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INDONESIA
Medical Journal of Indonesia
Published by Universitas Indonesia
ISSN : 08531773     EISSN : 22528083     DOI : 10.13181
Core Subject : Health,
This quarterly medical journal is an official scientific journal of the Faculty of Medicine Universitas Indonesia in collaboration with German-Indonesian Medical Association (DIGM) Indexed in: IMSEAR; CAB Abstracts; Global Health; HINARI; DOAJ; DRJI; Google Scholar; JournalTOCs; Ulrichsweb Global Serial Directory; WorldCat; New Jour; Electronic Journals Library; ISJD Accredited (2013-2018) by DIKTI Kemendikbud Republik Indonesia (No:58/DIKTI/Kep/2013)
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Articles 12 Documents
Search results for , issue "Vol. 18 No. 4 (2009): October-December" : 12 Documents clear
Isolation of environmental microorganisms from clinical specimens: A report of the occurrence of Acinetobacter anitratus in blood of hospitalized patients in Jakarta in a 7 year period
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.365

Abstract

Aim To report the presence of environmental microorganisms, A. anitratus, in blood of hospitalized patients in Jakarta from 2002 to 2008 and their susceptibility to antibiotics. Methods A Retrospective study was performed on all blood specimens that were received in Clinical Microbiology Laboratory (CML) Faculty of Medicine University of Indonesia during 2002-2008. Culture and antimicrobial susceptibility examination were carried out according to up to date standard practice in CML and Clinical Laboratory Standard Institute, recpectively. Data was collected by WHONET 5.4 program. All Gram-negative microorganisms that were isolated from blood specimens were tabulated, and so the antibiotics susceptibility of A. anitratus. The origin of the specimens in term of institutions where the specimens came from was also analyzed. Results In a 7 year period up to 2008, A. anitratus was found in blood specimens, and these invironmental bacteria were in fact the most predominant isolated Gram negative microorganisms. Together with another environmental microorganism, Pseudomonas aeruginosa, it composed nearly 50%. Antimicrobial susceptibility test of this microorganism showed some degree of resistance to all tested antibiotics. The origin of those blood specimens which yielded A. anitratus were mainly from government-owned hospitals, that was 88 specimens (74%), followed by private hospitals (18 specimens, 15%), individuals (3 specimens, 3%), and unknown source (10 specimens, 8%). Conclusion Persistent occurrence of A. anitratus in blood specimens of hospitalized patients in hospitals in Jakarta was observed. In the near future, a study to fi nd risk factors for the acquisition of A. anitratus bacteremia is needed to reduce potential hospital associated infection. Moreover, genotyping is advised in order to determine the relationship of hospital and patient derived strains. (Med J Indones 2009; 18:227-32)
Computed tomography findings of retinoblastoma patients at Cipto Mangunkusumo Hospital Jakarta
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.366

Abstract

Aim As data of CT findings for retinoblatoma in Indonesia is not yet available, this study aimed to determine patient distribution and to describe CT findings of RB patients at Cipto Mangunkusumo Hospital. Methods From April 2004 to August 2007, CT scans were performed on 64 new patients of RB with clinical findings: leukocoria (19 patients), leukocoria with proptosis (41 patients), buphthalmus (2 patients) and red eyes (2 patients). The CT can was performed using single slice CT scan and multislice CT scan with axial and coronal section. The cases were categorized into 3 groups: grade I: tumor confined to the globe, grade II: tumor extended to orbital soft tissue or involved the optic nerve, and grade III: tumor extended beyond the orbit or intracranial space. The CT features were evaluated in each group for the presence of calcification, contrast enhancement and lateralization. Results Sixty four patients (30 females and 34 males) were evaluated. Age range: 3 months up to 9 years old; bilateral 20 patients, unilateral 44 patients. Six patients of 19 patients with clinical finding leukocoria were included in group I, and the remaining were included in group II. Twenty seven patients of 41 patients with proptotic eyes were included in group II, and the remaining were included in group III. Patients with clinical finding buphthalmus and red eyes were included in group II. All of the group I tumors (6 patients) showed calcification and enhancement. In group II (44 patients), calcification was detected in 41 patients, and there was no evidence of contrast enhancement in 6 patients. Group III (14 patients): no calcification in 2 patients, all of the tumors showed enhancement. Conclusion Our study showed calcification in 92% of RB. Calcification was not a favorable prognostic sign, because calcification was detected in almost all of the extraocular and intracranial tumors. Tumor enhancement was not correlated with extraocular tumor extension. The finding of leukocoria without proptosis could not exclude the presence of extraocular tumor extension. Suspicious intracranial invasion should be considered in proptotic RB patient. Most retinoblastoma cases in Indonesia are diagnosed at advanced stage, so that the objective of the therapy is life saving rather than visual salvation. (Med J Indones 2009; 18: 239-43)
The effect of lycopene on the total cytochrome P450, CYP1A2 and CYP2E1
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.367

Abstract

Aim Some carotenoids such as canthaxantin, astaxanthin and beta apo-8'€™-carotenal were reported to have modulatory effect on the cytochrome P450. The present study was conducted to investigate the effects of lycopene, a nonprovitamin A carotenoid, on microsomal cytochrome P450, CYP1A2 and CYP2E1. Methods Total cytochrome P450 levels, CYP1A2 and CYP2E1-catalyzed reactions (acetanilide 4-hydroxylation and p-nitrophenol hydroxylation) were studied in the liver microsomes of male Sprague Dawley rats. Microsomes were prepared using differential centrifugation combined with calcium aggregation method. Lycopene was orally administered in the dosages of 0, 25, 50 or 100 mg/kgBW/day for 14 days in a repeated fashion. Data were analyzed using ANOVA test. Results Total cytochrome P450 level and acetanilide 4-hydroxylase activity were unaffected by any of the treatments. The CYP2E1 probe enzyme (p-nitrophenol hydroxylase) was significantly reduced by repeated administration of 100mg/ kgBW/day lycopene (7.88 + 2.04 vs 12.26 + 2.77 n mol/min/mg prot). Conclusion The present results suggest that lycopene does not affect the total cytochrome P450 or CYP1A2 activity but it inhibits the activity of CYP2E1 (p-nitrophenol hydroxylase) in the rat. (Med J Indones 2009; 18: 233-8)
Meconium periorchitis: An unusual cause of newborn scrotal mass
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.368

Abstract

A case of meconium periorchitis in a 2-month-old boy is reported. The patient was delivered normally, only a scrotal mass was noted which became harder in weeks. Clinical and intrauterine ultrasonographic findings were suggestive of a neoplasm and orchidectomy was performed. Microscopic examination revealed separate nodules of myxoid stroma with varying amounts of calcifi cation separated by fibrous septa. The unexpected diagnosis of meconium periorchitis was confirmed. This condition is due to inflammatory reaction from the meconium within the scrotal sac and resulted from an intrauterine perforation of the gastrointestinal tract. Since solid benign or malignant paratesticular masses cannot be differentiated by ultrasonography, tissue biopsy or fresh frozen tissue examination is required for diagnosis. (Med J Indones 2009; 18: 290-3)
Adiponectin, total anti-oxidant status, and high sensitivity C-reactive protein in Indonesian men with metabolic syndrome
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.369

Abstract

Aim To examine biochemical markers of adiponectin, total anti-oxidant status (TAOS) and high sensitvity C-reactive protein (hsCRP) in individuals with and without metabolic syndrome (MetS). Methods A cross-sectional study on 36 non-MetS and 36 MetS subjects was undertaken in Jakarta. Measured indicators were adiponectin, TAOS and hsCRP, apart from weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and fasting blood glucose (FBG). Odds ratio (OR) of adiponectin, TAOS and hsCRP were calculated to assess risk for the development of MetS. Median values were determined as cut-offs to define high and low values of each parameter. Relationships between adiponectin, TAOS and hsCRP with WC were analyzed by using Spearman correlation analysis, and the contributions of all indicators to the development of MetS were analyzed by using logistic regression. Results: Adiponectin dan hsCRP differed significantly between non MetS and MetS subjects (4.2 + 1.4 vs 3.1 + 1.0 ug/mL) dan (0.97 + 0.92 vs 3.35 + 3.43 mg/L) (p < 0.01), but no significant difference was found in TAOS (1.24 + 0.1 vs 1.28 + 0.2 mmol/L). Adiponectin associated negatively with WC (rs= -0.436; p < 0.01), while TAOS and hsCRP associated positively with WC (rs= 0.286, p = 0.02 and rs= 0.597, p < 0.01). The odds ratios (ORs) of adiponectin and hsCRP for the development of MetS were 4 (p = 0.01) and ~6,8 (p < 0.01), respectively; while the risk of subjects with adiponectin-hsCRP ratio of ≤ 2.31 to develop MetS was 25 times (p < 0.01) those with adiponectin-hsCRP ratio > 2.31. Conclusion The use of adiponectin-hsCRP ratio increases the predictive power for the occurrence of MetS by 4-6 times the predictive power of adiponectin or hsCRP alone. (Med J Indones 2009; 18: 262-8)
In vitro maturation (IVM) as a new technique to treat polycystic ovary syndrome (PCOS) and induce pregnancy in Indonesia
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.370

Abstract

Aim To assesse the success of inducing pregnancies in the treatment of PCOS (Poly Cystic Ovary Syndrome) cases with in vitro maturation as a newly application technique in Indonesia. Methods This paper is a report of 7 cases in Indonesia that used the newly developed technique. There were 7 cases confirmed PCOS, in which 1 patient with a history of OHSS (Ovary Hyper Stimulation Syndrome) in a previous IVF procedure and 1 patient with PCOS characteristics, suspected hyper responder, in the Family Hospital from January to May of 2009. Follicular induction was performed with a minimum dose, primming with HCG 10.000 IU, on the 10th day and 40 hours later ovum pick up was performed, followed by in vitro maturation. Subsequently, insemination was performed and the inseminated follicle was assessed. Well qualified embryos then transferred them into the uterus. We then performed assessment of pregnancy biochemically, by the presence of embryonic sac and embryonic heart beat. Results We have performed the IVM (In Vitro Maturation) technique in the Family Hospital, West Jakarta, along with the TRB team of the Family Hospital in seven PCOS cases. From these patients, we have found 156 antral follicles (average of 22 follicles per patient), 82 oocytes, and after maturation, 61 nature oocytes (75 %). In three cases, in vitro fertilization was performed, while in 4 cases ICSI (In Cystoplasmic Sperm Infection) was performed. In these serial cases we obtained 41 embryos, and 22 fertilized embryos were transferred. Of 7 cases, we achieved two successful pregnancies (29%). Conclusion In vitro maturation is an alternative procedures in solving infertility problems for PCOS patients with lower risk of OHSS and more cost effective than conventional IVF. (Med J Indones 2009; 18: 269-75)
Prediction of pregnancy success rate through in vitro fertilization based on maternal age
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.371

Abstract

Aim To evaluate the correlation between the success of pregnancy through in vitro fertilization and maternal age. Methods Assessment of pregnancy was performed in eight in vitro fertilization centers in Indonesia: Harapan Kita Pediatric and Obstetric Hospital from 1997 to 2001, and seven in vitro fertilization centers in Indonesia. Follicular induction was performed through the long protocol, short protocol and natural cycle. Insemination was performed through ICSI (intra cytoplasmic sperm injection) on petri dish. Spermatozoa were obtained through masturbation, testicular biopsy and epididimical biopsy. A successful pregnancy was indicated chemically, with the presence of fetal heart beat and the birth of a baby (take home baby). Results There was a 34% pregnancy rate for the age group below 30 years, 33.75% for those between 31 and 35 years olds, and 26% for the age group 36 to 40 years old, and 8% for the age group above 40 years. Conclusion The higher the maternal age, the lower pregnancy rate. In other words, the higher the maternal age, the higher the rate of miscarriage. (Med J Indones 2009; 18: 244-8)
VEGF-C level as a predictor of pelvic lymph node metastases of cervical cancer at early stage
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.372

Abstract

Aim Vascular endothelial growth factor (VEGF) works to stimulate angiogenesis and lymphogenesis which is one of the factors in the metastasis process. This study aimed to identify whether VEGF level could be used to predict metastasis into pelvic lymph node of stage IB-IIA cervical cancer. Methods The study was case control study, a case (cervical cancer metastasis into pelvic lymph node), a control (cervical cancer without metastasis). Independent variables included primary lesion size, histological type, grade of cell differentiation, lymph vascular space involvement, and VEGF level. Dependent variable was metastasis into pelvic lymph node. Results Based on cut-off point, VEGF-C serum level, i.e., 10,066.90 pg/ml, 11/47 patients or 23.41%, had the level above that value, and 10/11 of the group of patient or 90.91% were found to develop metastasis into pelvic lymph node. Sensitivity of the examination of VEGF-C level in relation to the risk for the incidence of lymph node in this study was 71.43%, with a specificity of 96.97%, positive predictive value (PPV) of 90.91%, and negative predictive value (NPV) of 88.89%. Conclusion: VEGF-C level in the serum could be used to predict lymph node metastasis of stage IB-IIA cervical cancer, with a sensitivity of 71.43% and specificity of 96.97%. (Med J Indones 2009; 18: 257-61)
Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.373

Abstract

Aim To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis. Methods This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confirm the symptomatic VTE. These patients were followed up to one month after surgery. Results A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1%) underwent hip fracture surgery (HFS). The median time from injury to surgery was 23 days (range 2 to 197 days), the median duration of surgery was 90 minutes (range 60 to 255 minutes), and the median duration of immobilization was 3 days (range 1 to 44 days). Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2%) at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%), all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study. Conclusion The incidence of asymptomatic (69.2%) and symptomatic (23.1%) VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA), and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted. (Med J Indones 2009; 18: 249-56)
Health status, ability, and motivation infl uenced district hospital nurse performance
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.374

Abstract

Aim To investigate the influence of health status, ability and motivation of nurses'€™ performances in a district hospital. Methods A survey was conducted during May 2009 in a district hospital in West Java, Indonesia. Nurses in the inpatient and outpatient unit and fulfilled inclusion and exclusion criteria were randomly chosen as the unit of analysis. A questionnaire of 18-23 questions was used to measure the indicator of the four variables. The path analysis was performed using multiple regressions for calculating ß as the value of path coefficient between variables, p value and R2. Goodness of fit test was used to calculated Q and W coefficient. Results Test was performed on 125 of 493 nurses with exogenous (independent) and endogenous (intermediate or dependent) variables in the model proposed. The p-value was > 0.05, indicating that the characteristics variation of the subjects did not affect the answers on the endogenous and exogenous variables. The health status, ability, motivation and performance variables showed normal and homogenous distribution. Line equation between variables showed linear relation with p<0.05. Simple correlation score between variables was 0.376 to 0.833. Ability was the biggest variable that influences nurses' performance (44.8%), followed by motivation (33.9%) and health status (21.8%). The influences of the three exogenous variables to nurses'€™ performance were 76.2% and 23.8% which was influenced by other variables. Conclusion Nurses' health status, ability, and motivation influenced their performance. Therefore, these variables can be considered for an intervention to improve the nurses'€™ performance. (Med J Indones 2009; 18: 283-9)

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