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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Rino A Gani
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Medicine & Pharmacology

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Pathogenesis in Portal Hypertensive Gastropathy Due to Liver Cirrhosis Loli J Simanjuntak; Chudahman Manan; Marcellus Simadibrata; Rino A Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 3, December 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/53200495-101

Abstract

The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other etiologic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2 (PGE2), and increased nitric oxyde (NO) which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis. Keywords: Pathogenesis, PHG, liver cirrhosis
Non Cirrhotic Portal Fibrosis Ralph Girson; Andri Sanityoso; Rino A Gani; Wirasmi Marwoto; Murdani Abdullah; Ari Fahrial Syam
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200560-64

Abstract

Diagnosis of non cirrhotic portal fibrosis was considered when the following criteria were fulfilled evidence of portal hypertension (oesophageal varices, hypersplenism, ascites, or increased hepatic venous pressure gradient), Doppler ultrasound showing patent portal and hepatic veins, and liver biopsy showing sign of cirrhosis. Non cirrhotic portal fibrosis clinically characterized by splenomegaly, anemia, portal hypertension, and histopathological examination portal tract showing fibrosis and sclerosis. Portal hypertension are most caused by a cirrhotic liver (85%), there are only a few reports on non cirrhotic portal hypertension, mostly in Japan and India. We reported a case of non cirrhotic portal fibrosis in young male.  The clinical complications of portal hypertension are variceal bleeding and pancytopenia due to hypersplenism. Variceal band ligation and splenectomy were performed. The patient showed good clinical response.   Keywords: portal hypertension, non cirrhotic portal fibrosis, young male
Treatment of Chronic Hepatitis B Prasna Pramita; Rino A Gani; Ali Sulaiman
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120059-15

Abstract

Chronic hepatitis B is still a major health problem in Indonesia. Unfortunately, to date, treatment of chronic HBV (Hepatitis B virus) infection had not shown satisfactory Result. Monotherapy with alpha interferon or lamivudine have been widely used as treatment of chronic HBV. However, treatment response to Alpha interferon in Asian people was not satisfactory (15% - 20%), while monotherapy with lamivudine was not sufficient to eradicate HBV in chronically infected patients and commonly induce drug resistance. The occurrence of chronic hepatitis B resistant to lamivudine had encouraged development of newer agents such as adefovir, entecavir, emtricitabine and nucleoside analog. New therapeutic strategy using combination therapy should be considered if there is no sufficient response to monotherapy. Keywords: Treatment, chronic hepatitis B, combination therapy
Correlation between Branched Chain Amino Acids to Tyrosine Ratio and Child Pugh Score in Liver Cirrhosis Patients Irsan Hasan; Rino A Gani; Nurul Akbar; Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 1, April 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/6120051-3

Abstract

Background: The determination of branched chain amino acids (BCAA) to tyrosine ratio (BTR) was available in making differentiation of chronic hepatitis from liver cirrhosis, because there was a strong association between BTR and staging (fibrosis) scores. Branched chain amino acids to tyrosine ratio have a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic assay. Materials and Methods: To evaluate the correlation between BTR and Child-Pugh score, we examined the amino gram of 52 liver cirrhosis patients consisted of 26 Child-Pugh A, 19 Child-Pugh B, and 7 Child-Pugh C. The examination of amino gram was done by High Pressure Liquid Chromatograph (HPLC) analyzer. Branched chain amino acids to tyrosine ratio were compared to Child-Pugh score, albumin, ammonia level, number connection test to Fischer ratio. Results: Significant differences in BTR among Child-Pugh A, B, C were observed (Child-Pugh A 7.75 + 1.2; Child Pugh B 6.0 + 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyrosine ratio had a weak correlation with albumin (r = 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.006) and strong correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between BTR and number connection test. Conclusion: These results showed that the determination of the molar ratio of branched chain amino acids to tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fischer ratio. Keywords: Branched chain amino acids, tyrosine, liver cirrhosis
Pancreatic Adenocarcinoma Presenting as Obstructive Jaundice in A Young Woman Evy Yunihastuti; Julius R Samban; H.M. Sjaifoellah Noer; Daldiyono Daldiyono; Unggul Budihusodo; Rino A Gani; Zubairi Djoerban
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 2, August 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/22200132-37

Abstract

Pancreatic carcinoma commonly occur in patients over 60 years. It is usually manifested as abdominal pain, jaundice, and pancreatic mass. In this report, a pancreatic carcinoma occurred in young woman is presented. A surgical drainage was done and followed by Whipple resection. However, the patient passed away three month after the diagnosis.    Keywords: pancreatic carcinoma, young woman, obstructive jaundice, whipple resection
Study of Transaminases in Heroin Addicts Rino A Gani; Agus Sudiro Waspodo; Unggul Budihusodo; Irsan Hasan; Muhammad Sjaifoellah Noer
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 1, April 2001
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2120011-4

Abstract

A recent increase in the number of drug users particularly of heroin has been noted in the community. A cross-sectional study on the level of transaminases as a representation of liver damage in drug users was done in privated hospital in Jakarta. Exclusion criteria were fever, serious illness or the multiple use of addictive drugs based on a urinary test. The hepatitis B surface antigen (HBsAg) was examined using reverse passive hemaglutination assay (RPHA) and the antibody of hepatitis C virus core-protein (anti- HCV) with dipstick anti-HCV.  AST and ALT levels were determined using an automatic chemical analyzer. Of 132 patients who fulfill the criteria, 83.5 % were injection drug users (IDU). Means AST and ALT were significantly higher in IDU. Anti-HCV positive patients with increased AST and ALT were significantly higher compared to anti-HCV negative. The increase of transaminase was also consistent in injection drug users although no viral marker could be detected. In conclusion, the examination of transaminases in drug users especially IDU is important besides tests for hepatitis viral markers because there is often an increase with or without viral infection and this can be associated with hepatocellular damage.     Key words: Transaminase, heroin addicts, hepatitis
Co-Authors Agus Sudiro Waspodo Ali Sulaiman Andri Sanityoso Ari Fahrial Syam Chudahman Manan Daldiyono Daldiyono Evy Yunihastuti H.M. Sjaifoellah Noer Irsan Hasan Julius R Samban Loli J Simanjuntak Marcellus Simadibrata Muhammad Sjaifoellah Noer Murdani Abdullah Nurul Akbar Prasna Pramita Ralph Girson Sjaifoellah Noer Unggul Budihusodo Wirasmi Marwoto Zubairi Djoerban