BackgroundUric acid (UA) plays important roles in inducing renal inflammation, intra-renal vasoconstriction and renal damage. Endothelin-1 (ET-1) is a well-known profibrotic factor in the kidney and is associated with fibroblast expansion. We examined the role of hyperuricemia conditions in causing elevation of ET-1 expression and kidney injury.MethodsHyperuricemia was induced in mice using daily intraperitoneal injection of uric acid 125 mg/Kg body weight. An NaCl injection was used in control mice. Mice were euthanized on days-7 (UA7) and 14 (UA14). We also added allopurinol groups (UAL7 and UAL14) with supplementation of allopurinol 50 mg/Kg body weight orally. Uric acid and creatinine serum were measured from blood serum. Periodic Acid Schiff (PAS) and Sirius Red staining were done for glomerulosclerosis, tubular injury and fibrosis quantification. mRNA expression examination was performed for nephrin, podocin, preproEndothelin-1 (ppET-1), MCP-1 and ICAM-1. PDGFRβ immunostaining was done for quantification of fibroblast, while α-SMA immunostaining was done for localizing myofibroblast. Western blot analysis was conducted to quantify TGF-β1, α-SMA and Endothelin A Receptor (ETAR) protein expression.ResultsUric acid and creatinine levels were elevated after 7 and 14 days and followed by significant increase of glomerulosclerosis and tubular injury score in the uric acid group (p < 0.05 vs. control). Both UA7 and UA14 groups had higher fibrosis, tubular injury and glomerulosclerosis with significant increase of fibroblast cell number compared with control. RT-PCR revealed down-regulation of nephrin and podocin expression (p < 0.05 vs. control), and up-regulation of MCP-1, ET-1 and ICAM-1 expression (p < 0.05 vs. control). Western blot revealed higher expression of TGF-β1 and α-SMA protein expression. Determination of allopurinol attenuated kidney injury was based on reduction of fibroblast cell number, inflammation mediators and ppET-1 expression with reduction of TGF-β1 and α-SMA protein expression.ConclusionsUA induced glomerulosclerosis, tubular injury and renal fibrosis with reduction of podocyte function and inflammatory mediator elevation. ET-1 and fibroblast expansion might modulate hyperuricemia induced renal fibrosis.

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The aim of this study to evaluate clinical and management of penile cancer patients at Sardjito Hospital. Data were collected from medical record of Sardjito Hospital from 2006 - 2013. The clinical factors and therapy were studied from each patient. Correlation between age and stadium of disease were analyzed using Chi-Square Test while the correlation among pathological grade and T, N and M stage were analyzed by using Fisher Test. There are 35 cases of penile cancer with mostly of 40-60 years old man (45.7%) , circumcised (42.9%), squamos cell type (91.4%) and perform partial penectomy (45.7%) followed by chemotherapy (6 patients) and radiotherapy (4patients). There are no correlation between age and stadium of cancer (P>0.05), also among pathological grade with T, N and M Stage (P>0.05). Penile cancers at Sardjito Hospital mostly found on 40-60 years old, and already developed into advanced disease. Thetherapy is consist of partial penectomy followed by chemo- radiotherapy.ABSTRAKPenelitian ini bertujuan untuk mengevaluasi klinis dan manajemen kanker penis di Rumah Sakit Sardjito. Data dikumpulkan dari rekam medis RS Sardjito tahun 2006-2013. Faktor klinis dan terapi dipelajari dari tiap pasien. Hubungan antara usia dan stadium penyakit dianalisis menggunakan tes Chi-Square, sedangkan hubungan antara tingkatan histopatologi dengan stadium T, N, M dianalisis dengan tes Fisher. Ada 35 kasus kanker penis dengandominan pada usia 40-60 tahun (45,7%); telah disunat (42,9%); tipe karsinoma sel skuamosa (91,4%); dan dilakukan penektomi parsial (45,7%) diikuti dengan kemoterapi (6 pasien) serta radioterapi (4 pasien). Tidak ada hubungan antara usia dengan stadium penyakit (>0,05) dan juga antara tingkatan histopatologi dengan stadium T, N, M (p>0,05). Kanker penis di RS Sardjito kebanyakan ditemukan pada usia 40-60 tahun dan telah berkembang menjadi tingkat lanjut. Terapi terdiri dari penektomi parsial diikuti kemo-radioterapi.

Background Most of the outcomes after radical cystectomy (RC) are directly associated with the type of urinary diversion. This study sets out to evaluate the outcomes of ileal conduit (IC) and transuretero-cutaneostomy (TUC) urinary diversion after RC. Methods This retrospective study included 52 patients (IC, n = 30; TUC, n = 22) at Dr. Sardjito Hospital between January 2014 and December 2019. The clinical outcomes were compared using Chi-squared tests and independent t tests. Multivariable logistic regression analysis was performed to determine the odds of developing related complications. Results Demographically, both groups were similar in terms of age, gender, ASA score, staging, body mass index, and comorbidities. IC was associated with a high incidence of postoperative complications than TUC (56.7% vs. 27.3%; p = 0.035). Long-term postoperative complications stoma stenosis was more common in the TUC than IC (p = 0.010). Multivariate analysis showed TUC was a significant predictor for stoma stenotic with odds ratio of 1.29 (95% confidence interval, 1.03–1.62; p = 0.006). Meanwhile, metabolic change was found higher in IC (p = 0.047). No difference between the rate of required blood transfusion, postoperative ileus, re-operation, and anastomotic stricture in both groups. Operative time (p = 0.000) and length of stay (p = 0.002) were lower in patients who underwent TUC. The hospitalized cost was also lower in TUC ($ 2311.8 ± 1448 for IC vs. $ 1844.2 ± 948.8 for TUC; p = 0.005). Nonetheless, the follow-up cost was higher in the TUC but not statistically significant. Additionally, there was no difference between the overall satisfaction and diversion-related symptoms scores in both groups. The psychological score was better in IC groups. Conclusions Both of these techniques can be an option in a urinary diversion after RC with various advantages and disadvantages. TUC provides reduced complication rates, operative time, shorter length of stay, and hospitalized costs, but IC may reduce postoperative stoma stenosis complications and better psychological function.