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"The current book focuses on three of these categories, pleuritis, acsites and pericarditis. The presented book reports valuable information about malignant effusions to basic and clinical medical specialists in academia, practice, as well as industry. The main topics considered include contemporary diagnostic approaches and modern therapeutic strategies, including conventional drugs, methods of intracavitary adoptive immunotherapy, chemotherapy and hyperthermia, commercial and experimental drugs being still under study. "

"Spontaneous bacterial peritonitis (SBP) is one of serious complication of liver cirrhosis. Most of the patient with SBP have severe reduced liver function that clasified as Child Plugh class C. There are other risk factors for SBP such as poor nutritional status, GI bleeding, intravascular catheter insertion, ascites fluid protein concentration of less than I g/L, large volume paracentesis, urinary tract infection and respiratory tract infection. The management of SBP is mainly the administration of proper antibiotics. The antibiotic of choice for the emperial treatment is cefotaxim."

"Aim: to obtain survival rate and mortality-related factors of malignant obstructive jaundice patients.Methods: all medical records of obstructive jaundice inpatient at Cipto Mangunkusumo Hospital, Jakarta from January 2010 to December 2013 were reviewed retrospectively. The following factors were analyzed in terms of mortality: age, gender, sepsis, hypoalbumin, serum bilirubin level, serum CA 19-9 level, billiary drainage, non-ampulla Vateri carcinoma, and comorbid factors.Results: total 181 out of 402 patients were enrolled in this study with male proportion was 58.6%, and patients aged 50 years or above was 57.5%. Multivariate analysis showed that only sepsis, unsuccessful or no prior biliary drainage and Charlson comorbid score ≥4 were independent predictors of mortality. Patients with significant prognostic factors had median survival 14 days compared with overall median survival 26 days. Score ≥2 identified as the highest prognostic score threshold with sensitivity 68%, specificity 75%, and AUC on ROC curve 0.769.Conclusion: sepsis, unsuccessful or no prior bilirary drainage, and Charlson comorbid score ≥4 are factors significantly associated with shortened survival in malignant obstructive jaundice patients. Prognostic score ≥2 was determined to classify patients into high risk mortality group. Mortality of patients with those significant prognostic factors can be predicted in 76.9%

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.Tujuan: mendapatkan kesintasan dan faktor-faktor yang berhubungan dengan mortalitas pada pasien ikterus obstruktif dengan etiologi maligna.

Metode: penelitian kohort retrospektif dan prospektif dilakukan dengan data sekunder pasien ikterus obstruktif yang dirawat di RS. Cipto Mangunkusumo, Jakarta antara Januari 2010-Desember 2013. Faktor-faktor yang dinilai meliputi umur, jenis kelamin, sepsis, hipoalbumin, tingkat bilirubin serum, tingkat CA 19-9 serum, drainase bilier, keganasan non ca ampula Vater, dan komorbid dengan hasil keluaran berupa mortalitas pasien.

Hasil: sebanyak 181 dari 402 pasien ikterus obstruktif dengan etiologi maligna memenuhi kriteria penelitian dengan proporsi laki-laki sebesar 58,6 % dengan pasien berumur ≥50 tahun sebesar 57,5%. Analisis multivariat menunjukkan bahwa sepsis, riwayat drainase bilier sebelumnya dan skor komorbid Charlson ≥4 merupakan prediktor independen terhadap mortalitas. Median kesintasan pasien dengan faktor prognosis bermakna adalah 14 hari sedangkan median kesintasan keseluruhan 26 hari. Ambang skor prognostik terbaik didapatkan pada skor ≥2 dengan sensitivitas 68% dan spesifisitas 75%. AUC pada kurva ROC 0.769.

Kesimpulan: kesintasan pasien dengan faktor prognosis sepsis, drainase bilier tidak berhasil/tidak ada, dan skor indeks komorbid Charlson ≥4 lebih pendek dibandingkan kesintasan keseluruhan pasien. Skor prognostik ≥2 termasuk dalam risiko tinggi kematian dan kemampuan prediksi mortalitas dari faktor prognosis bermakna adalah 76.9%."

"Background: The ideal therapy for ascites in liver cirrhosis is a low sodium chat and a combination of furosemide and spironolacton. However; this still sometimes does not produce satisfactory results, even after increasing the dose of the diuretic. Such failure occurs due to the influence ol the Renin Angiotensin Aldosterone (RAA) system. Low doses ol ACE inhibitors (captopril) should improve renal blood llow and increase filtration at the glomeruli, thus increasing natriuresis without causing haemodynamic imbalance. Study aim: To discover the natriuretic and diuretic effects of low dose captopril achuvant in patients with liver cirrhosis who have received furosemide and splronolacton by measuring urinary sodium and 24-hour urine output. Materials and method: This study was conducted on in- and out- patients with liver cirrhosis and Ascites at the Dr. Kariedi Central Public Hospital. Semarang, who met the inclusion and exclusion criteria. The study took place from June 1st, 1997 to March 3st1, 1998, and included 40 cases of liver cirrhosis with ascites. Study design: Open comparative randomized clinical trial with permuted blocks. All of the patients received a low let diet, 40 mg of lurosemide, 3x50 mg of spironolacton for 2 weeks, and patients with a urinary sodium level was below 80 mEq/L were randomized into two groups: group A receiving 3 x 6.25 mg of captopril, and group B receiving standard therapy. "

"[Latar belakang : Angka ketahanan hidup dalam 5 tahun pasien penderitakeganasan kanker ovaeium rendah, karena > 70% kasus terlambat didiagnosis.CA125 asites merupakan metode untuk memprediksi kanker ovarium pra bedahsebelum dilakukan tindakan atau tatalaksanha selanjutnya. Tujuan : Penelitian ini bertujuan untuk menurunkan angka kematian akibatkanker ovarium stadium lanjut.Metode : Uji ini adalah uji diagnostik dengan desain potong lintang. Penelitianberlangsung dari Juli 2014 sampai Juni 2015 di Poli onkologi DepartemenObstetri dan Ginekologi RSUPN Dr Cipto Mangunkusumo sampel sebanyak 41kasus. Sampel diambil langsung dari pasien kanker ovarium dengan asites masif.Selanjutnya sampel di analisa nilai sensitivitas dan spesifitasnya. Hasil : Dari 41 orang subjek penelitian didapatkan nilai sensitivitas dan spesifitasyang cukup baik dalam mendiagnosis kanker ovarium, berturut ? turut nialisensitivitas dan spesifitasnya adalah 96% dan 100%. Pemeriksaan kadar CA125asites dapat dipertimbangkan untuk digunakan sebagai salah satu tumor markeruntuk mendiagnosis kanker ovarium dengan asites masif.Kesimpulan : Kadar CA125 asites memiliki nilai sensitivitas dan spesifitas 96% dan 100% untuk mendiagnosa kanker ovarium jenis sel epitel.;Background : Overall five-year survival rate of ovarian cancer is the lowest ofamongst gynecological malignancies, as it diagnosed in late stage diseases.Preoperative CA125 level in ascites fluid is one of the method to guide thesubsequent management. This research aimed to improve ovarian cancer survivalrate.Method :This study was a diagnostic study with cross-sectional review of CA125level in ascites fluid of 41 ovarian malignancy patients in Obstetrics andGynecology Department of RSUPN Dr. Cipto Mangunkusumo to analyze itssensitivity and specificity. Results :This research showed a good sensitivity and specificity of CA125 level,96 % and 100 % respectively. CA125 level in ascites fluid may consider as one ofthe tumour marker to diagnose ovarian malignancy with massive ascited fluid.Conclusion: CA125 level in ascites fluid had a good sensitivity and specificity to diagnose epithelial ovarian malignancy., Background : Overall five-year survival rate of ovarian cancer is the lowest ofamongst gynecological malignancies, as it diagnosed in late stage diseases.Preoperative CA125 level in ascites fluid is one of the method to guide thesubsequent management. This research aimed to improve ovarian cancer survivalrate.Method :This study was a diagnostic study with cross-sectional review of CA125level in ascites fluid of 41 ovarian malignancy patients in Obstetrics andGynecology Department of RSUPN Dr. Cipto Mangunkusumo to analyze itssensitivity and specificity. Results :This research showed a good sensitivity and specificity of CA125 level,96 % and 100 % respectively. CA125 level in ascites fluid may consider as one ofthe tumour marker to diagnose ovarian malignancy with massive ascited fluid.Conclusion: CA125 level in ascites fluid had a good sensitivity and specificity to diagnose epithelial ovarian malignancy.]"

"Ada beberapa metode untuk mendiagnosis karsinoma ovarium, diantaranya pemeriksaan ginekologi, pemeriksaan ultrasonografi, pemeriksaan tumor marker, dan gabungan beberapa pemeriksaan. Akan tetapi, gabungan pemeriksaan tersebut belum memberikan hasil spesifitas dan sensitivitas yang tinggi. Untuk itu masih diperlukan pemeriksaan lain untuk meningkatkan baik sensitivitas ataupun spesifitas, dan salah satu yang menarik untuk diteliti adalah pemeriksaan sitologi kavum uteri. Dengan pemeriksaan sitologi kavum uteri diharapkan dapat ditemukan sel-sel ganas yang berasal dari tumor ganas ovarium. Penemuan sel tumor ganas ovarium dimungkinkan karena adanya mekanisme peristaltik pada tuba fallopii dan tekanan negatif dari kavum uteri, sehingga memungkinkan terjadinya transportasi sel ganas ovarium ke dalam kavum uteri melalui tuba. Penelitian ini bertujuan mengetahui sensitivitas dan spesifitas pemeriksaan sitologi kavum uteri dalam mendeteksi keganasan ovarium dibandingkan dengan pemeriksaan histologi yang umum dilakukan. Penelitian ini merupakan uji diagnostik, dengan pemeriksaan histologi sebagai baku emas, untuk mengetahui sensitivitas, spesifisitas, nilai praduga positif, dan nilai praduga negatif pemeriksaan sitologi kavum uteri. Sebanyak 30 kasus masuk dalam penelitian ini. Ada beberapa faktor yang meningkatkan nilai positif sitologi kavum uteri, antara lain stadium, dan asites. Semakin tinggi stadium semakin besar nilai positif, adanya asites memperbesar kemungkinan positif. Pada uji diagnostik didapatkan sensitivitas sitologi kavum uteri sebesar 48%, spesifisitas 60%, nilai praduga positif 85,7%, dan nilai praduga negatif 18,8%. Kesimpulan: pemeriksaan sitologi kavum uteri dapat digunakan sebagai salah satu metode untuk membantu dalam mendiagnosis karsinoma ovarium. (Med J Indones 2004; 14: 92-6)

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There are several methods for diagnosing ovarian carcinoma, such as gynecological examination, ultrasonographic examination, and tumor marker examination. However, all these combinations have not yielded high specificity and sensitivity results. For this reason, it is necessary to perform other examinations to enhance both specificity and sensitivity, and one of them which is of interest to be studied is cytological examination of uterine cavity. By cytological examination of uterine cavity, it is hoped that malignant cells originating from ovarian malignant tumor can be found. Discovery of ovarian malignant cells is possible because of peristaltic mechanism in the fallopian tube and negative pressure from uterine cavity, that makes possible the transportation of ovarian malignant cells into uterine cavity through the tube. The objective of this study is to understand the sensitivity and specificity of cytological examination of uterine cavity in detecting ovarian malignancy. This study was a diagnostic test with histological examination as the gold standard, to understand sensitivity, specificity, positive prediction value, and negative prediction value of cytological examination of uterine cavity. A total of 30 cases were included in the study. A number of factors enhanced positive results in cytology of uterine cavity. Those factors were stage and ascites. The more advanced the stage, the greater the positive results, and the presence of ascites increased positive results. On diagnostic test, sensitivity of uterine cavity cytology was 48%, specificity 60, positive predictive value 85.7%, and negative predictive value 18.8% respectively. In conclusion, cytological examination of uterine cavity could be used as one of the methods in assisting the diagnosis of ovarian carcinoma. (Med J Indones 2004; 14: 92-6)"

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 22-24Lichen planus is relatively common inflamatory disorder which may have cutaneous and/or mucosal manifestation. The maglinant potential of oral lichen planus is still debatable. Some authors are sceptical about the premaglinant nature of the disease, while other investigators have reporterd that maglinant transformation occur in 1-10% of the cases. The aim of this study is to report a case of erosive oral lichen planus which shows maglinant transformation on histopatologic examination. A man of 39 years old visited the Dental Departement of Kariadi's Hospital with pain symptom of palatum, buccal and gingival mucosa both side for 6 months. On the physical examination shows the white lesions with striae configuration and pain, red erosive area inside on the palatum extends to the buccal mucosa and the gingival. The suspect dignose is erosive lichen planus, but the histopathologic examination shows epidermoid carcinoma. lt is concluded that erosive oral lichen planus has the potential to transform into epidermoid carcinoma."