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Marcellus Simadibrata
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Medicine & Pharmacology

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The Difference Expressions of EBNA-1 in Epstein-Barr Virus Infection in Low and High Grade Colorectal Carcinoma Epistel Pangujian Simatupang; Marcellus Simadibrata; Rino Alvani Gani; Dyah Ratna Budiani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (773.777 KB) | DOI: 10.24871/13120122-7

Abstract

Background: Colorectal carcinoma is a common malignancy with the highest mortality rate. Epstein- Barr virus (EBV) as the virus that most commonly infect humans, also can infect the body in a latent and induce the occurrence of malignancy. This study aimed to prove an association between EBV virus infection with degree of colorectal carcinoma by examining the main EBV oncogene expression, namely Epstein-Barr nuclear antigen-1 (EBNA-1), in low grade and high grade colorectal carcinoma. Method: Cross-sectional study was performed in 14 colorectal cancer patients in Moewardi Hospital, Surakarta between July 2011 and January 2012. The biopsy specimens were stained for EBNA-1 expression using immunohistochemical technique. Statistical analysis was performed using T-test and Mann-Whitney by SPSS software version 19.0 for windows. Results: Of the 14 patients, there were 7 patients with low grade colorectal carcinoma and 7 patients with high grade colorectal carcinoma. EBNA-1 expression was found in epithelium of low grade and high grade colorectal carcinoma with p = 0.01; CI = -5.24-0.88. We also assessed the expression of EBNA-1 on lymphocytes B of low grade colorectal carcinoma and high grade colorectal carcinoma with p = 0.043. Conclusion: Significant differences in the expression of EBNA-1 was found in association with EBV infection either in low grade and high grade colorectal carcinoma. The role of EBNA-1 as tumor initiator needs to be elucidated further. Keywords: carcinoma colorectal, Epstein-Barr virus, EBNA-1
Chronic Diarrhea Caused by Amebic Colitis and Inflammatory Bowel Disease Hery Djagat Purnomo; Adjeg Tarius; Marcellus Simadibrata; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200795-99

Abstract

The diagnosis of intestinal amebiasis is easily established based on colonoscopy, i.e. there is a specific characteristic of ulcer/lesion “discrete flask-shape ulcer” with normal mucosa among the ulcers. However, most patients with amebic colitis have non-specific clinical manifestations and their colonoscopy findings are hardly distinguished from inflammatory bowel disease. In the present case, the patient had a chief complaint of chronic bleeding diarrhea and abdominal pain. The fecal analysis found trophozoites of Entamoeba histolytica. Serology test (sero-amebic) revealed negative result. The colonoscopy examination reveals hyperemic mucosa, edema, and multiple ulcers with various sizes covered with fragile and easily bleed debris, from the rectum to ascending colon, rigid colon, narrowing lumen and tumor/mass appearance on ascending colon. The differential diagnosis was severe amebic colitis and inflammatory bowel disease. Based on the colonoscopy biopsy, we found an active chronic colitis along with dysplasia. The patient received management and treatment of severe amebic colitis and inflammatory bowel disease. Keywords: amebic colitis, bleeding diarrhea, fecal analysis, colonoscopy, biopsy, inflammatory bowel disease
Post-Endoscopic Retrograde Cholangiopancreatography Complications at Dr. Cipto Mangunkusumo General Hospital Rolan Sitompul; Achmad Fauzi; Dadang Makmun; Murdani Abdulah; Ari Fahrial Syam; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 2, August 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/102200941-45

Abstract

Background: This study retrospectively evaluated post-endoscopic retrograde cholangiopancreatography (ERCP) complications at Cipto Mangunkusumo hospital in order to improve management of a subsequent prospective study of post-ERCP complications.Method: The indications, findings, diagnostic or therapeutic procedure, cannulation, devices used during the procedure, and complications of patients treated consecutively with ERCP between January 2004 and November 2008 were evaluated retrospectively.Results: Of 176 ERCP patients who were initially evaluated, 38% had undergone diagnostic ERCP and 62% therapeutic ERCP. The median age of the patients was 49 years (range 18–80 years); 95 (53.9%) were male. Only 54 of these 176 procedures could be evaluated for post-ERCP complications. A computed tomographic abdominal scan or magnetic resonance cholangio-pancreatography was performed in 23 (42.6%) patients and a biliary sphincterotomy in 14 (25.9%) patients. The overall complication rate was 33.3%: 14.8% after diagnostic ERCP and 18.5% after therapeutic ERCP. The complications after diagnostic ERCP were pancreatitis in 3 (15%) patients, cholangitis in 3 (15%) patients, hemorrhage in 1 (5%) patient, pancreatitis and hemorrhage in 1 (5%) patient; the complications after therapeutic ERCP were pancreatitis in 6 (17.6%) patients, cholangitis in 3 (8.8%) patients, hemorrhage in none, and concomitant pancreatitis with hemorrhage in 1 (2.9%) patient. No significant difference was observed between the complication rates and the type of ERCP performed.Conclusion: There were no differences in the complications after diagnostic and therapeutic ERCP. As our study shows the post-ERCP complication rate to be higher than those of other large retrospective and prospective studies, we must evaluate it in a prospective study.Keywords: post-ERCP, complications, therapeutic ERCP, diagnostic ERCP
The Role of Esophageal pH-metri Test on Gastro-Esophageal Reflux Disease Diagnosis Katharina Setyawati; Murdani Abdullah; Ari Fahrial Syam; Achmad Fauzi; Dadang Makmun; Marcellus Simadibrata; Chudahman Manan; Abdul Aziz Rani
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: 10.24871/93200891-97

Abstract

Gastro-esophageal reflux disease is a pathological condition of esophagus which is caused by gastric content reflux into esophagus. There is an increased prevalence of gastro-esophageal reflux disease. The roles of esophageal pH-metry in clinical application include looking for abnormal acid exposure on esophagus with no abnormality found in endoscopy; evaluating patients following the anti-reflux surgery who are being suspected for abnormal esophageal reflux; evaluating patients with normal endoscopic result but still having refractory reflux symptoms against proton pump inhibitor medication; detecting refractory reflux in patients chest pain following the heart evaluation; evaluating patients with otolaryngologic manifestations (laryngitis, pharyngitis, chronic cough) of the esophageal reflux disease after therapeutic failure of 4-weeks proton pump inhibitor treatment; and looking for correlation between adult onset gastro-esophageal reflux disease and non-allergic asthma. Keywords: gastro-esophageal reflux disease, esophagus pH-metry, symptoms-reflux correlation
Management of Gastric Varices Lusy Erawati; Marcellus Simadibrata; 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: 10.24871/52200462-67

Abstract

Upper gastrointestinal bleeding is one of the emergency conditions in the field of gastroenterology and variceal bleeding is the most common cause of it. Gastric varices accounts only 5% to 10% of all causes of upper gastrointestinal bleeding respectively, but it could be fatal and difficult to control despite provision of adequate therapy. Early diagnosis and appropriate management may decrease the morbidity and mortality of gastric variceal bleeding. Keywords: Gastric varices, upper gastrointestinal bleeding, endoscopy
The Efficacy of L-Ornithine L-Aspartate Granules and Normal Protein Diet in Minimal Hepatic Encephalopathy with Malnutrition Suzanna Ndraha; Irsan Hasan; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201011-14

Abstract

Background: The dietary protein restriction that was commonly recommended to hepatic encephalopathy (HE) patients, often leads to malnutrition, whereas malnutrition can deteriorate cirrhosis prognosis. The aims of this study were to find out encephalopathy improvement that was measured by critical flicker frequency (CFF) test and nutritional status by measuring prealbumin level after L-Ornithine L-Aspartate (LOLA) treatment with adequate calories and protein intake in patients with HE. Method: Patients with liver cirrosis who visited Cipto Mangunkusumo hospital on June-October 2009 was evaluated by CFF test using HEPAtonormTM device. Encephalopathy was defined when CFF 39 Hz. Nutritional status was measured by the mid-arm muscle circumference (MAMC) and was stated as malnutrition when the MAMC was below the 15th percentile. Patients had been treated by 3 x 6 mg LOLA granules for 2 weeks, and adequate calories and protein intake with branched-chain amino acid (BCAAs) substitution. The change of encephalopaty was evaluated by the CFF test and the nutritional status by measuring prealbumin blood level. Results: There were 17 patients with liver cirrhosis who fulfilled the inclusion criteria. The mean CFF Result increased from 34.1 ± 2.5 Hz to 36.5 ± 2.9 Hz after LOLA treatment with the adequate calories and protein intake including BCAAs substitution, which was statistically significant (p 0.001) compared to before treatment. The prealbumin level also increased significantly compared before treatment, i.e. from 5.4 ± 2.1 mg/dL to 6.4 ± 2.6 mg/dL, p = 0.008. Conclusion: HE patients with malnutrition could be given adequate calorie and protein with BCAAs substitution  to  improve  their  nutritional  status,  and  LOLA  granules  for  the improvement of HE. Keywords: minimal hepatic encephalopathy, malnutrition, CFF, LOLA, prealbumin, BCAAs
Problems in Diagnosis Approach for Carcinoma of Pancreatic Head Ratu Ratih Kusumayanti; Marcellus Simadibrata; Murdani Abdullah; Rino Alvani Gani; Lies Luthariana
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 9, ISSUE 2, August 2008
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/92200864-69

Abstract

Incidences of pancreatic cancer worldwide have been known to be increased. It is the fifth leading cause of death in United State of America. Seventy percent occurs in the head of the pancreas. Major risk factors are related to age, black race, smokers, high-fat diet, chronic pancreatitis, diabetes mellitus and alcohol consumption. Some clinical symptoms such as jaundice, abdominal pain, unexplained weight loss or ascites can occur early or even late in the course of disease. Diagnosing pancreatic cancer sometimes can be difficult, regarding to discrepancy between clinical symptoms and radiological findings. It is important to take good history of the patient, thorough examination, and combine several modalities in diagnosing tumor of pancreatic head. In this case report, a 54 year-old female, came to the hospital with abdominal swelling and jaundice. Physical examination revealed liver and spleen enlargement and edema on both lower extremities. The laboratory result showed increment in Carcinoembryonic Antigen (CEA) and carbohydrate antigen 19-9 (CA19–9) level, without marked increase in bilirubin level. Dilatation of the pancreatic duct was found in this patient, without any sign of bile stone. Endoscopic Retrograde Cholangiopancreatography (ERCP) in this patient was failed to have significant result. Keywords: carcinoma of pancreatic head, papilla vater carcinoma, diagnosis, ERCP, jaundiceHF
Child Pugh C and Male Gender were Related to Nutritional Status of Liver Cirrhosis Patients in Koja Hospital Jakarta Suzanna Ndraha; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, NUMBER 3, December 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/1032009110-112

Abstract

Background: Malnutrition is found in 65-90% patients with liver cirrhosis. Malnourished patients with cirrhosis have a higher rate of complications. Aim of this study was to evaluate the prevalence and risk of malnutrition in liver cirrhosis patients at Koja hospital, Jakarta. Method: All liver cirrhosis patients visited Koja hospital during January - March 2009 was evaluated. An inclusion criterion was liver cirrhosis. An exclusion criterion was unable to speak Indonesia. The distributions of age, gender, body mass index (BMI), triceps skin-fold thickness (TSF), mid-upper arm circumference (MUAC), mid-arm muscle circumference (MAMC), Child Pugh classification were assessed. The criteria of malnutrition was done according to MAMC and BMI. Result: There were 38 liver cirrhosis patients fit the criteria. Twenty five  (65.8%) cases were classified as malnutrition according to MAMC, 21 (55.3%) were classified as malnutrition according to BMI. Four patients (10.5%) were Child Pugh scores A, 15 Child Pugh B (39.5%) and the rest 19 patients (50.0%) were Child Pugh C. There was a trend correlation between malnutrition according to MAMC and Child Pugh criteria but not statistically significant. Conclusion: In our study we found 65.8% of liver cirrhosis patients were malnourished according to MAMC. Malnutrition was higher in male, as well as in Child Pugh score C. MAMC is more accurate than BMI in assessing nutritional status in liver cirrhosis. Keywords: liver cirrhosis, nutritional status, MAMC, BMI, Child Pugh score
Prevalence of Crohnƒs Disease in Endoscopic Unit Cipto Mangunkusumo Hospital Nata Pratama; Murdani Abdullah; Dolly Dolven Kansera; Jane Estherina; Rizki Yaruntradhani; Fransiska Hardi; Raden Nur Ista; Marcellus Simadibrata; Achmad Fauzi; Daldiyono Daldiyono; Abdul Aziz Rani; Diah Rini Handjari; Pamela Abineno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.343 KB) | DOI: 10.24871/122201185-88

Abstract

Background: The cumulative number of inflammatory bowel disease patients in Asia has raised three times since early 1990s, although Crohn’s disease is still less common than ulcerative colitis. The objective of this study was to provide clinical and demographic data of Crohn’s disease patients seen in Endoscopic Unit Cipto Mangunkusumo Hospital and compare the Results with other Asian countries. Method: This study was done retrospectively cross-sectional descriptive from medical records of all patients underwent colonoscopy at Endoscopic Unit, Cipto Mangunkusumo Hospital, and histological evaluation in the Department of Anatomical Pathology, Faculty of Medicine, University of Indonesia, between 2007 and 2008. Data was analyzed using SPSS version 17. Results: Of 921 patients who underwent colonoscopy, 19 (2.1%) patients were diagnosed with Crohn’s disease. There was no sex preponderance. The mean age was 47.7 years with a peak age at presentation between 51 and 60 years. The main clinical complaints were diarrhea (42.1%), lower gastrointestinal bleeding (36.8%), abdominal pain (10.5%) and upper gastrointestinal bleeding (5.3%). Colonoscopic findings were hyperemia in 94.7%, edema in 57.9%, erosions in 63.2%, ulcerations in 89.5%, pseudopolyp in 31.6%, fragile lesion in 10.5%, stenosis, fistulation, and cobblestone appearance in 5.3%. Involvement of isolated left colon was 26.3%; other manifestations were isolated right colon (10.5%), pancolitis (57.9%), ileitis (5.3%), ileocolitis (36.8%) and skip lesion (5.3%). Conclusion: The prevalence of Crohn’s disease in this study was similar to the findings in previous studies in Asian countries, with diarrhea as the main clinical complaint, and pancolitis as the dominant finding in colonoscopy examination. Keywords: Crohn’s disease, prevalence, clinical complaints, colonoscopy description
Clinical Approach to Chronic Pancreratitis Tri Juli Edi T; Marcellus Simadibrata; Murdani Abdullah
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: 10.24871/43200389-95

Abstract

Chronic pancreatitis is still considered an uncertain process with an undetermined pathogenesis and ill defined treatment. Chronic pancreatitis is distinguished from acute pancreatitis based on structural and functional differences. In acute pancreatitis, the gland is normal prior to the attack, and returns to normal after an acute attack, while in chronic pancreatitis, the gland is already in an abnormal state prior to or following an attack or prior to and following an acute attack. The most common local complication of chronic pancreatitis is the formation of pseudocysts. Psedocysts are usually formed due to passage obstruction of the pancreatic tract (retention cyst) or due to recurrent acute exacerbation Several pancreatic abnormalities, such as stones, ductal stricture, fluid collection, and functional sphincter abnormality, could be treated using endoscopy. Adjuvant treatment for biliary duct abnormality such as biliary stricture due to pancreatitis, and stent insertion in cases of duodenal obstruction, could also be performed via endoscopy Keywords: Chronic pancreratitis, tropical pancreatitis, treatment
Co-Authors Aan Santi Abdul Aziz Rani ACHMAD FAUZI Adang Bachtiar Adjeg Tarius Agi Satria Putranto Ahmad Fauzi Ahmad Soefyani Ali Imron Yusuf Ana Mira Lubis Andree Kurniawan Andri Sulaiman Angga Pramudita Anna Mira Lubis Ari F Syam Ari Fahrial Syam Arief Hakiki Armen Armen Arnold Hasahatan Harahap Arshita Auliana Arya Govinda Aziz Rani Badriul Hegar Bambang Sutopo Bona Adhista Bradley Jimmy Waleleng Budi Tan Oto Budiman Sudjatmika Ceva W. Pitoyo Chatarina Umbul Wahyuni Chudahman Manan Chudahman Manan Dadang Makmun Daldiyono Daldiyono Daldiyono Hardjodisasto Daldiyono Hardjodisastro Daniel Gunawan Dasril Nizam David Reinhard Sumantri Samosir Deddy Gunawanjati Dharmika Djojoningrat Diah Rini Handjari Diana Aulia Diany N Taher Dicky Levenus Tahapary Didi Kurniadhi Djulzasri Albar Dolly Dolven Kansera Drupadi Harnopidjati Singh Dillon Dyah Ratna Budiani Ekowati Rahajeng Elizabeth Merry Wintery Elli Arsita Endang Susalit Ening Krisnuhoni Epistel Pangujian Simatupang FJW Ten Kate Fransiska Hardi Gerie Amarendra GNJ Tytgat Guntur Darmawan Haryanto Surya Helsi Helsi Herdiman T Pohan Hery Djagat Purnomo Hotmen Sijabat Ilham Ahmadi Ina Susianti Timan Ina Sutanto Timan Indah S. Widyahening Indra Marki Irfan Maulani Irsan Hasan Iskandar A Ivo Novita Sah Bandar Iwan Ariawan Jacobus Albertus Jane Estherina Jeffri Gunawan Jeffry Beta Tenggara Joseph JY Sung Juferdy Kurniawan Julwan Pribadi Kaka Renaldi Katharina Setyawati Kharia Utia Khie Chen Kie Chen L A Lesmana Laurentius Lesmana Lianda Siregar Lies Luthariana Loli J Simanjuntak Lusy Erawati Lydia D Simatupang M Purnomo Isnaeni Moch Ikhsan Mokoagow Murdani Abdulah Murdani Abdullah Nata Pratama Nisan Soeheri Noto Dwimartutie Novie Rahmawati Zirta Nur Rasyid Nurmiati Amir Pamela Abineno Parlindungan Siregar Paulus Kusnanto Paulus Simadibrata Poerniati Koes Andrijani Prima Yuriandro Rabbinu Rangga Pribadi Raden Nur Ista Ralph Girson Gunarsa Ratu Ratih Kusumayanti Riadi Wirawan Riahdo Saragih Rino A Gani Rino Alvani Gani Rizki Yaruntradhani Rolan Sitompul Rudolf Simadibrata Rudy Hidayat Ryan Ranitya Salius Silih Sedijono Sedijono Seri Mei Maya Ulina Simon Salim Siti Setiati Steven Sumantri Suryantini Suryantini Suzana Ndraha Suzanna Ndraha Syarif Hidayat Syarif Hidayat T Yuli Pramana Teguh Karyadi Tengku Riza Zarzani N Tjahjadi Robert Tedjasaputra Toman L Toruan Tommy P Sibuea Tony Loho Tri Hapsoro Guno Tri Juli Edi T Unggul Budihusodo Vera D Yoewono Vera Yuwono