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"ABSTRAKLatar belakang: Karbamazepin KBZ merupakan obat terpilih untuk epilepsi fokaldan dapat digunakan juga untuk pengobatan nyeri neuropatik dan gangguan bipolar,namun dapat menyebabkan reaksi obat yang berat berupa sindrom Stevens-Johnson SSJ /nekrolisis epidermal toksik NET . Saat ini banyak penelitian yangmembuktikan terdapat hubungan antara HLA-B 1502 dengan SSJ/NET yangdisebabkan oleh KBZ pada orang Asia.Tujuan: Meneliti apakah HLA-B 1502 dapat dijadikan marker terjadinya SSJ/NETyang disebabkan oleh KBZ di Indonesia.Metode: Subjek penelitian direkrut dari poliklinik saraf RSUPN CiptoMangunkusumo Jakarta, RS Hasan Sadikin Bandung 2 kasus dan RSUP Prof RDKandou Manado 2 kasus pada Mei 2015 sampai dengan Desember 2016. Subjekdengan riwayat SSJ/NET yang disebabkan KBZ dan toleran KBZ dilakukanpemeriksaan typing HLA-B dengan metode sequence specific oligonucleotidesprobes, dibaca dengan Luminex 200 dan dianalisis dengan perangkat lunak HLAfushion4.0. Dipilih beberapa subjek SSJ/NET dengan HLA-B 1502 positif dannegatif dan toleran dengan HLA-B 1502 positif dan negatif. Subjek yang dipilih inidilakukan kultur PBMC dengan perlakuan penambahan KBZ dan tanpa perlakuanselama 24 dan 48 jam, kemudian diukur kadar granulisin, granzim B dan perforindalam medium kultur dengan metode ELISA, untuk melihat peranan HLA-B 1502dalam terjadinya SJS/NET.Hasil: Total subjek 67 orang, 14 kasus dan 53 toleran. Pada semua subjek dilakukantyping HLA-B, sedangkan kultur dan pemeriksaan kadar granulisin, granzim B danperforin dilakukan pada 17 subjek 6 SSJ/NET dengan HLA-B 1502 positif dan 3negatif; 5 toleran HLA-B 1502 positif dan 3 negatif HLA-B 1502 positifditemukan pada 8 kasus 57,14 dan 14 toleran 26,42 , dengan rasio prevalensi2,73 dan p= 0,0353. Terdapat kecenderungan lonjakan kadar granulisin padakelompok subjek dengan SSJ/NET dibandingkan kelompok toleran KBZ.Kesimpulan: HLA-B 1502 dapat digunakan sebagai marker pada SSJ/NET karenaKBZ.Kata Kunci: HLA-B 1502, KBZ, SJS/NET, Indonesia

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ABSTRACTBackground Carbamazepine CBZ is a drug of choice for focal epilepsy and canbe used for neuropatic pain and bipolar disorder, but it can also causes severe drugreaction in the form of Stevens Johnson Syndrome SJS toxic epidermal necrolysis TEN . Currently, there are many studies that prove the relationship between HLAB 1502and SJS TEN caused by CBZ in Asian ancestry.Objective To study whether HLA B 1502 can be used as marker for SJS TENcaused by CBZ in Indonesia.Method Subjects were recruited from neurology clinic RSUPN CiptoMangunkusumo, RS Hasan Sadikin Bandung two cases , and RSUP Prof. RDKandou Manado two cases , from May 2015 to December 2016. Subjectswith SJS TEN history caused by CBZ and CBZ tolerant went through HLA Btyping examination with sequence specific oligonucleotides probes method, readwith Luminex 200 and analyzed with HLA fusion 4.0 software. Some subjectswith SJS TEN with HLA B 1502 positive and negative, and tolerant subjects withHLA B 1502 positive and negative, were chosen. These subjects went throughPBMC culture with and without CBZ addition for 24 and 48 hours, then granulysin,granzyme B and perforin concentration in culture medium were measured usingELISA method to see the role of HLA B 1502 in SJS TEN occurrence.Result Total number of subjects were 67 with, 14 CBZ induced SJS NET cases and53 CBZ tolerants. All subjects went through HLA typing, while culture andgranulysin, granzyme B and perforin examination were conducted in 17 subjects 6with SJS TEN with HLA B 1502 positive and 3 negative 5 tolerant HLA B 1502positive and 3 negative . HLA B 1502 positive were found in 8 cases 57,14 and14 tolerant 26,42 , with prevalence ratio 2,73 p 0,035. There is a tendencyincreased of granulysin level in CBZ induced SSJ NET cases.Conclusion HLA B 1502 can be used as marker in SJS TEN induced by CBZ. "

"ABSTRAKLatar belakang: Erupsi obat alergik EOA tipe sindrom Stevens-Johnson dan nekrolisis epidermal toksik SSJ/NET adalah EOA berat yang jarang terjadi namun dapat mengancam nyawa. Tata laksana utama EOA tipe SSJ/NET saat ini adalah menghentikan pajanan obat penyebab. Di beberapa negara Asia, polimorfisme gen HLA-B telah digunakan sebagai metode skrining pada pemberian obat berisiko tinggi. Tujuan: Mengetahui sebaran obat penyebab dan polimorfisme gen HLA-B pada pasien EOA tipe SSJ/NET di Jakarta. Metode: Studi potong lintang ini dilakukan pada bulan April ndash; Juni 2017 di RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, dan RSUD Tarakan. Pemilihan sampel dilakukan secara total sampling pada pasien EOA tipe SSJ/NET di 5 RS tersebut selama 2 tahun. Dilakukan anamnesis dan penentuan obat dengan algoritma ALDEN dan pemeriksaan typing gen HLA-B dengan metode PCR ndash;SSOP. Hasil: Didapatkan 22 subjek dengan median usia 45,5 tahun dan sebagian besar perempuan. Obat penyebab tersering yang ditemukan adalah karbamazepin. Pada subjek, alel HLA-B yang tersering adalah HLA-B 15:02 dan HLA-B 18:01. Alel HLA-B 15:02 ditemukan pada lima 72 dari tujuh SP dengan obat penyebab karbamazepin. Simpulan: Obat penyebab EOA tipe SSJ/NET yang paling sering ditemukan pada SP adalah karbamazepin, dengan 5 dari 7 SP memiliki gen HLA-B 15:02.

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ABSTRACTBackground Stevens Johnson syndrome and toxic epidermal necrolysis is a very rare but life threatening type of cutaneous drug eruption. The principle management of SJS TEN is withdrawal of causative drug and preventing reexposure to said drug. In other countries in Asia, spesific HLA B allele has already been utilized as a screening method to prevent SJS TEN. Objective to acquire data regarding causative drugs and HLA B allele polymorphism in SJS TEN patient in Jakarta. Method This cross sectional study was performed in RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, and RSUD Tarakan from April to June 2017. The sampling method is total sampling of all patient in all five hospital from March 2015 to March 2017. Subject fulfilling the inclusion and exclusion criteria was interviewed and their blood sample was taken for DNA extraction. The DNA was examined with PCR SSOP and Luminex technology for high resolution HLA B typing. Results We studied 22 subjects. The median age was 45,4 years old 14 74 and female gender predominate. The most common causative drug in this study is carbamazepine. HLA B 15 02 and HLA B 18 01 were the most common allele in all subjects. HLA B 15 02 was found in five 72 out of seven subjects whose condition was caused by carbamazepine. Conclusion The most common causative drug of SJS TEN in five hospitals in Jakarta is carbamazepine, with five 72 out seven subjects had HLA B 15 02 allele. "

"Epilepsi masih menjadi masalah neurologis pada anak, dengan pertambahan kasus sebesar 75%-80% setiap tahunnya di negara-negara berkembang. Sudah terdapat banyak pilihan Obat Anti Epilepsi (OAE) yang tersedia. Sayangnya, mencapai 30% pasien anak yang menjalani pengobatan tidak mencapai bebas kejang, dan berkembang menjadi epilepsi dengan kejang tidak terkontrol, atau disebut dengan epilepsi intraktabel. Perjalanan pengobatan sangat penting pada keadaan epilepsi anak usia di bawah tiga tahun, yang masih dalam masa perkembangan otak, namun belum banyak penelitian yang melihat evolusi faktor risiko dalam memprediksi kejadian epilepsi intraktabel. Penelitian ini melihat perubahan atau evolusi faktor risiko pasien epilepsi anak usia di bawah tiga tahun pada 3 lokasi penelitian di Jakarta, dengan melakukan studi kasus-kontrol.Tujuan penelitian ini yaitu untuk mengidentifikasi peran evolusi faktor risiko untuk memprediksi epilepsi intraktabel anak usia di bawah tiga tahun. Penelitian dilakukan secara retrospektif, menggunakan data sekunder, dengan melihat rekam medis pasien epilepsi anak usia di bawah tiga tahun yang diperoleh dari RSUPN Cipto Mangunkusumo, Jakarta Pusat, RS Puri Cinere Depok, dan Klinik Anakku Pondok Pinang Center, Jakarta Selatan. Total subjek sebanyak 102 rekam medis pasien, dengan perbandingan kasus:kontrol yaitu 1:1. Hasil analisis pearson chi-square memperoleh 3 evolusi faktor risiko yang signifikan terhadap kejadian epilepsi intraktabel, yaitu: evolusi kelumpuhan motorik kasar (p<0,001; OR 7,86; IK95% 3,142-19,659); evolusi status neurologis (p<0,001; OR 9,84; IK95% 3,934-24,614); dan evolusi gelombang epileptiform EEG (p<0,001; OR 23,25; IK95% 7,657-70,599). Evolusi tipe kejang menunjukkan hasil tidak bermakna terhadap kejadian epilepsi intraktabel anak. Hasil analisis multivariat kemudian menunjukkan bahwa evolusi gelombang epileptiform EEG baik/buruk memiliki peran paling kuat dalam memprediksi kejadian epilepsi intraktabel (p<0,001; OR 0,075; IK95% 0,022-0,253). Evolusi gelombang epileptiform EEG buruk merupakan faktor prediktor epilepsi intraktabel anak usia di bawah tiga tahun yang paling berpengaruh.

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Epilepsy is still a neurological problem among children, with an increase in cases of 75% -80% annually in developing countries. There are already many choices of Anti-Epileptic Drugs (AED) available. Unfortunately, up to 30% of pediatric patients who undergo treatment do not achieve seizure-free, and develop epilepsy with uncontrolled seizures, also known as intractable epilepsy. The course of treatment is very important in the epilepsy of children under three years of age, who are still in the process of brain development, but not many studies have looked at the evolution of risk factors in predicting the incidence of intractable epilepsy. This study looked at changes or evolution of risk factors for epilepsy patients under three years of age in 3 study locations in Jakarta, by conducting a case-control study. The objective of this research is to Identified the evolution of risk factors role in predicting intractable epilepsy in children under three years of age. The study was conducted retrospectively, using secondary data, by looking at the medical records of epilepsy children under three years of age obtained from RSUPN Cipto Mangunkusumo, Central Jakarta, Puri Cinere Hospital Depok, and Klinik Anakku Pondok Pinang Center, South Jakarta. The total subjects were 102 patient medical records, with a case: control ratio of 1: 1. The results of the Pearson chi-square analysis obtained three significant evolution of risk factors for the incidence of intractable epilepsy, namely: the evolution of gross motor paralysis (p<0.001; OR 7.86; 95% CI 3.142-19.659); evolution of neurological status (p<0.001; OR 9.84; CI95% 3,934-24.614); and EEG epileptiform wave evolution (p<0.001; OR 23.25; IK95% 7,657-70,599). The evolution of seizure types showed no significant effect on the incidence of intractable epilepsy in children. The results of multivariate analysis then showed that the evolution of epileptiform EEG waves good/bad had the strongest role in predicting the incidence of intractable epilepsy (p<0.001; OR 0.075; CI95% 0.022-0.253). The bad evolution of EEG epileptiform waves was the most influential predictor of intractable epilepsy among children under three years of age."

"Latar belakang : Efek potensial EGFR-TKI terhadap fungsi paru belum diinvestigasi secara mendalam. Penelitian ini bertujuan untuk menilai efek pemberian EGFR TKI terhadap fungsi paru terutama nilai DLCO.Metode : Penelitian berlangsung secara prospektif dari September 2018 hingga Juni 2019 di Rumah Sakit Persahabatan Jakarta. Terdapat 20 subjek adenokarsinoma paru dengan mutasi tunggal di exon 19/21 yang dapat menyelesaikan pemeriksaan DLCO baik sebelum mendapat EGFR TKI dan setelah tiga bulan terapi.Hasil : Penelitian ini mendapatkan peningkatan bermakna nilai rerata KVP prediksi dari 60,6% menjadi 68,25% (p=0,03), nilai rerata VEP1 Prediksi dari 59,7% menjadi 67,05% (p=0,036), nilai rerata DLCO dari 11,55 ml/menit/mmHg menjadi 13,72 ml/menit/mmHg (p=0,004) dan DLCO prediksi dari 53,4% menjadi 63,85% (p=0,03). Peningkatan nilai rerata DLCO prediksi paling besar pada kelompok dengan hasil RECIST partial response yaitu sebesar 16,43% (p=0,056).Kesimpulan : Terapi EGFR TKI selama tiga bulan pada subyek adenokarsinoma paru dengan mutasi tunggal exon19/21 dapat meningkatkan fungsi paru secara bermakna baik nilai KVP prediksi, VEP1 prediksi, DLCO, dan DLCO prediksi.

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Background : The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are drugs of choice in non-small cell lung cancer possessing EGFR mutation. Its effect on the lung function is not well understood. This study aims to assess lung function using the lung diffusion capacity (DLCO) test in lung cancer patients treated with EGFR-TKIs. mingMethod :This prospective study included lung cancer patients treated with EGFR-TKIs at Persahabatan Hospital Jakarta, Indonesia, between September 2018 andGrowt June 2019. The study recruited 20 lung adenocarcinoma patients presented with a single mutation at exon 19 or 21 as subjects in the process. Their DLCO was examined before and three months after receiving EGFR-TKI. Subjects were grouped according to the Response Evaluation Criteria in Solid Tumors (RECIST) assessment.Results: There was an increase in predicted FVC from 60.60% to 68.25% (p=0.03), predicted FEV1 from 59.7% to 67.05% (p=0.036%), DLCO from 11.5 mL/minute/mmHg to 13.72 mL/minute/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03) during the therapy. The largest increase of predicted DLCO was shown in RECIST group of partial response (16.43%, p=0.056) Conclusion: This study found an improvement in lung function (predicted FVC, predicted FEV1, DLCO, and predicted DLCO) among lung adenocarcinoma subjects exhibiting single mutation at exon 19 or 21 after three months of EGFR-TKIs treatment."

"Latar belakang: Epilepsi adalah suatu keadaan atau penyakit otak yang yang ditandai dengan kecenderungan menimbulkan kejang hal ini karena adanya bangkitan yang terjadi secara berulang. Layanan telemedis adalah layanan yang menggunakan fasilitas komunikasi elektronik yang bertujuan untuk memberikan dukungan atau pelayanan medis dari jarak yang terpisah. Pada layanan ini, banyak faktor yang mempengaruhi dokter dalam membuat keputusan. Sehingga, penelitian ini akan melihat perbandingan keputusan tatalaksana farmakologi dan rujukan pasien epilepsi baru dengan pasien yang pernah didiagnosis sebelumnya oleh dokter pada layanan telemedis di Indonesia. Metode: Penelitian ini menggunakan desain potong lintang retrospektif dengan sumber data sekunder yang dilakukan di salah satu layanan telemedis di Indonesia. Terdapat 100 subjek yang terpilih pada layanan telemedis. Pemberian keputusan tatalaksana farmakologi dan rujukan dapat dilihat dari riwayat chat. Hasil: Dari 100 subjek, hasil analisis menunjukkan tidak terdapatnya perbandingan yang bermakna antara pasien baru dengan pasien yang pernah didiagnosis sebelumnya dengan pemberian tatalaksana farmakologi (P=0,298) dan dengan keputusan rujukan (P=0,025). Selai itu, terlihat pasien baru memiliki presentase rujukan lebih tinggi (18,87%) dibandingkan dengan pasien yang pernah terdiagnosis (4,26%). Kesimpulan: Tidak terdapat perbandingan yang bermakna antara pasien baru dengan yang pernah terdiagnosis sebelumnya dengan pemberian farmakologi, serta terdapatnya perbandingan yang bermakna dengan keputusan rujukan. Sehingga, diperlukannya jumlah subjek yang lebih besar dan dilakukannya studi lebih lanjut.

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Introduction: Epilepsy is a condition or disease of the brain characterized by a tendency to cause seizures due to repeated seizures. Telemedical services are services that use electronic communication facilities for the purpose of providing medical support or remote services. In this service, many factors influence doctors in making decisions. Thus, this study will look at the comparison of pharmacological treatment decisions and referrals of new epilepsy patients with patients who have previously been diagnosed by doctors at telemedical services in Indonesia. Method: This study uses a retrospective cross-sectional design with secondary data sources conducted in a telemedicine service in Indonesia. There are 100 subjects selected for the telemedicine service. Decisions on pharmacological treatment and referrals can be seen from the chat history. Result: From 100 subjects, the results of the analysis showed that there was no significant comparison between new patients and patients who had previously been diagnosed with pharmacological treatment (P=0.298) and referral decisions (P=0.025). In addition, it was seen that new patients had a higher referral percentage (18.87%) compared to patients who had been diagnosed (4.26%). Conclusion: There was no significant comparison between new patients and those who had previously been diagnosed with pharmacology, and there was a significant comparison with referral decisions. Thus, a larger number of subjects is needed and further studies are needed."

"[ABSTRAKLatar Belakang: Kanker prostat adalah kanker yang paling umum pada pria. Kanker terjadi karena hilangnya kontrol atas proliferasi sel dan apoptosis sehingga sel berproliferasi terus menerus tanpa ada kematian sel. Apoptosis diregulasi oleh beberapa protein tertentu diantaranya protein keluarga Bcl-2 dan protein kanal. Perkembangan kanker prostat memerlukan transformasi dari sel epitel yang normal menjadi sel ganas yang kehilangan kemampuan untuk mengakumulasi zinc. Salah satu efek utama zinc adalah mencegah pertumbuhan sel kanker prostat dengan menginduksi apoptosis dengan memfasilitasi proses pembentukan pori Bax yang memulai apoptogenesis mitokondria. Selain keluarga Bcl-2, VDAC1 juga berperan penting dalam proses apoptosis. Beberapa penelitian menyatakan Bcl-2 mempunyai kaitan erat dengan VDAC1 terkait proses apoptosis dan protein pro-apoptotik Bax juga secara langsung berinteraksi dengan VDAC yang kemudian menginduksi keluarnya sitokrom c dari membran mitokondria.Tujuan: Mengevaluasi ekspresi mRNA dari gen mengkode keluarga protein Bcl-2 (Bax dan Bcl-2) dalam proses apoptogenesis pada galur sel kanker prostat yg diinduksi oleh zinc; Mengevaluasi ekspresi mRNA dari gen VDAC1 dalam proses apoptogenesis pada galur sel kanker prostat yang diinduksi oleh zinc; Menganalisis hubungan antara ekspresi VDAC1 dengan protein keluarga Bcl-2 pada apoptogenesis galur sel kanker prostat.Desain: Penelitian ini menggunakan eksperimental in vitro dan analisis statistikMetode: Untuk memperbanyak galur sel kanker prostat (PC3) dilakukan kultur sel, kemudian diberi perlakuan dengan tiga kelompok (kontrol, zinc 20 μM dan staurosporin 0,16 μM). Selanjutnya dilakukan isolasi RNA dan elektroforesis RNA untuk mengetahui keutuhan RNA. Terakhir dilakukan qRT PCR yang kemudian datanya dianalisis secara statistika.Hasil: Ekspresi Bax, Bcl-2 dan VDAC1 pada galur sel kanker prostat (PC-3) yang diberi perlakuan zinc mengalami penurunan dibandingkan dengan kontrol (tidak diberi perlakuan). Akan tetapi penurunan ekspresi tersebut tidak bernilai signifikan karena nilai p > 0,05 (nilai signifikansi Bax = 0,309; nilai signifikansi Bcl-2 = 0,236; nilai signifikansi VDAC1 = 0,437). VDAC1 mempunyai korelasi yang signifikan (p < 0,05) dengan Bax (p = 0,01) dibandingkan dengan Bcl-2 (p = 0,118).Kesimpulan: Terjadi perubahan ekspresi pada setiap gen (Bax, Bcl-2 dan VDAC1) pada galur sel kanker prostat yang diberi perlakuan zinc dengan yang tidak diberi perlakuan, akan tetapi tidak bernilai signifikan. VDAC1 mempunyai korelasi yang bermakna dengan Bax dan mempunyai korelasi yang tidak bermakna dengan Bcl-2.

ABSTRACT

Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2.;Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2., Background: Prostate cancer is the most common cancer in men. Cancer occurs due to loss control of cell proliferation and apoptosis thus continuously proliferating cells without cell death. Apoptosis is regulated by specific proteins including Bcl-2 family proteins and channel proteins. The development of prostate cancer requires the transformation of normal epithelial cells into malignant cells that lose the ability to accumulate zinc. One of the main effects of zinc is to prevent the growth of prostate cancer cells by inducing apoptosis by facilitating the process of pore formation Bax that started apoptogenesis mitochondrial. In addition to Bcl-2 family, VDAC1 also plays an important role in the process of apoptosis. Some studies suggest Bcl-2 has close links with related VDAC1 apoptosis and pro-apoptotic protein Bax also directly interact with VDAC which then induces the release of cytochrome c from the mitochondrial membrane.

Objective: To evaluate the expression of mRNA of the gene encoding the Bcl-2 family proteins (Bax and Bcl-2) in the process apoptogenesis on prostate cancer cell line that is induced by zinc; Evaluate the mRNA expression of genes in the process VDAC1 apoptogenesis on prostate cancer cell line induced by zinc; Analyzing the relationship between the expression of VDAC1 with Bcl-2 family proteins in prostate cancer cell lines apoptogenesis.

Design: This study used an experimental in vitro and statistical analysis

Methods: To reproduce the prostate cancer cell lines (PC3) performed cell culture, then treated with three groups (control, zinc 20 μM and staurosporin 0,16 μM). Furthermore, the isolation of RNA and RNA electrophoresis to determine the integrity of the RNA. Recently performed qRT PCR and the data were analyzed statistically.

Results: The expression of Bax, Bcl-2 and VDAC1 on prostate cancer cell line (PC-3) were treated with zinc decreased than the control (untreated). However, a decrease in the expression of no significant value because the value of p > 0.05 (Bax significant value = 0.309; the value of the significance of Bcl-2 = 0.236; VDAC1 significant value = 0.437). VDAC1 has a significant correlation (p < 0.05) with Bax (p = 0.01) than Bcl-2 (p = 0.118).

Conclusion: There is a change in the expression of each gene (Bax, Bcl-2 and VDAC1) in prostate cancer cell lines that treated with zinc than untreated, but no significant value. VDAC1 has a significant correlation with Bax and had no significant correlation with Bcl-2.]"

"Pendahuluan: Tyrosine Kinase Inhibitors (TKIs) sangat efektif terhadap KankerParu jenis Karsinoma Bukan Sel Kecil (KPKBSK) dengan mutasi EpidermalGrowth Factor Receptor (EGFR). Gefitinib dan Erlotinib adalah generasi pertamaEGFR-TKI untuk pengobatan KPKBSK dengan mutasi EGFR. Obat-obat ini telahtersedia melalui asuransi kesehatan di Indonesia untuk pasien Adenokarsinomaparu dengan mutasi EGFR. Data mengenai efikasi dan toksisitas EGFR-TKI saatini belum tersedia di Indonesia.Metode: Kami melakukan analisis observasional kohort retrospektif pada pasienAdenokarsinoma paru dengan mutasi EGFR di RSUP Persahabatan, JakartaIndonesia dari Januari 2015 sampai dengan Desember 2017. Kami meninjaurekam medis 331 pasien dengan diagnosis Adenokarsinoma paru dengan mutasiEGFR stage lanjut yang diobati dengan EGFR-TKI generasi pertama. Sebanyak192 subjek yang memenuhi kriteria inklusi.Hasil: Subjek yang mendapatkan Gefitinib (n=132) dan Erlotinib (n=60). Medianprogression free survival (PFS) sebanding antara Gefitinib dan Erlotinib (9,0 dan7,0 bulan, interval kepercayaan 95% [IK] 0,57-1,07, p=0,126). Median Overallsurvival (OS) dan angka tahan hidup 1 tahun masing-masing kelompok adalah44,5 vs 39,5 bulan (95% IK 0,35-1,29, p=0,670) dan 92% berbanding 92%(p=0,228). Terdapat toksisitas termasuk diare, paronikia, skin rash dan stomatitisyang diamati tetapi tidak ada perbedaan yang bermakna pada toksisitas derajat 3atau 4 antara kedua kelompok (p=0,713).Kesimpulan: Kedua EGFR-TKIs generasi pertama sebanding dalam PFS dan OS,meskipun Gefitinib terlihat lebih tinggi, tetapi secara statistik tidak bermakna dankeduanya memiliki toksisitas yang sebanding dan dapat ditoleransi.

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Introductions: Tyrosine kinase inhibitors (TKIs) are effective against non-smallcell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR)mutation. Gefitinib and erlotinib are the first-generation EGFR-TKIsrecommended as first-line treatments for NSCLC with EGFR mutations and areavailable through Universal Health Coverage in Indonesia for lungadenocarcinoma patients with EGFR mutations. However, the efficacy and safetydata of EGFR-TKIs are unavailable in Indonesia.Methods: We did a retrospective cohort analysis of the patients of lungadenocarcinoma with EGFR mutations treated in Persahabatan Hospital Jakarta,Indonesia, between January 2015 and December 2017. We reviewed the recordsof 331 patients with advanced stage lung adenocarcinoma with EGFR mutationtreated with the first-generation EGFR-TKIs. The subjects were 192 patients whomet the inclusion criteria.Results: Subjects were receiving gefitinib (n=132) and erlotinib (n=60). Medianprogression-free survival (PFS) was comparable between gefitinib and erlotinib(9.0 vs 7.0 months, 95% confidence interval [CI] 0.57-1.07, p=0.126). Themedian overall survival (OS) and 1-year survival were 44.5 vs 39.5 months(95%CI 0.35-1.29, p=0.228; and 92% vs 92%, p=0.228, respectively). Reportedtoxicities were diarrhea, paronychia, rash, and stomatitis but not of significantdifference between grade 3 or 4 toxicities (p=0.713).Conclusions: The PFS and OS of the first-generation EGFR-TKIs werecomparable, although gefitinib PFS and OS was shown to be better, but withoutsignificance. Both gefitinib and erlotinib had comparable and tolerable adverseeffects"

"Latar Belakang: Endometriosis merupakan penyakit multifaktorial yang mempengaruhi 10% wanita usia subur. Diketahui bahwa gen EGFR dan MMP-2 mengalami peningkatan ekspresi pada endometriosis sehingga memiliki peran dalam perkembangan endometriosis, dan gen yang dapat meregulasi sitoskeleton. Tujuan dari penelitian ini adalah untuk mengevaluasi hubungan antara tingkat metilasi gen EGFR dan MMP-2 dengan ekspresi mRNA-nya pada jaringan endometriosis peritoneum.Metode Penelitian: Penelitian ini menggunakan desain cross sectional. Sampel yang digunakan sebanyak 20 wanita endometriosis dan 20 wanita bukan endometriosis yang usianya sekitar 20-45 tahun. Pada wanita endometriosis diambil jaringan endometriosis peritoneum dengan tindakan laparoskopi, sedangkan 20 wanita bukan endometriosis diambil jaringan endometrium normal dengan tindakan mikrokuretase. Tingkat metilasi DNA gen EGFR dan MMP-2 dianalisis dengan metode Methylation Specific PCR (MSP) dan Ekspresi mRNA gen EGFR dan MMP-2 dianalisis dengan metode qRT-PCR.Hasil: Tingkat metilasi DNA pada gen EGFR dan MMP-2 mengalami hipermetilasi. Pada gen EGFR, tingkat metilasi DNA antara jaringan endometriosis peritoneum dibandingkan dengan jaringan endometrium normal terdapat perbedaan yang bermakna (p=0,001), sedangkan pada gen MMP-2 tingkat metilasi DNA-nya tidak terdapat perbedaan yang bermakna (p=0,596) antara jaringan endometriosis peritoneum dibandingkan dengan jaringan endometrium normal. Nilai ekspresi relatif mRNA EGFR dan MMP-2 mengalami peningkatan ekspresi pada jaringan endometriosis peritoneum. Penelitian ini tidak menunjukkan korelasi yang bermakna antara tingkat metilasi dengan tingginya ekspresi mRNA baik gen EGFR maupun MMP-2. (gen EGFR (p=0,947 dan r=-0,016) dan gen MMP-2 (p=0.769 dan r=0.070)Kesimpulan: Tingginya ekspresi mRNA EGFR dan gen MMP-2, kemungkinan bukan hanya disebabkan karena faktor metilasi DNA, melainkan faktor lainnya.

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Background: Endometriosis is a multifactorial disease that affects 10% of women of childbearing age. It is known that the EGFR and MMP-2 genes have increased expression in endometriosis and thus have a role in the development of endometriosis, and genes that can regulate the cytoskeleton. The purpose of this study was to evaluate the relationship between the level of methylation of the EGFR and MMP-2 genes with their mRNA expression in peritoneal endometriosis tissue.

Method: The study used a cross sectional design. The sample used was 20 women with endometriosis and 20 women without endometriosis who were around 20-45 years old. In endometriosis women are taken to peritoneal endometriosis tissue by laparoscopic, while 20 women without endometriosis are taken to normal endometrial tissue by microcuretase. The levels of EGFR and MMP-2 gene methylation were analyzed by the Methylation Specific PCR (MSP) method and the mRNA expression of the EGFR and MMP-2 genes were analyzed by the qRT-PCR method.

Results: The level of DNA methylation in the EGFR and MMP-2 genes was hypermethylated. In the EGFR gene between peritoneal endometriosis tissue compared to normal endometrial tissue there were significant differences (p=0,001), whereas in the MMP-2 gene there was no significant difference (p=0.596) between peritoneal endometriosis tissue compared to normal endometrial tissue. The relative expression value of EGFR and MMP-2 mRNA has increased expression in peritoneal endometriosis tissue. This study did not show a significant correlation between the level of methylation and the high mRNA expression in both the EGFR and MMP-2 genes. (EGFR gene (p=0.947 and r=-0.016) and MMP-2 gene (p=0.769 and r=0.070)

Conclusion: The high expression of EGFR mRNA and MMP-2 gene, the possibility is not only due to hypermethylation factors, but other factors."

"Epilepsi merupakan penyakit neurologis yang menyerang segala usia. Diperlukan pengobatan jangka panjang untuk mencegah kekambuhan. Kepatuhan adalah hal yang penting dalam pengobatan epilepsi. Tujuan penelitian ini adalah untuk mengetahui gambaran kepatuhan minum obat pada pasien epilepsi dan faktor-faktor yang mempengaruhinya. Metode yang digunakan adalah deskriptif analitik dengan desain crossectional. Jumlah sampel dalam penelitian ini sebanyak 102. Alat ukur yang digunakan adalah kuesioner kepatuhan, kuesioner pengetahuan, kuesioner dukungan keluarga, kuesioner ketersediaan sarana dan fasilitas kesehatan, kuesioner, keyakinan, dan kuesioner motivasi. Hasil penelitian menunjukkan bahwa tingkat kepatuhan minum obat masih rendah (49%). Analisis dengan chi square didapatkan ada hubungan antara jenis kelamin (p=0,003), ketersediaan sarana dan fasilitas kesehatan (p=0.036), dan keyakinan (p=0,038) dengan kepatuhan minum obat. Rekomendasi dari penelitian ini adalah perlunya meningkatkan edukasi dan pemberian informasi mengenai penyakit dan pengobatan terhadap pasien epilepsi.

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Epilepsy is a neurological disease that affects all ages. Long-term treatment is needed to prevent recurrence. Adherence is important in the treatment of epilepsy. The purpose of this study was to determine the description of medication adherence in epilepsy patients and the factors that influence it. The method used is descriptive analytic with a cross-sectional design. The number of samples in this study was 102. The measuring instruments used were compliance questionnaires, knowledge questionnaires, family support questionnaires, questionnaires on the availability of health facilities and facilities, questionnaires, beliefs, and motivation questionnaires. The results showed that the level of adherence to taking medication was still low (49%). Chi-square analysis showed that there was a relationship between gender (p=0.003), availability of health facilities and facilities (p=0.036), and confidence (p=0.038) with medication adherence. The recommendation from this study is the need to increase education and provide information about the disease and treatment of epilepsy patients."

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Latar belakang: Kista dan tumor odontogenik adalah lesi yang terjadi pada rahang dan berasal dari sisa epitel pembentuk gigi. EGFR adalah salah satu reseptor growth factor yang penting sebagai regulator proliferasi dan diferensiasi sel, diantaranya perkembangan dan morfogenesis gigi. EGFR juga dikenal  sebagai proto onkogen yang menginisiasi signalling pathway pada terjadinya beberapa tumor ganas. Penelitian melaporkan adanya peningkatan ekspresi EGFR pada beberapa kista dan tumor odontogenik sebagaimana yang terjadi pada tumor ganas. Tujuan: Untuk melihat dan membuat suatu profil ekspresi EGFR pada kista dan tumor odontogenik. Metode penelitian: 73 blok parafin kista dan tumor odontogenik didapatkan secara consecutive sampling dari data spesimen pada Departemen Patologi Anatomi FKUI/RSUPN-CM selama periode November 2015 – November 2019. Seluruh sampel diperiksa secara imunohistokimia menggunakan antibodi EGFR.  Hasil: Didapatkan 7 jenis lesi odontogenik: kista radikular (4), kista dentigerous (5), OKC (5), ameloblastoma (54), AOT (1), CEOT (2), ameloblastic carcinoma (2). Seluruh sampel memberikan ekspresi EGFR yang positif, dengan lokasi ekspresi pada sitoplasma. Skor EGFR bervariasi antara 1-2 dengan rerata 1,34. Intensitas beragam terdiri dari 41 % sampel lemah, 48% sampel sedang dan 11% sampel kuat.  Kesimpulan: EGFR berperan dalam terjadinya kista dan tumor odontogenik. Lokasi pulasan yang dominan terjadi pada sitoplasma sesuai dengan karakteristik kista dan tumor odontogenik yang tumbuh dan berkembang lambat.

 

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Background: Odontogenic cysts and tumors are lesions that occur in the jaw and derived from the remnants of tooth-forming epithelium. EGFR is one of  the growth factor receptors that is important as a regulator of cells proliferation and differentiation, including the development and morphogenesis of the tooth.  EGFR is also known as a protooncogen which initiates signalling pathway in the occurrence of several malignant tumors. Recent studies have reports an increase EGFR expression on odontogenic cysts and tumors as occurs in malignant tumors. Objective: This study aims to observe and make an expression profile of odontogenic cysts and tumors. Method: 73 paraffin blocks were collected through consecutive sampling from speciment data in Pathological Anatomy Department FKUI/RSUPN-CM during 2015 – 2019 period. The EGFR expression were detected using immunohistochemistry. Results: There were 7 types of odontogenic lesion: radicular cyst (4), dentigerous cyst (5), OKC (5), ameloblastoma (54), AOT (1), CEOT (2), ameloblastic carcinoma (2). All samples showed positive expression of EGFR and staining location on cytoplasm. EGFR score was vary between 1 – 2 with a mean of 1,34. Intensity of staining were consisted of 41% samples have weak staining, 48% samples have moderate staining and 11% sampels have strong staining Conclusion: EGFR have a role in the occurance of odontogenic cysts and tumors. All the staining location occurs in the cytoplasm was appropriate to the characteristics of these lessions that grows and develops slowly.

 

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