Bambang Hariwiyanto
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Uji Validitas dan Reliabilitas Kwesioner Etiologi dan Faktor Risiko Kanker Nasofaring Awal Prasetyo; Bambang Hariwiyanto; Mohammad Hakimi; Soenarto Sastrowijoto
MEDIA MEDIKA INDONESIANA 2013:MMI VOLUME 47 ISSUE 1 YEAR 2013
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (317.307 KB)

Abstract

ABSTRACT Validity and reliability tests on questionnaires designed for etiology and risk factors of nasopharynx cancerBackground: The etiology and risk factors of NPC is a combination of multi-risk factors of genetic history, lifestyle, environmental exposure, and EBV infection. Currently, there is no publication about NPC’s questionnaire. This study analyzed the reliability and validity of the questionnaire of NPC’s etiology and risk factors.Methods: The cross-sectional study of the questionnaires of NPC’s etiology and risk factors were filled by the used-tryout samples i.e NPC sufferers and their family members, in April to August 2012. The study were done at Anatomical Pathology Laboratory of Kariadi & St. Elisabeth Hospitals Semarang. There are three main constructs, namely; genetic, lifestyle, and environmental exposure. The 74 filled-questionnaires were tested by correlation analysis of product moment for the validity, and the reliability tests conducted with Cronbach's Alpha. The data were analyzed with SPSS for Windows version 17.0.Results: A test for risk family history constructs were valid (p>0.932) and reliabel (Cronbach's Alpha=0.864). A test for lifestyle with a Pearson Correlation were p>0.785 for smoking habit, eating salted fish p>0.793, eating grilled-fish p>0.862, eating pickled p>0.831, drinking alcohol p>0.760, instant noodle p>0.497, food preservation p>0.495, food contains MSG p>0.627, with Cronbach's Alpha>0.751. A test for environmental exposure risk were valid for the exposure to passive cigarette smoke (p>0.486) Cronbach's Alpha=0.789,the exposure of the home environment p>0.658 Cronbach's Alpha=0.832, exposure-related jobs p>0.373 Cronbach's Alpha=0.697, and chronic nasopharingitis are all valid (p>0.900) with Cronbach's Alpha=0851.Conclusions: The questionnaires designed as a tool of NPC’s etiology and risk factors are valid and reliable.Keywords: Validity, realibility, questionnaires, NPC’s etiology and risk factorsABSTRAKLatar belakang: Etiologi dan faktor risiko KNF merupakan kombinasi risiko riwayat genetik, gaya hidup, paparan lingkungan, dan infeksi EBV. Saat ini, belum ada publikasi tentang kwesioner KNF. Penelitian ini membuktikan validitas dan reliabilitas alat ukur kwesioner etiologi dan faktor risiko KNF.Metode: Penelitian cross-sectional terhadap hasil pengisian kwesioner etiologi dan faktor risiko KNF yang diisi oleh sampel tryout terpakai, yaitu penderita KNF dan anggota keluarganya, pada April - Agustus 2012, di Laboratorium Patologi Anatomi RSUP  Dr. Kariadi Semarang dan RS St. Elisabeth Semarang. Kwesioner berdasar pada tiga konstruk utama, yaitu risiko genetik, risiko kebiasaan/gaya hidup, dan risiko paparan lingkungan. Sebanyak 74 kwesioner dilakukan uji validitas dengan analisis korelasi product moment, serta uji reliabilitas Cronbach's Alpha. Data dianalisis dengan SPSS for Windows version 17.0.Hasil: Uji konstruk risiko riwayat keluarga didapatkan valid (p>0,932) dan reliabel (Cronbach's Alpha=0,864). Uji konstruk risiko gaya hidup dengan Pearson Correlation didapatkan p>0,785 untuk subkonstruk kebiasaan merokok, kebiasaan makan ikan asin p>0,793, kebiasaan makan ikan/daging asap/bakar p>0,862, kebiasaan makan asinan p>0,831, kebiasaan minum alkohol p>0,760, kebiasaan makan mie instan p>0,497, kebiasaan makan makanan awetan p>0,495, kebiasaan makanan mengandung MSG p>0,627, Cronbach's Alpha=0,751. Uji konstruk risiko paparan lingkungan didapatkan valid untuk subkonstruk paparan pasif asap rokok (p>0,486), Cronbach's Alpha=0,789, paparan lingkungan rumah p>0,380, Cronbach's Alpha=0,713, paparan yang berhubungan dengan pekerjaan p>0,373 Cronbach's Alpha=0,697, infeksi nasofaringitis kronik semuanya valid (p>0,900), Cronbach's Alpha=0,851.Simpulan: Kwesioner yang diuji sebagai alat ukur untuk menggali etiologi dan faktor risiko KNF layak dipergunakan karena valid dan reliabel
Kajian terhadap hasil terapi karsinoma nasofaring berdasarkan EBNA1 dan EBNA2 Bambang Hariwiyanto; Soenarto Sastrowiyoto; Sofia Mubarika; Salugu Masesadji
Oto Rhino Laryngologica Indonesiana Vol 41, No 1 (2011): Volume 41, No. 1 January - June 2011
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (370.547 KB) | DOI: 10.32637/orli.v41i1.52

Abstract

Background: Nasopharyngeal carcinoma (NPC) is one of the most common among head and neck malignancies, especially in some Asian countries. Epstein-Barr Virus (EBV) is one of the agent causing NPC, expressing many proteins such as Epstein-Barr nucleus antigen (EBNA). Expression of EBNA theoretically influencing therapy KNF outcome. Purpose: To differentiate therapy result between NPC expressed positive EBNA1 and EBNA2 compared with NPC expressed negative EBNA1 and EBNA2. Method: Nested case control study toward 28 complete remission NPC patients and 28 partial remission NPC patients post treatment. Result: There was no significant difference in therapy outcome between NPC with EBNA1 expression =4.90 compared to EBNA1 <4.90 (p: 0.160; OR: 0.222) and there was a significant difference therapy outcome between NPC with expression of EBNA2 =1.30 compared to EBNA2 <1.30 (p: 0.029; OR: 0.289). Conclusion: EBNA2 expression is one of protective agents in NPC post treatment outcome. Keywords: NPC, EBNA1, EBNA2, protective factor   Abstrak :  Latar belakang: Karsinoma nasofaring (KNF) merupakan salah satu keganasan yang di beberapa negara benua Asia merupakan keganasan paling banyak didapatkan di antara keganasan di kepala leher. Keterlibatan infeksi virus Epstein-Barr (EBV) merupakan salah satu faktor penyebab terjadinya KNF. Infeksi EBV mengekspresikan beberapa protein antara lain Epstein-Barr nucleus antigen (EBNA) yang secara teori mempengaruhi onkogenesis termasuk hasil terapi KNF. Tujuan:Menentukan adanya perbedaan hasil terapi antara KNF yang mengekspresikan EBNA1 serta EBNA2 dengan KNF yang tidak mengekspresikan EBNA1 serta EBNA2. Metode: Nested case-controlterhadap 28 penderita KNF yang mengalami remisi sempurna dan yang mengalami remisi parsial pascaterapi KNF. Hasil: Tidak terdapat perbedaan yang bermakna antara hasil terapi KNF yang mengekspresikan EBNA1 =490 dengan KNF yang mengekspresikan <4,90 (p: 0,160; OR: 0,222), dan terjadi perbedaan bermakna antara hasil terapi KNF yang mengekspresikan EBNA2 =1,30 dengan KNF yang mengekspresikan EBNA2 <1,30 (p: 0,029; OR: 0,289). Kesimpulan: Ekspresi EBNA2 merupakan salah satu faktor protektif terhadap keberhasilan terapi KNF. Kata kunci: KNF, EBNA1, EBNA2, faktor protektif
Pewarnaan Toluidin blue sebagai petanda ketepatan biopsi pasca terapi karsinoma sel skuamosa kepala-leher Bambang Hariwiyanto; Camelia Herdini; Inawati Bobot
Oto Rhino Laryngologica Indonesiana Vol 42, No 1 (2012): Volume 42, No. 1 January - June 2012
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (474.44 KB) | DOI: 10.32637/orli.v42i1.41

Abstract

Background: Squamous cell carcinoma (SCC) is the most frequent malignancy in the head and neck. The treatment modalities of SCC are surgery followed by chemotherapy and/or radiotherapy, could also chemotherapy and/or radiotherapy without surgery. The gold standard of assessing success  in SCC treatment is if there no malignant cells found not only in frozen section tissues, but also in  post chemotherapy and/or radiotherapy tissues. Determining the spot of biopsy tissue for malignancy assessment after treatment is not easy. Toluidin Blue (TB) is a staining material, absorbed by intercellular space in epithelial dysplasia, included SCC.   To determine the validity of Toluidin Blue as sign of accuracy for biopsy site in SCC post treatment malignancy, which not only for surgically treated cases, but also after chemotherapy and/or radiotherapy without surgical treatment. Method: Diagnostic test study to determine sensitivity test, specificity test, positive predictive value and negative predictive value of TB to detect malignant cells in post treatment head and neck SCC patients. Result: There were 30 samples biopsy material from 30 post treatment SCC patients. Sensitivity test was 83,3%, specificity  test: 66,7%, positive predictive value: 79.0%, negative predictive value: 72,7%. Conclusion: TB staining is accurate for determining biopsy spot in post treatment head and neck SCC. Keyword : Validity, toluidin blue, squamous cell carcinoma, post treatment.  Abstrak :  Latar belakang: Karsinoma sel skuamosa (KSS) merupakan jenis keganasan kepala dan leher yang paling sering dijumpai dibanding keganasan yang lain. KSS kepala leher dapat dilakukan terapi pembedahan diikuti kemoterapi dan/atau radioterapi maupun kemoterapi dan/atau radioterapi tanpa pembedahan. Penentuan keberhasilan radikalitas pengobatan ditandai dengan tidak adanya sisa tumor secara mikroskopis yang diambil pada jaringan pasca kemoradiasi tanpa pembedahan, atau pemeriksaan jaringan secara frozen section. Untuk menentukan apakah pada jaringan masih ada sisa tumor atau sudah bebas tumor secara makroskopis terkadang sulit. Toluidin Blue (TB) adalah zat pewarna yang dapat terserap pada ruang interseluler epitel yang mengalami displasia seperti yang terjadi pada KSS. Tujuan: Menilai validitas pewarnaan TB sebagai petanda ketepatan lokasi biopsi KSS pasca terapi, baik pasca pembedahan, maupun yang diterapi dengan kemoterapi dan/atau radioterapi tanpa pembedahan. Metode: Uji diagnostik untuk menentukan sensitifitas dan spesifitas pewarnaan, nilai duga positif dan nilai duga negatif TB sebagai salah satu petanda ketepatan biopsi KSS pasca terapi KSS kepala-leher. Hasil: Didapatkan 30 sampel penelitian yang berasal dari 26 penderita KSS yang telah dilakukan terapi baik bedah maupun kemoradiasi tanpa bedah. Sensitifitas pewarnaan TB terhadap hasil biopsi pasca terapi 83,3%, spesifitas 66,7%, nilai duga positif 79,0% dan nilai duga negatif 72,7%. Kesimpulan: Pewarnaan TB valid untuk menentukan ketepatan biopsi keganasan KSS kepala dan leher pasca terapi. Kata kunci: Validitas, toluidin blue, karsinoma sel skuamosa, pasca terapi
Uji serologi IgA karakter KNF EBNA1+VCA p-18 pada penderita keluhan kronis kepala leher Camelia Herdini; Susanna Hutajulu; Sagung Rai Indrasari; Bambang Hariwiyanto; Jajah Fachiro; Sofia Mubarika; Jaap Middeldorp
Oto Rhino Laryngologica Indonesiana Vol 41, No 2 (2011): Volume 41, No. 2 July - December 2011
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (413.826 KB) | DOI: 10.32637/orli.v41i2.46

Abstract

Background: Nasopharyngeal carcinoma (NPC), especially the WHO type III, is correlated almost100% with Epstein Barr Virus (EBV) infection. This is indicated by high IgG and IgA antibody responsesagainst viral capsid antigen (VCA), early antigen (EA) and Epstein Barr Nuclear antigen (EBNA).Increased IgA NPC character antibodies may be detected 2-10 years before the presence of the tumor. Thisoccurs as a result of reactivation of EBV infection. Purpose: To find out the level of IgA NPC characterantibodies (EBNA1+VCA p-18) in patients with chronic symptoms in the head and neck and to determine whether the level of IgA can be used as an early sign of NPC. Methods: Observational analytic study on 218 patients with chronic symptoms in the head and neck. The research was conducted from July 2006to September 2010. ELISA technique was used as serology test for IgA (EBNA1+VCA p-18). Result: Samples were 90 males and 128 females. High level of IgA by ELISA was found in 28 males (31.1%) and 45 females (35.2%). The IgA level tended to increase with age. The most common chronic symptoms inthe head and neck were chronic rhinitis (15.6%) and nasal obstruction (7.8%). From all patients who hadhigh level of IgA, 3 patients (4.1%) were found positive of early stage NPC. Conclusion: More than 33%of patients with chronic symptoms of head and neck had high level of IgA NPC character. This methodcan be used as an early detection of NPC. Keywords: serology test in NPC, EBNA1, VCA p-18, NPC symptoms in head and neck Abstrak :  Latar belakang: Karsinoma nasofaring (KNF) terutama tipe WHO III berkorelasi hampir 100%dengan infeksi Epstein Barr Virus (EBV). Hal ini ditunjukkan dengan tingginya respons antibodi IgGdan IgA terhadap viral capsid antigen (VCA), early antigen (EA) EBV serta antibodi Epstein BarrNuclear Antigen (EBNA). Kenaikan antibodi IgA dengan karakter KNF dapat terjadi 2-10 tahun sebelumterjadinya tumor. Hal ini terjadi sebagai akibat adanya reaktivasi infeksi EBV. Tujuan: Mengetahui kadarIgA karakter KNF (EBNA1+VCA p-18) pada penderita dengan gejala kronis di daerah kepala dan leherdan mengetahui apakah kadar IgA dapat digunakan sebagai tanda awal terjadinya KNF. Metode: Suatukajian analitik observasional terhadap 218 penderita dengan gejala kronis di daerah kepala dan leher.Penelitian ini dilakukan Juli 2006 sampai dengan September 2010. Pemeriksaan serologi IgA (EBNA1+VCA-p18)dilakukan denganteknik ELISA.Hasil:Terdapat90penderita laki-lakidan128 penderitaperempuan.HasiltesserologiIgAELISAdengankadartinggiditemukanpada28laki-laki(31,1%)dan45perempuan (35,2%). Kadar IgA cenderung meningkat pada peningkatan usia. Gejala kronis yangterbanyak dikeluhkan penderita adalah rinitis kronis, yaitu sebanyak 34 penderita (15,6%), diikuti denganobstruksi hidung sebanyak 17 penderita (7,8%). Pemeriksaan klinis lebih lanjut dari penderita yangmempunyai kadar IgA tinggi menunjukkan bahwa 3 penderita (4,1%) positif terkena kanker nasofaringstadium awal. __ Lebih dari 33% penderita dengan gejala kronis di daerah kepala dan lehermemiliki kadar IgA karakter KNF yang tinggi. Kadar IgA karakter KNF yang tinggi dapat digunakansebagai penanda awal kejadian KNF. Kata kunci: uji serologi KNF,EBNA1, VCA p-18, gejala KNF