HERNOMO ONTOSENO KUSUMOBROTO
Department of Internal Medicine, Dr. Soetomo General Hospital

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Analyses of Precore and Core Promoter Mutations of Hepatitis B Virus in Patients with Chronic Hepatitis B in Surabaya, Indonesia JUNIASTUTI, .; AKSONO, EDUARDUS BIMO; UTSUMI, TAKAKO; YANO, YOSHIHIKO; SOETJIPTO, .; HAYASHI, YOSHITAKE; HOTTA, HAK; RANTAM, FEDIK ABDUL; KUSUMOBROTO, HERNOMO ONTOSENO; LUSIDA, MARIA INGE
Microbiology Indonesia Vol 4, No 3 (2010): December 2010
Publisher : Indonesian Society for microbiology

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Abstract

Mutations of precore (A1896) and core promoter (T1762/A1764) of hepatitis B virus can reduce HBeAg production. These mutations are frequently found in the late HBeAg seroconversion. However, it has been a controversy about the role played by precore and core promoter mutations in determining outcome of chronic hepatitis B. In the present study, the variability of precore and core promoter of hepatitis B virus were analyzed using PCR amplification and sequencing, according to the outcome (viral load and HBeAg/anti-HBe) in chronic hepatitis B patients in Surabaya. The study groups included 5 patients with uncomplicated chronic hepatitis B and 10 patients with chronic hepatitis B and liver cirrhosis in Dr. Soetomo Hospital, Surabaya. The control group included 6 blood donors obtained from Indonesia Red Cross, Surabaya. All groups were HBsAg positive. Precore mutation A1896 was predominant in all groups (60%-67% of each), together with precore variant T1858. As reported, precore variant T1858 is a prerequisite for precore A1896 and characteristic for viral genotype. Nevertheless, core promoter mutations T1762/A1764 were predominant only in LC patients (60%). All of these mutations were found mostly after HBeAg seroconversion (anti-HBe+). Of most samples with anti-HBe+, precore mutation was related with low viral load (<105 copies/mL), but core promoter mutations with high viral load (>105 copies/mL). Precore mutation A1896 was predominant in all groups, but core promoter mutations T1762/A1764 were only predominant in LC patients. The precore mutation alone is possible not critical to indicate a poor outcome, the core promoter mutations must be considered also.
Ekstrak Buah Delima Terstandar Menurunkan Derajat Fibrosis Hati pada Hewan Model Tikus Putih (STANDARDIZED POMEGRANATE FRUIT EXTRACT REDUCES LIVER FIBROSIS DEGREE ON ALBINO RATS (RATTUS NORVEGICUS) AS AN ANIMAL MODEL) Yuniarti, Wiwik Misaco; Handajani, Retno; Kusumobroto, Hernomo Ontoseno; Sudiana, Ketut
Jurnal Veteriner Vol 14, No 4 (2013)
Publisher : Jurnal Veteriner

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The objective of this study was to analyse the effect of standadized pomegranate fruit extracton liver fibrosis due to biliary obstruction.  Liver fibrosis was induced with bile duct ligation (BDL)technique.  Examinations were performed on the expressions of collagen type 1 and the degree ofliver fibrosis. Thirty two male albino rats (Rattus norvegicus), 2.5 month old, weighing 160-190grams were divided into four experimental groups.  The first group (P0) consisted of rats  whichunderwent laparotomy and treated with 2 ml of  carboxymethyl cellulose (CMC) 0.3%.  Three othergroups consisted of rats which underwent laparotomy and bile duct ligation (BDL) but receiveddifferent treatments.  Group P1 was given carboxymethyl cellulose (CMC) 0.3%, P2 was treatedwith standardized pomegranate fruit extract 150 mg/kgBW/po/day within CMC 0.3% , and P3 wasgiven ellagic acid (EA) 60 mg/kgBW/po/day of equal volume.  Treatments were administered on thesecond day after BDL for 21 days.  The livers were excised one day after the last administration.Observations were made on the expressions of collagen type 1 and the degree of liver fibrosis. Theresults showed that standardized pomegranate extract can inhibit the expression of collagen type Isignificantly in the P2 and P3 compared with P1 group (p <0.05). Treatment with standardizedpomegranate fruit extract also significantly suppressed the progression of liver fibrosis comparedto P1, eventhough there was more liver fibrosis compared to P0 (p<0,05).  The degree of liverfibrosis was not significantly different between P2 and P3, and between P3 and P1 (p>0,05).The administration of standardized pomegranate fruit extract 150 mg/kgBW/po/day  exertedantifibrotic effect by inhibiting the increase the expression of collagen type I and the degree of liverfibrosis.
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Maimunah, Ummi; Rudyanto, Rudyanto; Setiawan, Poernomo Boedi; Adi, Pangestu; Nusi, Iswan Abbas; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Background: One of physician’s functions at primary health care center (PHC) is the ability to diagnose some diseases especially that contribute to high morbidity and mortality. Until now, hepatitis B virus infection has become a major health problem worldwide. The aim of this study was to identify the knowledge level of primary care physicians concerning hepatitis B in Surabaya. Method: The present study was a cross-sectional study that performed by investigators through interviews with primary care physicians in Surabaya to fill questionnaires for measuring their knowledge level. The questionnaires were modified from questionnaire survey in Tur Key performed by Peksen et al. It reflected the level of knowledge of the physicians including their comprehension, application and analysis. Validity and reliability test were performed on the Result of those questionnaires. The knowledge level was categorized as follows: > 75 (excellent), 70.0–74.9 (very high), 65.0–69.9 (high), 60.0–64.9 (medium), 55.0–59.9 (moderate), 47.5–54.9 (nearly moderate), 40.0-47.4 (less moderate), < 40 (low). Results: Based on validity test, we obtained 14 items of 17 question items with correlation coefficient 0.287–0.561 and alpha reliability index 0.639; therefore, the instrument can be used to measure the knowledge level. The results of mean score conversion included comprehension, which was 84.878 ± 16.499 (excellent category); application, which was 47.556 ± 31.870 (nearly moderate category) and analysis, which was 14.634 ± 35.562 (low category). Statistically, the mean value of the knowledge level scale, which was the combination of comprehension, application and analysis, was obtained at 49.023 ± 19.085 including the nearly moderate category. Conclusion: By using a valid and reliable instrument, the knowledge level of primary care physician in Surabaya concerning hepatitis B can be categorized as nearly moderate. Keywords: hepatitis B, liver cirrhosis, hepatoma
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Purbayu, Herry; Setiawan, Poernomo Boedi; Nusi, Iswan A; Adi, Pangestu; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
Validation of 13C-urea Breath Test for the Diagnosis of Helicobacter pylori Infection Among Dyspeptic Patients at Dr Soetomo Hospital Surabaya Purbayu, Herry; Setiawan, Poernomo Boedi; Nusi, Iswan A; Adi, Pangestu; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/83200776-79

Abstract

Background: The urea breath test (UBT) has been published as the most sensitive and specific non-invasive test to detect Helicobacter pylori (H. pylori) infection. The limitation of UBT is the need of expensive equipment that is not always widely available. Recently, UBT has already been available in Surabaya. In the other hand, our experience using rapid urease test which detected urease enzyme produced by H. pylori as UBT showed low sensitivity. Objective: To investigate the validation of UBT for the diagnosis of H. pylori infection in patient with dyspepsia. Design: Cross-sectional study. Method: Sixty patients who complained symptoms of dyspepsia were examined for H. pylori infection using UBT. Gastroscopy and biopsy was were performed and the biopsy specimens were examined by Pathologist. Results: Sixty patients consist of 28 male and 32 female were enrolled of this study. Eight patients had H. pylori positive by both UBT and histologic examination. One patient was H. pylori positive by UBT but negative by histologic examination. One patient was H. pylori negative by UBT but positive by histologic examination. The sensitivity of UBT was 88.9% and the specificity was 98 %. The negative predictive value was 98%. Conclusion: In this study, UBT has lower sensitivity (88.9%) and comparable specificity (98%) for diagnosing H. pylori infection. Comprehensive studies to determine the doses of 13C-urea, test meal and appropriate collection time, which is more suitable for local population was suggested. Keywords: 13C-Urea Breath Test, Helicobacter pylori, dyspepsia, diagnosis
The Knowledge Level of Primary Care Physicians in Surabaya Primary Health Care Center Concering Hepatitis B Maimunah, Ummi; Rudyanto, Rudyanto; Setiawan, Poernomo Boedi; Adi, Pangestu; Nusi, Iswan Abbas; Kusumobroto, Hernomo Ontoseno
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/111201019-25

Abstract

Background: One of physician’s functions at primary health care center (PHC) is the ability to diagnose some diseases especially that contribute to high morbidity and mortality. Until now, hepatitis B virus infection has become a major health problem worldwide. The aim of this study was to identify the knowledge level of primary care physicians concerning hepatitis B in Surabaya. Method: The present study was a cross-sectional study that performed by investigators through interviews with primary care physicians in Surabaya to fill questionnaires for measuring their knowledge level. The questionnaires were modified from questionnaire survey in Tur Key performed by Peksen et al. It reflected the level of knowledge of the physicians including their comprehension, application and analysis. Validity and reliability test were performed on the Result of those questionnaires. The knowledge level was categorized as follows: > 75 (excellent), 70.0–74.9 (very high), 65.0–69.9 (high), 60.0–64.9 (medium), 55.0–59.9 (moderate), 47.5–54.9 (nearly moderate), 40.0-47.4 (less moderate), < 40 (low). Results: Based on validity test, we obtained 14 items of 17 question items with correlation coefficient 0.287–0.561 and alpha reliability index 0.639; therefore, the instrument can be used to measure the knowledge level. The results of mean score conversion included comprehension, which was 84.878 ± 16.499 (excellent category); application, which was 47.556 ± 31.870 (nearly moderate category) and analysis, which was 14.634 ± 35.562 (low category). Statistically, the mean value of the knowledge level scale, which was the combination of comprehension, application and analysis, was obtained at 49.023 ± 19.085 including the nearly moderate category. Conclusion: By using a valid and reliable instrument, the knowledge level of primary care physician in Surabaya concerning hepatitis B can be categorized as nearly moderate. Keywords: hepatitis B, liver cirrhosis, hepatoma