Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Disfungsi dasar panggul disebabkan tersering oleh trauma otot dasar panggul persalinan. Platelet rich plasma (PRP) adalah serum darah yang disertifugasi sehingga mengandung konsentrasi platelet dan growth factors yang tinggi. Terapi PRP mudah dilakukan dan aman untuk proses regenerasi trauma otot levator ani pascasalin. Studi ini bertujuan untuk mengetahui peran PRP dalam mendukung pemulihan trauma otot dasar panggul pascasalin. Studi prospektif, penyamaran tunggal, uji acak terkendali merupakan studi yang melibatkan wanita hamil anak pertama, dilakukan di kamar bersalin di Rumah Sakit tempat rujukan berjenjang, Puskesmas Lingkungan Suku Dinas, dan praktik bidan mandiri. Subjek diinjeksi dengan PRP autologus atau plasebo pada otot levator ani selama perineorafi pascasalin. Pemeriksaan utrasonografi transperienal dan perineometri dilakukan untuk menilai luas hiatus genital dan kekuatan otot levator ani pada kehamilan trimester 3, 40 hari pascasalin, dan 3 bulan pascasalin. Uji Mann-Whitney dan Wilcoxon signed-rank digunakan untuk analisis. Dari total 116 subejk, 58 subjek memenuhi syarat untuk analisis. Penurunan kekuatan otot pada 3 bulan pascasalin bermakna secara statistik dari 41.45 (Interquartile Range, IQR = 18.05) menjadi 30.88 (IQR = 18.33) cmH2O pada kelompok kontrol, namun pada kelompok intervensi penurunan dari 37.45 (IQR = 13.89) menjadi 35.83 (IQR = 18.81) cmH2O (uji Wilcoxon, p = 0.001 vs p = 0.29). Sub-kelompok kasus ballooning menunjukkan peningkatan luas hiatus genital pada kelompok intervensi dari 26/59 (IQR = 7.53) menjadi 20.25 (IQR = 8.47) cm2, secara kontras terjadi perburukan pada kelompok kontrol dari 22.45 (IQR = 6.59) menjadi 26.8 (IQR = 7.16) cm2 (uji Wilcoxon, p = 0.047 vs p = 0.508). Selain itu, secara bermakna kekuatan otot levator ani menurun dari 47.1(IQR = 24.9) menjadi 34.7 (IQR = 33.8) cmH2O pada kelompok kontrol dibandingkan dengan kelompok intervensi yang mengalami penurunan dari 38.5 (IQR=17.2) menjadi 35.45 (IQR = 16.3) cmH2O (uji Wilcoxon, p = 0.038 vs p = 0.878). Simpulan: Platelet rich plasma dapat menjadi terapi alternatif menjanjikan untuk trauma mikro atau ballooning otot dasar panggul pada wanita pascasalin anak pertama. ......Pelvic floor dysfunction (PFD) is mostly caused by childbirth pelvic floor muscle trauma. Platelet rich plasma (PRP) is centrifugated blood which contains concentrated platelets and high level of growth factors. PRP can be a feasible and safe therapy for post-partum levator ani muscle trauma regeneration process. This study aims to explore the role of PRP in supporting pelvic floor muscle recovery after childbirth trauma. A prospective, single blind, randomized control trial was enrolling primigravid women at 21 health facilities in Jakarta, Indonesia, from November 2016 to July 2019. Subjects were injected with autologous PRP or placebo at levator anal muscles (LAM) during perineorraphy after childbirth. Transperineal ultrasound and perineometry was used to asses the levator hiatal area and LAM strength at third trimester of pregnancy,40 days post-partum and three months post-partum. Mann- Whitney U-test and Wilcoxon signed-rank test were used to analyze. Among 116 primigravid women, 58 women were eligible for analysis. Muscle strength reduction three months after childbirth was found statistically significant from 41.45 (Interquartile Range, IQR = 18.05) to 30.88 (IQR = 18.33) cmH2O in control group, not in intervention group which reduction only from 37.45 (IQR = 13.89) to 35.83 (IQR = 18.81) cmH2O (Wilcoxon test, p = 0.001 vs p = 0.29). In ballooning subgroup case analysis showed hiatal area improvement in intervention group from 26.59 (IQR = 7.53) to 20.25 (IQR = 8.47) cm2, in contrast with worsening in control group from 22.45 (IQR = 6.59) to 26.8 (IQR = 7.16) cm2 (Wilcoxon test, p= 0.047 vs p = 0.508). Also, significant LAM strength reduction was also found from 47.1 (IQR = 24.9) to 34.7 (IQR = 33.8) cmH2O in control group compared to intervention group which only from 38.5 (IQR = 17.2) to 35.45 (IQR = 16.3) cmH2O (Wilcoxon test, p = 0.038 vs p = 0.878). Conclusion: Platelet rich plasma can be a promising alternative therapy for micro trauma or ballooning of pelvic muscle injury in primiparous women.

Abstrak :
Diabetes mellitus (DM) is one of the public health problems worldwide, including in Indonesia. Cardiovascular disease was the main cause of death (75-80%) in DM, three-fourths of this death was caused by coronary heart disease (CHD). Approximately 34.2% of patients with acute coronary syndrome (ACS) receiving care at ICCU of Dr. Cipto Mangunkusumo General Hospital (RSCM) suffered from DM. Mortality rates of ACS in DM patients were still high and ACS prognosis in DM patients were still unfavorable. There are many factors playing a part in atherosclerosis and ACS incidence in DM patients, such as metabolic disorders due to hyperglycemia and the fomration of advanced glycation end product (AGE), oxidative stress, atherogenic dyslipidemia in DM in the form of high triglyceride level and low HDL cholesterol as well as an increase in small dense LDL, and insulin resistance. In addition, other risk factors of CHD frequently encountered with DM were hypertension, obesity, thrombocytc hyperaggregation and hypercoagulation. The management ofthis disease which was based on the control of risk factors was not yet satisfactory. Inflammatory response played an important role in pathogenesis of atherosclerosis, beginning with early lesion up to acute coronary syndrome. Increase in inflammatory responses (hsCRP) could predict cardiovascular event and predict post-ACS prognosis. Studies in DM population showed an increase in inflammation. ln-depth studies on inflammatory responses in ACS DM patients have not yet been reported. In normal condition, there was a balance of proinflammatory and antiinflammatory cytokines. The ratio of proinflammatory and antiinflammatory cytokines in ACS, particularly DM patients has not been studied. The relationship between metabolic factor (blood glucose, glyco Hb and lipid) and inflammatory response in ACS DM patients has not yet also been studied. Currently, the effort to decrease inflammatory response is made, among others, by aspirin, statin hypolipidemic medication and insulin sensitizer. Although aspirin and statin were used routinely in ACS patients and have proved to reduce inflammation, morbidity and mortality rates of ACS patients were still high. Thus, we would like to observe whether an addition of other medications in standard therapy could reduce inflammation better. Curcumin in experimental animals-and humans) showed -hypolipidemic effect (decrease 'in absorption and increase in catabolism) and hypoglycemia (effect on PPAR-7). Curcumin also demonstrated antiinflammatory effect. In this study we would like to observe the effects of curcumin on both metabolic factors and inflammatory responses in ACS patients. PROBLEM IDENTIFICATION The above elaboration showed a discrepancy associated with inflammatory response in DM ACS patients. Up to now, the relationship of metabolic factor and inflammatory response in DM ACS has not been clear yet. Likewise, the effects of curcumin on metabolic factor and inflammatory response in ACS have not yet been identified. OBJECTIVES To evaluate inflammatory responses in DM ACS and its relationship with metabolic factors (glucose, blood; glyco Hb, total cholesterol, LDL cholesterol, HDL cholesterol and triglyceride); to evaluate the ratio of proinflammatory and antiinflammatory cytokines (IL-6/IL-10) in ACS DM patients, and to identify the effects of curcumin on metabolic factors and inflammatory responses in ACS patients. SETTING The study was conducted at ICCU of RSCM, ICCU of Persahabatan, ICCU of RS MMC and ICCU of Medistra Hospital, Cardiology Polyclinic, Department of Internal Medicine, Faculty of Medicine University of Indonesia! RSCM and Integrated Cardiac Service Poiyclinic of RSCM. STUDY SUBJECTS ACS patients (DM and non-DM) and CHD (DM and non-DM). DESIGN There were two studies: l. Observational design to observe inflammatory responses (hscRP, IL-6, IL-IO, VCAM and ICAM) in DM ACS, non-DM ACS, DM CI-ID, and non-DM CHD; to evaluate the relationship between metabolic factors (fasting blood glucose, blood glucose 2 hours PP, glyco Hb, total cholesterol, LDL cholesterol, HDI.. cholesterol and triglyceride) and inflammatory responses (hsCRP, IL-6, IL-10, VCAM and ICAM) in ACS DM. 2. Interventional study which was a double-blind randomized trial to evaluate the effects of curcumin at escalating doses (low dose 3:-:IS mglday, moderate dose 3x30 mg/day and high dose 3x60 mg/day on metabolic factors (fasting blood glucose. blood glucose 2 hours PP and glyco Hb) and the effects of curcumin at escalating doses on inflammatory responses (hsCRP, ll.-6, VCAM and ICAM) in ACS patients. RESULTS In observational study, |46 subjects were analyzed, consisting of 84 ACS patients, (30 DM ACS patients and 54 non-DM ACS), and 62 CHD (25 DM CHD patients and 37 non-DM CHD patients). The results of the study in the four groups of patients showed: 1. Inflammatory response in DM ACS was higher than in DM CHD (hsCRP, p=0.00; II..-6, p=0.00; IL-10, p=0.00) and non-DM ACS (ICAM, P=0.03). 2. The ratio of proinflammatory and antiinflammatory cytokines (IL-6/II..-10) in DM ACS did not differ from that of DM CHD (p=0.2l) and non-DM ACS (p=0.5 l). 3. There was a relationship between metabolic factors and inflammatory responses in DM ACS: triglyceride and ll.-6 (r=O.39, p=0.03) and II..-I0 (r=0.37, p=o.o4). In interventional study we performed randomization in 75 ACS patients divided into four groups, consisting of low-dose curcumin group of 15 patients, moderate-dose curcumin group of 15 patients, high-dose curcumin group of IS patients, and placebo group of 30 patients. The results of the study in these four groups showed: l. Low-dose curcumin showed a decrease in hsCRP in one week ofthe first month after intervention, there was a significant difference liom that of placebo (p=0.04). Low-dose, moderate-dose, high-dose curcumin groups showed a decrease in IL-6, but was not significantly different from placebo. Low-dose, moderate-dose, high-dose curcumin did not show a decrease in VCAM and ICAM after intervention of 2 months. 2. Low-dose curcumin group tended to experience a decrease in glyco Hb level after intervention of 2 months (p=0.06); however, it was not significantly different from that of placebo. 3. There was a tendency that low-dose curcumin reduced total cholesterol and LDI. cholesterol; however, it was not significantly different from that of placebo. There was a tendency that low-dose curcumin increased HDL cholesterol; however, it was not significantly different from that of placebo. 4. There was a tendency that the pattern of escalating doses had some effects in inflammatory responses and metabolic factors, in which low-dose curcumin showed the best effects, followed by moderate-dose and finally high- dose curcumin. CONCLUSIONS In this study, inflammatory responses in DM ACS patients were higher than those in DM CHD and non-DM ACS patients. There was no difference in the ratio of proinflammatory and antiinflammatory cytokines (IL-6fIL-IO) in DM ACS compared with DM CHD and non-DM ACS. ln addition, the present study identified some of the relationships between metabolic factors and inflammatory responses. Low-dose curcumin reduced hsCRP in one week of the first month after the intervention in ACS patients. There was a tendency that low-dose curcumin reduced glyco Hb level in ACS.

Abstrak :
ABSTRAK
Prolaps uteri merupakan kondisi yang sering dialami oleh perempuan dan dapat menurunkan kualitas hidup. Penyebab prolaps uteri multifaktorial, pada umumnya berupa faktor klinis.Penelitian ini bertujuan untuk mengetahui adanya variasi gen berupa mutasi gen HOXA11 dan COL3A1 pada penderita prolaps uteri, mengetahui adanya perbedaan ekspresi protein HOXA11, COL3A1, COL1A1, MMP2, MMP9, TIMP, dan p53 pada penderita prolaps uteri dibandingkan pada perempuan tanpa prolaps uteri, serta mengetahui faktor risiko yang berhubungan dengan prolaps uteri.Studi potong lintang ini melibatkan 22 pasien prolaps uteri dan 22 tanpa prolaps uteri mulai Juni 2016 sampai Februari 2017 di RSUP dr. Kariadi Semarang. Dilakukan pencatatan data karakteristik berupa usia, paritas, IMT dan berat lahir bayi. Dilakukan pemeriksaan sekuens DNA gen HOXA11 dan Col3A1, pemeriksaan imunohistokimia pada ligamentum sakrouterina untuk menilai ekspresi protein HOXA11, COL1A1, Col3A1, MMP2, MMP9, TIMP, dan p53 pada perempuan menopause dengan prolaps uteri dan tanpa prolaps uteri.Tidak didapatkan variasi berupa mutasi gen HOXA11 pada perempuan dengan prolaps uteri sepanjang fragmen yang digunakan untuk sekuensing DNA. Didapatkan mutasi pada gen COL3A1 pada 10 pasien dengan prolaps uteri dan 6 pasien tanpa prolaps uteri p = 0,719 sepanjang fragmen yang digunakan untuk sekuensing DNA. Ekspresi protein COL1A1, MMP-9 dan p53 lebih tinggi pada kelompok prolaps p < 0,05 . Rerata usia, rerata paritas dan rerata berat lahir bayi, berbeda secara uji statistik pada kedua kelompok.Pada fragmen yang diperiksa tidak didapatkan mutasi gen HOXA11, namun didapatkan mutasi gen COL3A1 pada penderita prolaps maupun perempuan tanpa prolaps uteri. Tampak adanya faktor internal yang berperan untuk terjadinya prolaps uteri selain berbagai faktor risiko klinis. Faktor eksternal berupa usia, berat bayi lahir, dan paritas memiliki hubungan dengan prolaps uteri. Kata kunci: COL1A1, COL3A1, faktor klinis, HOXA11, menopause, MMP2, MMP9, mutasi gen, p53, prolaps uteri, TIMP.

---

ABSTRACT
Uterine prolapse is a condition that decreases the quality of life of women. Multiple factors, mostly clinical, affect the course of uterine prolapse.The aims of the study were to investigate the genetic variation in the form of HOXA11 and Col3a2 gene mutations in women with uterine prolapse. This study also aimed to investigate different expression of HOXA11, COL3A1, COL1A1, MMP2, MMP9, TIMP, and p53 proteins in women with and without uterine prolapse, and to understand risk factors associated with uterine prolapse.A total of 44 women were enrolled in this cross sectional study, 22 of which with uterine prolapse and 22 others without uterine prolapse. This study was conducted between June 2016 and February 2017 in RSUP dr Kariadi, Semarang. demographic data including age, parity, BMI, and birth weight were recorded. HOXA11 and COL3A1 gene sequencing, immunohistochemistry testing of uterosacral ligament were conducted to assess HOXA11, COL1A1, COL3A1, MMP2, MMP9, TIMP, and p53 protein expressions.A mutation in COL3A1 gene along the fragment used in DNA sequencing was found among 10 women with uterine prolapse and 6 women without uterine prolapse although this did not reach statistical significance p .719 . No genetic variation in the form of HOXA11 gene mutation was found in women with uterine prolapse. Higher expression of COL1A1, MMP 9 and p53 proteins were found in prolapse group p .05 . The average of age, parity, and birth weight in two groups were statistically different.Only the COL3A1 gene mutation was detected in women with and without uterine prolapse. Beside, various clinical factors, it was confirmed that some internal factors also play important role in the course of uterine prolapse. Examples of external factors are age, birth weight, and parity. Key word COL1A1, COL3A1, clinical factors, gen mutation, HOXA11, menopause, MMP2, MMP9, p53, TIMP, uterine prolapse.

Abstrak :
ABSTRAK
Defisiensi vitamin B12 merupakan masalah kesehatan di negara maju dan berkembang. Penelitian ini menganalisis hubungan restriksi vitamin B12 dengan perubahan struktur dan fungsi ginjal. Tikus Sprague-Dawley 18 ekor dibagi menjadi tiga kelompok: 1 kontrol yang diberi pakan standar hewan coba AIN-93M selama 12 minggu; 2 perlakuan-1 P-1 diberi pakan AIN-93M modifikasi tanpa vitamin B12 selama 4 minggu; dan 3 perlakuan-2 P-2 selama 12 minggu. Vitamin B12 plasma total turun dari 529.17 166.51 pg/ml menjadi 426.33 60.59 pg/ml pada P-1 dan 708.70 124.35 pg/ml menjadi 519.16 84.96 pg/ml pada P-2, pada kelompok kontrol meningkat dari 567.79 102.52 pg/ml menjadi 650.26 193.12 pg/ml. Homosistein plasma meningkat pada kelompok perlakuan setelah 4 minggu kontrol vs P-1 = 351.05 110.69 pmol/ml vs 597.09 308.02 pmol/ml dan 12 minggu kontrol vs P-2 = 414.473 224.13 pmol/ml vs 1055.12 651.68 pmol/ml, p

---

ABSTRACT
Vitamin B12 deficiency is still a health problem in both developed and developing countries. This study was conducted to explore possible relationship between vitamin B12 dietary restriction with kidney rsquo;s histological and physiological changes. Eighteen male Sprague Dawley rats were divided into three groups: 1 control group were fed with standard AIN-93M for 12 weeks; 2 1st treatment group P-1 were fed with cobalamin restricted AIN-93M for 4 weeks; and 3 2nd treatment group P-2 were fed with cobalamin restricted AIN-93M for 12 weeks. Vitamin B12 level decreased from 529.17 166.51 pg/ml to 426.33 60.59 pg/ml in P-1 group and from 708.70 124.35 pg/ml to 519.16 84.96 pg/ml in P-2 group, while it increased from 567.79 102.52 pg/ml to 650.26 193.12 pg/ml in control group after 12 weeks. Plasma Hcy increased in treatment group after 4 weeks control vs P-1 = 351.05 110.69 pmol/ml vs 597.09 308.02 pmol/ml and 12 weeks control vs P-2 = 414.473 224.13 pmol/ml vs 1055.12 651.68 pmol/ml; p

Abstrak :
Disfungsi dasar panggul adalah komplikasi persalinan per vaginam dengan manifestasi utama prolaps organ panggul (POP), inkontinensia urin dan inkontinensia fekal sehingga menurunkan kualitas hidup. Diduga terdapat peran jaringan ikat kolagen dan elastin, namun biopsi berulang memiliki risiko perdarahan, nyeri serta infeksi. Oleh karena itu, dipikirkan produk metabolitkolagen dan elastin serum untuk mewakili kadar kolagen dan elastin di jaringan penunjang dasar panggul. Tujuan penelitian ini adalah mendapatkan penanda serum produk metabolit kolagen dan elastin untuk memprediksi disfungsi dasar panggul setelah persalinan per vaginam. Penelitian tahap pertama menggunakan desain prospektif kohort satu sisi untuk mengukur angka kejadian disfungsi dasar panggul 3 bulan setelah persalinan. Penelitian dilakukan di Poliklinik Obstetri Departemen Obstetri dan Ginekologi FKUI/RSUPN dr.Cipto Mangunkusumo dan Puskesmas di lingkungan DKI Jakarta, selama periode Januari 2015 sampai Juli 2019. Tahap kedua menggunakan desain nested case control untuk menganalisis hubungan penanda serum kolagen dan elastin serta aktivitas MMP-9 pada kehamilan dan setelah persalinan dengan disfungsi dasar panggul. Penanda metabolit kolagen dan elastin (ICTP, desmosin), remodeling kolagen dan elastin (PINP, PIIINP, tropoelastin), serta MMP-9 diukur pada saat hamil, 24–48 jam, dan 6 minggu setelah persalinan. Tiga bulan setelah persalinan, inkontinensia urin, tekanan dan POP dinilai berdasarkan gejala, pemeriksaan POP-Q dan tes batuk. Data luaran sebelum dan sesudah persalinan dianalisis dengan uji t tidak berpasangan dan uji Mann Whitney. Dari 177 calon subjek, 4 subjek dieksklusi dan 113 subjek drop out. Dari 60 subjek yang diinklusi, 38 (63,3%) mengalami POP derajat 2 dan 25 subjek di antaranya (41,7%) mengalami sistokel derajat 2. Tidak ada perbedaan rerata seluruh marker degradasi dan sintesis kolagen 1,3 dan elastin serta MMP-9 antara kelompok POP dan kontrol. Analisis dilakukan dengan analisis kategorik menggunakan titik potong pada variabel yang memiliki AUC > 0.6. Pada hasil analisis bivariat prolaps organ panggul didapatkan hasil yang bermakna adalah yang memiliki nilai variabel p < 0,05 yaitu PINP setelah persalinan dan ICTP setelah persalinan. Setelah itu, dilakukan analisis multivariat dengan mengambil nilai variabel p < 0,25 ditemukan pada biomarker PINP setelah persalinan 106,9 dengan RR = 1,76 (95%CI: 1,14–3,00). Pada hasil analisis bivariat sistokel didapatkan hasil yang bermakna adalah yang memiliki nilai variabel p < 0,05 yaitu PINP kehamilan dan PINP setelah persalinan. Setelah itu, dilakukan analisis multivariat sistokel dengan menggambil nilai variabel p < 0.25 yaitu ditemukan biomarker PINP setelah persalinan 106,9 dengan RR = 2,53 (95%CI: 1,05–6,09). ......Pelvic floor dysfunction is a complication of vaginal delivery with the main manifestations of pelvic organ prolapse (POP), urinary incontinence and fecal incontinence, thereby reducing quality of life. It is suspected that there is a role for collagen and elastin connective tissue, but repeated biopsies carry the risk of bleeding, pain and infection. Therefore, it was considered the metabolic products of serum collagen and elastin to represent the levels of collagen and elastin in the pelvic floor supporting tissues. The aim of this study was to obtain serum markers of collagen and elastin metabolism products to predict pelvic floor dysfunction after vaginal delivery. The first phase of the study used a one-sided prospective cohort design to measure the incidence of pelvic floor dysfunction 3 months after delivery. The study was conducted at the Obstetrics Polyclinic, Department of Obstetrics and Gynecology, FKUI/RSUPN dr. Cipto Mangunkusumo and Puskesmas in DKI Jakarta, during the period January 2015 to July 2019. The second phase used a nested case control design to analyze the relationship between serum collagen and elastin markers and MMP-9 activity in pregnancy and after delivery with pelvic floor dysfunction. Markers of collagen and elastin metabolism (ICTP, desmosin), collagen and elastin remodeling (PINP, PIIINP, tropoelastin), and MMP-9 were measured during pregnancy, 24–48 hours, and 6 weeks after delivery. Three months after delivery, urinary incontinence, pressure and POP were assessed on the basis of symptoms, POP-Q examination and cough test. The outcome data before and after delivery were analyzed by unpaired t test and Mann Whitney test. From 177 prospective subjects, 4 subjects were excluded and 113 subjects dropped out. Of the 60 included subjects, 38 (63.3%) had grade 2 POP and 25 (41.7%) had grade 2 cystocele. There was no difference in the mean of all markers of degradation and synthesis of collagen 1,3 and elastin and MMP-9 between the POP and control groups. The analysis was carried out by categorical analysis using cut points on variables that had AUC > 0.6. In the bivariate analysis of pelvic organ prolapse, significant results were obtained which had a variable value of p < 0.05, there were PINP after delivery and ICTP after delivery. After that, multivariate analysis was carried out by taking the variable value p < 0.25 it was found in PINP biomarkers after delivery ≥ 106.9 with RR = 1.76 (95% CI: 1,14–3,00). In the results of bivariate cystocele analysis, significant results were obtained which had a variable value of p < 0.05, there were PINP during pregnancy and PINP after delivery. After that, multivariate analysis of cystocele was carried out by taking the value of the variable p < 0.25, it was found in PINP biomarkers after delivery ≥ 106.9 with RR = 2.53 (95% CI: 1,05–6,09).

Abstrak :
Pelaku tindak pidana yang disebut sebagai Pemilik manfaat/penerima manfaat menggunakan korporasi sebagai sarana/kendaraan (corporate vehicle) untuk menyembunyikan/menyamarkan hasil tindak pidana dapat dipertanggungjawabkan secara pidana. Terkait pelaku tindak pidana tersebut belum ada pengaturan khususnya dalam tindak pidana korupsi terkait korporasi sebagai penerima/pemilik manfaat sehingga terjadi kekosongan hukum. Sehingga untuk mengambil hasil tindak pidana yang telah dialihkan atau dinikmati atau dimiliki oleh penerima manfaat tersebut hanya dapat dilakukan melalui gugatan perdata atau memprosesnya dengan Pasal 5 Undang-undang Nomor 8 Tahun 2010 tentang Pencegahan dan Pemberantasan Tindak Pidana Pencucian Uang. Namun, apabila digunakan instrumen-instrumen tersebut maka akan melalui proses yang panjang dan dikhawatirkan hasil tindak pidana akan dialihkan atau dinikmati oleh pelaku tindak pidana sebelum kedua proses tersebut selesai. Berdasarkan hal tersebut disertasi ini melakukan telahaan mengenai konsep pemilik manfaat dalam rezim hukum di Indonesia, alasan pemilik manfaat dapat dipertanggungjawabkan secara pidana dan praktek pertanggungjawaban pidana pemilik manfaat dalam tindak pidana korupsi berdasarkan putusan pengadilan di Indonesia. Metode penelitian ini kualitatif mengkaji secara sistematis mengenai aturan hukum, perbandingan, konsep, doktrin, putusan kasus, dan dokumen-dokumen yang didukung dengan wawancara kepada akademisi dan praktisi. Dari hasil penelitian yang dilakukan dapat disimpulkan bahwa Korporasi dapat menjadi pemilik manfaat selain orang perorangan karena Indonesia mengakui korporasi sebagai subjek hukum pidana, dan kebutuhan dalam praktik hukum untuk merampas hasil tindak pidana menjadikan korporasi sebagai pemilik manfaat; berdasarkan kasus-kasus di Indonesia antara lain tindak pidana korupsi, pemilik manfaat/penerima manfaat atau penikmat manfaat dari hasil tindak pidana menggunakan modus operandi baru antara lain pelaku tindak pidana berada diluar struktur korporasi, tetapi dapat mempengaruhi kebijakan korporasi untuk menghindari pertanggungjawaban pidana oleh karena itu perlu dibuat aturan yang lebih jelas dalam Undang-undang Tindak Pidana Korupsi; dalam praktik hukum belum ada korporasi yang disangkakan korupsi karena menerima manfaat dan dalam hal terjadi peralihan harta kekayaan kepada penerima manfaat sementara itu harta kekayaan tersebut merupakan hasil tindak pidana. Dalam hal Ultimate Beneficial Owner atau Beneficial Owner statusnya melarikan diri atau meninggal dunia untuk perampasan hasil tindak pidana tersebut dapat menggunakan Peraturan Mahkamah Agung (Perma) Nomor 1 Tahun 2013 tentang Tata Cara Penyelesaian Permohonan Penanganan Harta Kekayaan Dalam Tindak Pidana Pencucian Uang Atau Tindak Pidana Lain. Penelitian ini merekomendasikan agar dilakukan reformulasi KUHP, UU Tipikor dan Perma No.1 Tahun 2013 terkait dengan pertanggungjawaban pidana pemilik manfaat (Beneficial Owner) dalam kasus tindak pidana korupsi di Indonesia. ......The perpetrator of a criminal act is referred to as the beneficial owner/beneficiary to hide/disguise the proceeds of criminal acts can be held criminally liable. Regarding the perpetrators of these criminal acts, there are no regulations, especially for criminal acts of corruption related to corporations as recipients/beneficial owners, resulting in a legal vacuum. So, retrieving the proceeds of criminal acts that have been transferred or enjoyed or owned by the beneficiary can only be done through a civil lawsuit or processed in accordance with Article 5 of Law Number 8 of 2010 concerning Prevention and Eradication of the Crime of Money Laundering. However, if these instruments are used, it will go through a long process and it is feared that the proceeds of the crime will be transferred or enjoyed by the perpetrator of the crime before both processes are completed. Based on this, this dissertation examines the concept of beneficial owners in the legal regime in Indonesia, the reasons why beneficial owners can be held criminally liability and the practice of criminal liability for beneficial owners in criminal acts of corruption based on court decisions in Indonesia. This qualitative research method systematically examines legal rules, comparisons, concepts, doctrine, case decisions, and documents supported by interviews with academics and practitioners. From the results of the research conducted it can be concluded that corporations can be beneficial owners other than individuals because Indonesia recognizes corporations as subjects of criminal law, and the need in legal practice to confiscate the proceeds of criminal acts makes corporations as the beneficial owners; based on cases in Indonesia, including criminal acts of corruption, the beneficial owners/beneficiaries or beneficiaries of the proceeds of criminal acts using new modus operandi, among others, the perpetrators of criminal acts are outside the corporate structure but can influence corporate policy to avoid criminal liability, therefore it is necessary clearer regulations are made in the Corruption Crime Law; In legal practice, no corporation has been suspected of corruption because it received benefits and in the event of a transfer of assets to the beneficiary, the assets were the proceeds of a criminal act. In the case that the Ultimate Beneficial Owner or Beneficial Owner has the status of running away or dies, to confiscate the proceeds of the crime, you can use Supreme Court Regulation (Perma) Number 1 of 2013 concerning Procedures for Settlement of Applications for Handling Assets in the Crime of Money Laundering or Other Crimes. This research recommends that reformulation of the Criminal Code, the Corruption Law and Perma No.1 of 2013 be carried out regarding the criminal liability of beneficial owners in cases of criminal acts of corruption in Indonesia.

Abstrak :
Undang-Undang Nomor 31 Tahun 1999 sebagaimana diubah oleh Undang-Undang Nomor 20 Tahun 2001 tentang Pemberantasan Tindak Pidana Korupsi (UU Tipikor) telah mengatur model pertanggungjawaban pidana korporasi yaitu bilamana suatu tindak pidana korupsi dilakukan oleh atau atas nama korporasi maka tuntutan dan penjatuhan pidananya dapat dilakukan terhadap korporasi dan/atau pengurusnya. UU Tipikor tidak mengatur kriteria bilamana pertanggungjawaban pidana hanya ditujukan terhadap korporasi atau korporasi dan pengurusnya. Ketidaklengkapan UU Tipikor tersebut menyebabkan multi tafsir di kalangan penegak hukum dan hakim sehingga menimbulkan ketidak-pastian hukum dan ketidak-konsistenan putusan pengadilan. Disertasi ini melakukan telaah mengenai perumusan model pertanggungjawaban pidana korporasi dalam perkara korupsi yang ideal di Indonesia agar tidak terjadi lagi ketidakpastian hukum dan multi tafsir dalam putusan pengadilan. Metode penelitian yang digunakan adalah studi dokumen, didukung dengan wawancara mendalam (in-depth interview) terhadap penegak hukum dan hakim. Adapun pendekatan masalah penelitian yang digunakan yaitu pendekatan perundang-undangan, konseptual, kasus dan perbandingan. Dari hasil penelitian yang dilakukan dapat disimpulkan bahwa diperlukan penentuan kriteria model pertanggungjawaban pidana korporasi secara otonom, dependen dan independen. Model otonom mensyaratkan pertanggungjawaban korporasi tidak digantungkan dan dihubungkan dengan pertanggungjawaban pengurusnya sama sekali karena kesalahan korporasi tidak berasal dari atribusi kesalahan pengurusnya secara individu. Terdapat empat kriteria dalam model otonom yaitu: pertama, perbuatan pengurus merupakan perbuatan korporasi; kedua, perbuatan pengurus dilakukan untuk dan dalam rangka kepentingan korporasi dan tidak ada kepentingan individu pengurus; ketiga, kesalahan korporasi berasal dari atribusi kesalahan perbuatan korporasi; dan keempat, alokasi tanggung jawab hanya dibebankan kepada korporasi, tanpa sekalipun membebani tanggung jawab kepada pengurus. Model dependen mensyaratkan alokasi kesalahan dan pertanggungjawaban korporasi digantungkan pada terbuktinya kesalahan pengurus atas terjadinya tindak pidana korupsi. Terdapat dua kriteria model dependen yaitu pertanggungjawaban korporasi atas penerimaan manfaat hasil tindak pidana korupsi dan/atau pertanggungjawaban korporasi sebagai sarana tindak pidana korupsi. Model independen mensyaratkan pertanggungjawaban korporasi diajukan secara gabungan dengan pengurusnya dimana konstruksi kesalahan korporasi dibedakan dari pengurusnya dengan mengakomodasi kesalahan original atau organisasi atas reaksi saat terjadinya korupsi dan/atau budaya korporasi yang memicu korupsi. Penelitian ini merekomendasikan agar dilakukan reformulasi UU Tipikor dan pembentukan yurisprudensi terkait dengan kriteria model pertanggungjawaban pidana korporasi ......Law Number 31 of 1999 as amended with Law Number 20 of 2001 on Corruption Crime Eradication (Corruption Law) governs a corporation criminal liability model i.e. if a corruption crime is committed by or on behalf of a corporation, then its indictment and criminal charge may be implemented against the corporation and/or its management. However, Corruption Law does not govern criteria whether criminal liability is only addressed to corporation or corporation and its management. Incomplete Corruption Law has led to multi-interpretations among law enforcers and judges causing legal uncertainty and inconsistency in court verdicts. This dissertation scrutinizes the formulation of a corporation criminal liability model in corruption cases that is ideal for Indonesia to prevent legal uncertainty and multi-interpretations in court verdicts. The research method used is a document study, supported with in-depth interviews with law enforcers and judges. The approaches of research problems used are the approaches of statutory laws, concept, case, and comparison. The research concludes that the determination of an autonomous, dependent, and independent corporation criminal liability model criteria is required. Autonomous model requires that corporation liability does not depend on and is not related to the liability of its management at all since the faults of a corporation are not originated from the attribution of its management’s faults individually. There are four criteria in the autonomous model, namely: first, the act of management is the act of a corporation; second, the act of management is conducted for and for the interest of a corporation and there is no individual interest of the management; third, the faults of a corporation come from the attribution of the faults of a corporation’s acts; and fourth, the allocation of liability is only imposed to corporation, without imposing liability to management. The dependent model requires that the allocation of faults and liability of a corporation depends on the proven faults of management regarding a corruption crime. There are two dependent model criteria namely corporation liability over the receipt of proceeds of corruption crime and/or corporation liability as a facility for corruption crime. The independent model requires corporation liability to be submitted collectively with its management in which the construction of a corporation’s faults is distinguished from its management by accommodating original or organizational faults over a reaction during the occurrence of corruption and/or corporation cultures that trigger corruption. This research recommends the reformulation of Corruption Law and the formation of relevant jurisprudence through corporation criminal liability model criteria.