Rino Alvani Gani
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Association between HBV DNA Level and Intrahepatic HBcAg Protein Expression of Hepatocytes in Patients with Chronic Hepatitis B Devy Serevina; Ening Krisnuhoni; Rino Alvani Gani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201079-82

Abstract

Background: Correlation between serum Hepatitis B viral deoxyribonucleic acid (HBV DNA) and hepatitis B core antigen (HBcAg) protein expression in the liver regarding hepatitis B e-antigen (HBeAg) status have not been well studied. This study was aimed to demonstrate association between serum HBV DNA and HBeAg levels with HBcAg expressions in the liver. Method: A total of 55 naive chronic hepatitis B (CHB) patients were enrolled. All samples were tested for HBeAg serum by serological test enzyme-linked immunosorbent assay (ELISA) and HBV DNA was determined by polymerase chain reaction (PCR) HBsAg and HBcAg were evaluated immunohistochemically in the liver tissue Results: Of 55 patients, 44 (80%) were HBeAg positive and 11 (20%) were HBeAg negative. There was a positive correlation between serum HBV DNA and HBcAg expression in the nuclei (r: 0.383; p = 0.004). There was association between HBcAg expression in the nucleus and qualitative HBeAg (p = 0.017). Conclusion: In the patient with chronic HBV, there is a very significant positive correlation between the level of viral replication and HBcAg expression in the nucleus of hepatocytes. Moreover, there is association between HBcAg expression in the hepatocytes nucleus and HBeAg serum level. These finding lead to the proposition that nucleus localization of HBcAg protein function to amplify the pool of cccDNA in the replication cycle of HBV.. Keywords: HBV DNA, Imunohistochemistry, HBcAg
Acalculous Cholecystitis Prevalence on Abdominal Ultrasonography Examination of HIV/HCV Co-infection Patients in Cipto Mangunkusumo Hospital Bambang Sutopo; Unggul Budihusodo; Irsan Hasan; Rino Alvani Gani; Evy Yunihastuti
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: 10.24871/111201032-34

Abstract

Background: Acalculous cholecystitis is commonly found in patients with human immunodeficiency virus (HIV) compared to general population. Surprisingly, the signs and symptoms are unremarkable. On the other hand, HIV/hepatitis C virus (HCV) co-infection is a common finding. The aim of this study was to evaluate whether HCV infection has any influence to HIV patients concerning acalculous cholecystitis prevalence. Method: A cross-sectional study was performed in HIV/HCV patients who visited AIDS study group clinic at Cipto Mangunkusumo hospital during September 2008 to February 2009. The patients who met the criteria were examined physically and underwent abdominal ultrasonography. Routine blood count, alanine aminotranferase, aspartate aminotransferase, cluster of differentiation 4 (CD4) and serum albumin were recorded. Results: Of 63 patients underwent ultrasonography examination, we found acalculous cholecystitis in 33 patients (52.3%), cholelithiasis and cholecystitis in 2 patients, and 28 patients were considered normal. Patients with CD4 less than 200 cells, tend to have acalculous cholecystitis more than those who had CD4 more than 200 cells. Conclusion: The prevalence of acalculous cholecystitis among HIV/HCV co-infection is higher compared to those with HIV infection alone. Keywords: acalculous cholecystitis, HIV/HCV co-infection, CD4
CD4+ and CD8+ Counts in Liver and Their Correlation with Necroinflammatory and Fibrosis Grades in Chronic Hepatitis C Chyntia Olivia Maurine; Rino Alvani Gani; Ening Krisnuhoni; Kuntjoro Harimurti
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 (364.96 KB) | DOI: 10.24871/1332012145-150

Abstract

ABSTRACTBackground: Studies on the characteristics CD4+ and CD8+ in hepatitis C and their correlation with the severity of the disease have been rarely conducted. This study was aimed to obtain the mean difference between CD4+ and CD8+ count in liver to evaluate their correlation with fibrosis and necroinflammatory grades in chronic hepatitis C. Method: A cross-sectional study was conducted between March and July 2010 with 30 liver biopsies obtained from patients with non-B and non-HIV chronic hepatitis C who visited the Outpatient Clinic of Hepatology Unit at Cipto Mangunkusumo Hospital in January 2008–February 2010. Fibrosis and necroinflammatory grades were determined using METAVIR methods on liver biopsies. The mean values of CD4+ and CD8+ in portal tracts and hepatic lobules in liver biopsy specimens were evaluated. Statistical analysis was performed by using independent T-test and Spearman test. Results: There was a difference in mean CD4+ counts between portal tracts and the lobules (95% CI = 4.3-17.9; p = 0.002) and also differences in mean CD8+ counts in portal tracts and hepatic lobules (95% CI = 15.4-35.6; p 0.001). There was no correlation between CD4+ and CD8+ counts, either in portal tracts or the lobules, and inflammatory grades as well as the liver fibrosis. Conclusion: CD4+ and CD8+ counts are greater in portal area compared to the hepatic lobules, with greater CD8+ counts than CD4+. However, both CD4+ and CD8+ counts are not correlated to the severity of liver damage.  Keywords: CD4+, CD8+, intrahepatic, chronic hepatitis C, METAVIR
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
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