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Journal : The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Non-endoscopic Examination as Predictor of Varices Degree in Liver Cirrhosis Patients Who have Experienced Esophageal Variceal Bleeding Paulus Kusnanto; Marcellus Simadibrata; Irsan Hasan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 1, April 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/121201115-22

Abstract

Background: Standard diagnosis for determining the degree of varices is by endoscopy. However, sometimes there are obstacles in the implementation of endoscopy. Based on the factors, we need to know the parameters of non-endoscopic examination which include ascites, splenomegaly, thrombocytopenia, Child-Pugh, portal vein diameter as a predictor of the degree of liver cirrhosis patients with varices who have experienced esophageal variceal bleeding. Method: The study design was cross-sectional study. The study was conducted on hospitalized patients in Cipto Mangunkusumo hospital, Gatot Subroto hospital, and Kraton hospital from September 2008 to November 2009. The patients were liver cirrhosis patients with history of upper gastrointestinal bleeding, no present bleeding, and hemodynamically stable. Examination of predictor factors in the patients such as ascites, splenomegaly, thrombocytopenia, Child-Pugh and portal vein diameter were done. Statistical analysis was performed with student’s t-test, Mann-Whitney test, and stepwise multivariable logistic regression. Results: The study involved 44 patients with liver cirrhosis who have esophageal variceal bleeding. Based on the results of endoscopic examination, large varices (F3) were found in 21 (47.73%) patients, small varices (F1 F2) in 23 (52.27%) patients, located on the distal esophagus extending to the medial (86.4%), with red color sign present (54.5%). Results of non-endoscopic examination such as splenomegaly, ascites, thrombocytopenia, portal vein diameter and Child-Pugh score was known not to be associated with the degree of esophageal varices (p 0.05). Conclusion: Non-endoscopic examination was not related to the degree of varices in liver cirrhosis patients who have experienced esophageal variceal bleeding. Keywords: esophageal variceal bleeding, liver cirrhosis, predictor factors, endoscopic criteria
Histopathology of Helicobacter pylori in Chronic Dyspepsia Patients Wildan Nur; Paulus Kusnanto; Triyanta Yuli Pramana; Michael Tantoro Harnomo; Oyong Oyong; Ambar Mudigdo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (341.801 KB) | DOI: 10.24871/1332012161-165

Abstract

ABSTRACTBackground: Helicobacter pylori (H. pylori) are the most common infection found in dyspepsia cases. This infection is almost always found in digestive tract inflammation and commonly develops into chronic gastritis. Meanwhile, chronic gastritis is a condition assumed as the early event in pathological abnormalities of the stomach which finally may develop into carcinoma of the gaster. In Indonesia, data describing the incidence of H. pylori infection based on the histopathological appearance, location of specimen collection, inflammatory degree, and age of chronic dyspepsia patients is not yet available. The aim of this study is to determine the incidence of H. pylori based on histopathology appearance in chronic dyspepsia patients in Moewardi Hospital Surakarta.Method: This study is a cross sectional descriptive study by performing endoscopy-biopsy and histopathology examination to chronic dyspepsia patients who came to Gastroenterohepatology Clinic, Department of Internal Medicine, Moewardi Hospital, Surakarta on 1 January 2009 - 31 December 2010.Results: More than 90% subjects were 40 year old with the distribution of majority patients were 46-55 year old (32.43%). The most commonly found endoscopic appearance in subjects with positive H. pylori was superficial chronic gastritis (81.08%) with mild inflammatory degree (64.86%) and majority located in the antrum 97.3%.Conclusion: The proporsion of H. pylori infection in male and female was almost equal and was mostly found in the age group of 46-55 year old. This infection frequently happens in chronic dyspepsia who has histopathologic appearance of superficial chronic gastritis with mild inflammatory degree in the antrum area. Keywords: Helicobacter pylori, superficial chronic gastritis, age
A 17-Years Old Man of Colitis Tuberculosis with Fistula Perianal Paulus Kusnanto; Marcellus Simadibrata; Ari Fahrial Syam; Achmad Fauzi; Murdani Abdullah; Dadang Makmun; Chudahman Manan; Daldiyono Daldiyono; Abdul Aziz Rani; Ening Krisnuhoni
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 3, December 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/932008103-106

Abstract

Tuberculosis (TB) remains to be one of the most common problems in developing countries such as Indonesia. It can involve many organs including gastrointestinal tracts. Colonic tuberculosis is an ancient disease and has long been recognized. However, it is sometimes difficult to make early diagnosis due to its nonspecific signs and symptoms. Perianal granulomas or perianal fistula presents some degree of diagnostic difficulty. A spectrum of diseases can produce granulomas in perianal region and perineum. Most are infectious or inflammatory diseases. Standard histological diagnosis often less significant to clarify the etiology and treatment will vary from one to another disease entity. In this report, we present a case 17-years old man with colitis TB and fistula perianal, in which the initial diagnostic workup suggested Crohn’s disease. Mantoux test, Acid Fast Bacilli test on fecal examination and polymerase chain reaction analysis revealed negative result. The chest X-ray was normal; while the fistulography X-ray: revealed 2 orifices in rectosigmoid area. The colonoscopy revealed mucosa edema with ulceration in rectosigmoid and pedincular polyp in the caecum. Initial colonoscopy diagnosis was Crohn’s disease with differential diagnosis colitis ulcerative, colitis TB, colitis infection. results of direct or post homogenizes examination (Ziel–Nielsen staining) revealed that no acid-fast bacilli was found. Multiple biopsies were done, which indicated  mucosa edema with ulceration in rectosigmoid area, pedincular polyp in the caecum, and surrounded by fistula perianal; while histopathological examination showed inflammatory-caseating-epithelioid-granulomas and giant cells (Langhans datia cell) caused by tuberculosis. It highlights the need for awareness of intestinal TB along with the differential diagnosis of chronic intestinal disease. Standard regimen of antituberculosis treatment was given and the patient showed good clinical response. Keywords: Crohn’s disease, caseating epithelioid granuloma, giant cell, colitis TB, perianal fistula
Phenotype and Conditioning Medium on Umbilical Cord-Mesenchymal Stem Cell (UC-MSC) Kusnanto, Paulus; Purwanto, Bambang; Wasita, Brian; Widyaningsih, Vitri
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023127-131

Abstract

Stem cells are unspecialized cells that differentiate into more specialized cells for various tissues in the human body. Stem cells have the characteristics and ability to become themselves by performing various mitoses and differentiating different cells. Stem cells also have great potential for tissue regeneration. Detection and isolation of specific cells is very important in understanding biological processes such as development, aging, regeneration, and cell pathogenesis. Therefore, stem cells are present as an invaluable therapeutic option. Before stem cells can be applied, it is important to know the characteristics of the specific function cells or phenotypic markers. Isolation and characteristics of stem cells on culture morphology or immunotaining on specific markers. Immunohistochemistry can provide a general description of the expression of markers in a cell under certain conditions. Surface markers are the basis for identifying the characteristics and isolation of stem cells. The basic characteristics of stem cells are one that influences the outcome of the therapy to be carried out. The presence of marker cell surface expressions can also be a differentiator in searching for the origin of the stem cells used6. MSC culture method was performed with DMEM + 5% HPL. UC-MSCs with phenotype differentiation were found to be CD73+, CD90+, CD105+, Lin- while the parameters found were IL-6, SDF-1, BDNF, FGF, NGF, IL-12p70, IL-23, IL-18, IL-10 , VEGF, EGF, IL-17A, IFN-, IL-1β, PDGF, MCP-1.The results obtained are in accordance with the standard content of UC-MSC cells which can be continued as cell research.