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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Mutiara Medika: Jurnal Kedokteran dan Kesehatan Jurnal Gizi Klinik Indonesia
Johan Kurnianda
Division Of Hematology And Medical Oncology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Gadjah Mada / Dr. Sardjito Hospital Yogyakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation between the Symptoms of Depression and Sexual Function in Breast Cancer Patients Receiving Chemotherapy Rohmawati, Dwi; Siswanto, Agus; Kurnianda, Johan; Sofia, Noor Asyiqah
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACT             Symptoms of depression and sexual problems that occur among breast cancer patients are a rarely detected and get good handling. Therefore, an early detection for any psychological problems that may affect the sexual life of patients with breast cancer is needed so that the patients can have better life. This study aims to assess the correlation between symptoms of depression and sexual function in women with breast cancer who undergo chemotherapy at Dr. Sardjito Hospital.            Research design was cross sectional. The study necquited 38 breast cancer patients in Tulip outpatients Cancer Clinic in Dr. Sardjito Hospital. Assessment of depressive symptoms used Beck Depression Inventory questionnaire and Female Sexual Function Index to assess sexual function.            The results showed that the proportion of subjects aged 46-55 years at 55.2% followed by 36-45 years of age at 39.5% and aged 26-35 years by 5.3%. The mean age of subjects was 45.4 + 6.5 years. Correlation between symptoms of depression with sexual function among participants was r=- 0.30 with significance p=0.068. Correlation between symptoms of depression with the domains of sexual function domain of desire (r=-0.296, p=0.072), stimulation (r = -0.470, p = 0.003), lubrication (r=-0.353, p=0.030), orgasm (r=-0.223, p=0.179), satisfaction (r=-0.233, p=0.158), pain (r=-0.186, p=0.262).            The conclusion is that there is no correlation between symptoms of depression with sexual function. Keywords: Depression symptoms, Breast Cancer, Sexual Dysfunction
The Accuracy of Wells Clinical Model for Predicting Pretest Probability in Deep Vein Thrombosis (DVT) at Dr. Sardjito Hospital Wulansih, Dwi; Kurnianda, Johan; Widayati, Kartika
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground: The diagnosis of deep vein thrombosis (DVT) is an important issue in the medical field because a large number of cases are undiagnosed. The accurate diagnosis of the DVT is essential to prevent complications of acute pulmonary embolism and long-term complications. The complication such as pulmonary hypertension and post phlebitis syndrome. It also to avoid improper anticoagulant therapy associated with a high risk of bleeding. There are several models of clinical suspicion of DVT include Hamilton’s score and Wells’ score. The Wells clinical model for predicting pretest probability for DVT has been widely used and tested its validity in several countries in Europe. The accuracy of a Wells clinical model of pretest probability for DVT has not been done for the races of Asia especially in Indonesia.Objective: This study aimed to test the accuracy and precision (sensitivity, specificity and predictive value) of Wells clinical model for predicting pretest probability for diagnose DVT for patients in the Dr. Sardjito Hospital.Methods: This study was a diagnostic study with cross-sectional design. The subjects were patients with DVT symptoms who visited Tulip clinic, outpatient and inpatient in the department of Dr. Sardjito General Hospital during January 2011-May 2012. In this study, a total of 100 patients were participated the Wells clinical model of pretest probability for DVT examination, Doppler ultrasound and D-dimer examination. The negative results on the fi rst ultrasound examination will be examined again 1 week later.Results: DVT was confi rmed in 56 patients (56%) from 100 patients. The baseline characteristics showed the number of women more than men and the mean age was 52.98 ±1.335 years. The 57% of subjects were women and the median age was ≥60 years. The most frequent risk factors of DVT were cancer 49 patients (49%), bed ridden 42 patients (42%) and elderly 33 patients (33%). The accuracy of the Wells clinical model of pretest probability for DVT was 81%, precision was 77.6%, sensitivity was 92.8%, specifi city was 65.9%, and negative predictive value was 87.9%.Conclusion: The Wells clinical model for predicting pretest probability in DVT has a high accuracy, moderate precision, high sensitivity and poor specifi city to diagnose DVT at Dr. Sardjito Hospital.Keywords: deep vein thrombosis/DVT, the Wells clinical model of pretest probability for DVT, accuracy test, precision
JAK2 mutation and treatment of JAK2 inhibitors in Philadelphia chromosome-negative myeloproliferative neoplasms Hutajulu, Susanna Hilda; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTThe Philadelphia chromosome-negative (Ph-negative) myeloproliferative neoplasms (MPNs) polycythaemia vera (PV), essential thombocythaemia (ET) and primary myelofi brosis (PMF) are clonal disorders of multipotent haematopoietic progenitors. The genetic cause of these disorders was not fully defi ned until a somatic activating mutation in the JAK2 non-receptor tyrosine kinase, JAK2V617F, was identifi ed in most patients with PV and a considerable proportion of patients with ET and PMF. The discovery of JAK2 mutation has changed the molecular reclassification of MPNs and served as a genomic target for therapeutic implication. A number of JAK2 inhibitors have been developed and tested for MPNs. Several JAK2 inhibitors have reached the phases of clinical trial and included patients with intermediate-risk or high-risk MF. This population of MF is the best candidate for trials because currently it has no effective therapy besides patients’ poor survival. Considering all clinical data on Ph negative MPNs, JAK2 inhibitors have shown a clinical benefi t and reduced symptoms in the vast majority of MF cases. The most developed among JAK2 inhibitors is Ruxolitinib, which has demonstrated clinical improvement with well tolerated toxicities. However, JAK2 inhibitor was equally active in patients with and without JAK2 mutation. Other JAK2 inhibitors are less developed, but showed a similar clinical benefi t. Furthermore, its effect on the natural course of MPNs in treating patients needs to be investigated.Keywords: myeloproliferative neoplasms – JAK2 mutation – JAK2 inhibitors.
THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sendjaja, Sukendro; Purwanto, Ibnu; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy. Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline 
ANEMIA AS RISK FACTOR OF HANDGRIP STRENGTH DECREASED ON ELDERLY IN YOGYAKARTA PROVINCE’S PANTI WERDHA Hidayat, Ganda; Kurnianda, Johan; Pramantara, I Dewa Putu
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTBackground: According to the WHO, by the end of 20 th century, the more the world population grow, the more the elderly population will be. Yogyakarta province has a 13.72% of Indonesian elderly. The anemia prevalence increased as the age added. Aging process resulted in strength muscle reduced. Handgrip strength test is a valid and consistent as well as simple alternative to value the muscle strength decreased advanced age. Purpose of this study is to know whether anemia is a risk factor against muscle strength decreased measured by handgrip strength test on elderly population in nursing house.Method: This study used cross sectional study design to the advanced ages in DIY province’s nursing house. The study time was in August 2010. The advance ages fullfilling the inclusion and exclusion criteria were conducted physical examination, routine blood test and handgrip strength measurement.Result: This study involved 118 elderly participants. There was difference of mean handgrip strenght in: age (14.52 kg vs 19.64 kg; p=0.001), gender (13.39 kg vs 22.47 kg; p=0.001), activity level (7.94 kg vs 16.75 kg; p=0.001) and anemia status (13.60 kg vs 17.84 kg; p=0.001); for women even in mild anemia group, there was difference with non anemia group (12.36 kg vs 14.68 kg ; p=0.027). Conclusion: According to multivariable analysis,. There are 3 factors involving of handgrip strength in elderly, namely; Age, activity levels, and anemia which are statistically significant. In this study, it was conclude anemia is a risk factor of handgrip strength decreased in elderly, for women even in mild anemia, there was statistically significant different with non anemia group. Keywords : Elderly, anemia, handgrip strength
Risk Factors of anemia in head and neck cancer patients undergoing chemotherapy with high-dose cisplatin Kurnianda, Johan; Wiyadi, Nugroho; Wulaningsih, Wahyu
Medical Journal of Indonesia Vol 17, No 4 (2008): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (469.871 KB) | DOI: 10.13181/mji.v17i4.328

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Cisplatin is well-known for its effectiveness against cancer, as well as its toxicity to human tissues. Of several documented side effects, anemia was reported to have significant association with decreased quality of life. This study was conducted to investigate development of cisplatin-induced anemia, and to identify independent factors contributing to anemia. Clinical data from head and neck cancer patients treated with high-dose cisplatin between December 2002 and December 2005 were obtained in this study. Incidence and risk factors of anemia were assessed in a model including age, sex, baseline hemoglobin level, baseline creatinine clearance, and occurrence of distant metastases. Multivariate logistic regression was used to define independent predictors of anemia. Among 86 eligible patients, 26 (30.2%) developed anemia, defined as Hb level lower than 11 g/dL. Age > 55 years old (RR = 2.2, 95% CI, 1.2-4.0), female sex (RR = 2.0, 95% CI, 1.2-3.8), baseline Hb ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4) and baseline CrCl < 50 mL/min (RR = 2.9, 95% CI, 1.7-5.1) were significantly correlated with incidence of anemia (P < 0.05). In multivariate analysis, baseline Hb and baseline CrCl were identified as independent risk factors for anemia. However, considerable confounding was observed in baseline CrCl after stratified by age (aRR = 2.2, 95% CI, 1.1-4.7). Thus, baseline Hb level was the strongest predictor of anemia. The findings suggested that baseline Hb and CrCl were useful to recognize cisplatin-treated patients at risk for anemia who might benefits from preventive measures. (Med J Indones 2008; 17: 248-54)Keywords: anemia, cisplatin, chemotherapy, hemoglobin, creatinine clearance
Morphological characteristics of leukemia cells in acute myeloblastic leukemia with t(8;21)(q22;q22): possible predictability of t(8;21) Purwanto, Ibnu; Tatsumi, Eiji; Syampurnawati, Meilani; Furuta, Kaho; Hayashi, Yoshitaka; Saigo, Katsuyasu; Masuda, Kayoko; Sakoda, Hiroyuki; Kawano, Seiji; Kumagai, Shunichi; Nagai, Ken-Ichi; Takahashi, Takayuki; Isono, Setsuki; Kondo, Shin-Ichi; Kurnianda, Johan; Haryana, Sofia M.
Medical Journal of Indonesia Vol 16, No 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (170.854 KB) | DOI: 10.13181/mji.v16i2.260

Abstract

The laboratory systems for chromosomal analysis or the detection of fusion genes are generally not available in Indonesia. Therefore, bone marrow (BM) morphological analysis should be developed and applied to get an accurate diagnosis. In this study the BM smears of eight (8) cases of acute myeloblastic leukemia (AML) which had already been known to have t(8;21)(q22;q22), were morphologically evaluated in order to find out the characteristics, which might be used to predict t(8;21)(q22;q22) or the presence of AML1-ETO(MTG8) fusion gene. All of the cases belonged to AML-M2. The morphological characteristics, indicative of t(8;21) were pink colored cytoplasm in mature neutrophil (75%), neutrophilic myelocytes or metamyelocytes without granules or with scarce granules (2.3%), eosinophilia (eosinophilic myelocytes and metamyelocytes) (above 5%), myelocytes with abundant granules 8.5%, and low percentage of type I blasts (below 10%). These characteristics were not observed in AML-M2 cases without t(8;21) or AML1-ETO(MTG8). The myelocytes with abundant granules have not been described so far, while other characteristics were in line with the findings of Nakamura et al (Leukemia 1997;11:651-55). (Med J Indones 2007; 16:84-8)Keywords: PML-RARA fusion gene, AML1-ETO (MTG8), myelocytes, abundant granul
Non secretory multiple myeloma – a case report Taroeno-Hariadi, Kartika W.; Purwanto, Ibnu; Kurnianda, Johan; Mangunsudirjo, Sagiri; Harijadi, A.; Puntodewo, Puntodewo
Medical Journal of Indonesia Vol 16, No 4 (2007): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.558 KB) | DOI: 10.13181/mji.v16i4.284

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A rare variant of multiple mieloma, non-secretory multiple myeloma (NSM), is reported. Diagnosis of NSM is made by presentations of lytic bone lesions with bone pain, anemia, slight hypercalcemia, good renal function, negative results of protein and immunoelectrophoresis detecting monoclonal gammopathy, and positive clonal proliferation of plasma cells and atypical plasma cells in bone marrow biopsy. Immunophenotypic study resulted negative pan-B cell antigens and positive CD 79a. Patient condition was improved after institution of combination chemotherapy and 1 year afterward. (Med J Indones 2007; 16:257-60)Keywords: multiple myeloma, non-secretory multiple myeloma, diagnosis, management
Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report Hardianti, Mardiah Suci; Kurnianda, Johan; Taroeno-Hariadi, Kartika Widayati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 03 (2014)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.544 KB) | DOI: 10.19106/JMedScie004603201405

Abstract

A rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed.
Long-Term Predictors of Disease Free Survival (DFS) in Ovarian Cancer Sensitive to Platinum Based Chemotherapy selvyana, Dita Ria; Kurnianda, Johan
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 19, No 2: July 2019
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mm.190232

Abstract

Until now, there has been progress in the treatment of ovarian cancer, but ovarian carcinoma is still a cause of high mortality. Various factors have been known to be associated with a poor prognosis, such as the absence of symptoms, lack of an effective screening tool, diagnosis of the disease that was only detected after an advanced stage, high recurrence of disease resistant to chemotherapy. There are more than 70% of cases detected in advanced stage, with long-term survival of only 15-30%; while those detected in early stages, the survival reaches 90%. The recurrence risk of IIIC stage disease is as high as 40% -50%. However, there is a small group of patients who can recover after standard therapy. There is variability in the recurrence-free period and survival, so it is difficult to predict the outcome with certainty. Ovarian cancer patients with the same characteristics can show a different prognosis, related to high molecular heterogeneity of tumor genetics. We report a rare case that is a 56-year-old woman who has experienced a 5-year free disease after complete remission after standard chemotherapy from stage IIIC ovarian cancer. The disease-free period of up to 5 years after therapy may be related to factors that can be predictors of prognosis, such as age at diagnosis, body mass index, physical performance, cancer cell biology, and the success of surgical response and chemotherapy in these patients.
Co-Authors A. Harijadi Agus Siswanto Astuti, Herni David Dwi Putera Diah Ari Safitri Dwi Rohmawati Dwi Wulansih Eiji Tatsumi Ganda Hidayat Herni Astuti Hiroyuki Sakoda I Dewa Putu Pramantara I Dewa Putu Pramantara I Ketut Suada I Wayan Dwija Karyasa Ibnu Purwanto Jamhari Jamhari Jarir At Thobari Kaho Furuta Kartika W. Taroeno-Hariadi Kartika Widayati Taroeno Hariadi Karyasa, I Wayan Dwija Katsuyasu Saigo Kayoko Masuda Ken-Ichi Nagai Mardiah Suci Hardianti Meilani Syampurnawati Muhammad Ihsan Qomaruzzaman Nina Mulyani Noor Asyiqah Sofia Nugroho Wiyadi Prafita Cahya Dewanti Puntodewo Puntodewo Qomaruzzaman, Muhammad Ihsan Sagiri Mangunsudirjo Seiji Kawano Selvyana, Dita Ria Setsuki Isono Shin-Ichi Kondo Shunichi Kumagai Sofia M. Haryana Sukendro Sendjaja Susetyowati Syahru Agung Setiawan Takayuki Takahashi Teguh Triyono Wahyu Wulaningsih Yenita . Yenita Yenita Yoshitaka Hayashi