Mataram Biomedical Research Group

BEBERAPA CATATAN TENTANG

ULTRASONOGRAFI HATI

Prof. Dr.dr.Soewignjo Soemohardjo SpPD,KGEH

RS. Biomedika  Mataramliver edge

Pendahuluan:

Artikel  pendek ini di tujukan untuk para dokter Internist yang ingin mempelajari USG hati. Namun tidak ada salahnya bahwa  artikel ini dibaca oleh para ahli radiologi yang banyak berkecimpung dalam USG hati sebagai bahan penyegaran. Dalam artikel ini dikemukakan tentang kasus-kasus ultrasonografik yang sering dikelirukan (common mistakes). Dalam melakukan USG hati para radiologist diharapkan mempunyai frekuensi pemikiran yang sama dengan klinisi, dan harus mengikuti hal-hal baru dalam klinik.

Hal-hal   yang   penting   yang   harus   diperhatikan   waktu melakukan USG hati  adalah:

1. Permukaan hati : Parameter ini menurut penelitian paling besar artinya. Permukaan hati dapat bersifat :

• Rata (smooth)
• Tidak rata lagi  (fine irrigular)
• Nodular

1. Tepi dari hati (liver edge) :

• Tajam rata (sharp smooth)
• Tajam  tidak rata ( sharp irrigular)
• Tumpul rata ( blunt smooth)
• Tumpul  tidak rata ( blunt irrigular)

3. Ukuran hati : Normal, membesar atau mengkerut.

4. Echolevel :

• Hypoechoic ( echo rendah )

atau sering disebut dark liver

• Isoecho (echo normal)
• Slight hyperechoic(echo agak meningkat)
• Hyperechoic (echo tinggi) sering juga disebut bright liver

Dark liver didapatkan pada hepatitis acut karena udema hati sehingga

mudah meneruskan gelombang suara.

Brigth liver didapatkan pada fatty liver. (more…)

Original Article

The Discrepancy Between Histology And PCR Methods for the Detection of Helycobacter Pylori In Patients With Dyspepsia Without Proper Preparation Before Endoscopy

* Maruni Wiwin Diarti, ** Haris Widita, * Soewignjo Soemohardjo, **  Weny Astuti,     *** Troef Sumarno, ***** Yunan Jiwintarum,*  Zainul Mutaqin, and **** Retno Handayani

* Biomedical Research Unit Mataram General Hospital

** Department of Internal Medicine Mataram General Hospital

*** Department of Pathology Medical Faculty  Airlangga University

**** Department of Biochemistry Medical Faculty  Airlangga University

***** Department of Laboratory Technology, Institute of Health Technology West Nusa Tenggara Mataram

Abstract

Background : Detection of H. pylori in gastric tissue by tests based on urease enzymatic activity needs that the patients  stop antibiotics or acid suppressor drugs two weeks before endoscopy to avoid false negative result. The objectives of this study is to compare the result of the detection of H. pylori in gastric biopsy by histology and Ure C PCR in patients with dyspepsia underwent upper GI endoscopy without preparations other than 6 hours fasting before endoscopy.

Material: 156 paraffin blocks of gastric endoscopic biopsy sample taken from antrum and corpus of patients with dyspepsia underwent endoscopy in the endoscopy Unit Biomedika Hospital Mataram.

Methods: All of the biopsy samples were stained with Hematoxylin and Eosin for tissue diagnosis and the Giemsa stain for the detection of H. pylori. PCR Ure C was done on all blocks. PCR for Cag a was done on all PCR Ure C positive samples.

Results: From 156 paraffin blocks, only 17 blocks (10.9%) were positive for H. pylori by histology. PCR was 100% positive from all 17 samples with positive histology. From 156 blocks PCR for Ure C was positive in 73% (45.9%). The PCR method has increased the positivity rates of H. pylori more than four times compared with histology. This study showed that the rate of cag a was 63.0%.

Conclusion : This study showed is that PCR ureC was superior to histology in patients without stopping acid supressor drug and antibiotic 2 weeks before endoscopy. This results can be explained by the change of spiral form into coccoid form that is difficult to detect using Giemsa stain.

Keywords : Helicobacter pylori, histology, ureC,  Cag a, PCR. (more…)