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Analysis of Cell Block and Cytology Specimen Preservation from Lung Aspiration Biopsy Poernomo, Adinda Sandya; Sandhika, Willy; Budipramana, Vicky Sumarki
Jurnal Kedokteran Brawijaya Vol 31, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Cytology smear technique is often used in Indonesia because the process is safe, simple, easy, fast, and cost effective. At present, several studies have found that smears with cell block techniques are of better quality than smears with cytology smear techniques. The aim of this study was to analyze whether the cytology smear technique can produce adequate specimens compared to cell block towards results of lung Fine Needle Aspiration Biopsy (FNAB). Lung FNAB specimens were divided into two parts: one part was processed with cytology and the other part with cell block technique. The specimens were observed under a microscope to count the number of inflammatory cells and the number of artifacts. The numbers of inflammatory cells and artifacts were scored 0-3. The inflammatory cells consisted of neutrophils, lymphocytes and plasma cells, also macrophages. The result showed no significant difference between the number of inflammatory cells in cytology and cell block (p neutrophils=0.543; p lymphocytes and plasma cells=0.192; p macrophages=0.487) in 38 samples. The artifact score comparison test result showed a significant difference between the number of artifacts in cytology and cell block (p=0.027) with more artifacts in cytology. The most common artifact in cytology was air bubble artifacts, while cell block was dominated by torn pieces artifacts. There was no significant difference between the number of inflammatory cells found in cytology and cell block techniques. Cell block technique has less artifacts than cytology, but artifacts found in cytology can be corrected so that the cytology smear technique is still an option.

Unusual Skin Metastasis from Gastric Cancer: A Case Report Vicky Sumarki Budipramana
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 32 No. 2 (2020): AUGUST
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V32.2.2020.163-166

Background: Skin metastasis from gastric cancer are relatively rare, but they have important clinical significance because they usually indicate a worse prognosis. Skin metastasis from gastric cancer may spread through lymphatic ducts, blood vessels in the ligamentum teres, contiguous extension, or embryologic remnants of the umbilicus. Purpose: To report an unusual skin metastasis from gastric cancer that clinically resembles as a benign lesion of skin papules. Case: A rare metastasis from gastric cancer origin in a 61-year-old male in the abdominal skin. Gastric cancer metastasis in an unusual site such as the abdominal skin often resembles as dermatitis, especially in the early course of metastatic spreading, which looked like common papules on the skin. Discussion: In the beginning, the skin papules were not suspected to be a metastatic process because there was no palpable or no tenderness in the subcutan or fascia underneath. The appearance resembled common dermatitis. However, as papules rapidly spread to the surrounding skin, the malignancy was then suspected. The incisional biopsy from the papules was performed and showed that it was metastatic diffuse-type gastric adenocarcinoma. Conclusion: The skin metastasis was different from general nodules, but rather as skin papules of general dermatitis in initial appearance. The surgeon and dermatologist should be alert if they find any benign appearance of a skin lesion on the abdominal wall in a patient with a history of gastric cancer surgery.

Examination of Micro Vascular Density on Metastatic Colorectal Cancer of RAS Mutant-Type as Anti Vegf Therapy Predictor Heru Sulistyo; Vicky Sumarki Budipramana
Folia Medica Indonesiana Vol. 57 No. 2 (2021): June
Publisher : Universitas Airlangga

According to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) on Colon Cancer Version 2.2019, mCRC patients with mutant type RAS were treated with anti-VEGF. However, the use of the targeting therapy still had inconsistent results. Neoangiogenesis studies had been used as a basis to assess the prognosis of mCRC. Microvascular density (MVD) had become the morphological gold standard to assess neovascularization in human tumors. This study proved the existence of low microvascular density (MVD) in mCRC patients with mutant type RAS status as a predictor of failure of anti-VEGF therapy. There were 29 patients at Dr. Soetomo Academic Hospital from 2015-2018 who had their RAS status checked and tested for microvascular density (MVD). The results of this study were analyzed using SPSS 23.0. In the Mutant-type of RAS group, this study examined microvascular density (MVD). 11 (73%) research subjects with high MVD scores and 4 (27%) research subjects had low MVD scores. Besides, 27% microvascular density (MVD) was low, in the mutant-type of RAS mCRC patient which could be a predictor factor for the failure of anti-VEGF therapy.

Lactate Level as a Prediction Factor of Reperforation after Repairing Gastric Perforation Vicky Sumarki Budipramana
Folia Medica Indonesiana Vol. 55 No. 1 (2019): March
Publisher : Universitas Airlangga

Reperforation after gastric perforation repair is a complication which increases the rate of morbidity and mortality in gastric perforation. The lack of ability of the tissue to use oxygen in septic condition causes anaerobic cellular metabolism and furthermore it will cause failure in closing the perforation. The production of anaerobic metabolism is lactic acid which can be measured from the blood. The aim of this study is to determine the cut-off point of blood lactate level as a predictor of reperforation after repairing gastric perforation. Forty-six patients diagnosed as gastric perforation, who were repaired in Dr Soetomo Hospital from October 2014 to October 2015 were recruited as samples. Serum lactate was taken one hour before repairing the perforation. After being repaired, the patients were observed until the 14th day to evaluate whether any reperforation would occur or not . The design of this research was cross-sectional, analytic observational. The data was analyzed using independent t-test and ROC for obtaining the cut-off point as a predictor of the reperforation after the gastric perforation was repaired. There was a significant difference in the mean of lactate level in the group with reperforation compared with that of the non-reperforation group, that is as big as 3.74±0.59 mmol/L and 2.60±0.76 mmol/L. Using ROC curve analysis, there was the cut-off point of lactate level for reperforation 3.35 mmol/L, with sensitivity 92.9%, specificity 84.4%, positive predictive value 72% and negative predictive Value 96.4%, accuracy 87.0% and in the AUC value 0.902.

The Most Dominant Predictability Factor of Boey Score on The Level of Mortality in Perforation Gaster Boey Score 1 and Boey Scores 2 Patients in RSUD Dr Soetomo Surabaya Sandi Halim Naga Saputra; Vicky Sumarki Budipramana; Marjono Dwi Wibowo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.357

Introduction: The Boey score is the most commonly used scoring system for risk stratification because of its simplicity and high predictive value for mortality and morbidity in cases of gastric perforation. This score is widely used in daily practice because it only assesses 3 assessment components; namely the onset of perforation, shock at first admission, and comorbid disease; which is easy to do and has a fairly good accuracy. In Boey score 2, the mortality rate is still high, so research on the factors that most influence mortality at Boey Score 2 needs to be done.Methods: This study uses secondary data from medical records of patients who meet criteria of inclusion and exclusion. This study is a comparative test using a cohort analytic observational study design (longitudinal retrospective), comparing the components of the Boey score which is the most influential in predicting the mortality rate in gastric perforated patients. Boey score 1 and Boey score 2 at RSUD Dr. Soetomo SurabayaResults: Total subject of the study was 65 people, consisting of 43 men (66.2%) and 22 women (33.8%). The Boey score was 16 people (24.6%) with a Boey score of 1 and 49 people (75.4%) with a Boey score 2.From the Boey score component, 49 people (75.4%) were obtained with the onset of perforation> 24 hours, 31 people (47.7%) with preoperative shock, and 34 people (52.3%) with comorbidities. Comorbidity in study subjects included hypertension in 17 people (26.2%), diabetes mellitus in 4 people (6.2%), heart disease in 4 people (6.2%), lung disease in 5 people (7.7%), and kidney disease in 7 people. people (10.8%)Conclusion: Shock is the most dominant Boey Score predictability factor that affects the mortality rate in gastric perforation patients with Boey score 1 and Boey score 2.

Correlation Between Candidiasis And Mortality In Gastric Ulcer Perforation Patients Faradina Sulistiyani; Vicky Sumarki Budipramana; Pepy Dwi Endraswari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.370

Background: Gastric ulcer disease remains the most common gastrointestinal disease. This affects about 4 million people every year worldwide with an incidence of 1.5%-3% and 2-14% of these will progress to perforation. Mortality is reported in 30% of cases and caused morbidity in 50% of patients. Some studies have suggested that mortality in patients with peritonitis accompanied by candidiasis ranges from 20%-75%, whereas others have argued that the presence of fungal isolates in patients with perforated peptic ulcer does not affect the outcome. A recent study reported an incidence of 45% of patients peptic ulcer perforation cases accompanied by candidiasis in Dr. Soetomo General Hospital Surabaya in 2019.Methods: This was a cross sectional study based on medical record data of patients with gastric ulcer perforation accompanied by candidiasis who underwent laparotomy and gastric repair surgery at Dr. Soetomo General Hospital Surabaya from January 2019 to December 2020.Results: There was no significant correlation between candidiasis and mortality in gastric ulcer perforation patients (p=0.989).Conclusion: Candidiasis does not increase mortality in patients with gastric ulcer perforation.

Pre-Operative Enhanced Recovery After Surgery (ERAS) Protocol Compliance Towards Major Surgery Patients at Dr. Soetomo General Hospital, Surabaya Ahmad Sabili Rifa'i; Vicky Sumarki Budipramana; Gadis Meinar Sari
Biomolecular and Health Science Journal Vol. 3 No. 1 (2020): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v3i1.19064

Introduction: The implementation of ERAS protocol can optimize patients after surgery, which in turn can reduce burdens both for patient and hospital. The purpose of this study is to describe the compliance and consistency of ERAS in the pre-operative period of surgery patients in Dr. Soetomo General Hospital Surabaya. Methods: We conducted consecutive observation of major surgical patients for 4 weeks. The type of surgery observed was digestive, thoracic and cardiovascular, and gynecological surgery. The pre-operative period will be calculated for compliance based on the ERAS international protocol. All data of compliance presented descriptively.s.Results: A total of 36 major surgery patients of which 7 (19,4%) were digestive surgeries, 14 (38,9%) were thoracic and cardiovascular surgeries, and 15 (41,7%) were gynecological surgeries. Overall compliance of the ERAS protocol in the pre-operative period of major surgery patients was 91%. The compliance of ERAS protocol in the pre-operative period of digestive surgery patients was 80%, in thoracic and cardiovascular surgery patients was 93,4% and gynecologic surgery patients was 84.3%. Major surgery patients with ≥90% compliance was 25%. Digestive surgery patients with ≥90% compliance was 0%. Thoracic and cardiovascular surgery patients with ≥90% compliance was 64,3%. Gynecologic surgery patients with ≥90% compliance was 0%.Conclusion: : Pre-operative elements of ERAS protocol in major surgery including digestive, thoracic and cardiovascular, and gynecologic surgery in Dr. Soetomo General Hospital, Surabaya needs to be improved.

The Most Dominant Predictability Factor of Boey Score on The Level of Mortality in Perforation Gaster Boey Score 1 and Boey Scores 2 Patients in RSUD Dr Soetomo Surabaya Sandi Halim Naga Saputra; Vicky Sumarki Budipramana; Marjono Dwi Wibowo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.357

Introduction: The Boey score is the most commonly used scoring system for risk stratification because of its simplicity and high predictive value for mortality and morbidity in cases of gastric perforation. This score is widely used in daily practice because it only assesses 3 assessment components; namely the onset of perforation, shock at first admission, and comorbid disease; which is easy to do and has a fairly good accuracy. In Boey score 2, the mortality rate is still high, so research on the factors that most influence mortality at Boey Score 2 needs to be done.Methods: This study uses secondary data from medical records of patients who meet criteria of inclusion and exclusion. This study is a comparative test using a cohort analytic observational study design (longitudinal retrospective), comparing the components of the Boey score which is the most influential in predicting the mortality rate in gastric perforated patients. Boey score 1 and Boey score 2 at RSUD Dr. Soetomo SurabayaResults: Total subject of the study was 65 people, consisting of 43 men (66.2%) and 22 women (33.8%). The Boey score was 16 people (24.6%) with a Boey score of 1 and 49 people (75.4%) with a Boey score 2.From the Boey score component, 49 people (75.4%) were obtained with the onset of perforation> 24 hours, 31 people (47.7%) with preoperative shock, and 34 people (52.3%) with comorbidities. Comorbidity in study subjects included hypertension in 17 people (26.2%), diabetes mellitus in 4 people (6.2%), heart disease in 4 people (6.2%), lung disease in 5 people (7.7%), and kidney disease in 7 people. people (10.8%)Conclusion: Shock is the most dominant Boey Score predictability factor that affects the mortality rate in gastric perforation patients with Boey score 1 and Boey score 2.

Correlation Between Candidiasis And Mortality In Gastric Ulcer Perforation Patients Faradina Sulistiyani; Vicky Sumarki Budipramana; Pepy Dwi Endraswari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.370

Background: Gastric ulcer disease remains the most common gastrointestinal disease. This affects about 4 million people every year worldwide with an incidence of 1.5%-3% and 2-14% of these will progress to perforation. Mortality is reported in 30% of cases and caused morbidity in 50% of patients. Some studies have suggested that mortality in patients with peritonitis accompanied by candidiasis ranges from 20%-75%, whereas others have argued that the presence of fungal isolates in patients with perforated peptic ulcer does not affect the outcome. A recent study reported an incidence of 45% of patients peptic ulcer perforation cases accompanied by candidiasis in Dr. Soetomo General Hospital Surabaya in 2019.Methods: This was a cross sectional study based on medical record data of patients with gastric ulcer perforation accompanied by candidiasis who underwent laparotomy and gastric repair surgery at Dr. Soetomo General Hospital Surabaya from January 2019 to December 2020.Results: There was no significant correlation between candidiasis and mortality in gastric ulcer perforation patients (p=0.989).Conclusion: Candidiasis does not increase mortality in patients with gastric ulcer perforation.

Uji Efektifitas Ekstrak Etanol Daun Annona Muricata Terhadap Sel Kanker Payudara MCF-7 Azarya Ibrahim; Willy Sandhika; Vicky Sumarki Budipramana
Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo Vol 6, No 1 (2020): JMK Yayasan RS.Dr.Soetomo, April 2020
Publisher : STIKES Yayasan RS.Dr.Soetomo

Kanker payudara adalah tumor ganas yang terbentuk dari sel-sel payudara yang tumbuh dan berkembang tanpa terkendali sehingga dapat menyebar ke jaringan atau organ yang berada dekat dengan payudara atau ke bagian tubuh lainnya. Annona muricata Linn atau Graviola telah digunakan sebagai obat tradisional untuk menangani berbagai jenis penyakit seperti demam, rematik, kanker dan juga sebagai sedatif, insektisida dan imunosupresif. Pada penelitian ini, cell line kanker payudara MCF-7 diberi ekstrak etanol A. muricata kemudian diinkubasi 24 jam. Setelah itu dilakukan uji sitotoksik menggunakan metode MTT assay. Parameter yang digunakan pada uji sitotoksik adalah IC50 yang menunjukkan konsentrasi inhibisi sel kanker sebanyak 50% dengan nilai IC50 sebesar 117,87 μg/ml. Ekstrak dapat dikatakan memiliki aktivitas sitotoksik jika nilai IC50 kurang dari 1000 μg/ml setelah 24 jam kontak dengan sel kanker. Dengan demikian, dapat disimpulkan bahwa ekstrak etanol daun A. muricata dapat digunakan sebagai pilihan terapi anti-kanker alami untuk kanker payudara.Kata Kunci: Kanker payudara, Ekstrak etanol daun Annona muricata, MCF-7, MTT assay

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