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"ABSTRAKLatar belakang: Retinoblastoma merupakan tumor ganas mata tersering pada anak, terutama yang berusia kurang dari 3 tahun. Penanganan kasus retinoblastoma didasarkan pada luasnya invasi sel tumor pada lapisa koroid, nervus optikus pre dan post laminar, sklera dan batas sayatan operasi yang merupakan faktor risiko histopatologi, dan dikelompokkan atas risiko rendah, menengah dan tinggi. Penilaian microvessel density (MVD) telah digunakan sebagai dasar terapi anti angiogenesis pada beberapa jenis karsinoma. Telah dilaporkan bahwa retinoblastoma dengan invasi koroid atau metastasis mempunyai nilai MVD yang lebih tinggi dibandingkan .yang tanpa invasi lokal ataupun tanpa metastasis. Dalam penelitian ini dilihat hubungan antara MVD dengan faktor risiko histopatologik. Selain itu, dipelajari pula hubungan antara: faktor risiko histopatologik dengan diferensiasi tumor; MVD dengan diferensiasi tumor; faktor risiko histopatologik dengan usia dan MVD dengan usia.Bahan dan cara: Penelitian ini menggunakan metode potong lintang dan analitik terhadap 59 kasus retinoblastoma tanpa kemoreduksi di Departemen PA FKUI-RSCM. Setelah dikelompokkan menurut risiko histopatologik, didapatkan 10 kasus risiko rendah, 17 kasus risiko menengah dan 32 kasus risiko tinggi. Dilakukan pulasan imunohistokimia CD31, dan selanjutnya dihitung MVD pada masing-masing kelompok, diikuti dengan analisis statistik antara MVD dan faktor risiko histopatologik.Hasil: Didapatkan hubungan bermakna yang signifikan antara MVD dan faktor risiko histopatologik (p<0,001) dan nilai OR 23. Tidak terdapat hubungan antara: faktor risiko histopatologik dengan diferensiasi tumor (p=0,063); MVD dengan diferensiasi tumor (p=0,274); faktor risiko histopatologik dengan umur (p=0,376) dan MVD dengan umur (p=0,712).Kesimpulan: Terdapat hubungan sejalan yang signifikan antara MVD dengan faktor risiko histopatologik pada retinoblastoma, sehingga dapat dipertimbangkan pemberian antiangiogenesis pada terapi retinoblastoma.

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ABSTRACTBackground: Retinoblastoma is the most common eye malignant tumor, especially in children under age of 3 years. The management of retinoblastoma is based on of tumor cells invasion in choroid layer, optic nerve pre and post laminer, sclera and optic nerve marginal excision which is a histopathological risk factors in retinoblastoma and categorised into low, intermediate and high risk. Microvessel density (MVD) is used in determining angiogenesis in some cancer as base of anti-angiogenesis therapy. It has been reported that retinoblastoma with local invasion and metastasis have higher MVD than retinoblastoma without local invasion and metastasis. In this study the association of MVD with histopathological risk factor in retinoblastoma was examined. We also assessed the association of: histopathological risk factors with tumor differentiation; MVD with tumor differentiation; histopathological risk factors with age and MVD with age.Material and methods: This is an analytic cross-sectional study on 59 retinoblastoma without chemoreduction in Anatomical Pathology Department, FMUI-RSCM. The cases was categorised into 3 group: 10 cases of low risk, 17 cases of intermediate risk and 32 cases of high risk retinoblastoma. MVD was assesed by CD 31 immuhistochemical staining for each histopathological risk factor, then statistical analysis was performed.Results: There was a significant association between MVD and histopathological risk factors in retinoblastoma (p<0,001) and OR score was 23. There was no association of: histopathological risk factors with tumor differentiation (p= 0.063); MVD with tumor differentiation (p= 0,274); histopathological risk factors with age (p=0,376) and MVD with age (p=0,712).Conclusion: MVD is significantly related to histopathological risk factors of retinoblastoma, therefore the uses of anti-angiogenesis could be considered in management of retinoblastoma."

"Pendahuluan: Pada penderita kanker selalu terjadi stres oksidatif yang ditandai dengan kadar MDA (malondialdehyde) yang tinggi dan aktivitas katalase yang rendah. Kanker terjadi karena ketidakseimbangan antara proses proliferasi sel dengan apoptosis. Penelitian ini bertujuan untuk mengetahui korelasi antara apoptosis dengan kadar MDA dan aktivitas antioksidan enzimatik katalase pada pasien kanker leher rahim stadium lokal lanjut. Metode penelitian: Penelitian ini merupakan studi cross sectional terhadap 16 pasien kanker leher rahim stadium lokal lanjut yang memenuhi kriteria inklusi dari Juli sampai Agustus 2013. Pengambilan darah pasien dilakukan sebelum radiasi dimulai. Pemeriksaan kadar MDA dan aktivitas katalase dilakukan dengan metode spektrofotometri. Indeks apoptosis dilakukan dengan motode TUNEL. Hasil: Didapatkan rerata indeks apoptosis sebesar 11,1 ± 0,59 sel; rerata kadar MDA serum sebesar 7,97 ± 0,26 nmol/mL dan rerata aktivitas katalase serum sebesar 0,98 ± 0,04 U/mL. Terdapat korelasi positif sedang yang bermakna (r=+0,51; p=0,043) antara indeks apoptosis dengan kadar MDA dan korelasi negatif lemah yang tidak bermakna (r=-0,02; p=0,94) dengan aktivitas katalase. Kesimpulan: Pada penderita kanker leher rahim stadium lokal lanjut terjadi stres oksidatif yang ditandai dengan kadar MDA serum yang tinggi dan aktivitas katalase serum yang rendah dan terjadi peningkatan indeks apoptosis. Terdapat korelasi positif sedang yang bermakna antara indeks apoptosis dengan kadar MDA dan korelasi negatif lemah yang tidak bermakna dengan aktivitas katalase.

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Introduction: Oxidative stress always occurs in cancer patient, which characterized with high level of Malondialdehyde (MDA) and low activity of catalase enzymatic antioxidant. Cancer occurs due to imbalance between cell proliferation and cell death due to apoptosis. The purpose of this study to determine the correlation between apoptosis with MDA level and catalase enzymatic antioxidant activity in patients with locally advanced cervical cancer.

Methods: This is a cross sectional study to 16 locally advanced cervical cancer patients who meet the inclusion criteria from July to August 2013. Blood sampling was done before patients began radiation. MDA level and catalase activity was measured by spectrophotometry. Apoptotic index was conducted by TUNEL method.

Results: The mean of apoptotic index is 11,1 ± 0,59 cell, the mean of serum MDA levels is 7.97 ± 0.26 2 nmol /mL, and the mean of serum catalase activity is 0.98 ± 0.04 U /mL. There was a significant moderate positive correlation (r = +0.51, p = 0.043) between the apoptotic index with serum MDA levels and a non-significant weak negative correlation (r = -0.02, p = 0.94) between the apoptotic index with serum catalase activity.

Conclusion: This study showed that oxidative stress occurs in patients with locally advanced cervical cancer, which characterized with high level of serum MDA and low activity of serum catalase. There is an increase in apoptotic index in patients with locally advanced cervical cancer. There was a significant moderate positive correlation between apoptotic index with MDA levels and a non-significant weak negative correlation with catalase activity."

"Pendahuluan: Prevalensi neuropati sensorik HIV (NS-HIV) di RS Cipto Mangunkusumo (RSCM) pada tahun 2006 adalah 33%, saat seluruh pasien mendapatkan terapi antiretroviral (ARV) stavudine. Walaupun stavudine tidak digunakan lagi, pasien masih mengeluhkan gejala NS-HIV. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor yang berhubungan dengan NS-HIV dan nyeri neuropatik; kadar kemokin CCL5 plasma dan antibodi IgG CMV pada NS-HIV dan nyeri neuropatik. Tujuan lain adalah untuk mengetahui dan gambaran intra-epidermal nerve fiber density (IENFD) dan makrofag CD14+ perineural pada NS-HIV. Metode: Penelitian potong lintang yang dilakukan di RSCM pada tahun 2015-2017. Didapatkan 197 pasien HIV dalam terapi ARV tanpa stavudin >12 bulan. NS-HIV ditegakkan berdasarkan The AIDS Clinical Trial Group Brief Peripheral Neuropathy Screening Tool (ACTG-BPNST/BPNST), sedangkan nyeri neuropatik dinilai menggunakan kuesioner Douleur Neuropathique 4 (DN4). Dilakukan pengambilan darah untuk mengukur hitung sel T CD4+, viral load, CCL5, antibodi IgG CMV. Dilakukan pemeriksaan nerve conduction study (NCS) dan Stimulated SkIin Wrinkle (SSW) test. Biopsi kulit dilakukan pada 9 pasien NS-HIV dan 5 pasien tanpa NS (NS-) untuk menilai intra-epidermal nerve fiber density (IENFD) dan makrofag CD14+ perineural dan dibandingkan kontrol sehat.Hasil: Prevalensi NS-HIV adalah 14,2% sedangkan prevalensi nyeri neuropatik 6,6%. Faktor yang berhubungan dengan NS-HIV adalah viral load >500 kopi/ml dan meningkatnya usia. Faktor yang berhubungan dengan nyeri neuropatik adalah penggunaan ARV Protease Inhibitor (PI) dan durasi ARV< 2 tahun. Kadar CCL5 plasma dan antibody IgG CMV tidak berhubungan terhadap NS-HIV dan nyeri neuropatik. Median IENFD pada pasien NS-HIV lebih rendah dibandingkan pasien HIV tanpa neuropati (3 vs 5,8 /mm2); median IENFD pasien HIV dengan dan tanpa neuropati sensorik lebih rendah dibandingkan kontrol sehat (11,2/mm2). Empat dari lima pasien NS-HIV dengan INEFD rendah mempunyai hitung CD4+ nadir yang rendah. Makrofag CD14+ dapat diidentifikasi perineural pada pasien NS-HIV dan pasien HIV tanpa neuropati sensorik. Kesimpulan: Prevalensi NS-HIV menurun jauh saat stavudin tidak lagi digunakan. Prevalensi nyeri neuropatik lebih rendah dari prevalensi NS-HIV. Meningkatnya usia dan terdeteksinya viral load berhubungan dengan NS-HIV; PI dan durasi penggunaan ARV yang lebih pendek berhubungan dengan nyeri neuropatik. IENFD pasien HIV lebih rendah dibandingkan kontrol sehat. Pasien NS-HIV dengan IENFD rendah memiliki hitung CD4+ nadir yang rendah. Makrofag CD14+ perineural di epidermis dapat diidentifikasi pada pasien HIV dengan dan tanpa neuropati sensorik.

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Introduction: Prevalence of HIV associated sensory neuropathy (HIV-SN) in Cipto Mangunkusumo Hospital (CMH) was 33% in 2006 where all patients used stavudine. Despite stavudine use has been reduced; some patients still complain the symptom of HIV-SN. This study aimed to explore the prevalence and associated factors of HIV-SN and neuropathic pain; to know plasma CCL5 chemokine level and CMV IgG antibody in HIV-SN and neuropathic pain; to study the pattern of intra-epidermal nerve fiber density (IENFD) and perineural CD14+ macrophage in HIV-SN. Method: It was a cross sectional study carried out at CMH from 2015 until 2017. We tested 197 HIV patients who had antiretroviral treatment (ART) without stavudine for >12 months. The AIDS Clinical Trial Group Brief Peripheral Neuropathy Screening Tool (ACTG-BPNST/BPNST) and Douleur Neuropathique 4 (DN4) questionnaire were used to assess HIV-SN and neuropathic pain respectively. Nerve conduction study (NCS) and Stimulated Skin Wrinkle (SSW) test were performed. The current CD4+ T-cell counts, viral load, CCL5 and IgG CMV antibidoy were measured. Skin biopsy was performed in 5 HIV-SN and 9 HIV-NoSN to assess IENFD and CD14+ macrophage compare to healthy control subjects.Result: The prevalence of HIV-SN was 14.2% and neuropathic pain was 6.6%. Viral load >500 copies HIV-RNA/ml and increasing age were associated with HIV-SN, while protease inhibitor (PI) and ART duration<2 years were associated with neuropathic pain. CCL5 plasma level and CMV IgG antibody were not associated with HIV-SN and neuropathic pain. IENFDs in HIV-SN were lower than HIV-NoSN (3 vs 5.8/mm2, respectively); IENFDs in HIV patients generally were lower than healthy control (11.2/mm2). Four of 5 HIV-SN patients with low IENFD had low nadir CD4+ T-cell count. CD14+ macrophage can be identified around the nerves of both HIV-SN and HIV-NoSN patients. Conclusion: Prevalence of HIV-SN in the era without stavudine is lower. Prevalence of neuropathic pain is lower than prevalence of HIV-SN. Increasing age and detectable viral load are associated with HIV-SN; PI and shorter duration of ART are associated with neuropathic pain. IENFDs in HIV patients are lower than healthy control. HIV-SN patients with low IENFD tend to have low nadir CD4+ T-cell count. CD14+ macrophage is present in both HIV patients with and without sensory neuropathy."

"Latar Belakang. Meningioma orbita merupakan tumor jinak saraf optik tersering setelah glioma. Walaupun termasuk dalam kelompok tumor jinak, meningioma memiliki perilaku progresif. Sebagian besar pasien datang dalam keadaan lanjut sehingga harus ditangani dengan operasi radikal. Oleh karena tanda dan gejala klinis yang tidak khas serta variabel penilaian histopatologis masih bersifat kualitatif sehingga tidak objektif, maka untuk memprediksi progresivitas, diperlukan faktor prediktor lain di tingkat molekular. Tujuan. Menilai ekspresi Ki-67, Bcl-2, MDM-2, RP, E-kaderin, MMP-2, TIMP-2, dan polimorfisme gen mdm-2 SNP-309 sebagai prediktor progresivitas meningioma orbita. Metode. Sebanyak 27 kasus meningioma orbita di Departemen Ilmu Kesehatan Mata, FKUI-RSCM mulai Juni 2010 sampai dengan Desember 2011, yang blok parafinnya tersedia dan telah dikonfirmasi diagnosisnya secara histopatologis, dikumpulkan data medisnya. Kemudian dilakukan pemeriksaan IHK Ki-67, Bcl-2, MDM-2, RP, E-kaderin, MMP-2, TIMP-2. Pemeriksaan gen mdm-2 SNP-309 dilakukan dengan teknik sekuensing DNA. Data yang terkumpul diolah secara statistik. Hasil. Ekspresi MDM-2 sejalan dengan progresivitas meningioma orbita (p < 0,05) IK95 % (1,31;125,71). Ekspresi TIMP-2 memiliki efek protektif terhadap meningioma orbita (p < 0,10) IK95 % (0,01;1,26). Pemeriksaan polimorfisme gen mdm-2 SNP-309 dengan sampel terbatas menunjukkan 9 heterozigot (t/g) dan 2 homozigot (t/t), tetapi tidak bermakna secara statistik. Peningkatan ekspresi biomarker Ki-67, Bcl-2, MMP-2, tidak berhubungan dengan progresivitas meningioma orbita dan penurunan ekspresi E-kaderin dan RP tidak berhubungan dengan progresivitas meningioma orbita. Simpulan. Dari semua faktor prediktor yang telah diperiksa pada penelitian ini, MDM-2 dan TIMP-2 lebih berperan memprediksi progresivitas meningioma orbita dibandingkan dengan pemeriksaan IHK lain dan pemeriksaan polimorfisme gen mdm-2 SNP-309. Pemeriksaan IHK lain dan polimorfisme SNP-309 tidak dapat digunakan sebagai prediktor progresivitas meningioma orbita. Penelitian ini menemukan satu model skoring probabilitas progresivitas meningioma orbita yang dapat digunakan dalam manajemen pasien pascaoperasi meningioma orbita.

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Background. Orbital meningioma is the second most common benign optical nerve tumor. Even though it is considered to be benign, it has progressive characteristics. Most patients were admitted at advance stage so they must be treated with radical surgery. Because clinical signs and symptoms are not specific, and histopathological variables are not objective to determine progressivity, another predicting factors at molecular level are needed.

Aim. To determine expression of Ki-67, Bcl-2, MDM-2, PR, E-cadherin, MMP- 2, TIMP-2, and to identify mdm-2 gene SNP-309 polymorphism, as factors to predict progressivity of orbital meningioma.

Methods.Twenty seven orbital meningioma cases with available paraffine blocks were collected between June 2010 and December 2011. Afterwards, Immuno- histochemistry (IHC) examinations of Ki-67, Bcl-2, MDM-2, PR, E-cadherin, MMP-2, TIMP-2 were performed. The outcome was subsequently processed with statistical program to determine a scoring model. DNA sequencing technique was used to identify polymorphism of mdm-2 gene SNP-309. Data were analyzed using univariate, bivariate, and multivariate statistical analysis.

Result. MDM-2 expression is associated with orbital meningioma progressivity ( p < 0.05) CI95 % (1.31;125.71). TIMP-2 expression has a protective effect against orbital meningioma (p < 0.10) CI 95 % (0.01;1.26). Nine out of eleven cases of orbital meningioma are positive for mdm-2 gene SNP-309 polymorphism with 9 heterozygote (t/g) and 2 homozygote (t/t), the difference, however is not statistically significant. Increase on Ki-67, Bcl-2, MMP-2, expressions and decrease on E-cadherin and RP are not correlated with orbital meningioma progressivity (p < 0.05).

Conclusion. Compared with other prediciting factors that have been investigated in this research, MDM-2 and TIMP-2 have larger role in predicting orbital meningioma progressivity. With limited number of samples, we found no association between polymorphism of mdm-2 gene SNP-309 and progressivity of orbital meningioma. One scoring model to predict orbital meningioma?s progressivity is proposed, this model is recommended in the management of orbital meningioma."

"Strktur uretra adalah kelainan berupa penyempitan lumen uretra akibat terbentuknya jaringan parut (scar) yang melibatkan epitel dan jaringan erektil korpus spongiosum. Proses patofisiologi terjadinya kelainan ini belum sepenuhnya diketahui. Di antara berbagai faktor yang terlibat, diferensiasi miofibroblas merupakan salah satu faktor kunci.Tujuan penelitian ini adalah untuk mengetahui diferensiasi miofibroblas pada proses terjadinya striktur uretra di tingkat selular dan melihat hubungan antara growth factor dan komposisi kolagen dengan diferensiasi miofibroblas.Penelitian ini adalah studi eksperimental pada kelinci New Zealand jantan dewasa yang dibagi menjadi dua kelompok, yaitu kelompok model penyembuhan uretra normal dan model striktur uretra.Dua kelinci pada masing-masing kelompok dilakukan eutanasia pada hari ke-2, 7, 14, 21, 30, 60, dan 90. Dilakukan pemeriksaan adanya sumbatan uretra dengan sondase bougie 8 F, pemeriksaan CRP serum darah, pemeriksaan hematoksilin-eosin, trichrome Masson, picrosirius red, TUNEL, dan RT PCR untuk melihat ekspresi gen α-SMA, TGF β, dan b-FGF. Dari hasil penelitian dijumpai adanya perbedaan dalam apoptosis miofibroblas, komposisi kolagen I/total, kadar TGF β dan b-FGF antara kedua kelompok. Terdapat korelasi positif sedang antara apoptosis miofibroblas dengan ekspresi gen TGF β dan korelasi positif lemah antara apoptosis miofibroblas dan komposisi kolagen tipe I/ kolagen total.

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Urethral stricture is a narrowing urethral lumen due to scar formation involving epithel and corpus spongiosum erectile tissue. Pathophysiology process of this abnormality is not fully understood. Among various factors involved, myofibroblast differentiation is a key factor. The purpose of this study is to investigate the process of myofibroblast differentiation on urethral stricture formation process at cellular level and observe the correlation between growth factors and collagen composition with myofibroblast.

The study was an experimental study in adult male New Zealand rabbits, divided into two groups, namely the normal urethral healing model and urethral stricture model. Euthanasia was performed in two rabbits of each group on days 2, 7, 14, 30, 60, and 90. Urethral stricture was confirmed by bougie. Several laboratory examination were done, including CRP blood serum, haematoxylin eosin, trichrome Masson, picrosirius red, TUNEL and RT PCR to look at gene expression of α- SMA, TGF β, b-FGF, dan EGF. The study found a difference in apoptosis myofibroblast, composition of collagen type I/total, TGF β and b-FGF levels between the two groups. There was also a positive moderate correlation between TGF β gene expression and myofibroblast apoptosis proportion and a positive weak correlation collagen type I/ total composition and myofibroblast apoptosis proportion."

"ABSTRAKLatar belakang. Prosedur stimulasi ovarium terkendali pada program FIV berdampak buruk terhadap reseptivitas endometrium. Efek buruk tersebut terjadi karena perubahan kadar hormon yang tidak fisiologis. Laporan penelitian menunjukkan bahwa keberhasilan hamil pada program FIV hanya sekitar 30%.Tujuan penelitian. Menilai dampak pemberian stimulator ovarium terhadap ekspresi petanda reseptivitas endometrium periode implantasi.Metodologi penelitian. Sebanyak 16 ekor Macaca nemestrina dibagi menjadi 4 kelompok: 1 kelompok kontrol dan 3 kelompok perlakuan, berupa pemberian stimulator ovarium dosis 30-70 IU selama 10-12 hari sampai diperoleh puncak sekresi estradiol pada fase folikuler akhir dan dilanjutkan dengan pemberian hCG dosis 3200 IU. Nekropsi jaringan uterus dilakukan hari ke 8-9 setelah puncak sekresi estradiol. Parameter yang dinilai adalah kadar hormon estradiol, progesteron dan ekspresi protein HOXA10, integrin αvβ3 pinopod endometrium dan hubungan hormon steroid dengan ekspresi petanda reseptivitas endometrium.Hasil dan pembahasan. Berdasarkan uji Anova, variasi dosis stimulator ovarium antara 30-70 IU tidak menunjukkan perbedaan bermakna kadar estradiol, progesteron serta ekspresi protein HOXA10 dan integrin αvβ3 antara kelompok kontrol dengan perlakuan (p > 0,05). Berdasarkan Uji korelasi Pearson terdapat hubungan bermakna antara kadar progesteron dengan ekspresi protein HOXA10 dan integrin αvβ3 terutama pada daerah fungsional endometrium ( p < 0,05), sedangkan dengan hormon estradiol tidak terdapat perbedaan yang bermakna (P>0.05). Perkembangan pinopod yang menunjukkan periode jendela implantasi (tahap perkembangan maksimal) diperoleh pada rasio progesteron/estrogen antara 0,20 ? 0,49 dan periode regresi yaitu pada rasio 0,26 ? 7,34.Kesimpulan.Variasi dosis stimulator ovarium 30-70 IU tidak mempengaruhi sekresi hormon estrogen, progesteron dan ekspresi petanda reseptivitas endometrium. Berdasarkan uji regresi Pearson terdapat hubungan bermakna antara hormon progesteron fase folikuler akhir dan fase luteal dengan ekspresi petanda reseptivitas endometrium. Lonjakan estradiol fase folikuler akhir tidak berpengaruh terhadap ekspresi petanda reseptivitas endometrium. Rasio progesteron/estradiol antara 0,20-0,49 menunjukan periode jendela implantasi, sedangkan rasio 0,26 ? 7,34 menunjukkan bahwa perkembangan pinopod mengalami regresi.

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ABSTRACT

Background.Controlled ovarian stimulation procedure on FIV program adversely affect endometrial receptivity. The adverse effects occur due to non physiological changes in hormone levels. Research reports showed that pregnant success rate of FIV program were only around 30%.

Research objective.To assess the impact of ovarian stimulator on the expression of endometrial receptivity markers of implantation period.

Research methodology.Total of 16 Macaca nemestrinawere divided into four groups, one control group and three treatment groups, ie giving a dose of 30-70 IU ovarian stimulator for 10-12 days to obtain peak estradiol secretion at the end of follicular phase and continued with a dose of 3200 IU of hCG administration. Uterine tissue necropsy was performed 8-9 days after the peak secretion of estradiol. The parameters assessed were levels of the hormones estradiol, progsterone and expression of proteins HOXA10, integrin αvβ3 pinopod endometrium and steroid hormone relationship with the expression of markers of endometrial receptivity.

Results and discussion. Based on analysis of variance (anova), ovarian stimulator dose variation between 30-70 IU showed no significant difference levels of estradiol, progesterone and protein expression of integrin αvβ3 HOXA10 and the control group with treatment (p> 0.05). Based on Pearson correlation test there is a significant correlation between the levels of progesterone with HOXA10 protein expression and integrin αvβ3 especially in the area of functional endometrium (p <0.05), whereas the hormone estradiol no significant difference (P> 0.05). Pinopod development which indicates implantation window period (maximum developmental stage) was obtained in the ratio of progesterone/estrogen between .20 to 0.49 and regression period is the ratio of 0.26 to 7.34.

Conclusion. Variations ovarian stimulator dose of 30-70 IU did not affect the secretion of the hormone estrogen, progesterone and endometrial receptivity marker expression. Based on Pearson regression test there was a significant relationship between the hormone progesterone late follicular phase and the luteal phase endometrial receptivity marker expression. While the surge in late follicular phase estradiol had no effect on the expression of markers of endometrial receptivity. Progesterone/estadiol ratio between 0.20 to 0.49 indicates implantation window period, while the ratio of 0.26 to 7.34 indicates that the development pinopod regresses."

"Latar belakang. Latihan fisik yang dijalankan secara teratur dengan intensitas dan durasi tertentu akan merangsang remodeling jantung sebagai usaha untuk mempertahankan fungsi ventrikel terhadap peningkatan beban biomekanik pada jantung. Diperkirakan bahwa latihan fisik jangka panjang menimbulkan remodeling jantung menyerupai hipertrofi kardiomiopati, berupa hipertrofi miosit dengan kekacauan tatanan miosit, fibrosis, apoptosis dan ko-lokalisasi gap junction. Tujuan penelitian. Mengetahui dampak latihan fisik jangka panjang dan henti-latih pada remodeling kardiomiosit. Metode penelitian. Penelitian eksperimental in vivo pada tikus Wistar ini dilakukan di Departemen Biokimia dan Biologi Molekuler, Laboratorium Imunohistologi Departemen Patologi Anatomi dan Bagian Fisiologi, FKUI. Latihan fisik dengan intensitas dan jangka waktu latihan yang berbeda, serta henti latih setelah periode latihan diterapkan pada tikus Wistar jantan dewasa muda. Dilakukan analisis terhadap perubahan morfologi kardiomiosit, fibrosis, apoptosis (ekspresi Caspase-3, Bax dan Bcl-2), gap junction (ekspresi Connexin43) dan pola EKG. Perubahan morfologi kardiomiosit diamati menggunakan pulasan Hematoxylin Eosin, fibrosis diamati menggunakan pulasan Masson?s Trichrome, sedangkan ekspresi Caspase-3, Bax, Bcl-2 dan Connexin43 diamati melalui pulasan imunohistokimia. Rekaman EKG dilakukan dengan filter 100 Hz, pada kecepatan kertas 50 mm/detik dan kepekaan 1 mV = 20 mm. Hasil dan pembahasan. Hasil penelitian ini menunjukkan bahwa latihan aerobik dan anaerobik menimbulkan hipertrofi eksentrik dengan peningkatan fibrosis dan apoptosis serta ko-lokalisasi gap junction ke arah lateral membran. Perubahan kardiomiosit, peningkatan fibrosis dan apoptosis lebih nyata pada latihan anaerobik dibandingkan latihan aerobik. Pola EKG menunjang adanya pembesaran ventrikel akibat latihan aerobik dan anaerobik disertai gangguan repolarisasi yang nyata terutama pada latihan anaerobik. Henti latih tidak mengembalikan morfologi miosit, apoptosis dan lokalisasi gap junction ke keadaan semula. Pola EKG setelah periode henti latih pada latihan aerobik tetap menunjukkan adanya hipertrofi ventrikel tanpa gangguan penghataran impuls yang berarti, namun pada latihan anaerobik tetap didapatkan gangguan repolarisasi berupa pemanjangan interval QTc yang bermakna. Kesimpulan. Remodeling kardiomiosit akibat latihan fisik jangka panjang tidak menyerupai struktur hipertrofi kardiomiopati, namun disertai peningkatan apoptosis, kolokalisasi Cx43 dan gangguan penghantaran impuls. Henti-latih tidak memulihkan remodeling jantung maupun gangguan penghantaran impuls listrik.

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Background. Regular physical exercise with certain intensity and duration stimulates remodeling of the heart as an effort to preserve ventricular function against an increased biomechanical load. It is postulated that long-term exercise induces cardiac remodeling that resemble cardiomyopathy hypertrophy marked by cardiomyocyte disarray, fibrosis, apoptosis and co-localization of gap junction. Research objective. To study the effect of long-term physical exercise and detraining on cardiomyocyte remodeling.

Methodology. This in vivo experimental study was conducted at the Departement of Biochemistry and Molecular Biology, Immunohistology Laboratory of Departement of Pathological Anatomy and Departement of Physiology FMUI. Physical exercise with different intensity and periods of training was performed in groups of young adult male Wistar rats, followed by a period of detraining. Analysis of cardiomyocyte morphological changes, fibrosis, apoptosis (expression of Caspase-3, Bax and Bcl-2), gap junctions (expression Connexin43) and ECG pattern was conducted. Changes in cardiomyocyte morphology was observed using Haematoxylin Eosin staining, fibrosis was observed using Masson's Trichrome staining, whereas the expression of Caspase-3, Bax, Bcl-2 and Connexin43 was observed through immunohistochemical staining. ECG recording was done with a filter of 100 Hz, the paper speed of 50 mm/sec and the sensitivity of 1 mV = 20 mm.

Results and discussion. The results showed that aerobic and anaerobic exercises cause the development of eccentric hypertrophy, with increased fibrosis and apoptosis as well as co-localization of gap junction to the lateral site of the membrane. Cardiomyocyte remodeling, fibrosis and apoptosis were more prominent in anaerobic compared to aerobic exercise group. The ECG pattern supports enlargement of the ventricles due to aerobic and anaerobic exercises with noticeable repolarization disturbances, especially in the anaerobic group. Detraining did not return myocyte morphology, apoptosis and localization of gap junctions to its basic state. The ECG pattern after a period of detraining following aerobic exercise supports the existence of ventricular hypertrophy without significant disturbances in impulse conduction, however repolarization disturbances in the form of significant prolongation of QTc interval persist in the group with anaerobic exercise.

Conclusion. Cardiomyocyte remodeling due to long-term physical exercise did not resemble cardiomyopathy hypertrophy structure, although increased apoptosis, colocalization of Cx43 and distrbances in impuls conduction were observed. Detraining did not restore cardiac remodeling and disturbances in electrical impulse conduction."

"Sindrom Ovarium Polikistik (SOPK) saat ini merupakan salah satu kelainan dengan keberhasilan kehamilan terendah di antara berbagai penyebab infertilitas. Penelitian ini bertujuan untuk menilai ultrasonografi (USG) sebagai prediktor diagnosis reseptivitas endometrium perempuan infertil Sindrom Ovarium Polikistik. Penelitian ini merupakan studi diagnostik observasional dengan disain potong lintang. Tiga puluh empat perempuan usia reproduksi (32,5 ± 3,8 tahun), mengalami infertilitas primer 4,9 ± 3,1 tahun dengan siklus anovulasi mendapat klomifen sitrat 100 mg perhari H2?6; perkembangan folikel dan ovulasi dikonfirmasi dengan pemeriksaan ultrasonografi (USG) H12?17. Pemeriksaan USG yang diikuti biopsi endometrium dan hormon progesteron dilakukan pada H19?21 atau pasca ovulasi H+5?+7. USG digunakan untuk menilai Zona Vaskularisasi menurut kriteria Sonai, Volume Endometrium menurut kriteria Zollner, dan Indeks Vaskularisasi-Arus Darah menurut kriteria Wu. Biopsi endometrium dinilai berdasarkan penanggalan histopatologis menurut kriteria Noyes, dan pemeriksaan imunohistokimia VEGF dan VEGFR-1 dengan penilaian secara H-Score. Kadar VEGF serum diperiksa dengan metode Elisa. Analisis statistik menggunakan uji chi-square, uji-t dan nilai ROC. Dihasilkan titik potong komposit endometrium sebagai baku emas reseptivitas endometrium berdasarkan pemeriksaan penanggalan histopatologis endometrium. Pemeriksaan USG berdasarkan pemeriksaan komposit endometrium ini akhirnya menghasilkan baku emas USG penetapan reseptivitas endometrium. Pemeriksaan USG H19?21 menunjukkan rerata tebal endometrium 10,47 ± 1,85 mm, Volume Endometrium 3,70 ± 1,31 ml, Indeks Vaskularisasi?Arus Darah Indeks Vaskularisasi?Arus Darah 0,08 (0,00-3,21) dan Zona Vaskularisasi di lapis 1,2,3 dan 4 masing-masing 14,7%, 41,2%, 35,3% dan 8,8%. Pemeriksaan histopatologis endometrium mendapatkan 58,8% in-phase dan 41,2% out-phase. Pemeriksaan VEGF endometrium mendapatkan ekspresi tertinggi di endotel (2,34 ± 0,26), kemudian di epitel luminal (2,23 ± 0,37), sel stroma (2,1±1,9), terendah di epitel kelenjar (2,00 ± 0,68). VEGFR-1 endometrium tertinggi di epitel kelenjar (2,85 ± 0,30), diikuti di epitel luminal (2,83 ± 0,54), endotel (2,70 ± 0,42) dan terendah di sel stroma (2,58 ± 0,42). Secara statistik, ditemukan hubungan bermakna antara Zona Vaskularisasi dengan VEGF sel stroma (p = 0,018), Volume Endometrium dengan VEGF endotel (p = 0,000), epitel luminal (p = 0,029) dan total sel (0,043) serta Penanggalan Histologis Endometrium dengan VEGFR-1 sel stroma (p = 0,009). Penetapan reseptivitas endometrium hasil penilaian Komposit USG berdasarkan baku emas komposit endometrium adalah ditemukannya Zona Vaskularisasi lapis 3?4, Volume Endometrium ≥ 3,090 ml dan Indeks Vaskularisasi-Arus Darah ≥ 0,253 yang menunjukkan spesifisitas 77,4%. Ultrasonografi dapat digunakan sebagai prediktor diagnosis reseptivitas endometrium masa jendela implantasi embrio perempuan infertil SOPK.

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Polycyctic ovary syndrome has been recognized as one of the lowest successful pregnancy rates in infertile women. This studi aimed to assess ultrasound as predictor of endometrial receptivity in PCOS infertile women.

Diagnostic observational study in cross sectional design was conducted. Thirty-four subjects suffered anovulatory cycles in a average 32,5 ± 3,8 years of age and primary infertility for 4,9 ± 3,1 years, receiving 100 mg/d clomiphene citrate therapy on D2?6 . Follicular development and ovulation were confirmed by tranasvaginal USG examination on D12?17 . Repeated USG procedures followed by endometrial biopsy and serum progesterone test were conducted on either D 19?21 or D+5?+7 post ovulatory. The use of USG was to assess Vascularization Zone by Sonai criteria, Endometrial Volume by Zollner criteria and Vascularization Flow Index (VFI) by Wu criteria. Endometrial biopsy was performed and dated, based on endometrial histological dating by Noyes citeria. Immunohistochemistry of VEGF and VEGFR-1 were done and counted by H-Score formula. VEGF serum was tested by Elisa method. Statistical analysis of Chi-squre test, student t-test and ROC value were used. Immunohistochemistry composite formation was based on histological dating of endometrium. Ultrasound composite based on immunohistochemistry composite was finally resulting the new cut-off of endometrial reseptivity. Ultrasound findings on D19?21 showed the average endometrial thickness 10,47± 1,85 mm, Endometrium Volume 3,70 ± 1,31 ml, Vascularization?Flow Index (VFI) 0,08 (0,00?3,21 ) and Vascularization Zone (ZV) of zone 1,2,3 and 4 were 14,7%, 41,2%, 35,3% and 8,8%. Endometrial dating was 58,8% in-phase and 41,2% out-phase. Endometrial VEGF staining showed the highest expression in endothel (2,34 ± 0,26), followed by luminal epithelium (2,23 ± 0,37), stromal cells (2,1 ± 1,9) and the lowest in glandular epithelial (2,00 ± 0,68); meanwhile the highest VEGFR-1 expression was seen in glandular epithelial (2,85 ± 0,30), followed by luminal epithelial (2,83 ± 0,54), endothelial (2,70 ± 0,42) and the lowest at the stromal cells (2,58 ± 0,42). Statistically, ZV was correlated to the VEGF stromal cells (p = 0,018) and Endometrial Volume was correlated to VEGF endothelial (p = 0,000) and VEGF luminal epithelium (p = 0,029) and VEGF total cells (p = 0,043); meanwhile Histological Dating of Endometrium was correlated to VEGFR-1 stromal cells (p = 0,009). Endometrial receptivity predictor determined by Ultrasound Composite based on immunohistochemistry composite was Vascularization Zone of layer 3?4, Endometrial Volume of ≥ 3,090 ml and endometrial VFI of 0,253 with a specificity of 77,4%. Ultrasound was the useful tools for diagnostic predictor of endometrial receptivity diagnosis during the implantation windows period of PCOS infertile female."