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"Gastroduodenal mucosat integrity has important role in the pathogenesis of gastroduodenal ulcer. It depends on imbalance between aggressive and defensive factors. However, many experts believe that defensive factors has more dominant role. Maintenance of gastrointestinal endothelial integrity appears to define the "cytoprotection" phenomenon and, as discussed below, is a critical component of NSAID-induced GI injury and a potential target for therapeutic intervention,"

"Even though there are still no epidemiological data on the prevalence of Gastro Esophageal Reflux Disease (GERD) in Indonesia, data from The Division of Gastroenterology Department of Internal Medicine Cipto Mangunkusumo Hospital demonstrate signs of esophagitis in 22.8% of all patients with dyspepsia who underwent endoscopic examination. Western countries report a higher rate of GERD than Asian and African countries, possibly due to dietary factors and increased obesity. Besides adequate history and physical examination, there are many other supporting examinations that could be performed to establish the diagnosis of GERD, especiaily endoscopy of the upper gastrointestinal tract and 24-hour esophageal pH monitoring. Even though this condition is rarely fatal, GERD patients should still receive adequate management. Most patients demonstrate a satisfactory response towards therapy which inciudes Iife-style modification as well as medication. Currently the drugs of choice for GERD are proton-pump inhibitors. A combination of proton-pump inhibitors and prokinetics produces a better effect. Patients resistant to medical treatment or those with recurrent esophageal stricture should be considered for anti-reflux surgery."

"We report a case of carcinoma of the esophagus in a 58 years old woman with achalasia, who has been diagnosed since 30 years ago, which initiated by surgical treatment (myotomy) and the symptoms recurred since 3 years ago. According to the progress of the disease, malignancy was strongly suspected due to prolonged stasis and mucosal irritation caused by achalasia (achalasia carcinoma sequence). Because of these contributing factors for the development of serious complications such as malignancy the diagnosis of achalasia must be systematically diagnosed and treated agressively. Surveillance endoscopy in patients with achalasia should be performed every 1-2 years."

"Hepatitis pasca transfusi (HPT) telah lama mendapat perhatian para ahli. Sampai saat ini masih tetap merupakan salah satu komplikasi tindakan transfusi yang sering terjadi dan sering berkembang menjadi kronis, walaupun telah dilakukan pemilahan HBsAg terhadap semua darah donor oleh PMI (1,2,3 ). Berbagai penelitian mengenai kekerapan hepatitis pasca transfusi pada penderita yang mendapat transfusi darah dan komponen-komponennya menunjukkan angka yang berbeda-beda. Angka kekerapan HPT di Amerika Serikat berkisar antara 10-20%, di - Eropa Utara berkisar antara 2-4% sedangkan di Eropa Selatan mungkin berkisar antara 15-20% (dikutip dari 4). Di Jakarta, Rahman (1988) pada penelitiannya terhadap 60 penderita dengan tindakan bedah yang mendapat transfusi darah melaporkan terjadinya 18 kasus (30%) hepatitis pasca transfusi, 3 diantaranya hepatitis virus B (5). Sedangkan Sutanto (1989) pada penelitiannya terhadap 80 penderita yang mendapatkan transfusi darah melaporkan terjadinya 13 kasus hepatitis pasca transfusi (16,25%), 1 diantaranya adalah hepatitis virus B (6). Pada kedua penelitian tersebut, penyebab hepatitis pasca transfusi belum dapat dideteksi, sehingga disebut hepatitis Non A Non B (5,6).

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Post-transfusion hepatitis (HPT) has long received the attention of experts. Until now, it is still a frequent complication of transfusion procedures and often develops into a chronic one, even though HBsAg has been screened for all donor blood by PMI (1,2,3). Various studies regarding the frequency of post-transfusion hepatitis in patients who received blood transfusions and its components show varying figures. The frequency of HPT in the United States ranges from 10-20%, in Northern Europe it ranges from 2-4%, while in Southern Europe it may range from 15-20% (quoted from 4). In Jakarta, Rahman (1988) in his research on 60 patients with surgical procedures who received blood transfusions reported the occurrence of 18 cases (30%) of post-transfusion hepatitis, 3 of which were viral hepatitis B (5). Meanwhile, Sutanto (1989), in his research on 80 patients who received blood transfusions, reported 13 cases of post-transfusion hepatitis (16.25%), 1 of which was hepatitis B virus (6). In both studies, the cause of post-transfusion hepatitis could not be detected, so it was called Non A Non B hepatitis (5,6).

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