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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Journal of Biomedicine and Translational Research The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana World Nutrition Journal
Jose RL Batubara
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Gambaran Masalah Psikososial pada Remaja dengan Thalassemia Mayor dan Diabetes Mellitus Tipe-1 Bernie Endyarni Medise; Naela Fadhila; Tjhin Wiguna; Zakiudin Munasir; Jose R.L Batubara; Pustika Amalia Wahidiyat; H.F. Wulandari; Rosalina Dewi Roeslani
Sari Pediatri Vol 22, No 2 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.2.2020.83-91

Abstract

Latar belakang. Thalassemia dan diabetes mellitus tipe-1 (DM tipe-1) merupakan penyakit kronik yang banyak didapatkan pada anak dan remaja di Indonesia. Adanya penyakit kronik pada remaja dapat berisiko meningkatkan terjadinya masalah psikososial 2-6 kali dibandingkan populasi sehat. Masalah psikososial pada remaja sulit dikenali sehingga perlu dilakukan evaluasi secara rutin. The strengths and difficulties questionnaire (SDQ) adalah instrumen yang praktis dan mudah digunakan untuk mendeteksi masalah tersebut. Tujuan. Mengetahui besaran masalah psikososial pada remaja dengan penyakit kronik di RS. Cipto Mangunkusumo, Jakarta. Metode. Desain potong lintang pada 140 remaja (100 thalassemia mayor dan 40 DM tipe-1), usia 10-18 tahun. Subyek diminta untuk mengisi kuesioner SDQ (laporan mandiri). Hasil. Prevalensi total skor abnormal pada remaja thalassemia mayor adalah 8%, dan DM tipe-1 adalah 15%. Tidak ada skor abnormal pada aspek perilaku pro-sosial kedua penyakit, dan aspek hubungan dengan teman sebaya DM tipe-1. Tidak didapatkan perbedaan bermakna antara diagnosis penyakit, jenis kelamin, dan tingkat pendidikan subyek pasien DM terhadap luaran hasil SDQ. Kesimpulan. Masalah psikososial lebih banyak didapatkan pada remaja DM tipe-1 dibandingkan thalassemia mayor.
Gambaran Tekanan Darah Anak dengan Diabetes Mellitus Tipe 1 di Indonesia Indra W Himawan; Aman B Pulungan; Bambang Tridjaja; Jose RL Batubara
Sari Pediatri Vol 13, No 5 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (590.871 KB) | DOI: 10.14238/sp13.5.2012.367-72

Abstract

Latar belakang.Salah satu komplikasi jangka panjang diabetes melitus tipe 1 (DM tipe 1) pada anak adalah nefropati diabetik. Lama menderita diabetes serta masa pubertas merupakan faktor yang mempengaruhi terjadi komplikasi tersebut. Kejadian nefropati diabetik pada umumnya akan disertai gejala peningkatan tekanan darah.Tujuan.Mengetahui gambaran tekanan darah anak dengan DM tipe 1 berdasarkan umur, jenis kelamin, lama sakit, dan kadar HbA1c.Metode.Studi observational retrospektif pada register nasional DM tipe 1 UKK Endokrin Anak IDAI sampai tahun 2010. Variabel yang diteliti adalah umur, jenis kelamin, lama sakit, kadar HbA1c, serta tekanan darah sistolik (TDS) dan diastolik (TDD).Hasil.Di antara 177 anak dengan DM tipe 1, 118 (66,7%) perempuan dan 59 (33,3%) laki-laki. Rerata umur saat pertama kali didiagnosis adalah 11,8 tahun. Dijumpai 1 (0,6 % ) anak perempuan yang menderita DM tipe 1 lebih dari 5 tahun mempunyai tekanan darah sistolik dan diastoik di atas persentil 95. Kesimpulan. Sebagian besar tekanan darah anak dengan DM tipe 1, normal. Terdapat 0,6% kasus dengan hipertensi (>95 persentil) yaitu seorang anak perempuan yang telah menderita DM lebih dari 5 tahun
Imunodiagnosis Tuberkulosis dengan Interferon Gamma Release Assay dan Uji Tuberkulin pada Anak dengan Infeksi Human Immunodeficiency Virus Nastiti Kaswandani; Dhyniek Nurul FLA; Jose R.L. Batubara
Sari Pediatri Vol 22, No 5 (2021)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.5.2021.261-9

Abstract

Latar belakang. Tuberkulosis (TB) dan Human Immunodeficiency Virus (HIV) merupakan salah satu penyebab utama kematian pada anak. Diagnosis dini penting untuk menurunkan angka mortalitas TB pada infeksi HIV. Uji tuberkulin dan interferon gamma release assay [IGRA, QuantiFERON®-TB Gold In-Tube (QFT-GIT)] diharapkan dapat mendeteksi lebih dini adanya infeksi TB pada HIV. Laporan akurasi QFT-GIT dan uji tuberkulin pada anak dengan infeksi HIV bervariasi. Tujuan. Mengetahui akurasi diagnostik dari QFT-GIT dan uji tuberkulin dalam mendiagnosis TB pada anak usia 1 bulan-15 tahun dengan infeksi HIV. Metode. Penelitian potong lintang dilakukan pada 48 pasien HIV tersangka TB usia 1 bulan-15 tahun. Pengambilan data dilakukan melalui anamnesis, pemeriksaan fisis, foto toraks, uji tuberkulin, QFT-GIT, dan pemeriksaan bakteriologis (Xpert MTB/RIF dan biakan MGIT). Hasil. Angka kejadian TB adalah 20,9% (confirmed TB 4,2% dan possible TB 18,7%). Gambaran klinis anak yang terdiagnosis TB adalah batuk lama (90%), penurunan BB (80%), penurunan aktivitas (80%), pembesaran KGB (60%), dan demam lama (50%). Sensitivitas QFT-GIT terhadap possible TB adalah 38% (IK 95%: 12-77%), spesifisitas 100% (IK 95%: 98-100), NDP 100% (IK 95%: 98-100), sedangkan NDN 88% (IK 95%: 76-94). Sensitivitas uji tuberkulin terhadap possible TB adalah 29% (IK 95%: 8-64%), spesifisitas 97% (IK 95%: 87-100), NDP 67% (IK 95%: 21-94), sedangkan NDN 88% (IK 95%: 76-95%). Sensitivitas QFT-GIT terhadap pemeriksaan bakteriologis 50% (IK 95%: 9-91%), spesifisitas 96% (IK 95%: 85-99%), NDP 33% (IK 95%: 6-79%), sedangkan NDN 98% (IK 95%: 88-100%). Hasil akurasi uji tuberkulin terhadap pemeriksaan bakteriologis tidak dapat dinilai. Kesimpulan. Pemeriksaan dengan QFT-GIT untuk mendeteksi TB pada anak dengan infeksi HIV sedikit lebih unggul dibandingkan uji tuberkulin sehingga dalam pelayanan kedua pemeriksaan ini dapat menjadi pilihan sesuai ketersediaan dan kenyamanan pasien. 
Komplikasi Jangka Pendek dan Jangka Panjang Diabetes Mellitus Tipe 1 Indra W. Himawan; Aman B. Pulungan; Bambang Tridjaja; Jose R.L. Batubara
Sari Pediatri Vol 10, No 6 (2009)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp10.6.2009.367-72

Abstract

Latar belakang. Diabetes mellitus tipe 1 (DM tipe-1) adalah kelainan metabolik yang disebabkan oleh reaksi autoimun yang menyebabkan kerusakan sel β pankreas dan terjadi pada hampir semua anak yang menderita diabetes. Dalam perjalanan DM tipe-1, sering timbul komplikasi jangka pendek dan jangka panjang.Tujuan. Mengetahui frekuensi komplikasi jangka pendek yaitu ketoasidosis dan jangka panjang yaitu nefropati dan retinopati berdasarkan kontrol metabolik, lama menderita diabetes, dan biaya pengobatan.Metode. Penelitian deskriptif pada 39 pasien yang terdaftar di IKADAR(Ikatan Keluarga Penyandang Diabetes Anak dan Remaja) selama September – Oktober 2007 di Departemen Ilmu Kesehatan Anak Divisi Endokrin FKUI/ RSCM Jakarta dengan melakukan anamnesis, pemeriksaan laboratorium HbA1c, mikroalbuminuria, dan evaluasi mata di poliklinik mata FKUI RSCM.Hasil. Dari 39 pasien yang diteliti antara umur 5-31 tahun, rerata diagnosis diabetes ditegakkan pada umur (9,8±4,1) tahun, HbA1c (10,1±2,3) % dan menderita diabetes selama (5,6±5,8) tahun, dengan dosis insulin yang dipakai (0,9±0,2) IU/kg/hari. Komplikasi yang ditemukan adalah ketoasidosis diabetik selama sakit pada 30 pasien (76,9 %) dan pada 12 minggu terakhir pada 3 pasien (7,9%), mikroalbuminuria pada 3 pasien (7,9%), sedangkan retinopati tidak ditemukan. Rerata pasien memeriksakan HbA1c 3-4 kali pertahun, memeriksa gula darah secara mandiri 1-2 kali/hari dan sebagian besar berobat dengan biaya sendiri.Kesimpulan. Tidak banyak perubahan karakteristik pasien dibandingkan penelitian yang lalu. Rerata kadar HbA1c masih kurang baik dibandingkan dengan rerata HbA1c di negara maju. Di negara maju sudah banyak perubahan pada cara pemberian insulin dan lebih ditingkatkannya perhatian dan pengetahuan pada pasien dan keluarga pasien diabetes.
Association of Growth Velocity with Insulin-Like Growth Factor-1 and Insulin-Like Growth Factor Binding Protein-3 Levels in Children with a Vegan Diet Arie Purwana; Budiono Budiono; Jose RL Batubara; Muhammad Faizi
Journal of Biomedicine and Translational Research Vol 6, No 1 (2020): April 2020
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v6i1.5474

Abstract

Background: The vegan diet in children provides the benefit of reducing the risk of being overweight and improving the fat profile. The risk that can occur in the provision of a vegan diet in children is anthropometric size below reference and low caloric intake. Growth hormone (GH) and Insulin like Growth Factors (IGFs) are powerful stimulators for longitudinal growth of bone and require insulin-like growth factor binding protein (IGFBPs) which acts as a transport protein for IGF-1. A vegan diet with lower calorie intake in children has lower IGF-I levels than children with an omnivorous diet.Objective: Examining the effect of vegan diets on IGF-1 levels, IGFBP-3 levels, and growth velocity.Methods: This study was done with a prospective cohort design. The study subjects were divided into two groups, namely the vegan group and the omnivorous group, then matched based on age and sex. During the study, anthropometric data collection, IGF-1 and IGFBP-3 levels measurements were done in both vegan children and omnivorous children.Results: During 6 months of observation, 22 subjects were divided into two groups, namely children with a vegan diet and children with an omnivorous diet. IGF-1 (ng / mL) in vegan children was 105.5 ± 47.3 compared to 102.7 ± 42.3 in omnivorous children with a value of p = 0.89. IGFBP-3 (ng / mL) in vegan children was 2146.4 ± 595.1 compared to 2142 ± 609.1 in omnivorous children with value of p = 0.99 and Growth Velocity (cm / 6 months) was 3.0 in vegan children (1.0-5.30), and 3.2 (2.6-6.5) in omnivorous children with value of p = 0.41.Conclusion:Children with vegan diet had IGF-1 level, IGFBP-3 level, and growth velocity that were the same as children with an omnivorous diet.
Metabolic syndrome and visceral fat thickness in obese adolescents Lanny C. Gultom; Damayanti R. Sjarif; Evita K. B. Ifran; Partini P. Trihono; Jose R. L. Batubara
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.167 KB) | DOI: 10.14238/pi47.3.2007.124-9

Abstract

Background Metabolic syndrome (MS) is one of the long-termconsequences of obesity which can be found in adolescents. MS iscaused by excessive visceral fat accumulation. The visceral fatthickness (VFT) itself can be measured by using waist circumference(WC) measurement and abdominal ultrasonography. Until now,there are no WC and VFT cut-off points to predict MS in childrenand adolescents. This study used MS criteria based on NationalCholesterol Education Program – Adult Treatment Panel III(NCEP-ATP III) which specifically modified.Objective The objectives of this study are (a) to determine the MSocurrence based on modified NCEP-ATP III in obese adolescents;(b) to measure the VFT by using abdominal ultrasonography in obeseadolescent with MS and obese adolescent without MS.Methods We conducted a cross-sectional study from March toMay 2006. Fifty obese adolescents were recruited from severaljunior and senior high schools in Jakarta.Results Of those 50 obese adolescents, there were 34 subjects withWC>P 80  and 16 subjects with WC <P 80 . Of those 34 subjectswith WC>P 80 , 17 subjects had MS and the others had no MS. Allthe 16 subjects with WC <P 80 did not have MS. The VFT in 17subjects with WC>P 80  who had MS was 5.19 cm (SD 2.07 cm).The VFT in 17 subjects with WC>P 80 who had no MS was 3.94cm (SD 1.62 cm). The VFT in all 16 subjects with WC <P 80 whodid not have MS was 3.54 cm (SD 0.92 cm). All obese adolescentswith MS had WC>P 80  and they also had visceral fat which wasthicker than obese adolescents without MS.Conclusions All obese adolescents with MS have WC>P 80  andthicker visceral fat than obese adolescents without MS; the VFTof obese adolescents without MS, who had WC>P 80 was 3.94cm (SD 1.62 cm), and the VFT of obese adolescents without MS,who had WC <P 80 was 3.54 cm (SD 0.92 cm).
Phenotype and genotype characteristics of Indonesian 21-hydroxylase deficient patients Atiek Widya Oswari; Bambang Tridjaja; Iswari Setianingsih; Taralan Tambunan; Aman B. Pulungan; Jose R. L. Batubara
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1077.537 KB) | DOI: 10.14238/pi47.5.2007.189-95

Abstract

Background Congenital adrenal hyperplasia (CAH) is the mostcommon cause of ambiguous genitalia in children and 90-95%cases show 21-hydroxylase deficiency. More than 100 mutationshave been described and of these, four mutations have beenfrequently reported in Asia. Those mutations are deletion/largegene conversion (LGC), intron2 splice mutation (I2 splice), pointmutations at codon 172 (I172N) and codon 356 (R356W).Genotyping is very valuable since close correlation observedbetween genotype and phenotype.Objective To identify phenotype and genotype characteristics ofCAH due to 21-hydroxylase deficiency (CAH-21OH) andcorrelation between them.Methods From June to November 2006 we analyzed 37 confirmedCAH-21OH patients treated at the Department of Child Health,Cipto Mangunkusumo Hospital during the period of 1990-2006.Polymerase chain reaction (PCR) followed by restriction fragmentlength polymorphism (RFLP) analysis or amplification-createdrestriction site (ACRS) were performed. We first identified deletion/LGC and I172N mutation that had been mostly reported in saltwasting (SW) and simple virilizing (SV) form patients respectively.Results There were 37 patients, consisted of 6 males and 31females with the ratio 1:5.2. Of those, 25, 10, 2 patients wereSW, SV and non-classic (NC) form, respectively. PCR-RFLP orACRS was performed to detect two mutations in 32 patients (64alleles). Deletion/LGC was found in 6 alleles while I172Nmutations in two. All deletion alleles showed SW phenotype butI172 mutated alleles showed SW and SV phenotype.Conclusion There is a consistent close association betweengenotype and phenotype in our CAH-21OH patients.
Relationship between lipid profiles with carotid intima--media thickness in children with type I diabetes mellitus Rubiana Sukardi; Bambang Madiyono; Sudigdo Sastroasmoro; Jose RL Batubara
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.541 KB) | DOI: 10.14238/pi48.3.2008.147-51

Abstract

Background The major cause of morbidity and mortality inpatients with type I diabetes mellitus is premature and extensiveartherosclerosis. Carotid intima-media thickness (IMT) isassociated with cardivascular risk factors and has been used as amarker of early artherosclerosis process.Objective To determine IMT of carotid artery and its relationshipwith duration of diabetes, lipid profiles, and mean HbA 1 level.Methods A cross-sectional study was conducted on patientswith type 1 DM at the Department of Child Health CiptoMangunkusumo Hospital. Ultrasound B-mode imaging wasperformed to measure the IMT. Age-matched non-diabteticsubjects served as controls. Statistical significant was assumedat P<O.S.Results The mean IMT values of type I DM patients aged < 12years, 12-18 years, 18+ years were 0.44 (SD 0.03) mm; 0.46(SD 0.01) mm; 0.51 (SD 0.01) mm, respectively, which weresignificantly greater than those of age-matched non-diabeticsubjects which were 0.39 (SD 0.01), 0.41 (SD 0.01) mm, 0.46(SD 0.01) mm, respectively. Patients with type I DM had ahigher apolipoprotein-Band HDL cholesterol levels than in non-diabetic subjects. Multiple regression analysis showed that therewas no relationship between total cholesterol, cholesterol LDL,chronic hyperglycemia (HbA 1) and IMT. However, IMT in typeI diabetes was linearly related with duration of diabetes .Conclusion Type I DM patients have greater IMT and highermean apolipoprotein B. There is a strong correlation betweenIMT and duration of diabetes.
Effect of intranasal mometasone furoate administered in children with coexisting allergic rhinitis and asthma towards asthma attacks and lung function Ellen P. Gandaputra; Zakiudin Munasir; Bambang Supriyatno; Jose R. L. Batubara
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.377 KB) | DOI: 10.14238/pi49.6.2009.359-64

Abstract

Background Allergic rhinitis and asthma are allergic manifestations in respiratory tract, which related each other. Intranasal corticosteroid is effective in allergic rhinitis and has benefits in decreasing lower airway reactivity.Objectives To evaluate effectiveness of intranasal mometasonefuroate towards asthma in children aged 6-18 years with coexisting allergic rhinitis and asthma.Methods A one group pretest-posttest ("before and after") study was conducted in Cipto Mangunkusumo Hospital from May to December 2008. Subjects were children aged 6-18 years, with moderate-severe intermittent or persistent allergic rhinitis with coexisting frequent episodic asthma or persistent asthma, and visited outpatient clinic of allergy immunology division or respirology division. Subjects were administered intranasal mometasone furoate 100 J-ig daily only for 8 weeks, without long term administration of oral and inhaled corticosteroid. Improvements in allergic rhinitis and asthma were evaluated using questionnaires and lung function tests.Results There were 35 subjects and four of them dropped outduring the study. There was >50% improvement in allergic rhinitis symptoms after 4 weeks of treatment (P<0.001). This improvement was associated with decreasing in frequency of asthma attack >50% after 8 weeks of treatment (P< 0.001). There was an insignificant improvement in FEY 1 (P=0.51). However, the evaluation of sinusitis was not performed in all subjects, thus may influence the results. During study, there were no side effects observed.Conclusions Intranasal mometasone furoate improves allergicrhinitis and decrease >50% of asthma symptoms, however it is not followed with significant improvement in lung function. No side effects are reported during 8 weeks use of intranasal mometasone furoate.
5-alpha-reductase deficiency: a case report Diana Mettadewi Jong; Aman B Pulungan; Bambang Tridjaja AAP; Jose RL Batubara
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1279.494 KB) | DOI: 10.14238/pi43.6.2003.234-40

Abstract

The condition of 5-alpha-reductase type 2deficiency (5-ARD) is an inherited disorderresulting in the inability to converttestosterone to dihydrotestosterone(DHT).This disorder was previously termed asfamilial incomplete male pseudohermaphroditism type2, pseudovaginal perineoscrotal hypospadias.Clinical manifestation of 5-ARD is limited to malegenetic. The affected males are usually identifiedas female in childhood but undergo striking virilizationat puberty.While overall incidence for various countries arenot established, increased incidence is reported in theDominican Republic, some highland tribes in NewGuinea, Lebanon and Turkey. This was the firstdocumented case in Cipto Mangunkusumo (CM)Hospital.
Co-Authors Abdul Latief Adji Suranto Agus Firmansyah Aman B Pulungan Aman B Pulungan Aman B Pulungan Aman B Pulungan Aman B Pulungan Aman B Pulungan Aman B. Pulungan Aman B. Pulungan Aman B. Pulungan Aman B. Pulungan Aman Pulungan Angèle JGMGerver-Jansen Angky Tririni Anies Irawati Anna Alisjahbana Ariani Dewi Widodo Arie Purwana Arry Rodjani Arto, Karina Sugih Arwin Akib Arwin AP Akib Arwin AP Akib Atiek Widya Oswari Bachti Alisjahbana Badriul Hegar Bambang Madiyono Bambang Supriyatno Bambang Tridjaja AAP, Bambang Tridjaja Bambang Tridjaya AAP Bernie Endyarni Medise Budiono Budiono christina olly lada Cissy B. Kartasasmita Corry S Matondang Cynthia Rindang Damayanti R. Sjarif Darmawan B. Setyanto Dhyniek Nurul FLA Diah Pramita Diah Pramita Diana Mettadewi Jong Edward Surjono, Edward Ellen P. Gandaputra Erna Mutiara Evita B. Ifran Evita K. B. Ifran H.F. Wulandari Hanifah Oswari Hardiono D Pusponegoro Hartono Gunardi Hartono Gunardi Harun Alrasyid Damanik Henriette A Delemarre–van de Waal Hindra Irawan Satari Hindra Irawan Satari Hindra Satari I Boediman I Made Arimbawa I Wayan Bikin Suryawan Idham Amir Ilham Wahyudi Indra W Himawan Indra W. Himawan Irfan Wahyudi Iswari Setianingsih Ivena Susanti Juhariah Juhariah Kadim S. Bachtiar Kanadi Sumadipradja Kemas Firman Lamtorogung Prayitno Lanny C. Gultom Lily Rahmawati Ludi Dhyani Melda Deliana Melda Deliana Miswar Fattah Muhammad Faizi Mulyadi Mulyadi Munar Lubis Naela Fadhila Najib Advani Nastiti Kaswandani Nia Kuniati Partini P. Trihono Piprim B Yanuarso Pustika Amalia Pustika Amalia Wahidiyat Rini Andriani Rini Sekartini Rini Sekartini Riza Mansyoer Rizki Aryo Wicaksono Ronny Suwento, Ronny Rosalina Dewi Roeslani Rubiana Sukardi Salimar Salimar Saptawati Bardosono Setyo Handryastuti Siska Mayasari Lubis Soedjatmiko Sri Rezeki Hadinegoro Sudigdo Sastroasmoro Sudigdo Sastroasmoro Sudung O Pardede, Sudung O Taralan Tambunan Tjhin Wiguna Tony Sadjimin Toto Wisnu Hendrarto Tya Listiaty Willem J Gerver Woro Indri Padmosiwi Yulniar Tasli Zakiudin Munasir Zakiudin Munasir