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All Journal BALI MEDICAL JOURNAL (BMJ) Buletin Udayana Mengabdi E-Jurnal Medika Udayana Jurnal Kedokteran Diponegoro MNJ (Malang Neurology Journal) The Indonesian Biomedical Journal JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Plastik Rekonstruksi Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia Cermin Dunia Kedokteran Jurnal Neuroanestesi Indonesia Cermin Dunia Kedokteran
I Wayan Niryana
Bagian SMF Ilmu Bedah RSUP Sanglah Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Civil Engineering, Building, Construction & Architecture Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Riwayat Penggunaan Akses Kateter Double Lumen sebagai Faktor Risiko Independen Terjadinya Stenosis Vena Sentral pada Pasien Penyakit Ginjal Kronis Stadium V Paska Operasi Fistula Arteri-Vena Prayoga, I Gusti Ngurah Agung Aditya; Budiarta, Ida Bagus; Niryana, I Wayan
JBN (Jurnal Bedah Nasional) Vol 8 No 1 (2024): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/JBN.2024.v08.i01.p02

Abstract

Tujuan: Untuk menilai dan membuktikan hubungan antara riwayat pemasangan akses kateter double lumen dengan kejadian stenosis vena sentral paska operasi pembentukan fistula arteri-vena pada pasien dengan penyakit ginjal kronis stadium V. Metode: Penelitian observasional analitik studi kasus-kontrol (case-control) terbagi 2 kelompok yaitu pasien penyakit ginjal stadium V dengan stenosis vena sentral dan tanpa stenosis vena sentral. Data jenis kelamin, usia, sisi lengan, lokasi fistula, riwayat infeksi pada kateter double lumen, penyakit komorbid, lama waktu setelah operasi fistula arteri-vena dan riwayat penggunaan kateter double lumen dikumpulkan. Analisis statistika meliputi analisis bivariat dan multivariat menggunakan uji Chi-Square dan Mann-Whitney. Hasil: Total subyek penelitian sebanyak 110 sampel, dengan masing masing kelompok berjumlah 55 subyek, dari hasil uji normalitas sebaran data tidak normal, usia ? 50 tahun sebanyak 78 (70,9%), laki-laki 60 (54,5%), ekstremitas atas kiri 61 (55,5%), lokasi fistula brachial-cephalic 47 (42,7%), tidak ada infeksi 33 (66%), IMT< 25 kg/m2 86 (78,2%), hipertensi 58 (52,72%), lama waktu setelah tindakan operasi fistula arteri-vena 1 tahun 66 (60%), riwayat penggunaan kateter double lumen 50 (45,5%) dengan OR=8 (IK 95% 3,39-18,89). Simpulan: Riwayat pemasangan kateter double lumen meningkatkan risiko kejadian stenosis vena sentral sebesar 8 kali pada pasien dengan penyakit ginjal kronis stadium V paska operasi pembentukan fistula arteri-vena.
Recent Updates of Stem Cell Therapy in Spontaneous Intracerebral Haemorrhage Patients: A Review Article Niryana, I Wayan; Wibawa, Ida Bagus Adiguna; Kusuma, Gede Febby Pratama
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 13, No 4 (2024): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v13i4.44046

Abstract

Background: Spontaneous intracerebral haemorrhage (sICH) is a severe neurological condition with high disability and mortality rates globally. Effective therapeutic strategies to overcome the acute and long-term problems caused by sICH are still lacking. Mesenchymal stem cell (MSCs) therapy with the neuroprotective and neuroregenerative properties has the potential to overcome the complex brain injury mechanisms caused by sICH.Objective: This review highlights the recent pre-clinical and clinical findings about MSCs therapy in sICH case and their mechanisms in promoting neurological recovery.Methods: This is a literature review study. Study reports available from various accredited database such as PubMed and Google Scholar are collected using the following keywords: ((“stroke” or “intracerebral haemorrhage”)) and (“stem cell”).Results: Pre-clinical studies proved that MSCs therapy can resolved the secondary brain insult caused by sICH and improved the brain functional and clinical status. The clinical studies proved that MSCs therapy are safe and well tolerated in human bodies. There were also beneficial MSCs therapy effects in sICH patients. However, the clinical studies results were still lacking and some were inconclusive.Conclusion: The preclinical studies of stem cell therapy in spontaneous intracerebral haemorrhage showed promising evidences and the potential of stem cell therapy for clinical use. However, the clinical studies were still lacking. Further clinical studies are needed to confirm the neuroprotective and neuroregenerative benefits of MSCs therapy from the pre-clinical studies.
Optic Nerve Pilocytic Astrocytoma in a Pediatric Patient: A Case Report Pramantara, I Made Stepanus Biondi; Niryana, I Wayan; Sista Satyarsa, Agung Bagus Sista; Golden, Nyoman; Mahadewa, Tjokorda Gede Bagus; Maliawan, Sri; Suarjaya, I Putu Pramana
Jurnal Neuroanestesi Indonesia Vol 13, No 3 (2024)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i3.594

Abstract

Pilocytic astrocytoma is a type of low-grade glioma that can develop in any part of the central nervous system. It primarily affects individuals in the pediatric and young adult age groups. Optic nerve pilocytic astrocytoma is an uncommon, gradually developing type of brain tumor known as a glioma. It is categorized as a grade I tumor by the World Health Organization (WHO). We aim to report rare optic nerve pilocytic astrocytomas and discuss their clinical findings and interconnection with the current literature. A 7-year-old male patient exhibited left-sided eye proptosis and complete loss of vision. A magnetic resonance imaging (MRI) performed before surgery showed the presence of a tumor in the left eye socket. The mass has a spherical shape and smooth boundaries, resulting in the compression of the left optic tract from behind. The left optic tract appears darker on T1-weighted images and brighter on T2-weighted images. On contrast administration, there is heterogenous contrast enhancement. A total resection of the mass was performed. Histopathology results show pilocytic astrocytoma (WHO Grade I). Optic nerve pilocytic astrocytoma is a tumor that can affect the optic nerve pathway. Early diagnosis and multidisciplinary team management are required. Treatment must be individualized, and the options include chemotherapy, radiotherapy, and surgical intervention. Surgery is only recommended in cases of painful or disfiguring proptosis and exposure keratopathy in eyes with severe vision impairment.
Three Years Follow-Up of Single-Stage Correction with Modified Chula Technique for Frontoethmoidal Encephalomeningocele: The Advantage of The Teamwork Approach (A Case Report) Lumintang, Loelita Marcelia; Niryana, I Wayan; Sanjaya, Hendra; Hamid, Agus Roy
Jurnal Plastik Rekonstruksi Vol. 8 No. 2 (2021): Jurnal Plastik Rekonstruksi
Publisher : Lingkar Studi Bedah Plastik Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v8i2.324

Abstract

Backgrounds: The main objective of Frontoethmoidal encephalomeningocele (FE) treatment are neural morbidities defect correction and aesthetically pleasing looks. Staged procedures are used to be performed in Indonesia. This article aimed to reveal the result of FE correction through the single-stage modified Chula technique (ST-MCT) procedure in collaboration with the neurosurgery team. Case Reports: A rare case of 5 years old girl diagnosed with FE was reported in this study. The FE was slowly increased in size, causing apparent facial deformity and the appearance of telecanthus. An ST-MCT procedure in collaboration with the neurosurgery team was conducted to correct the defects. The IOD values, IPD values, postoperative complications, and anesthetic improvements were evaluated in this study. Result: The patient was well after the surgery, with no complications and short length of stay. There were noted improvement of ICD, IOD and IPD postoperative follow up. At three years after the surgery ICD= 29mm; IOD= 26mm; IPD= 52 mm (normal range). Summary: ST-MCT procedure conducted in collaboration with neurosurgery team had shown excellent correction of ICD, IOD, and IPD values, no complication, shorter length of stay, and minimal scars. It considers as the most proper technique to reach a good result of correction and aesthetically pleasing looks in FE cases.  
Kranioplasti untuk Kasus Cedera Kepala Wayan Niryana; Dewa Putu Wisnu Wardhana; Heru Sutanto Koerniawan; Sri Maliawan
Cermin Dunia Kedokteran Vol 45 No 8 (2018): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i8.744

Abstract

Seiring kemajuan teknik operasi bedah saraf, jumlah pasien cedera kepala yang mampu selamat pasca-kraniektomi dekompresi meningkat signifikan. Pasien-pasien tersebut selanjutnya akan menjalani kranioplasti untuk memperbaiki defek kranium. Keuntungan lain prosedur kranioplasti antara lain: menyediakan proteksi otak, pencegahan, atau eliminasi kolapsnya hemisfer otak atau herniasi serebri yang disebut sindrom pasca-trepanasi. Hingga saat ini belum ada material ideal untuk kranioplasti.   Advances in neurosurgery techniques will increase decompressive craniectomy survivors significantly. These patients will undergo cranioplasty to correct the cranium defects. Cranioplasty has other advantages: to provide brain protection, to prevent, or to eliminate brain hemisphere collapse or cerebral herniation called post trephine syndrome. There is no truly ideal material for cranioplasty until now.
Expression of CD8+ and Foxp3+ T Lymphocyte as Predictor for Response to Neoadjuvant Chemotherapy in Stage III Breast Cancer Yasa, I Nyoman Wawan Tirtha; Sudarsa, I Wayan; Niryana, I Wayan; Sriwidyani, Ni Putu; Jawi, I Made; Yasa, I Wayan Putu Sutirta; Manuaba, Ida Bagus Tjakra Wibawa; Suryawisesa, Ida Bagus Made
The Indonesian Biomedical Journal Vol 17, No 3 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i3.3680

Abstract

BACKGROUND: Neoadjuvant chemotherapy (NAC) in breast cancer is usually utilized to eradicate micro-metastasis, induce apoptosis in tumor cells, and reduce the primary tumor size, enabling surgical intervention. Recent studies have shown that tumor-infiltrating lymphocytes (TILs), especially cytotoxic CD8+ T cells and immunosuppressive Foxp3+ regulatory T cells, influence tumor response to treatment. However, their role as predictive markers for NAC response remains unclear. Therefore, this study was performed to investigate whether high expression of CD8+ and low expression of Foxp3+ T lymphocytes are associated with better response to NAC in stage III breast cancer patients.METHODS: Total of 60 biopsy samples from stage III breast cancer patients were included, comprising 30 subjects in the response group (+) and 30 subjects in the non-response group (−). The expression levels of CD8+ and Foxp3+ T lymphocytes in tumor tissue were assessed semi-quantitatively by immunohistochemistry (IHC), using a scoring system based on the proportion and intensity of positively stained cells (Black’s grading criteria).RESULTS: Stage III breast cancer with high expression of CD8+ T lymphocytes was significantly associated with a better response to NAC (p=0.004; OR=6.882). Meanwhile, low expression of Foxp3+ T lymphocytes was not significantly associated with chemotherapy response (p=0.067; OR=3.250). A higher tumor grade was also associated with an improved response to treatment. The probability of achieving a positive response to NAC in subjects presenting with high CD8+ expression, low Foxp3+ expression, and high tumor grade was estimated at 96.98%.CONCLUSION: The combination of high expression of CD8+ T lymphocyte, low expression of Foxp3+ T lymphocyte and high tumor grade might be useful to predict good response to NAC in stage III breast cancer.KEYWORDS: CD8+ T lymphocyte, Foxp3+ T lymphocyte, neoadjuvant chemotherapy, breast cancer
A Rare Case of Rapidly Progressing Vertex Epidural Hematoma in A Child: Diagnostic Pitfalls and Management Considerations Bangun, Kristian Gerry Raymond Sinarta; Satyarsa, Agung Bagus Sista; Niryana, Wayan
Jurnal Neuroanestesi Indonesia Vol 14, No 2 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i2.661

Abstract

Vertex Epidural Hematoma (EDH) is a rare condition, often caused by injury to the superior sagittal sinus or parietal bone fractures, typically involving diploic veins. It can be associated with sudden death. This case highlights a rapidly progressing vertex EDH in a child within 12 hours, despite initial mild symptoms. A 10-year-old boy sustained a head injury and experienced a 10-minute loss of consciousness. Upon arrival at Ngoerah General Hospital, his Glasgow Coma Scale (GCS) score was E4V5M6, and a head CT showed a small vertex EDH. Conservative management was started. Twelve hours later, the child reported worsening headaches and drowsiness, and his GCS decreased to E3V5M6. A repeat CT scan revealed significant hematoma expansion, prompting emergency surgery. During surgery, a linear fracture of the parietal bone was found, with approximately 60cc of hematoma due to diploic vein rupture. Post-surgery, the patients GCS improved without neurological deficits. As conclusion the Vertex EDH in children, though rare, demands careful monitoring. This case underscores the importance of early reevaluation, prompt imaging, and timely surgical intervention to avoid irreversible neurological damage
Co-Authors A.A Davyn Anantha Ade-Chandra - Agung Aditya Arnaya Agung Bagus S. Satyarsa Agus Roy Rusly Hariantana Hamid Anne Saputra Bangun, Kristian Gerry Raymond Sinarta Budiarta, Ida Bagus D.P.W. Wardhana Dewa Ayu Wahyu Diantari Dewa Ngurah Suprapta Dewa Putu Wisnu Wardhana Dwijo Anargha Sindhughosa Dwikinta, Made Anindya Ellintang Charisma Dewi Gitari, Ni Made Gunawan, Made Favian Budi Gusti Ngurah Agung Adi Paramartha Hamid, Agus Roy I Gde Made Satya Wangsa Satya Wangsa I Gede Sutawan I Gede Suwedagatha I Gusti Agung Bagus Krisna Wibawa I Gusti Lanang Ngurah Agung Artha Wiguna I Gusti Ngurah Purnomo I Gusti Putu Hendra Sanjaya I Made Bagus Wirawan I Made Jawi I Made Stepanus Biondi Pramantara I Made Suka Adnyana I Made Sukarya I Nyoman Semadi I Putu Eka Widyadharma I Putu Gede Cahya Giartha Putra I Putu Yuda Prabawa I W. Sudarsa I Wayan Putu Sutirta Yasa Ida Bagus Yudha Prasista J Sasongko K.K. Putra Kevin Kristian Putra Koerniawan, Heru Sutanto Kusuma, Gede Febby Pratama LOELITA MARCELIA LUMINTANG, LOELITA MARCELIA Made Agus Dwianthara Sueta Made Indra Erlangga Prathiwindya Made Suka Adnyana Manuaba, Ida Bagus Tjakra Wibawa Mardliyah, Mumtazah Marthinson Andrew Tombeng Melissa Krisanty Moses Kharisma Setyawan Ni Luh Putu Julita Yanti Ni Putu Ayu Pande Arista Dewi Ni Putu Sri Wulandari Ni Putu Sriwidyani Nyoman Golden Nyoman Siska Ananda Prayoga, I Gusti Ngurah Agung Aditya Putu Anda Tusta Adiputra Putu Ayu Indra Shanti Wardani Putu Chandra Wibawa Putu Diahpradnya Oka Partini Putu Eka Mardhika Putu Pramana Suarjaya Raka-Sudewi A. A. S. Awyono Sanjaya, Feliani Sanjaya, Hendra Sianny Herawati Sista Satyarsa, Agung Bagus Sista Sri Maliawan Suryawisesa, Ida Bagus Made Tham Hong Yuan Thomas Eko Purwata Tjokorda Gde Bagus Mahadewa Wibawa, Ida Bagus Adiguna Yasa, I Nyoman Wawan Tirtha