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All Journal International Journal of Integrated Health Sciences The Indonesian Biomedical Journal Paediatrica Indonesiana Medicinus : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia
Julius July
Department Of Neurosurgery, Faculty Of Medicine, Pelita Harapan University, Neuroscience Center, Siloam Hospital Lippo Village, Tangerang, Banten
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Rare Distal Anterior Choroidal Artery Aneurysm Muhammad Zafrullah Arifin; Julius July; Bilzardy Ferry; Ahmad Faried
International Journal of Integrated Health Sciences Vol 4, No 2 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5345.98 KB)

Abstract

Objective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting.Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia.Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery.Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed.Keywords: Aneurysm, distal anterior choroidal artery, neuronavigation DOI: 10.15850/ijihs.v4n2.837
Dynamic Pattern of Interleukin-1beta and -10 in Cerebrospinal Fluid following Aneurysmal Subarachnoid Hemorrhage Yesaya Yunus; Julius July; Andi Asadul Islam; Eka Julianta Wahjoepramono; Irawan Yusuf
The Indonesian Biomedical Journal Vol 6, No 2 (2014)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v6i2.35

Abstract

BACKGROUND: Inflammation following aneurysmal subarachnoid hemorrhage (SAH) is associated with patient outcome. This study aimed to analyze the dynamics pattern of the pro-inflammatory interleukin (IL)-1β and anti-inflammatory cytokine IL-10 in the cerebrospinal fluid (CSF) following aneurysmal SAH.METHODS: This is a prospective observational study. The CSF was collected prior to surgery, and on the 2nd, 4th and 6th days after surgery. The CSF was then analyzed for IL-1β and -10 using enzyme-linked immunosorbent assay. Delayed Ischemic Neurological Deficits (DIND) was determined based on new neurological deficits within the first week after surgery. Data was analysed with T test or Wilcoxon Rank-Sum test to evaluate the pattern of biomarkers between DIND and non-DIND groups.RESULTS: There were 33 patients enrolled in this study, 16 patients (48.48%) who experienced DIND and 17 patients (51.52%) were non-DIND. There were significant increase dynamic levels of IL-10 and -1β in DIND patients (p<0.05).CONCLUSION: Significant increase levels of IL-10 and -1β in CSF after aneurysmal SAH are associated with DIND.KEYWORDS: IL-1β, IL-10, DIND
Diagnostic clues in spontaneous intracranial hemorrhage in babies Julius July; Eka Julianta Wahjoepramono; Beny Atmadja Wirjomartani
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.230-4

Abstract

Background There has been increasing number of babies detectedwith SIH. In regard to find diagnostic clues for the first-rate babieswho really needs CT scan and referral, simple observation to lookat certain clinical and laboratory findings is needed.Objective To identify diagnostic clues associated with spontaneousintracranial hemorrhage (SIH) in babies.Methods Retrospective observation was carried out among ba-bies with SIH within the last two and a half years. Patients wereexcluded if there was an obvious cause of SIH such as trauma orany underlying disease such as hemophilia. Variables that wereobserved were patient's age, seizure, decreased level of conscious-ness, tensed fontanel, neurological deficits, vomitting, fever(T > 3 7 .SOC), anemia, jaundice, PT and aPTT. All data weredescriptively evaluated.Results There were 53 babies with SIH (31 baby boys, 22 babygirls), forty eight of which (91%) were less than 3 months old.Of those, 50 patients (94%) had seizure as the leading clinicalpresentation, 44 patients (83%) had decreased level of conscious-ness, and 39 patients (74%) had tensed fontanel. PT and aPTTwere prolonged in 39 (74%) cases. The most common lesion wassubdural hematoma (38 cases/72%). Forty-three babies (81 o/o)required neurosurgical intervention. Overall mortality rate was22%.Conclusion Babies with seizure, decreased level of consciousness,tensed fontanel, and prolonged PT and aPTT should be consideredto harbor SIH. They need a CT scan and referral, particularlythose less than three months old. The prognosis is unfavorable,thus early recognition and treatment is needed
Preoperative intralesional injection of triamcinolone acetonide for a large head and neck lymphangioma in a baby: a case report Julius July; Sophie Peeters
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (873.144 KB) | DOI: 10.14238/pi57.5.2017.274-8

Abstract

Lymphangiomas (LMs) are uncommon congenital malformations of the lymphatic system, with an estimated incidence of one in 2,000 to 4,000 live births.1 About half of these lesions are diagnosed at birth, and by two years of age, 90% of those with lesions have been diagnosed.2 Histologically, LMs are benign lesions; however, they can pose a serious threat to the patient due to possible growth into surrounding structures, sometimes causing life-threatening complications. Treatment of large head and neck lymphangiomas in young infants is very challenging, due to the risk of surgical complications. Further challenges include the limited volume of blood loss that infants can tolerate, the lack of the option for radiotherapy or radiosurgery, and the high chance of life-threatening complications if the LM is not treated. Here, we report a case of a two-month-old baby girl presenting with a large head and neck lymphangioma. She was successfully treated with intralesional triamcinolone acetonide injections, followed by surgical resection of the lesion.
IL-4: PREDIKTOR ANTI INFLAMASI PADA STROKE ISKEMIK ? Lucia Herminawati; Julius July
Medicinus Vol 5, No 1 (2015): October 2015 - January 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i1.1178

Abstract

The brain ischemia due to vascular occlusion, especially in the main cerebral artery, could trigger the microglia as a natural immune cell in the brain. These activated microglia will turn up the inflammation cascade in the ischemic area. Interleukin-4 (IL-4) has a vital role in the microglial alteration to become an anti-inflammatory phenotype, which wind up the expression of MHC II and CD11c. Moreover, previous studies has supported that the stimulation of IL-4 in the culture of microglia/macrophage will produce this kind of “alternative” phenotype or neuroprotective phenotype, through the fall of TNF and rise of IGF-1. However, only a few have discussed the role and profile of IL-4 in ischemic stroke. This review article will cover the possibility of IL-4 role as an anti-inflammatory predictor in ischemic stroke.Keywords: Interleukin-4, microglia, ischemic stroke, inflammation
The Key role of MRI modalities in En Plaque Meningioma Novita Tirtaprawita; Wiradharma Wiradharma; Julius July
Medicinus Vol 6, No 2 (2017): February 2017 - May 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i2.1145

Abstract

En plaque meningioma is at frontal region is difficult to be differentiated from osteoma, based on CT scan only. En plaque meningioma represents in 2-9% of all meningioma cases. Usually en plaque meningioma grows on the sphenoid wing, whereas only 1 % grows on the frontal and temporal bone. This case is female 37 year- old who presents with chronic headache and huge lump on her right forehead that she believes it slowly enlarges for the last 5 years. The Computerized Tomography scan (CT scan) shows thickening of the right fronto-temporal bone (3-4 cm) with the diameter of 12 cm and bony hard. Initial impression suggests it could be osteoma or fibrous dysplasia. After the MRI (Magnetic Resonance Imaging) with contrast, it shows a carpet like tumor underline the thickening bone, and it suggest an en plaque meningioma. For en plaque meningioma, we have to remove the abnormal duramater. We suggest that for a case with a wide thickening calvarian bone, it’s better to get the MRI of the head with contrast.
The Importance of Immunohistochemical Analysis in Silent Pituitary Adenoma Ivan William Harsono; Nathania Victoria Stevina; Vivien Puspitasari; Julius July
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1150

Abstract

Pituitary adenoma contributes to 15% of all intracranial neoplasm. It is usually following benign course and some of them are silent (asymptomatic clinically, but hormone-secreting). Silent adenoma usually found incidentally or when the patients show mass effect (neurological deficits). Many of histologically aggressive silent adenoma subtypes are associated with invasiveness, recurrence and progression to clinically functioning adenomas. Aggressive silent adenoma radiologically tends to invade in downward direction, invading bone, sinus cavernosus, parasellar region. The nature of aggressive silent adenoma subtypes is differing in nature compared to benign nature of pituitary adenoma and should be confirmed immunohistochemically to determine the prognosis and anticipate the risk of recurrence or progression. The case illustration show a real case of 46 years old female progressive headache and visual disturbance diagnosed with non-functional pituitary macroadenoma but positive for more than one immunochemistry biomarker (plurihormonal aggressive silent adenoma).
Pengaruh Asam Traneksamat Pra-operasi Terhadap Pendarahan Perioperatif Tumor Otak Glioma yang Sedang Mendapat Deksametason Julius July
Jurnal llmu Bedah Indonesia Vol. 35 No. 2 (2007): Desember 2007
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibiikabi.v35i2.126

Abstract

Case Report : Management Penetrating Brain Injury Across Middle Third of Superior Sagittal Sinus Achmad Chumaidi; Julius July
Medicinus Vol 10, No 2 (2022): June 2022 - September 2022
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.5681

Abstract

Background: Penetrating cranial injuries are rarely reported on thick parietal bone. Goal of its management include removal of the foreign object while minimizing furher damage to the brain and associated neurovascular structures, also prevent further complications.Case Description: We report a case of a 22-year-old male presented with machete stucked in his head following an accidentally fell down of the weapon from a coconut tree. The cranial location affected were midparietal. He was disoriented on admission, with neither neurological focal signs nor seizure. Computed tomography (CT) revealed that the object penetrate middle superior sagittal sinus. After emergency craniotomy to remove the objects, debridement, dural sinus repair were performed. Recovery was complete without sequelae.Conclusion: Laceration of the middle thirds of the superior sagittal sinus require special handling and care during surgery. Operative approach and treatment strategies are among the most important considerations to achieve the best patient outcomes
Surgery of Intramedullary Tumours Julius July
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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Abstract

Surgery still offers a cure to the majority of intramedullary tumours. The challenge of the surgery is taking out the tumour while preserving the function. Very often the patient has a huge tumour with very minimal symptoms, such as mild numbness. The slow growth of the tumour nature provides enough time for the cord fibres to adapt accordingly. Usually, the motor function is preserved and most of the pathologies are benign. For this reasons, the majority of cases have good long-term tumour control. The functional outcome is depending on the preoperative functional state, especially for motor function. The patient should be educated prior to surgery, especially to anticipate the post-surgical rehabilitation period. The surgical technique should preserve the motor function, but the fine movement usually gets worst for several months after surgery and slowly recover within 6 months. We share our experience of 45 surgical cases with intramedullary tumour (14F;31M), the pathologies distributions are 20 ependymomas, 8 astrocytomas (1/8 anaplastic astrocytoma), 7 cavernomas, 8 hemangioblastomas, 1 glioblastoma multiforme, and 1 tuberculoma. The location distribution varied from 27 at the cervical cord, 11 thoracal, 4 thoracolumbal, and 3 MO-upper cervical. The surgical outcome for all cases experienced sensory changes and recovered over 6 months. Almost all cases experienced some degree of spasticity and fine movement difficulty and they are improving over 6 months. Motor strength is usually preserved. One case of GBM, improve gradually for the first two months then followed by the disease course regardless of the treatment. The tuberculoma case required one year to recover her neurological function with adequate treatment.
Co-Authors Abhijit Guha Achmad Chumaidi Achmad Chumaidi, Achmad Ahmad Faried Alexander Cahyadi, Alexander Anak Agung Istri Sri Wiadnyani Andi A. Islam Andi Asadul Islam As’ad, Suryani Beny Atmadja Wirjomartani Bilzardy Ferry Budhianto Suhadi Dermawan, Kevin Dong seok Lee Eka J. Wahjoepramono Harahap, Agnes S. Harsono, Ivan William Irawan Yusuf Ivan William Harsono Kristiani, Erna Lekatompessy, Michael Lucia Herminawati Lucia Herminawati, Lucia Maria F. Ham Marisca, Stephanie Mira Yuniarti Muhammad Zafrullah Arifin Nathania Victoria Stevina Novita Tirtaprawita Priscilla Muliantara Sophie Peeters Stevina, Nathania Victoria Suharyani, Sally Susanto, Eka Sutisna Himawan Tirtaprawita, Novita Tjahjadi, Hartono Uranus, Hans Christian Veli Sungono Vivien Puspitasari, Vivien Widjaya, Ingrid A Widodo, Stephanie T. Widyakrisna, Albertus Boyke Raditya Wiradharma Wiradharma Wiradharma Wiradharma, Wiradharma Yesaya Yunus Yesaya Yunus Yesaya Yunus