International Journal of Human Capital Management (IJHCM)
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Cancer Stem Cells and Signaling Pathways in Colorectal Cancer
Full text linkColorectal cancer (CRC) is the third most common cancer in males, the second in females and is the second leading cause of cancer related death worldwide. Despite recent advances in chemotherapy, and targeted therapy for CRC, the prognosis for patients with advanced cancer has remained poor, due to drug resistance, metastasis and recurrence. A small fraction of cells possess tumor propagation abilities. These are termed “cancer stem cells (CSCs). A subset of colorectal cancer stem cells, may hold a key to controlling cancer. The cancer stem cell (CSC) model suggests that tumors are hierarchically organized, only CSCs possess cancer-promoting potential. The killing of CSCs is thought to be a critical component of effective antitumor therapies. A number of signaling pathways, most notably the Wingless related (Wnt), transforming growth factor-beta (TGF-β), Notch and Hedgehog signaling and other mechanisms have been found to be associated with CSCs in CRC. They play important roles in maintaining the growth and functional integrity of CSC. Many new molecules are now being studied to block theses pathways. Some of the molecules block the self-renewal and induction of apoptosis in CSCs. The design of CSC-targeted interventions is a rational target, and reduce local recurrence and metastasis. This review aims to summarize the issue on CSCs and signaling pathway relevant for CRC, which may lead to more effective therapeutic strategies for CRC
Perendoscopic Placement of Palliative Stent for Obstructive Jaundice Caused by Head of Pancreas Malignancy in Dr Moewardi General Hospital-Surakarta
Full text linkPancreatic cancer is difficult to diagnose in early stage. Malignant bile duct obstruction is a severe complication of pancreatic cancer, this can lead to poor outcomes including cholangitis, delaying therapy, decreasing quality of life and increasing mortality. Perendoscopic placement of stents is a method widely used in the management of various malignant and benign pancreatico-biliary abnormalities. A 70-year-old woman came to Dr Moewardi General Hospital in Surakarta with body and yellow eye complaints for one month before doing admission. Patient was diagnosed as obstructive jaundice et causa suspect of advanced stage pancreatic cancer. Patient was subsequently performed endoscopic retrograde cholangiopancreatography (ERCP) which resulted an intrahepatal and extrahepatal bile ducts dilatation et causa pancreatic tumor infiltrated common bile duct and done placement of self expandable metalic stent (SEMS). Furthermore, patients got palliative therapy due to inadequate chemotherapy requirement
Efficacy of Combination Sofosbuvir, Pegylated-Interferon, and Ribavirin for Treatment of Hepatitis C Virus Genotype 1 Infection in Indonesia
Full text linkBackground: The presence of direct-acting antiviral (DAA) has improved the treatment of HCV infection and making it more preferable than Pegylated-interferon (PegIFN) and Ribavirin (RBV) based treatment. However, treatment with all DAA combination regimen is limited and expensive in low health care affordability country including Indonesia. The appearance of generic sofosbuvir (SOF) facilitate the utilization of SOF plus PegINF with or withour RBV combination. Therefore, in this study we assessed the efficacy of SOF+RBV and SOF+RBV+PegINF combination for treatment of chronic hepatitis C infections patient with genotype 1 in IndonesiaMethod: We performed retrospective study comprising 128 patients in Cipto Mangunkusumo Hospital with chronic hepatitis C, genotype 1, infection. 36 patients was treated with PegINF+SOF+RBV and 92 patients was treated with SOF+RBV with the duration of therapy was 12 and 24 weeks in both arms. The primary endpoint was sustained virologic response after treatment completion (SVR12)Results: In the end of treatment, 99.2% patients achieved undetected HCV RNA in 12 weeks and 24 weeks duration of therapy (100% in PegINF+SOF+RBV group and 98.9% in SOF+RBV group). The SVR12 of PegINF+SOF+RBV reach 100% meanwhile The SVR12 of SOF+RBV reach 88%. No different in SVR12 between cirrhotic and non-cirrhotic patient in PegINF+SOF+RBV group while in SOF+RBV group, the SVR12 was lower in cirrhotic patients (82.9%) compared to non-cirrhotic patients (92.2%). In multivariate analysis, HIV co-infection is associated with lower SVR12 in SOF+RBV group.Conclusion: 12 weeks and 24 weeks of PegINF+SOF+RBV and SOF+RBV is effective in the treatment of genotype 1 chronic hepatitis C infectio
Celiac Disease
Full text linkCeliac disease is a multisystem autoimmune disorder, which is induced by dietary gluten exposure. This disease usually found in European population, but with the increase of Asian population tendency to eat western style, which contain gluten, celiac disease frequency is expected to increase in Asian population for the near future. The finding of diagnostic modalities which is highly sensitive and specific, starting with the antigliadin, and then the antiendomysium and anti-transglutaminase antibodies, has increased the awareness of clinicians and patients towards this condition. The understanding of definition, pathogenesis, diagnostic procedure, and current management of celiac disease is needed to avoid morbidity and mortality of this disease
Intralesion Triamcinolon Injection Therapy on Esophageal Stricture as Side Effect of Long Term Use Biphosphonate
Full text linkSystemic Lupus Erythematous (SLE) is a chronic inflammatory disease that affect almost any organ system. Patient with SLE is at risk of osteoporosis. Biphosphonate is one of osteoporosis treatments. However, esophageal stricture (ES) caused by continuous esophageal inflammation as a result of long-term use Biphosphonate can occur. Intralesion Triamcinolone Injection (ITI) becomes one of ES therapy by inhibiting inflammatory response to injury and decrease subsequent collagen formation. ITI inhibits transcription of matrix protein genes, including fibronectin and procollagen. It also reduces the synthesis of α2-macroglobulin, an inhibitor of collagenase activity. A 43 year old woman was diagnosed with SLE. She was treated with Risedronic Acid (bisphosphonate class) 35 mg once a week. After 8 months, she started complaining difficulty to swallow. Symptom was getting worse 6 months later. One-third distal ES with inflammation process was found with endoscopy. ITI 150 mg was given in inflammation area. She was scheduled to follow up after 7 days for re-endoscopy. Endoscopy showed that inflammation process had been improved. Six months later, she had again complained difficulty to swallow and we found that she still consumed Risedonic Acid. ITI 150 mg was given because inflammation and ES was found with endoscopy. After 7 days, endoscopy showed that there was no ES and inflammation process had been improved. She was advised to stop Risedronic Acid consumption
Risk Factors Associated with in Hospital Complication Post Gastrointestinal, Pancreatic, Hepatic Cancer Surgery: A Retrospective Case Control Study (RAPHA Study)
Full text linkBackground:This study aims todevelop a scoring system that will predict in-hospital morbidity post gastrointestinal (GI), pancreatic, hepatic cancer surgery in adult patients. This study took place in De La Salle University Medical Center.Method: Two hundred eighty five (285) adult patients 18 years old and above who underwent gastrointestinal, pancreatic and hepatic cancer surgery from 2010 to July 31, 2014 were included. Variables were evaluated in the univariate and multivariate analysis. Calculation of specific score from the resulting factors was performed by logistic regression analysis to develop the scoring system and to determine the best cut-off score in predicting in-hospital morbidity.Results: Out of 142 patients with post-operative complications, factors significantly associated with morbidity were as follows: age ≥ 75 years (p = 0.002), low serum albumin (p = 0.00), abnormal electrocardiogram (ECG) findings (p = 0.036) and emergency surgery (p = 0.000). Calculated best cut-off score was 1.4.Conclusion: The RAPHA scoring system may serve as a promising aid in predicting morbidity and mortality among patients who will undergo GI cancer surgery
Effects of Curcumin against Matrix Metalloproteinase-2 (MMP-2) and Tissue Inhibitor Metalloproteinase-2 (TIMP-2) Serum Level on Rat Model of Liver Fibrosis Resolution Process
Full text linkBackground: Liver fibrosis is an effect from continuous fibrogenesis and fibrolysis process. During fibrogenesis, MMP-2 and TIMP-2 that produced by hepatic stellate cell (HSC) have a role to regulate extracellular matrix (ECM) homeostastic. Otherwise, curcumin inhibits both MMP-2 and TIMP-2 expression and enhances HSC apoptosis, thus inhibit fibrogenesis. Role of curcumin, MMP-2, and TIMP-2 in a fibrolysis process has not been widely studied. This study aimed to determine the correlation between curcumin administration and the decline of MMP-2 and TIMP-2 on rat model of liver fibrosis.Method: This is an experimental study done in male Wistar rats. There are 8 groups consist of 4 rats each. Both control and intervention group were exposed to CCl4 1 cc/kgBW intraperitoneally 2 times per week for 9 consecutive weeks to form F3 fibrosis. Negative control group was injected with normal saline. After CCl4 injection, control group was given curcumin solvent as placebo while intervention groups were given curcumin 200 mg/kgBW for 2, 5, and 9 weeks. Statistical analysis then conducted in the end of study. Results: MMP-2 and TIMP-2 were remarkably increased in positive control group, but found decreased in control group 5 and 9. There are remarkable decrease of MMP-2 and TIMP-2 serum level in intervention group 2, 5, and 9, but MMP-2 and TIMP-2 level was significantly lower in intervention group 2 compared to the control group.Conclusion: MMP-2 and TIMP-2 serum level were decreased after giving of curcumin for 2 weeks. The duration of curcumin administration correlated with decrease of TIMP-2 serum level but not correlated with MMP-2 serum level in rat model of liver fibrosis
Sedation in Gastrointestinal Endoscopy
Full text linkSedation helps patients to tolerate uncomfortable gastrointestinal endoscopy procedures by relieving anxiety and pain. It also decreases a patient’s risk of physical injury during gastrointestinal endoscopy procedures while providing the endoscopist with a good environment for an optimum examination. Not all sedation in gastrointestinal endoscopy is managed by an anesthesiologist. Using sedation has increases risk of cardiopulmonary complications. Therefore, sedation is an important part in gastrointestinal endoscopy to learn. This review will focus on basic pharmacology of sedatives and analgesic, common used drugs in sedation (Propofol, Midazolam, Fentanyl), and their use in gastrointestinal endoscopy
Colorectal Cancer: Epidemiological Trends, Screening, and Inheritability
Full text linkColorectal cancer is one of the most common cancer worldwide. The incidence and mortality trend in different areas of the world varies. Colorectal cancer incidence and mortality are increasing in some countries. There are also epidemiological shift towards younger age (below 40). Most common non-invasive screening tests are fecal immunochemistry test (FIT) and fecal occult blood test (FOBT). Both have good sensitivity. The best invasive method for colorectal screening is still colonoscopy. Hereditary colorectal cancer is an important factor in younger age colorectal cancer. Familial adenomatous polyposis and Lynch syndrome are most common hereditary CRC. In familial or hereditary CRC, the chance of developing the cancerous form of the disease is nearly inevitable. Genetic testing may benefit the patients and their future progenies
