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"Udara di tulang temporal mempunyai fungsi yang bervariasi, terutama sebagai cadangan udara telinga tengah. Gangguan fungsi tuba Eusthacius akan menyebabkan udara di tulang temporal berfungsi sehingga tidak terbentuk tekanan negatif yang disebabkan penyerapan udara oleh mukosa telinga tengah. Hal ini mencegah terjadinya perubahan mukosa telinga tengah dan mencegah terjadinya otitis media.Tujuan penelitian ini adalah untuk menilai kesesuaian klasifikasi pneumatisasi mastoid berdasarkan struktur sinus sigmoid terhadap volume akurat sel-sel udara mastoid menggunakan MSCT Scan Spiral di Rumah Sakit Cipto Mangunkusumo berupa 158 mastoid dari 78 pasien (40 laki-laki dan 38 perempuan) dengan rentang umur 18 sampai 60 tahun tanpa kelainan atau malformasi pada gambaran CT Scan.Data sekunder diambil dari raw data yang telah direkonstruksi menggunakan pesawat CT scan Somatom spiral scanner (Siemens Medical Systems) dengan tebal irisan 2,0 mm, Filter Kernel H 70 very sharp, mastoid window (window width 4.000 HU, window level 600 HU), densitas antara ? 1.000HU sampai dengan +70HU di dalam Compact Disc.Klasifikasi pneumatisasi mastoid ditentukan berdasarkan tiga garis paralel dengan kemiringan 45◦ yang diletakkan pada posisi garis melewati bagian paling anterior dari sinus sigmoid pada persimpangannya dengan tulang petrosus, bagian paling lateral di sepanjang bidang transversal sigmoid groove dan paling posterior dari sinus sigmoid.Statistik deskriptif (SPSS 17.0) disajikan berupa analisis volume sel-sel udara mastoid berdasarkan kelompok pneumatisasi menggunakan uji Kruskal Wallis dilanjutkan analisis Post Hoc dengan hasil rerata volume sel-sel udara masingmasing kelompok pneumatisasi berbeda bermakna dengan kelompok lainnya, dengan batas kemaknaan (α) 0,05, dan ROC (Receiver operator curve) menunjukkan bahwa masing-masing kelompok pneumatisasi mempunyai sensitivitas dan spesifisitas tinggi.

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The air in the temporal bone has various functions. In particular, it serves as the air reservoir of the middle ear. When the function of the Eustachian tube deteriorates, the air in the temporal bone acts to prevent negative pressure from developing due to absorption of air by the middle ear mucosa, and thus prevents changes of the middle ear mucosa, as well as progression of otitis media.The aim of this paper is to evaluate The Conformity Classification of Mastoid Pneumatization in Normal Adult based on Sigmoid Sinus with the Mastoid Air Cells Volume using Spiral MSCT Scan in Cipto Mangunkusumo Hospital of One hundred and fifty six mastoids of 78 subjects (40 males and 38 males) ranged in age from 18 years to 60 years without impairment or malformation of temporal bone CT scan were eligible for enrolment in this study.Secondary data drawn from raw data in Compact Disc that has been reconstructed using Somatom spiral scanner (Siemens Medical Systems) with 0,2 cm slice thickness, filter Kernel very sharp and mastoid window (window width 4.000HU and window level 600HU). We used -1.000 to + 70 HU.Classification of mastoid pneumatization is determined based on three parallel lines angled at 45◦ in the anterolateral direction which each line crossed the most anterior point of the sigmoid sinus at the junction with the petrous bone, the most lateral aspect along the transverse plane of the sigmoid groove, and the most posterior point of the sigmoid sinus, respectively.Descriptive statistics (SPSS 17.0) are presented in the form of air cells mastoid volume based on Classification of mastoid pneumatization using Kruskal Wallis test and followed by Post Hoc analysis with the volume of the mastoid air cells of each group differ significantly with other groups, significance limit of 0.05, and ROC (Receiver operator curve) showed that each group has a high sensitivity and specificity."

"Udara di tulang temporal mempunyai fungsi yang bervariasi, terutama sebagai cadangan udara telinga tengah. Gangguan fungsi tuba Eusthacius akan menyebabkan udara di tulang temporal berfungsi sehingga tidak terbentuk tekanan negatif yang disebabkan penyerapan udara oleh mukosa telinga tengah. Hal ini mencegah terjadinya perubahan mukosa telinga tengah dan mencegah terjadinya otitis media.Tujuan penelitian ini adalah untuk menilai kesesuaian klasifikasi pneumatisasi mastoid berdasarkan struktur sinus sigmoid terhadap volume akurat sel-sel udara mastoid menggunakan MSCT Scan Spiral di Rumah Sakit Cipto Mangunkusumo berupa 158 mastoid dari 78 pasien (40 laki-laki dan 38 perempuan) dengan rentang umur 18 sampai 60 tahun tanpa kelainan atau malformasi pada gambaran CT Scan. Data sekunder diambil dari raw data yang telah direkonstruksi menggunakan pesawat CT scan Somatom spiral scanner (Siemens Medical Systems) dengan tebal irisan 2,0 mm, Filter Kernel H 70 very sharp, mastoid window (window width 4.000 HU, window level 600 HU), densitas antara – 1.000HU sampai dengan +70HU di dalam Compact Disc.Klasifikasi pneumatisasi mastoid ditentukan berdasarkan tiga garis paralel dengan kemiringan 45◦ yang diletakkan pada posisi garis melewati bagian paling anterior dari sinus sigmoid pada persimpangannya dengan tulang petrosus, bagian paling lateral di sepanjang bidang transversal sigmoid groove dan paling posterior dari sinus sigmoid.Statistik deskriptif (SPSS 17.0) disajikan berupa analisis volume sel-sel udara mastoid berdasarkan kelompok pneumatisasi menggunakan uji Kruskal Wallis dilanjutkan analisis Post Hoc dengan hasil rerata volume sel-sel udara masingmasing kelompok pneumatisasi berbeda bermakna dengan kelompok lainnya, dengan batas kemaknaan (α) 0,05, dan ROC (Receiver operator curve) menunjukkan bahwa masing-masing kelompok pneumatisasi mempunyai sensitivitas dan spesifisitas tinggi.

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The air in the temporal bone has various functions. In particular, it serves as the air reservoir of the middle ear. When the function of the Eustachian tube deteriorates, the air in the temporal bone acts to prevent negative pressure from developing due to absorption of air by the middle ear mucosa, and thus prevents changes of the middle ear mucosa, as well as progression of otitis media.The aim of this paper is to evaluate The Conformity Classification of Mastoid Pneumatization in Normal Adult based on Sigmoid Sinus with the Mastoid Air Cells Volume using Spiral MSCT Scan in Cipto Mangunkusumo Hospital of One hundred and fifty six mastoids of 78 subjects (40 males and 38 males) ranged in age from 18 years to 60 years without impairment or malformation of temporal bone CT scan were eligible for enrolment in this study.Secondary data drawn from raw data in Compact Disc that has been reconstructed using Somatom spiral scanner (Siemens Medical Systems) with 0,2 cm slice thickness, filter Kernel very sharp and mastoid window (window width 4.000HU and window level 600HU). We used -1.000 to + 70 HU.Classification of mastoid pneumatization is determined based on three parallel lines angled at 45◦ in the anterolateral direction which each line crossed the most anterior point of the sigmoid sinus at the junction with the petrous bone, the most lateral aspect along the transverse plane of the sigmoid groove, and the most posterior point of the sigmoid sinus, respectively.Descriptive statistics (SPSS 17.0) are presented in the form of air cells mastoid volume based on Classification of mastoid pneumatization using Kruskal Wallis test and followed by Post Hoc analysis with the volume of the mastoid air cells of each group differ significantly with other groups, significance limit of 0.05, and ROC (Receiver operator curve) showed that each group has a high sensitivity and specificity."

"Latar Belakang: Identifikasi jenis kelamin merupakan langkah awal yang penting dan akan memengaruhi analisis forensik selanjutnya. Pada kasus tertentu, identifikasi jenis kelamin terbatas pada tulang jenazah. Mastoid merupakan bagian tulang yang potensial, didukung dengan dimorfisme seksual tinggi, keutuhan dan simetrisitasnya. Tinggi mastoid konsisten menunjukkan nilai akurasi diskriminasi jenis kelamin yang cukup tinggi. Kombinasinya dengan parameter osteometrik lainnya meningkatkan akurasi hingga 85%. Di Indonesia, penelitian radiologis mengenai estimasi jenis kelamin berdasarkan parameter mastoid masih terbatas, sehingga diperlukan penelitian awal yang dapat mendukung penelitian pada cakupan yang lebih mendalam. Tujuan: Menilai perbandingan rerata pengukuran parameter osteometrik mastoid antara jenis kelamin, serta menentukan akurasi dan model prediksi estimasi jenis kelamin. Metode: Penelitian ini merupakan penelitian perbandingan potong lintang, menggunakan data sekunder antemortem parameter osteometrik mastoid dari CT scan multiplanar. Tinggi mastoid sejati dan konvensional, diameter oblik dan sagital, serta volume mastoid diukur pada mastoid kanan dan kiri subjek. Jumlah subjek sebanyak masing-masing 105 perempuan dan laki-laki. Analisis komparatif dan penentuan titik potong dengan kurva ROC untuk menentukan akurasi (batas kemaknaan statistik alpha 5%). Model prediksi diperoleh dengan analisis regresi logistik. Hasil: Didapatkan perbedaan bermakna pada seluruh parameter mastoid antara laki-laki dan perempuan (p 0,000). Nilai AUC pada seluruh parameter mastoid berkisar antara 91,1%-96,5% dengan akurasi dalam estimasi jenis kelamin laki-laki berkisar antara 87%-93%. Estimasi jenis kelamin laki-laki menggunakaan kombinasi tinggi mastoid sejati dan konvensional, serta volume mastoid tertinggi dapat mencapai probabilitas sebesar 97%. Kesimpulan: Parameter osteometrik mastoid antara jenis kelamin menunjukkan perbedaan yang signifikan dan akurasi yang tinggi untuk estimasi jenis kelamin.

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Background: Gender identification is an initial and essential step for further forensic analysis. In certain cases, gender identification is often restricted to skeletal remains. Mastoid process is potential skeletal remains for gender estimation, considering its sexual dimorphism, strength, and symmetry. Mastoid height demonstrates consistent high accuracy in gender discrimination. Combinated with other mastoid parameters enhances its accuracy for up to 85%. In Indonesia, radiological research on gender estimation using these parameters is limited, requiring initial study to support deeper research scope. Objective: To compare mastoid osteometric parameter measurements between gender, to assess its accuracy and prediction model for gender estimation. Methods: This study was a cross-sectional comparative study using secondary antemortem measurements of mastoid osteometric parameters from multiplanar CT scan, which included bilateral true and conventional mastoid height, oblique and sagittal diameter, and mastoid volume measurements. Measurement datas from 105 male and female subject were analyzed. Comparative analysis and cut-off point were determined using ROC curve analysis to obtain accuracy. Statistical significance threshold used was alpha 5%. Prediction model was obtained from logistic regression analysis. Results: All mastoid osteometric parameters showed significant differences between gender (p 0,000). AUC value from all parameters ranged from 91,1% to 96,5%, with accuracy for male gender estimastion ranged from 87% to 93%. Combination of true and conventional mastoid height, and mastoid volume offered probability of male estimation for up to 97%. Conclusion: Mastoid osteometric parameters in each gender group demonstrated statistically significant differences and highly accurate for gender estimation."

"Teknik akuisisi scan spiral memperkenalkan istilah Pitch. Pitch yang besar mempengaruhi proses rekonstruksi karena interpolasi data menjadi lebih lebar sehingga dapat menurunkan resolusi citra. Penelitian ini dilakukan dengan menggunakan fantom toraks in house yang dibuat dan didesain berdasarkan pengukuran data citra CT Toraks 100 pasien laki-laki. Parameter eksposi yang digunakan 130 kVp, rotasi tabung 0,6 detik, perubahan arus tabung 70 mAs dan 100 mAs serta variasi pitch mulai dari 0.5, 0.8, 1, 1.5, 1.8 dan 2. Fantom terbagi menjadi 4 bagian. Fantom bagian A untuk evaluasi akurasi posisi dan kualitas citra pada selang berisi media kontras, bagian B untuk evaluasi kualitas citra lubang udara hole , bagian C untuk evaluasi mikrokalsifikasi dengan variasi ukuran mesh pada serbuk tulang dan hidroxyapatite, dan bagian D untuk evaluasi MTF. Scanning fantom A untuk evaluasi akurasi posisi selang antara ukuran di fantom dengan monitor menunjukkan deviasi < 4 berjumlah 408 data 84 di sisi kanan dan 417 data 86 di sisi kiri dari total 486 data. Evalusi kualitas citra pada fantom A, terdapat perbedaan ?SNR pada tiap slice dengan hubungan yang linier terhadap perubahan pitch, semakin besar pitch yang digunakan ?SNR akan semakin lebar. ?SNR paling lebar terdapat pada slice ke-1 dan ke-2, selanjutnya pada slice ke-3 sampai ke-9 ?SNR stabil dan cenderung menurun. Evaluasi fantom B menunjukkan hole titik I dan J yang berdiameter 0.9 mm dan 0.625 mm tidak dapat tervisualisasi pada seluruh slice. SNR yang didapat paling tinggi pada hole tengah titik H dengan diameter 2 mm. Sensitivitas Pesawat CT dapat mendeteksi serbuk tulang ukuran mesh 10 dan 30 tetapi tidak dapat memperlihatkan serbuk tulang ukuran mesh 50 yang tersebar merata di permukaan fantom, ditunjukkan dengan nilai SNR tertinggi pada pitch 0.8 sebesar 2.659 SNR.

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Acquisition technique in spiral scan introduce the term of Pitch. The big pitch could be influence for reconstruction process because interpolation will be wider, be affecting the spatial resolution. This study was performed by using in house thoracic phantom that made and designed based on image data measurement of CT Thorax of 100 men patient. Exposure Parameter which used was 130 kVp, tube rotation 0.6 second, tube current 70 mAs and 100 mAs, with pitch variation start from 0.5, 0.8, 1, 1.5, 1.8 and 2. Phantom was divided into 4 parts. Part A was used for evaluating the accuracy of position and image quality on a pipe that consist of contrast media, part B was used for evaluating image quality on hole, part C was used for evaluating micro calcification with various mesh size on bone material and hidroxyapatite, while part D was used for evaluating MTF. Phantom A scanning was performed for evaluating the accuracy of position between pipe in phantom and monitor showed deviation 4 with 408 number of data 84 on the right side and 417 data 86 on the left side from 486 all data. The result obtained for image evaluation, showed the different between delta SNR in every slice in phantom A with the pitch changing, used higher pitch becoming SNR wider. The widest SNR were occurred in the 1st and 2nd slice, furthermore in the 3rd until 9th slice SNR were stable and tend to decreased. Evaluation of phantom B showed that hole in point I and J which have diameter 0.9 mm and 0.625 mm could not visualized. The highest SNR was occurred in the middle hole point H with diameter 2 mm. The sensitivity of CT scanner is good enough to detect bone with the mesh size of 10 and 30 but not with the mesh size of 50 that spread in the phantom surface, this is shown with the highest SNR in the pitch 0.8 as 2.659 SNR."

"Latar belakang: Identifikasi forensik dengan parameter sinus sfenoidalis dapat berguna pada bencana massal di mana tubuh korban tidak lengkap, namun di Indonesia belum terdapat data parameter sinus sfenoidalis dan hubungannya dengan dismorfisme seksual pada populasi dewasa.Tujuan: Menilai peran parameter sinus sfenoidalis dengan pemeriksaan MSCT untuk penentuan jenis kelamin pada populasi dewasa, dengan membandingkan diameter anteroposterior, laterolateral, kraniokaudal, dan volume sinus sfenoidalis antara laki- laki dan perempuan dewasa lalu menentukan titik potong dan akurasinya dalam menentukan jenis kelamin.Metode: Penelitian ini dilaksanakan dengan desain potong lintang perbandingan. Terdapat 140 subjek penelitian (70 laki-laki dan 70 perempuan) berusia 20–45 tahun yang menjalani MSCT kepala, sinus, nasofaring, dan wajah pada periode April–Juni 2023. Analisis bivariat dilakukan pada setiap parameter sinus sfenoidalis untuk menentukan hubungannya dengan jenis kelamin.Hasil: Perbedaan rerata dari seluruh parameter bermakna secara signifikan (p=0,000) antara jenis kelamin laki-laki dan perempuan, dengan rerata laki-laki lebih besar dari perempuan. Titik potong untuk menentukan jenis kelamin laki-laki pada diameter anteroposterior adalah ≥2,94 cm (akurasi 67,9%), diameter laterolateral ≥3,595 cm (akurasi 62,9%), diameter kraniokaudal ≥2,235 cm (akurasi 73,6%), volume ≥12,265 cm3 (akurasi 69,3%). Kombinasi diameter anteroposterior dan kraniokaudal dapat memprediksi jenis kelamin laki-laki dengan probabilitas hingga 80,38%.Kesimpulan: parameter sinus sfenoidalis dapat digunakan untuk menentukan luaran jenis kelamin.

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Background: Forensic identification using sphenoidal sinus parameters can be helpful in mass disasters where the victim's body is incomplete. However, there is a lack of data regarding sphenoidal sinus parameters and their relationship with sexual dimorphism in the adult population in Indonesia.

Objective: To assess the role of sphenoidal sinus parameters in determining gender within the adult population using MSCT examination. This includes comparing the anteroposterior, laterolateral, craniocaudal diameters, and sphenoidal sinus volume between adult males and females. Additionally, it aims to establish cutoff points and accuracy in determining gender.

Method: A cross-sectional comparative design was employed in the study. The research involved 140 subjects (70 males and 70 females) aged 20–45 years who underwent head, sinus, nasopharynx, and facial MSCT scans between April and June 2023. Bivariate analysis was conducted for each sphenoidal sinus parameter to determine its association with gender.

Results: The mean differences in all parameters were significantly higher in males than in females (p=0.000). The cutoff points to determine male gender were as follows: anteroposterior diameter ≥2.94 cm (accuracy 67.9%), laterolateral diameter ≥3.595 cm (accuracy 62.9%), craniocaudal diameter ≥2.235 cm (accuracy 73.6%), and volume ≥12.265 cm3 (accuracy 69.3%). The combination of anteroposterior and craniocaudal diameters could predict male gender with a probability of up to 80.38%.

Conclusion: Sphenoidal sinus parameters can be utilized to determine gender."

"Tujuan: Penelitian ini dilakukan untuk mendapatkan data profil kanalis fallopii segmen mastoid dan korda timpani sebelum operasi mastoidektomi untuk mengurangi angka morbiditas cedera kanalis fallopii akibat operasi. Metode: Pada penelitian retrospektif ini dilakukan rekonstruksi High-Resolution Computed Tomography tulang temporal terhadap 100 tulang temporal normal pada 50 pasien yang menjalani pemeriksaan CT scan kepala dan leher, yang diambil dari raw-data mulai Desember 2012 sampai Februari 2013. Rekonstruksi dilakukan dengan parameter ketebalan irisan 0,6 cm, increment 0,3 cm, Kernel filter Very Sharp (H70s), Window setting Osteo/Mastoid, menggunakan pesawat MDCT Somatom Definition Flash Dual Source 128 slice. Hasil dan diskusi: Bentuk kanalis fallopii segmen mastoid paling banyak ditemukan tipe lurus sebanyak 75%, defleksi terhadap bidang sagital dan defleksi terhadap bidang horizontal anatomi paling banyak ditemukan tidak terdapat defleksi sebanyak 62% dan 68%. Percabangan korda timpani paling banyak ditemukan intratemporal sebanyak 75%, yang tersering pada 1/3 distal kanalis fallopii segmen mastoid. Sudut korda timpani yang dibentuk korda timpani terhadap kanalis fallopii segmen mastoid paling banyak ditemukan antara 16 sampai 30 derajat sebanyak 37,3%. Ukuran korda timpani yang minimal tervisualisasi adalah 0,04 cm. Kesimpulan: Proporsi defleksi kanalis fallopii segmen mastoid terhadap bidang sagital dan horizontal adalah tidak terdapat defleksi.

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Objectives: This research was conducted to obtain profile data of mastoid segment of fallopian canal and tympanic cord before masteidectomy to reduce the morbidity rate of surgery-related fallopian canal injury.

Material and method: In this retrospective study reconstruction of High Resolution Computed Tomography of the temporal bone in 100 normal temporal bone in 50 patients who underwent a CT scan of the head and neck, were taken from the raw-data from December 2012 to February 2013. Reconstruction is done by parameters slice thickness 0,6 cm, increment 0,3 cm, Kernel filter Very Sharp (H70s), Window setting Osteo/Mastoid,using MDCT Somatom Definition Flash Dual Source 128 slice.

Result: Mastoid segment of fallopian canal commonly found type of straight as much as 75%, deflection of the sagittal plane and the horizontal field of anatomy most commonly found there was no deflection were 62% and 68%, respectively. Branching chordate tympani most commonly found intratemporal as much as 75%, which is common in 1/3 distal of mastoid segmen fallopian canal. The angled formed by chorda tympani and mastoid segment fallopian canal is most prevalent among 16 to 30 degrees as much as 37.3%. The minimum size of the chorda tympani is 0.04 cm.

Conclusion: Proportion of deflection mastoid segment facial canal of the sagittal and horizontal plane there is no deflection."

"Keperawatan adalah sebuah seni dan ilmu pengetahuan yang merupakan gabungan dari ilmu fisik, manusia, sosial dengan kompetensi klinis dan kualitas yang berpusat pada pasien. Adanya peningkatan teknologi dan promosi kesehatan, maka perawat diharapkan memberikan pelayanan yang lebih berkualitas. Tujuan dari praktik residensi untuk memperoleh gambaran analisis pelaksanaan dan pengalaman praktik residensi keperawatan medikal bedah peminatan onkologi dalam menjalankan peran professional selama praktik residensi di RSUPN dr. Cipto Mangunkusumo. Residensi dilaksanakan selama 2 semester baik di ruang rawat inap, rawat jalan dan IGD dengan memberikan asuhan keperawatan, penerapan EBN yoga untuk mengurangi fatigue dan Proyek inovasi Edukasi Penanganan Mual Muntah berbasis Video untuk meningkatkan pengetahuan  pada pasien yang menjalani  kemoterapi. Pemberian asuhan keperawatan dilakukan pada pasien 1 kasus kelolaan dengan Adenocarsinoma Recti Sigmoid dan 30 kasus keganasan lainnya dengan menggunakan pendekatan Teori Model Adaptasi Roy, yoga terbukti efektif dalam menurunkan fatigue dan edukasi Penanganan Mual Muntah berbasis Video terbukti dapat meningkatkan pengetahuan pasien. Praktek residen bermanfaat dan dapat meningkatkan pengetahuan, keterampilan dan kompetensi dalam menjalankan peran perawat professional.

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Nursing is an art and a science, which combination of knowledge from the physical sciences, humanities, and social sciences along with clinical competencies and quality patient centered care.The improvement of technology and health promotion, nurses are expected to provide better quality services. The aims of the residency practice is to obtain an analysis of the implementation and practical experience of residency oncology specialization medical nursing residency in carrying out professional roles during residency practice at RSUPN Dr. Cipto Mangunkusumo. Residency was held for 2 semesters both in the inpatient, outpatient and emergency room by providing nursing care, implementing EBN yoga to reduce fatigue and the Innovation Project Video-based Vomiting Nausea Education Education to increase knowledge in patients undergoing chemotherapy. The provision of nursing care was carried out on patients with 1 case of management with Adenocarsinoma Recti Sigmoid and 30 other cases of malignancy using Roys Adaptation Model Theory approach, yoga effective in reducing fatigue and Video-based Vomiting Handling education effective to increase patient knowledge. Resident practices are useful and can increase knowledge, skills and competencies in carrying out the role of professional nurses."

"[ABSTRAK Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification]"