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Ahmad Fauzi
Pengaruh sildenafil terhadap percepatan penyembuhan fraktur dengan delayed union pada tikus sprague dawley = Role of sildenafil in acceleration of delayed union fracture healing on sprague dawley rats model
"Latar belakang : Delayed union merupakan salah satu komplikasi penyembuhan fraktur dengan insiden berkisar antara 4,4% hingga 31%. Penatalaksanaan delayed union dapat menimbulkan masalah ekonomi dan kesehatan pada pasien. Angiogenesis memiliki peran penting dalam penyembuhan fraktur. Sildenafil telah terbukti menjadi stimulator poten angiogenesis melalui peningkatan regulasi faktor pro-angiogenik atau yang dikenal sebagai vascular endothelial growth factor (VEGF). Studi ini akan menentukan apakah sildenafil juga mempengaruhi aktivitas angiogenesis dengan ekspresi VEGF dan mempercepat penyembuhan fraktur dengan delayed union.
Metode : Penelitian ini merupakan penelitian eksperimental dengan post test only control group design, yang dilakukan pada model delayed union tikus Sprague dawley menggunakan analisis histomorfometri dan imunohistokimia. Penelitian ini diawali dengan studi pendahuluan untuk menentukan model delayed union yang hasilnya akan digunakan sebagai kontrol pada penelitian selanjutnya. Tikus dibagi secara acak menjadi empat kelompok : kelompok delayed union (n=6), kelompok dengan pemberian sildenafil 3,5 mg/kgbb (n=6), sildenafil 5 mg/kgbb (n=6) dan sildenafil 7,5 mg/kgbb (n=6). Parameter yang dievaluasi meliputi luas total kalus, area tulang rawan, area penulangan, jaringan fibrosa dan ekspresi VEGF. Pengukuran dilakukan pada minggu ke-2 dan ke-4 setelah intervensi.
Hasil : Setelah dua minggu kondisi delayed union, sildenafil secara signifikan meningkatkan parameter penyembuhan fraktur. Terjadi peningkatan yang signifikan pada total luas kalus (p=0,004), area tulang rawan (p=0,015), area penulangan (p=0,001), jaringan fibrosa (p=0,005) dan ekspresi VEGF (p=0,037). Setelah empat minggu, perbedaan yang signifikan hanya terjadi pada area penulangan (p=0,015) dan jaringan fibrosa (p=0,001).
Diskusi : Analisis histomorfometri dan imunohistokimia menunjukkan peningkatan yang signifikan pada parameter penyembuhan fraktur dan ekspresi VEGF. Hal ini menunjukkan terjadinya percepatan penyembuhan fraktur dan peningkatan pembentukan pembuluh darah. Semakin sedikitnya area kalus dan berkurangnya area tulang rawan serta meningkatnya area penulangan menunjukkan percepatan proses penyembuhan fraktur. Sildenafil meningkatkan aktivitas angiogenesis dengan meningkatnya ekspresi VEGF dan perbaikan vaskularisasi. Perbaikan vaskularisasi pada fraktur tidak hanya memperbaiki oksigenasi dan nutrisi jaringan, tetapi juga menyediakan suplai mesenchymal stem cells (MSCs) pada jaringan fraktur.
Simpulan : Sildenafil terbukti mempercepat penyembuhan fraktur dan meningkatkan ekspresi VEGF pada fraktur dengan delayed union.
Introduction : Inspite of various methods of management to achieve optimum fracture healing, delayed union remains a major problem. The incidence of delayed union ranging from 4.4% to 31%. The management of such problem include secondary operative intervention, which results in economic impact and patient morbidity. Angiogenesis plays an important role in fracture healing. Sildenafil has been shown to be a potent stimulator of angiogenesis through upregulation of pro-angiogenic factors or known as vascular endothelial growth factor (VEGF). This study will evaluate whether sildenafil also influences VEGF expression and bone formation during the process of healing in delayed union fracture.
Method : This study was an experimental study with post test only control group design. It was performed ina delayed union femur fracture model of Sprague Dawley rats using histomorphometric and immunohistochemistry evaluation. A pilot study was initiated previously to determine the model for delayed union fracture healing, and the results were used as the control. Rats were randomized into four groups : delayed union (n=6), administration of sildenafil 3.5 mg/kgbw (n=6), sildenafil 5 mg/kgbw (n=6) and sildenafil 7.5 mg/kgbw (n=6). The parameters evaluated include total area of callus, cartilage area, total osseous tissue, fibrous tissue and VEGF expression. The measurement was carried out at 2 and 4 weeks after intervention.
Results : After two weeks of delayed union fracture healing, sildenafil significantly increased the parameter of fracture healing. The results showed a significant increase of total area of callus (p=0.004), cartilage area (p=0.015), total osseous tissue (p=0.001), fibrous tissue (p=0.005) and VEGF expression (p=0.037). After four weeks, the results were still significant in total osseous tissue (p=0.015) and fibrous tissue (p=0.001).
Discussion : Histomorphometric and immunohistochemistry analysis showed a significant increase of fracture healing parameter and higher expression of the proangiogenic factors (VEGF). Such result confirmed the increase of bone and vascular formation. A smaller callus area with a slightly reduced amount of cartilaginous tissue and increased osseous tissue indicated an accelerated healing process. Sildenafil improves the expression of VEGF and vascularization repair. The vascular invasion in a fracture not only provide oxygen and nutrients needed to repair the injured tissue cells, but also provide an additional source of MSCs.
Conclusion : Sildenafil is proven to effectively accelerate fracture healing and increase VEGF expression in delayed union fracture."
Depok: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tugas Akhir  Universitas Indonesia Library
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Yang, Andrew Jackson
Evaluasi kanker payudara lokal lanjut pasca mastektomi: rekurensi dan faktor klinikohistopatologis yang mempengaruhinya = Evaluation of locally advanced breast cancer post mastectomy: recurrence and affecting clinicohistopathology factors
"Pendahuluan: Kanker payudara lokal lanjut merupakan skenario klinis yang amat sering dijumpai di negara berkembang, dimana rekurensi masih menjadi permasalahan. Mastektomi merupakan salah satu terapi utama. Usia, stadium klinis, keterlibatan kelenjar getah bening, tipe histopatologis, grade histopatologis, subtipe tumor merupakan faktor-faktor klinikohistopatologis yang mempengaruhi rekurensi. Tujuan penelitian ini adalah untuk mengetahui pengaruh faktor-faktor tersebut terhadap rekurensi kanker payudara lokal lanjut pasca mastektomi.
Metode: Desain penelitian bersifat analitik potong lintang. Pengumpulan data dilakukan pada semua pasien kanker payudara lokal lanjut yang telah dilakukan mastektomi serta terapi definitif sesuai stadium tumor dan terdapat disease free interval serta dapat diikuti minimal 24 bulan pada periode Januari 2011 - Desember 2012 di RS Dr.Cipto Mangunkusumo.
Hasil: Didapatkan 39 pasien dengan kanker payudara lokal lanjut yang telah dilakukan mastektomi serta terapi definitif dan terdapat disease free interval dengan median follow up 30 bulan. Jumlah rekurensi adalah 7,6%. Pada analisis bivariat ditemukan hubungan bermakna antara jenis histopatologi (p 0,008) dan keterlibatan kelenjar getah bening (p 0,026) dengan rekurensi. Pada analisis multivariat didapati faktor yang paling berpengaruh terhadap rekurensi adalah keterlibatan kelenjar getah bening (p 0,002).
Konklusi: Faktor yang paling berpengaruh terhadap terjadinya rekurensi kanker payudara lokal lanjut pasca mastektomi adalah kelenjar getah bening positif tumor dengan jumlah lebih dari tiga.
Introduction: Locally advanced breast cancer is clinical scenario that is very common in developing countries where recurrence is still a problem. Mastectomy is one of the primary teraphy. Age, clinical stage, lymph nodes involvement, histopathlogic type, histopatologic grades, tumor subtypes are clinicohystopatoligic factors affecting recurrence. The purpose of this study was to determine the influence of these factors on the recurrence of locally advanced breast cancer after mastectomy.
Methodology: The study design was analytical cross-sectional. Data collection was performed in all patients with locally advanced breast cancer who had performed mastectomy and appropriate definitive therapy according to tumor stage, had disease free interval and can be followed at least 24 month in the period January 2011 - December 2012 at the Hospital Dr. Cipto Mangunkusumo.
Result: There were 39 patient with locally advanced breast cancer patient who had performed mastectomy as well as definitive therapy, had disease free interval with a median follow-up interval of 30 months. The number of recurrences was 7,6%. In the bivariate analysis found a significant relationship between the hystopathology type (p 0,008), lymph node involvement (p 0,026) with recurrence. In multivariate analysis found that the most influential factor to reccurrence was lymph node involvement (p 0,002).
Conclusion: The most influential factor on the occurrence of locally advanced breast cancer recurrence after mastectomy is tumor positive lymph nodes in an amount greater than three."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tugas Akhir  Universitas Indonesia Library
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Yulinda
Evaluasi tatalaksana kasus malformasi arteri vena di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo 2010-2013 = Evaluation therapy of arterial venous malformation at Cipto Mangunkusumo Hospital 2010-2013
"Malformasi Arteri Vena (MAV) adalah kelainan kongenital atau yang didapat(acquired) dan penegakan diagnosisnya cukup beragam,juga terapi dan prognosisnya. Modalitas terapi MAV bervariasi, mulai dari injeksi scleroting agent hingga teknik operasi yang kompleks, termasuk pilihan terapi pembedahan minimal invasif, yang berdampak pada prognosis pasien. Hasil penelitian menyatakan bahwa tatalaksana MAV dengan pendekatan secara multidisipliner sudah mulai dilakukan di RSUPN Cipto Mangunkusumo,dimana eksisi tetap merupakan terapi yang paling ideal untuk menciptakan kesembuhan. Akan tetapi, terapi pembedahan saja hanya menghasilkan kontrol inkomplit dari lesi karena morbiditas tinggi terkait reseksi komplit (complete surgical resection). Pembuangan lesi MAV total dengan pembedahan seringkali dikerjakan melawan morbiditas dan angka komplikasi yang tinggi (misalnya kehilangan darah masif, hilangnya fungsi organ). Hanya jika lesi dapat terlokalisasi dengan baik, sehingga memungkinkan morbiditas rendah dengan eksisi total, sebaiknya tatalaksana dikombinasi dengan pendekatan endovaskular menggunakan terapi emboli dan terapi sklerosis.
Arterial Venous Malformation (AVM) is a congenital or acquired abnormalities and enforcement is quite diverse diagnosis, therapy and prognosis as well. AVM therapeutic modalities varied, ranging from injection scleroting agent to complex surgery techniques, including minimally invasive surgical treatment options, which have an impact on patient prognosis. The study states that the management of AVM with a multidisciplinary approach has begun to do in Cipto Mangunkusumo, where excision remains the most ideal therapy to create healing. However, surgical treatment alone produced only an incomplete control of the high morbidity associated lesions because complete resection (complete surgical resection). Disposal of AVM total lesion with surgery is often done against morbidity and complication rates are high (eg, massive blood loss, loss of organ function). Only if the lesion can be localized well, allowing a low morbidity with total excision, preferably combined with the management of the endovascular approach using embolic therapy and therapy sclerosis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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Radhita Fatma Kamil
Manfaat skor APACHE II, MPI, dan ARPI sebagai penentu On Demand Relaparotomy = Benefits of APACHE II, MPI, and ARPI as determinants of On Demand Relaparotomy
"[ABSTRAK
Pendahuluan: Keputusan relaparotomi yang terlambat menambah morbiditas dan mortalitas. Keputusan on demand relaparotomy bersifat subjektif dari klinis, sehingga diperlukan pemeriksaan diagnostik tambahan dan alat untuk menentukan keputusan secara tepat, yaitu sistem skor. Metode penelitian: kasus kontrol dengan menggunakan 32 kasus on demand relaparotomy dan 64 kasus laparotomi, secara retrospektif. Hasil penelitian: Analisis perbedaan dua kelompok menunjukkan bahwa skor APACHE II tidak mempunyai perbedaan bermakna (p=0,144) sedangkan skor MPI dan ARPI mempunyai perbedaan yang bermakna (p<0,0001). Dari kurva ROC didaptkan APACHE II mempunyai AUC 59,2% dengan cut off point 10, MPI mempunyai AUC 86,4% dengan cut off point 20 dan ARPI mempunyai AUC 77,6% dengan cut off point 10. Kesimpulan: MPI dan ARPI bermanfaat sebagai penentu on demand relaparotomy.ABSTRACT Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.
Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.
Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.
Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ;Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.
Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. , Background: Delayed decision to do relaparotomy add morbidity and mortality. The decision to do on demand relaparotomy is subjective based on the clinical nature, therefore, it is necessary to have an examination and additional diagnostic and tools to determine the correct decisions, that is the scoring system. Methods: this is a case-control using 32 cases of on demand relaparotomy and 64 cases of laparotomy, retrospectively. Results: The analysis of the two groups showed that APACHE II has no significant difference (P = 0.114) while the MPI and ARPI has significant difference (P <0.0001) and on ROC curve obtained APACHE II had AUC of 59.2% with a cut-off point of 10, MPI had AUC of 86.4% with a cut-off point of 20 and ARPI had AUC of 77.6% with a cut-off point of 10.
Conclusion: MPI and ARPI can be used as determinants on demand relaparotomy. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Faisal Ali Ahmad Kler
Evaluasi spektrum gelombang USG Doppler dan kaitannya dengan Ankle Brachial Index (ABI) dan faktor-faktor risiko pada pasien Peripheral Arterial Disease (PAD) = The evaluation of Doppler Ultrasonography spectral waveform and its relationship with Ankle Brachial Index (ABI) value and risk factors in Peripheral Artery Disease (PAD) paitents
"[ABSTRAK
Salah satu komplikasi dari Peripheral Arterial Disease (PAD) adalah kerusakan tungkai bawah hingga tidak
dapat digunakan untuk beraktifitas. PAD disebabkan oleh gangguan vaskular yang menyebabkan atherosklerotik
pada vaskular di bagian distal. Suatu penelitian kohort di Swedia menyatakan bahwa penyembuhan primer, laju
amputasi dan mortalitas pada pasien PAD berhubungan dengan derajat insufisiensi vaskular. Dengan demikian perlu dilakukan penelitian untuk mengetahui karakteristik vaskular pada kasus PAD secara kuantitatif maupun kualitatif serta hubungannya dengan nilai Ankle Brachial Index (ABI) dan gambaran gelombang Doppler Ultrasonography(DUS). Metode penelitian menggunakan studi potong lintang. Hasil penelitian didapatkan
pasien PAD dengan nilai ABI rata-rata 0,7 dengan gambaran gelombang DUS yang berubah dari trifasik
menjadi non-tirfasik dominan pada arteri infrapopliteal. ABI di bawah 0.9 menunjukkan perubahan pada gelombang DUS dari arteri femoralis hingga a.dorsalis pedis dengan nilai p <0.05. Faktor-faktor risiko yang paling tampak adalah usia di atas 45 tahun yang menunjukkan peningkatan risiko PAD. Selain itu hubungan
ABI dan faktor ?faktor risiko menunjukkan bahwa hiperlipidemia dan diabetes melitus menunjukkan hubungan signifikan dengan p<0,05. Sedang pada hubungan DUS dan faktor-faktor risiko hanya usia >45 tahun yang
tampak secara statistik signifikan meski secara klinis faktor-faktor risiko yang lain menunjukkan jumlah
persentase yang diatas 50%. Disimpulkan bahwa dengan mengetahui nilai ABI dapat ditentukan derajat
keparahan PAD dan juga dengan mengetahui gelombang DUS saja maka dapat diketahui oklusi di tingkat segmen arteri yang mana.Selain itu, usia di atas 45 tahun, hiperlipidemia dan juga diabetes melitus merupakan faktor risiko yang penting untuk terjadinya atherosklerosis dan penyumbatan pada distal arteri. Penggunaan DUS untuk menentukan tingkat penyumbatan sangat informatif dalam hal penggambran gelombang, aman dan murah sehingga dapat menetukan tindakan selanjutnya.ABSTRACT One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. ;One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. , One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it’s safe, low cost and can indicate towards future intervention. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Siagian, Minarma
Reliabilitas submentovertex dalam pengukuran mandibula berdasarkan perbandingan ukuran radiogram terhadap ukuran tulang asli studi kuantitatif pada tulang tengkorak kering manusia = Reliability of submentovertex image compared to direct mandible measurements study in dried human skull
"[ABSTRAK
Berbagai macam panduan rekonstruksi mandibula telah dikembangkan untuk mengurangi angka komplikasi Golden standard panduan rekonstruksi mandibula saat ini adalah pemeriksaan radiologi 3 dimensi yang memberikan ukuran sesuai dengan ukuran aslinya namun proyeksi submentovertex memiliki kelebihan berupa efektifitas dalam menampilkan keseluruhan struktur kraniomaksilofasial dalam satu film sehingga menjadi lebih singkat pengerjaannya dan ekonomis Tujuan Penelitian ini bertujuan melihat reliabilitas ronsen submentovertex dengan membandingkan hasil pengukuran menggunakan kaliper mitutuyo langsung pada tulang mandibula dengan hasil pengukuran mandibula menggunakan PACS pada ronsen submentovertex Material dan metodePenelitian ini menggunakan 50 tulang mandibula yang dipasangkan dengan tulang kranium dan tulang kalvaria Penanda logam bentuk bulat diameter 1mm dipasang pada titik Pogonion Gonion kiri dan kanan Lateral Procesus Condylaris kiri dan kanan Parameter yang diukur adalah jarak titik Gonion kiri ke Gonion kanan jarak titik Lateral Procesus Condylaris kiri ke Lateral Procesus Condylaris kiri besar sudut yang dibentuk oleh titik Gonion kanan Pogonion Gonion kiri dan besar sudut yang dibentuk oleh titik Lateral Procesus Condylaris kiri Pogonion Lateral Procesus Condylaris kanan Tulang tengkorak kemudian dironsen submentovertex Pengukuran manual dilakukan menggunakan kaliper mitutuyo langsung pada tulang mandibula sedangkan pengukuran ronsen Submentovertex menggunakan program Picture Archiving Computerised System Pengukuran dilakukan tiga kali dengan jarak waktu pengukuran 24 jam oleh satu orang Hasil pengukuran manual dan submentovertex kemudian dibandingkan dengan menggunakan uji statistik t berpasangan dengan tingkat ketelitian 95 p0 05 yang berarti hasil pengukuran manual dan submentovertex berbeda bermakna Kesimpulan Ukuran tulang mandibula hasil pengukuran menggunakan kaliper dengan Submentovertex berbeda bermakna Hasil pengukuran angular dan linear pada submentovertex lebih besar daripada hasil pengukuran manual pada tulang mandibula ABSTRACT IntroductionAblative tumor surgery cause discontinuity of the mandible Various guidances had been introduced in mandible reconstruction to reduce complication rate Three dimensional computed assisted is the golden standard Plain radiology such as submentovertex has some advantages cost efective and low radiation dose Every guidance must be reliable Objective The purpose of this study is to examine the reliabity of submentovertex image compared to golden standard of direct mandible measurement using caliper Material and MethodThe sample of this study were 50 dried human mandibles paired with os calvaria and os cranium 1mm diameter of metal marker were placed in Pogonion left and right Gonion right and left Lateral Procesus Condylaris Linear measurements were left Gonion ndash right Gonion right Lateral Procesus Condylaris ndash left Lateral Procesus Condylaris Angular measurements were right Gonion ndash Pogonion ndash left Gonion and right Lateral Procesus Condylaris ndash Pogonion ndash left Lateral Procesus Condylaris Direct measurement on the mandible was done by using caliper Mitutuyo and Picture Archiving Computerised System for measuring the mandible on submentovertex image One observer measured the mandible three times 24 hours range of time for each measurements The result between direct measurement and submentovertex image were compared and tested using paired t test p0 05 Conclusion There were significant difference on both angular and linear measurement of the mandible between direct caliper measurement and Picture Archiving Computerised System for Submentovertex image ;IntroductionAblative tumor surgery cause discontinuity of the mandible Various guidances had been introduced in mandible reconstruction to reduce complication rate Three dimensional computed assisted is the golden standard Plain radiology such as submentovertex has some advantages cost efective and low radiation dose Every guidance must be reliable Objective The purpose of this study is to examine the reliabity of submentovertex image compared to golden standard of direct mandible measurement using caliper Material and MethodThe sample of this study were 50 dried human mandibles paired with os calvaria and os cranium 1mm diameter of metal marker were placed in Pogonion left and right Gonion right and left Lateral Procesus Condylaris Linear measurements were left Gonion ndash right Gonion right Lateral Procesus Condylaris ndash left Lateral Procesus Condylaris Angular measurements were right Gonion ndash Pogonion ndash left Gonion and right Lateral Procesus Condylaris ndash Pogonion ndash left Lateral Procesus Condylaris Direct measurement on the mandible was done by using caliper Mitutuyo and Picture Archiving Computerised System for measuring the mandible on submentovertex image One observer measured the mandible three times 24 hours range of time for each measurements The result between direct measurement and submentovertex image were compared and tested using paired t test p0 05 Conclusion There were significant difference on both angular and linear measurement of the mandible between direct caliper measurement and Picture Archiving Computerised System for Submentovertex image , IntroductionAblative tumor surgery cause discontinuity of the mandible Various guidances had been introduced in mandible reconstruction to reduce complication rate Three dimensional computed assisted is the golden standard Plain radiology such as submentovertex has some advantages cost efective and low radiation dose Every guidance must be reliable Objective The purpose of this study is to examine the reliabity of submentovertex image compared to golden standard of direct mandible measurement using caliper Material and MethodThe sample of this study were 50 dried human mandibles paired with os calvaria and os cranium 1mm diameter of metal marker were placed in Pogonion left and right Gonion right and left Lateral Procesus Condylaris Linear measurements were left Gonion ndash right Gonion right Lateral Procesus Condylaris ndash left Lateral Procesus Condylaris Angular measurements were right Gonion ndash Pogonion ndash left Gonion and right Lateral Procesus Condylaris ndash Pogonion ndash left Lateral Procesus Condylaris Direct measurement on the mandible was done by using caliper Mitutuyo and Picture Archiving Computerised System for measuring the mandible on submentovertex image One observer measured the mandible three times 24 hours range of time for each measurements The result between direct measurement and submentovertex image were compared and tested using paired t test p0 05 Conclusion There were significant difference on both angular and linear measurement of the mandible between direct caliper measurement and Picture Archiving Computerised System for Submentovertex image ]"
Fakultas Kedokteran Gigi Universitas Indonesia, 2015
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Budhi Arifin Noor
Pengaruh eksisi tangensial dini terhadap kadar prokalsitonin pasien luka bakar berat = The influence of early tangential excision to the level of procalcitonin serum in patients with severe burns
"[ABSTRAK
Luka bakar menyebabkan terbentuknya eskar. Endotoksin bakteri pada eskar dan mediator inflamasi yang terbentuk saat lisis eskar menyebabkan sepsis. Eksisi tangensial dini merupakan upaya menurunkan risiko sepsis melalui pembuangan eskar. Prokalsitonin (PCT) adalah penanda inflamasi yang baik pada sepsis yang akan menurun kadarnya dengan tatalaksana yang adekuat.
Sampai saat ini belum ada penelitian yang menghubungkan eksisi dini dengan PCT. Penelitian ini bertujuan untuk mengetahui pengaruh tindakan eksisi tangensial dini terhadap kadar PCT serum pasien luka bakar berat. Desain penelitian ini adalah analitik observasional pre and post intervention study. Besar sampel yang digunakan adalah empat puluh. Data PCT diambil dari data sekunder yaitu dari rekam medis kemudian dianalisis menggunakan uji Wilcoxon. Didapati perbedaan bermakna antara PCT sebelum operasi dengan PCT sesudah operasi (2,78 (0,09-50,62) vs 1,31 (0,02-83,14), p < 0,005).
ABSTRACT Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).;Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005)., Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn’t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Rizky Amaliah, supervisor
Karakteristik pasien ulkus peptikum perforasi dan kaitannya dengan morbiditas dan mortalitas di Rumah Sakit Cipto Mangunkusumo periode Januari 2006 - Maret 2012 = Characteristic of perforated peptic ulcer patient and correlation in morbidity and mortality in Cipto Mangunkusumo Hospital 2006 January - 2012 March
"[ABSTRAK
Ulkus peptikum perforasi merupakan salah satu kasus bedah gawat darurat yang cukup sering di RSCM. Perkembangan medikamentosa dalam tatalaksana ulkus peptikum telah berkembang pesat sehingga menurunkan angka tindakan bedah secara elektif. Studi ini bertujuan untuk melihat karakteristik dan faktor risiko pasien dengan morbiditas dan mortalitas ulkus peptikum perforasi. Seluruh pasien ulkus peptikum perforasi yang dilakukan tindakan pembedahan emergensi di Instalasi Gawat Darurat Rumah Sakit Cipto Mangunkusumo periode Januari 2006 sampai dengan Maret 2012 dievaluasi secara retrospektif. Empat puluh delapan pasien ulkus peptikum perforasi telah dilakukan tindakan pembedahan di IGD RSCM yang terdiri dari 36 pasien laki-laki dan 12 pasien perempuan dengan usia berkisar antara 17 ? 97 tahun. Faktor risiko terbanyak adalah pemakaian obat-obatan ulserogenik (NSAID dan jamu) sebanyak 70.83%. Sebanyak 52.08% pasien dengan ulkus peptikum perforasi datang dengan keluhan yang dirasakan >24 jam dengan rerata durasi 42 jam. Lokasi perforasi tersering adalah prepilorus sebanyak 66.7% dengan median diameter perforasi 10 mm. Tindakan tersering yang dilakukan adalah penjahitan primer dengan omental patch sebanyak 93.75%. Komplikasi tersering adalah acute kidney injury, sepsis dan infeksi luka operasi sebanyak 45.83%, 31.25% dan 14.58%. Angka morbiditas dan mortalitas pasien ulkus peptikum perforasi adalah 68.75% dan 33.3%. Pada studi ini tidak ditemukan hubungan yang bermakna antara karakteristik pasien dengan morbiditas dan mortalitas. Angka morbiditas dan mortalitas pasien ulkus peptikum perforasi masih tinggi. Faktor risiko yang ada dapat digunakan untuk meningkatkan pilihan tindakan dan menurunkan morbiditas dan mortalitas pasien ulkus peptikum perforasi. ABSTRACT Perforated peptic ulcer is one of the most common emergency case in RSCM. Development medicine treatment in peptic ulcer treatment had developed hence had decreased number of elective surgical treatment. This study was aimed to identify patients? characteristic and risk factor in perforated peptic ulcer in morbidity and mortality. All of the patient of perforated peptic ulcer that was done emergency laparotomy in emergency operating room of Cipto Mangunkusumo Hospital since 2006 January until 2012 March was evaluated retrospectively. Fourty eight percent of perforated peptic ulcer patients had been done surgery in Emergency Operating Room of Cipto Mangunkusumo Hospital that consist of 36 male and 12 female with age range 17 ? 97 years old. The most common risk factor is ulcerogenic drug using (70.83%). Patients came to hospital >24 hours (52.08%) after felt complaint with mean duration 42 hours. The most common location of perforation was prepiloric with median of diameter was 10 mm. The most common surgical treatment was primary suturing with omental patch (93.75%). The common complication were acute kidney injury, sepsis and surgical wound infection around 45.83%, 31.25% and 14.58%/. Morbidity rate was 68.75%. Mortality rate was 33.3%. There were no relation between patients? characteristic with morbidity and mortality. Morbidity and mortality rate in perforated peptic ulcer were still high. Risk factor that still be used to increase more choice for surgical treatment and decrease morbidity and mortality rate in perforated peptic ulcer., Perforated peptic ulcer is one of the most common emergency case in RSCM. Development medicine treatment in peptic ulcer treatment had developed hence had decreased number of elective surgical treatment. This study was aimed to identify patients’ characteristic and risk factor in perforated peptic ulcer in morbidity and mortality. All of the patient of perforated peptic ulcer that was done emergency laparotomy in emergency operating room of Cipto Mangunkusumo Hospital since 2006 January until 2012 March was evaluated retrospectively. Fourty eight percent of perforated peptic ulcer patients had been done surgery in Emergency Operating Room of Cipto Mangunkusumo Hospital that consist of 36 male and 12 female with age range 17 – 97 years old. The most common risk factor is ulcerogenic drug using (70.83%). Patients came to hospital >24 hours (52.08%) after felt complaint with mean duration 42 hours. The most common location of perforation was prepiloric with median of diameter was 10 mm. The most common surgical treatment was primary suturing with omental patch (93.75%). The common complication were acute kidney injury, sepsis and surgical wound infection around 45.83%, 31.25% and 14.58%/. Morbidity rate was 68.75%. Mortality rate was 33.3%. There were no relation between patients’ characteristic with morbidity and mortality. Morbidity and mortality rate in perforated peptic ulcer were still high. Risk factor that still be used to increase more choice for surgical treatment and decrease morbidity and mortality rate in perforated peptic ulcer.]"
Fakultas Kedokteran Universitas Indonesia, 2013
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Ridho Ardhi Syaiful
Infeksi daerah operasi pada pembedahan abdominal di Rumah Sakit Cipto Mangunkusumo Jakarta dari tahun 2012-2013 = Surgical site infection in abdominal surgery at Cipto Mangunkusumo Hospital from 2012-2013
"[ABSTRAK
Infeksi daerah operasi merupakan hal yang harus diperhatikan oleh para ahli bedah mengingat tingginya morbiditas dan mortalitas pada pasien yang menderita infeksi daerah operasi Penulis ingin melakukan analisa secara garis besar bagaimana infeksi daerah operasi terutama pada infeksi daerah operasi pada operasi dengan golongan operasi bersih dan bersih tercemar Dilakukan penelitian retrospektif terhadap semua pasien divisi bedah digestif FKUI RSCM dari september 2012 hingga Juli 2014 Pasien dinilai berdasarkan kondisi preoperatif intraoperatif dan pasca operatif Dari data yang terhimpun selama penelitian di dapatkan 57 pasien menderita infeksi daerah operasi Delapan persen dari seluruh total operasi bedah digestif Keganasan kolorektal adenocarcinoma kolorektal menempati urutan pertama 22 39 Didapatkan 2 kasus yang merupakan operasi dengan tipe operasi bersih Didapatkan 17 kasus yang merupakan operasi dengan tipe bersih terkontaminasi Kata kunci Infeksi Daerah Operasi Pembedahan abdominal ABSTRACTSurgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery , Surgical site infection SSI have been responsible for the increasing cost morbidity and mortality related to surgical operations and continue to be a major problem even in hospitals with most modern facilities This study aimed to determine the incidence of SSI in the abdominal surgeries Obsteric and Gynecology surgery was excluded It was conducted over a period of 12 months All Surgeries 791 cases where abdominal wall was opened were considered for the study Wound class was considered as clean clean contaminated contaminated and dirty The data collected includes details of timing of antimicrobial prophylaxis surgical wound infection types of surgeries emergency and elective nutrional status preoperative condition ASA preoperative bed stay intraoperative condition bleeding amount duration of operative and death rate The overall surgical wound infection rate was 8 Predominantly male had SSI than female Mostly case at productive age 25 65 years Colorectal was leading case of SSI 22 cases There was one case of clean surgery ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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Yusak Kristianto
Perbandingan antara klasifikasi Jepang dan sistem TNM dalam menentukan stadium keganasan sigmoid dan rektum di RSCM-RSF (laporan pendahuluan) = Comparison of Japanese classification with the tnm system in determining stage classification of sigmoid and rectal cancer patients at Cipto Mangunkusumo Hospital Fatmawati Hospital (preliminary study)
"[ABSTRAK
Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification]"
Fakultas Kedokteran Universitas Indonesia, 2015
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