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QUALITY OF LIFE COMPARATION IN METASTATIC BONE DISEASE PATIENT BEFORE AND AFTER SURGERY IN DR. SOETOMO GENERAL HOSPITAL Ferdiansyah Mahyudin; Mouli Edward; Muhammad Hardian Basuki; Rizky Agung Satria
Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 2 (2018): October 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i2.2018.132-138

Abstract

Background: Metastatic bone disease is bone pathologic process caused by spread of primary tumor. The incidence of metastatic bone disease varies between 20-75% corresponds to the primary site of the malignancy. Surgery in metastatic bone disease aim to cure or palliate the morbidity caused by the disease. Operative treatment could reduce pain, improve function, control metastatic focus of the malignancy, and provide mechanical stabilization. Based on those benefits, operative treatment is important to improve quality of life in patients with metastatic bone disease. Purpose:  Proved that there was a difference in the quality of life MBD patients before and after surgery.Methods: This research was a retrospective cohort on MBD patients which undergone surgery, and never given any other treatment in the course of the disease. The research was conducted in Dr. Soetomo General Hospital, Surabaya. Patient sampling was done using consecutive sampling. Karnofsky score was taken from the medical record before the procedure and direct interview via phone or completing questionnaire. Data analysis was done descriptively and analytically. Statistical tests were done using Wilcoxon test.Results: 146 patients enrolled in the research. The mean age of the sample was 48.77 ± 13.34 years. The mean of Karnofsky score before and after the procedure was 53.69±13.07 and 75.54±13.69 with statistical result of p<0.001.Conclusion: The Karnofsky score in MBD patients was higher after the surgery compared to before the surgery.
ANALYSIS OF IMMUNITY IN OSTEOSARCOMA AS A BASIS FOR DEVELOPMENT FOLLOWING THERAPY Ferdiansyah Mahyudin; Mouli Edward; Muhammad Hardian Basuki; Kadek Seta Prawira
Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 2 (2018): October 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i2.2018.139-148

Abstract

Background: Osteosarcoma is a malignant bone disease. Predictors which used to determine osteosarcoma from non-invasive (stage IIB) to invasive (stage III), through the ratio of macrophages-1 (M-1) which are pro-inflammatory (anti-cancer) with macrophages-2 (M-2) which have anti-inflammatory characteristic (pro cancer) is not clear yet.Purpose: To elaborate the role of M-1 ratio with M-2 in the development of non-invasive osteosarcoma become invasive, in effort to obtain predictors that can be used to the selection of neoadjuvant therapy time.Methods: An observational study with cross sectional analytic study design. The sample of this research were all of paraffin blocks containing osteosarcoma patient tissue, collected within 5 years. The number of samples that met the inclusion criteria was 26 samples, and then divided into two groups, namely group-I as many as 13 stages IIB and group-II as many as 13 samples of stage III. The measured variables are the number of macrophages that express TNF-α and those that express IL-10 by immunohistochemical methods.Results: Analysis of the data using a Mann-Whitney test, and the results were obtain is the number of macrophages expressing TNF-α in group-I was greater than in group-II (p <0.05). Likewise, macrophages that expressed IL-10 in group I were smaller than in group-II (p <0.05).Conclusion: The M-1 ratio which reflected by TNF-α expression cells with M-2 as reflected by IL-10 expression cells in the non-invasive group is 5: 1.Whereas in the group that develops to invasive is 1:6.
Giant Cell Tumor of The Proximal Phalanx of The Index Finger of The Hand: A Rare Case Report Mouli Edward; Ferdiansyah Mahyudin; Muhammad Hardian Basuki; Yunus Basrewan; Caesar Haryo Bimoseno
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.49-55

Abstract

Background: Giant cell tumor (GCT) of bone is a relatively common type of benign tumor involving the epiphyseal region of tubular bones, but GCT rarely occurs at hand (1–4% of all GCT). GCT within the hand tends to be more aggressive and recurs more rapidly in hand than in other locations. Most authors prefer curettage or resection with reconstruction to maintain anatomical and functional integrity.Case Report: A 27-year-old man with a chief complaint of an enlarged lump and pain in the index finger of his left hand. These lumps appeared three months ago. Plain radiographs showed lytic, eccentric, geographic lesions with well-defined borders and narrow transition zones. Magnetic resonance imaging (MRI) showed a primary aggressive bone tumor with extension to the surrounding soft tissue. Fine Needle Aspiration Biopsy (FNAB) revealed the lesion as a Bone Giant Cell Tumor. The patient then underwent local resection and reconstruction using an allograft. Range of movement (ROM) measurements and DASH scores were evaluated.Discussion: Radiographic and MRI examinations showed characteristic cortical breach, and FNAB showed multinucleated giant cell spread. After treatment, the patient was found to be pain-free, have an improved ROM, and reduced disability. There was no recurrence observed. Conclusion: Despite the tendency for hand GCT to be more aggressive, local resection and reconstruction using an allograft with adjuvant hydrogen peroxide can reduce recurrence and disability.
Comparison of pre- and post-implantation of Indonesian-made plates in fracture patients: Functional, radiological, biomechanical and chemical analyses Lisan, Rizal A.; Mahyudin, Ferdiansyah; Mubarok, Fahmi
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.752

Abstract

Bone implants are important in the recovery of fractures and degenerative diseases. Although many implants have been marketed, study on Indonesian-made plates is still limited. The aim of this study was to assess the patients’ functional and radiological improvements and biomechanical and chemical changes of Indonesian-made plates used in long bone fractures. retrospective study was conducted at Semen Gresik Hospital, Gresik, Indonesia. This study included adult patients with long bone fractures who had surgeries with Indonesian plates. Functional improvement (assessed using disabilities of arm, shoulder, and hand (DASH) or lower extremity functional scale (LEFS)) and radiological data (assessed using radiographic union score (RUS)) were assessed in week 4 and month 6, 12, and 15 after surgery. Biomechanical changes (hardness and roughness test) and chemical analysis were assessed after 15 months of use. The normality of the data was tested with Shapiro-Wilk while data analysis was conducted using paired Student t-test or Friedman test as appropriate with type of data. Our data indicated that the DASH and LEFS functional scores had significant improvement over the follow-ups indicating functional recovery. RUS scores also improved over time, indicating a good healing process. Hardness tests on post-surgery implants showed a decrease in hardness of 7.3% and an increase of 3.3% in roughness. Chemical analysis showed a reduction in chemical levels in the implant of 7.8%, indicating durability and minimal toxicity. This study highlights that Indonesian implants have been proven safe to use in fractures. Further examinations with a larger sample and a longer duration of monitoring are recommended for stronger validity.
Role of preservation methods using deep-freezing and liquid nitrogen in bone allograft characteristics: An in vitro study Lisan, Rizal A.; Mahyudin, Ferdiansyah; Edward, Mouli; Buwana, Dewan S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.757

Abstract

Bone grafting has emerged as a key solution in bone defect management such as allograft, graft of bone from another individual. However, bone allografts usually undergo rigorous preparation to eliminate immune-triggering elements. The deep-freezing methods may delay graft use, while cryopreservation using liquid nitrogen allows rapid freezing but may alter graft characteristics. The aim of this study was to investigate the post-preservation changes in bone allograft characteristics and to compare the effectiveness of deep-freezing and liquid nitrogen methods using animal model. An experimental study using a post-test only control group design was conducted. Fresh-frozen femoral cortical bone was obtained from male New Zealand white rabbits. Preservation by deep-freezing involved placing bone samples in a -80°C freezer for 30 days. For liquid nitrogen preservation, bone grafts were immersed in liquid nitrogen for 20 min, followed by a 15-min rest at room temperature and a final immersion in 0.9% sodium chloride at 30°C for 15 min. Bone samples then underwent evaluation of cell viability, compression, and bending tests. Cell viability test employed the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and the compression and bending tests used the Universal Testing Machine (UTM). Independent Student t-test or Mann-Whitney U test were used to compare the methods as appropriate. Our study found that the use of deep-freezing and liquid nitrogen resulted in similar outcomes for cell viability, compression, and bending tests, with p-values of 0.302, 0.745, and 0.512, respectively. Further exploration with larger sample sizes may help to optimize the methods for specific applications.
The Clinical and Radiological Outcome of Bovine Hydroxyapatite (Bio Hydrox) as Bone Graft Arifin; Mahyudin, Ferdiansyah; Edward, Mouli
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 1 (2020): April 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i1.2020.9-16

Abstract

Background: Bone grafting is a surgical procedure that involves transplanting material to enhance bone healing through osteogenesis, osteoconduction, and osteoinduction. While autografting has long been considered the gold standard, it has limitations, including a restricted supply and donor site morbidity. These limitations, along with those associated with allografts, have led to the development of bovine hydroxyapatite (BHA) as a bone graft substitute. This study aimed to evaluate the clinical and radiological outcomes of BHA.Methods: This descriptive study used a consecutive sampling design, including all trauma patients who received BHA at our hospital between 2016 and 2018. The BHA was obtained from the tissue bank at our institution. The clinical and radiological outcomes were evaluated, and the data was tabulated and analyzed descriptively.Results: Of the 56 patients who underwent surgery with BHA, most (80.36%) had excellent outcomes, 12.5% had good outcomes, 3.57% had fair outcomes, and 3.57% had poor outcomes.Conclusion: Bovine hydroxyapatite can be considered an alternative bone graft to support the bone healing process.
The Effect of Culture Techniques of Hypoxic Stem Cell Secretome on The Number of Growth Factor TGF-β, BMP-2, VEGF Edward, Mouli; Mahyudin, Ferdiansyah; Manyakori, Dionysius Bramta Putra
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.5-9

Abstract

Background: Mesenchymal stem/stromal cell (MSC) therapy is now an effective therapeutic modality for treating various diseases. In its application, stem cells require signaling molecules, including growth factors, cytokines, and chemokines. Signaling molecules function in an orderly manner and are greatly influenced by the physiological environment. Stem cell culture techniques with hypoxic conditions can produce growth factors similar to those found in fracture conditions. This study aimed to evaluate the differential expression of growth factors in cultured normoxic and hypoxic bone marrow stem cell (BMSCs).Methods: This in vitro laboratory experimental study examined normoxic and hypoxic BMSC cultures. BMSCs were harvested from rabbits, propagated in vitro, and cultured under normoxic and hypoxic conditions. Vascular endothelial growth factor (VEGF), Transforming growth factor-β (TGF-β), and Bone morphogenetic protein-2(BMP-2) levels were measured using ELISA.Results: VEGF, TGF-β, and BMP-2 expression showed significant differences between the normoxia and hypoxia groups. The VEGF, TGF-β, and BMP-2 expressions were higher in the hypoxia group compared with the normoxia group (p < 0.05).Conclusion: The expression of TGF-β1, VEGF, and BMP-2 growth factors in cultured BMSCs was significantly different between normoxic and hypoxic conditions. TGF-β1, VEGF, and BMP-2 expression increased under hypoxic conditions.
Growth Factor Comparison in Cortical Demineralized Bone Matrix that Demineralized Using Chloric and Acetic Acid Edward, Mouli; Mahyudin, Ferdiansyah; Basuki, Mohammad Hardian; Suroto, Heri; Perwira, Ferdiansyah Danang
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.1-9

Abstract

Background: Demineralized bone matrix (DBM) is an alternative biomaterial for which specific acid and immersion time are needed to optimize growth factor preservation. The optimal demineralization protocol for preserving growth factors in DBM remains unclear. This study investigated DBM extraction methods using different acids and immersion times to maintain optimal growth factor preservation.Methods: This in vitro experimental laboratory study used a randomized controlled post-test-only group design. We characterized the Insulin-like growth factor-1 (IGF-1), Bone morphogenetic protein-2 (BMP-2), and Transforming growth factor-β (TGF-β) content of 1 gram of New Zealand White Rabbit cortical bone immersed in 0.6 M hydrochloric acid and 0.5 M acetic acid for 3, 6, and 9 days. We then analyzed the differences in growth factor levels in each acid and performed statistical analysis.Results: IGF-1 levels were higher in DBM demineralized with acetic acid than with hydrochloric acid. BMP-2 and TGF-β levels were higher in DBM demineralized using hydrochloric acid. The concentration of growth factors decreased over time in DBM demineralized using acetic acid. The highest growth factor level was obtained after 6 days of immersion in hydrochloric acid.Conclusion: DBM demineralized with acetic acid yielded higher average IGF-1 levels compared to hydrochloric acid. However, BMP-2 and TGF-β levels were higher with hydrochloric acid. Growth factor levels in hydrochloric acid peaked at 6 days and then decreased. These results suggest that avoiding over-demineralization is important for maintaining growth factor levels. Further research is needed to optimize DBM processing.
Intraarticular Allogenic Mesenchymal Stem Cells and Vascular Endothelial Growth Factor Injection in Anterior Cruciate Ligament Reconstruction Utomo, Dwikora Novembri; Mahyudin, Ferdiansyah; Zulkarnain, Arif; Purwati, Purwati; Setyawati, Rossy
Folia Medica Indonesiana Vol. 56 No. 1 (2020): March
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (541.763 KB) | DOI: 10.20473/fmi.v56i1.24587

Abstract

Graft tunnel healing is important for the successful reconstruction of the anterior cruciate ligament by using the hamstring tendon autograft. There are studies that intra graft tunnel Bone Marrow Mesenchymal stem cells (BMSCs) or intra graft tunnel Vascular endothelial growth factor (VEGF) accelerated graft tunnel healing. This study aimed to investigate the effect of using BMSCs+VEGF injected intra-articular on graft tunnel healing. We reconstructed the anterior cruciate ligament (ACL) of 12 rabbits using an autograft hamstring tendon with and without intra-articular BMSCs+VEGF. Histological evaluation was done at 3 and 6 weeks after ACL reconstruction. On the surface between the graft and the bone tunnel obtained collagen fiber thickness or Sharpey fiber is significantly more than the control group (p< 0.05) in the evaluation of 3 weeks and 6 weeks either side of the tibia and the femur. To evaluate the progression of the treatment, treatment group and control group gained progression had significantly when compared to 3 weeks and 6 weeks. It can be concluded that intra-articular injection of VEGF+BMSCs can accelerate the integration of the graft tunnel from histology evaluation on 3 and 6 weeks.
ENHANCING KNOWLEDGE AND EDUCATION OF BONE CANCER FOR ADOLESCENT IN INDONESIA Abdul Bari, Yunus; Mahyudin, Ferdiansyah; Edward, Mouli; Basuki, Mohammad Hardian; Martanto, Tri Wahyu; Wardhana, Teddy Heri; Suyono, Rifki Effendi; Purnamasari, Yunita; Permana, Muhammad Dimas Arya Candra; Ardana, Fahrizal Novan
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 9 No. 1 (2025): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v9i1.2025.019-025

Abstract

Despite much-advanced therapy developed for bone cancer, prevention of the disease remains the most favorable and low-cost management approach. Bone cancer prevention and education should be initiated with adolescents.  Adolescents are the right group to receive bone cancer education, as they are in an active learning phase and have the potential to develop risky behaviors that can increase vulnerability to cancer, as they are in a stage of active learning but also face the development of risky and unhealthy behaviors. This study aims to assess the knowledge of bone cancer among adolescents in Indonesia. It is a cross-sectional study that uses a questionnaire to evaluate the participants' knowledge of bone cancer. A total of 39 questions regarding family history and general knowledge of cancer are given to the students in a pre-test and post-test format. Between the tests, a group of orthopedic specialists provided a short lecture to the students about the basic knowledge and prevention of bone cancer. The study involved 564 students from junior and senior high schools in Indonesia, with an overall mean age of 14.79 years. Bone cancer was mentioned in the family history of only 0.4% of the participants, but 21.5% to 23.5% were unsure about their own family cancer status. The study found a significant statistical result, indicating that the short lectures given by the orthopedic specialists were effective in enhancing the students' knowledge about bone cancer. The findings suggest that adolescents in Indonesia are still uncertain about their family cancer status and often misinformed about the symptoms of bone cancer. However, an educational lecture or discussion led by an expert in the field has proven to be an effective way to improve the students' knowledge about bone cancer.