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"Latar Belakang: Stenosis vena sentral adalah salah satu permasalahan utama yang dihadapi dalam penggunaan akses hemodialisis FAV. Kondisi ini dapat ditangani dengan tindakan single balloon angioplasty. Namun, tatalaksana ini memiliki angka patensi yang tidak memuaskan akibat respon pembuluh darah terhadap barotrauma. Mengetahui risiko yang mempengaruhi patensi pasca tindakan single baloon angioplasty pada penderita stenosis vena sentral penting untuk memprediksi prognosis pasien. Penelitian ini bertujuan untuk mengetahui faktor yang berpengaruh terhadap patensi 6 dan 12 bulan pasca tindakan single baloon angioplasty pada pasien stenosis vena sentral. Metode: Sebuah penelitian kohort retrospektif multicenter pada Januari 2018 – September 2022 di empat rumah sakit dilakukan untuk menilai faktor yang berpengaruh terhadap patensi 6 dan 12 bulan pasca tindakan single baloon angioplasty pada pasien stenosis vena sentral. Faktor yang diteliti mencakup derajat stenosis, panjang stenosis, jumlah stenosis, lokasi stenosis, residual stenosis, ukuran balon, dan tekanan balon. Hasil: Terdapat total 76 pasien pada penelitian ini. Pada penelitian ditemukan faktor yang berpengaruh pada patensi 6 bulan pasca single balloon angioplasty adalah jenis kelamin laki – laki (78.4% vs 46.2%; p 0.004), panjang stenosis ≥ 2 cm (85.7% vs 56.5%; p 0.042), lokasi stenosis pada vena innominata (75% vs 39.3%; p: 0.002),derajat stenosis ≥ 80% (83.3% vs 42.5%; p : 0.001), dan residual stenosis ≥ 30% (85% vs 53.6%; p 0.013). Tidak ditemukan faktor yang berpengaruh pada patensi 12 bulan pasca single balloon angioplasty. Kesimpulan: Terdapat hubungan antara panjang stenosis, lokasi stenosis, derajat stenosis, dan residual stenosis terhadap patensi single balloon angioplasty......Background: Central venous stenosis is one of the main problems encountered in AVF hemodialysis access. This condition can be treated with a single balloon angioplasty. However, this treatment has a low patency rates due to the response of the vessels to barotrauma. Knowing the risks that affect patency after single balloon angioplasty in patients with central venous stenosis is important to predict the patient's prognosis. This study aims to determine the factors influencing 6 and 12 months patency after single balloon angioplasty in central venous stenosis patient. Methods: A multicenter retrospective cohort study in January 2018 – September 2022 in four hospitals was conducted to assess factors that affect 6 and 12 months patency after single balloon angioplasty in patients with central venous stenosis. Factors studied included the degree of stenosis, length of stenosis, number of stenosis, location of stenosis, residual stenosis, balloon size, and balloon pressure. Results: There were a total of 76 patients in this study. In this study, it was found that the factors that affected the patency 6 months after single balloon angioplasty were male gender (78.4% vs 46.2%; p 0.004), stenosis length ≥ 2 cm (85.7% vs 56.5%; p 0.042),stenosis at the innominate vein (75% vs 39.3%; p: 0.002), stenosis degree ≥ 80% (83.3% vs 42.5%; p : 0.001), and residual stenosis ≥ 30% (85% vs 53.6%; p 0.013). There were no factors that had an effect on patency 12 months after single balloon angioplasty. Conclusion: There is a relationship between the length of the stenosis, the location of the stenosis, the degree of stenosis, and the residual stenosis on the patency of single balloon angioplasty"

"[Latar Belakang Gangguan penglihatan adalah gejala kedua yang sering muncul pada tumor otak setelah nyeri kepala. Gejala gangguan penglihatan yang paling sering terjadi pada tumor otak adalah penurunan visus atau tajam penglihatan (low vision sampai kebutaan), sedang tanda yang paling sering dijumpai adalah atrofi n. optikus dan papilledema. Penurunan tajam penglihatan yang dialami penderita tumor otak dapat sangat berat hingga berupa kebutaan. Sampai saat ini belum terdapat data angka kejadian gangguan penglihatan sampai kebutaan pada tumor otak di Indonesia. Metode Sebagai studi potong lintang analitik, dikumpulkanlah data pasien penderita tumor otak di atas usia 6 tahun yang datang berobat ke poliklinik Bedah Saraf FKUIRSCM pasien September 2013 hingga Februari 2014 dari catatan rekam medis. Hasil Jumlah pasien tumor otak yang mengalami buta sebanyak 37 orang (34,6 %) dengan usia rata-rata 45,3 (SD 11,3 tahun). Sebesar 86,5 % penderita berada pada usia produktif 15-54 tahun. Dari 37 pasien tumor otak yang buta terlihat proporsi gejala penyerta terbesar adalah sefalgia (terutama sefalgia kronis), diikuti oleh gangguan oftalmologi lain. Data pemeriksaan funduskopi hanya ditemukan pada kurang dari 50 % penderita, dengan temuan yang terbanyak adalah papil atrofi. Kesimpulan Besar angka kebutaan pada pasien tumor otak menunjukkan bahwa kondisi ini tidak hanya menjadi masalah medis saja tetapi juga masalah sosial yang serius. Banyaknya jumlah pasien tanpa data funduskopi menandakan masih lemahnya standar pemeriksaan neurooftalmologi ataupun pencatatan yang ada saat ini, padahal pemeriksaan funduskopi berperan sangat penting mendeteksi dini kejadian tumor otak pada pasien dengan gangguan penglihatan.......Background Vision impairment is the second most common symptom in brain tumor after headache, with decreased visual acuity or low vision as its most common manifestation, and optic nerve atrophy and papilledema as its most common sign. Blindness may be the final outcome of this impairment. Until now, there is no data regarding the prevalence of vision impairment in brain tumor patient in Indonesia. Method As a analytic cross-sectional study, data is collected from the medical record regarding brain tumor patient above the age of 6 years old who were seen in the neurosurgery facility in FKUI-RSCM from September 2013 to February 2014. Result As much as 37 patient (34,6%) brain tumor patient were found to be blind; mean age was 45,3 years old (SD 11,3 years old), with 86,5% patient was in the productive age 15-54 years old. The commonest related symptoms was headache (especially chronic headache), followed by other ophthalmologic symptoms. Funduscopy data was found only in less than 50% patient; the commonest finding was optic nerve atrophy. Conclusion Blindness rate in brain tumor patient is not just a medical issue, but also a social one. Funduscopy usage must be encouraged more to provide early detection for brain tumor patient with vision impairment.;BackgroundVision impairment is the second most common symptom in brain tumor afterheadache, with decreased visual acuity or low vision as its most commonmanifestation, and optic nerve atrophy and papilledema as its most common sign.Blindness may be the final outcome of this impairment. Until now, there is nodata regarding the prevalence of vision impairment in brain tumor patient inIndonesia.MethodAs a analytic cross-sectional study, data is collected from the medical recordregarding brain tumor patient above the age of 6 years old who were seen in theneurosurgery facility in FKUI-RSCM from September 2013 to February 2014.ResultAs much as 37 patient (34,6%) brain tumor patient were found to be blind; meanage was 45,3 years old (SD 11,3 years old), with 86,5% patient was in theproductive age 15-54 years old. The commonest related symptoms was headache(especially chronic headache), followed by other ophthalmologic symptoms.Funduscopy data was found only in less than 50% patient; the commonest findingwas optic nerve atrophy.ConclusionBlindness rate in brain tumor patient is not just a medical issue, but also a socialone. Funduscopy usage must be encouraged more to provide early detection forbrain tumor patient with vision impairment., BackgroundVision impairment is the second most common symptom in brain tumor afterheadache, with decreased visual acuity or low vision as its most commonmanifestation, and optic nerve atrophy and papilledema as its most common sign.Blindness may be the final outcome of this impairment. Until now, there is nodata regarding the prevalence of vision impairment in brain tumor patient inIndonesia.MethodAs a analytic cross-sectional study, data is collected from the medical recordregarding brain tumor patient above the age of 6 years old who were seen in theneurosurgery facility in FKUI-RSCM from September 2013 to February 2014.ResultAs much as 37 patient (34,6%) brain tumor patient were found to be blind; meanage was 45,3 years old (SD 11,3 years old), with 86,5% patient was in theproductive age 15-54 years old. The commonest related symptoms was headache(especially chronic headache), followed by other ophthalmologic symptoms.Funduscopy data was found only in less than 50% patient; the commonest findingwas optic nerve atrophy.ConclusionBlindness rate in brain tumor patient is not just a medical issue, but also a socialone. Funduscopy usage must be encouraged more to provide early detection forbrain tumor patient with vision impairment.]"

"ABSTRAKLatar belakang: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) merupakan sistem stratifikasi risiko terbaru yang dikembangkan sebagai prediktor mortalitas dan morbiditas pascoperasi penyakit jantung bawaan (PJB), namun belum pernah divalidasi di populasi Indonesia.Tujuan: Melakukan validasi eksternal RACHS-1 pada populasi Indonesia sebagai prediktor mortalitas pascoperasi PJB.Metode: Uji validasi dengan studi kohort, menggunakan data retrospektif dari bank data bagian bedah jantung anak dan kongenital Rumah Sakit Pusat Jantung Nasional Harapan Kita dari Januari 2015-Desember 2019. Uji diagnostik memperlihatkan nilai sensitivitas, spesifisitas dan area under curve-receiving operator characteristic (AUC-ROC) sebagai luaran utama dalam menilai kemampuan prediksi luaran mortalitas.Hasil: Penelitian melibatkan 4139 subjek dengan mortalitas pada 230 subjek (5,6%). RACHS-1 category memiliki sensitivitas 71% dengan spesifisitas 60% dalam memprediksi mortalitas. Kemampuan diskriminasi memperlihatkan hasil yang kurang baik dalam prediksi mortalitas (AUC-ROC 0,673).Kesimpulan: RACHS-1 memiliki kemampuan diskriminasi yang kurang baik sebagai prediktor mortalitas di Indonesia dengan nilai AUC-ROC 0,673.

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ABSTRACTBackground: Risk Adjusted Classification for Congenital Heart Surgery (RACHS-1) were the latest risk stratification methods for congenital heart disease (CHD) surgery that were developed to predict mortality and morbidity outcome, it hasn't been validated in Indonesian population.Objectives: To validate RACHS-1 category as a predictor of mortality in Indonesia.Methods: A Retrospective Cohort study using the database Pediatric and Congenital Heart Surgery Department of National Cardiovascular Harapan Kita Database from January 2015-December 2019. Statistical analysis was done using area under curve-receiving operator characteristic (AUC-ROC) to determine the predictive discrimination of mortality.Results: This study enrolled 4139 subjects with mortality rate of 230 subjects (5.4%). The RACHS-1 category have the sensitiviy of 71% with specificity of 60% to predict mortality. Both of the methods showed a fine discrimination to predict mortality (AUC-ROC 0.673).Conclusion: RACHS-1 has a poor discrimination ability as a predictor of mortality in Indonesia with an AUC-ROC value of 0.673."

"ABSTRAK Operasi dekomprasi vaskular mikro telah diterima sebagai tatalaksana definitif pada berbagai keluhan akibat kompresi mekanik pada kompleks neurovaskular. Tindakan eksplorasi fossa posterior diketahui berhubungan dengan komplikasi gangguan fungsi serebellar dan saraf kranial. Diperlukan adanya evaluasi pasca operasi yang mengintegrasikan aspek pemulihan atas keluhan, dan komplikasi terkait tindakan, dalam menilai luaran pasien secara menyeluruh.TujuanMenilai luaran pasca operasi dekompresi vaskular mikro pada penderita sindrom kompresi kompleks neurovaskular yang dikelola Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2011-Oktober 2015 menggunakan efficacy, complication, total score (ECT score) serta faktor-faktor yang mempengaruhi luaran.MetodePenelitian ini merupakan penelitian historikal prospektif terhadap pasien pasca operasi dekompresi vaskular mikro dengan sindrom kompresi kompleks neurovaskular yang dikelola Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2011-Oktober 2015. Sebagai pembanding digunakan data luaran menurut publikasi ECT score orisinil. Data penelitian ini diperoleh melalui catatan rekam medis.HasilSejak Januari 2011 sampai dengan Oktober 2015, didapatkan 21 pasien trigeminal neuralgia primer dan 11 pasien hemifasial spasme primer yang dilakukan tindakan microvascular decompression. Sebanyak 15 pasien trigeminal neuralgia telah melalui periode lebih dari satu tahun pasca operasi dengan hasil luaran excellent (T-0) 13 pasien (87%), good (T-1) 1 pasien (6%), fair (T-2) 0 pasien, poor (T3-5) 1 pasien (6%). Sebanyak 11 pasien hemifasial spasme primer telah melalui periode lebih dari satu tahun pasca operasi dengan hasil luaran excellent (T-0) 5 pasien (62,5%), good (T-1) 2 pasien (25%), fair (T-2) 0, poor (T3-5) 1 pasien (12,5%). Penelitian ini memiliki jumlah sampel yang terbatas dan tidak didapatkan faktor yang mempengaruhi luaran KesimpulanSkor ECT terbukti bermanfaat dalam menilai luaran pasien paska MVD di RSCM. Jumlah pasien trigeminal neuralgia primer yang sembuh sempurna tanpa komplikasi (T0) di RSCM didapatkan 13 pasien dari 15 pasien. Jumlah luaran pasien hemifasial spasme primer yang sembuh sempurna tanpa komplikasi (T0) di RSCM didapatkan 5 pasien dari 8 pasien. ABSTRACTOutcome of Neurovascular Compression Syndrome Based on Efficacy Complication Total Score in FKUI-RSUPNCM, 2011-2015BackgroundMicrovascular decompression has been administered as neurosurgical armamentary as definitive treatment of mechanical compression of neurovascular. Posterior fossa approach also related to post operative cerebellar and cranial nerve dysfunction. An integrated evaluation combining efficacy and complication of surgical exploration is crucial to determine a comprehensive outcome of post surgical patients.PurposeTo evaluate outcome of microvascular decompression surgery in patient diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score) and related factors.MethodA historical prospective study on patients diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score). The result is compared with the original publication of ECT score outcome. Research data was obtained through medical records.ResultsTwenty one patients diagnosed with trigeminal neuralgia and 11 patients diagnosed with hemifacial spasm were treated by microvascular decompression surgery since January 2011 - October 2015. In trigeminal neuralgia group shown fifteen patients with more than one year post operative period with categorized outcome : 13 patients (87%) excellent (T-0), 1 patient (6%) good (T-1), 0 patient fair (T-2), 1 patient (6%) poor (T3-5). In hemifacial spasm group shown 11 patient with more than one year post operative period with categorized outcome : 5 patient (62,5%) excellent (T-0), 2 patient (25%) good (T-1), 0 patient fair (T-2), 1 patient (12,5%) poor (T3-5). Sample size of research were limited and related to insignificant findings of related factors. ConclusionEfficacy complication total score is efficient in evaluating post microvascular decompression surgery outcome. Trigeminal neuralgia group shown 13 of 15 patients with excellent outcome (T0). Hemifacial spasm group shown 5 of 8 patients with excellent outcome (T0).;TitleOutcome of Neurovascular Compression Syndrome Based on Efficacy Complication Total Score in FKUI-RSUPNCM, 2011-2015BackgroundMicrovascular decompression has been administered as neurosurgical armamentary as definitive treatment of mechanical compression of neurovascular. Posterior fossa approach also related to post operative cerebellar and cranial nerve dysfunction. An integrated evaluation combining efficacy and complication of surgical exploration is crucial to determine a comprehensive outcome of post surgical patients.PurposeTo evaluate outcome of microvascular decompression surgery in patient diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score) and related factors.MethodA historical prospective study on patients diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score). The result is compared with the original publication of ECT score outcome. Research data was obtained through medical records.ResultsTwenty one patients diagnosed with trigeminal neuralgia and 11 patients diagnosed with hemifacial spasm were treated by microvascular decompression surgery since January 2011 - October 2015. In trigeminal neuralgia group shown fifteen patients with more than one year post operative period with categorized outcome : 13 patients (87%) excellent (T-0), 1 patient (6%) good (T-1), 0 patient fair (T-2), 1 patient (6%) poor (T3-5). In hemifacial spasm group shown 11 patient with more than one year post operative period with categorized outcome : 5 patient (62,5%) excellent (T-0), 2 patient (25%) good (T-1), 0 patient fair (T-2), 1 patient (12,5%) poor (T3-5). Sample size of research were limited and related to insignificant findings of related factors. ConclusionEfficacy complication total score is efficient in evaluating post microvascular decompression surgery outcome. Trigeminal neuralgia group shown 13 of 15 patients with excellent outcome (T0). Hemifacial spasm group shown 5 of 8 patients with excellent outcome (T0).;TitleOutcome of Neurovascular Compression Syndrome Based on Efficacy Complication Total Score in FKUI-RSUPNCM, 2011-2015BackgroundMicrovascular decompression has been administered as neurosurgical armamentary as definitive treatment of mechanical compression of neurovascular. Posterior fossa approach also related to post operative cerebellar and cranial nerve dysfunction. An integrated evaluation combining efficacy and complication of surgical exploration is crucial to determine a comprehensive outcome of post surgical patients.PurposeTo evaluate outcome of microvascular decompression surgery in patient diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score) and related factors.MethodA historical prospective study on patients diagnosed with neurovascular compression syndrome managed by Department of Neurosurgery RSUPN Dr. Cipto Mangunkusumo, January 2011-October 2015 based on efficacy, complication, total score (ECT score). The result is compared with the original publication of ECT score outcome. Research data was obtained through medical records.ResultsTwenty one patients diagnosed with trigeminal neuralgia and 11 patients diagnosed with hemifacial spasm were treated by microvascular decompression surgery since January 2011 - October 2015. In trigeminal neuralgia group shown fifteen patients with more than one year post operative period with categorized outcome : 13 patients (87%) excellent (T-0), 1 patient (6%) good (T-1), 0 patient fair (T-2), 1 patient (6%) poor (T3-5). In hemifacial spasm group shown 11 patient with more than one year post operative period with categorized outcome : 5 patient (62,5%) excellent (T-0), 2 patient (25%) good (T-1), 0 patient fair (T-2), 1 patient (12,5%) poor (T3-5). Sample size of research were limited and related to insignificant findings of related factors. ConclusionEfficacy complication total score is efficient in evaluating post microvascular decompression surgery outcome. Trigeminal neuralgia group shown 13 of 15 patients with excellent outcome (T0). Hemifacial spasm group shown 5 of 8 patients with excellent outcome (T0)."

"ABSTRAK Latar belakang: Kolesistektomi merupakan tindakan abdomen tersering dan saat inikolesistektomi laparoskopi (KL) merupakan baku emas dan telah dilakukan pada 90% kasuskolesistitis simtomatik. Tujuan penelitian ini adalah untuk mengetahui hasil KL di RSCM,Jakarta. Metode: Penelitian retrospektif observasional ini menggunakan data dari departemen bedahdivisi digestif RSCM dari bulan Januari hingga Desember 2014. Partisipan penelitian iniadalah pria atau wanita yang berusia 23-66 tahun yang menjalani KL. Tindakan bedahdilakukan baik berupa perawatan 1 hari (one day care (ODC)) maupun elektif. Data yangdikaji adalah temuan preoperatif dan intraoperatif, durasi operasi, lama rawat inap, dan angkakonversi ke tindakan kolesistektomi terbuka (open). Kemudian kami menganalisis faktoryang mempengaruhi angka konversi. Hasil: Jumlah pasien yang masuk inklusi adalah 90 orang. Usia rata-rata 43,9 tahun (SE=1,26tahun) dengan jumlah pasien wanita 61 orang (67,8%). Median durasi operasi adalah 90±36,9menit dimana pasien yang konversi membutuhkan operasi lebih dari 2 jam lebih banyak(12% vs 1,5%), namun tidak bermakna secara statistik (p= 0,63). Median lama rawat inapadalah 9±27.2 hari dan meningkat bermakna pada kasus yag konversi (24±9 hari, p = 0.011).Median lama pre-operasi = 7±26,8 hari, dan pasca-operasi = 2±3.8 hari, dengan 13,3% pasiendilakukan endoscopic retrograde cholangio-pancreatography (ERCP) sebelum KL. Cederaduktus biliaris komunis (CBDK) ditemukan pada 3 kasus (3,33%). Konversi menjadilaparotomi dibutuhkan pada 4,44% kasus. Faktor yang mempengaruhi angka konversi hanyapada kasus adhesi (RR (95%IK) = 25,7 (2,4-273,5); p=0,007. Kesimpulan temuan: kolesistektomi laparoskopi menawarkan lama rawat inap yang lebihsingkat. Durasi operasi pendek dan prosedur ini standard, aman, dan efektif di institusi kami. ABSTRACT Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation andcurrently laparoscopic cholecystectomy (LC) is considered gold standard being performed in90% cases of symptomatic gallstones. The aim of the study was to determine results obtainedwith LC at our hospital, RSCM, Jakarta. Methods: This retrospective observational study was conducted in digestive divison insurgery department of RSCM using data from January to December 2014. The studyparticipants were patients of both gender aged 23?66 years undergoing LC. Surgery wasperformed either in one day care (ODC) or elective schedule. Demographic variables,preoperative and intraoperative findings, mean operation time, hospital stay, and conversionrate were evaluated. Factors influencing rate of conversion were also studied. Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) witha female 61 (67.8%). Median operative time was 90±36.9 minutes which converted casespatient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in convertedcases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate ofconversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007. Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time isshort and procedure is standard, safe and effective in our institution."

"ABSTRAKLatar Belakang: Diagnosis dari fraktur mandibula diperlukan pemeriksaan klinis dan evaluasi radiologi yang akurat. Pemeriksaan radiolografis diperlukan untuk pemeriksaan ketebalan tulang dan evaluasi dari kondisi tulang tersebut, sehingga dapat mengurangi resiko terjadinya kerusakan struktur anatomi tulang antara lain cedera akar gigi dan kanalis mandibula.CBCT merupakan radiografis teknologi digital tiga dimensi yang dapat digunakan untuk melihat kondisi tulang tersebut. Tujuan: Mengetahui ketebalan tulang kortikal bukal dan tulang bukal pada regio gigi C P1 P2, serta ketebalan tulang kortikal regio foramen mental yang diukur menggunakan CBCT pada pria jika dibandingkan dengan wanita. Metode Penelitian: 32 sampel penelitian terdiri dari 16 pria dan 16 wanita yang merupakan pasien di RSGM RE Martadinata Ladokgi. Hasil foto radiografis CBCT dilakukan pengukuran ketebalan tulang kortikal bukal, tulang bukal pada regio gigi C P1 P2, dan ketebalan tulang kortikal regio foramen mental. Hasil: Ketebalan tulang kortikal bukal dan tulang bukal regio gigi C P1 P2, serta ketebalan tulang kortikal regio foramen mental jika dibandingkan antara pria terhadap wanita terdapat perbedaan yang bermakna (p<0,05) dimana pada pria menunjukkan nilai yang lebih tinggi dibandingkan pada wanita. Kesimpulan: Ketebalan tulang kortikal bukal dan tulang bukal regio gigi C P1 P2, serta ketebalan tulang kortikal regio foramen mental yang diukur menggunakan CBCT menunjukkan hasil yang berbeda antara pria dan wanita.

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ABSTRACTBackground: Accurate clinical examinations and radiographic evaluations are required to construct a proper diagnosis for mandibular fractures. To reduce risks of anatomical bone damages such as injuries to dental roots or mandibular canal, radiographic examinations are suggested to determine bone thickness and evaluate bone conditions. CBCT is a digital 3D radiographic technology used in such circumstances. Aim: To determine mandibular buccal cortical bone and buccal bone thickness in canine, first premolar and second premolar region and cortical bone thickness in mental foramen region under gender differentiation using CBCT. Research Method: 32 subjects comprised of 16 male and 16 female patients from RSGM RE Martadinata Ladokgi Hospital; with CBCT radiographs analyzed to determine mandibular buccal cortical bone and buccal bone thickness in canine, first premolar and second premolar region and cortical bone thickness in mental foramen region. Results: There is a significant differences (p<0.05) between females? and males? thickness of mandibular buccal cortical bone and buccal bone in canine, first premolar and second premolar region and the thickness of cortical bone in mental foramen region. Male subjects was found to have greater number of thickness compared to those of females?. Conclusion: Determination of mandibular buccal cortical bone and buccal bone thickness in canine, first premolar and second premolar region and cortical bone thickness in mental foramen region under different gender using CBCT, showed a different result."

"Latar belakang. Adenokarsinoma kolorektal AKR merupakan keganasan gastrointestinal yang sering ditemukan dan mempengaruhi lebih dari satu juta individu di seluruh dunia. Identifikasi histologis invasi limfovaskular telah dikenali sebagai indikasi potensial untuk metastasis KGB dan indikasi prognostik dan prediktor dari luaran pasien.Metode.Penelitian ini adalah penelitian retrospektif dengan regresi logistik multivariat.Hasil. Hasil penelitian didapatkan faktor usia, diferensisasi tumor, pT, dan jenis kelamin tidak mempengaruhi kejadian invasi limfovaskular. AKR diferensiasi sedang dan jenis kelamin laki-laki didapatkan kejadian invasi limfovaskular yang lebih besar dibanding diferensiasi lain dan jenis kelamin perempuan.Kesimpulan. Faktor-faktor yang mepengaruhi invasi limfovaskular yaitu diferensiasi tumor, usia, jenis kelamin, lokasi tumor dan derajat patologis T tidak bermakna secara statistik. Invasi limfovaskular merupakan prediktor terjadinya metastasis KGB.......Background. Adenocarcinoma colon and rectum are the most common gastrointestinal malignancy and afflict more than one million individual worlds wide. Histologic finding of limphovascular invasion has known as potensial indication for lymphatic metastatic and prognostic indication and predictor of patient outcome.Methods. This studi was retrospective, logistic regression test was used for multivariate analysis.Result. Result of this study ara gender, age, tumor differentiation and pT not significantly related to lymphovascular invasion. Mild differentiation and male gender recorded had bigger risk to had lymphovascular invasion descriptively.Conclusion. Factors affecting lymphovascular invasion ie tumor differentiation, age, sex, tumor location and pathologic T degree were not statistically significant. Lymphovascular invasion is a predictor of limph nodes metastasis."

"Pendahuluan. Pada usus yang mengalami iskemia, maka tindakan reperfusi akan dapat membuat kerusakan yang lebih besar pada usus dan juga organ lain. Penelitian ini bertujuan untuk mengetahui pengaruh destrangulasi intestinal terhadap organ yang dekat dengan organ yang mengalami iskemia yaitu usus halus, dan pada organ yang letaknya berjauhan yaitu gaster dan paru-paru, dibandingkan dengan subyek yang tidak mengalami destrangulasi sebelum reseksi usus. Metode. Studi eksperimental yang bersifat deskriptif analitik pada 14 ekor tikus Sprague-Dawley jantan. Pada kelompok perlakuan destrangulasi-reseksi DR dilakukan strangulasi dengan meligasi satu loop usus selama 4 jam, kemudian dilakukan destrangulasi dan reseksi segmen usus yang iskemia. Pada kelompok perlakuan reseksi R dilakukan strangulasi usus selama 4 jam, kemudian segmen usus yang iskemia direseksi tanpa melakukan destrangulasi terlebih dahulu. Pada kelompok kontrol dilakukan laparotomi tanpa strangulasi maupun reseksi. Empat jam setelah intervensi kedua, tikus dimatikan, dan dilakukan pengambilan sampel dari usus halus, gaster, dan paru-paru untuk pemeriksaan histomorfologi dan biokimia dengan menggunakan malondialdehyde MDA. Hasil. Pada pemeriksaan histomorfologi dan MDA, terdapat peningkatan kerusakan jaringan serta kadar MDA pada jaringan usus halus, namun perbedaannya tidak bermakna. Pada jaringan gaster dan paru-paru tidak ditemukan peningkatan kelainan histomorfologi maupun MDA. Kesimpulan. Destrangulasi intestinal sebelum dilakukan reseksi menimbulkan peningkatan kerusakan jaringan dan stress oksidatif pada usus yang berada di luar batas strangulasi, namun perbedaan yang didapatkan tidak bermakna secara statistik. Strangulasi terbatas pada satu segmen usus halus tidak selalu menimbulkan cedera iskemia-reperfusi pada organ gaster dan paru-paru.

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Introduction. On the intestinal ischemia events, reperfusion towards the injured intestine can cause further damage to the bowel and other organ as well. This study aims to understand the influence of intestinal destrangulation before bowel resection towards organs that are near and far from the ischemic bowel, compared with subjects without intestinal destrangulation. The studied subject's organ was small bowel outside margin of strangulation, stomach, and lung.

Methods. Fourteen male Sprague-Dawley rats were randomized either to destrangulation-resection DR, resection R, or control group. One bowel loop was ligated for 4 hours. On the DR group the strangulated bowel was released for 5 minutes and then resected. On the R group the strangulated bowel was immediately resected without destrangulation. The control group received sham laparotomy. After four hours the animals were euthanasized and samples were drawn from small bowel, stomach, and lung for histologic analysis and biochemical analysis of malondialdehyde MDA level.

Results. The histologic injury and MDA level on the small bowel tissue is unsignificantly higher on the DR group compared to the R group p>0,05 . There was no significant injury to the stomach and lung tissue, or elevation of MDA level in both groups.

Conclusion. Intestinal destrangulation before resection of the bowel cause more tissue injury and oxidative stress on the bowel outside the limit of strangulation, but the difference is not statistically significant. Limited strangulation of one bowel loop do not always cause ischemia-reperfusion injury to stomach and lung."

"ABSTRAK Hemodialisis merupakan tatalaksana renal replacement yang tersering pada pasien gagal ginjal kronik stadium 5, Akses vaskular dan morbiditas sebagai akibat komplikasi akses merupakanpenyebab utama perawatan di rumah sakit. Kegagalan maturitas merupakan hambatan utamapenggunaan arteriovenous fistula. Tujuan dari penelitian ini adalah untuk mengkaji korelasi peaksistolik velocity arteri brakialis dan volume flow draining vein intraoperatif denganmenggunakan ultrasonografi doppler untuk memprediksi maturasi AVF. Uji statistik yangdigunakan adalah uji Mann Whitney dan uji Chi Squere. Hasil yang didapatkan tidak ditemukankorelasi antara PSV arteri brakialis dengan maturitas. Rerata nilai titik potong volume flowdraining vein intraoperatif 259,43 ml/min dan paska operatif 679,22 ± 65,36 ml/mindihubungkan dengan maturitas, ini dapat menjadi acuan menetukan perlu tidaknya melakukantindakan revisi saat intraoperatif, yang pada akhirnya diharapkan dapat menurunkan angkakegagalan maturasi AVF. ABSTRACT Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure.;Hemodialisis as treatment for renal replacement often patient chronic renal disease grade 5.Vascular access for hemodialysis its associated problems is the leading cause for hospitaladmission and morbidity.Maturation failure is impeded by issues of maturation. The result fromthis study showed that correlation peak sistolik velocity brakial artery and bloodflow ratemeasured using Doppler ultrasonogaphy right creation of the brachiocephalic fistula can predictAVF maturation. Statistic analisis use Mann Whithey and Chi Squere. Result no correlation PSVwith maturation, The intraoperative Bloodflow rate 259,43 ml/min and post operative 6 week679,22 ± 65,36 ml/min, maybe used as a guide to decide whether or not a corrective procedurewas needed to repair the brachiochephalic and consequently help in reducing the rate of AVFmaturation failure."

"Hemodialisis merupakan tatalaksana renal replacement yang tersering pada pasien gagal ginjal kronik stadium 5, Akses vaskular dan morbiditas sebagai akibat komplikasi akses merupakan penyebab utama perawatan di rumah sakit. Pada tahun 1989 sampai sekarang posisi tip pada pemasangan kateter double lumen masih belum ada keseragaman. Inti dari perbedaan ini adalah kepentingan terhadap keselamatan pasien dan keinginan untuk kinerja kateter yang optimal dalam hal ini untuk akses hemodialisa yang adekuat. Rancangan penelitian adalah sebuah penelitian prospektif potong lintang terhadap pasien gagal ginjal yang menjalani hemodialisa dengan menggunakan CDL tunneling. Penelitian ini merupakan penelitian analitikkorelatif, mencari korelasi antara posisi tip CDL tunneling dengan lancar atau tidak lancarnya selang CDL dan kekuatan tarikan quick blood saat hemodialisa. Hasil yang didapatkan posisi rontgen thorax CAJ lebih memberikan kenyamanan pada pasien dibandingkan dengan posisiSVC. Uji statistic menunjukkan bahwa terdapat hubungan yang signifikan antara Ro Thorax dengan kenyamanan (p<0.05). Posisi tip di SVC memiliki blood flow <300 mL. sedangkan pada pasien dengan posisi tip di CAJ memiliki blood flow >300 mL. Uji statistic menunjukkan hubungan yang tidak signifikan antara ro thorax dengan blood flow (p>0.05).......Hemodialysis is the most common procedure of renal replacement in patients with stage 5 chronic renal failure, vascular access complications and morbidity as a result of access is a major cause of hospitalization. In 1989 to the present position of the tip of double lumen catheter is still no uniformity. The core of this difference is of interest to patient safety and the desire for optimal performance in terms of catheters for hemodialysis access adequate. The study design was a prospective cross-sectional study of patients with renal failure undergoing hemodialysis using tunneling CDL. This research is a correlative analytic, looking for a correlation between the position of the tunneling tip CDL smoothly or not smooth hose pull quick CDL and force of blood when hemodialysis. The results obtained CAJ thorax X-ray positioning more comfortable for patients compared to the SVC. Statistical test shows that there is a significant relationship between Ro Thorax with comfort (p <0.05). Position tip at SVC have blood flow <300 mL. whereas in patients with tip position in the CAJ have blood flow> 300 mL. Statistical tests showed no significant association between ro thorax with blood flow (p> 0.05)."