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Articles 1,979 Documents
EarlyWarning System (EWS) for Dengue in Indonesia and Thailand Dana A. Focks, Mohammad Juffrie, Dana A. Focks
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 03 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Dengue virus infection is an acute febrile disease caused by 4 sero-type viruses. The transmission via mosquito vector Ae. Aegypti. The morbidity of dengue virus infection is quite high and the mortality below 5%. The most dangerous form is dengue shock syndrome, the mortality is very high. The effort to reduce morbidity and mortality is improvement of the clinical management and control of vector. Today, most dengue control efforts are based on suppression of Aedes aegypti (L.) and not eradication. EWS would provide significant utility where mitigation methods were available. EWSs were possible for three reasons, an extensive time series on the disease incidence the available, dengue being a vector-borne disease, is significantly influenced by weather, in many sub-regions of SE Asia, weather anomalies are significantly influenced by and lag behind several months, sea surface temperature (SST) anomalies. Methods: Analytic cross sectional study was conducted. The dependant variable in this analysis, Epi.yr. is dichotomous and indicates whether an epidemic occurred during a particular year. The two independent (predictor) variables are sea surface temperature anomalies as reported by the Japanese Meteorological Association (JMA) and previous cases. The monthly number of cases were dengue and DHF in Yogyakarta, Indonesia and the metropolitan area of Bangkok, Thailand. Results: Yogyakarta, many years were very near the epidemic cutoff of 278 cases, yet only one year, 1992 with 237 cases, was incorrectly labeled. The false positive in 1992, had a probability of 0.64 of epidemic and 0.36 of no epidemic. Bangkok, the best three-month prediction gave 6 false indication in 35 years, 5 false negatives, 1 false positive. For two month prediction, 3 errors in 35 years were made, 2 false negatives, 1 false positive. Conclusion: The results presented in this study is very use full for predicting the incidence of dengue virus infection using weather data. This method would only require a simple calculator, or preferably a PC using the derived equation. Key words: dengue -incidence -early warning -weather - probability
The effect of metformin on proliferation and glucose uptake in keloid fibroblast culture Yohanes Widodo Wirohadidjojo, Nur Dwita Larasati, Sunardi Radiono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Metformin as an antihyperglycemic agent has a potential effect in increasing type I collagen synthesis and decreasing MMP, so that it has a potential to be an antiaging agent. One of aging failure processes is the development of keloids. Keloids are formed due to hyperproliferation of fibroblasts, an increase of collagen synthesis, particularly type I and III, and a decrease in MMP-1 and MMP-2. Fibroblast proliferation process and collagen synthesis need glucose uptake. The study on metformin ability to aggravate or stimulate the formation of keloid has never been conducted before. Objective: The aim of this study was to know the difference of proliferation and glucose uptake between keloid fibroblasts given metformin and without metformin. Method: A simple experiment was conducted using 3rdpassage keloid fibroblasts culture. Keloid fibroblasts were divided into 2 groups, the first group was treated with metformin in the dose of 100 pg/mL, 200 pg/mL, 300 pg/ mL, 400 pg/mL, and control. Keloid fibroblasts proliferation in the first group was measured using spectrophotometer with MTT assay, and glucose uptake of keloid fibroblast in the other group was measured using glucometer. The difference in proliferation and glucose uptake of keloid fibroblast was analyzed using one-way anova. Result: The result of this study showed that the average keloid fibroblast proliferation in the metformin treatment groups was not increased compared to that in control group. Meanwhile, the average keloid fibroblast glucose consumption in metformin treatment group significantlyincreased, at the dose of 300 ig/mL (p =0.044) and 400 I!g/mL (p = 0.0081. Conclusion: Metformin could not increase keloid fibroblasts proliferation, but it could increase glucose uptake of keloid fibroblasts.
The influence of endometriosis peritoneal fluid on the development of mouse embryo in in vitro pre-implantation Hasto Wardoyo, Ita Fauziah, O. Wahyu, Djaswadi Dasuki
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 01 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Endometriosis was associated with various immunologic changes detected both in the endometrial eutopic and blood edge sample. Some researchers reported that women with endometriosis have an increased amount of peritoneum fluid. Endometrial environment and peritoneal fluid diffusing to the ovarial tube may affect sperm-ovum interaction, initial phase of embryonic development and reduce endometrial receptability. The correlation between endometriosis and early in vitro embryonic development has been reported in some studies showing controversial results; therefore it is necessary to carry out researches to clarify the influence of endometriosis on the early embryonic development. Objective: to identify the influence of peritoneal fluid of infertile women with endometriosis and normal peritoneum fluid of fertile women on the development of mouse embryo in in-vitro pre-implantation. Methods: Prospective, randomized controlled trial subjects are 2 cells of the Swiss albino strain embryos super-ovulating procedure on mouse, 2 embryonic cells resulted from in-vivo fertilization were taken out and in-vitro culture was done with the exposure of 10% or 2.5% cell-free supernatant peritoneum fluid of infertile women with endometriosis and 10% or 2.5% cell-free supernatant peritoneum fluid of normal fertile women as the control. The blastocyst growth was observed in the 72 hour culture and hatching blastocyst culture in 96 hours. Results: An amount of 231 embryos of 2 cells was obtained. After 72 hours, there were 103 blastocyst cultures in both groups. Blastocyst development rate (BDR) culture with to endometriosis peritoneum fluid exposure was lower compared with the normal peritoneum fluid exposure (32.2% vs 56.9%, RR 0.5, 95% CI: 0.42-0.77). Hatching rate (HRI of blastocyst culture with endometriosis peritoneum fluid was lower than that of normal peritoneum fluid (35.1 % vs 92.4%, RR 0.38, 95%CI: 0.24-0.59). The exposure to 10% endometriosis peritoneum fluid lowered BDR significantly compared with the normal peritoneum fluid, 7.7% vs 43.9% (RR 0.18,95% CI: 0.07-0.42); while the exposure to 2.5 % BDR was significantly different, (64% vs 74%, RR 0.87,95% CI: 0.66-1.13). Exposure to 10% compared to 2.5% normal endometriosis peritoneum fluid showed significantly decreased BDR (p 0.05). There was a significant interaction between type of peritoneum fluid (endometriosis vs normal) and the concentration of peritoneum fluid (10% vs 2.5%1 in decreasing BDR (RR 0.17,95% CI: 0.04-0.65). Conclusion: Exposure to endometriosis peritoneum fluid lowered the blastocyst development rate and hatching rate as compared with that to normal peritoneum fluid on the development of the in- vitro mouse embryo model. Key words: embryonic development - peritoneum fluid - endometriosis
The Role of Cervical Erosion on Vaginal Colonization of Candida sp. Study on the Intrauterine Contraceptive Device Users in Puskesmas Depok I Sleman Satiti Retno Pudjiati, Erni Setyawati, Fajar Waskito
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 02 (2009)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: Candida sp is an opportunistic pathogenic yeast causing clinical diseases such as vulvovaginal candidiasis (VVC) under certain circumstances. Availability of erythrocytes in the vagina, as in cervical erosion, creates an ideal niche for yeast possessing erythrocyte-binding surface receptors to enhance colonization of Candida sp. Objective: To compare the number of vaginal Candida sp colonies among IUD users with and without cervical erosion. Methods: It was a cross-sectional study involving 45 IUD users. Subjects were classified into cervical erosion group and without cervical erosion group, who underwent vaginal lavage to obtain vaginal fluid samples. Candida sp were grown by inoculating 0.1 ml of vaginal fluid samples into CEA culture media and incubated at 25°C-30°C for 48 hours. Candida sp would grow as round and smooth colonies in blackish-brown color. The numbers of colonies (cfu/ml) in each CEA disk were measured manually, and multiplicated with the factors of dilution. Data were numeric variables, and analyzed with Students t-test. Results: Average number of Candida sp colonies in the group with cervical erosion was 154.25:t 102.61 cfulml, while that in the group without cervical erosion was 47.00:t 39.08 cfulml. Conclusion: Average number of Candida sp colonies in IUD users with cervical erosion was significantly higher than in IUD users without cervical erosion (p < 0.05). Key words: cervical erosion - Candida sp - VVC - yeast possessing erythrocyte-binding receptors -IUD
Risk factors of neonatal mortality of referred babies with birthweight of 1000- < 2500 grams Ekawaty Lutfia Haksari, Dian Murni Wardhani, Setya Wandita
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 03 (2009)
Publisher : Universitas Gadjah Mada

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Background: Almost 16% from all of the total births in the developing countries are low birthweight babies. Low birthweight babies are an important contribution in neonatal mortality and morbidity worldwide, and contribute to almost 70% of the total neonatal deaths. Proportion of the low birthweight babies in the developing countries is 90% of the total low birthweight babies around the world, which is 20 million annually. Mortality of babies weighing 1000-&lt; 2500 grams in Dr. Sardjito Hospital reached 51.4%, and that of referred babies was 74.6%. Objectives: This research was aimed to find out and measure the risk factors that contribute to the mortality of referred low birthweight babies in the neonatal period. Methods: A hospital-based research with case-control study design was done to discover the risk factors that related to the neonatal mortality of the referred babies with birthweight of 1000- &lt; 2500 grams. Data were collected from babies medical records treated in the Maternal-Perinatal Installation of Dr. Sardjito Hospital in 2005 to 2007. Target population of this research was the mentioned above who died at the age of 0-28 days. Variable analysis to find out the correlation between the risk factors and the mortality used odds.ratio (OR), 95% confidence interval (95% CI), and the significance level with Chi-square test. To measure the risk factors that contributed on the mortality multivariate logistic regression analysis was used. Result: This study involved 190 babies (95 cases and 95 control) weighing between 1000 and &lt; 2500 grams, who were referred to Dr. Sardjito Hospital. Several subjects were excluded, 23 babies because of going home on selfrequest, 24 because of incomplete status, 76 because of severe congenital anomaly, and 34 were extremely low birthweight babies. Sepsis (OR: 5.054, 95%CI2.433-11.198), HMO(OR:4.461, 95%CI1.595-10.497), hypoglycemia (OR: 3.358, 95%CI1.679-6.715), and hypothermia (OR: 2.221, 95%CI1.082-4.560) were the risk factors of mortality. Conclusion: Sepsis, HMO, hypoglycemia, and hypothermia increased the mortality risk of babies weighing 1000-&lt; 2500 grams referred to Dr. Sardjito Hospital, Yogyakarta. Key words: low birthweight baby -risk factor -referral -neonatal death
Serum iron level after ingestion of repeated dose of iron shortly after and 2 hours after meal Sri Kadarsih Soejono, Lukman Hakim, Erna Kristin, Mohammad Hakim,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Universitas Gadjah Mada

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Background: The prevalence of iron deficiency anemia in pregnant women is estimated to be higher than nonpregnant women. Ironsupplementation program has been proven clinicallyto improvethe hemoglobin (Hb)level of pregnant women. The absorption of iron is affected by food, therefore iron has to be given 2 hours after meal. However, in practice, iron was given shortly after meal. The physiologicalchange in pregnant women affects drug absorption, distribution, and eliminationphases. Objective: To understand serum iron level after ingestion of repeated dose of iron shortly after and 2 hours after meal for 12 weeks in trimester 2 pregnant women with iron deficiency anemia. Method: The research design was a phase IIclinical trial. Subjects were 24 trimester 2 pregnant women with iron deficiency anemia, classified into two groups, who were treated as follows: The first group was consisted of 12 women with irondeficiency anemia, treated with twice-a-day ferrous sulphate tablet @300 mg orally,given shortly after meal for 12 weeks; the second group was consisted of 12 women with iron deficiency anemia, treated with twice-a-day ferrous sulphate tablet @300 mg orally, given 2 hours after meal for 12 weeks. Bloodsamples were taken in week 2, 4, 6, 8, 10, and 12 after treatment. Serum (ferric) iron level was measured with Vitros Fe Slides method. Result: Minimum,maximum, and average steady-state ironlevels (Css min, Css max, Css average) of treatment 1 were 104.1 ::I:14.03 ug/dL, 96.44::1:13.22 ug/dL, and 112.38::1:14.03 ug/dL (mean ::I:SEM),respectively; while minimum, maximum, and average steady-state iron levels (Css min, Css max, Css average) of treatment 2 were 125.77::1:9.31 ug/dL, 118.03::1:9.21 ug/dL, and 125.77::1:9.31 ug/dL (mean::l:SEM),respectively. No statistical significant difference was found within treatment in minimumsteady-state level between week 2, 4, 6, 8, 10, 12 after treatment. There was also no significant difference in minimumsteady-state level between treatment groups in week 2, 4, 6, 8, 10, and 12. Conclusion: There were no differences in serum iron level after ingestion of repeated dose of ironshortly after and 2 hours after meal for 12 weeks intrimester 2 pregnant women with iron deficiency anemia.
The Change of Retinal Sensitivity in Diabetic Retinopathy after Photocoagulation Angela Nurini Agni, Arif Budiman, Hartono, Angela Nurini A
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 01 (2009)
Publisher : Universitas Gadjah Mada

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Background: Panretinal photocoagulation is used to destroy new blood vessel growth which develops on large areas of retina. Burns that occur would cause scars, that would stop bleeding. Laser has shown benefit in decreasing advance visual loss. Several studies stated that panretinal photocoagulation also decreased the light sensitivity, peripheral visual acuity, and night visual, paracentral scotoma, choroidal neovascularization (rare). submacular fibrosis, and laser injury cycatrical widening, Study on this problem is needed. Objective: To find out the influence of panretinal photocoagulation on retinal sensitivity in diabetic retinopathy patients. Methods: This study used pretest-posttest design. Subjects were diabetic retinopathy patients who visited Ophthalmology Outpatient Clinic Unit Dr. Sardjito Hospital and Dr. Yap Eye Hospital, Yogyakarta from March 2008 to January 2009. All subjects underwent panretinal laser photocoagulation and visual field was examined before treatment and 1 month (4 weeks) after treatment. Data were analyzed descriptively. The difference of retinal sensitivity before and after treatment were analyzed with paired Hest. Result: 19 patients (34 eyes) were included in the study. Average duration of diabetes mellitus in the subjects was 10.44 + 5.26 years. Most (82.4%) subjects had no history of hypertension. The number of laser given to subjects were 826-1850 burns (the average was 1164+218.95). There was improvement in the retinal sensitivity after photocoagulation, although it was statistically insignificant (p &gt; 0.05). There was no significant difference between old and new parameters on visual acuity improvement (p = 0.72 Conclusion: There was no significant change in retinal sensitivity between before and 4 weeks after panretinal photocoagulation in diabetic retinopathy patients. Key words: retinal sensitivity - panretinal photocoagulation - diabetic retinopathy
The effect of vitamin C on fibroblast proliferation and VEGFexpression in fibroblast culture Yohanes Widodo Wirohadidjojo, Munira, Sunardi Radiono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 03 (2009)
Publisher : Universitas Gadjah Mada

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Background: One of the factors that determine the success of efficient woul)d healing is wound healing rate, that can be achieved by increasingcell proliferation, angiogenesisor neovascularisation,and extracellular matrix production. Dermalfibroblast is a cell that plays an important role in wound healing. Fibroblast proliferation and neovascularisation are critical elements in granular tissue formation. Local hypoxia causes fibroblasts to express HIF-1a that will induce fibroblast VEGFexpression. The nature of vitamin C makes it easily oxidized. The addition of vitamin Con fibroblast culture medium is expected to produce local hypoxia condition that will induce fibroblast expression of HIF-1a, so that the expression of fibroblast VEGFwill be increased. Vitamin C may modulate the growth of various types of cells. The effect of vitamin Con normal fibroblast proliferation and fibroblast VEGFexpression is still unknown. Objective: This study was aimed to know whether vitamin Ccan increase normal human fibroblast proliferation and expression of VEGF. Method: A simple experimental study was conducted by using preputial skin fibroblast culture from 10-year-old donor, subculture passage 3. Fibroblast culture was divided into 6 groups, each group received vitamin C treatment with the dose of 50pg/mL, 100pg/mL, 150pg/mL, 200pg/mL, and 300pg/mL, and one group without treatment acting as control. Measurement of fibroblast proliferation was conducted by spectrophotometer using MTT, and fibroblast expression of VEGFwas measured using ELISA. The average of difference in fibroblast proliferation and VEGFexpression was analyzed with one-way analysis of variance. Result: There was a significant increase in fibroblast proliferation rate in the groups receiving vitamin C with the dose of 200 mg/mL (p = 0.016) and 300 mg/mL (p = 0.005), whereas in the group with the dose of 50 mg/mL, 100 mg/mL and 150 mg/mL there was no significant difference compared to the control (p = 0.933, p = 0.961, P = 0.301, respectively). Average fibroblast VEGFexpression between various concentrations of vitamin C compared to the control showed no significant difference (p &gt; 0.05). Conclusion: Vitamin Ccould be considered to be used as an agent to accelerate wounds healing. Keywords: vitamin C, skin fibroblast culture, fibroblast proliferation, fibroblast VEGFexpression
The effect of zinc supplementation on collagen of periodontitisrat Soeharyo Hadisaputro, Suryono, Praptiwi, Siti Fatimah Muis
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 04 (2009)
Publisher : Universitas Gadjah Mada

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Background: Zinc,cofactors of DNA-and RNA-polymerase, having great role in tissue heal-ing. In periodontitis, collagen type 1 the main fiberconstituting periodontal structure is des-troyed and be the main cause of lost of teeth among adult in Indonesia. Zndeficiency is still a nutritional problem. The aim of the study is to obtain the influence of 500 pg Zn supplementation (Zn,1and 200 pg (Zn2)per day for 7 days to periodontal collagen of Periodontitis (PI rat through histologic feature. Method: inthe experimental study with factorial design, 29 adult male Wistar rat were used. Subjects were grouped simple randomly into 6 i.e Healthy (H)at the start, Hatthe end, p, P+Te-tracycline IT), ,P + T+ Zn" and P+ T+ Zn2.Subject other than Hgroups were induced periodontitisby Porphyromonasgingivalisbacteria. Zn concentration was measured by AAS Flame, Periodontal tissue was stained with Mallory,s. T test and ANOVAwas used to analyse difference between mean of Znconcentration of groups studies. Result: There were similarity in the feature of groups H at the start, Hat the end, and P+ T+ Zn" in sense of regularity, length, and solidity of collagen. P group had irregular, and short collagen. Groups of P+ T with shorter collagen, had similarity to Health at the end. P+ T+ Zn2with shorter collagen similar to P+T+ Znl. There was significant difference inZn concentrat-ion between Hat the end and Pgroup. Nosignificant differencies among Zn concentrations of Psubject groups. Great variety of Zn concentration found among subjects of groups prob-ably were the cause of absence of difference, although means of the Zn concentration values depicted it. Conclusion: Zn supplementation dosage 500 pg/day given to periodontitis rat beside Tetra-cycline, gives better effect to collagen structure compared to 200 pg/day.
Standardization of Immunocytochemical method for the diagnosis of Dengue Viral Infection in Aedes aegypti Linn Mosquitoes (Diptera Culicidane) Umniyati, Sitti Rahmah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 41, No 01 (2009)
Publisher : Universitas Gadjah Mada

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methods for virus detection in the mosquito, such as the direct fluorescent-antibody test on head squashes. However, it has the disadvantages of being labor-intensive and requiring fluorescent microscope as well as cryofreezer. Newer methods involving enzyme conjugates such as peroxidase in conjunction with either polyclonal or monoclonal antibodies are greatly improved. With new methods of immunocytochemistry, it is now possible to detect dengue viral antigen in a variety of tissues. Objective: This study was aimed to standardize an immunocytochemical streptavidin-biotin-peroxidasecomplex assay for diagnosis of dengue infection in Aedes aegypti using monoclonal antibody DSSC7. Methods: The infected mosquitoes were held in small cylindrical cages covered with mosquito netting, and incubated at 27:t 1°C ami at relative humidity of 88:t 6 %. The specificity of the immunocytochemical procedure was validated by negative and positive controls showing that the antibody was bound to an appropriate structure. The sensitivity and specificity were also evaluated based on Herrmanns Formula. The presence of dengue antigen on head squash preparation was detected based on ISBPC assay using monoclonal antibody against dengue. The validity and reliability of the measurement were evaluated based on kappa values, according to Landis and Koch. Result: Positive result was detected as discrete brownish granular deposits throughout most visual fields of brain tissue. Dengue viral antigen was immunolocalized to the cytoplasm of brain cells. The immunocytochemical test under light microscope at magnification of 400x was 86.67% sensitive, 96.00% specific, and the kappa value is 0.64. Meanwhile the kappa value between two observers was 0.92, with sensitivity and specificity of 96% and 97% respectively at magnification of 1000x. Conclusion: The monoclonal antibody DSSC7 was sensitive, specific, valid, and reliable as primary antibody to detect dengue viral infection in Ae. aegypti head squash preparation based on immunocytochemical streptavidin-biotin-peroxidase-complex assay under light microscope. Key words: antigen - denguevirus - Aedes aegypti - immunocytochemistry - monoclonal antibody DSSC7

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