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"Bile reflux: gastropathy is a disease caused by reflux of duodenal fluid to the gaster: This fluid contains pancreatic juices and duodenal secretion. The manifestations that occur depend on the frequency amount, and duration of reflux. This disorder is quite rarely recognized in daily clinical practice. Endoscopy of the upper gastrointestinal tract is required to establish the diagnosis of this disorder: This paper will give a brief view ofthe pathogenesis and diagnostic method for this disorder."

"Latar belakang. Studi pH lambung pada pasien sirosis hati masih kontroversi Penelitian ini bertujuan untuk mengetahui adanya perbedaan pH lambung pada pasien sirosis hati dengan gastropati hipertensi portal GHP ringan dan berat. Metode Penelitian. Potong lintang dengan cara konsekutif pada pasien yang datang ke poliklinik gastro enterologi dan hepatologi RSCM pada periode Maret - Mei 2014 sebanyak enam puluh dua pasien sirosis hati dengan GHP dilakukan pemeriksaan endoskopi untuk menilai derajat gastropati sesuai klasifikasi McCormack dan pemeriksa pH lambung dengan menggunakan pH meter. Hasil. Dari 62 subjek didapatkan 50 subjek 80 6 berjenis kelamin laki laki dan perempuan 12 subjek 19 4 GHP paling banyak disebabkan oleh hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 dan alkohol 3 2 Rerata pH lambung pada seluruh pasien sirosis hati dengan GHP adalah 2 13 Rerata pH lambung pada pasien sirosis hati dengan GHP ringan 2 00 lebih rendah dibandingkan kelompok GHP berat 2 25 dengan perbedaan yang bermakna.

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Background. Studies show gastric pH in cirrhosis patient still in controversy Aim of this study to know differences of gastric pH in liver cirrhosis patient withmild and severe portal hypertensive gastropathy

Methods. Cross sectional method with consecutive to all liver cirrhotic patientwho came to gastroenterology and hepatology clinic in Ciptomangunkusumo hospital Sixty two liver cirrhosis patients with portal hypertensive gastropathyunderwent endoscopy to measure degree of gastropathy based on McCormack classification and measured mean basal gastric pH with pH metry.

Result. There are 50 male subject 80 6 and 12 female subject 19 4 participating in this research Portal hypertensive gastropathy mostly caused by hepatitis C 56 5 hepatitis B 32 3 non hepatitis 8 1 and alcohol 3 2 Mean of gastric pH in all liver cirrhosis patient with portal hypertensive gastropathy was 2 13. The mean gastric pH in liver cirrhosis patient with mildportal hypertensive gastropathy 2 00 mEq L lower than the gastric pH in severeportal hypertensive gastropathy 2 25 mEq L with significant differences."

"The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other dialogic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2, and increased nitric oxyde which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis."

"This book is a primer for translational vascular medicine and discusses the evolving and exciting areas of basic science applied to vascular medicine. The book is based on the third vascular biology conference held at The Royal College of Physicians in 2008. It provides a large amount of new basic and clinical information and the contributors are world leaders."

"Diabetic neuropathy is a complication of diabetes mellitus that is often overlooked, since there are often no subjective complaints during initial stages, and sensory deficit is often only found after objective examination.Diabetic neuropathy is defined by the San Antonio Concensus of 1988 as "clinical or subclinical neural disturbance that occurs in diabetes mellitus, with no signs of other peripheral neuropathy. Neuropathy may manifest on the somatic, peripheral, as well as autonomicic nervous systems."The incidence rate of diabetic neuropathy is reported to be 10-90%. Such high variation is due to differences in the diagnostic criteria or method to establish the diagnosis.Reports of peripheral neuropathy from various hospitals in Indonesia are as follows: Cipto Mangunkusumo Hospital / Jakarta (1989) 68.16%, Hasan Sadikin Hospital (1989) 12.2%, Dr. Sutomo Hospital / Surabaya (1990) 52.21%, Dr. Pirngadi Hospital / Medan (1996) 18.05%, Dr. Wahidin Sudirohusodo Hospital / Ujung Pandang (1997) 57.81%. Asril Bahar, Jakarta (1985), reported an incidence rate for parasympathetic autonomicic neuropathy of 11.9%, while Harsinen Sanusi, Ujung Pandang (1989) reported an incidence rate of 66.7%."