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All Journal Majalah Kedokteran Bandung Indonesian Journal of Urology Folia Medica Indonesiana Indonesian Journal of Cancer JBN (Jurnal Bedah Nasional)
Sunaryo Hardjowijoto
Department Of Urology, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
Health Professions Medicine & Pharmacology Public Health Other

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Giant Renal Angiomyolipoma ULIA, RIFKYA; HARDJOWIJOTO, SUNARYO
Indonesian Journal of Cancer Vol 6, No 3 (2012): Jul - Sep 2012
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Angiomyolipoma ginjal adalah tumor jinak ginjal yang tersusun atas jaringan lemak, otot polos dan pembuluh darah yang abnormal. Tumor ini jarang dijumpai dan bisa muncul sendiri (sporadis) atau juga berhubungan dengan tuberous sclerosis. Gambaran klinis dari angiomyolipoma adalah trias Lenk, yaitu massa pinggang, nyeri pinggang, dan gross haematuria. Kami melaporkan pasien pria usia 17 tahun yang dirawat di Rumah Sakit Dr. Soetomo, Surabaya, dengan keluhan utama benjolan pinggang kiri bawah sejak 1,5 tahun yang lalu yang bertambah besar.Diagnosis angiomyolipoma didasarkan atas hasil pemeriksaan Computerizad Tomography Scan abdomen. Pasien ini dilakukan terapi embolisasi arteri dan nefrektomi total, dengan hasil pemeriksaan Patologi Anatomi: angiomyolipoma.Kata kunci: ginjal, angiomyolipoma, embolisasi, nefrektomi
Kloning Gen Melanoma Antigen 1 (Mage-1) dari Jaringan Testis untuk mendapatkan Plasmid Rekombinan Mage-1 Mastutik, Gondo; I’tishom, Reny; Hardjowijoto, Sunaryo; Putra, Suhartono Taat
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gen Melanoma antigen-1 (Mage-1) diekspresikan oleh sel spermatogonia jaringan testis normal dan diekspresikan 60−80% oleh liver penderita karsinoma hepatoseluler (KH). Ekspresi Mage-1 merupakan penanda untuk diagnosis KH serta prediktor kanker lambung dan kolorektal. Isolasi messenger ribonucleid acid (mRNA) Mage-1 dari jaringan liver penderita KH sulit dilakukan sehingga dilakukan isolasi mRNA Mage-1 dari jaringan yang mengekspresikan Mage-1, yaitu jaringan testis normal. Penelitian ini merupakan penelitian eksploratif yang dilakukan di Lembaga Penyakit Tropis Universitas Airlangga, Agustus 2006–Agustus 2008. Tujuan untuk mengkloning seluruh area koding gen Mage-1 dari jaringan testis pada vektor dan mendapatkan plamid rekombinan Mage-1. Isolasi seluruh area koding gen Mage-1 dilakukan dengan teknik semi-nested polymerase chain reaction (PCR). Seluruh area koding gen Mage-1 diisolasi, kemudian dikloningkan ke plasmid pET101/D-TOPO dan ditransformasikan ke Escherichia coli (E. coli) Top10 untuk mendapatkan plasmid rekombinan Mage-1. Panjang pET101/D-TOPO adalah 5.753pb dan area koding gen penyandi Mage-1 927 bp sehingga total panjang plasmid rekombinan 6.680 bp (5.753+927). Hasil analisis restriksi dengan EcoRV menunjukkan pita 4.230 dan 2.450 (4.230+2.450 = 6.680). Analisis sekuens gen Mage-1 dari testis mempunyai homologi 100% dengan sekuens M77481 serta NM_004988, dan 99% dengan BC01755. Simpulan, berdasarkan hasil analisis restriksi dan sekuens maka diperoleh plasmid rekombinan pETGM/MAGE1-Testis yang mengandung seluruh area koding gen Mage-1 dan dapat digunakan untuk pengembangan kit diagnostik karsinoma.  [MKB. 2015;47(4):199–206]Kata kunci:  Jaringan testis, karsinoma hepatoseluler, kloning, melanoma antigen-1, pET101/D-TOPOCloning of Melanoma Antigen 1 (Mage-1) Gene from Testicular Tissue to Obtain the Recombinant Plasmid Mage-1Melanoma antigen-1 (Mage-1) is expressed by spermatogonia cells of normal testicular tissue and 60−80% is expressed by the liver of hepatocellular carcinoma (HC) patients. Mage-1 expression is a marker for diagnosing HC and predicting gastric and colorectal cancers. Isolation of messenger ribonucleid acid (mRNA) Mage-1 from the liver tissue of HC patients is difficult; therefore, Mage-1 mRNA isolates can be obtained from tissues that express Mage-1 such as normal testicular tissues . This is an explorative research that was conducted at the Institute of Tropical Diseases of Airlangga University during August 2006–August 2008. The aim was to clone the coding sequence of Mage-1 gene from testicular tissues into a vector and to get recombinant plasmid Mage-1. Isolation of the full-length Mage-1 was performed using semi-nested polymerase chain reaction (PCR) which was then cloned into plasmid pET101/D-TOPO and transformed into Escherichia coli (E. coli) Top10 to get recombinant plasmid Mage-1. The length of pET101/D-TOPO was 5,753 bp and Mage-1 was 927 bp. The length of recombinant plasmid was 6,680 bp (5,753+927). Restriction analysis using EcoRV showed 4,230 and 2,450 bp bands (4,230+2,450=6,680). Sequence analyses showed that Mage-1 was 100% homologous with M77481 and NM_004988, 99% homologous with BC01755. In conclusion, according to the results of the restriction and sequences analysis, the recombinant plasmid pETGM/MAGE1-Testis contains the full length coding region of Mage-1 and is useful for developing the hepatocellular carcinoma diagnostic kits. [MKB. 2015;47(4):199–206] DOI: 10.15395/mkb.v47n4.621
PSA, TZI, RI OF PROSTATE AS RISK FACTORS OF URINARY RETENTION Renaldo, Johan; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.16

Abstract

Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention  were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p =  0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients.Key words: prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention.
CORRELATION OF ROUTINE URINE CULTURE AND STONE CULTURE TO POST-OPERATIVE SIRS Indrawan, Taufik; Hardjowijoto, Sunaryo; Soebadi, Doddy M.; Juniastuti, Juniastuti; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.21

Abstract

Objective: This study evaluated the correlation between preoperative urine culture and intraoperative stone culture and the impact of stone culture findings on post-operative systemic inflammatory response syndrome. Material & Method:Patients with kidney stones who underwent percutaneous nephrolithotomy (PCNL) from February to May 2012 were prospectively analyzed. A pre-operative urine culture was obtained in the morning before the operation, fragmented stone collected were cultured in Departement of Microbiology. Patients were monitored closely in the postoperative period for signs of systemic inflammatory response syndrome (SIRS). Results:A total of 33 patients underwent PCNL and examined for urine cultures, stone culture and postoperative SIRS, 15 (45.45%) patients with positive urine culture, 18 patients (54.54%) with positive stone culture but only 1 patient (3.03%) had same pathogen (p = 0.629). Ten patients (55.6%) with positive stone cultures had evidence of systemic inflammatory respose syndrome postoperatively. The calculated stone culture value for sensitivity, specificity, positive predictive value and negative predictive value were 100%, 65.2%, 55.6%, and 100%. Preoperative hydronephrosis (p = 0.003) and operative time (p = 0.001) are identified as the key risk factors for SIRS after PCNL.Conclusion: Positive stone culture are better predictors for SIRS after PCNL. Stone culture examination is an essential in directing the proper antibiotic therapyin patients with SIRS after PCNL.  Keywords: Percutaneous nephrolithotomy (PCNL), urine culture, stone culture, systemic inflammatory response syndrome after PCNL.
DOXAZOSIN AND MELOXICAM COMBINATION THERAPY FOR BPH TREATMENT WITH LUTS Suarsana, Wayan; Hardjowijoto, Sunaryo; Wirjopranoto, Soetojo; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.22

Abstract

Objective: To compare the efficacy of combination therapy of 4 mg doxazosin + 15 mg meloxicam with 4 mg doxazosin single therapy for benign prostate hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS). Materials & Methods: A prospective, randomized and double blind study with total of 22 BPH patients with LUTS were randomized to receive 4 mg doxazosin + placebo once daily for 6 weeks or a combination of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks. Inclusion criteria included IPSS ≥ 8, age > 50 years, prostate blood flow grade II. Therapeutic efficacy was assessed by comparing changes in IPSS, maximal urinary flow (Q-max) and changes in prostate blood flow between baseline and immediately after 6 weeks of therapy. Results: There was no significant difference in IPSS change between the two treatment groups (delta IPSS 4 ± 1.1 versus 3.7 ± 1.5, p = 0.630). There was a significant difference in Q-max changes between the two groups (delta Q-max 4 ± 1.5 versus 2.1 ± 0.7, p < 0.001). In group therapied with 4 mg doxazosin + 15 mg meloxicam prostate blood flow decreased from grade II to grade I in 9 of 11 patients (81%). Whereas, in the treatment group of 4 mg doxazosin + placebo no reduction was found in prostate blood flow. Conclusion: Combination therapy of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks is better than 4 mg doxazosin therapy alone in improving Q-max and decreasing prostate blood flow in BPH patients with LUTS.Keywords: Benign prostate hyperplasia, inflammation, COX-2 inhibitors.
TRANSPLANTATION OF ALLOGENIC ADIPOSE-DERIVED STEM CELL IMPROVE URETHRAL MUSCLE-COLLAGEN RATIO AFTER VAGINAL DISTENSION Yudiana, I Wayan; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.30

Abstract

Objective:To investigate the effects of allogenic adipose-derived stem cell (ADSC) transplantation on urethral tissue regeneration after vaginal distension in a rat model.Material & Method:32 female wistar rats underwent vaginal distension (VD) for 4 h. Subsequently, PKH-labeled ADSCs (2 x 105 in 200 µl PBS, ADSC group, n = 18) or PBS (200 µl, placebo group, n = 18) were injected into periurethral tissue. Two and four weeks following transplantation (ADSC or PBS), voiding behavior (frequency) and muscle-collagen ratio of urethral tissue were measured to evaluate urethral sphincter regeneration. Data were analysed by paired-t test, one-way ANOVA and post hoc LSD.Results:Mean voiding frequency was significantly different in the ADSC group at two weeks (p<0.0001), but not significantly different at four weeks (p=0.448) when compared with the placebo group.Masson’s trichrome staining revealed that the muscle-collagen ratio of urethral tissue was not significantly different between study groups at two or four weeks (p=0.053 or p=0.166 respectively). Muscle-urethral ratio was more specific showing a significant difference at two weeks (p=0.043). There were significant differences about muscle-collagen or muscle-urethral ratio between control and placebo groups (p<0.05), whereas between control and ADSC groups no significant difference was observed (p>0.05).Conclusion:ADSC transplantation promotes urethral muscle-collagen ratio with development of striated muscle after vaginal distension, so that can improve voiding behavior in a rat model.Keywords:Adipose-derived stem cell, vaginal distension, rat-SUI model, muscle-collagen ratio, voiding stain on paper.
PROFILE OF BLADDER TRANSITIONAL CELL CANCER IN SOETOMO HOSPITAL SURABAYA Abdih, M. Asro; Djatisoesanto, Wahjoe; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.31

Abstract

Objectives: To describe the characteristic of bladder transitional cell cancer (TCC). Material & methods: We reviewed the medical records of patients with bladder TCC admitted in Soetomo General Hospital Surabaya, from January 2008 until December 2012. The data regarding demographic characteristics, clinical presentation and staging, grading and staging based on pathological examinations results, and the management of the cancer.Results: The 126 cases, consisted of 102 men (81%) and 24 women (19%) with its ratio was 4.2 : 1. All male patients were heavy cigarette smokers. Mean age was 57.8 years, peak incidence was50-59 years. Hematuria was the mostfrequent clinical presentation (112 patients, 88.9%), urinary retention and other complaints (12 patients, 9.5%), and chronic dysuria (2 patients, 1.6%). Clinical staging was T1 as NMIBC in 7 patients (5.7%). MIBC consisted of T2 in 37 patients (30.3%), T3 in 35 patients (28.7%), T4 in 43 patients (35.2%). The pathological grading as an high-grade were 74 patients (64.3%). All patients had underwent TURBT for diagnosis and staging, followed by definitive treatment. It consisted of TURBT and chemotherapy bladder instillation in 7 patients (5.6%), radical cystectomy in 13 patients (10.3%), EBRT in 5 patients (4%), MVAC chemotherapy in 24 patients (19%), EBRT and chemotherapy with MVAC in 3 patients (2.4%). There were 74 patients (58.7%) underwent TURBT alone.Conclusion: Bladder TCC was in advanced stage when diagnosed, most of the patients received only TURBT and refused further treatment. Keywords: Bladder transitional cell cancer, characteristics, managements.
THE DIAGNOSTIC VALUE OF PROCALCITONIN FOR EARLY DETECTION OF UROSEPSIS Nasution, M. Andriady S.; Hardjowijoto, Sunaryo; Soebadi, Doddy M.; Aryati, Aryati; Pujiraharjo, Widodo J
Indonesian Journal of Urology Vol 19 No 1 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i1.53

Abstract

Objective: To study procalcitonin as an early and accurate marker for urosepsis. Material & Method: We performed a diagnostic study of procalcitonin, CRP and peripheral blood leucocyte in 21 patients. Patients included 12 urosepsis patients with urosepsis, and 9 trauma patients without urosepsis. This study was conducted from September 2010 to December 2010. Results: Mean and standard deviation of procalcitonin level in urosepsis patients was 27,9 ± 30,7 ng/ml, CRP was 8,9 ± 7,9 mg/l and blood leucocyte was 15125,0 ± 8969,9 mm3. Sensitivity of procalcitonin in diagnosis of urosepsis was 83,3%, specificity was 77,8%, positive predictive value was 83,3%, negative predictive value was 77,8%, positive odds ratio was 3,75 and negative odds ratio was 0,2. Diagnostic value of procalcitonin was better compared to CRP and blood leucocyte. In the receiver operating characteristics (ROC) plot, area under the curve (AUC) for procalcitonin, blood leucocyte, and CRP were 0,806 (95% CI = 0,607 – 1,004), 0,773 (95% CI = 0,568 – 0,979), and 0,602 (95% CI = 0,341 – 0,863), respectively. Conclusion: Procalcitonin is an early marker for urosepsis cases with better diagnostic value than CRP and blood leucocyte. Keywords: Urosepsis, Procalcitonin, CRP, Blood Leucocyte.
COMPARISON OF FOSFOMYCIN TROMETAMOL WITH CIPROFLOXACIN FOR UNCOMPLICATED UTI DUE TO E.COLI IN WOMEN budiono, heri; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Soebadi, Doddy M; Widodo, Agung Dwi Wahyu; Budiono, Budiono
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.96

Abstract

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.
DIAGNOSTIC VALUE OF NON-CONTRAST HELICAL CT-SCAN AND INTRAVENOUS UROGRAPHY IN UROLITHIASIS EVALUATION Hasan, Fadhli; Soebadi, Doddy M; Hardjowijoto, Sunaryo; Soebadi, Mohamad Ayodhia; Pria, Triyono Karmawan Sukmana; Pudjirahardjo, Widodo J
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.99

Abstract

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya. Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.
Co-Authors A.A. Ketut Agung Cahyawan W Agung Dwi Wahyu Widodo Anak Agung Ngurah Oka Diatmika Aryati Aryati Aulia, Rifky Basuki B Purnomo, Basuki B Budiono Dimas Panca Andhika Doddy M Soebadi Doddy M. Soebadi Eddy Sunarno, Eddy Edwin Ongkorahardjo, Edwin Endang Joewarini Endi Prilansa Mahadi Fadhli Hasan Fauriski Febrian Prapiska, Fauriski Febrian Gondo Mastutik heri budiono I Wayan Yudiana I'tishom, Reny Ida Bagus Putra Pramana Johan Renaldo Juniastuti Juniastuti Kusuma, Raditya Lukman Hakim Lukman Hakim M. Andriady S. Nasution M. Asro Abdih Marta Hendry, Marta Meles, Dewa Ketut Moh. Ayodhia Soebadi Mohamad Ayodhia Soebadi Mohammad Ayodhia Soebadi Muhammad Ridha Mukti, Ade Indra Nurhadi, Pradana Purwati Purwati Purwati putri, Karinda triharyu caesari RIFKYA ULIA, RIFKYA Rizaldi, Fikri Sabilal Alif Satrya Husada, Satrya septa surya wahyudi, septa surya Septina Rahayu, Septina Soetojo Soetojo Suhartono Taat Putra Tarmono Djojodimedjo Taufik Indrawan Triyono Karmawan Sukmana Pria wahjoe djatisoesanto Wardhana, Sonny Andikha Wayan Suarsana Widjoseno Gardjito, Widjoseno Widodo J P Widodo J Pudjirahardjo Widodo J Pujiraharjo Willy Sandhika Yuanda, Rameshdo Zamroni Zamroni