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Journal : Majalah Kedokteran Andalas

PENGARUH OVARIEKTOMI TERHADAP KADAR VEGF,TGF-β, IGF, DAN CA15-3 PADA PASIEN KANKER PAYUDARA STADIUM LANJUT USIA MUDA Rini Suswita; Wirsma Arif; Edison Edison; Zelly Diarofinda
Majalah Kedokteran Andalas Vol 38, No 3 (2015): Published in December 2015
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (553.335 KB) | DOI: 10.22338/mka.v38.i3.p189-200.2015

Abstract

AbstrakKanker payudara stadium lanjut pada usia muda dikaitkan dengan gambaran klinis, patologis dan prognosis yang lebih buruk dibanding usia tua. Ovariektomi merupakan terapi paliatif yang efektif pada pasien ini, dengan menurunkan kadar estradiol yang akan mempengaruhi gen yang terlibat dalam proses proliferasi, diferensiasi, metastasis, angiogenesis, invasi, dan apoptosis. Penelitian ini bertujuan untuk mengetahui pengaruh ovariektomi terhadap kadar VEGF, TGF β, IGF dan CA15-3 pada pasien kanker payudara stadium lanjut usia muda. Penelitian ini menggunakan desain pre dan post test pada 12 pasien kanker payudara stadium lanjut usia muda sebagai subyek penelitian. Pemeriksaan kadar VEGF, TGF β, IGF dan CA 15-3 dilakukan sebelum dan tiga bulan sesudah pasien dilakukan tindakan ovariektomi dengan menggunakan teknik ELISA, kemudian dilakukan analisis statistik dengan uji non parametrik. Penelitian menemukan peningkatan kadar VEGF, TGF β, IGF dan CA 15-3 dan menurun sesudah dilakukan ovariektomi. Analisis statistik menunjukkan pengaruh ovariektomi yang bermakna terhadap penurunan kadar VEGF (p=0,023), TGF β (p=0,02), dan CA 15-3 (p=0,002), tetapi tidak berpengaruh terhadap kadar IGF(p=875). Ovariektomi dapat menurunkan kadar VEGF, TGF β dan CA 15-3 serum, sehingga dapat dipertimbangkan sebagai terapi pilihan pada kanker payudara stadium lanjut usia muda.AbstractAdvanced breast cancer in young age is associated with worse clinical features, pathology and prognosis than old age. Oophorectomy may be an effective palliative therapy in these patients, by decreasing estradiol concentration which will affect genes involved in proliferation, differentiation, metastasis, angiogenesis, invasion, and apoptosis. This research aimed at examining the effect of oophorectomy on the levels of VEGF, TGF-β, IGF and CA15-3 in patients with advanced breast cancer in young age. This study used a pre and post test design in twelve patients with advanced breast cancer in young age. The level of VEGF, TGF-β, IGF and CA 15-3 was measured before and three months after oophorectomy using the ELISA technique. Data was analyzed with non-parametric test. Of the twelve patients studied, there were increased levels of VEGF, TGF-β, IGF, and CA 15-3 before oophorectomy and there was a decrease after oophorectomy performed. Statistical analysis showed that oophorectomy significantly decreased levels of VEGF (p = 0,023), TGF-β (p = 0,02), and CA 15-3 (p = 0,002), but no significant effect on the decrease in IGF levels (p = 0,875 ). Oophorectomy reduces levels of VEGF, TGF β and CA 15-3 serum significantly in the first three months of observation. Thus, it could be considered for the management of advanced breast cancer in young age.
Role Of Endoscopy To Reduce Extreme Hyperbilirubinemia In Lemmel Syndrome : A Case Report Rini Suswita
Majalah Kedokteran Andalas Vol 46, No 4 (2023): Online Juli 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i4.p730-735.2023

Abstract

Duodenal diverticulum is a false diverticulum which is generally asymptomatic, frequently founded incidentally at endoscopy and 22% at autopsy. One to five percent of duodenal diverticulum have complications such as bilio-pancreatic complications. Lemmel syndrome is a complication of bilio-pancreatic characterized by jaundice, increased levels of bilirubin, liver and pancreatic enzymes. Reported a male patient, 72 years old, he complained abdominal pain in the right upper quadrant, yellow eyes and body, and dark tea-colored urine. Abdominal pain with Visual Analog Scale (VAS) value between 6 to 7. Blood test resulted prolonged APTT 37", PT 17.7", INR 1.66, increased in total bilirubin 26.0 mg/dL with a ratio of direct and indirect bilirubin was 15.0 mg/dL and 11.0 mg/dL consecutively, hyponatremia 133 mmol/L, and hypokalemia 5.2 mmol/L. Abdominal CT scan examination showed compression of the distal bile duct (common bile duct) and dilatation of the proximal bile duct, both intra and extra-hepatic bile ducts. ERCP with endoscopic sphincterotomy and biliary stent placement can be an option for drainage and decompression of the biliary tract to prevent further complications to severe hyperbilirubinemia and the effects of biliary tract obstruction.