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Cancer Stem Cell: Target Baru Obat Antikanker HALIM, DANNY; DJUWANTONO, TONO; AHMAD, TRI HANGGONO
Indonesian Journal of Cancer Vol 4, No 3 (2010): Jul - Sep 2010
Publisher : "Dharmais" Cancer Center Hospital

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Relaps, resistance and metastasis has become prominent problems that oncologists and cancer patients have to dealt with. Various studies have been done previously concluded that there are a subpopulation of cancer cells, identified as cancer stem cell, most likely to be the cause of relaps, resistance and metastasis of cancer. Cancer stem cell is a subpopulation of cancer cells that possess tumorigenicity, hence it can initiate the growth of tumor. Cancer stem cell has been suspected to be originated from normal stem cells reside in mature tissues, or from progenitor cells that gone through some series of alterations on its characteristics, including mutagenic and non-mutagenic changes. As seen in normal stem cells, cancer stem cell is also oftenly found in its inactive state. Therefore, cancer stem cell is not affected when it treated with many chemotherapeutic agents that are targeting cancer cells that proliferate extensively. Eventually, this event leads to the incidence of cancer relaps on cancer patients who already had series of cancer therapy. Based on this knowledge, it can be concluded that the only absolute way to overcome the incidence of metastasis, resistance and relaps on cancer patients, is to targeting cancer stem cell. Therefore, optimization on protocols of cancer stem cell identification and isolation strived continously. Some molecular markers that are oftenly used as a standard on cancer stem cell isolation are CD34, CD44 and CD133. In line with that, isolation methods that are based on sphere formation and the absorption of coloring dye could also be done to obtain cancer stem cell population. This review article would like to explain the nature of cancer stem cell existence, the pathology underlies its formation, characteristics and identification techniques that are commonly used, and challenges that have to be faced by scientists and physicians in order to optimize the application of cancer stem cell theory for the progress of science and patientsâ sake.

Effect of Lycopene on Peritoneal Fluid Malondialdehyde Level in Endometriosis Astarto, Nanang W.; Djuwantono, Tono; Yelliantty, .
Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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Oxidative stress is a factor that contribute in pathogenesis of endometriosis. This condition could also implicated in infertility. Lycopene is a carotenoid that has antioxidant activity. Supplementation of lycopene can reduce oxidative stress in peritoneal fluid of women with endometriosis. This study aims to compare the effect of lycopene on malondialdehyde (MDA) levels in peritoneal fluid of women with endometriosis. It is an experimental study on peritoneal fluid from five women with endometriosis. The result show that lycopene supplementation affecting the MDA levels in peritoneal fluid. MDA levels in peritoneal fluid with lycopene is lower than without lycopene. It conclude that lycopene is proved lowering MDA levels in peritoneal fluid of women with endometriosis.Â Keywords: endometriosis lycopene, malondialdehyde

Embryo Quality: The Most Critical Factor for Pregnancy Rates after day-2, day-3, and day-5 of Embryo Transfer Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 4, October 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To determine the most critical factor on day-2, day-3, and day-5 of embryo transfer in correlation with pregnancy rates. Method: This research is a retrospective study in Aster Fertility Clinic, IVF program- Dr. Hasan Sadikin Hospital, Bandung, Indonesia. One hundred ninety five women enrolled in an IVF program conducted from March 2006 through November 2009 at the Aster Fertility Clinic. Effect of embryo-transfer day and any other factors (including quality of embryo, oocyte quantity, difficulty of embryo transfer technique, and blood or mucus contamination on the catheter) on pregnancy rate in IVF. Results: The mean age of the pregnant group was 34.65 (SD = 3.91), and the mean of the infertility period was 7.25 years (SD = 3.54). There were no siginificant differences in pregnancy rates in the day-2, day-3, and day-5 groups. The most critical factor influencing pregnancy was the total score for the quality of embryos [p = 0.001; OR (CI 95%) = 1.94 (0.91 - 4.08)]. Otherwise, the day of embryo transfer, oocyte quantity, and difficulties in embryo transfer did not affect the pregnancy rate (p > 0.05). Conclusion: Our study suggests that the total score for the quality of the embryos was the most critical factor for the success rate of pregnancy rather than the day of embryo transfer, oocyte quantity, difficulty of embryo transfer technique, or contamination of blood and mucus on the catheter. [Indones J Obstet Gynecol 2010; 34-4: 175-9] Keywords: day of embryo transfer, in vitro fertilization, quality of embryo total score, oocytes quantity, catheter contamination

Knowledge and attitude of pregnant woman toward umbilical-cord-blood collection Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 34. No. 2, April 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: Stem cell technology from umbilical cord blood (UCB) has developed fast as health services. UCB could be used in many kinds of disease. Private UCB bank has been operated in many places all over Indonesia. Thereâs a need for research to evaluate the knowledge and attitude of pregnant woman towards the act of collecting UCB. Method: This is a cross-sectional study base on question-naire given to 163 pregnant women in three private hospitals in the Bandung City from September - November 2009. The result was analyzed with Rank-spearman correlation and Kruskal-Wallis chisquare. Result: Most respondent were 20 - 29 years old pregnant women (54.6%), with educational level of strata-1 (S-1) (41.1%), with monthly income within 5 - 10 million rupiah (35.6%). This is the second pregnancy or more (42.9%), with gestational age less than 24 weeks (61.3%) and variative obstetric history (59.5%). The average level of knowledge was poor and attitude scale was uncertain (3.4). There is a significant correlation between age (p = 0.008%; CI 95%), level of education (p = 0.0001; CI 95%) and knowledge. There is a significant correlation between gestational age and attitude (p = 0.003; CI 95%). Respondentâs level of knowledge also has a significant correlation with attitude (Ïs = 0.421; p = 0.0001; CI 95%). Conclusion: This study described the respondentâs poor knowledge will influence their attitudes toward UCB collection, so it is necessary for disseminating more information on UCB as an effort to get better research result on UCB. [Indones J Obstet Gynecol 2010; 34-2: 97-100] Keywords: knowledge level, attitudes, collecting UCB, pregnant woman, the Bandung city

Postlaparoscopic GnRHagonist Therapy does not Improve Spontaneous Conception Rates of Women with Endometriosis Tjandraprawira, Kevin D; Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the reproductive benefits of combining laparoscopic surgery with GnRH-agonist hormonal therapy in treating women with endometriosis. Methods: This is a non-randomized prospective analytic study of patients with endometriosis conducted in a private hospital in Bandung during the period of January 2014 to December 2015, whom were later followed up after 12-24 months for assessment of post-surgical reproductive performance. A total of 121 patients were enrolled, 60 of which received post-surgical GnRH-agonist hormonal therapy. Results: We discovered that 56 women (46.3%) eventually achieved spontaneous conception after surgery but upon further analysis, it was discovered that GnRH-agonist played no significantly meaningful role in improving the spontaneous pregnancy rates of these patients (OR 1.539; 95% CI 0.750-3.159; p-value 0.239). Furthermore, even though there was a wide range as to when they achieved conception, those untreated with hormonal therapy tended to conceive far more quickly than those who were (5.91 ± 6.28; 8.56 ± 4.24; p-value: 0.011). Conclusion: Post-laparoscopic GnRH-agonist administration to women with endometriosis does not significantly improve their chances of spontaneous conception. In fact, such administration seems to delay it. [Indones J Obstet Gynecol 2017; 5-2: 87-93] Keywords: endometriosis, GnRH-agonist, laparoscopy

Postlaparoscopic GnRHagonist Therapy does not Improve Spontaneous Conception Rates of Women with Endometriosis Tjandraprawira, Kevin D; Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 2, April 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Objective: To investigate the reproductive benefits of combining laparoscopic surgery with GnRH-agonist hormonal therapy in treating women with endometriosis. Methods: This is a non-randomized prospective analytic study of patients with endometriosis conducted in a private hospital in Bandung during the period of January 2014 to December 2015, whom were later followed up after 12-24 months for assessment of post-surgical reproductive performance. A total of 121 patients were enrolled, 60 of which received post-surgical GnRH-agonist hormonal therapy. Results: We discovered that 56 women (46.3%) eventually achieved spontaneous conception after surgery but upon further analysis, it was discovered that GnRH-agonist played no significantly meaningful role in improving the spontaneous pregnancy rates of these patients (OR 1.539; 95% CI 0.750-3.159; p-value 0.239). Furthermore, even though there was a wide range as to when they achieved conception, those untreated with hormonal therapy tended to conceive far more quickly than those who were (5.91 ± 6.28; 8.56 ± 4.24; p-value: 0.011). Conclusion: Post-laparoscopic GnRH-agonist administration to women with endometriosis does not significantly improve their chances of spontaneous conception. In fact, such administration seems to delay it. [Indones J Obstet Gynecol 2017; 5-2: 87-93] Keywords: endometriosis, GnRH-agonist, laparoscopy

MODIFIKASI METODE ISOLASI SEL ENDOTEL PEMBULUH DARAH OTAK (EPDO) TIKUS: TEKNIK DASAR KULTUR SEL PRIMER DI BIDANG NEUROSAINS Faried, Ahmad; Zafrullah Arifin, Muhammad; Sutiono, Agung Budi; Halim, Danny; Djuwantono, Tono; Achmad, Tri Hanggono
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Metode konvensional isolasi sel endotel pembuluh darah otak (EPDO) masih tergolong sulit, sehingga upaya mendapatkan populasi murni sel ini adalah tantangan. Pada penelitian ini dilakukan isolasi endotel dari tikus Wistar dan mencit C57/Bl6, berdasarkan protokol the care and use of laboratory animals, Universitas Gunma, Jepang. Modifikasi metode isolasi adalah menggunakan gradasi bovine serum albumin (BSA), bukan Dextran-70 yang umumnya dipakai, untuk memisahkan sel EPDO yang bersatu menjadi sel EPDO tunggal. Penelitian ini dilakukan di laboratorium sel kultur, Universitas Padjadjaran bekerjasama dengan Universitas Gunma, Jepang, Januari 2008?Juni 2009. Uji hasil isolasi dan karakteristik sel EPDO dilakukan dengan teknik imunofloresen. Ekspresi tight junction ZO-1, menunjukkan sel EPDO membentuk selapis sel utuh, rapat, tidak bertumpuk dan kompak, sesuai dengan karakteristik dinding EPDO. Fenotip sel EPDO dikonfirmasi dengan acethylated LDL, faktor von Willebrand dan CD31. Penghancuran kapiler dengan collagenase/dispase masih menghasilkan populasi sel yang terkontaminasi perisit. Kontaminasi dimurnikan dengan menggunakan puromycin, tingkat pemurnian sel EPDO mencapai 98,3%. Simpulan, teknik modifikasi berhasil mengisolasi sel EPDO tikus dan mencit, tanpa melakukan intervensi genetik. Puromycin dapat digunakan untuk memurnikan sel EPDO. [MKB. 2010;42(4):161?8].Kata kunci: Metode modifikasi isolasi sel EPDO, pembuluh sawar otak, teknik pemurnian Isolation Modified-Method of Mouse-Brain Microvessel Endothelial Cells: Primary Cell Culture Technique in NeuroscienceIsolation method to obtain pure BMVECs is hard to be done consistently and remains a challenge. In this study, we isolated BMVECs from Wistar rat and C57/Bl6 mouse from Japan SLC. All procedures performed according to guidelines for the care and use of laboratory animals of Gunma University, Japan. The modification of isolation method was using bovine serum albumin (BSA) gradation, not Dextran-70 in which generally used, to separate clusters of BMVECs into single cell. This study was done at Universitas Padjadjaran, in colaboration with Gunma University, Japan, January 2008?June 2009. Further,characteristic and purification results were proven by imunofluorescene staining. The results showed that staining of tight junction, ZO-1, formed a monolayer, tightly packed, non-overlapping and contact-inhibited BMVECs, as expected for a vessel wall endothelial. ECs phenotype confirmed by acethylated LDL, von Willebrand and CD31. The digestion of capillaries generated contaminating pericytes. Contamination was purified using puromycin and the results considered satisfactory (98.3%). In conclusion, our modification procedure allows the isolation of primary rat and mouse BMVECs, which form an endothelial-like monolayer in few days. Puromycin can be used for purification of primary rat and mouse BMVECs. [MKB. 2010;42(4):161?8].Key words: Blood brain barrier, isolation modified-method of mouse-BMVECs, purification methods DOI: http://dx.doi.org/10.15395/mkb.v42n4.30

Correlation between Estrogen Receptorβ (ERβ), Neurofilament Protein (NF), and Protein Gene Product 9.5 (PGP9.5) Expressions as a Marker of Pain on Adenomyosis Etiopathogenesis Arief Setiawan; Ruswana Anwar; Tita Husnitawati; Tono Djuwantono; Wiryawan Permadi
Majalah Kedokteran Bandung Vol 53, No 4 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n4.2363

Adenomyosis is a pathological condition characterized by the presence of endometrial glands and stroma within the myometrium. Endometrial like cells development was influenced by local inflammatory reactions, increases local estradiol due to asynchromatized estrogen synthesis (ERβ) and then stimulated to proliferation and fibrosis, are also irritation on small nerve fibers in women with painful characterized symptoms on adenomyosis. There are expressions of neurofilament protein (NF) and protein gene product 9.5 (PGP 9.5) is a highly specific pan-neuronal marker for microfilament nerve fibers and is related to presenting pain with adenomyosis symptoms. A retrospective immunohistochemical study of thirty samples histopathological of adenomyosis as study groups and 30 with control groups between 25–49 ages which were established at Dr. Hasan Sadikin General Hospital and the satellites in April 2014–May 2015. This case-control analyzed ERβ, NF, and PGP 9.5 expressions compared and correlation between study groups and controls. The results showed there were significant differences in expression of ERβ, NF, and PGP 9.5 on adenomyosis higher than the control study (p<0.05). The intensity was higher and very strong into the study groups (p<0,001). Cut off point of ERβ was more than>6(sensitivity 66.7%; specificity 70%), NF>3 (sensitivity 93%; specificity 46%), PGP 9.5>4 (sensitivity 90%; specificity 67%). Odds Ratio (CI 95%) ERβ>6= 4.67; NF >3=12.25; PGP 9.5 >4=24.75 (p<0.001). The value of histoscore of ERβ and PGP9.5 have correlates to adenomyosis, the differences were statistically significant (p<0.05). The conclusion were that the adenomyosis had higher ERβ, NF, and PGP 9.5 expressions. There are simultant correlates and positive values between ERβ, NF, and PGP9.5 based on etiophatogenesis of pain on adenomyosis.

Pengaruh Penerapan Aplikasi Sayang ke Buah Hati (SEHATI) terhadap Pengetahuan Ibu dan Aktivitas Fisik pada Anak Sekolah Dasar Nurul Auliya Kamila; Hadi Susiarno; Dida Akhmad Gurnida; Irvan Afriandi; Herry Garna; Tono Djuwantono
Global Medical & Health Communication (GMHC) Vol 5, No 2 (2017)
Publisher : Universitas Islam Bandung

Aktivitas fisik yang tidak cukup adalah 1 dari 10 faktor risiko utama kematian di seluruh dunia karena merupakan faktor risiko utama penyakit tidak menular seperti penyakit kardiovaskular, kanker, dan diabetes melitus. Aplikasi Sayang ke Buah Hati (SEHATI) adalah media informatif yang merupakan panduan bagi ibu dalam meningkatkan pengetahuan dan panduan tentang aktivitas fisik yang benar pada anak usia sekolah dasar yang dikemas dalam bentuk animasi bergerak, warna menarik, dan sistem pengingat waktu/reminder. Dilakukan penelitian quasi experiment dengan pretest-postest with control group design untuk menganalisis pengaruh aplikasi SEHATI terhadap pengetahuan ibu dan aktivitas fisik pada anak usia sekolah dasar selama Januari 2017. Subjek penelitian ibu yang memiliki anak usia sekolah dasar berusia 8−12 tahun di SDIT Uchuwwatul Islam Kota Bandung sebanyak 60 orang yang terbagi dalam 2 kelompok, yaitu kelompok intervensi menggunakan aplikasi SEHATI dan kelompok kontrol tidak diterapkan. Pengambilan sampel berdasar atas teknik proportionate stratified random sampling. Pengujian statistik menggunakan uji chi-square dengan kemaknaan p<0,05. Hasil penelitian menunjukkan tidak terdapat perbedaan karakteristik responden pada kedua kelompok meliputi usia, pendidikan, pekerjaan, dan paritas. Karakteristik ibu pada kelompok intervensi dan kontrol didominasi oleh usia 30−39 tahun, berpendidikan menengah (SMA, SMP), tidak bekerja, dan paritas multipara. Persentase peningkatan skor pengetahuan pada kelompok intervensi lebih baik daripada kelompok kontrol (25% vs 19%; p=0,001). Skor aktivitas fisik anak peningkatannya lebih baik pada kelompok intervensi (78% vs 61%; p=0,602). Simpulan, aplikasi SEHATI berpengaruh dalam meningkatkan pengetahuan ibu dan aktivitas fisik anak usia sekolah dasar.THE EFFECT OF AFFECTIONATE TO BABY (SEHATI) APPLICATION ON MOTHER'S KNOWLEDGE AND PHYSICAL ACTIVITY IN PRIMARY SCHOOL AGE CHILDRENThe lack of physical activity is one of the 10 major risk factors of death in the world, it is major risk factors for non-communicable diseases such as cardiovascular diseases, cancer, and diabetes mellitus. Affectionate to Baby (SEHATI) application is informative media which is a guide for mothers in improving the knowledge and guidance on the correct physical activity in children of primary school age are packaged in the form of moving animations, exciting colors, and the system time reminder. A quasi experiment with pretest-posttest control group design was conducted to analyze the effect of the SEHATI application toward knowledge mother and physical activity in school age children during January 2017. The subjects of this research were 60 mothers who have primary school age children as well as those aged 8−12 years in SDIT Uchuwwatul Islam Bandung. The respondent were divided into two groups the intervention group and the control group. The sampling based on proportionate stratified random sampling. The statistical test using chi square test with the significance of test results is determined by the value of p<0.05. The results showed there were no differences in the characteristics of respondents in both groups, including age, education, occupation, and parity. Characteristics of mothers in the intervention and the control group was dominated by the age of 30−39, secondary education (high school, junior high school), not working, and parity multiparous. The percentage increase of knowledge score in the intervention group was better than the control group 25% vs 19%, p=0.001. Percentage increase of the children's physical activity score in the intervention group was better than the control group 78% vs 61%, p=0.602. Conclusion, SEHATI application is influential in increasing the knowledge of the mother and the physical activity of children of primary school age.

Penggunaan Aplikasi Sayang ke Buah Hati (SEHATI) terhadap Asupan Zat Gizi Anak dan Pengetahuan Ibu Menerapkan Konsumsi Aneka Ragam Makanan Gizi Seimbang pada Anak Sekolah Dasar Giyawati Yulilania Okinarum; Irvan Afriandi; Dida Akhmad Gurnida; Herry Herman; Herry Garna; Tono Djuwantono
Global Medical & Health Communication (GMHC) Vol 5, No 3 (2017)
Publisher : Universitas Islam Bandung

Kesehatan dan gizi yang buruk pada anak usia sekolah dapat menghambat pertumbuhan fisik, perkembangan, dan kecerdasan. Konsumsi pangan masyarakat Indonesia belum sesuai dengan pesan gizi seimbang. Aplikasi Sayang ke Buah Hati (SEHATI) diharapkan dapat menjadi alat strategi promosi kesehatan untuk meningkatkan asupan zat gizi anak dan pengetahuan ibu menerapkan konsumsi aneka ragam makanan gizi seimbang. Tujuan penelitian ini menganalisis perbedaan asupan zat gizi anak dan pengetahuan ibu menerapkan konsumsi aneka ragam makanan gizi seimbang pada anak sekolah dasar sebelum dengan sesudah diterapkan aplikasi SEHATI. Periode penelitian 2–18 Maret 2017 di SDIT Jabal Nur Yogyakarta. Subjek adalah ibu yang memiliki anak usia sekolah dasar (8–12 tahun) dan anaknya yang memenuhi kriteria penelitian. Penelitian ini merupakan randomized controlled trial (RCT). Pengambilan sampel dilakukan secara acak. Kelompok intervensi mendapatkan pemasangan aplikasi SEHATI dan kontrol diberikan pendidikan kesehatan, tiap-tiap kelompok terdiri atas 30 responden. Data diolah dengan uji nonparametrik, yaitu uji t berpasangan pada data yang berdistribusi normal dan uji Mann-Whitney pada data yang tidak berdistribusi normal. Terdapat perbedaan bermakna penggunaan aplikasi SEHATI terhadap peningkatan pengetahuan ibu pada kelompok intervensi (25,9%; p≤0,001), terjadi peningkatan skor asupan zat gizi anak pada kelompok intervensi yang bermakna, yaitu karbohidrat (13,8%; p=0,038) dan vitamin A (51,5%; p=0,005). Simpulan, terdapat perbedaan peningkatan asupan zat gizi dan pengetahuan ibu menerapkan konsumsi aneka ragam makanan gizi seimbang pada anak sekolah dasar sebelum dengan sesudah penggunaan aplikasi SEHATI.SAYANG KE BUAH HATI (SEHATI) APPLICATION USAGE ON CHILDREN NUTRIENT INTAKE AND MOTHERS’ KNOWLEDGE IN IMPLEMENTING NUTRITIONALLY BALANCED FOOD VARIETY AMONG PRIMARY SCHOOL CHILDRENNutrient imbalance affects children growth and development. Sayang ke Buah Hati (SEHATI) was an application developed for health promotion strategies to increase children nutrient intake and mothers’ knowledge in implementing consumption on nutritionally balanced food variety. The purpose of this study was to analyze the differences of children nutrient intake and mothers’ knowledge in implementing consumption of a variety of nutritionally balanced food on primary school children before and after applying the SEHATI application. Subjects were 30 randomly selected mothers who have primary school age children (8−12 years) and their children. This study is a randomized controlled trial (RCT) conducted on 2–18 of March 2017 in SDIT Jabal Nur Yogyakarta. The intervention group got the SEHATI application installed and health education. The data collected is processed by the paired t test on normally distributed data and Mann Whitney tests on data that are not normally distributed. Results showed significant increased knowledge of mothers in the intervention group significantly (25.9%, p≤0.001). Increased nutrients scores of children in the intervention group were carbohydrates (13.8%, p=0.038) and vitamin A (51.5%, p=0.005). In conclusions, there are differences of child nutrient intake and mothers’ knowledge in implementing consumption of a variety of nutritionally balanced food in primary school children before and after SEHATI application usage.

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