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"Colorectal polyp is one important factors that have roles in developing malignancy of lower gastrointestinal tract. Adenomatous polyp is the most common colorectal polyps and it has been known as a lesion precusor for transformation process in developing gastrointestinal malignancy...."

"We report three rare cases of mucosal-associated lymphoid tissue (MALT) lymphoma. Two cases are of gastric MALT lymphoma and one is a case of transverse colon MALT lymphoma. The two cases of gastric MALT lymphoma were diagnosed by endoscopy which demonstrated an ulcer in the cardia and another in the corpus. The first case is in a 62-year-old male. The patients medical history revealed upper GI tract bleeding with melaena in 1993. At the time no diagnosis was made on endoscopy In August 2000, melaena recurred and endoscopy showed an ulcer in the cardio. Histology showed high-grade gastric MALT lymphoma. Based on Ann Arbor classification, the patient was classified as stage IE gastrointestinal lymphoma. H. pylori was negative. The patient received chemotherapy The second case is in a 53-year-old male. He suffered from gastric lymphoma for 3 years. He complained of annually recurring haematemesis before a definitive diagnosis was finally established. He suffered jiom stage IE low-grade well-differentiated lymphocytic MALT lymphoma. H. pylori was negative. Endoscopic procedure after H. pylori eradication showed ulcer regression though histology still showed low-grade MALT lymphoma and H. pylori as positive. The third case is in a 46-year-old male with a complaint of haematochezia. Colonoscopy showed intususception due to tumor in the transverse colon. Histologic examination showed chronic colitis and granulomatosa. lnvagination due to colon tumor was reported. Histologic examination of the biopsy specimen showed low-grade small cell lymphocyte-plasmocytoid lymphoma. "

"This atlas will illustrate the distribution and morphological features of interstitial cells of cajal (ICC) which are the key cells to understanding of the regulatory mechanism of gastrointestinal motility, since ICC act as both pacemaker and as intermediates in neural transmission, and since ICC show specific distribution patterns depending on their anatomical positions. All subtypes of ICC located in the different tissue layers and different levels of the gastrointestinal tract will be revealed by immunohistochemistry for Kit receptors and nerves by using mainly whole-mount stretch preparation of the guinea-pig tissues. Three-dimensional reconstruction of confocal images will particularly help the readers to understand the peculiar arrangement of ICC networks in situ and the correlation between ICC and nerves. Electron micrographs will help illustrate the characteristic features of ICC and their ultrastructural differences from fibroblasts, smooth muscles and other interstitial cells."

"Latar belakang: Infeksi saluran cerna dengan manifestasi klinis berupa diare merupakan penyakit infeksi dengan kesakitan dan kematian yang tinggi terutama di negara-negara yang sedang berkembang. Diare menimbulkan kematian terutama pada bayi baru lahir di bawah 1 tahun. Penanganan telah ditingkatkan secara terus menerus, namun demikian kemajuan dalam diagnosis maupun pengobatan tidak terjangkau oleh negara-negara yang sedang berkembang. Salah satu penyebab infeksi saluran cerna adalah bakteri. Oleh karenanya dengan mengetahui bakteri penyebab serta pola resistensi bakteri terhadap antibiotik dapat menunjang penatalaksanaan penyakit ini. Studi ini dilakukan untuk mengetahui berbagai jenis mikroba yang diisolasi dari saluran cerna serta pola resistensinya terhadap beberapa antibiotik.Metode: Spesimen berupa tinja, usap dubur atau anus yang diterima oleh Laboratorium Mikrobiologi FKUI selama 2005- 2008. Isolasi, identifi kasi kepekaan dan uji antibiotik dikerjakan sesuai prosedur standar yang berlaku. Interpretasi hasil uji kepekaan menggunaan panduan NCCLS/CLSI. Data dianalisis menggunakan WHOnet versi 5.3.Hasil: Diperoleh 28 isolat Escherichia coli patogen, 1 isolat Salmonella paratyphi A, dan 4 isolat ragi yang diisolasi dari tinja dan swab dubur penderita. Walaupun Escherichia coli patogen masih peka terhadap beberapa antibiotik, namun kepekaannya menurun terhadap amoxicillin, sulbenicillin, ticarcillin dan trimethoprim/rulfamethoxazole.Kesimpulan: Escherichia coli patogen merupakan bakteri terbanyak yang berhasil diisolasi dari tinja/usap dubur. Bakteri ini telah menunjukkan penurunan kepekaan terhadap beberapa antibiotik yang sering digunakan untuk mengobati infeksi saluran cerna. (Med J Indones 2011; 20:105-8).

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AbstractBackground: Digestive tract infection with clinical manifestation of diarrhea is an infectious disease that has the highest morbidity and mortality rate, especially in developing countries. Diarrhea causes mortality mostly in infants under one year old. Improvement in management is done continuously, but advances in diagnosis and therapy cannot be reached by developing countries. One of the etiological agents causing infection of digestive tract is bacteria. Therefore, knowledge of bacteria that cause gastrointestinal infection and their resistance patterns may support the management of this disease. The aim of this study was to examine microbes that were isolated from the digestive tract and their resistance patterns against antibiotics.Methods: Samples (stool, rectal/anal swab) were collected from the Clinical Microbiology Laboratory, FKUI during 2005-2008. Isolation, identifi cation and sensitivity test were conducted according to standard laboratory procedures. Interpretation of sensitivity test was done according to NCCLS/CLSI guidance. Data was analyzed using WHOnet version 5.3.Results: We found 28 isolates of pathogenic Escherichia coli, 1 isolate of S. paratyphi A and 4 isolates of yeasts. Pathogenic Escherichia coli were still sensitive against some antibiotics, but the sensitivity was reduced against amoxicillin, sulbenicillin, ticarcillin and trimethoprim/sulfamethoxazole.Conclusion: The most predominant gastrointestinal tract infection causing microbes was pathogenic Escherichia coli. These bacteria showed decrease sensitivity against some antibiotics commonly used to treat patients with gastrointestinal tract infection. (Med J Indones 2011; 20:105-8)"

"Backgrounds: Gastrointestinal bleeding such as hematemesis or melena are common conditions in clinical practice and endoscopic service. The mortality rate due to gastrointestinal bleeding is relatively high. In this study, we evaluate the causes of hematemesis melena for the last 5 years and the factors associated with the bleeding.Methods: The study was done retrospectively. We obtained data from medical record of patients that performed endoscopy of upper gastrointestinal tract in Division of Gastroenterology, Department of Internal medicine, Cipto Mangunkusumo hospital (Jakarta, Indonesia) during the period of 2001 to 2005.Results: Of 4.154 patients who underwent upper gastrointestinal tract endoscopy from 2001 to 2005, we found that 837 patients (20.1%) were due to upper gastrointestinal bleeding. They were 552 male (65.9%) and 285 female patients (34.1%). Mean age of male patients was 52.7 ± 15.82 years, while for female patients was 54.46 ± 17.6 years. Of 837 patients who came due to hematemesis were 150 patients (17.9%), melena were 310 patients (37.8%), both melena and hematemesis were 371 patients (44.3%), 557 cases (66.5 %) due to non varices. Endoscopic results showed that 280 cases (33.4%) were due to esophageal varices. In general, this study had demonstrated that esophageal varices was the most frequent cause of upper gastrointestinal bleeding. We found 229 cases of esophageal varices were coincidence with portal hypertensive gastropathy. While ulcer was found in 225 cases (26.9%) and most of them were gastric ulcer (51.1%). Of gastrointestinal bleeding caused by esophageal varices, most were grade HI in 138 cases (49.3%). The incidence of bleeding of bleeding were found more frequently in patients age group of 40 - 60 years (389 cases; 46.5%), > 60 years (305 cases; 36.2%), < 40 years (242 cases; 16.8%). The causes of bleeding in patients whose age > 60 years, most were caused by ulcer (37.4%). In this study, we also found that cancer as the cause of gastrointestinal bleeding in 26 cases (3.1%). Gastrointestinal cancer comprised of gastric cancer in 15 cases (57.7%), duodenal cancer in 7 cases (26.9%), and esophageal cancer in 4 patients (15.4%).Conclusion: The most frequent cause of upper gastrointestinal bleeding was esophageal varices and usually had reached stage HI. The non variceal cause of bleeding was gastric cancer. Upper gastrointestinal malignancy was also found to be the etiology of bleeding in this study."

"Studi ini bertujuan menilai peranan CT pada cedera saluran aerodigestif bagian atas."

"Studi ini bertujuan menilai peranan CT pada cedera saluran aerodigestif bagian atas. Dua puluh enam pasien dengan cedera saluran aerodigestif atas telah dievaluasi. Enam belas pasien mengalami trauma tumpul pada leher sementara 7 pasien mengalami luka (embus. Sebagian besar pasien datang berobat segera setelah mengalami cedera. Gejala yang timbul meliputi gangguan napas (14), nyeri leher (18), suara serak (7), batuk darah (2) dan kesulitan menelan (3). Cedera jaringan lunak lerdapat pada 8 pasien, udem daerah ariepiglotik pada 4 pasien, hematom ariepiglotik pada 1 pasien, udem pita suara (2)dan obliterasi sinus pirifonnis (5). Cedera daerah supraglotik terjadi pada 6 pasien, cedera glotis (8), dan subglotis (4). Cedera trakea terlihat pada 8 pasien yang terdiri dari pemisahan kriko-trakea (I), robekan trakea (5) dan penyempitan trakea (4). Cedera hipofaring-esofagus terjadi pada 2 pasien. CT bermanfaat memastikan lokasi benda asing yang terjadi pada 2 kasus. CTjuga membantu dalam mengatnbil keputusan pemilihan tata laksana pasien dan menghindari eksplorasi terbuka pada pasien dengan lesi mukosa minimal, fraktur stabil dan robekan tertutup. CT juga lerutama bermanfaat untuk kasus-kasus dimana laringoskopi tidak bisa dilakukan. (Med J Indones 2006; 15:81-9).

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This study was aimed to assess the role of CT in upper aerodigestive tract injuries. Twenty six patients presenting with upper aerodigestive tract injury were examined by CT. Nineteen patients had blunt trauma to the neck while seven had penetrating injury. Most of the patients presented soon after injury. Symptoms included respiratory distress (14), neck tenderness (18), hoarseness (7), haemoptysis (2) and odynophagia (3). Soft tissue injuries were seen in 8 patients, aryepiglottic fold edema in 4, aryepiglottic fold haematoma in 1, vocal cord edema in 2 and pyriform sinus obliteration in 5 patients, Supraglottic injuries were seen in six patients, glottic injury in 8 patients and subglottic injuries in 4 patients. Tracheal injuries were seen in 8 patients and included cricotracheal separation (1), tracheal tears (5) and trachea! narrowing (4). Hypopharyngoesophageal injuries were seen in 2 patients. CT was helpful for localization of foreign bodies in 2 cases. CT is useful in deciding management of patients with upper aerodigestive tract injuries obviating the need of open exploration in patients with minimal mucosal injuries, undisplaced fracture and sealed tears. It is particularly helpful in cases when indirect laryngoscopy was not possible. (Med J Indones 2006; 15:81-9)."

"The pathogenesis of inflammatory bowel disease (IBD) is not yet fully understood A genetic predisposition, some environmental factors and microbial flora of the grit are the key factors. The presence of bacteria in the intestinal lumen is a prerequisite for the development of IBD. In animal models, mice incapable of expressing IL, or IL invariably develop a colitis- or Crohn-like inflammation. No inflammation occurs if they grow up in a pathogen free environment or if they are fed with Lactobacillus sp when exposed to environmental bacteria. Thus, the absence of liminal bacteria or a different make-up there of prevents the development of inflammatory bowel disease in this model. Patients with IBD have been found to have a decreased stool excretion Lactobacillus andlor Bifidobacteria. Furthermore, an increased number of bacteria adherents to the mucosa and within the epithelium has been demonstrated in quantitative studies. It appears that these bacteria trigger a strong abnormal mucosal immunological response, leading to intestinal epithelial cell injury mediated by activated T-cells, mononuclear cells and macrophages. If this response can not be down regulated by regulatory T-cells, mononuclear inflammatory cytokines are activated by stimulation of the intracellular transcription factor NF-kB. Recently it was shown that bacterial lipopolysaccharides can activate NF-kB by binding to two specific receptors on the cell membrane (Toll-like receptors [TLR's]) or intracellular receptors (NOD's). New insights of the role of bacteria in IBD became available by identifying susceptibility genes for IBD. Several IBD susceptibility loci were recently identified. The IBD-l locus on chromosome 16 shows positive evidence for linkage in Crohn's disease and IBD-2 locus on chromosome l2 for ulcerative colitis. The evidence for' an association with Crohn's disease at the IBD-I locus have been shown to be attributed to mutations in the CARDI5/NOD2 gene. This gene is exressed in peripheral blood monocytes and in intestinal epithelial cells and serves as a key factor of innate mucosal response to luminal bacteria as an antibacterial factor. The intact intercellular NOD2 protein binds LPS and activates NF-kB. This activation of the NF-kB signalling pathway in response to bacterial components plays a protective role in the mucosal epithelial cells for the host against inviting pathogens and an increased apoptosis of infected cells. There is evidence, that the defective NOD2 protein variants increase the susceptibility to pathogen invasion and a decrease in cellular apoptosis. NF-kB plays a dual role in IBD. On the mucosal epithelial cells, bacterial components bind on NOD2 proteins and protect bacterial invasion. If this barrier mechanism is not intact, the bacterial invasion stimulates via TLR- and NOD2 receptors in immune-active cells (macrophages, T-cells and monocytes) NF-kB and triggers an aberrant inflammatory response leading to tissue damage. These new insights in the pathogenesis in IBD have led to new treatment possibilities including pre- and probiotics. These therapies are aimed at directly modulating the host immune system to suppress intestinal inflammation. This has prompted considerable interest in manipulating the enteric microenvironment as a novel therapeutic strategy Several clinical studies showed promising results rising pre- and probiotics in patients with ulcerative colitis, pouchitis and Crohn's disease. The introduction of genetically engineered probiotic organism to produce and deliver anti-inflammatory cytokines or other biological relevant molecules to the mucosa offers further new potential for the treatment of IBD."