Prognostic Significance of Serum Vascular Endothelial Growth Factor-C (Serum Vegf-C) and Lymph-Vascular Space Invasion in Early Stage Cervical Cancer

Background: Management of early stage cervical cancer is still challenging. Several clinical-pathological prognostic factors that are currently used in clinical practice include stage, bulky tumor, stromal deep invasion, differentiation, histology, lymph vascular space invasion and status of lymph-node. Serum Vascular Endothelial Growth Factor-C (VEGF-C) has an important role in metastasis as an angiogenic and lymphangiogenic factor. This study aimed to determine prognostic significance of serum VEGF-Cand lymph-vascular space invasionin early stage cervical cancer. Subjects and Method: This was a case-control study conducted at January to October 2007. A sample of47 early-stage cervical cancer patients including 14 patients with lymph node metastasis (case) and 33 patients without lymph node metastasis (control) was selected for this study. The dependent variable was lymph node metastasis. The independent variables were serum VEGF-C and lymph vascular space invasion. Serum VEGF-C levels were examined by ELISA method. The data were analyzed by logistic regression. Results: A cut-off point of serum VEGF-C level of 10.07 pg/ mLresulted in 78.57% sensitivity and 96.97% specificity. The risk of lymph node metastasis increased with serum VEGF-C level > 10.07 pg/ mL (OR= 80.0; 95% CI=7.99 to 800.71; p< 0.001) and lymph vascular space invasion (OR= 20.00; 95% CI=2.32 to 171.7; p= 0.006). Conclusion: Serum VEGF-C and lymph vascular space invasion can be used as independent prognostic factor on the risk of lymph-node metastasis in early stage cervical cancer. Keywords: cervical cancer, prognostic factor, serum VEGF-C, lymph node metastasis

Relative Effectiveness of Neoadjuvant Chemotherapy Versus Primary Surgery in Patients with Advanced Ovarian Cancer

Background: This study aimed to compare the morbidity and disease free progression between patients with advanced ovarian cancer treated with neoadjuvant chemotherapy (NAC) followed by surgery and those treated conventionally with cytoreductive surgery followed by cytotoxic chemotherapy. Subjects and method: This was a retrospective-cohort study conducted at Dr. Cipto Mangunkusumo Hospital, Jakarta. A sample of 84 patients with advanced-stage ovarian cancer was selected for this study, consisting of 64 patients treated conventionally (CT group) with primary surgery followed by platinum based adjuvant chemotherapy, 20 patients treated with neoadjuvant chemotherapy, of which 8 patients subsequently underwent interval debulking and adjuvant chemotherapy (NAC group). The dependent variables were morbidity and disease free progression. The independent data were neoadjuvant chemotherapy and cytoreductive surgery followed by cytotoxic chemotherapy. The data were collected from medical record and questionnaire. Difference in means between the two groups was tested by t-test. Difference in percents between the two groups was tested by chi-square. Results: The response rate to the NAC assessed at three cycles was 40%. Performance status (Hb, albumin, ascites, pleural effusion, Ca 125, and stage) in the NAC group was worse than CT group. Disease free progression after 12 and 24 months in the NAC group was 30% and 5%, CT group was 10% and 7.5%, respectively. Parameters of surgical aggressiveness (massive bleeding, organ injury, and ICU stay) were lower in the NAC group than the conventional group. Complication rate of surgical injury in CT group was 17% and zero in the NAC group. Conclusion: Neoadjuvant chemotherapy followed by interval debulking in advanced ovarian cancer does not affect disease free progression but reduces morbidity. Keywords: neoadjuvant chemotherapy, interval debulking, cytoreductive surgery, cytotoxic chemotherapy, disease free progression, morbidity, advanced ovarian cancer

Potensi Umbi Gadung (Dioscorea Hispida) dan Daun Zodia (Euodia Suaveolens) sebagai Insektisida Nabati

Dengue hemorrhagic fever (DHF) is a disease with a high rate incidence in Indonesia. In some areas of Aedes aegypti which is the vector of dengue is currently indicated resistance to insecticides. The development of technology requires industry and researchers to studying insecticide research utilizing natural materials, such as yam and zodia. Yam contains diascorin, while zodia contains evodiamine and rutaecarpine, all three off these substances can be used as an insecticide. The way to obtain such materials by extraction with maceration method used ethanol 70%. In this study conducted two tests, namely larvacide test and repellent test. The dose used to the test the repellent concentration of 100%, to test the concentration used for larvacide were 50%; 25%; 12.5%; 6.25%; 3.12%, and 1.56%. Based on the results of research: zodia as a repellent dose of 100 % able to reject 88.6% of mosquito bites of Aedes aegypti for about 1 hour, 88.2% for 2 hours; 84.5% for 3 hours; 80% for 4 hours; 77.1% for 5 hours; and 73.5% for 6 hours. Extract of yam repellent concentration of 100% able to reject 61.2% of mosquito bites for 1 hour; 42.2% for 2 hours; 39.2% for 3 hours; 31.2% for 4 hours; 28.4% for 5 hours; and 26.3% for 6 hours. Extract zodia as larvicides have LC50 LC90 0.194% and 0.628%, while the yam tuber extract LC50 0.585% and LC90 1.494%. It can be concluded yam tuber extract and zodia leaf extract has potential as nabati pesticide, namely as larvacide. However zodia extract more potential as a repellent than yam tuber

The Effect of Neoadjuvant Chemotherapy on HIF-1α Expression in Cervical Uterine Cancer

Background: Uterine cervical cancer is one of the main causes of female death related to cancer. Neoadjuvant chemotherapy aims to reduce tumor mass to allow radical surgery. HIF-1α is thought to have a key role in the development of cancer and the main target for chemoprevention.Objective: This study aims to prove the effect of neoadjuvant chemotherapy on HIF-1α expression in uterine cervical cancer as an assessment parameter for chemotherapy response. Subjects and methods: The study was carried out in the Department of Obstetrics and Gynecology and the Pathology Department of Anatomy Dr. Moewardi - Faculty of Medicine, Sebelas Maret University, Surakarta. Thirty (30) cervical cancer samples that met the inclusion and exclusion criteria were examined for HIF-1α expression before and after giving 3 times neoadjuvant chemotherapy. Examination using immunohistochemical methods. Data analysis using t-test.Results: Mean HIF-1α expression before administration of neoadjuvant chemotherapy 5.10± 1.174 cell/field, after administration of neoadjuvant chemotherapy 4.00±1.174 cell/field with p=0.001.Conclusion: Neoadjuvant chemotherapy has an effect on reducing HIF-1α expression in uterine cervical cancer.Keywords: neoadjuvant chemotherapy, HIF-1α, uterine cervical cancerCorrespondence: Sri Sulistyowati. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sebelas Maret. Mobile: 08122968215. email: [email protected] Indonesian Journal of Medicine (2018), 3(2): 109-114https://doi.org/10.26911/theijmed.2018.03.02.0

Beberapa Aspek Bionomik Vektor Malaria dan Filariasis Anopheles Subpictus Grassi di Kecamatan Tanjung Bunga, Flores Timur, NTT

Studies on some aspect of the bionomics of a malaria and filariasis vector Anopheles subpictus Grassi were carried out in Tanjung Bunga Subdistrict, Eas Florest, Nusa Tenggara Timur. An. subpictus in Tanjung Bunga subdistrict was found all over the year, two peak densities periods were found, one in April-June and other in November-January. This species is active nocturnally and feeds indoor as well as outdoor from 19.00-05.00 and a peak of biting activity around 20.00-22.00 and 01.00-03.00. During day time this species was found in high numbers resting indoor (55.3%) compared to low number (44.7%) resting outdoor. Abdominal conditions of mosquitoes resting indoor 53.3% were engorged, 8,5% gravids and 37.8% unfed Larvae of An. subpictus were found in brackish as well as fresh water and in clear as well as turbid water, covered by green algae or decaying leaves. Mosquito dissections reveal an infective rate of 1,42% (2/141) q/*Wuchereria bancrofti and no sporozoites at all

Implementasi Nilai Nilai Pancasila Dalam Best Practice Corporate Governance Perbankan Indonesia

The purpose of this research is to develop a model in implementing Pancasila values in the best practice corporate governance (IPCG) and to examine the relation between IPCG and banking performance in Indonesia. IPCG was measured by using index based on the CG principles which had been adjusted to the values of Pancasila. Bank performance was measured by using ROA, ROE, LDR, and OER. The result shows that Pancasila values have been well implemented in the Indonesian banking. IPCG does not affect ROA and ROE, but negatively effects on LDR and OER, in which LDR becomes lower as IPCG becomes higher, meaning that it has less risk