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All Journal Medical Journal of Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Daldiyono Hardjodisastro
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Medicine & Pharmacology

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Colorectal cancer among young native Indonesians: A clinicopathological and molecular assessment on microsatellite instability Sudoyo, Aru W.; Hernowo, Bethy; Krisnuhoni, Ening; Reksodiputro, Ary H.; Hardjodisastro, Daldiyono
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (341.879 KB) | DOI: 10.13181/mji.v19i4.411

Abstract

Aim: To obtain clinicopathological characteristics of colorectal cancer among young native Indonesians and to assess MLH1, MSH2, and SMAD4 protein expressions, comparing them with a matched population of colorectal cancer patients aged 60 years old and older.Methods: Medical records of colorectal cancer patients aged 40 years or younger and 60 years or older from several hospitals in three Indonesian cities – Jakarta, Makassar, and Bandung - were reviewed. The “native” ethnic groups were selected from those originating from Java, Makassar (South Celebes),  Minangkabau (West Sumatra). Ethnicity of 121 colorectal  carcinoma patients was confirmed by fulfilling requirements in a questionnaire. Tumor specimens of those patients underwent evaluation for histopathology, tumor grading as well as  immunohistochemical analysis to assess MLH1, MSH2 protein expressions to detect microsatellite instability mutation pathway and SMAD4 protein expression to reconfirm that the specimens were not microsatellite instability origin.Results: There were 121 colorectal carcinoma cases of Sundanese, Javanese, Macassarese and Minangkabau ethnic group. This study indicated that colorectal cancer has statistically different grade (p = 0.001) between the young and the older patients. Immunohistochemical staining for MSH2 protein and MLH1 were done for 92 and 97 specimens respectively. There was no significant difference between the expressions of MLH1 and MSH2 on tumor grading, indicated there was no correlation between microsatellite instability and tumor grading in this study.Conclusion: Colorectal cancer in young native Indonesian patients (40 years old or less) was not different in clinicopathological characteristics compared to older patients (60 years old or more) in similar ethnic groups. There was also no difference in MSH2 and MLH1 protein expressions, important indicators of microsatellite instability and. (Med J Indones 2010; 19:245-51)Keywords: colorectal cancer, microsatellite instability, MLH1, MSH2, native Indonesian, SMAD4
A Randomized Trial Comparing The Effect of Soy Protein Diet Supplement Versus Hospital Standard Supplement on Clinical and Laboratory Parameters in Malnutrition Patients Ari Fahrial Syam; Marcellus Simadibrata; Chudahman Manan; Daldiyono Hardjodisastro; Riadi Wirawan; Helsi Helsi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 3, December 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/43200370-74

Abstract

Background: Studies have shown that soy protein diet may improve clinical nutrition status of malnutrition patients. Soybeans itself are unique foods because of their rich nutrient content. The complete nutrient in soybean is important and also offers many health benefits especially in malnutrition patient during hospitalization. Objective: The objective of this study was to assess the effect of soy protein supplement and hospital standard supplement (animal protein) on anthropometries and laboratory findings in malnutrition patients during hospitalization. Method: Forty-eight patients with malnutrition (confirmed by Body Mass Index 20 kg/m2) aged 14- 70 years old were recruited from Internal Medicine wards in Cipto Mangunkusumo hospital, Jakarta, Indonesia. The study design was randomized controlled trial. The subjects were randomly divided into 2 groups were fed supplement diet contained soy protein supplement diet (40 g/d) or hospital standard supplement (40 g/d) for 2 weeks. Body weight was measured in the first day (base line data), 7-dayand 14-day after intervention. Blood and urine was collected at baseline, 7-day and 14-day for measuring transferin, prealbumin and nitrogen balance. The intake of supplement, gastrointestinal symptoms and others adverse event were noted every day. Result: From 48 subjects, there were only 32 patients that completed the study during 2 weeks. In the base line data there were no significant different for intake diet calculation, anthropometrics and laboratory  parameters in study group and control group. A total of patients 32 consist of 20 (62,5 %) female and 12 (37,5%) male with a mean age 31,8 + 12,9 years old. Anthropometrics evaluation after 1 week and 2 weeks intervention in soy protein supplement showed significantly increased every week in 2 weeks. In control group, significantly increased showed only after two weeks intervention. But there was no significantly increased of BMI of two groups. Serum transferin concentration increased from 1,489 ± 0,502 at base line to be 1,600 ± 0,502 at week 1 and to bel, 695 ± 0,402 in study group. But this increasing was no significantly between two groups. No significant differences were found between two groups for prealbumin level after 1 week and 2 weeks intervention. Nitrogen balance improved significantly (p0,05) more with soy protein supplement than hospital standard supplement (animal protein). In this study, there was no side effect in soy protein supplement diet and 1 case with diarrhea and nausea in hospital standard supplement (animal protein) Conclusion: Soy protein supplement diet improved both of nutrition parameter: anthropometrics and laboratory parameter. There were no significantly different in anthrometrics and laboratory parameter berween soy protein supplements tahan hospital standar supplement (animal protein). But nitrogen balance improved significantly in study group than control group. Substitution of soy protein for animal protein has the potential role for the patient with malnutrition Keywords: Soy protein diet, Malnutrition
Difficulties in Making Diagnosis of Inflammatory Bowel Disease: Several Cases Analysis Daldiyono Hardjodisastro; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200468-70

Abstract

Inflammatory bowel disease (IBD) is rarely found in clinical practice. However, the incidence of IBD seems to have increased recently. Generally, the patients will come to hospital with chief complaint of chronic diarrhea with or without hematochezia. We reported two cases of IBD in which they had been misdiagnosed as colitis tuberculosis based on colonoscopy examination. Treatment of anti tuberculosis drugs had made no clinical improvement. Further evaluation suggested the diagnosis of IBD. They responded very well clinically after treated as IBD. This case report reminds us to consider the diagnosis of IBD in patient with chronic diarrhea and ulceration in colonic mucosa at colonoscopy. Keywords: Chronic diarrhea, inflammatory bowel disease, hematochezia
Pancreatic Exocrine Insufficiency in Chronic Diarrhea Marcellus Simadibrata; Daldiyono Hardjodisastro; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120054-9

Abstract

Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia. Materials methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 mg E1/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 mg E1/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests. Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency ( 200 mg E1/g stool) than in dyspepsia (control) ( 200 mg E1/g stool, p 0.001). The mean fecal elastase-1 Result in chronic diarrhea and in dyspepsia were 316.29 + 195.44 vs. 475.93 + 65.33 mg E1/g stool (p 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency. Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea Keywords: pancreatic exocrine insufficiency, chronic diarrhea, fecal pancreatic elastase-1
Expression of Cyclooxygenase Enhances Tumor Invasion and Metastasis in Human Gastric Carcinoma Murdani Abdullah; Abdul Aziz Rani; Daldiyono Hardjodisastro; Hiroyuki Otsuka; Tadashi Sato; Yuichiro Kojima; Masayuki A Fujino
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200443-47

Abstract

Background: Expression of COX-2 in vitro has been shown to have a number of cellular effects including increasing proliferation, reducing apoptosis promoting angiogenesis, decreasing E-cadherin expression and increasing invasive/metastatic potential. Aims: To determine the role of COX-2 in the development and metastasis potential of gastric carcinoma in human subjects. Methods: Tissue samples were obtained from surgically removed specimens of 48 patients with primary gastric adenocarcinoma who underwent gastrectomy from January 1998 to December 1999. The specimens were stained for HE while COX-2 expressions in cancer fold and antrum site were evaluated immunohistochemically. Expression of COX-2 was defined as positive when either one of cancer lesion or antrum site showed immunoreactivity. Results: Preliminary result from 12 out of 48 cases, COX-2 immunoreactivity was detected in 50% (6 of 12 specimens). Expression of COX-2 were more frequent in tumor with serosal invasion (5 of 6 specimens), lymph node metastases (3 of 3 specimens), tumor size more than 4 cm and were significant, statistically (p0.05). The expression of COX-2 in well differential carcinoma type was similar with in poorly differentiated carcinoma type. Conclusion: COX-2 expression in gastric carcinoma tissue is correlated closely with tumor size, serosal invasion and lymph node metastases, indicating that COX-2 is involved in the growth and metastases of gastric carcinoma. Keywords: Gastric carcinoma, cyclooxygenase-2, invasion, immunochemistry
Co-Authors Abdul Aziz Rani Abdul Aziz Rani Ari Fahrial Syam Aru W. Sudoyo Ary H. Reksodiputro Bethy Hernowo Chudahman Manan Chudahman Manan Ening Krisnuhoni Helsi Helsi Hiroyuki Otsuka Marcellus Simadibrata Marcellus Simadibrata Masayuki A Fujino Murdani Abdullah Murdani Abdullah Riadi Wirawan Riadi Wirawan Tadashi Sato Yuichiro Kojima