Nathaniel Jason Zacharia

Arnetta Naomi Louise Lalisang, Nathaniel Jason Zacharia, Kemal Fariz Kalista, Taufik Agung Wibowo, Lam Sihardo, Vania Myralda Giamour Marbun, Yarman Mazni, Toar Jean Maurice Lalisang, Mureo Kasahara. Clin Transplant Res -0001;0:. https://doi.org/10.4285/ctr.26.0004

Background/Objectives: Population-specific genomic data are essential for understanding hepatocellular carcinoma (HCC) biology, particularly in underrepresented regions. This study aimed to perform exploratory single-nucleotide polymorphism (SNP)-array-based profiling of HCC tumor samples from Indonesian patients and to prioritize candidate functional variants using a systematic in silico framework. Methods: This retrospective cross-sectional study included 15 resected HCC cases with available formalin-fixed paraffin-embedded (FFPE) tumor tissue. Genome-wide SNP genotyping was performed using the Illumina Asian Screening Array. Following quality control and filtering, variants were annotated using the Ensembl Variant Effect Predictor. A case-only functional prioritization approach incorporating multiple in silico prediction tools was applied, followed by gene-level burden aggregation. Results: After multistep filtering, 11 samples and 104 prioritized variants were retained for analysis. Variants consisted predominantly of splice-region, missense, and regulatory changes. Gene-level burden analysis identified Nuclear Autoantigenic Sperm Protein (NASP, rs775916096) as the highest-ranked candidate gene, while G protein-coupled receptor 78 (GPR78, rs558447540) emerged as a secondary candidate with predicted functional annotations but currently limited biological evidence in HCC. Given the tumor-only design without matched normal tissue, the prioritized variants cannot be distinguished from rare germline variants. Conclusions: This exploratory SNP-array study provides a hypothesis-generating framework for functional variant prioritization in Indonesian HCC. NASP and GPR78 represent preliminary candidates that require validation in larger cohorts with matched normal tissue and sequencing-based confirmation.

Introduction: Charity circumcision is common in Indonesia. It is usually done by general practitioners or medical students under supervision. Procedures are often held on a mass scale and rarely followed with post-monitoring. We developed a telemedicine follow-up protocol to educate and address post-procedure complications. This pilot study evaluates the acceptability of telemedicine follow-up protocol for charity circumcision in Indonesia. Method: Data were collected from operators and caregivers of children attending charity circumcision. The protocol consisted of text interviews (pain, urinary retention) and surgical sites' four-angle photographs (epithelialization, bleeding, infection, edema, and glans excoriation). The protocol was conducted two-way between caregivers and operators on days 1, 3, 7, and 30 after circumcision. The Ethics Committee of the Faculty of Medicine, Universitas Indonesia, has approved this study. Result: Twenty-five boys with a mean age of 8.02±1.53 years old have similar pre-operative, operative, and postoperative protocols. Twenty-one caregivers completed four times follow-ups, one missed two times follow-ups, and three missed the last follow-up. Mild pain was the most reported complication, with 32% (8/25), 12% (3/25), 8% (2/24) incidence on days 1, 3, and 7, respectively. By the end of the follow-up, there were no persisting complications, and 80% (20/25) of boys showed complete epithelialization. All caregivers and most operators were satisfied with telemedicine for post-mass circumcision monitoring. Conclusion: The telemedicine-based follow-up is acceptable and feasible to be applied in mass charity circumcision. This protocol is beneficial for monitoring the results and adverse events, therefore, should be routinely adopted in mass charity circumcision programs.

Background: Stoma is made for various indications and the closure is performed with open surgery once the indication is resolved. The case of spontaneous stoma closure rarely happens. Case presentation: In this case report, we present a 62-year-old male with a malignant rectal tumor who experienced spontaneous closure of a stoma. Laparotomy adhesiolysis exteriorization of the sigmoid and transverse colon was made with distended with tenderness all over the abdominal area as the indication. After nine months, the indication was resolved, stoma closure was planned, but the right-sided stoma was closed. Left stoma closure was performed. The patient is currently stable now. Conclusion: Spontaneous stoma closure can be considered the outcome of progressive stoma retraction followed by healing of the mucocutaneous fistula. In this case, we report the benefit of spontaneous stomal closure, no complications were found from stoma closure, and the primary goal of stoma placement was achieved. Management of spontaneous stoma closure can be done conservatively after carrying out a comprehensive examination to rule out possible complications. We report the usefulness of endoscopy and looposcopy in achieving these goals.

Arnetta Naomi Louise Lalisang, Afid Brilliana Putra, Nathaniel Jason Zacharia, Vania Myralda Giamour Marbun, Lam Sihardo, Ridho Ardhi Syaiful, Febiansyah Ibrahim, Wifanto Saditya Jeo, Yarman Mazni, Agi Satria Putranto, Toar Jean Maurice Lalisang. Korean J Transplant 2023;37:179-88. https://doi.org/10.4285/kjt.23.0030

Introduction: Smoking habit still becomes one of the problems in Indonesia with the high number of active smokers in university students. Smoking is one of the causes of several conditions of respiratory symptoms and risk factor of multiple case of lung function impairment. This study aimed to examine characteristic of lung function and respiratory symptoms and its relationship in active smokers among university student in Depok, Indonesia. Methods: This was a cross-sectional study using American Thoracic Society (ATS) questionnaire for respiratory symptoms and Brinkman index for smoking habits. Lung function was examined using EasyOne® Air Spirometer. Results: This study was participated by 116 male university students who are active smokers. This study found that majority of respondents fell into the mild category of smoking habit (96.56%) and complained of respiratory symptoms (74.14%). This study found lung function impairment in 15.5% respondents (8.6% obstructive and 6.9% restrictive disorder). There was no significant relationship between smoking habits with respiratory symptoms and lung function impairment among respondents. Conclusion: This study found the characteristics of smoking habits in male university students were categorized as mild smoking habit, followed by the appearance of respiratory symptoms and lung function impairment. However, there was no significant relationship between smoking habits and respiratory symptoms or lung function. This issue needs to be paid attention to strengthen the campaign to prevent smoking initiation and to help smoking cessation among young adults as early as possible.