Pub Date : 2020-04-20DOI: 10.19106/JMEDSCI005202202003
Desin Pambudi Sejahtera, I. Setyopranoto, I. Setyaningsih, S. Sutarni, Tri Ratnaningsih
Determining an accurate prognosis in patients with severe traumatic brain injury (TBI) still becomes a difficult challenge for neurologists. Clinical and laboratory findings have been used as important parameters to establish clinical decisions or even predict future prognosis including death in these patients. We studied the clinical, laboratory and neuroimaging parameters in predicting mortality in patients with severe TBI. This study used the medical records of severe TBI cases in Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2015 until July 2016. We evaluated the clinical, laboratory, and neuroimaging examinations of seventy patients with severe TBI in association with mortality. The result showed among 70 patients involved, 35 were dead. Clinical findings of age 140 mmHg (OR=3.852; p=0.008) were associated with mortality. Laboratory and neuroimaging parameters of hyponatremia (OR=3.667; p=0.027), hyperkalemia (OR=1.771; p=0.030), and the presence of traumatic subarachnoid hemorrhage (SAH) (OR=6.526; p=0.003) in head CT-scan were significantly associated with mortality. In conclusion, our study showed that productive age <40 y.o. multiple injuries, hyponatremia, hyperkalemia and the presence of traumatic SAH increase the mortality risk in patients with severe TBI.
{"title":"Prognostic factors for mortality in patients with severe traumatic brain injury in Yogyakarta, Indonesia","authors":"Desin Pambudi Sejahtera, I. Setyopranoto, I. Setyaningsih, S. Sutarni, Tri Ratnaningsih","doi":"10.19106/JMEDSCI005202202003","DOIUrl":"https://doi.org/10.19106/JMEDSCI005202202003","url":null,"abstract":"Determining an accurate prognosis in patients with severe traumatic brain injury (TBI) still becomes a difficult challenge for neurologists. Clinical and laboratory findings have been used as important parameters to establish clinical decisions or even predict future prognosis including death in these patients. We studied the clinical, laboratory and neuroimaging parameters in predicting mortality in patients with severe TBI. This study used the medical records of severe TBI cases in Dr. Sardjito General Hospital, Yogyakarta, Indonesia from January 2015 until July 2016. We evaluated the clinical, laboratory, and neuroimaging examinations of seventy patients with severe TBI in association with mortality. The result showed among 70 patients involved, 35 were dead. Clinical findings of age 140 mmHg (OR=3.852; p=0.008) were associated with mortality. Laboratory and neuroimaging parameters of hyponatremia (OR=3.667; p=0.027), hyperkalemia (OR=1.771; p=0.030), and the presence of traumatic subarachnoid hemorrhage (SAH) (OR=6.526; p=0.003) in head CT-scan were significantly associated with mortality. In conclusion, our study showed that productive age <40 y.o. multiple injuries, hyponatremia, hyperkalemia and the presence of traumatic SAH increase the mortality risk in patients with severe TBI.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75930098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-25DOI: 10.19106/JMEDSCI005202202008
W. Widayati, E. Dwianingsih, B. Ardianto, D. S. Heriyanto, S. R. Indrasari, C. Herdini, Irianiwati
Undifferentiated carcinoma of the head and neck is frequently observed in nasopharynx, however it may also occur in oropharynx, salivary gland and sinonasal. Overlapping lesions in those regionscreate difficulty in determining the origin of the tumor. Thus, it causes diagnostic pitfall not only for pathologists, but also for clinicians. A 40 yearold man, presented with nasal obstruction, epistaxis, diplopia, and headache for a yearand showed nasal cavitysinistra and nasopharynx masses on CT-scan. Lymph node enlargement was not detected. First biopsywas performed and histopathologically diagnosed as nasopharyngeal undifferentiated carcinoma(NPC), extended into nasal cavity. Chemo-radiation protocol for NPC was conducted, and showing uncomplete response. Second biopsy was done, and reviewed with the first biopsy result. Thetumourwas arranged insolid, syncytial and trabecular pattern, with vesicular nuclei, prominent nucleoli, and lack of lymphoplasmacytic infiltrat. Immunohistochemistry (IHC) analysis of p16, EBNA1 and LMP1 were negative. PCR analysis of HPV-18 was positive, while EBV detection showed negative result. General association of EBV with NPC suggests that the presence of latent EBV infection can serve as a positive marker for NPC. Therefore, in this case, the EBV negativity and strong HPV association led to diagnosis of SNUC. The distinction of sinonasal undifferentiated carcinoma (SNUC) or from NPC was important for appropriate management and therapy.
{"title":"Sinonasal or nasopharyngeal undifferentiated Carcinoma?: diagnostic pitfall and the role of Epstein-Barrvirus (EBV) and human papillomavirus(HPV) examination","authors":"W. Widayati, E. Dwianingsih, B. Ardianto, D. S. Heriyanto, S. R. Indrasari, C. Herdini, Irianiwati","doi":"10.19106/JMEDSCI005202202008","DOIUrl":"https://doi.org/10.19106/JMEDSCI005202202008","url":null,"abstract":"Undifferentiated carcinoma of the head and neck is frequently observed in nasopharynx, however it may also occur in oropharynx, salivary gland and sinonasal. Overlapping lesions in those regionscreate difficulty in determining the origin of the tumor. Thus, it causes diagnostic pitfall not only for pathologists, but also for clinicians. A 40 yearold man, presented with nasal obstruction, epistaxis, diplopia, and headache for a yearand showed nasal cavitysinistra and nasopharynx masses on CT-scan. Lymph node enlargement was not detected. First biopsywas performed and histopathologically diagnosed as nasopharyngeal undifferentiated carcinoma(NPC), extended into nasal cavity. Chemo-radiation protocol for NPC was conducted, and showing uncomplete response. Second biopsy was done, and reviewed with the first biopsy result. Thetumourwas arranged insolid, syncytial and trabecular pattern, with vesicular nuclei, prominent nucleoli, and lack of lymphoplasmacytic infiltrat. Immunohistochemistry (IHC) analysis of p16, EBNA1 and LMP1 were negative. PCR analysis of HPV-18 was positive, while EBV detection showed negative result. General association of EBV with NPC suggests that the presence of latent EBV infection can serve as a positive marker for NPC. Therefore, in this case, the EBV negativity and strong HPV association led to diagnosis of SNUC. The distinction of sinonasal undifferentiated carcinoma (SNUC) or from NPC was important for appropriate management and therapy.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78677495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-02DOI: 10.19106/JMEDSCI005201202003
Kian Sinanjung, H. Nirwati, A. T. Aman
Globally, the prevalence of Klebsiella pneumoniae (K. pneumonia) producing extended spectrum beta lactamase (ESBL) has been increasing steadily. The susceptibility patterns of ESBL-producing K. pneumonia varies considerably among countries. Therefore, the investigation of ESBL-producing K. pneumoniae in clinical isolates and their susceptibility are warranted. This research aimed to determine the proportion of ESBL-producing K. pneumoniae and the antibiotic susceptibility patterns of clinical isolates from Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java. Identification of K. pneumoniae was performed by analyzing colony morphology, microscopic examination, and biochemical testing using Microbact. Both antibiotic susceptibility testing and ESBL screening (using ceftazidime, cefotaxime, and ceftriaxone discs) were conducted using disc diffusion method according to CLSI. The positive results were confirmed with modified double disk synergy (MDDST) using amoxicillin-clavulanate, ceftazidime, cefotaxime, and cefepime discs. From 962 clinical bacterial isolates, 168 (17.46%) isolates were identified as K. pneumoniae, during June 2017-May 2018. K. pneumoniae was mainly isolated from the Intensive Care Units (ICU) (29.17%) and with sputum being the most common specimen (45.24%). Overall ESBL producers were 52.98%, with the majority from ICU (41.57%) and isolated from sputum specimens (40.45%). ESBL-producing K. pneumoniae showed high resistance to many antibiotics. The sensitivity of ESBL-producing K. pneumoniae isolated from respiratory tract samples against piperacillin-tazobactam, amikacin, and meropenem was more than 80%. In conclusion, among all K. pneumoniae isolates, ESBL K. pneumoniae was 52.98%. ESBL K. pneumoniae from respiratory tract specimens had a sensitivity of more than 80% against piperacillin-tazobactam, amikacin, and meropenem.
在全球范围内，产生广谱β -内酰胺酶(ESBL)的肺炎克雷伯菌(肺炎克雷伯菌)的流行率一直在稳步上升。产esbl克雷伯肺炎的易感模式在各国之间差别很大。因此，研究临床分离株中产生esbl的肺炎克雷伯菌及其敏感性是有必要的。本研究旨在确定中爪哇Klaten Dr. Soeradji Tirtonegoro总医院临床分离株产esbls肺炎克雷伯菌的比例和抗生素敏感性。肺炎克雷伯菌鉴定采用菌落形态分析、显微镜检查和Microbact生化检测。抗生素药敏试验和ESBL筛查(使用头孢他啶、头孢噻肟、头孢曲松片)均按照CLSI采用片扩散法进行。使用阿莫西林-克拉维酸酯、头孢他啶、头孢噻肟和头孢吡肟片进行改良双盘协同(MDDST)，证实阳性结果。2017年6月至2018年5月，从962株临床分离细菌中，鉴定出168株(17.46%)为肺炎克雷伯菌。肺炎克雷伯菌主要来自重症监护病房(ICU)(29.17%)，以痰标本最常见(45.24%)。ESBL生产者占52.98%，其中大部分来自ICU(41.57%)和痰标本(40.45%)。产esbl肺炎克雷伯菌对多种抗生素具有高耐药性。呼吸道样本中分离的产esbl肺炎克雷伯菌对哌拉西林-他唑巴坦、阿米卡星和美罗培南的敏感性均大于80%。结论肺炎克雷伯菌分离株中，ESBL肺炎克雷伯菌占52.98%。呼吸道标本中的ESBL肺炎克雷伯菌对哌拉西林-他唑巴坦、阿米卡星和美罗培南的敏感性超过80%。
{"title":"Extended spectrum beta lactamase (ESBL)-producing Klebsiella pneumoniae clinical isolates and its susceptibility pattern to antibiotics at Dr. Soeradji Tirtonegoro General Hospital Klaten, Central Java","authors":"Kian Sinanjung, H. Nirwati, A. T. Aman","doi":"10.19106/JMEDSCI005201202003","DOIUrl":"https://doi.org/10.19106/JMEDSCI005201202003","url":null,"abstract":"Globally, the prevalence of Klebsiella pneumoniae (K. pneumonia) producing extended spectrum beta lactamase (ESBL) has been increasing steadily. The susceptibility patterns of ESBL-producing K. pneumonia varies considerably among countries. Therefore, the investigation of ESBL-producing K. pneumoniae in clinical isolates and their susceptibility are warranted. This research aimed to determine the proportion of ESBL-producing K. pneumoniae and the antibiotic susceptibility patterns of clinical isolates from Dr. Soeradji Tirtonegoro General Hospital, Klaten, Central Java. Identification of K. pneumoniae was performed by analyzing colony morphology, microscopic examination, and biochemical testing using Microbact. Both antibiotic susceptibility testing and ESBL screening (using ceftazidime, cefotaxime, and ceftriaxone discs) were conducted using disc diffusion method according to CLSI. The positive results were confirmed with modified double disk synergy (MDDST) using amoxicillin-clavulanate, ceftazidime, cefotaxime, and cefepime discs. From 962 clinical bacterial isolates, 168 (17.46%) isolates were identified as K. pneumoniae, during June 2017-May 2018. K. pneumoniae was mainly isolated from the Intensive Care Units (ICU) (29.17%) and with sputum being the most common specimen (45.24%). Overall ESBL producers were 52.98%, with the majority from ICU (41.57%) and isolated from sputum specimens (40.45%). ESBL-producing K. pneumoniae showed high resistance to many antibiotics. The sensitivity of ESBL-producing K. pneumoniae isolated from respiratory tract samples against piperacillin-tazobactam, amikacin, and meropenem was more than 80%. In conclusion, among all K. pneumoniae isolates, ESBL K. pneumoniae was 52.98%. ESBL K. pneumoniae from respiratory tract specimens had a sensitivity of more than 80% against piperacillin-tazobactam, amikacin, and meropenem.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88872613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-01DOI: 10.19106/medsci005104201901
I. Astuti, Torizal Gf, Nihayatus Sa’adah, R. Oktriani, Tirta Wardana, Ysrafil, T. Aryandono, S. Mubarika
Doxorubicin (Dox)has beenused widely in breast cancer therapy. One of the problems in chemotherapy is the development of resistance to chemotherapy that lead to metastasis and relapse aggressiveness of cancer. MicroRNAs (miRNAs) are small non-coding RNA that regulate protein expression and play role in carcinogenesis, as well as cancer chemotherapy resistance. MiR-451 is classified as tumour suppressor miRNA, that binds to messenger RNA (mRNA) of MDR1, and leads disruption of P-glycoprotein (Pgp) expression. Thestudy aimed to investigate the association between miR-451 and Pgp related with Dox resistance mechanism. In silico analysis was conducted to predict the binding affinity between miR-451 and mRNA of MDR1. The MCF-7 cell line was used as wild type model, while MCF-7/Dox was used as a model of resistance. qPCR was conducted to calculated miR-451 expression and immunocytochemistry was used to observe Pgp expression. miRNA was down-regulated in both on MCF-7 and MCF-7/Dox. On the other hand, Pgp expression was detectable in the cytoplasmic and cytoplasmic membrane in MCF-7/Dox. The Pgp expression was higher in the MCF-7/Dox compared to MCF-7. In conlusion, the over expression of Pgp is associated with the resistance to MCF-7/Dox.
{"title":"Resistance to doxorubicin correlated with dysregulation of microRNA-451 and P-glyoprotein, caspase 3, estrogen Receptor on Breast Cancer cell line","authors":"I. Astuti, Torizal Gf, Nihayatus Sa’adah, R. Oktriani, Tirta Wardana, Ysrafil, T. Aryandono, S. Mubarika","doi":"10.19106/medsci005104201901","DOIUrl":"https://doi.org/10.19106/medsci005104201901","url":null,"abstract":"Doxorubicin (Dox)has beenused widely in breast cancer therapy. One of the problems in chemotherapy is the development of resistance to chemotherapy that lead to metastasis and relapse aggressiveness of cancer. MicroRNAs (miRNAs) are small non-coding RNA that regulate protein expression and play role in carcinogenesis, as well as cancer chemotherapy resistance. MiR-451 is classified as tumour suppressor miRNA, that binds to messenger RNA (mRNA) of MDR1, and leads disruption of P-glycoprotein (Pgp) expression. Thestudy aimed to investigate the association between miR-451 and Pgp related with Dox resistance mechanism. In silico analysis was conducted to predict the binding affinity between miR-451 and mRNA of MDR1. The MCF-7 cell line was used as wild type model, while MCF-7/Dox was used as a model of resistance. qPCR was conducted to calculated miR-451 expression and immunocytochemistry was used to observe Pgp expression. miRNA was down-regulated in both on MCF-7 and MCF-7/Dox. On the other hand, Pgp expression was detectable in the cytoplasmic and cytoplasmic membrane in MCF-7/Dox. The Pgp expression was higher in the MCF-7/Dox compared to MCF-7. In conlusion, the over expression of Pgp is associated with the resistance to MCF-7/Dox.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78818895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-26DOI: 10.19106/JMEDSCI005104201909
Agus Supartoto, M. Djaja, Datu Respatika, M. B. Sasongko
Conjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr. Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location, histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79 years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence.
结膜黑色素瘤可能致命的肿瘤。虽然许多结膜黑色素瘤的病例似乎是复发，但没有有效的数据参数来预测这种肿瘤的复发。本研究旨在评估组织病理学特征是否可以作为结膜黑色素瘤复发的预测因子。这是一项回顾性研究，涉及2013- 2010年在日惹的Dr. Sardjito总医院和Dr. Yap眼科医院的结膜黑色素瘤患者。患者的特征由年龄、性别、侧边、肿瘤大小、肿瘤位置、组织病理学优势、MMC应用、复发和转移决定。16例，男占62.5%，女占37.5%。年龄5 ~ 79岁，平均56.19岁。肿瘤位于球茎11例(68.7%)，眼睑5例(31.3%)。转移与肿瘤复发有显著相关性(OR 13.0;95% ci 1.9-85.4;P = 0.007)。位置与黑色素瘤复发之间也有良好的关联趋势(OR 15.0;95% ci 0.9-228.8;P = 0.06)。总之，我们的研究表明发生远处转移的患者肿瘤复发的风险更大。
{"title":"The predictive factor for conjunctival melanoma recurrence","authors":"Agus Supartoto, M. Djaja, Datu Respatika, M. B. Sasongko","doi":"10.19106/JMEDSCI005104201909","DOIUrl":"https://doi.org/10.19106/JMEDSCI005104201909","url":null,"abstract":"Conjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr. Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location, histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79 years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77919626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phacomatosis pigmentokeratotica (PPK) is a distinct epidermal naevus syndrome. The syndrome is characterized by the coexistence of an organoid naevus with sebaceous differentiation arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, in association with other extracutaneous anomalies. We report on two cases of PPK. The first case was an 11-year-old girl with sebaceous naevus on the right side of the body following the lines of Blaschko present since birth, whereas a papular naevus spilus involving the dorsal area of the neck was noted at 8 years of age. The second case was a 15-year old girl presented with sebaceous naevus on her face and neck and papular naevus spilus involving left side of her chest. Electroencephalography (EEG) of both cases revealed abnormal irritative epileptiform waves, and brain mapping showed symmetrical structures and no focus. The diagnoses of our two cases were based on clinical pictures of the coexistence of sebaceous naevus arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, and EEG anomalies. To our knowledge, these cases were first reported in Indonesia. The association with various extracutaneous manifestation is often, as well as the possibility of malignant transformation.Hence a close follow-up of PPK patients is important, which may help in early recognition of the development of extracutaneous anomalies and the possibility of malignant transformation.
{"title":"Phacomatosis pigmentokeratotica: Two cases series of a neurocutaneous rarity from Indonesia","authors":"Retno Danarti, Nafiah Chusniyati, Yuli Sulistiyowati","doi":"10.19106/jmedsci005104201910","DOIUrl":"https://doi.org/10.19106/jmedsci005104201910","url":null,"abstract":"Phacomatosis pigmentokeratotica (PPK) is a distinct epidermal naevus syndrome. The syndrome is characterized by the coexistence of an organoid naevus with sebaceous differentiation arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, in association with other extracutaneous anomalies. We report on two cases of PPK. The first case was an 11-year-old girl with sebaceous naevus on the right side of the body following the lines of Blaschko present since birth, whereas a papular naevus spilus involving the dorsal area of the neck was noted at 8 years of age. The second case was a 15-year old girl presented with sebaceous naevus on her face and neck and papular naevus spilus involving left side of her chest. Electroencephalography (EEG) of both cases revealed abnormal irritative epileptiform waves, and brain mapping showed symmetrical structures and no focus. The diagnoses of our two cases were based on clinical pictures of the coexistence of sebaceous naevus arranged along Blaschko's lines, a papular naevus spilus arranged in a checkerboard pattern, and EEG anomalies. To our knowledge, these cases were first reported in Indonesia. The association with various extracutaneous manifestation is often, as well as the possibility of malignant transformation.Hence a close follow-up of PPK patients is important, which may help in early recognition of the development of extracutaneous anomalies and the possibility of malignant transformation.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76089619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-26DOI: 10.19106/jmedsci005103201903
S. Supomo, Kelik Wagiyanto, A. Nugraha
Infective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surgery
{"title":"Infective endocarditis as a morbidity predictor in patients who underwent mitral valve surgery","authors":"S. Supomo, Kelik Wagiyanto, A. Nugraha","doi":"10.19106/jmedsci005103201903","DOIUrl":"https://doi.org/10.19106/jmedsci005103201903","url":null,"abstract":"Infective endocarditis (IE) often develops into rheumatic heart disease (RHD) that has many perioperative complications during the evolution of the disease. Cardiac surgery in patients with IE is often followed by post-operative morbidities that can decrease the quality of life. This study aimed to investigate the correlations between preoperative IE and the emergence of various morbidities in patients undergoing heart valve surgery. This was a cross-sectional study with secondary data analysis of the medical record in 60 patients with mitral valve surgery at Dr. Sardjito General Hospital, Yogyakarta from 2012 to 2017. As much as 30 of 60 patients were suffered IE before mitral valve surgery. The most common valve disease in the IE group was mitral stenosis (60%). IE was significantly associated with arrhythmia and cardiac event with p=0.002 (PR: 6.91), prolonged ICU stay with p=0.011 (PR: 5.68), prolonged ventilator use with p=0.015 (PR: 12.43) and severe pulmonary arterial hypertension (PAH) with p=0.033 (PR: 0.192) post mitral valve surgery. As many as 26 (87%) and 29 (96.7%) of patients with IE had a prolonged ICU stay and prolonged ventilator after mitral valve surgery respectively. The incidence of severe PAH postoperatively in the IE group was lower than in the non-IE group (10% vs 36.7%). IE was significantly associated with the increased risk of arrhythmia, prolonged ventilator use and prolonged ICU stay after mitral valve surgery","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84707970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-26DOI: 10.19106/JMEDSCI005104201908
Bambang Udji Djoko Rianto, A. Wibowo, C. Herdini
Thyroid stimulating hormone (TSH) is a cancer growth stimulus factor that have effect on the progression of thyroid carcinoma, common neck head malignancy. This hormonelevel has diagnostic value and can assist in the diagnosis, staging and management of the thyroid carcinoma.This study aimed to investigatethe role of TSH level as a predictor of advance stage thyroid carcinoma. This was case-control study involvingthyroid enlargement subjects who underwent thyroidectomy at Dr. Sardjito General Hospital, Yogyakartafrom 2015 to 2017. Cancer staging examination using AJCC 2102and TSH levels examination were conducted before underwent thyroidectomy.The inclusion criteria for case group were advanced stage(stage III and IV), while for control group wereearly-stage of thyroid carcinoma (stage I and II). The exclusion criteria for both case and control groups were 1) suffering from thyroid hormone disorders requiring therapy before thyroidectomy, 2) receiving thyroid suppression therapy prior to thyroidectomy. Sixty-six post thyroidectomy patients were involved in this study. The patients were divided into case and control groups consisted of 33 patients in each group. Based on receiver operating characteristic curve, the cut of point 1.27 mIU/L for TSH was obtained with sensitivity of 72.7% and specificity of 78.8%. There was statistically significant difference TSH levelsbetween early stage thyroid carcinoma and late stage thyroid carcinoma(p = 0.001;OR: 9.9;95% CI: 3.19-30.15).It can be concluded that TSHlevels ≥ 1.27mIU/L as predictor of advance stage thyroid carcinoma.
{"title":"The role of thyroid stimulating hormone level as a predictive factor for advance stage thyroid carcinoma","authors":"Bambang Udji Djoko Rianto, A. Wibowo, C. Herdini","doi":"10.19106/JMEDSCI005104201908","DOIUrl":"https://doi.org/10.19106/JMEDSCI005104201908","url":null,"abstract":"Thyroid stimulating hormone (TSH) is a cancer growth stimulus factor that have effect on the progression of thyroid carcinoma, common neck head malignancy. This hormonelevel has diagnostic value and can assist in the diagnosis, staging and management of the thyroid carcinoma.This study aimed to investigatethe role of TSH level as a predictor of advance stage thyroid carcinoma. This was case-control study involvingthyroid enlargement subjects who underwent thyroidectomy at Dr. Sardjito General Hospital, Yogyakartafrom 2015 to 2017. Cancer staging examination using AJCC 2102and TSH levels examination were conducted before underwent thyroidectomy.The inclusion criteria for case group were advanced stage(stage III and IV), while for control group wereearly-stage of thyroid carcinoma (stage I and II). The exclusion criteria for both case and control groups were 1) suffering from thyroid hormone disorders requiring therapy before thyroidectomy, 2) receiving thyroid suppression therapy prior to thyroidectomy. Sixty-six post thyroidectomy patients were involved in this study. The patients were divided into case and control groups consisted of 33 patients in each group. Based on receiver operating characteristic curve, the cut of point 1.27 mIU/L for TSH was obtained with sensitivity of 72.7% and specificity of 78.8%. There was statistically significant difference TSH levelsbetween early stage thyroid carcinoma and late stage thyroid carcinoma(p = 0.001;OR: 9.9;95% CI: 3.19-30.15).It can be concluded that TSHlevels ≥ 1.27mIU/L as predictor of advance stage thyroid carcinoma.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74335589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-24DOI: 10.19106/JMEDSCI005104201905
S. Soetrisno, Bambang Arinekso, S. Sulistyowati
Preeclampsia is one of the main contributors on morbidity and mortality of mother and fetus. Imbalance of body antioxidants and oxidants has a role on endothelial destruction causing endothelial dysfunction which leads to preeclampsia. L-arginine administration is indicated to be able to fix the remodelling process of hepatocytes which was damaged on preeclampsia. The aim of this study was to investigate the effect of L-arginine on hepatocyte cells damage on mouse ( Mus musculus ) model of preeclampsia. Experimental study was conducted in the Experimental Animal Warehouse and Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University, Surabaya. A total of 30 pregnant mice were divided into three groups with 10 mice in each group i.e. normal, preeclampsia model and preeclampsia model with L-arginine therapy pregnant mice. Preparates were taken from dissected mice liver, with prior paraffin block and were then stained with hematoxylin-eosin. Results were analyzed semi quantitatively with Manja Roenigk hepar histology scoring method. Data were analyzed using Kruskal-Wallis and Man-Whitney test. Mean of hepar histopathology score of preeclampsia model with L-arginine therapy (40.80±1.17/µm 2 ) was significantly lower compared with preeclampsia model pregnant mice (58.80±4.23/µm 2 ) (p<0.05), however it was significantly higher compared with normal pregnant mice (18.40±2.41/µm 2 ) (p<0.05). It was indicated that the L-arginine therapy on preeclampsia mouse model can reduce the score of hepar histopathology. In conclusion, L-arginine administration can reduce the hepatocyte cells damage of mouse due to preeclampsia.
{"title":"The effect of L-arginine therapy on hepatocyte cells damage in mice ( Mus musculus ) model of preeclampsia","authors":"S. Soetrisno, Bambang Arinekso, S. Sulistyowati","doi":"10.19106/JMEDSCI005104201905","DOIUrl":"https://doi.org/10.19106/JMEDSCI005104201905","url":null,"abstract":"Preeclampsia is one of the main contributors on morbidity and mortality of mother and fetus. Imbalance of body antioxidants and oxidants has a role on endothelial destruction causing endothelial dysfunction which leads to preeclampsia. L-arginine administration is indicated to be able to fix the remodelling process of hepatocytes which was damaged on preeclampsia. The aim of this study was to investigate the effect of L-arginine on hepatocyte cells damage on mouse ( Mus musculus ) model of preeclampsia. Experimental study was conducted in the Experimental Animal Warehouse and Biomedical Laboratory, Faculty of Veterinary Medicine, Airlangga University, Surabaya. A total of 30 pregnant mice were divided into three groups with 10 mice in each group i.e. normal, preeclampsia model and preeclampsia model with L-arginine therapy pregnant mice. Preparates were taken from dissected mice liver, with prior paraffin block and were then stained with hematoxylin-eosin. Results were analyzed semi quantitatively with Manja Roenigk hepar histology scoring method. Data were analyzed using Kruskal-Wallis and Man-Whitney test. Mean of hepar histopathology score of preeclampsia model with L-arginine therapy (40.80±1.17/µm 2 ) was significantly lower compared with preeclampsia model pregnant mice (58.80±4.23/µm 2 ) (p<0.05), however it was significantly higher compared with normal pregnant mice (18.40±2.41/µm 2 ) (p<0.05). It was indicated that the L-arginine therapy on preeclampsia mouse model can reduce the score of hepar histopathology. In conclusion, L-arginine administration can reduce the hepatocyte cells damage of mouse due to preeclampsia.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75326752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-24DOI: 10.19106/JMEDSCI005104201903
H. N. E. Surniyantoro, Y. Lusiyanti, W. Mailana, D. Tetriana
X-rays repair cross-complementing group 1 (XRCC1) gene is one of the gene that plays an important role in base excision repair system (BER) and DNA repair both single and double strand breaks. Individuals with XRCC1 exon 10 (Arg399Gln) gene polymorphisms and carrying 399Gln allele variants (A allele) have a greater risk of DNA damage than their wildtype, 399Arg. The aim of this study was to examine the genotype frequencies of single nucleotide polymorphisms (SNPs) of XRCC1 exon 10 among medical radiation workers. This study involved 77 samples from several hospitals in Indonesia. Genotyping of XRCC1 exon 10 gene polymorphism was performed using PCR-RFLP. Individuals carryingA allele had lower frequency than that is carrying their wildtype of 399Arg (0.39 vs. 0.61). The results indicated that 39% of medical radiation workers had a risk of repair efficiency of DNA damage and might influence an individual's risk of cancer. Ionizing radiation induces many types of damage to DNA, requiring multiple repair pathways to restore genomics integrity. Other important genes/pathways, especially those for DNA double-strand break repair, might also play a role and should be further investigated. Furthermore, polymorphisms leading to inefficient DNA repair might also be associated with late reactions to radiotherapy.
{"title":"Genetic polymorphism in DNA base excision repair gene XRCC1among medical radiation workers","authors":"H. N. E. Surniyantoro, Y. Lusiyanti, W. Mailana, D. Tetriana","doi":"10.19106/JMEDSCI005104201903","DOIUrl":"https://doi.org/10.19106/JMEDSCI005104201903","url":null,"abstract":"X-rays repair cross-complementing group 1 (XRCC1) gene is one of the gene that plays an important role in base excision repair system (BER) and DNA repair both single and double strand breaks. Individuals with XRCC1 exon 10 (Arg399Gln) gene polymorphisms and carrying 399Gln allele variants (A allele) have a greater risk of DNA damage than their wildtype, 399Arg. The aim of this study was to examine the genotype frequencies of single nucleotide polymorphisms (SNPs) of XRCC1 exon 10 among medical radiation workers. This study involved 77 samples from several hospitals in Indonesia. Genotyping of XRCC1 exon 10 gene polymorphism was performed using PCR-RFLP. Individuals carryingA allele had lower frequency than that is carrying their wildtype of 399Arg (0.39 vs. 0.61). The results indicated that 39% of medical radiation workers had a risk of repair efficiency of DNA damage and might influence an individual's risk of cancer. Ionizing radiation induces many types of damage to DNA, requiring multiple repair pathways to restore genomics integrity. Other important genes/pathways, especially those for DNA double-strand break repair, might also play a role and should be further investigated. Furthermore, polymorphisms leading to inefficient DNA repair might also be associated with late reactions to radiotherapy.","PeriodicalId":17474,"journal":{"name":"Journal of thee Medical Sciences (Berkala Ilmu Kedokteran)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79710337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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