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All Journal Medical Journal of Indonesia Indonesian Journal of Cancer
Karmel L. Tambunan
Department of Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Experience of treatment of lung cancer patients using paclitaxel and carboplatin Jusuf, Anwar; Mariono, Sutji A.; Tambunan, Karmel L.; Reksodiputro, A. H.; Soetandyo, Noorwati; Hukom, Ronald; Suratman, Eddy; Jayusman, A. M.
Medical Journal of Indonesia Vol 9, No 1 (2000): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (191.443 KB) | DOI: 10.13181/mji.v9i1.650

Abstract

[no abstract available]
Anti-thrombin III, Protein C, and Protein S deficiency in acute coronary syndrome Ismail, Dasnan; Harun, S.; Alwi, Idrus; Tambunan, Karmel L.; Effendy, Shufrie
Medical Journal of Indonesia Vol 11, No 2 (2002): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (756.386 KB) | DOI: 10.13181/mji.v11i2.54

Abstract

The final most common pathway for the majority of coronary artery disease is occlusion of a coronary vessel. Under normal conditions, antithrombin III (AT III), protein C, and protein S as an active protein C cofactor, are natural anticoagulants (hemostatic control) that balances procoagulant activity (thrombin antithrombin complex balance) to prevent thrombosis. If the condition becomes unbalanced, natural anticoagulants and the procoagulants can lead to thrombosis. Thirty subjects with acute coronary syndrome (ACS) were studied for the incidence of antithrombin III (AT III), protein C, and protein S deficiencies, and the result were compare to the control group. Among patients with ACS, the frequency of distribution of AT-III with activity < 75% were 23,3% (7 of 30), and only 6,7% ( 2 of 30 ) in control subject. No one of the 30 control subject have protein C activity deficient, in ACS with activity < 70% were 13,3% (4 of 30). Fifteen out of the 30 (50%) control subjects had protein S activity deficiency, while protein S deficiency activity < 70% was found 73.3.% (22 out of 30). On linear regression, the deterministic coefficient of AT-III activity deficiency to the development ACS was 13,25 %, and the deterministic coefficient of protein C activity deficient to the development of ACS was 9,06 %. The cut-off point for AT-III without protein S deficiency expected to contribute to the development of vessel disease was 45%. On discriminant analysis, protein C activity deficiency posed a risk for ACS of 4,5 greater than non deficient subjects, and AT-III activity deficiency posed a risk for ACS of 3,5 times greater than non deficient subjects. On binary logistic regression, protein S activity acted only as a reinforcing factor of AT-III activity deficiency in the development of ACS. Protein C and AT III deficiency can trigger ACS, with determinant coefficients of 9,06% and 13,25% respectively. Low levels of protein C posed a greater risk of ACS than low levels of AT III. Protein S deficiency was a reinforcing factor on AT-III deficient to development of ACS. The cut-off point of AT-III without protein S deficiency expected to give single vessel disease was 45%, and 9,5% for the development of triple vessel disease. (Med J Indones 2002; 11: 87-92)Keywords: acute coronary syndrome, Anti-thrombin III, Protein C, Protein S
Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery Tambunan, Karmel L.; Hutagalung, Errol U.; Sukrisman, Lugyanti; Saleh, Ifran; Gunawan, S. B.; Sofyanuddin, Sofyanuddin; Setiawati, Arini
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 | Full PDF (98.389 KB) | 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 confi rm 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)Keywords: venous thromboembolism (VTE), orthopedic surgery, Indonesia
Efficacy and Safety of In-Asia-Manufactured rhG-CSF 300 mcg As Primary Prophylaxis for Prevention of CHOP Chemotherapy-induced Severe Neutropenia in Elderly Patients with Lymphoma Non-Hodgkin Reksodiputro, Harryanto; Djoerban, Zubairi; Tambunan, Karmel L.; Sudoyo, Aru W.; Widjanarko, Abidin; Atmakusuma, Djumhana; Syafei, Syafrizal; Prayogo, Nugroho; Hukom, Ronald; Ranuhardy, Dody; Jack, Zakifman; Harsal, Asrul; -, Noorwati S; Karsono, Bambang; Effendi, Shufrie; Tadjoedin, Hilman
Indonesian Journal of Cancer Vol 3, No 1 (2009): Jan - Mar 2009
Publisher : "Dharmais" Cancer Center Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (790.74 KB)

Abstract

Penelitian open-label, non-komparatif ini dilakukan untuk mengevaluasi efektivitas dan keamanan recombinant human G-CSF produksi Asia sebagai profilaksis primer dalam pencegahan neutropenia derajat berat pada pasien usia lanjut (>60 tahun) dengan limfoma non-Hodgkin (LNH) derajat sedang dan lanjut (stadium II,III,IV) yang mendapat terapi CHOP (siklofosfamid, doksorubisin, vinkristin). Profilaksis primer recombinant human G-CSF (rhG-CSF) produksi Asia dapat mengurangi median durasi neutropenia derajat 4 pada siklus sitostatistika ke-1 dan ke-2 menjadi tiga hari, sementara median durasi neutropenia derajat 3 pada siklus sitostistika ke-1 menjadi dua hari dan pada siklus sitostatistika ke-2 menjadi dua setengah hari, dari median durasi neutropenia grade 4 dan grade 3 tanpa G-CSF, yaitu empat dan lima hari berurutan. Febrile neutropenia ditemukan pada 7 pasien yang mendapat rhG-CSF produksi Asia (24.1%), lebih rendah jika dibandingkan studi tanpa rhG-CFS (31.3-34% FN). Tiga pasien mendapat rhG-CSF produksi Asia (10,3%) dirawat inap akibat febrile neutropenia, lebih rendah jika dibandingkan rawat inap pada studi tanpa rhG-CSF (24-28%). Kejadian yang tidak diinginkan terbanyak adalah mual dan muntah yang terjadi pada 9 (31%) pasien. Sebagai kesimpulan, penggunaan rhG-CSF produksi Asia untuk profilaksis primer pada pasien LNH usia lanjut yang mendapat regimen CHOP dapat mengurangi durasi neutropenia, mengurangi kejadian febrile neutropenia, dan angka rawat inap akibat febrile neutropenia.Kata kunci : Efektivitas, keamanan, G-CSF, LNH pada usia lanjut
Child single worst criterion as a predictor of hemostatic state in patients with liver cirrhosis Tambunan, Karmel L.
Medical Journal of Indonesia Vol 6, No 1 (1997): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (497.772 KB) | DOI: 10.13181/mji.v6i1.804

Abstract

[no abstract available]
Experience in the use of human recombinant erythropoietin (rHuEPO) in cancer patient with anemia Tambunan, Karmel L.; Sudoyo, Aru; Reksodiputro, A. H.
Medical Journal of Indonesia Vol 6, No 1 (1997): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (533.815 KB) | DOI: 10.13181/mji.v6i1.805

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[no abstract available]
The role of platelet antibody and bone marrow in adult dengue hemorrhagic fever with thrombocytopenia Waly, Taufiq M.; Tambunan, Karmel L.; Nelwan, R. H.H.; Pohan, Herdiman T.; Hendarwanto, Hendarwanto; Muljono, Muljono
Medical Journal of Indonesia Vol 7, No 4 (1998): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (983.117 KB) | DOI: 10.13181/mji.v7i4.751

Abstract

[no abstract available]
Co-Authors A. H. Reksodiputro A. M. Jayusman Abidin Widjanarko Anwar Jusuf Arini Setiawati Aru Sudoyo Aru W. Sudoyo Asrul Harsal, Asrul Bambang Karsono Dasnan Ismail Djumhana Atmakusuma, Djumhana Dody Ranuhardy, Dody Eddy Suratman Errol U. Hutagalung Harryanto Reksodiputro, Harryanto Hendarwanto Hendarwanto Herdiman T. Pohan HILMAN TADJOEDIN, HILMAN Idrus Alwi Ifran Saleh Lugyanti Sukrisman Muljono Muljono Noorwati S -, Noorwati S Noorwati Soetandyo Nugroho Prayogo R. H.H. Nelwan Ronald Hukom S. B. Gunawan S. Harun Shufrie Effendi, Shufrie Shufrie Effendy Sofyanuddin Sofyanuddin Sutji A. Mariono Syafrizal Syafei, Syafrizal Taufiq M. Waly Zakifman Jack, Zakifman Zubairi Djoerban