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All Journal Medical Journal of Indonesia Paediatrica Indonesiana Indonesian Journal of Rheumatology Jurnal Respirologi Indonesia Majalah Patologi Indonesia Narra J Cermin Dunia Kedokteran Makara Journal of Health Research Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Cermin Dunia Kedokteran
Lisnawati Rachmadi
Department Of Anatomical Pathology, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Effect of the modified Atkins diet on NLRP3, caspase-1, IL-1β, and IL-10 in patients with tetralogy of Fallot undergoing open-heart surgery: A randomized controlled trial Yanuarso, Piprim B.; Djer, Mulyadi M.; Hendarto, Aryono; Pudjiadi, Antonius H.; Rachmadi, Lisnawati; Wibowo, Heri; Advani, Najib; Murni, Indah K.; Kekalih, Aria; Sukardi, Rubiana; Dilawar, Ismail; Susanti, Dhama S.; Supriatna, Novianti
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.2138

Abstract

Cardiopulmonary bypass in tetralogy of Fallot (TOF) corrective surgery induces hyperinflammation by activating NLRP3, caspase-1, and interleukin-1β (IL-1β), subsequently triggering an interleukin-10 (IL-10) response. Despite its known metabolic and anti-inflammatory effects, the impact of the modified Atkins diet (MAD) in pediatric cardiac surgery remains unexplored, with no studies on its use in TOF patients undergoing open-heart surgery. The aim of this study was to assess the effect of MAD on the expression of NLRP3, caspase-1, IL-1β, and IL-10, in TOF patients undergoing open-heart surgery. A double-arm, randomized-controlled trial was conducted with 44 TOF patients. The treatment group (n=22) received the MAD, a low-carbohydrate, high-fat regimen with unrestricted fat and protein intake for at least 14 days preoperatively, while the control group (n=22) followed a standard diet without carbohydrate restriction. Blood plasma and infundibulum heart tissues were collected for analysis. Whole blood samples were collected using a winged infusion needle before the intervention, an Abbocath infusion needle after 14 days of intervention, and a syringe without a needle connected to an arterial line in patients undergoing open-heart surgery at 6, 24, and 48 hours post-surgical correction. Infundibulum heart tissues were collected during the open-heart surgery. This study demonstrated significant differences in NLRP3 protein expression (p=0.015), caspase-1 protein expression (p=0.001), and IL-10 levels between before intervention and 6-, 24-, and 48-hours post-surgery in the MAD group compared to the control group. In contrast, no significant differences in IL-10 levels were observed in the control group between before intervention and 48 hours post-surgery (p=0.654). In conclusion, MAD may modulate perioperative inflammation in TOF patients undergoing open-heart surgery by downregulating NLRP3 and caspase-1 expression while sustaining IL-10 levels. Despite reduced NLRP3 and caspase-1 expression, unchanged IL-1β levels indicate alternative regulatory mechanisms.
Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Indira Priya Darsini; Lukman Edwar; Iris Rengganis; Lisnawati; Joedo Prihartono
Cermin Dunia Kedokteran Vol 46 No 1 (2019): Obstetri-Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.521

Abstract

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS. The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.
Spectrum of rare EGFR mutations in Indonesian lung adenocarcinoma: Findings from an 8-year analysis of 4,778 cases highlighting the need for advanced targeted therapies Heriyanto, Didik S.; Trisnawati, Ika; Rachmadi, Lisnawati; Tenggara, Jeffry B.; Lau, Vincent; Gunawan, Andrew N.; Halim, Brigitta N.; Yuliani, Fara S.; Laiman, Vincent; Gondhowiardjo, Soehartati; Chuang, Hsiao-Chi
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.1721

Abstract

Lung cancer patients in Indonesia exhibit a high prevalence of epidermal growth factor receptor (EGFR) mutations, with a substantial proportion attributed to rare or uncommon variants. The clinical significance of rare EGFR mutations lies in their differential sensitivity to tyrosine kinase inhibitors (TKIs). While they are frequently resistant to first- and second- generation TKIs, they often respond to third-generation TKIs, necessitating tailored treatment options. The need for improving access to advanced targeted therapies in Indonesia also highlights the importance of conducting research on rare EGFR mutations. The aim of this study was to identify the spectrum and frequency of EGFR mutations in patients with lung adenocarcinoma in Indonesia. A cross-sectional observational study with total sampling was conducted from January 2016 to April 2024 to investigate EGFR mutation profiles in lung adenocarcinoma patients. Samples were acquired from patients with a confirmed anatomical pathology diagnosis from various healthcare centers across Indonesia. A total of 4,778 samples were analyzed using real-time quantitative polymerase chain reaction (RT-qPCR) on various specimen types to determine EGFR mutation prevalence and patterns. Associations between demographic data and EGFR mutation status were assessed. EGFR mutations were detected in 54.6% of samples, with common mutations (exon 19 deletions/insertions and point mutation L858R) comprising 76.2% of positive cases and rare mutations (exon 20 insertions, point mutation G719X, S768I, T790M, and L861Q) accounted for 20.3%. Significant associations were found between geographic origin, age, and sex with EGFR mutation status. This study confirms substantial genetic variability and geographical differences in EGFR mutations among Indonesian lung adenocarcinoma patients, emphasizing the urgent need for further research to prompt enhanced molecular diagnostics and targeted therapies in the region.
Subcategorization of the AUS/FLUS Thyroid Nodule Based on the 2017 Bethesda System at Dr. Cipto Mangunkusumo Hospital from 2018-2021 Linggodigdo, Michelle; Rachmadi, Lisnawati
Majalah Patologi Indonesia Vol. 34 No. 3, September 2025
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v34i3.647

Abstract

IntroductionThe AUS/FLUS (Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance) category is one of the most challenging diagnoses in thyroid fine-needle aspiration biopsy (FNAB) for pathologists. This is due to the heterogeneous cytomorphological features with low Risk of Malignancy (ROM) accuracy, which is crucial to determining further management. The 2017 Bethesda System introduced subcategorization of AUS/FLUS to improve ROM accuracy. However, the widespread adoption of this subcategorization remains limited. MethodsA retrospective analytical cross-sectional study was carried out using secondary data of thyroid FNAB cases diagnosed with AUS/FLUS followed by surgical procedures at the Department of Anatomical Pathology, Faculty of Medicine, University Indonesia/Dr. Cipto Mangunkusumo Hospital from 2018 to 2021. Furthermore, a review and subcategorization into AUS-C1 (focal nuclear atypia), AUS-C2 (mild nuclear atypia), AUS-A (architectural atypia), AUS-C&A (nuclear and architectural atypia), AUS-H (Hűrthle cell aspiration), AUS-NOS (atypia not otherwise specified), and AUS-L (lymphoid cell atypia other than lymphoma) was performed. ResultAmong a total of 2,082 patients, 599 (28.7%) were diagnosed as AUS/FLUS. There were 75 patients with AUS/FLUS who proceeded with surgery, while 64 (85.3%) showed malignancy. The most common subcategory was AUS-C1 (60%), followed by AUS-NOS (21.3%), AUS-C&A (9.3%), AUS-C2 (8%), and AUS-H (1.4%). ROM subcategory AUS-C1 was significantly higher compared to AUS-C2 (p=0.009) and AUS-NOS (p=0.011). Conclusion The percentage of AUS/FLUS diagnoses at Dr. Cipto Mangunkusumo Hospital from 2018 to 2021 was 28.7% with ROM ranging from 10.6% to 85.3%. There was a significant difference in ROM between AUS-C1 and AUS-C2, as well as AUS-C1 and AUS-NOS. Therefore, it was concluded that AUS-C1 thyroid nodules with or without architectural atypia require more aggressive management compared to those with AUS-C2 and AUS-NOS features.
Effects of Physalis angulata extracts on bleomycin-induced rat: analysis on lung inflammation and fibrosis Wibowo, Suryo Anggoro Kusumo; Rumende, Cleopas Martin; Isbagio, Harry; Setiyono, Agus; Setiabudy, Rianto; Rachmadi, Lisnawati; Kertia, Nyoman
Medical Journal of Indonesia Vol. 34 No. 4 (2025): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257875

Abstract

BACKGROUND Scleroderma is an immune-mediated connective tissue disease, with interstitial lung disease as one of its manifestations. Physalis angulata (P. angulata) or ciplukan has shown potential in treating fibrosis, but its role in preventing lung inflammation and fibrosis remains unknown. This study aimed to evaluate the effect of P. angulata extract in a bleomycin (BLM)-induced scleroderma rat. METHODS Sprague-Dawley rats were divided into 6 groups. For lung inflammation prevention, 3 groups received: (1) BLM only, (2) BLM+50 mg/kgBW P. angulata, and (3) BLM+100 mg/kgBW P. angulata. After 14 days, rats were sacrificed and bronchoalveolar lavage (BAL) leukocyte count, interleukin-6 (IL-6) levels, and lung injury score were assessed. For fibrosis prevention, another 3 groups received the same interventions and were sacrificed after 51 days. Fibrosis score, fibrosis area, hydroxyproline, transforming growth factor-beta (TGF-β), and matrix metalloproteinase-13 (MMP-13) levels were analyzed. BLM was administered subcutaneously, while P. angulata was given orally for 14 days. IL-6, TGF-β, and MMP-13 were measured by ELISA and hydroxyproline by colorimetric method. Mean differences and p-values were calculated using appropriate statistical tests. RESULTS P. angulata extract did not prevent lung inflammation, as there were no differences in BAL leukocyte count (p = 0.126), IL-6 levels (p = 0.173), or lung injury scores (p = 0.397) between the BLM-only group and those receiving P. angulata. The extract also did not prevent lung fibrosis, with no differences in fibrosis scores (p = 0.173), fibrosis area (p = 0.359), hydroxyproline (p = 0.295), TGF-β (p = 0.374), or MMP-13 (p = 0.088) levels among groups. CONCLUSIONS P. angulata extract did not prevent the development of lung inflammation or fibrosis.
Papiloma Sinonasal dan Keganasan Terkait Papiloma Sinonasal: Studi dari Pusat Rujukan Tersier di Indonesia Sitinjak, David; Rachmadi, Lisnawati; Billianti, Yayi Dwina
Majalah Patologi Indonesia Vol. 31 No. 2, Mei 2022
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v31i2.498

Abstract

Background Sinonasal papilloma is a benign tumor arising from Schneiderian epithelia in sinonasal mucosa. It has the propensity towards malignant transformation. This preliminary study aims to report clinicopathological aspects of sinonasal papilloma and its malignant transformation rate. Methods A descriptive, cross-sectional study was conducted in Anatomical Pathology Department, FKUI/RSCM over a period of 2014-2019) A total of 127 histologic specimens with diagnosis of sinonasal papilloma obtained from 80 cases. Results The prevalence of sinonasal papilloma among all sinonasal neoplasms is 17.6%. Inverted papilloma was the most common histologic type 91.3%, exophytic papilloma 6.3% and oncocytic papilloma 2.5%, among male (70%), age rate 50 years old. Malignant transformation of squamous cell carcinoma 12.5%, and recurrence 21.3%, nasal congestion was the most complaint 50%. Cases were usually in T3 of Krouse stage 37.5% and managed with functional sinus endoscopic surgery 51.3%. Histological parameters were grade II 54.4%, surface keratinization 17.5%, bony trabeculae 41.3%, nasal polyps 20% and dense lymphocytic infiltrates 53.8%, foam cell infiltrates 2.5%. Mild to moderate dysplasia 8.8% and severe dysplasia 18.8%. Conclusion Sinonasal papilloma was rare sinonasal benign tumor. Inverted papilloma type was local aggressive, recurrence, dysplastic and malignant transformation, among male, age 50 years old, main complaint of nasal congestion, in Krouse stage T3, and managed by Functional Sinus Endoscopy Surgery (FSES
Aspek Klinik dan Karakteristik Tipe Histopatologik Timoma Maria Mayella Vianney; Lisnawati Rachmadi
Majalah Patologi Indonesia Vol. 30 No. 1, Januari 2021
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v30i1.455

Abstract

BackgroundThymoma is the most common neoplasm found in thymus gland and is classified into 5 main histopathological types, A, AB, B1, B2,and B3. Thymomas are most commonly found in the anterior mediastinum and accompanied with myasthenia gravis. The aim of thisstudy was to find out clinical feature and histopathological characteristics of thymomas in Department of Anatomical Pathology, Facultyof Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital (FKUI/RSCM) in 2014-2018.MethodsThis is a descriptive study, using a cross-sectional design. Clinical and histopathological data obtain from the medical records andarchives of the Department of Anatomical Pathology of FKUI/RSCM. Clinical data consists of age, sex, tumor location, clinicalsymptom, concomitant disease, metastasis, and treatment. Histopathological assessment consists of histopathology type using WorldHealth Organization criteria and staging using Masaoka-Koga staging system.ResultsThere were 31 thymoma cases matched the inclusion criteria. Nineteen (61.3%) of 31 cases were women. The mean age of thesubjects was 46.7 years old. A total of 12 cases (37.5%) had muscle weakness due to myasthenia gravis as chief complaint and 21cases (67.7%) of tumor mass in the anterior mediastinum. There 9 cases of type AB and 2 cases of type B2.ConclusionThymoma is more common in women with an average age of 46.7 years. The most common paraneoplastic syndrome is myastheniagravis and mostly found in the anterior mediastinum. The most common histopathologic type is type AB, while type B2 is the least.
Co-Authors A S Sulaiman Abror Irsan Agus Setiyono Andi Yasmon Anna Rozaliyani Antonius H. Pudjiadi Aria Kekalih Aryono Hendarto Astrid E Greijer Bambang Setiyohadi C Matin Rumende Chuang, Hsiao-Chi Cleopas Martin Rumende David Sitinjak Diana Natalia Diana Natalia Dilawar, Ismail Djajadiman Gatot Djatikusumo, Ari Dwi Wulandari Effiana Effiana Effiana, Effiana Elisna Syahruddin F Oktaviana Gede Wirya Kusuma Duarsa Gunawan, Andrew N. Halim, Brigitta N. Harry Isbagio Heri Wibowo Heriyanto, Didik S. I Bing Tan Ika Trisnawati, Ika Ika Wulan Yuliani Ikhwan Rinaldi Indira Priya Darsini Indira Priya Darsini Irfan Wahyudi Iris Rengganis Iris Rengganis Jaap M Middeldorp Jasin, Madeleine Ramdhani Joedo Prihartono Junita Indarti Kusumowidagdo, Gladys Laiman, Vincent Lau, Vincent Linggodigdo, Michelle Lukman Edwar M A Yudharto M S Azizi M Simadibrata Mardhia, Mardhia Mardhia, Mardhia Mardianto, Umar Maria Mayella Vianney Marlinda Adham Mulyadi M. Djer Murni, Indah K. N Anggraini N Sukmana Najib Advani Namira Kesuma Jelita Nia Kurniati Nyoman Kertia Piprim B. Yanuarso, Piprim B. Ponco Birowo Pramita Gayatri R Sandra R Wahyuningsih Raharja, Putu Angga Risky Rianto Setiabudy Romi Baginta Rubiana Sukardi, Rubiana Sarah Fitriani Sari Rahmayanti Setyanto, Darmawan Budi Shanty R. Kusumawardani Sitinjak, David Soehartati Argadikoesoema Gondhowiardjo Soehartati Gondhowiardjo Sri Rezeki Hadinegoro Suhendro Suhendro Supriatna, Novianti Susanti, Dhama S. Tenggara, Jeffry B. Tjahjani M. Sudiro Wibowo, Suryo Anggoro Kusumo Yayi DB Susanto Yayi Dwina Billianti Yudantha, Anggun R. Yuliani, Fara S. Zaini, Jamal