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"Esophageal polyp can be found by chance during endoscopic examination. Polyps can be formed by changes in the esophageal mucosa due to reflux esophagitis. We report a case of multiple esophageal polyp in a patient with complaints of recurrent regurgitation without heartburn. Endoscopy demonstrated multiple polyps at the distal esophagus. Anatomic pathology evaluation of the polyp demonstrated mucosa lined with squamous epithels demonstrating elongation of the papilla and deposition of acute and chronic inflammatory cells, indicating chronic esophagitis with hyperplastic epithels. In this case, we conducted recurrent ligation of the multiple polyps. Evaluation at 2 weeks after the final ligation demonstrated no polyp remains, and the post-ligation ulcer was found. Evaluation at 1 month following treatment found diminished complaints. From this case, we can conclude that endoscopy is an important investigation modality to establish the diagnosis in cases of chronic gastrointestinal complaints. Ligation is a choice for the management of esophageal polyps"

"ABSTRAKLatar belakang: Strategi tatalaksana hemoroid interna derajat dua dan tiga terdiri dari tatalaksana non bedah dan bedah. Apabila tatalaksana non bedah tidak berhasil, maka pilihan terapi disarankan minimal invasi atau pembedahan tergantung kondisi klini. Seiring dengan perkembangan IPTEK, dikenal teknik rubber band ligation RBL dan stapled hemorrhoidopexy SH . Di Indonesia, belum ada data yang menggambarkan distribusi angka komplikasi pascaoperasi.Metode penelitian: Studi potong lintang komparatif dilakukan dengan mengambil data rekam medis subjek yang telah menjalankan RBL atau SH periode 2011-2014 pada tiga rumah sakit di Jakarta. Dilakukan analisis univariat untuk menilai komplikasi pascaoperasi RBL dan SH subjek hemoroid interna derajat dua dan tiga. Kami menggunakan uji chi square untuk menilai faktor-faktor yang mempengaruhi komplikasi variabel kategorik, t-test untuk variabel numerik, dan uji fisher bila syarat chi square tidak terpenuhi.Hasil penelitian: Didapatkan 183 subjek yang menjalani RBL 49,2 dan SH 50,8 , hemoroid interna derajat dua 40 dan derajat tiga 60 . Komplikasi pascaoperasi terdiri dari nyeri RBL 4,4 , SH 8,8 , perdarahan RBL 2,3 , SH 4,9 , retensi urin RBL tidak ada, SH 2,7 , infeksi RBL 0,5 , SH 1,6 dan stenosis RBL tidak ada, SH 0,5 . Komplikasi pascaoperasi subjek hemoroid interna derajat dua 8,2 dan derajat tiga 13,1 p = 0,71 . Subjek hemoroid interna derajat tiga, komplikasi pasca RBL 2,8 , SH 19,4 p = 0,03 .Kesimpulan: Komplikasi hemoroid interna derajat dua dan tiga pasca RBL tidak berbeda dengan SH. Pada hemoroid interna derajat tiga, komplikasi pasca RBL lebih rendah secara signifikan dibandingkan SH.

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ABSTRACTBackground The management of second and third degree internal hemorrhoid consists of non surgical and surgical treatments. If non surgical treatment does not succeed, then the recommended therapy is minimal invasive or surgery, depends on the clinical condition. Along with the development of science and technology, a technique known as rubber band ligation RBL and stapled hemorrhoidopexy emerges. In Indonesia, there is no data that can describe the distribution of postoperative complication rate. Method A comparative cross sectional study was conducted by gathering short term outcomes data from the subjects 39 medical records that underwent RBL or SH between 2011 to 2014 in three different hospitals in Jakarta. A univariate analysis was conducted to assess postoperative complications of RBL and SH subjects of third and second degree internal hemorrhoids. We use chi square test to assess the factors that influence the complications of categorical variables and t tests for numerical variables, and Fisher test if the chi square condition is not met. Results Among 183 subjects, 49,2 underwent RBL and 50,8 SH. Second degree internal hemorrhoids were 40 and third degree were 60 . Postoperative complications consist of pain RBL 4,4 , SH 8,8 , hemorrhage RBL 2,3 , SH 4,9 , urinary retention RBL 0, SH 2,7 , infection RBL 0,5 , SH 1,6 and stenosis RBL 0, SH 0,5 . Postoperative complications on second degree internal hemorrhoidal was 8,2 and third degree 13,1 p 0,71 . Complication of subject with third degree internal hemorrhoids after RBL 2,8 , SH 19,4 p 0,03 . Conclusion Complications of second and third degree internal hemorrhoids post RBL are no different with SH while for third degree internal hemorrhoid, complications after RBL ware significantly lower than SH. "

"Latar Belakang: Fibrosis hati disebabkan cedera hati kronis akan menjadi sirosis. Vesikel ekstraseluler (VE) dan Hepatocyte Growth Factor (HGF) banyak dipelajari sebagai terapi fibrosis dan regenerasi hati. Penelitian ini memanfaatkan kombinasi VE dan recombinant human-HGF ( rh-HGF) sebagai terapi alternatif fibrosis hati pada model tikus ligasi duktus bilier (LDB).Metode: Sebelas tikus Sprague Dawley (SD) menjalani LDB, 5 tikus kontrol dan 6 tikus mendapat perlakuan injeksi VE 150 uL dan rh-HGF 0,1 mg intravena sejak 3 minggu pasca LDB, selama 7 hari. Satu tikus kontrol diterminasi 3 minggu pasca LDB sebagai data dasar. Tikus-tikus kelompok kontrol dan perlakuan diterminasi pada 1 hari dan 2 minggu setelah injeksi terakhir. Dilakukan penilaian skor Laennec hati serta kadar HGF, alanine aminotransferase (ALT) dan aspartate aminotransferase (AST).Hasil: Histopatologi 3 minggu pasca LDB menunjukkan skor Laennec 2. Skor fibrosis kelompok kontrol (KK) dan kelompok perlakuan (KP) 1 minggu dan 2 minggu pasca injeksi VE dan rh-HGF seluruhnya dengan skor 2. Kadar HGF pada KP lebih rendah secara signifikan dibandingkan dengan KK 1 hari pasca injeksi terakhir (1,35+0,06 vs 1,53+0,06; p<0,001), semakin menurun setelah 2 minggu pasca injeksi terakhir namun tidak bermakna secara statistik 0,83 (0,73-0,84) vs 0,76 (0,73-0,80) p=0,248). Kadar AST 1 hari pasca injeksi terakhir; KK 1,66+0,05 KP 0,91+0,12 debgan p = 0,001. Setelah 2 minggu pasca injeksi; kadar AST pada kedua kelompok menurun 1,12 (1,11-1,22) vs (0,96+0,03); p=0,021). Kadar ALT pada kelompok perlakuan lebih rendah secara signifikan pada 1 hari pasca injeksi dan 2 minggu pasca injeksi dengan nilai p<0,001 dan 0,033a

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Background: Fibrosis of the liver due to a chronic liver injury will become cirrhosis at the end-stage. The Extracellular Vesicles (EV) and hepatocyte growth factor (HGF) are recently learned as much as fibrosis and liver regeneration therapy. This study aims to know the result of using a combination of EV and recombinant human HGF (rh-HGF) as an alternative therapy due to liver fibrosis on the rat bile duct ligation (BDL) model.

Methods: Eleven BDL Sprague Dawley (SD) were divided into two groups, five mice as the untreated control group and six mice as the treatment group was getting an EV 150 ul and rh-hgf 0.1 mg intravenous injection three weeks after BDL, for seven days. One control rat is expanded three weeks after BDL as baseline data. The control and treatment group mice were projected at day one and two weeks after the final injection. This study was assessed from liver fibrosis by using Laennec score, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and Hepatocyte Growth Factor (HGF) level.

Results: Scoring of histopathology by using the Laennec score at 3 weeks after BDL was 2. Meanwhile scoring of fibrosis of the control group and treatment group at 1 week and 2 weeks after ve and rh-hgf injection were 2. HGF level of the treatment group was lower significantly than control group at day 1 after last injection (1,35+0,06 vs 1,53+0,06; p<0,001), and within 2 weeks, the number of HGF levels decreased but statistically insignificant; 0,83 (0,73-0,84) vs 0,76 (0,73-0,80) p=0,248). AST level at day 1 after last injection; control group vs treatment group ;1,66+0,05 vs 0,91+0,12, p value = 0,001. 2 weeks after injection; AST level for both group were become lower 1,12 (1,11-1,22) vs (0,96+0,03); p=0,021), and ALT level on treatment group was significantly lower at day 1 and 2 weeks after injection with p value <0,001 and 0, 033a"