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Abstrak :
ABSTRAK Latar belakang: latihan fisik aerobik teratur dapat menyebabkan perubahan morfometrik, peningkatan ukuran miosit dengan peningkatan ekspresi connexin43 (Cx43) tanpa lateralisasi, serta peningkatan deposisi matriks ekstraseluler. Latihan fisik sebaiknya dimulai sejak masa anak-anak, guna mencapai kesehatan kardiovaskular di masa dewasa. Metode: Tikus usia juvenile dan dewasa muda dibagi secara acak dalam 7 kelompok, yaitu: kelompok latihan fisik onset juvenile durasi 4 minggu dan kontrol, kelompok latihan fisik onset juvenile durasi 8 minggu dan kontrol, kelompok latihan fisik onset juvenile durasi 12 minggu, kelompok latihan fisik onset usia dewasa muda durasi 8 minggu dan kontrol. Latihan fisik disesuaikan dengan usia tikus dan dipertahankan pada kecepatan 20 m/menit selama 20 menit intermitten, 5x seminggu. Analisis morfometrik jantung, peningkatan ukuran miosit, deposisi matriks ekstraseluler, serta ekspresi serta distribusi Cx43. Hasil: Tikus terlatih (5, 8, dan 12 minggu) pada kedua kelompok usia menunjukkan nilai berat jantung, berat ventrikel kiri, diameter rongga ventrikel, ketebalan otot jantung yang lebih tinggi dibandingkan dengan kelompok kontrolnya. Peningkatan ukuran panjang miosit juga meningkat kelompok latihan dibanding kontrol. Deposisi matriks ekstraseluler meningkat pada kelompok latihan dibandingkan kontrol. Ekspresi Cx43 juga meningkat pada sisi lateral. Kesimpulan: Latihan fisik aerobik dapat meningkatkan ukuran jantung dengan peningkatan ukuran sel, peningkatan deposisi matriks ekstraseluler, peningkatan Cx43 pada sisi lateral. Peningkatan matriks ekstraseluler dan peningkatan lateralisasi menunjukkan peningkatan risiko aritmia.

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ABSTRACT Background: Regular aerobic exercise can improve morphometric changes, an increase in the size of myocytes with increased expression of connexin43 (Cx43) without lateralization, and increase extracellular matrix deposition. Exercise should be started since childhood, in order to achieve cardiovascular health in adulthood. Methods: Juvenile and young adult Rats randomly divided into 7 groups: juvenile onset 4 weeks exercise duration and control group, juvenile onset 8 weeks exercise duration and control group, exercise juvenile onset 12 weeks exercise duration, young adult onset 8 weeks exercise duration and control group. Physical exercise adapted to the age of rats and maintained at speed of 20 m/minute for 20 minutes intermittent, 5 times a week. Morphometric analysis of the heart, increase the size of myocytes, extracellular matrix deposition, expression and distribution of Cx43. Results: Trained rats (5, 8, and 12 weeks) in both age groups showed values of heart weight, left ventricle weight, ventricular cavity diameter, heart muscle thickness is higher than control group. Increased length of myocytes also increased in exercise group compared to the control. Increased deposition of extracellular matrix in exercise group than control. Cx43 expression was also increased in the lateral side. Conclusions: Aerobic exercise can increase the size of the heart with increased cell size, increased extracellular matrix, increased Cx43 lateralization. Increased extracellular matrix deposition and increased lateralization showed an increased risk of arrhythmia.

Abstrak :
[ABSTRAK
Latar Belakang: Karsinoma papiler tiroid (KPT) merupakan keganasan tersering organ endokrin dengan prognosis yang sangat baik, namun pada beberapa kasus dapat terjadi rekurensi dan mortalitas. Beberapa faktor prognostik dan mutasi Btype rapidly accelerated fibrosarcoma V600E (BRAF V600E) dikatakan berhubungan dengan prognosis yang lebih buruk. Pemeriksaan imunohistokimia protein BRAF V600E dipercaya dapat mendeteksi adanya mutasi dengan spesifisitas 100% dan sensitivitas 89%. Tujuan penelitian ini untuk mengetahui imunoekspresi BRAF V600E dan hubungannya dengan faktor-faktor prognostik. Bahan dan Cara: Penelitian dilakukan secara retrospektif, desain deskriptif analitik studi potong lintang. Sampel penelitian berasal dari RSCM berjumlah 50 kasus KPT yang dinilai ulang untuk menentukan faktor-faktor prognostik secara mikroskopik. Pemeriksaaan mutasi BRAF V600E menggunakan tehnik imunohistokimia dan penilaian menggunakan H score. Hasil: Nilai H score ³ 326,5 ditentukan sebagai mutasi BRAF V600E positif dan < 326,5 sebagai mutasi BRAF V600E negatif. Terdapat 17 (34%) kasus positif mengalami mutasi BRAF V600E. Rerata usia pada kasus dengan mutasi BRAF V600E positif adalah 44,71 tahun. Ukuran tumor pada kasus dengan mutasi BRAF V600E positif berkisar antara 0,1-4cm. Tujuh belas kasus yang mengalami mutasi, 6 dlaki-laki dan 11 perempuan. Tujuh kasus dengan perluasan keluar tiroid, 11 kasus dengan metastasis kelenjar getah bening (KGB), dan 8 kasus dengan varian histopatologik tall cell. Kesimpulan: Terdapat hubungan bermakna antara mutasi BRAF V600E dengan perluasan keluar tiroid, metastasis kelenjar getah bening (KGB), dan varian histopatologik tall cell. Tidak terdapat hubungan bermakna antara mutasi BRAF V600E dengan usia, jenis kelamin, dan ukuran tumor.

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ABSTRACT
Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant neoplasm of the endocrine organ with an excellent prognosis, but in some cases present with recurrency and mortality. There are prognostic factors and BRAF V600E mutation that related to worse prognosis. Immunohistochemical investigetion of BRAF V600E protein believe can detect mutation wth 100% specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E mutation do thyroidectomy with prophylactic lymph node dissection. BRAF V600E specific inhibitor effective to the patient with advance stadium, patient with metastases, and resistant to iodium radioactive. Aim of this study is to obtain BRAF V600E and the relation with prognostic factors. Material and Methods: This is a retrospective descriptive-analytic crosssectional study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital and reviewed to determine prognostic factors microscopicaly. BRAF V600E mutation detected by immunohistochemical staining and assesed with H score. Result: H score ³ 326,5 determined as positive BRAF V600E mutation and < 326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected in 17 (34%) cases by immunohistochemistry. The mean age of the cases with positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The size of the tumor in cases with BRAF V600E mutation positive range between 0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases with lymph node metastasis (KGB), and 8 cases with tall cell variant. Conclusion: There are significant correlation between BRAF V600E mutation with extrathyroidal extension, lymph node metastases, and tall cell variant. There are no significant correlation between BRAF V600E mutation with age, gender, and size of the tumor, Backgroud: Papillary Thyroid Carcinoma (PTC) is the most common malignant neoplasm of the endocrine organ with an excellent prognosis, but in some cases present with recurrency and mortality. There are prognostic factors and BRAF V600E mutation that related to worse prognosis. Immunohistochemical investigetion of BRAF V600E protein believe can detect mutation wth 100% specificity and 89% sensitivity. Recent study suggest PTC with BRAF V600E mutation do thyroidectomy with prophylactic lymph node dissection. BRAF V600E specific inhibitor effective to the patient with advance stadium, patient with metastases, and resistant to iodium radioactive. Aim of this study is to obtain BRAF V600E and the relation with prognostic factors. Material and Methods: This is a retrospective descriptive-analytic crosssectional study. Fifty patient with PTC comes from Ciptomangunkusumo Hospital and reviewed to determine prognostic factors microscopicaly. BRAF V600E mutation detected by immunohistochemical staining and assesed with H score. Result: H score ³ 326,5 determined as positive BRAF V600E mutation and < 326,5 as negative BRAF V600E mutation. BRAF V600E mutation was detected in 17 (34%) cases by immunohistochemistry. The mean age of the cases with positive BRAF V600E mutation was 44.71 years, while the negative 41.58. The size of the tumor in cases with BRAF V600E mutation positive range between 0,1-4cm, while negative 0,1-9cm. Seventeen cases have mutations, 6 of them sex male and 11 female. Seven cases with extrathyroidal extension (ETE), 11 cases with lymph node metastasis (KGB), and 8 cases with tall cell variant. Conclusion: There are significant correlation between BRAF V600E mutation with extrathyroidal extension, lymph node metastases, and tall cell variant. There are no significant correlation between BRAF V600E mutation with age, gender, and size of the tumor]