Yudi Mulyana Hidayat
DIVISI ONKOLOGI-GINEKOLOGI DEPARTEMEN OBSTETRI & GINEKOLOGI RUMAH SAKIT HASAN SADIKIN BANDUNG

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Hubungan antara Ekspresi mRNA Gen Epidermal Growth Factor Receptor (EGFR) dengan Penurunan Kadar β-hCG Serum Pasca-evakuasi Mola Hidatidosa Komplit

Indonesian Journal of Cancer Vol 9, No 3 (2015): Jul - Sept 2015
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

In 2008, the incidence of hydatidiform mole that occurred in West Java around 1:28. Malignant transformation of Complete Hydatidiform Mole (CHM) is influenced by many factors, among others, is the expression of the epidermal growth factor receptor (EGFR). This study uses Historical Cohort to retrieve CHM patients data and trophoblastic tissue paraffin block in 2007-2012, and perform examination of Polymerase chain reaction.Results of the study: 40 CHM patients, 24 with EGFR (-) and 16 with EGFR (+), at 12 weeks monitoring post evacuation using the Mochizuki regression curve was not obtained persistent mole in the group with EGFR (-), while the group of EGFR (+), all showed an increase in β-hCG levels. Relative risk (RR) of 3.4 in the CHM group with EGFR (+) into a persistent mole compared with EGFR (-) at 6th week and RR of 13.0 in CHM group with EGFR (+) into a persistent mole compared with EGFR (-) at 8th week. The conclusion of this study demonstrate the suitability of the hypothesis that the higher mRNA gene expression of EGFR, the slower decrease in serum levels of β-hCG after CHM evacuation and expression EGFR (+) may be a predictor of the occurrence of persistent mole. Pada 2008, insiden mola hidatidosa (MH) yang terjadi di Jawa Barat sekitar 1:28. Transformasi keganasan dari mola hidatidosa komplit (MHK) dipengaruhi oleh banyak faktor, antara lain ekspresi Epidermal Growth Factor Receptor (EGFR). Penelitian ini menggunakan metode historical cohort dengan mengambil data dan parafin block jaringan trofoblas pasien MHK tahun 2007−2012, dan dilakukan pemeriksaan POLYMERASE CHAIN REACTion. Hasil penelitian menunjukkan dari 40 pasien MHK, 24 di antaranya EGFR (-) dan 16 EGFR (+) pada 12 minggu pascaevakuasi menggunakan kurva regresi Mochizuki. Tidak didapatkan mola persisten pada kelompok EGFR (-), sedangkan kelompok EGFR (+) semuanya menunjukkan peningkatan β-hCG (mola persisten). Risiko relatif (RR) sebesar 3,4 pada EGFR (+) menjadi mola persisten dibandingkan dengan EGFR (-) pada minggu ke-6 dan RR sebesar 13,0 pada EGFR (+) menjadi mola persisten dibandingkan dengan EGFR (-) pada minggu ke-8. Hasil penelitian ini menunjukkan kesesuaian dengan hipotesis bahwa semakin tinggi ekspresi EGFR maka semakin lambat penurunan kadar β-hCG serum pasca-evakuasi MHK. Ekspresi EGFR dapat menjadi prediktor terjadinya mola persisten.

Epidermal growth factor polymorphism most prevalent in stage II cervical carcinoma

Universa Medicina Vol 33, No 3 (2014)
Publisher : Faculty of Medicine, Trisakti University

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Abstract

Background    Cervical cancer ranks second among female cancers worldwide and is widely associated with human papilloma virus (HPV) infection. However, HPV infection progression is influenced by various host factors. Epidermal growth factor (EGF) is a host factor important for proper epithelial proliferation and development, and may play a role in cervical cancer progression. A functional A61G polymorphism in the EGF gene has been hypothesized to alter EGF concentration in vivo with increasing guanine content associated with greater EGF level. However, a map of A61G polymorphism distribution is not available for any population, including Indonesia. This study aims to determine the distribution of EGF A61G polymorphism among cervical cancer patients at Dr. Hasan Sadikin General Hospital.MethodsA retrospective cross-sectional study was conducted between July-November 2010. Included were 61 cervical cancer patients of various stages at Dr. Hasan Sadikin hospital, who had previously undergone blood sample collection, DNA isolation and finally genotyping for EGF gene using Illumina BeadXpress®. Chi-square test was used to analyse the data. ResultsThe EGF A61G polymorphism was exhibited by 88.5% of patients (as genotypes A/G and G/G). The majority of patients with this polymorphism were of moderate severity (FIGO stage II and III, 42.6% and 38.1% respectively). Patients with the polymorphism but with the lightest severity (FIGO stage I) accounted for 22.2% of the population. ConclusionEGF A61G polymorphism affected the majority of cervical cancer patients and that once stratified, the patients showed intermediate severity in terms of their cancerous growth.

Hubungan antara Karakteristik Klinis Pasien Mola Hidatidosa dengan Performa Reproduksi Pascaevakuasi di Rumah Sakit Hasan Sadikin Bandung

Jurnal Sistem Kesehatan Vol 3, No 1 (2017): Volume 3 Nomor 1 September 2017
Publisher : Universitas Padjadjaran

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Abstract

Pada penderita mola hidatidosa terdapat beberapa karakteristik klinis yang dapat memengaruhi performa reproduksi, yaitu gambaran histopatologi proliferasi berlebih, besar uterus≥20minggu, kadarβ–hCG>100.000mIU/mL, dan kista lutein praevakuasi.Banyak penderita mola hidatidosa merasa khawatir kondisinya dapat memengaruhi fungsi reproduksinya di kemudian hari.Penelitian ini bertujuan untuk mengetahui hubungan antara karakteristik klinis pasien mola hidatidosa dengan luaran kehamilan pascaevakuasi di Rumah Sakit Hasan Sadikin Bandung. Penelitan analitik komparatif ini menggunakan desain kohort retrospektif. Subjek penelitian adalah penderita mola hidatidosa di Rumah Sakit Hasan Sadikin Bandung pada periode 1 Januari 2010-31 Desember 2015 yang memenuhi kriteria penerimaan penelitian. Penelitian mencari hubungan antara variabel karakteristik klinis risiko tinggi (gambaran histopatologi proliferasi berlebih, besar uterus, kista lutein, dan kadar β-hCG) dengan variabel luaran kehamilan pascaevakuasi. Analisis data menggunakan uji Eksak Fisher dengan interval kepercayaan 95%.Subjek penelitian berjumlah 51orang, terdapat 28orang berkarakteristik klinis risiko tinggi. Hasil penelitian menunjukkan karakteristik klinis dan luaran kehamilan pada tipe mola komplit dan mola parsial tidak memiliki perbedaan signifikan(p>0,05). Tidak terdapat hubungan yang signifikan antara gambaran histopatologi proliferasi berlebih, besar uterus, kista lutein, dan kadar β-hCG dengan luaran kehamilan pascaevakuasi(p>0,05). Penelitian ini menyimpulkan tidak terdapat hubungan antara karakteristik klinis pasien mola hidatidosa dengan performa reproduksi pascaevakuasi di Rumah Sakit Hasan Sadikin Bandung.Kata kunci: karakteristik klinis risiko rendah, karakteristik klinis risiko tinggi, luaran kehamilan, mola hidatidosa

Serum Selenium Concentration in Cervical Cancer Patients: Preliminary Study and Literature Review

International Journal of Integrated Health Sciences VOL 4, NO 2, September (2016)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To analyze the role of selenium and glutathione peroxidase (GPx) in cervical cancer.Methods: Serum selenium concentrations and GPx activities of 19 women with cervical cancer along with their healthy counterparts (control group) were obtained. Selenium concentration were measured fluorometrically and GPx activities were measured spectrophotometrically based on the quantity of NADPH used in the reduction of glutathione. Results: The mean of serum selenium concentrations in cervical cancer group was significantly lower than that in the control group, 67.24±15 ng/mL and 77.05±12 ng/mL (p=0.03), respectively. The mean GPx activity in the cervical cancer group was also significantly lower than that in the control group, 128.18±38 ∆mmol NADPH/min/L and 148.9±23 ∆mmol NADPH/min/L (p=0.04), respectively. Multivariate analysis in the cervical cancer patients showed that the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) staging score (early vs. advanced) was inversely correlated with serum selenium concentration (p=0.027).Conclusions: Serum selenium concentration and GPx activity was significantly lower in the cervical cancer patients. Our results demonstrate that selenium and GPx activity may have an important role in the carcinogenesis of cervical cancer. Keywords: Cervical cancer, glutathione peroxidase activity, selenium DOI: 10.15850/ijihs.v4n2.833

Akt–the Mammalian Target of Rapamycin (mTOR) Pathway Inhibition Increases Cervical Cancer Cell Chemosensitivity to Active Form of Irinotecan (SN-38)

International Journal of Integrated Health Sciences VOL 1, NO 1, July (2013)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To investigate the molecular pathway of the cytotoxic effect of SN-38 in human cervical cancer cell lines.Methods: Two human cervical cancer cell lines were treated with various concentrations of irinotecan for 24–72 hours and the sensitivity was analysed using the MTT assay. Apoptosis was further observed through microscopic examinations. The protein expression was determined using Western blot analysis.  Results: CaSki cells demonstrated the highest sensitivity to SN-38, whereas HeLa cells showed the lowest. In cervical cancer cells, SN-38 induced apoptosis through an intrinsic- and extrinsic-pathways. In addition, we showed that SN-38 downregulated the phosphorylation of Akt-mTOR pathways in CaSki cells, but not in HeLa cells. Interestingly, in HeLa cells, which were more suggestive of a resistant phenotype, pre-treatment with LY294002 and rapamycin inhibited activation of Akt-mTOR signaling and significantly enhanced the sensitivity of HeLa cells to SN-38. Conclusions: Irinotecan exerts its anti-neoplastic effects on cervical cancer cells by inducing apoptosis through caspase-cascade. Inhibition of Akt-mTOR, LY294002 and rapamycin, which is targeted to Akt-mTOR pathways, may sensitize irinotecan-resistant cervical cancer cells.Keywords: Akt-mTOR pathways anti-neoplastic drugs, cervix cancer cells, LY294002, rapamycin DOI: 10.15850/ijihs.v1n1.103

Mixed Juice Consumption During Labor to the Mother's Blood Lactate Levels

Global Medical & Health Communication (GMHC) Vol 6, No 3 (2018)
Publisher : Faculty of Medicine Universitas Islam Bandung

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Abstract

Maternal nutritional needs aim to prevent fatigue marked by lactate accumulation. Mix juice is made for the needs of the mother's energy quickly and reduces the accumulation of lactate. The objective of this study was to find out the influence of mix juice during labor to the mother's blood lactate levels. This study used a randomized controlled trial pretest-posttest group design. This research was carried out at the Pelayanan Obstetri Neonatal Emergensi Dasar/PONED (Basic Emergency Obstetric and Neonatal Care/BEONC) Puskesmas (Public Health Center) Garuda, Puter, Pagarsih, Padasuka, and Ibrahim Aji in Bandung city in March–April 2017. The population was all mothers who gave birth in Bandung. Sampling was carried out randomization, the number of samples of 60 people in treatment and control group. The treatment group received mix juice during labor, while the control group was free to eat and drink. The result was analyzed using comparative-numerical categorical analysis test, and the mean difference was analyzed using unpaired t test. The results showed the average increased in blood lactate levels in the treatment group (1.9 mmol/L) was lower than in the control group (4.0 mmol/L). Statistically, there was a significant difference in elevated blood lactate levels after intervention between the treatment and control group. Mothers who did not receive the mix juice in labor have a risk of elevated blood lactate levels 4 times higher than the mothers who received the mix juice. Conclusion, giving mix juice to the labor process affects the prevention of maternal blood lactate levels. KONSUMSI MINUMAN MIX JUICE PADA PERSALINAN UNTUK KADAR LAKTAT DARAH IBUKebutuhan nutrisi ibu bersalin bertujuan mencegah kelelahan yang ditandai dengan akumulasi laktat. Mix juice dibuat untuk memenuhi kebutuhan energi ibu bersalin secara cepat dan mengurangi penumpukan laktat. Penelitian ini bertujuan menganalisis pengaruh pemberian mix juice terhadap kadar laktat darah ibu. Penelitian ini menggunakan desain randomized controlled trial pretest-posttest group. Penelitian dilaksanakan di Puskesmas Pelayanan Obstetri Neonatal Emergensi Dasar (PONED) Garuda, Puter, Pagarsih, Padasuka, dan Ibrahim Aji di Kota Bandung pada Maret–April 2017. Populasi penelitian adalah semua ibu yang akan melahirkan di Kota Bandung. Penarikan sampel dilakukan secara acak yang berjumlah 60 orang pada kelompok perlakuan dan kontrol. Kelompok perlakuan mendapatkan mix juice selama persalinan, sedangkan kelompok kontrol dibebaskan untuk makan dan minum. Hasil dianalisis menggunakan uji analisis komparatif kategorik numerik dan perbedaan rerata dianalisis menggunakan uji t tidak berpasangan. Hasil penelitian didapatkan rerata kenaikan kadar laktat darah pada kelompok perlakuan (1,9 mmol/L) lebih rendah dibanding dengan kelompok kontrol (4,0 mmol/L). Secara statistik terdapat perbedaan bermakna dalam kenaikan kadar laktat darah setelah intervensi antara kelompok perlakuan dan kontrol. Ibu yang tidak mendapatkan mix juice pada persalinan memiliki risiko kenaikan kadar laktat darah 4 kali lebih tinggi dibanding dengan ibu yang mendapatkan mix juice pada persalinan. Simpulan, pemberian mix juice pada proses persalinan berpengaruh terhadap pencegahan peningkatan kadar laktat darah ibu.

Perbandingan Fungsi Berkemih pada 3 Hari dan 5 Hari Katerisasi Urin Pascaoperasi Histerektomi Radikal pada Wanita Penderita Keganasan Serviks Stadium Awal

Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 2 September 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Abstract

AbstrakTujuan: Menganalisis perbandingan fungsi berkemih pada pemakaian kateter urin selama 3 hari dan 5 hari pasca operasi histerektomi radikal.Metode: Non-inferiority randomized controlled trial. Subjek penelitian adalah penderita kanker serviks di Rumah Sakit Hasan Sadikin Bandung yang dilakukan operasi histerektomi radikal. Dilakukan penilaian fungsi berkemih dan kejadian infeksi saluran kemih sebelum dan setelah operasi hari ke−3 (kelompok intervensi) dan hari ke−5 (kelompok kontrol). Hasil: Pascaoperasi terjadi penurunan fungsi sensorik 8,5% pada kelompok intervensi dan 13,5% pada kelompok kontrol dan penurunan fungsi motorik 87,5% pada kelompok intervensi dan 150% pada kelompok kontrol. Kejadian infeksi saluran kemih meningkat 6,7% pada kelompok kontrol. Kesimpulan: Penggunaan kateter urin selama 3 hari pasca histerektomi radikal tidak lebih buruk dari 5 hari dan dapat digunakan sebagai manajemen pada penderita kanker serviks pasca histerektomi radikal. Kata kunci: Disfungsi berkemih pasca histerektomi radikal, kateter 3 dan 5 hari pasca histerektomi radikal, infeksi saluran kemih.AbstractObjective: To compare the urinary function after radical hysterectomy  with catheter usage for 3 days and 5 days. Method: A non-inferiority randomized controlled trial. Subjects were women diagnosed with cervical cancer that underwent radical hysterectomy in Hasan Sadikin Hospital Bandung. The study conducted by comparing urinary function and urinary tract infection in 3 days catheterization and 5 days catheterization after radical hysterectomy. Result: Post operation, there was decreased 8,5% sensory function in intervention group and 13,5% in control group and decreased 87,5% motoric function in intervention group and 150% in control group. The urinary tract infection increased about 6,7% in control group. Conclusion:3-days urethral catheterization following radical hysterectomy is non inferior to 5 days urethral catheterization and could be used for management of women with early stage cervical cancer after radical hysterectomy. Key  words: Urinary dysfunction after radical hysterectomy, 3 and 5 days catheterization after radical hysterectomy, urinary tract infection

Serum Selenium Concentration in Cervical Cancer Patients: Preliminary Study and Literature Review

International Journal of Integrated Health Sciences Vol 4, No 2 (2016)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To analyze the role of selenium and glutathione peroxidase (GPx) in cervical cancer.Methods: Serum selenium concentrations and GPx activities of 19 women with cervical cancer along with their healthy counterparts (control group) were obtained. Selenium concentration were measured fluorometrically and GPx activities were measured spectrophotometrically based on the quantity of NADPH used in the reduction of glutathione. Results: The mean of serum selenium concentrations in cervical cancer group was significantly lower than that in the control group, 67.24±15 ng/mL and 77.05±12 ng/mL (p=0.03), respectively. The mean GPx activity in the cervical cancer group was also significantly lower than that in the control group, 128.18±38 ∆mmol NADPH/min/L and 148.9±23 ∆mmol NADPH/min/L (p=0.04), respectively. Multivariate analysis in the cervical cancer patients showed that the Fédération Internationale de Gynécologie et d’Obstétrique (FIGO) staging score (early vs. advanced) was inversely correlated with serum selenium concentration (p=0.027).Conclusions: Serum selenium concentration and GPx activity was significantly lower in the cervical cancer patients. Our results demonstrate that selenium and GPx activity may have an important role in the carcinogenesis of cervical cancer. Keywords: Cervical cancer, glutathione peroxidase activity, selenium DOI: 10.15850/ijihs.v4n2.833

Akt–the Mammalian Target of Rapamycin (mTOR) Pathway Inhibition Increases Cervical Cancer Cell Chemosensitivity to Active Form of Irinotecan (SN-38)

International Journal of Integrated Health Sciences Vol 1, No 1 (2013)
Publisher : International Journal of Integrated Health Sciences

Show Abstract | Original Source | Check in Google Scholar

Abstract

Objective: To investigate the molecular pathway of the cytotoxic effect of SN-38 in human cervical cancer cell lines.Methods: Two human cervical cancer cell lines were treated with various concentrations of irinotecan for 24–72 hours and the sensitivity was analysed using the MTT assay. Apoptosis was further observed through microscopic examinations. The protein expression was determined using Western blot analysis.  Results: CaSki cells demonstrated the highest sensitivity to SN-38, whereas HeLa cells showed the lowest. In cervical cancer cells, SN-38 induced apoptosis through an intrinsic- and extrinsic-pathways. In addition, we showed that SN-38 downregulated the phosphorylation of Akt-mTOR pathways in CaSki cells, but not in HeLa cells. Interestingly, in HeLa cells, which were more suggestive of a resistant phenotype, pre-treatment with LY294002 and rapamycin inhibited activation of Akt-mTOR signaling and significantly enhanced the sensitivity of HeLa cells to SN-38. Conclusions: Irinotecan exerts its anti-neoplastic effects on cervical cancer cells by inducing apoptosis through caspase-cascade. Inhibition of Akt-mTOR, LY294002 and rapamycin, which is targeted to Akt-mTOR pathways, may sensitize irinotecan-resistant cervical cancer cells.Keywords: Akt-mTOR pathways anti-neoplastic drugs, cervix cancer cells, LY294002, rapamycin DOI: 10.15850/ijihs.v1n1.103

Evaluasi Program Deteksi Dini Kanker Serviks dengan Metode See and Treat di Kabupaten Karawang

Indonesian Journal of Obstetrics & Gynecology Science Volume 2 Nomor 1 Maret 2019
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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Abstract

AbstrakTujuan: Kanker serviks merupakan jenis kanker terbanyak nomor dua di kalangan perempuan di Indonesia setelah kanker payudara. Kanker serviks dikenal dengan “silent killer” karena perkembangannya yang sulit dideteksi. Metode see and treat dengan pemeriksaan Inspeksi Visual Asam Asetat (IVA) dan tindakan segera jika ditemukan IVA positif menggunakan krioterapi merupakan upaya untuk menurunkan angka kejadian dan mortalitas yang disebabkan kanker serviks. Tujuan penelitian ini adalah untuk melakukan evaluasi pelaksanaan program deteksi dini kanker serviks di Kabupaten Karawang dari dimulainya pelaksanaan program pilot project dari tahun 2007 hingga sekarang.    Metode: Desain penelitian menggunakan metode mixed method. Rancangan penelitian kuantitatif dengan metode potong lintang dan rancangan penelitian kualitatif dengan melakukan wawancara dengan panduan open-ended question.Hasil: Dari hasil penelitian variabel yang paling berpengaruh terhadap komponen input adalah sumber daya manusia dan dukungan pemerintah berupa pendanaan, pada komponen proses adalah variabel pelaksanaan dan monitoring evaluasi, sedangkan pada variabel output sasaran target program masih jauh dari yang diharapkan. Kesimpulan: Dapat disimpulkan bahwa program deteksi dini  kanker serviks dengan metode see and treat di Kabupaten karawang masih kurang optimal. Dibutuhkan sumber daya manusia yang baik secara kualitas dan kuantitas, ketersediaan sarana dan prasarana, dukungan pemerintah yang optimal, dan sosialisasi masyarakat untuk menunjang keberhasilan program.Kata kunci: Evaluasi program, Kanker serviks, see and treatAbstractObjective: Cervical cancer is the second most common cancer among women in Indonesia after breast cancer. Cervical cancer is known as the “silent killer” because its development is difficult to detect. The see and treat method with IVA examination and immediate action if a positive IVA was found using cryotherapy is an attempt to reduce the incidence and mortality caused by cervical cancer. The purpose of this research is to explore the implementation of early detection program of cervical cancer in Kabupaten Karawang from the beginning of pilot project implementation from year 2007 until now.Method: The research design used mixed method. The design of quantitative research with cross sectional method and qualitative research design by conducting an interview with open-ended question guide. Result: From the results of research, the most influential variables on the input components are human resources and government support in the form of funding, the component of the process is the implementation and evaluation variables evaluation, while the target output variable target program is still far from expected. Conclusion: It can be concluded that early detection program of cervical cancer with see and treat method in Karawang district is not optimal. Good human resources needed in quality and quantity, availability of facilities and infrastructure, optimal government support, and socialization of the community to support the success of the program.Key words: Cervical cancer, program evaluation, see and treat