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Effect of LMP-1 and mutant p53 on the Prognosis of Undifferentiated Type of Nasopharyngeal Carcinoma Atikah, Atikah; Sadhana, Udadi; Miranti, Ika Pawitra; Puspasari, Dik; Karlowee, Vega
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 22, No 1 (2022): January
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v22i1.13035

Undifferentiated carcinoma is a subtype of NPC with a higher EBV antibody titer than healthy people. The carcinogenic effect of EBV involves LMP-1 associated with poor prognosis, and mutant p53 predicts tumor recurrence. This study aims to assess the effect of LMP-1 and mutant p53 on the prognosis of NPC patients. 40 paraffin blocks were stained with LMP-1 and p53 mutant. LMP-1 was positive when the cytoplasm and tumor cell membranes were brown, and mutant p53 was positive for the brown tumor cell nucleus. Pearson correlation test was performed. Most respondents were in the age group 40 years, males, regional lymph node involvement (N) in group N1, and no metastasis (M). The expression levels of LMP-1 and mutant p53 were strongly positive. The study showed the correlation between LMP-1 with age (p 0.327), gender (p 0.599), category N (p 0.512), category M (p 0.019) and the correlation between mutant p53 with age (p 0.329), gender (p 0.981), category N (p 0.013), category M (p 0.705). LMP-1 expression with mutant p53 (p 0.760). It can be concluded that LMP-1 and mutant p53 could be used as prognostic factors in NPC patients.

Garcinia Mangostana Pericarp Extract Protection on Reproductive Function of Obese-Diabetic Rats Model Nindita, Yora; Karlowee, Vega; Kesumayadi, Irfan; Istiadi, Hermawan; Muniroh, Muflihatul
Althea Medical Journal Vol 10, No 3 (2023)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v10n3.2905

Background: Type 2 diabetes mellitus (T2DM) in obese has been considered a risk factor for male infertility. Garcinia mangostana pericarp extract (GMPE) is known to have anti-hyperglycemic, anti-diabetic, and anti-inflammatory effects. This study aimed to evaluate the effect of GMPE therapy on reproductive function in obese T2DM rats by examining testosterone level, testicular histopathological features, and hs-CRP level.Methods: Thirty-six male Wistar rats, aged 2–3 months, were randomly divided into 6 groups and treated with a standard diet (NC), high-fat diet (HFD) with GMPE 200 mg/kgBW (obese GMPE control/OGC200), HFD with 45 mg/kgBW STZ-NA (obese-diabetic control/ODC), obese-diabetic rats with GMPE 100 (DG100); 200 (DG200); and 400 mg/kgBW (DG400). STZ-NA was administered after 8 weeks of HFD treatment and followed by GMPE for 8 weeks after T2DM was confirmed. The level of hs-CRP and testosterone were measured in the serum using an enzyme-linked immunosorbent assay. Testicular histopathological examination was measured after 8 weeks of treatment by using Modified Jonhson Score (MJS) with HE staining. Results: ODC rats significantly showed increased hs-CRP level compared to NC (8.76±0.27 vs 0.30±0.07 ng/mL, p<0.001) and reduced testosterone level and MJS compared to NC (73.69±2.22 vs 170.14±1.34 ng/dL, 4.57±0.93 vs 9.87±0.16 MJS, respectively, P<0.001). Testosterone and hs-CRP levels showed a negative and significant correlation (r=-0.974 and p<0.001). On the treatment group, GMPE significantly reduced hs-CRP and increased testosterone levels in a dose-dependent manner.Conclusion: GMPE effectively protects reproductive function in obese DM rats by increasing testosterone levels and advanced spermatogenesis, as well as decreasing hs-CRP level

Schneiderian Carcinoma Apriana, Ledisda; Sadhana, Udadi; Wijaya, Indra; Karlowee, Vega
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Latar Belakang: Squamous Cell Carcinoma (SCC) adalah keganasan paling umum dari kepala dan leher (sekitar 3%), tetapi hanya <1% dari seluruh jenis keganasan (insidensi jarang), yang dibagi menjadi jenis keratinizing dan non-keratinizing. Nonkeratinizing squamous cell carcinoma mempunyai berbagai nama lain, salah satunya Schneiderian carcinoma. Dahulu, Schneiderian carcinoma disebut sebagai Carcinoma Ex-Schneiderian Papilloma (malignant transformation). Atas kelangkaan dan keberagaman penamaan kasus ini, maka penulis tertarik untuk menyajikan kasus ini. Laporan Kasus: Seorang laki-laki 68 tahun datang dengan keluhan utama benjolan di leher kanan. Dilakukan tindakan wide eksisi dan rekontruksi, kemudian dikirimkan sampel untuk pemeriksaan histopatologi, didapatkan gambaran kelompok-kelompok sel epithelial ganas, dengan inti bulat oval, pleomorfik, hiperkromatik, berkromatin kasar, sitoplasma eosinofilik, mitosis dapat ditemukan, tumbuh papilifer, infiltratif diantara dalam stroma jaringan ikat fibrous. Dilakukan pemeriksaan lanjutan dengan pengecatan imunohistokimia yang memberikan hasil: CK5/6 positif, P63 positif, dan Ki67 positif > 80%. Diskusi: Ciri dan gejala pada pasien ini sesuai dengan kekhasan epidemiologi berdasarkan literatur. Berdasarkan pemeriksaan histopatologis dan pulasan imunohistokimia menyokong diagnosis Squamous cell carcinoma, transisional differenteated (Schneiderian carcinoma) regio colli sisi dekstra. Kesimpulan: Pemeriksaan histopatologi dan imunohistokimia pada kasus Schneiderian carcinoma ini menjadi penting serta harus dibedakan dengan jenis lainnya karena masing-masing manajemen dan prognosisnya pun berbeda. Kata Kunci: Schneiderian carcinoma, nonkeratinizing squamous cell carcinoma, transisional differenteated, Carcinoma Ex-Schneiderian Papilloma. Background: Squamous Cell Carcinoma (SCC) is rare, accounting for <1% of malignant tumours and only about 3% of malignancies of the head and neck, that includes a keratinizing and a non keratinizing type. Nonkeratinizing squamous cell carcinoma has various other names, which one is Schneiderian carcinoma. In the past, Schneiderian carcinoma was referred to as Carcinoma Ex Schneiderian Papilloma (Malignant Transformation). Based on the scarcity and diversity of naming these cases, the authors are interested to presenting this case. Case Description: A 68-year-old man comes with a complaint of a lump in the right neck. Wide excision and reconstruction were carried out, then samples were sent for histopathology, a description of malignant epithelial cell groups, with oval, pleomorphic, hyperchromatic, coarse chromatin nuclei, eosinophilic cytoplasm, mitosis can be found, papilliferous growth, infiltrative within the tissue fibrous stroma. Follow-up examination with immunohistochemical staining that gave results: CK5/6 positive, P63 positive, and Ki67 >80%. Discussion: Characteristics and symptoms in these patients are consistent with epidemiological characteristics based on literature. Based on histopathological and immunohistochemical examination support to diagnosis Squamous cell carcinoma, transitional differenteated (Schneiderian carcinoma) in colli region right side. Conclusion: Histopathology and immunohistochemistry examination in the case of Schneiderian carcinoma are important and must be distinguished from other types because each management and prognosis are different. Keywords: Schneiderian carcinoma, nonkeratinizing squamous cell carcinoma, transisional differenteated, Carcinoma Ex-Schneiderian Papilloma.

Peningkatan Ekspresi PD-L1 pada Squamous Cell Carcinoma Nasofaring Tipe Undifferentiated Non Keratinizing Yusuf, Franky; Prasetyo, Awal; Karlowee, Vega; Astuti, Meira Dewi Kusuma; Nur, Rizki Widya
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Increased Expression of PD-L1 in Undifferentiated Non Keratinizing Squamous Cell Carcinoma Nasopharynx ABSTRACT BACKGROUND: PD-L1 expressed by tumor cells in nasopharyngeal carcinoma (NPC) can be used by tumor cells to avoid the patient's immune system. This can affect prognosis such as age, gender, histopathological type, tumor stage and quality of life through immunosuppressive activity. PD-L1 expression is expected to be a biomarker for prognostic factor assessment and immunotherapy. OBJECTIVE: To determine whether there is a relationship between the level of PD-L1 expression and prognostic factors in NPC. METHODS: This is analytic observational study with a cross-sectional design. PD-L1 expression was examined immunohistochemically using 61 samples of paraffin block, which had been diagnosed as NPC in the Laboratory of Anatomical Pathology, Dr. Kariadi from January 2017 to June 2020. Patient clinical data were used as prognostic factors, namely age, gender, histopathological type, tumor stage and quality of life. Analysis was performed with the Chi-Square test to determine the relationship between the level of PD-L1 expression and prognostic factors. RESULTS: There was a significant correlation between PD-L1expression in tumor cells and histopathological type (p=0.001). No significant correlation between PD-L1 expression and age (p=0.405), gender (p=0.241), tumor stage (p=0.928) and quality of life (p=0.103). CONCLUSION: PD-L1 expression in this study cannot be used as a prognostic factor in NPC patients, although the histopathological type shows a significant relationship, so further research is needed with a larger sample and a longer period. Keywords: Nasopharyngeal carcinoma; PD-L1; prognostic factor

Correlation Between Testosterone Level With HBA1C Level As Glycemic Control Marker Among Type 2 Diabetes Mellitus Patient Halim, Fenny; Listiana, Devia Eka; Karlowee, Vega; Istiadi, Hermawan; Prasetyo, Awal; Astuti, Meira Dewi Kusuma
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.959

BACKGROUND: Helicobacter pylori is classified as a grade 1 carcinogen by the International Agency for Research on Cancer. Identification of Helicobacter pylori infection is crucial for the prevention of malignancy. Immunohistochemistry is more specific and sensitive than modified Giemsa because it based on the antigen- antibody binding so it can exclude other organisms. However, it can be expressed in all species of Helicobacter genus. OBJECTIVE: To compare the identification methods of Helicobacter spp in stomach biopsy between modified Giemsa and immunohistochemistry. METHOD: This research was a cross-sectional study. There were 64 biopsies taken by simple random sampling. They consisted of 32 positive and 32 negative Helicobacter spp based on the interpretation of modified Giemsa. Statistical analysis using x2 test. RESULT: The number of atypical Helicobacter spp was 42.%. The number of samples that received Proton Pump Inhibitor (PPI) therapy was 93.75%. Helicobacter spp was positive in 31 samples and negative in 33 samples based on the interpretation of immunohistochemistry staining. There was no significant difference (p=0.617) between the identification results of Helicobacter spp using immunohistochemistry compared to the Modified Giemsa at both 400x and 1000x magnification. CONCLUSION: Modified Giemsa is still reliable for identifying Helicobacter spp, especially in classical form, compared to immunohistochemistry. Due to the administration of PPI, there are a lot of cases with atypical form of Helicobacter spp which can be differentiated into coccoid form and intraepithelial located. Immunohistochemistry staining is useful in identify these cases.

Hubungan Ekspresi LMP-1 dengan Overall Survival Pasien Diffuse Large B-Cell Lymphoma di RSUP Dr Kariadi Semarang Hamidiyah, Silpi; Sadhana, Udadi; Istiadi, Hermawan; Karlowee, Vega; Miranti, Ika Pawitra
Medica Arteriana (Med-Art) Vol 4, No 1 (2022): Juni 2022
Publisher : University of Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/medart.4.1.2022.18-25

Latar Belakang: Latent membrane protein 1 (LMP1) merupakan onkoprotein abnormal yang paling utama ditemukan pada infeksi virus Epstein-Barr (EBV). LMP1 sering terekspresi pada berbagai keganasan terkait EBV, salah satunya adalah diffuse large B cell lymphoma (DLBCL). Beberapa literatur telah menjelaskan keterlibatan EBV terhadap outcome klinis pasien namun nilai prognostik dari ekspresi LMP1 terhadap overall survival pasien DLBCL terkait EBV masih belum dapat dijelaskan.Metode: Penelitian dengan desain cross sectional ini melibatkan 50 pasien DLBCL yang didiagnosis antara Januari 2017 sampai Juni 2018. Pengamatan dilakukan selama 60 bulan. Data yang dikumpulkan meliputi usia, gejala B, stadium tumor, subtipe molekuler, dan survival 5 tahun. Analisis data menggunakan uji beda dan kurva Kaplan-Meier.Hasil: Dari 50 pasien, sebagian besar berusia diatas 40 tahun (88%), jenis kelamin laki-laki (60%), subtipe non GCB (62%), mengeluhkan semua gejala B (30%) dan stadium I (38%). Sebanyak 21 pasien meninggal (42%). Pasien dengan skor LMP1 yang tinggi menunjukkan overall survival yang lebih buruk secara bermakna dibandingkan dengan skor LMP1 yang rendah (P <0.001).Kesimpulan: DLBCL yang mengekspresikan LMP1 berhubungan dengan rendahnya overall survival 5 tahun dibandingkan dengan yang tidak mengekspresikan LMP1.

Hubungan Antara Ekspresi LMP1 dan Karakteristik Klinikopatologis Karsinoma Payudara Invasif Di RSUP Dr. Kariadi Semarang Utami, Asih Ratna; Miranti, Ika Pawitra; Puspasari, Dik; Istiadi, Hermawan; Karlowee, Vega
Medica Arteriana (Med-Art) Vol 6, No 1 (2024): Juni 2024
Publisher : University of Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/medart.6.1.2024.1-9

Latar Belakang: Sekitar 30-50% karsinoma payudara positif terhadap virus Epstein-Barr (EBV). Studi melaporkan bahwa karsinoma payudara positif EBV cenderung lebih agresif. Infeksi EBV dapat dibuktikan salah satunya melalui pemeriksaan LMP1. Sejauh ini studi tentang infeksi EBV terhadap karakteristik klinikopatologis karsinoma payudara di negara-negara Asia termasuk Indonesia masih terbatas. Penelitian ini bertujuan menganalisis hubungan ekspresi LMP1 dengan karakteristik klinikopatologis karsinoma payudara invasif.Metode: Penelitian cross-sectional menggunakan 64 sampel blok parafin dari pasien karsinoma payudara invasif di RSUP Dr. Kariadi periode Juni-September 2019. Ekspresi LMP1 dinilai dengan immunostaining. Data klinikopatologis berupa usia, ukuran tumor, grade, ekspresi ER, PR, HER2, Ki67, subtipe molekuler dan keterlibatan KGB aksila. Analisis menggunakan uji korelasi dan SPSS 17.Hasil: Dari 64 kasus karsinoma payudara invasif, sebagian besar berusia >50 tahun (59,4%), ukuran T2 (45,3%), grade 2 (70,3%), ekspresi ER positif (62,5%), ekspresi PR negatif (56,3%), ekspresi HER2 negatif (64,1%), indeks Ki67 > 20% (75%), subtipe molekuler Luminal B-like (HER2 negative) (31,3%) dan metastasis KGB N1 (35,9%). Ekspresi hanya berkorelasi dengan metastasis KGB (p=0.01), bermakna karsinoma payudara invasif dengan LMP1 positif menunjukkan semakin tinggi risiko keterlibatan KGB.Kesimpulan: Ekspresi LMP1 berkorelasi dengan tingkat metastasis KGB.

Effects of topical hyaluronic acid on nasal mucosa wound healing Sabig, Lidya; Dewi, Anna Mailasari Kusuma; Hariyati, Riece; Karlowee, Vega; Septarina, Faiza Rizky Aryani
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 2 (2024): VOLUME 54, NO. 2 JULY - DECEMBER 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i2.544

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nasal and paranasal sinuses mucosa that takes place for more than 3 months. The treatment paradigm nowadays depends on Functional Endoscopic Sinus Surgery (FESS) in the hope to repair the damaged mucosa, restoring it to its physiological condition. Hyaluronic Acid (HA) could restore the natural barrier of the mucosa and stop the inflammatory cascade. Purpose: To understand the difference in the number of inflammatory cells in the post-FESS nasal mucosa in CRS patients that had been treated with HA. Method: This was pre and post-test, double-blinded, randomized control group study design of 22 CRS patients (range 18 to 55 years) in Dr. Kariadi General Hospital, Semarang from May to August 2019. All subjects had undergone biopsies of the inferior turbinate at the time of surgery and 4 weeks after surgery. The number of pre and post-test neutrophil, eosinophil and lymphocyte counts were compared between control and treatment groups. The neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to- lymphocyte ratio (ELR) levels were also compared between the two groups. Data analysis was done using the Wilcoxon test. Result: When the pre and post-test treatment group and the control group were compared, no statistically significant difference was found between two groups except for ELR in the treatment group (p=0.028). Conclusion: ELR was decreased significantly in the treatment group. NLR level was also decreased but not significant. This study had shown that topical HA could positively modulate the inflammatory response. Keywords: chronic rhinosinusitis, FESS, histopathology, neutrophil, eosinophil, lymphocyte ABSTRAK Latar belakang: Rinosinusitis kronis (RSK) merupakan penyakit inflamasi kronik pada mukosa hidung dan sinus paranasal yang berlangsung lebih dari 12 minggu. Bedah Sinus Endoskopi Fungsional (BSEF) pada RSK bertujuan untuk memperbaiki mukosa yang rusak dan mengembalikannya ke kondisi fisiologis. Asam hyaluronat (AH) dapat mengembalikan penghalang alami mukosa dan menghentikan proses inflamasi. Tujuan: Untuk mengetahui perbedaan jumlah sel inflamasi pada mukosa hidung pasca BSEF pada pasien RSK yang diberikan terapi tambahan AH. Metode: Penelitian ini merupakan penelitian pre dan post-test, tersamar ganda, desain penelitian kelompok kontrol acak terhadap 22 pasien RSK (berusia 18 hingga 55 tahun) di RS Dr. Kariadi, Semarang dari bulan Mei hingga Agustus 2019. Semua subjek dilakukan biopsi konka inferior pada saat operasi dan 4 minggu setelah operasi. Jumlah neutrofil, eosinofil, dan limfosit sebelum dan sesudah terapi dibandingkan antara kelompok kontrol dan kelompok perlakuan. Rasio neutrofil terhadap limfosit (NLR) dan rasio eosinofil terhadap limfosit (ELR) juga dibandingkan antara kedua kelompok. Analisis data dilakukan dengan menggunakan uji Wilcoxon. Hasil: Hasil perbandingan kelompok perlakuan dan kelompok kontrol sebelum dan sesudah terapi, menunjukkan tidak ada perbedaan yang signifikan secara statistik antara kedua kelompok kecuali ELR pada kelompok perlakuan (p=0,028). Kesimpulan: ELR menurun secara signifikan pada kelompok perlakuan. Tingkat NLR juga menurun tetapi tidak signifikan. Penelitian ini menunjukkan bahwa AH topikal dapat secara positif memodulasi respon inflamasi. Kata kunci: rinosinusitis kronis, BSEF, histopatologi, neutrofil, eosinofil, limfosit

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