Chronic inflammation is a crucial driver of carcinogenesis in pancreatic ductal adenocarcinoma (PDAC). Several studies have investigated the prognostic significance of cyclooxygenase−2 (COX−2) expression in PDAC patients, obtaining conflicting results. Nuclear factor kappa−B (NF−κB), specificity protein 1 (Sp1), and c−Jun are known as the transcription factors of the COX2 gene. This exploratory observational study investigated the association of the NF−κB, COX−2, Sp1, and c−Jun expressions with patient survival in PDAC. We used the immunohistochemical method to detect the PDAC tissue expressions of NF−κB (RelA/p65), COX−2, Sp1, and c−Jun. The expressions of these proteins were correlated with the overall survival (OS) and other clinicopathological characteristics of PDAC patients. We obtained 53 PDAC specimens from resections and biopsies. There were significant correlations between the four proteins’ expressions in the PDAC tissues. The expression of the cytoplasmic (aHR = 0.31; 95% CI 0.11–0.90; p = 0.032) or nuclear NF−κB (aHR = 0.22; 95% CI 0.07–0.66; p = 0.007) was independently associated with a better prognosis in the PDAC patients. COX−2, Sp1, and c−Jun showed no significant association with a prognosis in the PDAC patients. The PDAC patients who expressed NF−κB had a better prognosis than the other patients, which suggests that the role of inflammation in PDAC is more complex than previously thought.

Excessive release of interleukin-6 (IL-6) during the progression of coronavirus disease 2019 (COVID-19) induces cytokine storms, resulting in multi-organ damages including liver injury, similar in nature with mechanism of viral hepatitis. Systemic IL-6 has been associated with the incidence of liver injury among COVID-19 patients; however, studies on IL-6 expression in the liver tissue are completely lacking. The aim of this study was to measure the IL-6 expression in the liver tissues and to determine its correlation with the degree of liver injury in fatal COVID-19 patients. Through this first cross-sectional study, IL-6 expression was measured through immunohistochemical staining and the degree of liver injury was identified based on level of serum alanine aminotransferase (ALT). The Spearman correlation test was used to identify the correlation between IL-6 expression and the degree of liver injury. A total of 47 deceased COVID-19 patients were included and IL-6 expression was observed in all post-mortem liver specimens, ranging from mild to strong expression. Liver injury at various degrees (mild to severe) was found in more than half (59.5%) of the cases. The Spearman correlation analysis suggested a statistically insignificant correlation between liver IL-6 expression and the degree of liver injury (r=0.152; p=0.309). In conclusion, even IL-6 expression was observed in all post-mortem liver specimens, there was an insignificant correlation between IL-6 expression in the liver tissue with the degree of liver injury among fatal COVID-19 patients, suggesting that IL-6 was not the only main factor contributing to liver damage in COVID-19 patients.

Introduction: Breast cancer is still a burden by being the most frequent malignancy and the highest cause of cancer death in women. The death rate from breast cancer can be reduced by early case finding and appropriate immediate treatment. Early case finding can be started with a simple periodic examination that can be carried out by each individual independently, namely by breast self-examination. This study aims to determine the effect of education on early detection and screening of breast cancer on the level of knowledge among women in Gandul village, Madiun district. Methods: This study involved 101 participants aged from 25 to 87 years old, including female residents of Gandul village and cadres of public health center. We conduct health education about breast cancer and early detection of breast cancer, especially regarding breast self-examination. Pre-test and post-test were also conducted to assess the the knowledge of the participants before and after the seminar held. Results: The pre-test score of participants with low scores (75) were only 21.78% (22 people) in the pre-test and increased to 56.44% (57 people) in the post-test. Conclusion: There is a knowledge improvement about the early detection of breast cancer among participants after the intervention. The knowledge improvement can be seen through the increased score from pre-test to post-test.

Introduction: The liver and kidney are the main sites of aluminum (Al) accumulation. Lifetime exposure to significant amounts of Al is inevitable, hence its toxicity on the liver and kidney should be a health concern. Natural antioxidants have been proven to alleviate pathologies in various liver and kidney injuries. However, the effect of olive leaf extract (OLE) on Al-exposed animals is yet to be confirmed. This study aimed to investigate the OLE effect against AlCl3 chronic exposure in rats’ liver and kidneys. Methods:Thirty-two male Wistar rats were divided into four groups (n=8), including the control group, the AlCl3 group treated with 128 mg/kg AlCl3 solution, as well as AlCl3 +OLE50, and AlCl3 +OLE100 groups (Other than AlCl3 they received 50 and 100 mg/kg of OLE, respectively, 2 hours after AlCl3 administration). All treatments were given orally for 12 weeks. All groups were evaluated for liver and kidney histopathological features, then scoring was performed. Results: AlCl3 administrations produced histopathological lesions in the liver and kidney, indicated by increased liver necro-inflammatory grades, ballooning scores, and renal inflammatory cell infiltration (P<0.05). OLE100 mg/kg significantly reduced liver necroinflammatory grade, ballooning score, and kidney inflammatory cell infiltrations. The dose of 50 mg/kg also reduced these parameters (P<0.05), except for the liver necro-inflammatory grade. There was a significant correlation between OLE dose and liver necro-inflammatory grade and ballooning score amelioration. Conclusion: OLE ameliorates liver and kidney histopathological features induced by oral Al chronic exposure in a dose-dependent manner.

Introduction: The most common infection in cholestatic infants is caused by human cytomegalovirus (HCMV). The aims were to detect the presentation of HCMV in cholestatic infants and to evaluate the concordance, sensitivity, and specificity between serology and polymerase chain reaction (PCR) of HCMV from liver biopsy and urine specimens. Methodology: A descriptive observational study with a cross-sectional approach was conducted on 35 cholestatic infants with ethical approval. Specimens were liver biopsy, urine, and anti-HCMV serology. Liver and urine specimens were performed to nested PCR, followed by statistical analysis. Results: PCR from the liver biopsy and urine specimen were positive in 74.3% and 85.7%, respectively. There was no concordance between IgM with the liver PCR, but there was a concordance between IgM with the urine PCR and between IgG with the liver and urine PCR. The sensitivity and specificity of IgM with the liver PCR were 46 % and 56%, respectively, with a diagnostic accuracy of 49%. While IgG sensitivity was 96% with a diagnostic accuracy of 80%. IgG sensitivity and IgM specificity compared with the urine PCR were 93% and 100%, respectively, with a diagnostic accuracy of more than 60%. Conclusions: It demonstrates a high prevalence of HCMV DNA in urine and liver biopsy from cholestatic infants. HCMV PCR assay is more sensitive and specific than the anti-HCMV IgM, but IgG has high sensitivity and accuracy diagnostic. Therefore, serological examination is an option for diagnosing HCMV infection in cholestatic infants in developing countries with no PCR facilities.

Objective: Colorectal cancer is the third malignant tumor and the second cause of death in the world. There are several prognostic factors in colorectal adenocarcinoma, one of which is the TNM stage. The T stage is determined based on the depth of tumor invasion. Various proteins can be involved in the invasion process. EMMPRIN is expressed and functions on the surface of cancerous cells. as a mediator of tumor cell invasion. Increased β-Catenin accelerates the process of tumor cell proliferation, migration, and invasion. We aimed to analyze the correlation between EMMPRIN and β-Catenin expression in the T stages of colorectal adenocarcinoma. Methods: An observational analytic study was conducted using a cross-sectional approach on 47 paraffin blocks of colorectal adenocarcinoma at the Anatomic Pathology Laboratory of Dr. Soetomo Hospital Surabaya from January 2018 to December 2022. An immunohistochemical examination was performed using EMMPRIN and β-Catenin antibodies, and then the expression of both antibodies will be analyzed using statistical tests. Result: There was a significant correlation between the expression of β-Catenin with various T stages of colorectal adenocarcinoma (p-value 0.0201). There was a significant correlation between the expression of EMMPRIN and β-Catenin in various T-stages of colorectal adenocarcinoma (p-value: 0.0209). Conclusion: There is a positive correlation between EMMPRIN and β-Catenin expression and various T-stages of colorectal adenocarcinoma with weak strength. The existence of EMMPRIN and β-Catenin stimulates colorectal cancer cells to continue invasion.