Objective: This study aims to determine the relationship between BRAF V600E and Ki-67 expression with the recurrence of well-differentiated thyroid cancers. Method: The design of this study is a case-control and survival analysis. The data was taken from the thyroid cancer registry in Padang, Indonesia, where samples were taken from well-differentiated thyroid cancer patients who underwent therapy according to the protocol between 2015 and 2020. During this period, 396 well-differentiated thyroid cancer cases were obtained, of which 24 cases experienced recurrence. Of the cases that recurred, we found as many as 20 cases with complete tissue preservation documents later designated as cases. Calculating the expression of BRAF V600E and Ki-67 was performed semi-quantitatively per 100 tumor cells at random. For statistical tests, chi-square and survival analysis were performed using Kaplan-Meier and Cox regression analysis using a computer program with a determined significance level of p < 0.05. Result: BRAF V600E expression was found in all cases and controls in which 85% of cases had vigorous intensity and 15% had moderate intensity. Ki-67 expression was found positive in 35% of the recurrent cases, while in control, there was no expression of Ki-67. Patients with positive Ki-67 expression had shorter median survival than patients with negative Ki-67 expression of 40 months (95% CI 35-45 months) to 60 months (95% CI 53-67 months). An association was obtained between Ki-67 expression and thyroid cancer recurrence based on disease-free survival (p<0.05) with HR 1.34 (95% CI 1. 13-1.92). Conclusion: This study confirms the association between Ki-67 expression and thyroid cancer recurrence based on disease-free survival and can be used as alternative to support the significance of Ki-67 as a predictor of thyroid cancer recurrence. In addition, Ki-67 can complement other molecular markers such as the BRAF V600E, to increase its prognostic strength.

Abstrak   Arteriovenous hemangioma (AH) adalah lesi jinak pembuluh darah kulit yang jarang, biasanya muncul pada kulit wajah berupa lesi tunggal, meninggi, papul merah, atau keunguan; kadang-kadang papul coklat. Dilaporkan satu kasus AH dengan gambaran klinis menyerupai nevus pada pasien perempuan yang berusia 19 tahun. Ini adalahkasus pertama di Bagian Ilmu Kesehatan Kulit dan Kelamin RS. Dr. M. Djamil Padang. Pasien datang dengan keluhan bintik hitam di lengan kanan bawah sejak satu bulan lalu. Pada pemeriksaan fisik, terdapat papul hitam soliter, dengan ukuran 0,3 x 0, 4 mm, bentuk bulat, skuama halus,  berbatas tegas, pinggir reguler dengan permukaan tidak rata.Berdasarkan pemeriksaan histopatologi, lesi terdiri dari pembuluh darah yang berdinding tebal dan berdinding tipis yang sangat melebar, penuh dengan eritrosit dan dilapisi oleh selapis endotel yang sesuai untuk AH. Arteriovenous hemangioma adalah tumor yang dijumpai pada usia pertengahan hingga dewasa lanjut dengan puncak insiden pada dekade keempat dan kelima kehidupan. Pada kasus ini, umur pasien tergolong dewasa muda dengan gambaran klinis lesi menyerupai nevus pigmentosus. Kata kunci: arteriovenous hemangioma, kasus jarang, nevus pigmentosus Abstract Arteriovenous hemangioma (AH) is a rare benign vascular skin lesion, which typically appears in the skin of the face and extremities and  most commonly occurring on the head and neck region with appearances as single, raised, red, or violaceous papules; sometime tan papule. A case of AH clinically mimicking pigmented nevus in 19year-old womanwas reported. This is the first case in Dermatology Department of Dr.M. Djamil Padang Hospital. She complained about a black pimple on the right lower arm since one month. Physical examination: there is a solitare black papule, with 0,3x0,4 mm, round shape, fine scales, well defined, regular border with irreguler surface.Histopathology findings: the lesions consist of thicked-walled and very dilated thin-walled vessels that full-filled with erythrocytes and are lined by an endothelial layer that suitable for AH. Arteriovenous hemangioma is a tumor of middle-age to elderly adults with a peak incidence in the fourth and fifth decades of life. In this case, the patient was young adult and clinically the lesion mimicking pigmented nevus.Keywords:  arteriovenous hemangioma, rare case, pigmented nevus

BACKGROUND: Mesenchymal Stem Cell Wharton’s Jelly (MSC-WJ) is promising candidates for osteoarthritis (OA) therapy since they have chondrogenic potential and the ability to form the extracellular matrix. AIM: This study aimed to determine the effect of the time giving MSC-WJ on bioactive markers of osteoarthritis. METHODS: The osteoarthritis rat model was treated by intra-articular injection with MSC-WJ and α _MEM as a control. Four and 8 weeks later performed a histological analysis of cartilage and the determination of the levels of Matrix Metalloproteinase-1(MMP-1) and Transforming growth factor β1 (TGF-β1) in serum by ELISA. RESULTS: The results showed that administration of MSC-WJ showed improvement in the histological picture of knee joints in experimental animals characterized by an increase in cartilage thickness on the joint surface. The administration of MSC-WJ showed a tendency to decrease MMP-1 serum levels of OA rats treated for 8 weeks, although statistically did not show a significant difference. Whereas, administration of MSC-WJ showed a decrease in serum levels of TGF-β1 OA rat treated for 8 weeks. CONCLUSION: MSC-WJ can repair damaged knee OA cartilage tissue. The administration of MSC-WJ can reduce serum levels of TGF-β1 OA rats treated for 8 weeks.

BACKGROUND: Decreased Natrium iodide symporter (NIS) expression levels or diminished NIS targeting thyroid cancer cells’ plasma membrane leads to radioiodine-refractory disease. AIM: The aim of this study was to analyze the NIS expression in thyroid tumors. MATERIALS AND METHODS: The samples were thyroid tissues of patients who underwent surgery for a thyroid tumor. The tissues were processed for NIS protein expressions by immunohistochemistry (IHC) and Western blot (WB). Graves’ disease samples were used as positive controls. The samples were incubated without the primary antibody, and they were used as negative controls for IHC examination. Na+/K+ ATPase was a plasma membrane protein marker in the WB procedure. RESULTS: Twenty-nine samples were assessed for NIS protein. All of them showed the expression in the cytoplasm with intensity 1+ to 3+ with Allred score 3-8. Fourteen out of 29 cases (48.2%) showed NIS cytoplasm staining intensity ≥2+ consist of 10 papillary thyroid cancer (PTC), three follicular thyroid cancer, and one adenoma. Membrane staining was found in 2 samples of PTC (6.9%). Six samples (adenoma 1 sample, PTC 5 samples) showed NIS expression at membrane very weak (1+); they were considered as negative. NIS protein has several bands of ~ 80 kDa, ~ 62 kDa, and ~ 49 kDa. CONCLUSION: NIS expression in thyroid cancer mostly expresses in the cytoplasm instead of the membrane. NIS will play a functional role in the membrane to bring iodine across the membrane against the concentration. It can be the main reason for the lack of response of radioiodine in some differentiated thyroid cancers.

BACKGROUND: Glutamine, a non-essential amino acid, is the main fuel in the gastrointestinal mucosa. It is thought to protect the intestinal mucosa against local or systemic injury from diarrhea. This study aimed to determine the relationship between glutamine supplementation and ileum histopathology in acute and chronic diarrhea rats induced by enteropathogenic Escherichia coli (EPEC).METHODS: A randomized post-test only control group design was conducted. Thirty Rattus norvegicus Wistar strain were divided into 5 groups: one negative control group, two acute, and two chronic diarrhea groups. All four diarrhea groups were induced by EPEC at a dose of 108 CFU/mL. One acute and one chronic groups were supplemented with glutamine at a dose of 810 mg/200 g body weight for 14 days. While the other two diarrhea groups were not treated. The intestinal histopathology of each group was assessed and the level of inflammation was classified.RESULTS: Significant differences in inflammation levels were found among the groups (p<0.05). The highest inflammation level was observed in the acute diarrhea group without glutamine supplementation. Inflammation levels of both acute and chronic diarrhea with glutamine supplementation groups were significantly lower than the inflammation levels of acute and chronic diarrhea without glutamine supplementation groups.CONCLUSION: Supplementation of glutamine reduces the level of inflammation and leads to the histopathological improvement of the rat’s ileum.KEYWORDS: enteropathogenic Escherichia coli, glutamine, gastrointestinal tract, histopathology, ileum