esophagitis, and the remaining 22 patients were found to be negative (68.75%). Bernstein test found 11 patients (34.37%) positive and 21 (65.63%) negative, while endoscopy of the upper gastrointestinal tract showed positive esophagitis in 25 patients (78. 13%) and negative in 7 patients (2l.87%). The degree of accordance between double contrast barium esophagogram and the Bernstein test or even a combination of the two was unsatisfactory in diagnosing esophagitis in reflux type dyspepsia. Based on this, this study concludes that double contrast barium esophagogram and Bernstein are incapable of replacing endoscopic examination in establishing the diagnosis of esophagitis. "

"ABSTRAKGangguan ketersediaan oksigen akibat perburukan kondisi fisiologis akut akan meningkatkan risiko moralitas, khususnya pada pasien kritis yang memiliki keterbatasan daya konpensasi. Tujuan dari penelitian ini adalah untuk menilai saturasi oksigen perifer (Spo2) saat pasien masuk dalam memprediksi moralitas pasien gawat darurat medis dengan kondisi kritis di Rumah Sakit Cipto Mangunkusumo (RSCM) yang merupakan rumah sakit rujukan nasioanl di indonesia.metode kami melakukan penelitian kohort retrospektif pada pasien kritis di ruang Resutasi Instalasi Gawat Darurat RSCM pada bulan Oktober sampai November 2012. pengukuran Spo2 dilakukan dalam waktu 15 menit setelah pasien masuk. Subjek kemudian dibagi menjadi dua kelompok: kelompok dengan SpO2 lebih atau sama dengan 95% (1) dan kurang dari 95% (2). Luaran yang dinilai adlah moralitas selama perawatan. Uji log-rank digunakan untuk membandingkan kesintasan kedua kelompok. Risiko moralitas selama perawatan dianalisis dengan Cox propotional hazard model.Hasil moralitas selama perwatan terjadi pada 69 ( 40,1%) dari 172 subjek penelitian. Pasien dengan SpO2 kurang dari 95% memiliki laju kesintasan yang lebih rendah secara bermakna ( rerata kesintasan 21,3 vs 28,6 hari, log-rank p = 0,011). rasio hazard terjadinya moralitas adalah 1,8 (IK 95% 1,13 sampai 2,90) pada pasien dengan SpO2 di bawah 95%.simpulan saturasi oksigen perifer di bawah 95% pada saat pasien masuk meningkatkan risiko moralitas secara bermakna. Karena mudahnya nilai saturasi tersebut, maka SpO2 sebaiknya dipertimbangkan sebagai prediktor moralitas pada pasien gawat darurat medis dengan kondisi kritis."

"Latar Belakang : Perbedaan antara demam dengue ( DD ) dan demam berdarah dengue ( DBD ) adalah terjadinya kebocoran plasma pada DBD. Kebocoran plasma pada ruang interstitial ditandai dengan adanya efusi cairan di pleura dan peritoneal, hemokonsentrasi, serta hipovolemia intravaskular. Keadaan ini menyebabkan gangguan perfusi ke jaringan, sehingga menyebabkan metabolism anaerob. yang menimbulkan peningkatan kadar laktat dalam darah. Tujuan Penelitian: Mengetahui peran laktat sebagai prediktor prognosis dan diagnosis kebocoran plasma pada infeksi dengue pasien dewasa. Metode: Studi potong lintang, pada infeksi virus dengue pasien dewasa yang dirawat di bangsal penyakit dalam RS Cipto Mangunkusumo dan RS Persahabatan Jakarta. Jumlah subjek sebanyak 57 orang. Dilakukan pemeriksaan kadar laktat untuk melihat perbedaan rerata kadar laktat antara DD dan DBD dengan uji t-tes tidak berpasangan, dan nilai titik potong kadar laktat pada keadaan tanpa atau dengan kebocoran plasma dilakukan dengan menentukan sensitifitas dan spesifisitas terbaik dari kurva ROC yang sudah dibuat. Hasil: Rerata kadar laktat pada DBD secara bermakna lebih tinggi daripada DD. Nilai titik potong untuk prediktor prognostik pada hari ke-3 yang ditentukan dengan kurva ROC mendapatkan nilai kadar laktat ≥ 2,65 mmol/ L dengan AUC 0,626 ; IK 95% 0,480-0,772. Dan nilai titik potong untuk diagnostik pada hari ke-5 mendapatkan nilai kadar laktat ≥ 2,55 mmol/L memberikan sensitivitas 66,6%% dan spesifisitas 54,2%. Kesimpulan: Terdapat perbedaan bermakna kadar laktat antara DD dan DBD. Nilai kadar laktat ≥ 2,65 mmol/L belum dapat digunakan sebagai prediktor prognostik adanya kebocoran plasma pada fase kritis. Nilai kadar laktat ≥ 2,55 mmol/L pada saat fase kritis dipakai sebagai petanda adanya kebocoran plasma dengan akurasi yang rendah.

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Background: The difference between dengue fever (DF) and dengue hemorrhagic fever (DHF) is plasma leakage which occurs in DHF. The leakage of plasma into interstitial space is shown by pleura and peritoneal effusion, hemoconcentration, and intravascular hypovolemia. Anaerob metabolism will occur due to perfusion dysfunction which will cause increased serum lactate.

Objectives: To determine the role of lactate as a prognostic predictor and diagnostic in plasma leakage which occurs in adult dengue-infected patients.

Methods: This is cross-sectional study which is conducted in adult dengueinfected patients hospitalized in internal medicine ward of Cipto Mangunkusumo Hospital and Persahabatan Hospital in Jakarta. There are 57 adult dengue-infected patients recruited. Serum lactate is examined to determine the mean difference between DF and DHF. The data is analyzed by t-test independent and cut-off point is identified in presence as well as absence of plasma leakage which is to determine the sensitivity and specificity based on ROC curve.

Results: The mean of serum lactate in DHF is significantly higher compared to DF. The cut-off point of prognostic predictor in day three of fever which is determined based on ROC curve shows lactate serum ≥ 2.65 mmol/L with AUC 0.626; 95% CI 0.480-0.772. Moreover, the cut-off point of diagnostic factor in day five of fever is shown by serum lactate ≥ 2.55 mmol/L with sensitivity 66.6% and specificity 54.2%.

Conclusion: There is difference of serum lactate in DF and DHF. Serum lactate ≥ 2.65 mmol/L could not be used as a prognostic predictor of plasma leakage in critical phase. Serum lactate ≥ 2.55 mmol/L during critical phase could be used as a marker of plasma leakage but low of accuracy."

"Sindrom mielodisplasia (Myelodysplastic Syndrome, MDS) adalah sejumlah gangguan yang terjadi akibat sumsum tulang tidak mampu menghasilkan sel-sel darah yang sehat.1 Diferensiasi sel prekursor darahterganggu, 2 dan apoptosis meningkat dengan signifikan sehingga sel-sel darah menjadi abnormal yang tidak sepenuhnya berkembang. 3 Gen PI-PLCß1 terlibat dalam proliferasi dan diferensiasi. Mutasi gen PI-PLCß1 dapat memengaruhi peningkatan proliferasi sel blast pada MDS dan cenderung bertransformasi menjadi Leukemia Mieloblastik Akut (Acute Myeloblastic Leukemia, AML). Diketahui PI-PLCβ1 berperan dalam kontrol siklus sel pada transisi G1/S dan perkembangan G2/M. Disregulasi ekspresi gen PI-PLCß1 menyebabkan gangguan pada jalur pensinyalan yang melibatkan proses diferensiasi sel, sehingga terjadi perubahan diferensiasi sel prekursor darah yang menyimpang. Banyak faktor yang menyulitkan pengamatan dalam pemeriksaan sitogenetika pada pasien MDS. Sehingga pemeriksaan ekspresi gen PI-PLCß1 diharapkan akan menjadi pengkajian awal dalam menilai prognostik MDS. Desain penelitian deskriptif dan analitik pada 4 subjek penelitian (3 pasien MDS-MLD, 1 pasien MDS yang telah menjadi AML), dan kontrol pasien dengan kelainan hematologi lain (Multiple Mieloma) sebanyak 1 pasien, serta 1 kontrol sehat. Sebanyak 3/5 (80%) memiliki kelainan kariotip kompleks, dan 1/5 (20%) memiliki kelainan kariotip ganda, dan 1/5 (20%) memiliki kelainan kariotip tunggal. Ekspresi gen PI-PLCß1 lebih rendah pada 4 pasien (MDS dan AML). Sedangkan pada 1 kontrol pasien dengan kelainan hematologi lainnya memiliki ekspresi gen PI-PLCß1 lebih tinggi dibandingkan dengan kontrol sehat. Ekspresi gen PI-PLCß1 lebih rendah pada pasien MDS dengan prognosis yang lebih buruk menurut skoring IPSS-R.

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Myelodysplastic syndrome (MDS) is a number of disorders that occur due to the bone marrow is not able to produce healthy blood cells. 1 The differentiation of blood precursor cells is impaired, 2 and apoptosis increases significantly that the blood cells become abnormal and do not fully develop. 3 The PI-PLCß1 gene is involved in proliferation and differentiation. PI-PLCß1 gene mutations can affect the increase in blast cell proliferation in MDS and tend to transform into Acute Myeloid Leukemia (AML). It is known that PI-PLCβ1 plays a role in cell cycle control in the G1/S transition and G2/M development. Dysregulation of PI-PLCß1 gene expression causes disruption of signaling pathways that involve the process of cell differentiation, resulting in aberrant changes in blood precursor cell differentiation. Many factors complicate observations in the cytogenetic studies of MDS patients. Therefore, it is hoped that the examination of PI-PLCß1 gene expression will be an initial assessment in assessing the prognostic value of MDS. The study design was descriptive and analytic in 5 study subjects (3 MDS-MLD patients, 1 AML patient, and 1 MM patient). Most of the patients had complex karyotype abnormalities, the rest had multiple karyotype abnormalities and single karyotype abnormalities. PI-PLCß1 gene expression was decreased in all MDS and AML patients. Meanwhile, MM patients had normal PI-PLCß1 gene expression. However, the increase in IPSS-R scores in patients was not significantly associated with a decrease in the expression of the PI-PLCß1 gene."