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All Journal E-Jurnal Medika Udayana Jurnal Kedokteran Brawijaya
Bal'afif, Farhad
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Health Professions Medicine & Pharmacology

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Journal : Jurnal Kedokteran Brawijaya

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Pengaruh BDNF dan Neurotrophin Receptorpada Derajat Hidrosefalus Kongenital Pasca Ventrikulo Peritoneal Shunt Bal'afif, Farhad; Widodo, M Aris; ES, M Istiadjid; Hafid B, Abdul
Jurnal Kedokteran Brawijaya Vol 27, No 3 (2013)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (524.693 KB) | DOI: 10.21776/ub.jkb.2013.027.03.5

Abstract

Peningkatan  tekanan  intrakranial  (TIK)  akibat  hidrosefalus  dapat  menyebabkan  penipisan  cerebral  mantle  dan bertanggungjawab  terhadap  peningkatan  Evan's  ratio  (ER).  Apoptosis  dan  degenerasi  neuron  berperan  penting  pada perubahan patologis tersebut. Pada hidrosefalus berat terjadi ketidakpastian dari perbaikan pasca Ventrikulo-Peritoneal Shunt  (V-P  Shunt),  yang  diduga  dipengaruhi  oleh  kadar  Brain  Derived  Neurotropic  Factor  (BDNF)  dan  reseptornya. Penelitian  ini  bertujuan  untuk  membuktikan  pengaruh  Kadar  BDNF ,  solubleT yrosine  Kinase  B  (sT rkB)  dan  soluble  P75 NTRneurotrophin receptor (sP75 ) cairan serebrospinal terhadap perbaikan Evan's ratio  hidrosefalus kongenital Pasca V-P Shunt.  Cairan serebrospinal (CSS)  diambil dari 22 sampel  bayi hidrosefalus saat  dilakukan V-P Shunt,  12 jam,  24 jam  dan 3 NTRbulan  kemudian.  Kadar  BDNF ,  sT rkB  dansP75 diukur  menggunakan  tehnik  ELISA.  Derajat  hidrosefalus  di  ukur menggunakan  Evan's  ratio  dari  hasil  CT-Scan  sebelum  dan  3  bulan  pasca  V-P  Shunt.  Hasil  analisis  data  menunjukkan  bahwa delta  Evan's  ratio  3  bulan  pasca  V-P  Shunt  pada  hidrosefalus  kongenital  berkorelasi  positif  dengan  kadar  BDNF  pre  operatif dan  berkorelasi  negatif  dengan  kadar  sT rkB  pre  operatif .  Disamping  itu  delta  Evan's  ratio  3  bulan  pasca  V-P  ShuntNTRdipengaruhi  secara  negatif  oleh  delta  BDNF dan sP75   dan secara  positif  oleh  delta  sT rkB  3  bulan pasca  V-P Shunt.    Kadar NTRBDNF ,  sT rkB  dan  sP75   terlibat  pada  respon  adaptif  otak  karena  peningkatan  TIK  akibat  hidrosefalus  kongenital  dan berpengaruh  pada  perbaikan  Evan's  ratio  pasca  V-P  Shunt.
Anal Extrusion of Ventriculoperitoneal Shunt: A Case Report and Review of Literature Bal'afif, Farhad; Wardhana, Donny Wisnu; Nazwar, Tommy Alfandy; Nastiti, Novia Ayuning
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.13

Abstract

Ventriculoperitoneal (VP) Shunt is a commonly performed surgical procedure and offers a good result in the treatment of hydrocephalus. In general, 25% of the complication rate of this surgical procedure is abdominal complications. Anal extrusion of a peritoneal catheter is a rare complication ranging from 0.1 to 0.7% of all shunt surgeries. This study presents a rare case of anal extrusion of ventriculoperitoneal shunt in a 1-year-old female child who was asymptomatic. The physical examination revealed swelling and redness along the shunt tract on the retro auricular region, soft abdomen, and no catheter was observed in the anal. This study found several contributing factors affecting the complications in the anal extrusion of a peritoneal catheter, that are thin bowel wall in children and sharp tip and stiff end of VP shunt. The shunt should be disconnected from the abdominal wall, and the lower end should be removed through the rectum by colonoscopy or sigmoidoscopy/proctoscopy or by applying gentle traction on the protruding tube. This study concludes that due to potentially life-threatening consequences and case rarity, thorough anamnesis, physical examination, and objective investigation are needed to determine the appropriate management for anal extrusion of ventriculoperitoneal shunt. 
Co-Authors Abdul Hafid B Alfandy, Tommy Nazwar Anindhita, Prisca M Aris Widodo M Istiadjid ES Nastiti, Novia Ayuning Nazwar, Tommy Alfandy Wardhana, Donny Wisnu