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The profile of physical activity and coronary risk factors in Monica Jakarta survey.
(2001-01) Kusmana, Dede
A population study was done to know the profile of daily physical activity including sports, and its influence on major coronary risk factors in three districts of Jakarta using questionnaire, physicaL and laboratory examination, and 12 leads ECC. The questionnaire gave the data about physical activity (work load and sport), and smoking habit. Work load was divided into light, moderate and heavy. Sport activity was divided into regular (≥ twice a week, 20 minutes or more), irregular (≤ once or occasional), and no sport activity. In addition, blood pressure (hypertension was grouped according to WHO criteria), total cholesterol (regarded as hypercholesterolemia when > 200 mg%), and ECG were measured. ECG interpretation was done using Minnesota Code. Statistical analysis was done using SPSS. Out of 2400 people there were 2073(86.4%) respondents that consist of 1086 females and 987 males. The profile of physical activity as a whole showed 33.4% light, 50.7% moderate and 15.8% heavy activity. OnLy 22.5% of respondents had sport regularly, while 30.3% had sport irregularly, and 47.2% had no sport activity. The type of sport was walking (45.0%), callisthenic (22.0%) jogging/running (15.6%), badminton (6.5%), volley ball/soccer (4.1%), tennis (3.8%), and golf (0.1%). There was a significant difference in the prevalence of hypertension between people with heavy (12.0%), moderate (44.8%) and light work load (43.2%) (P<0.003), in the prevalence of hypercholesterolemia (13.2%: 50.8%: 36%) (P<0.0003), and smoking (19.7%; 44.1%: 36.2%) (P<0.00001), respectively. The difference also occurred in the prevalence of abnormal ECG (Q/QS, ST and T abnormalities) between people having regular sport (19.0%), irregular (22.7%), and no sport activity (58.3% (P<0.05). The number of respondents having enough physical activity (including regular sport) was relatively low. Therefore, promotion should be done as a preventive method to overcome cardiovascular risk factors.
The immunohistopathological features of prurigo Hebra.
(2001-01) Boediardja, Siti Aisah; Tjarta, Achmad; Cornain, Santoso; Budimulja, Unandar; Djuanda, Adhi; Roostini, Endang S; Hartati, Meny
Until now the pathologic mechanisms of prurigo Hebra (PH) is still understood. Earlier study the genetic inheritance of PH showed the multifactorial pattern. Considering the genetic inheritance and the existence of allergic reaction to insects bite in all patients, might be the mechanisms followed hypersensitivity reactions. The purpose of this study is to evaluate the general and specific local inflammatory features of early and late lesions of prurigo Hebra (PH). Fifty biopsy specimens of early and late lesions of prurigo Hebra patients were processed with haematoxylin-eosin (HE) and immunoperoryde (lP) staining using monoclonal antibodies against specific inflammatory cells namely B cells, T cells, helper T (CD4+) cells, supressor T (CD8+) cells, Langerhans cells, and antigen presenting cells (APC) that expressed HLA-DR antigen. HE-stained specimens: In early lesions, PMN cells were few, while eosinophils were present in great quantity and independent of mast cells and plasma cells; this feature was similar to that of insect bite reaction. IP-stained specimens: In late lesions, the amounts of lympho-histiocytic infiltration consisting of T cells, CD8+ cells, HLA-DR-expressing APCs were greater than those of early lesions, although it was not statistically significant. An exception was for the CD4+ cells, whose number in early lesions was significantly higher. The ratio of CD4+ to CD8+ in early lesions was higher than in late lesions (3/1: 2/1). This suggested that CD4+ cells were predominant. B cells, which were normally absent, appeared in small quantity in both early and late Lesions. The presence of B cells was not statistically correlated with T cells or eosinophils. The number of Langerhans cells in late lesions was higher than in early lesions. There was a strong correlation (r=0.39) between T cells and HLA-DR-expressing antigen-presenting cells (APCs/HLA-DR). Those cells found in great qunntity suggested that PH patients usually expose to extrinsic factors. In some cases with severe condition, the presence of eosinophils was more profound and was statistically significant. It is conclude that immunohistopathological mechanisms of PH follow the mixed types (one and IV) hypersensitivity reaction.
Possible factors influencing high serum Prostate-specific Antigen (PSA) in Indonesian patients with Benign Prostatic Hyperplasia (BPH).
(2001-01) Rahardjo, Djoko; Pakasi, Levina S; Birowox, Ponco; Gardian, Siti Tersiani K; Himawan, Sutisna
Benign prostatic hyperplasia (BPH) cases in Indonesia frequently associated with high serum prostate specific antigen (PSA). To explore possible factors that could increase serum PSA level, we performed a retrospective, cross-sectional study on 805 consecutive patients in Sumber Waras and Dr. Cipto Mangunkusumo Hospitals from 1994 to 1997. Clinical manifestations were evaluated and prostate biopsies were performed if indicated. Complete histopathological data were only available in 82 BPH patients with no urinary retention from 1998-1999 and a thin section of paraffin blocks of BPH patients which still could be found from 1994-1999 was analyzed using flow cytometer to obtain the S-phase fraction as a parameter of proliferative activity, From 805 patients, 461 (57%) presented with urinary retention and need to be catheteized. Catheteization significantly increased PSA level if compared to noncatheterized patients (16.3 vs. 6,8 ng/mL, p= 0,000). Another data of 82 uncatheteized patients from 1998-1999 has revealed that 79 patients (96.3%) had chronic prostatitis and 19 (23.2%) showed the presence of prostatic-intraepithelial neoplasia (PIN) with an increase of PSA level (5.4 ng/mL). The S-phase fraction of BPH without PIN cases was significantly higher in cases with PSA > 4 ng/ml than patients with PSA ≤ 4 ng/ml (I3.1% vs. 8.9%, p=0,008). As conclusion, the high serum PSA level was mostly due to urethral catheteization and increased prostate volume. There was a tendency of increasing PSA in subclinical inflammation and PIN. Cases with high PSA also showed high proliferative activities which is suggestive of mitogenic activity.
Metastatic chondroblastoma.
(2001-01) Hutagalung, Errol U; Gumay, Saukani
A case of chondroblastoma, which is a benign tumor of the bone, with distant metastases to the lung and abdominal wall is reported. The clinical course of the disease was progressive like that of malignant process.
Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study.
(2001-01) Misbach, Jusuf
To better understanding the demographic characteristics, admission time, clinical pattern, risk factors, stroke type, length of stay, and discharge outcome of hospitalized acute stroke patients in ASEAN member countries, ASEAN Neurological Association (ASNA) formed a Standing Commiltee for Stroke in 1996 and this is the first ASNA Stroke Epidemiological Study using the same stroke protocol. This prospective hospital based study was conducted in seven ASEAN countries (Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) by participating neurologists from October 1996 to March 1997. Of the 3723 consecutive hospitalized stroke patients (2030 males and 1660 females) from 44 participating hospitals in this study ie Brunei (n=53), Indonesia (n=2065), Malaysia (n=300),Philippines (n=545),Singapore (n=232), Thailand (n=244) and Vietnam (n=284), the mean age was 59.0 ± 13,8 years 16% of patients were younger than 45 years and 37% of patients were older than 65 years. There were no significant differences in age at onset among stroke subjects except in Vietnam (younger) and Singapore (older). The sex distribution showed a slight higher prevalence of women in Singapore and in the age group > 64 years. The mean adrnission time was 41.5 ± 87.0 hours, 19% of patients were admitted within 3 hours, 29% within 6 hours and 66% more than 6 hours (delayed admission) especially in Malaysia and Singapore (80% and 77% respectively). Motor disability was the most prevalent clinical feature in all countries and carotid bruit was the rarest (1%). Hypertension was the most common risk factor (68%) in all countries, followed by TIA (35%), smoking, diabetes mellitus, ischnemic heart disease and hypercholesterolemia. CT scan was performed on 76% of subjects. The diagnostic classification was non lacunar anterior circulation (32%), lacunar infarction (14%), hemorrhagic stroke (26%), SAH (4%). Mean length of stay was 11.4 ± 11.8 days. Most of the patients discharged from the hospital were alive improved (57%) and mean death rate was 22%, highest in Thailand (45%) and lowest in Brunei (8%). This hospital based stroke data showed the recent characteristics of stroke pattern in seven ASEAN member countries and it will be very important data for health policy maker in these countries and for further cooperative researches in the future.
The risk factors profile of coronary heart disease in dyslipidemic patients : Results from a survey in 13 cities in Indonesia.
(2001-01) Kalim, Harmani; Kaligis, Rinambaan Willem Mamentu
The incidence of coronary heart disease (CHD) has significantly increased and has been associated to the high mortality rate in Indonesia. One important CHD risk is the abnormal lipid profile or dyslipidemia, but there are other risk factors that has been associated with CHD in Western population. In Indonesia, data on CHD risk factors are very limited and usually only available as hospital-based data. The aim of this study is to analyze the CHD risk profile in the private clinical practice setting and to determine the factors affecting CHD in dyslipidemic patients in Indonesia. This study is a cross-sectional survey which targeted physicians in 13 cities in Indonesia who regularly treat patients with dyslipidemia. The majority of dyslipidemic patients in clinical practice setting was the CHD high-risk group. Age, Iow HDL-C and hypertension were the most common risk factors. The prevalence of the risk factors and the proportion of dyslipidemic patients which belongs to the high risk group were comparable to the result of US (L-TAP) study.
The role of plasma C-reactive protein in the evaluation of antibiotic treatment in suspected neonatal sepsis.
(2001-01) Aminullah, Asril; Sjachroel, Djaja Noezoeliastri; Hadinegoro, Sri Rezeki; Madiyono, Bambang
Analysis of serial C-reactive protein (CRP) levels was done to evaluate the effectiveness of antibiotic treatment in 35 suspected neonatal sepsis (SNS) patients who were hospitalized at Cipto Mangunkusumo Hospital, Jakarta. This cross sectional study was conducted from April to September 1999. Among 35 SNS patients, 18 had positive blood culture, 10 of which had positive CRP level at the time of diagnosis. Among 17 patients with negative blood culture, 9 had negative CRP level. Serial CRP in severe cases with positive CRP titer showed persistent high CRP level, and in those with negative CRP titer rose up to day 4 of treatment. On the other hand patients who were discharged and have negative blood culture demonstated low CRP level in day 4. This study confirms the benefit of serial CRP examination in the evaluation of antibiotic treatment in SNS.
Age, body posture, daity working load, past antihypertensive drugs and risk of hypertension: A rural Indonesian study.
(2001-01) Basuki, Bastaman; Setianto, Budhi
Indonesia has about 210 million inhabitans and most of them live in rural areas, therefore in rural community it is estimated that a big number of hypertensive people can be found. However, few rural community-based studies have been conducted to identify hypertensive risk factors. This study aims to identfy some risk factors related to hypertension in rural areas. The data for this study came from the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta. The study was conducted on July 12, 2000 at 10:00 AM to 1:00 PM in a rural area, the Cijeruk subdistrict in Bogor regency. The subjects were selected randomly using neighborhood cluster. Interviews and blood pressure were taken at the houses of the subjects. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 17-39 year old group, and the risk was most prominent among the 55-59 year group (adjusted odds ratio = 21.62; 95% confidence intervals (CI) = 4.10-113.97). Compared to the subjects with normal body posture, those who were obese had more than 6.3-folds increase in the risk to be hypertensive (adjusted OR = 6.33: 95% CI = 2.62-15.29). In addition, those who discontinued antihypertensive drugs had almost 12-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR = 11.92; 95% CI = 4.61 -30.80). This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs, and whom had light daily working load to prevent hypertension.
Comparison of the effïcacy and safety of isepamicin plus metronidazole and amikacin plus metronidazole in intra-abdominal infections.
(2001-04) Philippi, Bernardus; Lalisang, Toar J M; Th-Akib, Husniah; Setiabudy, Rianto; Hudiono, Johannes; Darmansjah, Iwan
Intra-abdominal infections due to penetrating wound through the abdominal wall or rupture of the gastrointestinal tract are acute conditions requiring prompt surgical intervention and the use of appropriate antimicrobial agents. Isepamicin is an effective aminoglycoside against various Gram-negative pathogens causing intra-abdominal infections. The objective of the present study is to compare the efficacy and safety of isepamicin (15 mg/kgBW IV o.d.) with amikacin (7.5 mg/kgBB b.i.d.), in conjunction with metronidazole for both drugs. An open, randomized, parallel design was applied in this trial. The subject allocation ratio for isepamicin: amikacin is 2:1. Out of 50 patients enrolled in this study, 27 fuffilled the criteria for safety and efficacy population, and 46 for intent-to-treat population. In the safety and efficacy population, the clinical success rare for isepamicin and amikacin group did not differ significantly (i.e., 95% and 100%, respectively). In the intent-to-treat population, the clinical success rates for isepamicin and amikacin group were also insignifficantly different (i.e., 97% and 100%, respectively). The rates of bacteriological elimination for isepamicin and amikacin, were 95% and 100%, respectively in the efficacy and safety population, and 90% and 93%, respectively in the intent-to-treat population. Streptococci and staphylococci were the most frequent (40%) pathogens isolated from pus, and Acinetobacter anitratus (55%) was the most common one isolated from blood. In the efficacy and safety population, the mean (± SD) length of hospital stay in the isepamicin and amikacin groups was 10.7 ± 3.9 and 11.1 ± 3.8 days, respectively, while in the intent-to-treat population, the mean (± SD) length of hospital stay in the isepamicin and amikacin groups was 10.1 ± 3.4 and 10.5 ± 3 days, respectively. In the present study, both aminoglycosides were well tolerated and there was no patient withdrawal associated with side effect. It is concluded that for intra-abdominal infections, intravenous isepamicin given once daily is as effective as intravenous amikacin given twice daily in combination with metronidazole.
Mechanism of normal menstruation and abnormality associated with menorrhagia.
(2001-04) Pawitan, Jeanne Adiwinata
Normal menstruation involves endometrial tissue breakdown and bleeding, followed by hemostasis and repair. Abnormality of this process at any stage may result in changes in the quantity of menstrual blood loss. When menstrual blood loss is greater than 80 ml, it is called menorrhagia. This review discuss the mechanism of normal menstruation, and factors associated with menorrhagia. Those factors are the endometrial bleeding associated factor (ebaf), the role of various cells (migratory leucocytes, macrophages, and mast cells), the role of various substances (lysosomal enzymes, prostaglandins, endothelins, growth factors and its receptors), impairment of fibrinolysis and hemostatic proces, and changes in endometrial blood flow.
Acute mountain sickness.
(2001-04) Sharma, Ashok
Acute mountain sickness, HAPE (high altitude pulmonary edema) and HACE (high altitude cerebral edema) are associated with acute exposure to altitudes greater than 8000 ft. Although usually self limiting, they can be life threatening. We are not yet clear abour the pathophysiological processes in acute mountain sickness. Descent to lower elevation is the definitive treatment for altitude illness. There is no unanimity of opinion regarding other modes of therapy. Treatment consists of bed rest, orygen inhalation and judicious use of morphine, diuretics, steroids and niftdipine as vasodilator therapy.
Lipid Treatment Assessment Project (L-TAP) Study : a survey in 13 cities in Indonesia to evaluate the percentages of dyslipidemic patients achieving NCEP LDL-C target goals after treatment.
(2001-04) Kaligis, Rinambaan Willem Mamentu; Kalim, Harmani
Clinical trials have demonstrated significant benefit from low density lipoprotein cholesterol (LDL-C) lowering for primary and secondary prevention of cardiovascular disease. In the US, it is well recognized that a substantial number of hypercholesterolemic patients were not treated to the LDL-C goals recommended by the National Cholesterol Education Program (NCEP) guidelines. In 1996, the Indonesian Heart Association (PERKI) has issued guidelines recommending goals for screening and lipid treatment in Indonesia adopted from NCEP guidelines; however, the frequency of undertreatment in Indonesia is not known. The objective of this study was to determine the percentage of patients treated with lipid-lowering therapy who reached LDL-C goals as defined by NCEP guidelines in routine clinical practice. This was a cross-sectional survey targeted physicians who regularly treated dyslipidemic patients in 13 cities in Indonesia. Participating doctors were asked on their awareness of NCEP guidelines and to complete the case record form (CRF) of the enrolled patients. One-hundred and eighty-eight (188) out of four hundreds (400) physicians who were invited, have participated in this study. Among the evaluable 1420 CRF, 1082 patients received statins, 301 used fibrates, 14 patients used combination drugs, and 23 others received non-drug treatments only. Success rates on achieving target LDL-C in low-risk, high-risk, and CHD groups were 73.0 %, 43.6 %, and 14.8 %, respectively. Overall success rate in patients using statins was 55.1 %, while in low-risk group, high-risk group, and CHD patients, the success rates with statin were 77.8%, 50.1%, and 18.6 %, respectively. Atorvastatin showed the highest success rate (77.4 %) if compared to other statins. Only 14 % of physicians were knowledgeable about the NCEP goals. Conclusion : A large number of dyslipidemic patients who were on lipid-lowering therapy were not achieving the recommended LDL-C target levels. Success rates were lower in CHD patients and high risk group. Atorvastatin seemed more effective in lowering the LDL-C to target levels. There are still many physicians in Indonesia who do not aware about the NCEP guidelines and LDL-C treatment goals.
The influence of exposure to UVβ of fluorescent light on the bone remodeling of hypoestrogenic macaca fascicularis.
(2001-04) Rachman, I A
The prevention of osteoporosis is a spesific problem that should be dealt with by increasing the women's lift expectation. The decrease of calcitriol and estrogen levels, which have a receptor in the osteoblast, will result in bone mineralization (due to calcitriol) and the information of type 1 collagen (due to estrogen). The formation of calcitriol with the main basic materials from vitamin D3 is achieved with the aid of sunray UVβ, The changes in the lifestyle of women, which make them now accustomed to performing indoor activities and prevent them from being exposed to UVβ all day, have resulted in the decrease of vitamin D3 in calcitriol in women. In addition, when entering the menopausal age they will be threatened with early osteoporosis. The exposure to the UVβ of fluorescent light with the wave length identical to sun of 290-320 nm has long been known as a modality for treating skin diseases in the hope that the production of vitamin D3 will be increased. We exposed Macaca fascicularis, whose estrogen levels were set at normal, beginning low, beginning very low levels, to UVβ of fluorescent light. It showed that the Macaca fascicularis that were exposed to UVβ experienced an increase in osteocalcin with unchanged DPD which means that bone remodeling remains unchanged. By contrast, Macaca fascicularis with normal, beginning low, and beginning very low estrogen levels which were not exposed to UVβ were found to experience a decrease in osteocalcin and unchanged DPD levels. This means that a change has occurred in the bone remodeling toward bone resorption.
Hypoatphalipoproteinemia: Prevalence and the impact of treatment on reaching HDL cholesterol target level in patients with dyslipidemia.
(2001-04) Kalim, Harmani
A low serum high density lipoprotein cholesterol (HDL-C) level is a potent predictor of coronary heart disease (CHD). It has been estimated that 11% of the Framingham men have isolated low HDL-C levels and about 30% of dyslipidemia patients have HDL-C level of less than 35 mg/dl (hypoalphalipoproteinemia). In addition, there is uncertainty regarding the management of these patients. There is no epidemiological data on the prevalence low HDL-C level in dyslipidemia patients and the results of treatment on HDL-C on a large number of patients in Indonesia. We conducted a survey in 13 cities in Indonesia to evaluate the prevalence of hypoalphalipoproteinemia among dyslipidemic patients and the impact of treatment with lipid modification drugs on achieving target level of HDL-C 35 mg/dl or more in routine clinical practice. A total number of 1420 dyslipidemia patients (mean age 50 years, male 58%) were included and analyzed in this report. The overall prevalence of hypoalphalipoproteinemia in our study was 35.4% and it was correlated with the risk level of the patients; 21.9% among low risk group (patient with < 2 other risk factor), 39.6% in high risk group (≥ 2 other risk factors) and 44.3% in patients with CHD. After 12 week treatment, the prevalence decreased to 12%, 20% and 18% in low risk, high risk and CHD patients respectively. The magnitude of HDL-C changes correlated inversely with base-line HDL-C and it was highest (59%) in the lowest HDL-C group (< 25 mg/dl) and the least change (23%) was found in group with the highest HDL-C level (≥ 45 mg/dl). Only 46% of patients with low HDL-C value at baseline achieved normal HDL-C level after treatment. In conclusion, the prevalence of low HDL-C in dyslipidemia patients was high especially in high risk group and in CHD patients. The majority of patients with low HDL-C at base-line could not reach the target level for HDL-C of 35 mg/dl or more after 12 weeks treatment with lipid modification drugs.
Lung cancer among young patients in Dharmais Cancer Center Hospital, Jakarta (1994-1998).
(2001-04) Jusuf, Anwar; Sutandyo, Noorwati; Arumdati, Sariasih; Burhan, Erlina; Suratman, Eddy; Jayusman, A Mulawarman
Lung cancer is usually seen in patients of middle and old age. The disease is rarely seen in patients under 40 years. In Dharmais Cancer Center Hospital 37 patients of 40 years of age or younger were seen. The number was 5.9% of the total of lung cancer cases that was seen in this hospital in 1994 - 1998. The disease was more dominant among males (male to female ratio 3 : 1), age between 26-40 years. Most of the patients were stage IV (45.7%), chief complaints were dyspnea (58.I%) and pain (32.5%). Nonsmall cell carcinoma was the most frequent histologic type (91.9%), small sell carcinoma was seen in 2.7% and in 5.4% the histologic type could not be determined. The treatment consisted of surgery in 9 cases, radiotherapy in 17 cases and chemotherapy in 5 cases. Fourteen patients (38%) died in hospital, the rest were not followed further.
The aging male project.
(2001-04) Saad, Farid
With an increasing life expectancy and a decreasing reproduction rate, the population structure changes. A Jenapharm R & D program investigates the endocrinology of aging men. In men, a decrease in production of sex steroids and other hormones with age can be observed. The typical patterns of daily rhythmicity become less distinct. This is part of a very complex picture in which not only isolated hormones are involved, but also the influence of hormones on each other. Many factors from the external and intemal environment mediated by neurotransmitters constantly affect the highly sensitive hormonal balance. Therefore, aging has also been defined as "the gradual dysfunction of homeostatic processes". Declining testosterone (T) levels are involved in 'andropausal' symptoms in men: loss of libido, erectile dysfunction, insulin receptor resistance, obesity, osteoporosis, disturbances of lipid metabolism, myocardial and circulatory disturbances, impaired well-being and mood. Data are derived from studies in hypogonadal men treated by T replacement. In such parients under T treatment libido increases, fat mass decreases, muscle strenth, bone mineral density and erythropoesis increase. Whether the symptoms of andropause in aging men could successfully be treated by T substitution remains to be investigated. Negative effects of T, especially on the prostate and the cardiovascular system, are under discussion. There is increasing evidence that low T levels seem to be a risk factor for both the prostate and the cardiovascular system. Jenapharm's new testosterone undecanoate formulation for intramuscular injection can be administered every three months. T levels remain within the physiologic range. No supraphysiologic peaks occur. In women, estrogens have beneficial non-genital effects. Studies concentrate on synthetic estrogens for men without feminizing properties such as gynecomastia and reduced testicular size. Several derivatives of 17- alpha estradiol have been synthesized some of which show selectivity for the central nervous system. CNS effects have been demonstrated in female and male animals. Cardiovascular protection by estrogens has been shown in animal and human studies. Atherosclerotic plaque size was reduced after estrogen injections in cholesterol-fed rabbits. Phytoestrogen-fed monkeys had lower total cholesterol and LDL cholesterol and higher HDL cholesterol. Apart from atherosclerotic lesions, coronary artery vascular reactivity was improved. Some of these experimental findings were confirmed in human studies in postmenopausal women with and without estrogen treatment. Whether all of the described estrogenic effects can be seen in men remains to be investigated.
The problem of Taeniasis and Cysticercosis in Irian Jaya, Indonesia.
(2001-04) Margono, Sri S; Ito, Akira; Suroso, Thomas
The disease, caused by the adult and larva of Taenia solium, spread to the western part of Irian Jaya crossing the border of Indonesian to Papua New Guinea. Twenty local health centers reported 638 and 945 new cases with epileptic seizures in 1994 and 1995 respectively. Questionnaires were distributed to 31 respondents with results as follows: 83.9% were illiterate, 93.6% farmers and all of them sometimes ate not well-cooked pork; no other meat was consumed. In this area no healthy drinking water was available; also there was no sanitary facilities. Pigs were roaming around the houses, rarely the pigs were put behind fences. After international collaboration with several institutions, e.g with Asahikawa Medical College, Japan, 29 serum samples were examined by immunoblot with positive results for 67% of the cases suffering from epileptic seizures and 65% with subcutaneous nodules. Moving of people to other areas personal and environmental hygiene, the importance of pigs in the daily life of the community were important issues in maintaning the disease being caused by T.Solium in this area.
The review of the patterns of presentation and various prognostic factors in male breast cancer patients.
(2001-04) Parida, Dillip Kumar; Majhail, Navneet Singh; Rath, Goura Kishore; Julka, Pramod Kumar
This study was aimed to analyze the patterns of presentation, various prognostic factors and therapeutic modalities for the management of breast cancer in male patients. Thirty cases of male breast cancer were treated with radiotherapy at our department between 1983 and 1997. All the patients were treated with radiotherapy besides surgery (26) and chemotherapy (12). Radical mastectomy was performed in 18 patients, while 6 patients were treated with modified radical mastectomy and 2 patients with simple mastectomy. The post operative radiotherapy was applied at the dose of 50 Gy in 25 fractions over a period of five weeks. The chemotherapy was administered in an adjuvant setting. All the patients were received hormonal therapy. Four patients were lost to follow up. The follow up period ranged from 10-92 months with a median of 38 months. The disease-free survival at 2 and 5 years were 87.7% and 54.67%, respectively. One patient recurred locally, whereas 5 patients had distant metastasis. The age, lymph node status at presentation and presence of distant metastasis were the important prognostic factors. At present, the trend is to treat male breast cancer patients like those of females stage per stage. More randomized studies are required for optimizing therapeutic approach.
The histopathological predictor factors in the recurrence of cervical carcinoma stage IB - IIA after radical hysterectomy.
(2001-04) Edianto, Deri; Taufik, Emil; Aziz, M Farid
The aim of this study is to know the incidence of cervical carcinoma stage IB - IIA recurrence after radical hysterectomy and the histopathologic factors which are related to it. This was a retrospective cohort study involving 68 patients with recurrence cervical carcinoma stage IB - IIA who underwent radical hysterectomy, However, there were only 58 cases which fulfilled the study citeria, and therefore were evaluated histopathologically. The histopathologic evaluation consisted of differentiation, inflammatory reaction, lymph-vascular permeation, invasion to the vagina incision margin, and to endometrium, lymph nodes metastasis, and the depth of stromal invasion. The incidence of the cervical carcinoma stage IB-IIA recurrence 2 years after radical hysterectomy was 30.8% (21 out of 68 cases). The recurrence occurred in nine (75%) out of 12 cases with lymph node metastasis, compared to 10 (21.7%) out of 46 cases without lymph node metastasis (P = 0.0004). In addition, eight out of 11 adenosquamous carcinoma cases had recurrence (p = 0.01). There was only one out of the 12 cases with the depth of stromal invasion of < 5 mm that had recurrence compared to 18 out of 45 cases with stromal invasion of > 5 mm (P = 0.02). The clinical factors such as parity, staging, size of the tumor were not statistically significant. The other pathologic factors such as differentiation, inflammatory reaction, and parametrial, vagina incision margin and endometrial invasion were not statistically signifcant. The incidence of the recurrence of cervical carcinoma within 2 years after hysterectomy was related to the pathological risk factors i.e. lymph node metastasis, adenosquamous cell carcinoma and the depth of stromal invasion.
Epstein-Barr virus in non-Hodgkin lymphoma of the tonsil in Indonesian patients.
(2001-04) Kurniawan, A N; Elizabeth, Meryanne; Leong, Anthony S-Y
Twenty cases of tonsillar non-Hodgkin lymphoma seen at the Department of Anatomic Pathology, Faculty of Medicine, University of Indonesia during 1995-1997 were studied clinicopathologically. The specimens were analysed for routine histopathology, in situ hybridization and immunohistochemistry. The lymphoma was found mostly in the 7th decade, the median age was 57.5 year. Male to female ratio was 1:1. The hostological types were 70% of intermediate grade and 30% of high grade of malignancy. All of the lymphomas were B cell lymphomas. EBER and LMP1 were not expressed in all cases.

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