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Papsmear Examination for Diagnosing PreCancer Lesion in Invisible SquamoColumnar Junction Nuranna, Laila; Daud, Sulaeman; Purwoto, Gatot; Winarto, Hariyono; Nuryanto, Kartiwa H
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (105.731 KB)

Objective: To know the concealed pre-cancer lesion in women with invisible squamo-columnar junction (SCJ) by Papsmear examination. Method: This study was a descriptive cross-sectional design starting from August 2014 to March 2015 at several Public Health Cares in Jakarta. A total of 1,682 subjects were screened by Acetoacetate Visual Inspection (AVI) examination. After the data was collected, the process was continued by verification, editing, and coding. The descriptive analysis showed the percentage of SCJ in age distribution, the percentage of AVI examination based on SCJ, and the percentage of Papsmear examination in invisible SCJ according to negative AVI result. Result: There were 1,484 (88.2%) women with the visible SCJ and 198 (11.8%) women with invisible SCJ. The percentage of invisible SCJ in the menopausal women group was 122 (61,6%); meanwhile, in the non-menopausal women group, it was 76 (38.4%). Almost half of the percentage from visible SCJ was found in menopausal women group 45.8% (103/225 women). The positive AVI result was 4 (7.1%) in the menopausal women group and 52 (92.9%) in non-menopausal women group. The result of Papsmear examination with invisible SCJ were 197 (100%) normal. Conclusion: Almost half of visible SCJ was found in menopausal women group. Most of positive AVI result was found in the nonmenopausal women group. All women with the invisible SCJ have a normal Papsmear result. Keywords: acetoacetate visual inspection, papsmear, pre-cancer lesion, squamo-columnar junction

Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Markus, Unedo H; Winarto, Hariyono; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p

The Prevalence of Occult Omental Metastases in Patients with Epithelial Ovarian Cancer Winarto, Hariyono; Indra, Ken
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: Studies regarding omentectomy on epithelialovarian cancer are scarce with conflicting results; this study isaimed to investigate the prevalence of occult metastases inpatients with epithelial ovarian cancer of the omentum.Methods: A cross-sectional study design was used by evaluating themedical records of surgically staged ovarian cancer patients in Dr.Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the periodof January 2009 to December 2015.Results: A total of 51 subjects were involved in this study. One(2%) of 51 subjects was found to have occult metastases in theomentum. The prevalence of metastases of early stage epithelialovarian cancer in 2009-2015 is 33.3% (17 out of 51 subjects),whereas the omental involvement is found only in 2% subjects(1 out of 51).Conclusion: The prevalence of occult metastases of early stageepithelial ovarian cancer in Dr. Cipto Mangunkusumo Hospital,Jakarta, Indonesia, from 2009-2015 in 2% (1/51 subjects).[Indones J Obstet Gynecol 2018; 6-2: 119-122]Keywords: cancer, epithelial, metastases, omentum, ovarian cancer,ovary, prevalence

Radiotherapy Response of Cervical Cancer Patients at a Tertiary Referral Hospital in Indonesia Winarto, Hariyono; Supriana, nana
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the response of radiotherapy and related clinicopathologic characterictics on cervical cancer patients. Methods: This was a retrospective study. Subjects were patients diagnosed with cervical cancer stage IIA-IIIB who had undergone radiation therapy based on standard protocol in our hospital, during the period of January 2014 to December 2015. The clinical factors ofthose patients, such as age, Body Mass Index, blood pressure, hemoglobin level, blood leucocyte count, serum albumin, largest tumor diameter, the International Federation of Gynecology and Obstetrics (FIGO) staging, as well as pathologic characteristic, i.e histopathology and grading were recorded. During radiation protocol until 3months post radiation, we also noted any side effects of gastrointestinal tract, genitourinary tract, and hematologic. Evaluation of radiotherapy response was based on Response Evaluation Criteria in Solid Tumors (RECIST).  Results: A total of 123 subjects were enrolled in this study. 84 cases or 68.29% was complete response, 30 cases or 24.39% was partial response, 6 cases or 4.88% was stabile response, and 3 cases or 2.44% was progressive. Based on gastrointestinal side effect, there was no side effect or grade 0 on 99 cases (80.49%), grade 1 on 20 cases (16.26%), grade 2 on 4 cases (3.25%), grade 3 on 0 case (0%). Based on side effect of genitourinary, there was no side effect or grade 0 on 105 cases (85.37%), grade 1 on 17 cases (13.82%), grade 2 on 1 case (0.81%), grade 3 on 0 case (0%). Based on hematologic side effects, there was no side effecton 108 cases (87.80%), grade 1 on 15 cases (12.20%), grade 2 on 0 case (0%), grade 3 on 0 case (0%). Largest tumor diameter was statistically significant, with p=0.036 (RR 2.64 (1.07-6.56)). Conclusion: The majority of definitive-curative radiotherapy response on cervical cancer stage IIA-IIIB was complete (68.29%). Acute side effects involving the gastrointestinal, genitourinary, and hematologic system were commonly can be tolerable during and 3 months post radiation therapy. Clinicopathologic characteristics significantly associated with the complete response of radiotherapy was the largest tumor diameter. Keywords: largest tumor diameter, radiation response, radiationside effect

Survival and Side Effects of Cisplatin/Cyclophosphamide and Carboplatin/Paclitaxel Adjuvant Chemotherapy in Stage IC-IV Ovarian Cancer Markus, Unedo H; Winarto, Hariyono; Andrijono, Andrijono; Sutrisna, Bambang
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To compare the survival and side effects in epithelial ovarian cancer patients receiving adjuvant chemotherapy of cisplatin/ cyclophosphamide and carboplatin/paclitaxel. Method: We recruited epithelial ovarian cancer patients receiving cisplatin/cyclophosphamide (group A) or carboplatin/paclitaxel (group B) adjuvant chemotherapy after surgery. Chemotherapy was given for six cycles. Overall survival and side effects were assessed. Result: A total of 49 patients were recruited, consisting of 25 patients for group A and 24 patients for group B. In this study, the overall survival of stage IC-IV ovarian cancer patients was 37.3 months in group A (95%CI=31.86-43.46) and 35.5 months (95%CI= 13.93- 43.46) in group B (p

Caspase-3 can not be Used to Predict the Response to Neoadjuvant Chemotherapy Regiment PVB in Cervical Cancer Stage IB-IIA Ambari, Ediwibowo; Winarto, Hariyono; Sutrisna, Bambang; Siregar, Budiningsih
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 3, July 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objectives: To determine the factors that may be used as the prognostic parameter for the therapeutic efficacy of neoadjuvant chemotherapy, which can be used to revising the management of early stage cervical cancer patients with large lesions. Methods: This was a retrospective cohort study. The study was conducted in the Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia. The subjects were 15 cervical cancer stage IB2 and IIA patients with lesions’ size of > 4 cm, who would be treated with neoadjuvant chemotherapy, consisted of cisplatin 50 mg/m2, vincristine 2 mg/m2 and bleomycin 15 mg regiment. The patients’ response would be evaluated after completing 3 series of chemotherapy. Data was retrieved from medical records and cervical biopsy paraffin blocks and examined histopathologically using IHC staining to see expression of caspase-3 with histoscore assessment score. Data was analyzed by univariate, bivariate analysis. Results: Response to PVB neoadjuvant chemotherapy was found in 5 out of 15 patients. None of the clinicopathology variables can be used to predict response to therapy. Expression of caspase-3 as a marker of apoptosis, can not predict the response of the therapy before administrating neoadjuvant chemotherapy either. There is a significant difference between the levels of caspase-3 in epidermoid carcinoma with adenocarcinoma, with p value of 0.02 (RR 6;95% CI 1.69-21.26). Conclusion: Clinicopathologic factors and the expression of caspase-3 before getting chemotherapy neoadjuvant can not predict the succeed of the therapy. [Indones J Obstet Gynecol 2013; 1-3: 156-60] Keywords: caspase -3, clinicopathologic, early-stage cervical cancer lession in large, neoadjuvant chemotherapy response to therapy

Papsmear Examination for Diagnosing PreCancer Lesion in Invisible SquamoColumnar Junction Nuranna, Laila; Daud, Sulaeman; Purwoto, Gatot; Winarto, Hariyono; Nuryanto, Kartiwa H
Indonesian Journal of Obstetrics and Gynecology Volume. 4, No.3, July 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To know the concealed pre-cancer lesion in women with invisible squamo-columnar junction (SCJ) by Papsmear examination. Method: This study was a descriptive cross-sectional design starting from August 2014 to March 2015 at several Public Health Cares in Jakarta. A total of 1,682 subjects were screened by Acetoacetate Visual Inspection (AVI) examination. After the data was collected, the process was continued by verification, editing, and coding. The descriptive analysis showed the percentage of SCJ in age distribution, the percentage of AVI examination based on SCJ, and the percentage of Papsmear examination in invisible SCJ according to negative AVI result. Result: There were 1,484 (88.2%) women with the visible SCJ and 198 (11.8%) women with invisible SCJ. The percentage of invisible SCJ in the menopausal women group was 122 (61,6%); meanwhile, in the non-menopausal women group, it was 76 (38.4%). Almost half of the percentage from visible SCJ was found in menopausal women group 45.8% (103/225 women). The positive AVI result was 4 (7.1%) in the menopausal women group and 52 (92.9%) in non-menopausal women group. The result of Papsmear examination with invisible SCJ were 197 (100%) normal. Conclusion: Almost half of visible SCJ was found in menopausal women group. Most of positive AVI result was found in the nonmenopausal women group. All women with the invisible SCJ have a normal Papsmear result. Keywords: acetoacetate visual inspection, papsmear, pre-cancer lesion, squamo-columnar junction

Radiotherapy Response of Cervical Cancer Patients at a Tertiary Referral Hospital in Indonesia Winarto, Hariyono; Rahakbauw, Erwin; Supriana, Nana
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the response of radiotherapy and related clinicopathologic characterictics on cervical cancer patients. Methods: This was a retrospective study. Subjects were patients diagnosed with cervical cancer stage IIA-IIIB who had undergone radiation therapy based on standard protocol in our hospital, during the period of January 2014 to December 2015. The clinical factors ofthose patients, such as age, Body Mass Index, blood pressure, hemoglobin level, blood leucocyte count, serum albumin, largest tumor diameter, the International Federation of Gynecology and Obstetrics (FIGO) staging, as well as pathologic characteristic, i.e histopathology and grading were recorded. During radiation protocol until 3months post radiation, we also noted any side effects of gastrointestinal tract, genitourinary tract, and hematologic. Evaluation of radiotherapy response was based on Response Evaluation Criteria in Solid Tumors (RECIST).  Results: A total of 123 subjects were enrolled in this study. 84 cases or 68.29% was complete response, 30 cases or 24.39% was partial response, 6 cases or 4.88% was stabile response, and 3 cases or 2.44% was progressive. Based on gastrointestinal side effect, there was no side effect or grade 0 on 99 cases (80.49%), grade 1 on 20 cases (16.26%), grade 2 on 4 cases (3.25%), grade 3 on 0 case (0%). Based on side effect of genitourinary, there was no side effect or grade 0 on 105 cases (85.37%), grade 1 on 17 cases (13.82%), grade 2 on 1 case (0.81%), grade 3 on 0 case (0%). Based on hematologic side effects, there was no side effecton 108 cases (87.80%), grade 1 on 15 cases (12.20%), grade 2 on 0 case (0%), grade 3 on 0 case (0%). Largest tumor diameter was statistically significant, with p=0.036 (RR 2.64 (1.07-6.56)). Conclusion: The majority of definitive-curative radiotherapy response on cervical cancer stage IIA-IIIB was complete (68.29%). Acute side effects involving the gastrointestinal, genitourinary, and hematologic system were commonly can be tolerable during and 3 months post radiation therapy. Clinicopathologic characteristics significantly associated with the complete response of radiotherapy was the largest tumor diameter. Keywords: largest tumor diameter, radiation response, radiationside effect

The Prevalence of Occult Omental Metastases in Patients with Epithelial Ovarian Cancer Winarto, Hariyono; Indra, Ken
Indonesian Journal of Obstetrics and Gynecology Volume 6. No. 2 April 2018
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: Studies regarding omentectomy on epithelialovarian cancer are scarce with conflicting results; this study isaimed to investigate the prevalence of occult metastases inpatients with epithelial ovarian cancer of the omentum.Methods: A cross-sectional study design was used by evaluating themedical records of surgically staged ovarian cancer patients in Dr.Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the periodof January 2009 to December 2015.Results: A total of 51 subjects were involved in this study. One(2%) of 51 subjects was found to have occult metastases in theomentum. The prevalence of metastases of early stage epithelialovarian cancer in 2009-2015 is 33.3% (17 out of 51 subjects),whereas the omental involvement is found only in 2% subjects(1 out of 51).Conclusion: The prevalence of occult metastases of early stageepithelial ovarian cancer in Dr. Cipto Mangunkusumo Hospital,Jakarta, Indonesia, from 2009-2015 in 2% (1/51 subjects).[Indones J Obstet Gynecol 2018; 6-2: 119-122]Keywords: cancer, epithelial, metastases, omentum, ovarian cancer,ovary, prevalence

Augmented Reality Application for Surgery Simulation: Circumcision Augmented Reality Simulation (CARS) Maulana, Muhammad Sobri; Winarto, Hariyono; Amalia, Gassani
Medika Teknika : Jurnal Teknik Elektromedik Indonesia Vol 2, No 1 (2020): October
Publisher : Universitas Muhammadiyah Yogyakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mt.020111

As one of the most common minor surgical procedure performed globally, male circumcision has some complications when performed by medically trained providers and non-medically trained providers. Presently, there is no standardized circumcision training approach, and there have been variable resources and materials used. We constructed a low-cost, and mobile circumcision training application augmented reality called Circumcision Augmented Reality Simulation (CARS). CARS is built in a computer with minimum processor 4Ghz (RAM 4GB, VGA 2GB) and smartphone with Blender, Inkscape, Audacity and Unity3D software. Features that are provided in CARS are including 3D models, animation and sound of circumcision procedure. CARS was tested through several steps including black box technique, response time loading and layer resolution examination. The trial is also done with various smartphones. The angles detected ranging from 20o-90o, with a maximum distance of 4 m using markers measuring 20x22 cm. Based on the percentage of the enclosed barrier, the marker can be detected between 0-90 percent. CARS as an example of augmented reality application for surgery simulation has been successfully built with features performing circumcision simulation and suitable for potential users (medical students and doctors). Implications for future research include assessing reliability and validity by growing its use to a broader population, creating another surgery procedure simulation with augmented reality technology using smartphone.

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