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"Latar belakang: Untuk menilai peningkatan imunitas selular terhadap biakan sel endometriosis dari sel LAK hasil perangsangan Sel Mononuklir Darah Tepi (SMDT) penderita endometriosis dengan IL-2. Metode: Studi ini merupakan penelitian kuasi-eksperimental pra dan pasca-perlakuan dengan menggunakan pembanding (kontrol). Dilakukan pemeriksaan fenotip CD3+ CD4+, CD3+ CD8+ dan CD56+ sel efektor dari SMDT endometriosis dan kontrol. Dilakukan pula uji sitotoksisititas SMDT penderita endometriosis dan kontrol terhadap lini-sel Daudi, K562, dan biakan sel endometriosis dengan menggunakan 51 Chromium pada teknik teraradioimun (radioimmunoassay, RIA). Hasil: Pada pemeriksaan fenotip SMDT dari 10 pasien endometriosis dan 6 pasien kontrol pada sebelum dan sesudah perangsangan dengan IL-2 ditemukan bahwa sebelum perangsangan dengan IL-2 ditemukan CD3+CD4+, CD56+ pada kelompok endometriosis lebih rendah daripada kelompok kontrol (p>0,05); fenotip CD3+ CD8+ pada kelompok endometriosis lebih tinggi daripada kelompok kontrol. Setelah perangsangan dengan IL-2 ditemukan CD3+CD8+, CD56+ dari SMDT kelompok endometriosis lebih tinggi daripada sebelum perangsangan dengan IL-2 dan ditemukan perbedaan yang bermakna (p < 0,05). Pada uji sitotoksisitas ditemukan peningkatan bermakna (p < 0,05) sitotoksisitas sel efektor baik pada SMDT endometriosis maupun SMDT kontrol terhadap sasaran (target) lini-sel Daudi dan K562 setelah perangsangan IL-2. Sitotoksisitas sel efektor baik pada SMDT endometriosis maupun SMDT kontrol terhadap sasaran biakan sel endometriosis setelah perangsangan IL-2 tampak meningkat. Kesimpulan: Sel LAK hasil perangsangan SDMT penderita endometriosis dengan IL-2 meningkatkan imunitas selular terhadap biakan sel endometriosis. (Med J Indones 2011; 20:87-93 ).

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Background: To assess the increased cellular immunity of Peripheral Blood Mononuclear Cells (PBMC) derived LAK cells from endometriosis patients towards endometriosis cell cultures after stimulation with IL-2.

Methods: This study is a quasi-experimental study of pre and post treatment using controls. Phenotype evaluation of CD3+CD4+, CD3+CD8+ and CD56+ effector cells of PBMC from endometriosis patients and controls was performed. Cytotoxicity test of PBMC from endometriosis patients and control towards Daudi, K562 cell line and endometriosis cell cultures using 51Chromium release assay was also carried out.

Results: Phenotype evaluation of PBMC from endometriosis patients (n=10) and controls (n=6) were done prior to and after IL-2 stimulation. Before IL-2 stimulation, CD3+CD4+, CD56+ from endometriosis group (n=10) tend to be lower than control (n=6) whereas CD3+CD8 + were higher in endometriosis group than controls. After IL-2 stimulation, CD3+ CD8+, CD56+ of PBMC from endometriosis group were signifi cantly increased (p <0.05).Cytotoxicity test revealed a signifi cant increase (p <0.05) in both PBMCâ??s effector cells from endometriosis and control group towards target cells, Daudi, and K562 cell lines after IL-2 stimulation. PBMCâ??s effector cells cytotoxicity from both endometriosis and control towards target endometriosis cell cultures were also elevated after IL-2 stimulation.

Conclusion: LAK cells derived IL-2 stimulated PBMC from endometriosis patients increased cellular immunity towards endometriosis cell cultures. (Med J Indones 2011; 20:87-93 )."

"Latar Belakang: Salah satu hipotesis yang menjelaskan hubungan endometriosis dengan infertilitas adalah endometriosis diyakini menyebabkan gangguan fisiologi ovarium, salah satunya dengan mempengaruhi folikulogenesis yang menyebabkan penurunan kualitas oosit. Oosit memainkan peran penting dalam mengatur dan mendukung pertumbuhan folikel, melalui produksi faktor pertumbuhan oosit. Beberapa faktor pertumbuhan telah diidentifikasi pada oosit manusia, termasuk growth differentiation factor-9 GDF-9 . Namun, sampai saat ini penelitian mengenai ekspresi GDF-9 pada sel granulosa pada wanita infertil dengan endometriosis masih belum banyak dilakukan. Tujuan: Untuk mengetahui ekspresi mRNA GDF-9 pada sel granulosa pasien endometriosis yang menjalani FIV dan untuk mencari adanya korelasi antara ekspresi GDF-9 dengan kualitas oosit. Metode: Penelitian potong lintang ini dilakukan di Klinik IVF Yasmin RSCM dan Klinik Sander B di Jakarta pada bulan Juli 2014 - Juli 2017. Sebanyak 50 sampel terdiri atas 25 wanita dengan endometriosis dan 25 kontrol. Sampel sel granulosa dikumpulkan pada saat petik oosit. Ekspresi mRNA GDF-9 dinilai menggunakan real time PCR. Hasil: Terdapat penurunan jumlah ambilan oosit, jumlah oosit matur dan skor morfologi oosit pada kelompok pasien dengan endometriosis dan bermakna secara statistik. Ekspresi GDF-9 secara kuantitatif lebih rendah pada kelompok endometriosis dibandingkan dengan kontrol 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01 . Pada penelitian ini tidak didapatkan korelasi antara ekspresi GDF-9 dan kualitas oosit dari skor morfologi oosit dan laju fertilisasi. Kesimpulan: Ekspresi GDF9 lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol. Namun, kami tidak menemukan korelasi antara ekspresi GDF-9 dengan kualitas oosit. Dibutuhkan studi dengan besar sampel yang lebih besar untuk mengkonfirmasi apakah perubahan ekspresi GDF-9 memiliki korelasi dengan kualitas oosit serta untuk membuktikan apakah GDF-9 dapat digunakan sebagai penanda molekuler baru untuk memprediksi kompetensi perkembangan oosit.

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Background: One of the hypothesis that explains the association between endometriosis and infertility is that endometriosis is believed to cause ovarian physiology disturbances, one of them by affecting folliculogenesis that cause decreased oocyte quality. The oocyte plays an important role in regulating and promoting follicle growth, by the production of oocyte growth factors. Several growth factors have been identified in human oocytes, including growth differentiation factor-9 GDF-9. However the studies on GDF-9 expression in granulosa cells of infertile women with endometriosis are sparse.

Objective: To investigate the expression of GDF-9 mRNA in granulosa cells of endometriosis patients undergoing IVF and to find the correlation between GDF-9 expression and oocyte quality.

Method: This cross sectional study was done at Yasmin IVF Clinic and dr. Sander B Clinic Jakarta in July 2014 - July 2017. A total fifty samples of 25 womens with endometriosis and 25 controls were included. We collect the granulosa cells sample at the time of oocyte retrieval. GDF-9 mRNA expression were investigated by Real-Time PCR.

Result: The number of oocytes retrieved, mature oocytes and the oocyte morphology score were lower in the group of patients with endometriosis and this was statistically significant. GDF-9 mRNA expression levels was quantitatively lower in endometriosis groups compared to control 5.05 0.00002 ndash; 3523 ng/ l vs 81.93 1,47 ndash; 32450 ng/ l; p=0,01. However, we did not find any correlation between GDF-9 expression levels and oocyte quality from oocyte morphology score and fertilization rate.

Conclusion: GDF9 mRNA level was lower in endometriosis group compared to control group. However, we did not find correlation between individual GDF-9 level and oocyte quality. Large-sample studies were needed to confirm whether the expression of GDF-9 had a correlation with oocyte quality as well as to prove whether GDF-9 could be used as a new molecular marker to predict the oocyte developmental competence."

"Pengantar: Endometriosis merupakan salah satu penyebab infertilitas dan menjadi indikasi fertilisasi in vitro (FIV). Laju apoptosis dan stress oksidatif yang tinggi pada pasien endometriosis diyakini menimbulkan efek negatif terhadap peluang keberhasilan FIV. Namun, pengaruh endometriosis terhadap keberhasilan FIV menunjukkan bukti yang inkonsisten dan belum banyak studi yang menilai langsung efek endometriosis terhadap kualitas oosit sebagai parameter keberhasilan FIV.Tujuan: Untuk menilai laju apoptosis pada sel granulosa pasien endometriosis dibanding pasien non-endometriosis melalui rasio ekspresi mRNA BAX/BCL-2 dan menilai korelasinya dengan kualitas oosit yang didapatkan saat petik ovum.Hasil: Sampel didapatkan dari 15 subjek dengan endometriosis dan 15 subjek kontrol. Dosis rekombinan FSH total yang diterima pada kelompok endometriosis untuk stimulasi ovarium lebih tinggi dibandingkan kelompok kontrol (p=0.005). Terdapat perbedaan bermakna kadar ekspresi BAX (p=0.029) dan BCL-2 (p<0.001) pada kedua kelompok, tetapi perbedaan rasio keduanya tidak signifikan (p=0.787). Korelasi antara rasio BAX/BCL-2 dengan parameter kualitas oosit tidak menunjukkan hubungan bermakna di kedua kelompok.Kesimpulan: Tidak terdapat perbedaan signifikan pada rasio kadar BAX/BCL-2 di kedua kelompok dan tidak ditemukan hubungan bermakna antara rasio tersebut dengan kualitas oosit. 

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Introduction: Endometriosis is one of common conditions causing infertility and an indication to undergo in vitro fertilization (IVF). High apoptosis rate and oxidative stress in patient with endometriosis is believed to cause negative effect on IVF success rate. However, there has been conflicting results on endometriosis effect to IVF success and there have been limited studies that directly assess endometriosis and its effect on oocyte quality.

Aim: To assess apoptosis rate on granulosa cells in patients with endometriosis compared to non-endometriosis patients through mRNA BAX/BCL-2 ratio and how it correlates with oocyte quality collected during ovum pick up.

Results: Samples were collected from 15 subjects with endometriosis and 15 control subjects. Total dose of recombinant FSH received by endometriosis group is significantly higher compared to control (p=0.005). There is difference in BAX level (p=0.029) and BCL-2 level (p<0.001) in both groups. However, the ratio does not differ significantly (p=0.787). No significant correlation is found in BAX/BCL-2 ratio and any of the oocyte quality parameters.

Conclusion: We found no significant difference in BAX/BCL-2 ratio between endometriosis and control group as well as significant correlation between the ratio and oocyte quality."

"Pendahuluan: Endometriosis merupakan suatu kelainan jinak ginekologi yang dapat mengalami transformasi menjadi kanker. Stres oksidatif diduga berperan dalam perkembangan penyakit endometriosis. Gen supresor tumor ARID1A banyak ditemukan termutasi dan inaktif pada kanker ovarium yang berhubungan dengan endometriosis. Tujuan penelitian adalah untuk menganalisis peran stres oksidatif terhadap ekspresi gen supresor tumor ARID1A dalam transformasi endometriosis menjadi ganas. Metoda: Penelitian dimulai dengan 10 sampel jaringan kanker ovarium, 10 sampel endometriosis dan3 jaringan endometrium eutopik sebagai kontrol yang diisolasi mRNA dan proteinnya. Analisis ekspresi gen ARID1A pada tingkat mRNA dilakukan dengan pemeriksaan RT-qPCR dan pada tingkat protein dengan ELISA. Pada sel endometriosis dan kanker ovarium dilakukan analisis stres oksidatif dengan pemeriksaan aktivitas antioksidan MnSOD dan pemeriksaan kadar MDA sebagai salah bukti kerusakan salah satu komponen sel. Setelah itu dilakukan uji eksperimental pada kultur sel endometriosis dan endometrium eutopik sebagai kontrol. Kedua sel kultur diinduksi dengan H2O2 konsentrasi 0 nM, 100 nM, dan 1000 nM. Analisis dilakukan terhadap ketahanan hidup sel, kadar ROS dan ekspresi gen ARID1A pada tingkat mRNA dan protein. Hasil: Efek induksi H2O2 dalam menekan ekspresi gen ARID1A sel endometriosis dan sel endometrium eutopik pada tingkat mRNA dan protein, bermakna, meskipun pada kanker ovarium tidak bermakna pada penelitian ini. Kesimpulan: Stres oksidatif berperan dalam menekan ekspresi gen supresor tumor ARID1A ditingkat mRNA dan protein pada endometriosis.

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Introduction: Endometriosis as a gynecologic benign lesion, can transform itself into cancer. Oxidative stress is considered as an important factor in endometriosis development. Studies found that ARID1A as tumor suppressor gene, was frequently mutated and inactivated in endometriosis associated ovarian cancer. The aim of the study is to analyze the role of oxidative stress on ARID1A expresion in endometriosis malignant transformation.

Methods: This study started with ten samples of ovarian cancer, ten samples of endometriosis, and 3 samples of eutopic endometrioid tissues as control. They were analyzed for the expression of ARID1A by RT-qPCR and ELISA, then analyzed for the activity of MnSOD as antioxidant enzyme and level of malondialdehyde as one of the oxidative stress damage effect evidence on cell's components. The second part of the study was experimental study on cultured eutopic endometrial and endometriosis cells. They were induced by H2O2 of 0, 100, and 1000 nM concentration. Analysis of the expression of ARID1A by RTqPCR and ELISA, and the DCFH-DA for the level of Reactive oxygen species were done.

Result: The impact of the H2O2 induction in repressing ARID1A gene expression on the endometriosis as well on the eutopic endometrium cells are significant, but not on the ovarian cancer in this study.

Conclusion: Oxidative stress has a role in repressing the expression of ARID1A gene at the mRNA and protein levels on the endometriosis."

"Latar belakang: Peran estrogen pada patofisiologi endometriosis sudah dikenal sejak lama. Namun, belum ada studi yang menganalisis rasio estradiol, estron dan estriol antara wanita dengan dan tanpa endometriosis. Tujuan: Menganalisis kadar estron (E1), estradiol (E2) dan estriol (E3) dalam darah dan rasio E2:E1, E2:E3 dan E1:E3 antara wanita dengan dan tanpa endometriosis. Metode: Penelitian dengan desain potong lintang analitik, dengan 27 wanita dengan endometriosis dan 27 wanita tanpa endometriosis yang memenuhi kriteria inklusi. Sampel didapatkan dari RS Cipto Mangunkusumo dan rumah sakit jejaring lainnya periode Oktober 2012 - April 2013. Kadar metabolit estrogen dalam darah diperiksa dengan uji enzyme-linked immunosorbent (ELISA). Perbandingan data antara dua kelompok dianalisis dengan uji Mann-Whitney. Hasil: Kadar estron ditemukan lebih rendah pada kelompok endometriosis dibandingkan kelompok kontrol (54,66 pg/ml vs 73,52 pg/ml, p 0,229). Demikian pula, kadar estradiol dan estriol lebih rendah pada kelompok endometriosis (29 pg/ml vs 35 pg/ml, p 0,815 dan 1,11 pg/ml vs 1,67 pg/ml, p 0.095, berturut-turut). Rasio E2:E1 lebih tinggi pada kelompok endometriosis (0,51 pg/ml vs 0,38 pg/ml, p 0,164), demikian pula dengan rasio E2: E3 (26,53 pg/ml vs 21,11 pg/ml , p 0,223) dan rasio E1:E3 (58,55 pg/ml vs 50,28 pg/ml, p 0,684). Namun, semua perbedaan itu tidak bermakna secara statistik. Kesimpulan: Kadar estron, estradiol, dan estriol pada wanita dengan kelompok endometriosis lebih rendah dibandingkan pada wanita tanpa endometriosis. Rasio E2: E1, E2: E3 dan E1: E3 lebih tinggi pada kelompok endometriosis. Namun, semua perbedaan itu tidak bermakna secara statistik.

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Background: The role of estrogen in the pathophysiology of endometriosis has been well known. However, no study has observed the ratio of estradiol, estrone, and estriol between women with endometriosis and without endometriosis.

Objectives: To assess the estrone (E1), estradiol (E2) and estriol (E3) blood level and its ratio (E2:E1, E2:E3 and E1:E3) between women with and without endometriosis.

Methods: An analytical cross sectional study with 27 women with endometriosis and 27 women without endometriosis who met the inclusion criteria. The samples were recruited in Cipto Mangunkusumo hospital and other satellite hospitals from October 2012 to April 2013. The blood level of estrogen metabolites was examined by enzyme-linked immunosorbent assay (ELISA). The data comparison between two groups was analyzed by using Mann-Whitney test.

Result: The level of Estrone was found to be lower in endometriosis group compared to this in control group (54,66 pg/ml vs 73,52 pg/ml, p 0.229). Similarly, the level of estradiol and estriol were lower in endometriosis group (29 pg/ml vs 35 pg/ml, p 0.815 and 1,11 pg/ml vs 1,67 pg/ml, p 0.095, consecutively). The E2:E1 ratio was higher in endometriosis group (0,51 pg/ml vs 0,38 pg/ml, p 0.164), as well as E2:E3 ratio (26,53 pg/ml vs 21,11 pg/ml, p 0.223) and the E1:E3 ratio (58.55 vs 50.28, p 0.684). However, all those differences were not statistical significant.

Conclusion: The estrone, estradiol and estriol level in women with endometriosis group was lower compared to these in women without endometriosis group. The ratio E2:E1, E2:E3 and E1:E3 was higher in endometriosis group. However, all those differences were statistically insignificant."

"Latar belakang: Endometriosis merupakan penyakit yang sering ditemukan melatarbelakangi infertilitas pada seorang wanita. Untuk meningkatkan angka kehamilan, pada kasus-kasus endometriosis yang diterapi program bayi tabung (IVF) dilakukan seleksi embrio. Penelitian ini ingin membuktikan efektifitas penilaian seleksi embrio terhadap keberhasilan kehamilan di sebuah rumah sakit di Jakarta.Metode: Penelitian ini adalah sebuah studi epidemiologi klinik dengan rancangan potong-lintang pada pasien-pasien endometriosis yang datang pada kurun waktu 2007-2009 di sebuah rumah sakit di Jakarta. Pasien didiagnosis endometriosis menggunakan laparoskopi. Seleksi embrio dilakukan dengan metode penilaian morfologi dan jumlah sel. Data demografi, pemeriksaan laboratorium sampai kepada kehamilan diambil dari rekam medik untuk dianalisis lebih lanjut.Hasil: Sebanyak 72 subjek mengikuti program IVF dalam kurun waktu penelitian ini yang datanya berhasil diambil. Ada satu kasus yang di-drop out karena oosit tidak matur. Sementara yang mengalami pembuahan ada 65 orang, dimana dua tidak dilakukan transfer embrio. Diantara mereka yang dilakukan transfer embrio, terjadi 26 kehamilan (36,1%). Pada kasus endometriosis berat, kehamilan terjadi pada kualitas embrio excellent (50%) dan good-moderate (16,7%). Tetapi peluang tidak hamil yang ditemukan juga sama yaitu 50% pada kasus endometriosis berat. Pada kasus endometriosis ringan-sedang, peluang kehamilan bila embrio excellent adalah 39% dibandingkan good-moderate (25%). Bila dibandingkan dengan jumlah embrio yang ditransfer, maka probabilitas kehamilan meningkat 50% apabila ditransfer 3 embrio dibandingkan 1 atau 2 embrio.Kesimpulan: Penelitian ini menunjukkan bahwa kualitas embrio dan jumlah embrio transfer berperan meningkatkan peluang kehamilan pada pasien-pasien IVF. Namun karena dibandingkan peluang tidak hamil yang tidak berbeda bermakna, diperlukan marker lain yang lebih sensitif untuk menilai kualitas embrio transfer.

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AbstractBackground: Endometriosis is the most common condition underlying infertility in women. To increase the rate of pregnancy in women with endometriosis, embryo selection is performed during in vitro fertilization. This study aims to prove the effectiveness of embryo selection on the rate of pregnancy in a hospital in Jakarta.Methods: This is a cross sectional clinical epidemiology study, performed on endometriosis patients who visited the hospital between 2007 ? 2009. Patients were diagnosed with endometriosis using the laparoscopy technique. Embryo selection was performed by assessing the morphology and cell count.Results: We were able to collect data from 72 subjects who underwent IVF during this research period. One subject was dropped out of the program due to immaturity of the oocyte. Successful fertilization was achieved for 65 subjects, but two of them did not undergo embryo transfer. Out of all the subjects undergoing embryo transfer, 26 subjects successfully became pregnant (36.1%). In severe endometriosis cases, pregnancy was achieved with excellent quality embryos (50%) and good-moderate quality embryos (16.7%); but the probability of failure to become pregnant was found to be the same (50%). In mild-moderate endometriosis cases, the probability of pregnancy with excellent quality embryos was 39% compared to 25% chance with good-moderate quality embryos. Regarding the number of embryos that were transferred, we have found that the probability of pregnancy was 50% higher when 3 embryos were transferred, compared to 1 or 2 transferred embryos.Conclusion: This study shows that embryo quality and the number of transferred embryos are relevant to increase the probability of pregnancy in patients undergoing IVF. But because the probability of not achieving pregnancy is not significantly different, we need to find another marker that is more sensitive to assess the quality of embryo transfer."

"ABSTRAK Latar belakang: Endometriosis merupakan kelainan ginekologik yang palingsering ditemukan. Seperti halnya endometrium di uterus juga dapat terjadiberbagai perubahan pada epitel yang melapisi kista endometriosis di ovarium,antara lain metaplasia, hiperplasia, atipia bahkan perubahan ke arah keganasan.Saat ini banyak penelitian yang menghubungkan antara endometriosis dan kankerovarium terutama jenis clear cell dan dikenal dengan istilah endometriosisassociatedovarian carcinoma (EAOC) dan dilaporkan adanya mutasi yangmenginaktifkan gen supresor tumor (ARID1A), sehingga protein BAF250a tidakdiekpresikan pada Clear cell carcinoma (CCC) ovarii.Bahan dan cara: Dilakukan pulasan imunohistokimia ARID1A pada sampel 20kasus endometriosis non atipik, 20 kasus atipik dan 20 kasus CCC ovarii tahun2012 hingga Maret 2015. Dari kelompok kasus CCC didapatkan 9 kasus EAOC.Selanjutnya dilihat adakah perbedaan persentase ekspresi ARID1A padaendometriosis non atipik, atipik, CCC ovarii serta endometriosis disertai CCC(EAOC).Hasil: Pada kelompok kasus endometriosis non atipik, atipik dan CCC adaperbedaan bermakna persentase ekspresi ARID1A (uji Kruskal-Wallis p=0,0035).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan didapatkanperbedaan bermakna persentase ekspresi ARID1A antara endometriosis non atipikdan atipik dengan CCC ovarii (p=0,001 dan p=0,0015). Pada kelompok kasusendometriosis non atipik, atipik dan endometriosis pada EAOC, didapatkan adaperbedaan bermakna persentase ekspresi ARID1A (Uji Kruskal-Walis p=0,011).Selanjutnya dilakukan analisis Post Hoc uji Mann-Whitney dan ada perbedaanbermakna persentase ekspresi ARID1A antara endometriosis non atipik dan atipikdengan EAOC (p=0,005 dan p=0,008). Kesimpulan: Ekspresi ARID1A pada endometriosis non atipik dan atipik lebihtinggi bermakna dibanding CCC ovarii dan EAOC. Sehingga ekspresi ARID1Akemungkinan dapat digunakan sebagai petanda adanya transformasi ganas padaendometriosis.ABSTRACT Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis.;Background: Endometriosis is one of the most common gynecologicalabnormalities found. Endometriosis cyst in the ovary also exhibited changes inepithelial cyst just like endometrium in the uterus. Changes in the epithelial cellsalso include metaplasia, hyperplasia, atyphia even changes toward malignancharacteristics. Nowadays, there are some research that linked endometriosis andclear cell ovarian cancer which is known with endometriosis-associated ovariancarcinoma (EAOC) it is reported that there?s a mutation that activated tumorsuppressor gene (ARID1A), so protein BAF250a is not expressed in Clear CellCarcinoma (CCC) in the ovarium.Materials and Methods: Immunohistochemistry staining of ARID1A were donein 20 samples of non-atypical endometriosis, 20 samples of atypicalendometriosis, 20 samples of CCC in the ovarium from the year 2012 until march2015. From the group that experienced CCC we get 9 cases of EAOC. After that,we see if there?s any difference in the percentage of ARID1A expression in nonatypicalendometrosis, atypical endometriosis, CCC in the ovarium andendometriosis with CCC( EAOC).Results: In non-atypical endometriosis, atypical and CCC cases groups there aresignificant differences on the percentage of ARID1A expression (Kruskal-Walistest p=0,0035). Post Hoc analysis were done using Mann-Whitney test and thereare significant differences on ARID1A expression between non-atypical andatypical endometriosis with CCC (p=0,001 and p=0,0015). In non-atypicalendometriosis, atypical and EAOC groups there are significant differences on thepercentage of ARID1A expression (Kruskal-Walis test p=0,011). Post Hocanalysis were done using Mann-Whitney test and there are significant differenceson ARID1A expression between non-atypical and atypical endometriosis withEAOC (p=0,005 and p=0,008).Conclusion: Expression of ARID1A in non atypical and atypical endometriosisare significantly higher compared to ovarian CCC and EAOC. So, we can say thatARID1A may be used as a marker for malignancy transformation inendometriosis."

"Latar Belakang: Kejadian infertilitas di Indonesia 10-15 dari 39,8 juta wanita usia subur. Infertilitas dapat memberi masalah fisik, mental, sosial hingga perceraian. Sekitar 25 -50 perempuan infertil disertai endometriosis dan laparoskopi telah menjadi salah satu pilihan tatalaksananya. Dalam menjalani suatu metode, ahli bedah dan pasangan selalu ingin mengetahui peluang keberhasilan mereka baik dari data praoperasi ataupun intraoperasi. Lee dkk menyatakan keberhasilan kehamilan alamiah pasca laparoskopi secara keseluruhan adalah 41,9 dan tidak berhubungan dengan derajat endometriosis atau temuan laparoskopi atau jenis operasi. Di Indonesia, belum ada studi yang membahas faktor yang paling mempengaruhi keberhasilan kehamilan alamiah pada perempuan yang menjalani metode laparoskopi operatif.Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor apa saja yang mempengaruhi keberhasilan kehamilan alamiah pasca laparoskopi operatif.Metode: Penelitian ini menggunakan desain kohort retrospektif. Dengan total sampling, data diambil dari catatan pasien yang menjalani operasi laparoskopi karena infertilitas dengan endometriosis di RS Cipto Mangunkusumo dan RS Yayasan Pemeliharaan Kesehatan YPK di Jakarta, Indonesia. Analisis data dilakukan dengan perangkat lunak SPSS 20 untuk mengetahui hubungan antara usia, durasi infertilitas, jenis infertilitas, kadar CA-125, ukuran dan bilateralitas endometrioma, perlekatan organ genitalia interna, nodul endometriosis dan patologi tuba dengan keberhasilan kehamilan alamiah dalam 1 tahun pasca laparoskopi operatif.Hasil: Terdapat 70 subjek yang dianalisis. Sebanyak 32 subjek 45,7 hamil dalam satu tahun pasca laparoskopi. Lama infertilitas menggunakan titik potong

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Background and aims The incidence of infertility in Indonesia is 10 15 of the 39.8 million women of childbearing age. It can give physical, mental, social and divorce problems. Approximately 25 50 of infertile women cause by endometriosis. Laparoscopy operative LO has become one of its treatments. In choosing a method, surgeon and couples always want to know the chances of their success either from preoperative or intraoperative data. In Indonesia, there are no studies that address the factors influence the success of natural pregnancy in women undergoing LO methods. This study aims to determine what factors affect the success of natural pregnancy postoperative laparoscopy.Methods This study used a retrospective cohort design. With total sampling, the data were taken from the patient records who underwent laparoscopic operative due to infertility with endometriosis at RS Cipto Mangunkusumo and the Health Care Foundation Foundation YPK in Jakarta, Indonesia. Data analysis was performed with SPSS 20 software to determine the relationship between age, duration of infertility, type of infertility, ca 125 levels, size and bilaterality of endometrioma, internal genital adhesion, endometriosis nodules and tubal pathology with successful natural pregnancy in 1 year after laparoscopic operative.Result There were 70 subjects analyzed. A total of 32 subjects 45.7 were pregnant within one year after laparoscopy. The length of infertility using a "

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Latar belakang: Heterogenitas pasien endometriosis terkait presentasi fenotip klinisnya memerlukan standar pengambilan data. Saat ini belum ada standardisasi pengambilan data fenotip klinis pasien endometriosis di Indonesia. Translasi kuesioner klinis WERF-EPHect Clinical Questionnaire (Standard) (EPQ-S) ke dalam Bahasa Indonesia dan validasi kuesioner ini diperlukan untuk mengetahui apakah alat ini dapat digunakan di Indonesia sebagaimana telah digunakan di negara lain dan memastikan bahwa data yang dihasilkan akurat dan andal.

 

Tujuan: Untuk membuat sebuah standar pengambilan data fenotip klinis pasien endometriosis di Indonesia dan untuk mengetahui hasil terjemahan dan validitas kuesioner klinis WERF-EPHect Clinical Questionnaire (Standard) (EPQ-S) yang telah diterjemahkan ke dalam Bahasa Indonesia

 

Metode: Penelitian ini dilakukan dengan metode transkultural adaptasi. Uji validasi ini kuesioner EPHect EPQ-S dilakukan melalui proses forward-backward translation, harmonisasi oleh para expert, cognitive debriefing kepada target kuesoioner serta proofreading dan finalisasi oleh para expert. Penelitian dilakukan di RSCM selama 6 bulan yaitu Januari 2019 sampai Juli 2019.

 

Hasil: Translasi dan validasi isi kuesioner WERF-EPHect Clinical Questionnaire (Standard) Versi Indonesia memiliki 10 tahap termasuk proses persiapan, Forward Translation (translasi maju), proses rekonsiliasi, Backward Translation (translasi balik), review translasi balik, Proses Harmonisasi, proses Cognitive Debriefing, review hasil cognitive debriefing dan finalisasi, proses Proofreading dan laporan Final. Terdapat perbedaan budaya dari negara kuesioner asal termasuk obat-obatan yang tersedia di Indonesia, istilah-istilah medis yang lumrah di Negara asal namun asing di populasi Indonesia, dan penyajian suku ras yang tidak menggambarkan varian suku ras Indonesia.

 

Kesimpulan: Didapatkan kuesioner klinis WERF-EPHect Clinical Questionnaire (Standard) (EPQ-S) versi Bahasa Indonesia dengan isi sesuai kebutuhan pengguna di Indonesia dan dapat diaplikasikan di RSCM, dari 116 butir pertanyaan terdapat 21 butir pertanyaan dalam kuesioner yang harus terpimpin.

 

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Background: The heterogeneity of endometriosis patients related to the presentation of clinical phenotypes requires standard data collection. At present there is no standardization of clinical phenotype data for endometriosis patients in Indonesia. Translation of the WERF-EPHect Clinical Questionnaire (Standard) clinical questionnaire (EPQ-S) into Indonesian language and the validation of this questionnaire is needed to find out whether this tool can be used in Indonesia as it has been used in other countries and ensure that the resulting data is accurate and reliable.

 

Objective: To create a standard for taking clinical phenotype data for endometriosis patients in Indonesia and to find out the translation results and the validity of the WERF-EPHect Clinical Questionnaire (Standard) clinical questionnaire (EPQ-S) that has been translated into Indonesian and has been accurate and reliable.

 

Method: This research was conducted with the transcultural adaptation method. This validation test EPHect EPQ-S questionnaire was carried out through a process of forward-backward translation, harmonization by experts, cognitive debriefing to questionnaire targets and proofreading and finalization by experts. The study was conducted at the RSCM for 6 months, namely January 2019 to July 2019.

 

Results: Translation and validation of the contents of the Indonesian version of the WERF-EPHect Clinical Questionnaire (Standard) questionnaire have 10 stages including the preparation process, Forward Translation, forward reconciliation process, Backward Translation, back translational review, Harmonization Process, Cognitive Debriefing process, reviewing cognitive debriefing and finalization results, Proofreading process and Final report. There are cultural differences from the country of origin of the questionnaire including medicines available in Indonesia, medical terms that are common in the country of origin but unfamiliar in Indonesian population, and the presentation of racial tribes that do not describe variants of Indonesian racial tribes.

 

Conclusion: The WERF-EPHect Clinical Questionnaire (Standard) (EPQ-S) Indonesian version was obtained with contents according to the needs of users in Indonesia and can be applied at the RSCM, out of 116 questions there are 21 questions in the questionnaire that must be guided.

 

Keywords: Translation, Validation, WERF-EPHect Clinical Questionnaire (Standard), Clinical Phenotype, Endometriosis, Indonesia

 

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"ABSTRAKLatar Belakang: Endometriosis merupakan kondisi yang sering ditemukan pada wanita usia reproduksi. Keterlambatan dignosis masih menjadi kendala. Saat ini, metode diagnosis non invasif termasuk transvaginal sonography telah direkomendasikan. Penelitian ini bertujuan mengevaluasi akurasi transvaginal sonogrpahy untuk mendiagnosis kista endometriosis di RS Cipto MangunkusumoMetode: Penelitian ini merupakan penelitian uji diagnostik yang dilakukan di RS Cipto Mangunkusumo pada Januari 2014 ? Juni 2015. Subjek penelitian merupakan pasien rawat jalan dengan kecurigaan kista endometriosis berdasarkan anamnesis dan pemeriksaan fisik. Pasien kemudian diperiksa transvaginal sonography oleh pemeriksa berpengalaman sesuai dengan protokol penelitian. Selanjutnya, pemeriksaan histologi dengan sediaan masa yang diambil dari prosedur operasi dijadikan baku emasHasil: Terkumpul 98 pasien yang dianalisis. Kista endometriosis terkonfirmasi pada 85 pasien (86,7%) berdasarkan pemeriksaan histologi. Akurasi, sensitivitas, spesifisitas, nilai duga positif dan nilai duga negatif transvaginal sonography yakni 84,9 (71,0-98,8)%, 92,9%, 76,9%, 96,3%, and 62,5%. Transvaginal sonography memiliki area under the curve yang lebih tinggi secara signifikan dibandingkan dengan hanya pemeriksaan fisik (84,9% vs 78,8%).Kesimpulan: Transvaginal sonogprahy bermanfaat untuk mendiagnosis kista endometriosis dan dapat direkomendasikan dalam praktik sehari-hari

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ABSTRACTBackground: Endometriosis is common among reproductive age women. Late diagnosis is still the main concern. To date, non-invasive diagnostic test including transvaginal sonography is recommended. This study aimed to evaluate the accuracy of transvaginal sonography to diagnose endometriosis cyst among patients in Cipto Mangunkusumo Hospital.Method: This was a diagnostic study performed in Cipto Mangunkusumo Hospital from January 2014 to June 2015. Outpatients with suspicion to have endometrial cyst based on patients? history and clinical examination were recruited. Patients were then scanned by experienced sonologist using transvaginal sonography following our research protocol. The gold standard was histologic finding of removed surgical massResults: A total of 98 patients were analyzed. Endometrial cyst was confirmed by histology among85 patients (86.7%). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of transvaginal sonography were 84.9 (71.0-98.8)%, 92.9%, 76.9%, 96.3%, and 62.5%, respectively. Transvaginal sonogpraphy significantly had higher area under the curve compared to clinical examination alone (84.9% vs 78.8%).Conclusion: Transvaginal sonography appears to be usefull to diagnose endometriosis cyst among outpatients and recommended in daily clincial practice"