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All Journal Medicina E-Jurnal Medika Udayana Universa Medicina ISM (Intisari Sains Medis) : Jurnal Kedokteran Ina Kidney Neurologico Spinale Medico Chirurgico Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Ni Wayan Winarti
Department Of Anatomical Pathology, Faculty Of Medicine Udayana University, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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TERATOMA IMATUR PADA PROSTAT Elizabeth Padang, Arlene; Winarti, Ni Wayan
Medicina Vol 44 No 2 (2013): Mei 2013
Publisher : Medicina

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Abstract

Germ cell tumor sakrokoksigeal sangat jarang terjadi dan dapat mengenai berbagai area termasuk prostat. Umumnya tumor ini terjadi pada usia dua dekade pertama. Kami melaporkan sebuah kasus teratoma imatur prostat pada seorang remaja usia 16 tahun dengan data klinis preoperatif dan pemeriksaan makroskopis dan mikroskopis secara histopatologi di RSUP Sanglah, Denpasar, bagian Patologi Anatomi, yang kami simpulkan sebagai teratoma imatur grade 1 / low grade. Pasien dirujuk ke bagian interna untuk mendapat kemoterapi kombinasi, namun pasien meninggal sebelum dilakukan kemoterapi kombinasi. [MEDICINA 2013;44:124-127]
THE CHARACTERISTIC OF CYTOLOGICAL AND PCR TESTS RESULT OF FINE NEEDLE ASPIRATION (FNA) SPECIMEN FROM NECK LYMPH NODE/S ENLARGEMENT CLINICALLY DIAGNOSED AS TUBERCULOUS LYMPH ADENITIS Winarti, Ni Wayan; Sriwidyani, Ni Putu
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

Diagnosis of Tuberculous (TB) lymph adenitis is still problematic due to paucibacillar. Since histopathological biopsy examination is relatively expensive and needs times, FNA is being more frequently chosen. The specimen from FNA can be processed for cytological and PCR tests, but there is no data available describe the characteristic of the result of both methods. Hence, study is needed in order to improve knowledge and health services. A cross sectional study had been conducted from January 1st   until December 31st   , 2011, at Anatomical Pathology Laboratory of Medical School of Udayana University/Sanglah Hospital and Biomolecular Laboratory of Medical School of Udayana University. The subjects were all patients with clinical diagnosis TB lymph adenitis who met the eligibility criteria. During 6 months, there were 46 patients included in the study. They were 65% female and 35% male. The age was ranging from 5 years old until 83 years old and 30-39 years old age group was the highest in number (39%). Positive cytology result was found in 22 cases (48%), while PCR test revealed no positive result. There was significant diference between positive and negative cytology test in pain sensation category, conversely in onset, number of enlarged lymph node/s, localization, conglomeration and fixation categories. If every single clinical character was marked with score 1, node/s with accumulative scores 4-6 showed no different cytology result with node/s with score 1-3. This study shows that in detecting TB lymph adenitis using FNA specimen, cytology test was be#er than PCR
HUBUNGAN ANTARA EKSPRESI TELOMERASE REVERSE TRANSCRIPTASE (TERT) DENGAN BERBAGAI PARAMETER KLINIKOPATOLOGIS AGRESIVITAS KARSINOMA TIROID PAPILER KLASIK DI RSUP SANGLAH DENPASAR Hilda Santosa
E-Jurnal Medika Udayana Vol 10 No 8 (2021): Vol 10 No 08(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i8.P09

Abstract

Karsinoma Tiroid Papiler (KTP) merupakan keganasan tiroid tersering di seluruh dunia. Sebagian besar KTP memiliki prognosis baik, sekitar 10% kasus menunjukkan gambaran klinikopatologis agresif, dan sebagian terkait mutasi promoter Telomerase Reverse Transcriptase (TERT). Tujuan penelitian ini adalah membuktikan hubungan antara ekspresi TERT dengan berbagai parameter klinikopatologis agresivitas KTP klasik di RSUP Sanglah Denpasar. Penelitian ini menggunakan rancangan analitik potong lintang. Sampel adalah semua penderita KTP klasik yang dilakukan pemeriksaan histopatologi di Laboratorium Patologi Anatomi RSUP Sanglah tahun 2017-2019 dengan besar sampel 43. Ekspresi TERT dinilai dengan pemeriksaan imunohistokimia, interpretasi menggunakan H-score. Hubungan ekspresi TERT dinilai pada parameter agresivitas, usia, ukuran tumor, perluasan ekstratiroid, LVI, metastasis KGB regional,. Dianalisis dengan uji Chi-square dengan nilai kemaknaan p<0,05. Hasil penelitian didapatkan hubungan yang signifikan antara ekspresi TERT dengan agresivitas KTP klasik (p=0,041). Terdapat hubungan yang signifikan pula antara ekspresi TERT dengan parameter perluasan ekstratiroid (p=0,010), dan metastasis KGB (p=0,036), namun tidak terdapat hubungan yang signifikan dengan parameter usia (p=0,202), ukuran tumor (p=0,780), dan LVI (p=0,137). KTP klasik dengan ekspresi TERT tinggi memiliki kemungkinan 1,84 kali lebih besar untuk perluasan ekstratiroid, 2,36 kali lebih besar untuk metastasis KGB, dan 2,53 kali lebih besar untuk menjadi agresif. Sebagai simpulan, terdapat hubungan antara ekspresi TERT dengan agresivitas KTP klasik parameter perluasan ekstratiroid dan metastasis KGB regional. Diharapkan pemeriksaan TERT dipertimbangkan untuk dikerjakan rutin pada KTP klasik disamping dari penilaian faktor-faktor agresivitas klinikopatologi, serta sebagai salah satu penanda prognosis buruk pada KTP klasik dalam memprediksi risiko kekambuhan.Kata kunci : TERT, Karsinoma Tiroid Papiler Klasik, Agresivitas, IHK, Klinikopatologis
PERAN MUTASI GEN p53 PADA KARSINOGENESIS SEL BASAL KULIT Dewi, Kadek Pramesti; Winarti, Ni Wayan
Medicina Vol 45 No 1 (2014): Januari 2014
Publisher : Medicina

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Abstract

Karsinoma sel basal (KSB) merupakan keganasan kulit non-melanotik tersering dan mempunyai kaitan erat dengan paparan sinar ultra violet (UV). Keganasan ini berasal dari sel-sel pluripotensial stratum basalis epidermis maupun selubung akar folikel rambut. Gambaran klinis dan histopatologis terdiri dari KSB tipe klasik (noduler) dan KSB varian (tipe superfisial, fibroepithelial, KSB dengan diferensiasi adneksal, basoskuamous, infiltrating, morpheaform).Kanker pada tubuh manusia muncul karena adanya mutasi genetik pada gen-gen yang terlibat dalamkontrol pertumbuhan sel, seperti onkogen, tumor suppressor gene, gen apoptosis, dan DNA repair gene.Pada kebanyakan kasus KSB, gen yang tersering mengalami mutasi adalah tumor suppressor genep53. Mutasi ini timbul akibat paparan langsung sinar UV, bergantung pada dosis, durasi dan intensitas paparan.Gen p53 dikenal dengan sebutan guardian of the genome, karena fungsinya sebagai sensor terhadapterjadinya kerusakan DNA. Adanya kerusakan DNA menginduksi aktivasi p53 untuk menghentikan siklus sel saat memasuki fase G1, sehingga memberikan kesempatan kepada DNA repair proteinbekerja memperbaiki kerusakan DNA. Lebih dari itu, p53 juga mengaktivasi gen GADD45 (growth arrest and DNA damage) untuk membantu perbaikan DNA. Jika perbaikan gagal, p53 akanmengarahkan sel dengan DNA yang rusak ke mesin apoptosis.Pada sel-sel basal terpapar UV, gen p53 mengalami mutasi dan inaktivasi. Karena itu, sel-sel dengan DNA yang mengalami kerusakan non-lethal akan mengalami ekspansi klonal sehingga tumbuh menjadilesi pra kanker dan akhirnya kanker (KSB). [MEDICINA 2014;45:38-42]
Hubungan antara Ekspresi Vascular Endothelial Growth Factor (VEGF) dengan Berbagai Parameter Patologik Karsinoma Sel Skuamosa Serviks Uteri di RSUP Sanglah Denp annie minerva datui; Ni Wayan Winarti; Luh Putu Iin Indrayani Maker; I Gusti Ayu Sri Mahendra Dewi; I Made Muliarta; Ni Putu Sriwidyani
E-Jurnal Medika Udayana Vol 10 No 8 (2021): Vol 10 No 08(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i8.P08

Abstract

Cervical cancer is the second most common malignancy in women with increasing morbidity and mortality rate. VEGF is known as one of pro-angiogenic factors that induce angiogenesis in various malignancy. VEGF overexpression is associated with poor prognosis and plays an important role in cervical cancer progression. This study aimed to investigate the association between VEGF expression and pathological parameters of squamous cell carcinoma of uterine cervix in Sanglah General Hospital Denpasar. This is a cross-sectional study design. The sampel size was 36 paraffin blocks which were selected by consecutive sampling. Pathological parameter data were divided into 2 categories; tumor size (£4 cm, >4 cm), tumor extension (intra and extra-uterine), lymphatic vascular invasion (positive, negative), vascular density (low, high) and lymph node metastasis (positive, negative). VEGF expressions were examined by imunohistochemical technique and evaluated by Histo-Score method. All variables were analyzed by Chi-square analysis with significance value p <0.05. Chi-square analysis revealed an association between tumor size and VEGF expression (p=0.035). In addition, large tumor size (>4 cm) has 2.17 times probability of causing high VEGF expression. VEGF expression were not associated with tumor extension (p=0.502), lymphatic vascular invasion (p=0.346), vascular density (p=0.364) and lymph node metastasis (p=0.209). This study has proved that tumor size is associated with VEGF expression. Large tumor size has greater risk of causing high VEGF expression therefore anti-VEGF targeted therapy could be proposed in large tumor size. There were no association between VEGF expression and tumor extension, lymphatic vascular invasion, vascular density and lymph node metastasis. Keywords: VEGF expression, squamous cell carcinoma, uterine cervix.
Histopathology Interstitial Severity Index Associated with Glomerular and Tubular Severity Index in Nephrotic Syndrome Patients Reny Setya Pratiwi Duarsa; Ni Wayan Winarti; I Gde Raka Widiana
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2019): September - December 2019
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1104.906 KB) | DOI: 10.32867/inakidney.v2i3.30

Abstract

Introduction: Nephrotic syndrome is characterized by massive proteinuria due to leakage of glomerular basal membrane, and subsequent process in tubular and interstitial tissue. It should be elucidated whether the severity of histopathological lesions in compartments of kidney tissue play a role and whether lesion in those compartments associated one to another. Aim: The study aims to correlate severity histopathologic lesions among compartments in kidney tissue. Method: All patients with nephrotic syndrome were biopsied and the cores were stained with Hematoxylin-Eosin, PAS, Masson’s Trichrome to look at glomerular, tubular, interstitial and vascular involvements. Glomerular abnormalities including mesangial hypercellularity, endocapillary hypercellularity, membranous; tubular, interstitial, and vascular severities were scored according to type, activity, severity and distribution in histopathologic features. Results: This study included 46 patients consisted of 16 (34.8%) males and 30 (65.2%) females, aged 26 ± 10 years, SBP 121.7 ± 13.10 and DBP 78.21 ± 7.80 mmHg, diagnosed with 14 lupus and 32 non-lupus nephrotic syndrome. Histopathologic abnormalities showed glomerular index was 4.26 ± 2.34, tubular index was 3.09 ± 1.90, interstitial index was 3.02 ± 1.48, vascular index was 0-3, pathologic index was 10.56 ± 4.54. There was significant correlation of severity index between interstitial and glomerular lesions (R=0.49, P=0.001), and between interstitial and tubular lesions (R=0.45, P=0.002). However, there were no significant correlations of severity index between interstitial and vascular lesions, and glomerular and tubular lesions. Conclusion: There are significant correlations of severity index between interstitial with glomerular and tubular lesions. It may implicate that histopathological process in interstitial tissue plays a central role in the pathogenesis of proteinuria in nephrotic syndrome.
Terminalia ferdinandiana inhibited the increased of matrix metalloproteinase-1 and prevent collagen decreased in mice skin exposed to UV-B Shalihaty Emy; Ida Sri Iswari; Ni Wayan Winarti
Neurologico Spinale Medico Chirurgico Vol 4 No 1 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i1.136

Abstract

Background: Kakadu cream contained 0,1% Kakadu plum (Terminalia ferdinandiana) extract with a high content of phenolic compound, flavonol, tocopherol, luthein, chlorophyll, and ellagic acid has potential to prevent the Ultraviolet-B (UV-B) effect on skin aging acceleration. To date, there’s no in vivo experiment on the effect of kakadu plum extract on collagen nor matrix metalloproteinase-1 (MMP-1). This research aims to evaluate the effectiveness of Kakadu cream administration in inhibiting the increase of MMP-1 expressions and prevent the decrease of collagen amount in mice (Mus musculus) skin exposed to UV-B. Methods: An experimental study with a post-test only control group design was employed in 36-male-mice, 6-8 weeks old, weighing 20-25 grams. The samples were divided randomly into two groups, a control group given base cream and the study group, given Kakadu cream 0,1% on their shaved backs, 1 cm2 in size as the UV-B exposure's location. The UV-B irradiation was done three times a week for 4-weeks. The base and Kakadu cream were given twice a day. Comparative analysis was carried out to compare MMP-1 expression and collagen amount in both groups. Results: The results show that the mean of MMP-1 expression on the study group was significantly lower compared to control group (p<0.001). The mean collagen amount was significantly higher in the study group than in the control group (p< 0,001). Conclusion: From the results, can be concluded that Kakadu cream inhibited the increase MMP-1 expression and prevent the decrease of collagen amount in mice skin exposed to UV-B.
Centella asiatica extract cream inhibited microphthalmia-associated transcription factor (MITF) expression and prevented melanin amount increase in Guinea pig skin exposed to ultraviolet-B Fatri Idana; Anak Agung Gde Putra Wiraguna; Ni Wayan Winarti
Neurologico Spinale Medico Chirurgico Vol 5 No 1 (2022)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v5i1.177

Abstract

Background: Centella asiatica has been popularly used in cosmetic products, especially due to its antioxidant benefits in soothing and healing wounds. However, the inhibition of melanogenesis in the content of Centella asiatica has not been widely studied. This study aimed to prove the effectiveness of 10% Centella asiatica cream on male Guinea pig (Cavia porcellus) skin exposed to UVB. Methods: The randomized posttest-only control group study was conducted on 36 Guinea pigs aged 3-months, body weight 300-350 grams with a healthy skin condition. They were randomly divided into two groups; each consists of 18 Guinea pigs. The first group was a control group given base cream 20-minutes before and 4-hours after UVB exposure, 3-times-a-week for two weeks. The second group was the treatment group given 10% Centella asiatica cream and expose to UVB with the same procedure. The histopathological preparations were made using a punch biopsy after intervention was completed. Immunohistochemical staining was performed to measure the expression of microphthalmia-associated-transcription-factor (MITF) and Masson-Fontana to measure the amount of melanin. Data analysis was conducted to compare the results in both groups. Results: The treatment group had a significantly lower mean MITF expression (13.61 ± 5.36 vs. 27.24 ± 6.50%) and melanin amount (5.95 ± 3.81 vs. 16.59 ± 5.77%) (p < 0.001) compared to the control group. Conclusion: The administration of cream consists of Centella asiatica extract 10% effectively inhibits the expression of MITF and prevented the increase of melanin amount in male guinea pigs (Cavia porcellus) exposed to UVB.
Eucalyptus globulus essential oil increased neovascularization and vascular endothelial growth factor expression in male wistar rats exposed to UVB Noviana Indrawati; Ida Sri Iswari; Ni Wayan Winarti
Neurologico Spinale Medico Chirurgico Vol 4 No 3 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i3.187

Abstract

Background: Eucalyptus globulus essential oil contained 1,8-cineol, which may accelerate wound healing. This study aimed to prove Eucalyptus globulus essential oil's effect on increasing neovascularization and Vascular Endothelial Growth Factor (VEGF) expression in Wistar rats skin exposed to ultraviolet B (UVB). Methods: A Post-test only controls group study design was applied on 36 male Wistar rats, aged 3-4 months old, weighing 150-200 grams. The animal subject was exposed to UVB (65 mJ/cm2, 65 seconds for seven days), injured on their back using a punch biopsy with a diameter of 10 mm, and divided into two groups. For seven days, on the wound, the control group was given 2 cc of 0.9% NaCl twice a day, while the treatment group was given Eucalyptus globulus essential oil (2 cc). Both groups were given oral Amoxicillin three times a day. The skin tissue was taken on day eight to assess neovascularization and VEGF expression. Results: The results show that neovascularization in the treatment group was higher than in the control group (p < 0.05). Meanwhile, the median VEGF expression in the treatment group was also higher than in the control group (p < 0.05). Conclusions: Topical administration of Eucalyptus globulus essential oil increased neovascularization and VEGF expression in the skin of male Wistar rats injured and exposed to UVB. Further research is needed to assess the effectiveness of the essential oil in enhancing neovascularization and VEGF expression in humans with multiple exposures at different doses to optimize the wound-healing effect.
HUBUNGAN ANTARA EKSPRESI EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) DENGAN P-STAGE PADA ADENOKARSINOMA KOLOREKTAL TIPE TIDAK SPESIFIK DI RSUP SANGLAH DENPASAR Sylvi Diahningrum; I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; I Made Gotra; Ni Wayan Winarti; I Made Muliarta
E-Jurnal Medika Udayana Vol 11 No 7 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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Abstract

ABSTRAKEGFR memegang peranan penting dalam progresifitas dari KKR. P-Stage merupakan faktor prognosis independen pada KKR. Tujuan penelitian ini adalah untuk membuktikan adanya hubungan ekspresi EGFR dengan P-Stage pada karsinoma kolorektal tipe tidak spesifik di RSUP Sanglah Denpasar. Penelitian ini merupakan cross-sectional study, observasional analitik potong lintang. Sampel adalah penderita adenokarsinoma kolorektal tipe tidak spesifik yang telah dilakukan operasi dan pemeriksaan histopatologi di Laboratorium Patologi Anatomik RSUP Sanglah, Denpasar yang memenuhi kriteria inklusi dan eksklusi yang ditetapkan peneliti dengan besar sampel 46 pasien. P-Stage adalah sistem pengelompokan pasien yang dibuat berdasarkan penggabungan nilai dari 3 faktor prognosis yaitu umur pasien, derajat diferensiasi dan ukuran tumor, dikelompokkan menjadi P0 dan P1. Hasil penelitian dianalisis dengan analisis Chi square menganalisis hubungan antara ekspresi EGFR dengan P-Stage pada adenokarsinoma kolorektal tipe tidak spesifik di RSUP Sanglah Denpasar. Analisis uji rasio risiko prevalensi untuk mengetahui rasio risiko prevalensi dari ekspresi EGFR dengan P-stage. Nilai kemaknaan ditetapkan pada p<0,05. Hasil penelitian menunjukkan rentang usia 81 tahun, median 61,5 tahun dan rerata usia 61,98±9,824 tahun, kasus terbanyak pT3 (80,4%), derajat diferensiasi sedang (71,7%), lokasi tumor di kiri (45,7%), laki-laki (67,4%), P0 (67,4%) dan ekspresi EGFR positif (69,6%). Dari analisis chi-square didapatkan hubungan yang signifikan secara statistik antara ekspresi EGFR dengan P-Stage (p= 0,036). Pada analisis estimasi risiko didapatkan adenokarsinoma kolorektal tipe tidak spesifik yang memiliki ekspresi EGFR positif memiliki risiko 10 kali lebih besar ditemukan dengan P-stage P1 dibandingkan dengan kasus ekspresi EGFR negatif (IK 95% 1,177-86,846).Kata kunci: Adenokarsinoma kolorektal, Ekspresi EGFR, P-Stage, Faktor Prognostik
Co-Authors Anak Agung Ayu Ngurah Susraini Anak Agung Gde Putra Wiraguna annie minerva datui Arlene Elizabeth Padang Fatri Idana Herman Saputra Herman Saputra I Dewa Nyoman Wibawa I Gde Raka Widiana I Gusti Ayu Agung Elis Indira I Gusti Ayu Sri Mahendra Dewi I Ketut Agus Somia I Made Gotra I Made Muliarta I MADE MULIARTA . Ida Ayu Ista Nariswari Ida Ayu Jelantik Astuti Ida Ayu Krisna Cantika Dewi Ida Ayu Meilasari Dewi Ida Bagus Nyoman Putra Dwija Ida Sri Iswari Kadek Agus Suhardinatha Putra Kadek Pramesti Dewi, Kadek Pramesti Ketut Tuti Parwati Merati Luh Putu Iin Indrayani Maker Made Dalika Nareswari Made Yogi Oktavian Prasetia Ni Kadek Ayu Maya Damayanti Ni Kadek Ayu Maya Damayanti Ni Made Dewi Dian Sukmawati Ni Putu Ekawati Ni Putu Sriwidyani Nicholas Wijayanto Noviana Indrawati Putu Erika Paskarani Reny Setya Pratiwi Duarsa Santi Maya Lestari Siahaan Shalihaty Emy Sylvi Diahningrum Yenny Kandarini