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Perbandingan antara penggunaan karbonat apatit dan hidroksi apatit pada proses penutupan defek kalvaria dengan menggunakan plasma kaya trombosit Surbakti, Atmaja; Oley, Maximillian Ch.; Prasetyo, Eko
JURNAL BIOMEDIK : JBM Vol 9, No 2 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.2.2017.16359

Abstract: Carbonate hydroxy apatite (CHA) and hydroxyapatite (HA) are calcium phosphate biomaterials for bone substitute which have the characteristics of biocompatibility, bioactivity, and osteoconductivity. Platelet rich plasma (PRP) has platelet concentration of 3-5 times above normal and contains growth factor. This study was aimed to compare the effectiveness of CHA-PRP and HA-PRP in the occlusion of calvaria deffect. This was a descriptive observational study. Subjects were 18 Wistar rats (Rattus norvegicus), aged 20-22 weeks, weighing 350-400 g. PRP was processed from 3 ml of intracardiac blood. Calvaria defect of 3 mm diameter was performed as a burr hole. Subjects were divided into 2 groups. Group 1 was treated with CHA-PRP meanwhile group 2 was treated with HA-PRP. The rats were terminated at weeks 2, 3, and 4, then the calvaria bone tissue was evaluated histopathologically. The results showed that at week-2, group 1 had inflammatory cells of 80-90% and immature bone formation of 10%, while group 2 had inflammatory cells of 60-70% and immature bone formation of 5%. At week-3, group 1 had inflammatory cells of 80% and immature bone formation of 10-45% while group 2 had inflammatory cells of 60-70% and immature bone formation of 10-20%. At week-4, group 1 had inflammatory cells of 80-90% and immature bone formation of 45-90% while group 2 had inflammatory cells of 20-70% and immature bone formation of 15-55%. Conclusion: In rats (Rattus norvegicus) with calvaria defects, CHA-PRP treatment could accelerate the occlusion process better than HA-PRP.Kata kunci: carbonate hydroxy apatite, hydroxyapatite, platelet rich plasmaAbstrak: Karbonat hidroksi apatit (KHA) dan hidroksi apatit (HA) merupakan biomaterial kalsium fosfat pengganti tulang yang bersifat biokompatibilitas, bioaktivitas, osteokonduktif. Plasma kaya trombosit (PKT) mempunyai konsentrasi trombosit 3-5 kali di atas normal dan mengandung faktor pertumbuhan. Penelitian ini bertujuan untuk membandingkan pengaruh pemberian KHA-PKT dan HA-PKT pada proses penutupan defek kalvaria tikus. Jenis penelitian ialah deskriptif observasional. Subyek penelitian berupa 18 ekor tikus putih (Rattus norvegicus) galur Wistar, umur 20-22 minggu, berat badan 350-400 gr. Pengambilan darah tikus 3 cc intrakardiak diolah menjadi PKT. Defek kalvaria dibuat berbentuk burr hole diameter 3 mm. Subyek dibagi atas dua kelompok. Kelompok 1 diberikan KHA-PKT sedangkan kelompok 2 diberikan HA-PKT. Tikus diterminasi pada minggu ke-2, 3, dan 4 dan jaringan tulang kalvaria dievaluasi secara histopatologik. Hasil penelitian memperlihatkan di minggu ke-2, pada kelompok 1 terdapat infiltrasi sel radang 80-90% dan pembentukan tulang imatur 10% sedangkan kelompok 2 infiltrasi sel radang 60-70% dan pembentukan tulang imatur 5%. Di minggu ke-3, pada kelompok 1 terdapat infiltrasi sel radang 80% dan pembentukan tulang imatur 10-45% sedangkan kelompok 2 infiltrasi sel radang 60-70% dan pembentukan tulang imatur 10-20%. Di minggu ke-4, pada kelompok 1 terdapat infiltrasi sel radang 80-90% dan pembentukan tulang imatur 45-90% sedangkan kelompok 2 infiltrasi sel radang 20-70% dan pembentukan tulang imatur 15-55%. Simpulan: Pada tikus (Rattus norvegicus) dengan defek kalvaria, pemberian KHA-PKT dapat lebih mempercepat proses penutupan defek dibandingkan pemberian HA-PKT.Kata kunci: karbonat hidroksi apatit, hidroksi apatit, plasma kaya trombosit

PENGARUH PERLAKUAN HIPOTERMIA RINGAN PADA KASUS CEDERA OTAK AKIBAT TRAUMA RISIKO TINGGI BERDASARKAN GLASGOW COMA SCALE DAN KADAR PROTEIN TNF-Î± Hendratno, Josep; Prasetyo, Eko; Oley, Maximillian Ch.
JURNAL BIOMEDIK : JBM Vol 10, No 2 (2018): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.10.2.2018.20089

Abstract: Mild hypothermia treatment could be a useful method for improving the outcome of neurological treatment in patients with severe traumatic brain injury (TBI). There are several mechanisms underlying this effect inter alia reduction of metabolic rate, attenuation of excitatory amino acid and free radical synthesis, suppression of inflammatory responses, and prevention of blood-brain barrier disruption and brain edema. This study was aimed to obtain the effect of mild hypothermia treatment on Glasgow Coma Scale (GCS) dan TNF-? level among patients with severe TBI. This was an experimental analytical study. Subjects were adults aged 16-45 years, divided randomly into two groups (mild hypothermia and control groups) which were observed within 24 and 72 hours. TNF-? serum level was estimated by using TNF-? in vitro simple step ELISA. The assessments of outcomes were determined by using Glasgow Coma Scale (GCS) during the mild hypothermia therapy. The results showed that there were 20 TBI patients enrolled in this study, divided randomly into two groups. The treatment group, treated with mild therapeutic hypothermia, showed a decrease in TNF-? serum level and improved clinical value of GCS score (P <0.05). Conclusion: Mild hypothermia could significantly improve the GCS score and decrease TNF-? serum level among patients with severe TBI.Keywords: mild hypothermia treatment, TNF-?, GCS score,TBIAbstrak: Terapi hipotermia ringan (HPTr) dapat memperbaiki hasil pengobatan neurologik pada pasien dengan cedera otak traumatik (COT) risiko tinggi. Beberapa mekanisme yang mendasari efek tersebut ialah antara lain pengurangan tingkat metabolisme, atenuasi asam amino rangsang maupun sintesis radikal bebas, penekanan respons inflamasi, dan pencegahan gangguan sawar darah otak serta edema otak. Penelitian ini bertujuan untuk mengetahui pengaruh perlakuan HPTr pada kasus COT risiko tinggi berdasarkan skor Glasgow Coma Scale (GCS) dan kadar TNF-?. Jenis penelitian ialah analisis eksperimental. Subjek ialah orang dewasa berusia 16-45 tahun, diacak menjadi dua kelompok yaitu kelompok perlakuan HPTr dan kelompok kontrol. Pengamatan subjek dilakukan pada 24 jam dan 72 jam. Kadar serum TNF-? diperoleh dengan menggunakan metode TNF-? in vitro simple step ELISA. Penilaian klinis dilakukan dengan mengunakan skor GCS pada 24 dan 72 jam perlakuan HPTr. Hasil penelitian mendapatkan 20 penderita COT, dibagi menjadi dua kelompok secara acak. Kelompok perlakuan HPTr menunjukkan kecenderungan penurunan kadar TNF-? serum dan perbaikan nilai klinis dinilai dengan skor GCS (P <0,05). Simpulan: Pada penderita dengan cedera otak traumatik risiko tinggi, terapi hipotermia ringan dapat meningkatkan nilai klinis skor GCS dan menurunkan kadar TNF-? serum secara bermakna.Kata kunci: hipotermia ringan, TNF-?, skor GCS, COT

Pengaruh penggunaan helm terhadap cedera kraniofasial berdasarkan skor FISS dan CT Marshall Mengga, Hendrik; Hatibie, Mendy; Prasetyo, Eko; Oley, Maximillian Ch.
Jurnal Biomedik : JBM Vol 9, No 2 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.2.2017.16362

Abstract: Helmet can reduce head trauma as well as maxillofacial trauma due to motorcycle accident. This study was aimed to prove the effect of helmet and its type in reducing craniofacial injury. Any intracranial abnormalities were evaluated with the CT Marshall scoring system and maxillofacial abnormalities were evaluated with FISS. This was an analytical comparative study with a cross sectional design. The results showed that there were 72 patients with craniofacial trauma; 59 patients with intracranial abnormalities and 24 patients with maxillofacial abnormalities. There were 43.1% patients that wore helmet; 31.9% of them wore open-face helmet. Data were analyzed by using the unpaired t-tests. Based on FISS, the effect of helmet on maxillofacial injury obtained a t-value of 0.787 (P = 0.217) which indicated that there was no difference in FISS scores between patients wearing helmet and not. Based on the CT Marshall scoring system, the effect of helmet on the intracranial injury obtained a t-value of 1.822 (P = 0.036) which indicated that there was a difference in scores between patients wearing helmet and not. This meant that wearing helmets had some influence on the occurence of head injuries. Based on FISS, the impacts of full-face helmet and open-face helmet on maxillofacial injuries obtained a t-value of 1.890 (P = 0.034) which indicated that there was a difference in FISS between the two types of helmets. Based on the CT Marshall scoring system, the impacts of full-face helmet and open-face helmet on intracranial injuries obtained a t-value of 1.714 (P = 0.049) which indicated that there was a difference in CT Marshall scores between the two types of helmets. Conclusion: Helmet and its type, full-face and open-face, had some influence on the occurence of either maxillofacial or intracranial injuries.Keywords: craniofacial injury, motorcycle, helmetAbstrak: Penggunaan helm dapat mengurangi kejadian trauma kepala dan trauma maksiofasial akibat kecelakaan sepeda motor. Penelitian ini bertujuan untuk membuktikan bahwa pemakaian helm dan tipe helm berperan dalam menurunkan cedera kraniofasial. Abnormalitas intrakranial dievaluasi dengan skoring CT Marshall dan abnormalitas maksilofasial dievaluasi dengan FISS. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan trauma kraniofasial; 59 pasien dengan abnormalitas intrakranial dan 24 pasien dengan abnormalitas maksilofasial. Terdapat 43,1% pasien yang menggunakan helm; 31,9% menggunakan helm open-face. Data dianalisis menggyunakan uji t tidak berpasangan. Berdasarkan FISS, efek helm terhadap cedera maksilofasial mendapatkan t = 0,787 (P = 0,217) yag menunjukkan tidak terdapat perbedaan skor antara pasien yang menggunakan dan tidak menggunakan helm. Berdasarkan skoring CT Marshall, efek helm terhadap cedera intrakranial mendapatkan t = 1,822 (P = 0,036) yang menunjukkan terdapat perbedaan skor antara pasien yang menggunakan dan tidak menggunakan helm. Hal ini memperlihatkan bahwa penggunaan helm berpengaruh terhadap kejadian cedera kepala. Berdasarkan FISS, dampak jenis helm full-face dan open-face terhadap cedera maksilofasial mendapatkan t = 1,890 (P = 0,034) yang menyatakan terdapat perbedaan skor FISS antara pengggunaan kedua jenis helm. Berdasarkan skoring CT Marshall, dampak helm full-face dan open-face terhadap cedera intrakranial mendapatkan t = 1,714 (P = 0,049) yang menunjukkan terdapat perbedaan skor CT Marshall antara penggunaan kedua jenis helm. Simpulan: Penggunaan helm dan jenis helm (full-face dan open-face) memengaruhi terjadinya cedera maksilofasial dan intrakranial.Kata kunci: cedera kraniofasial, sepeda motor, helm

Hubungan Kadar Interleukin 10 Serum dan Klasifikasi CT Marshall pada Pasien Cedera Otak Berat akibat Trauma Kurniawan, Melina O.; Prasetyo, Eko; Oley, Maximillian Ch.
JURNAL BIOMEDIK : JBM Vol 11, No 2 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.2.2019.23321

Abstract: Increased level of interleukin 10 (IL 10) in patients with severe traumatic brain injury (TBI) has been documented, yet studies of its ability to predict the outcome based on the Marshall CT classification are still limited and lacks of clarity. This study was aimed to evaluate the relationship between serum level of IL 10 and the Marshall CT classification among patients with severe TBI. This was an analytical observational single-center study with a cross-sectional design. Immediate CT scans were used to determine the Marshall CT classification and to categorize the location (extra-axial, intra-axial, both), hemisphere (midline/diffuse, dextral, sinistral), and area (frontal, parietal, temporal, occipital, multiple) of the injury. Venous blood sample for IL 10 was taken less than 24 hours of trauma in the Intensive Care Unit. Age and gender were also recorded. Variable selection was run in stepwise forward fashion. Proportional odds models were conducted to assess the changes in the Marshall CT classification related to levels of IL 10. There were 25 patients admitted consecutively to the emergency room (ER) with severe TBI included in this study. The results showed that the mean IL 10 was 107.3 pg/ml (SD 16.2 pg/ml). Patients were distributed almost uniformly within four detected categories (diffuse injury II, III, V, and VI) of the CT Marshall classification. Final regression model consisted of IL 10, age, and injury on temporal area as predictors. Controlling for the others, every 10 pg/ml additional of IL 10 increased the odds to higher (worse) categories in the CT Marshall classification by about 1.95 (95% CI 1.16 â€“ 3.30) times. Conclusion: Interleukin 10 is a potential predictor for the CT Marshall classification in patients with severe TBI.Keywords: IL 10, Marshall CT classification, TBIAbstrak: Peningkatan kadar serum interleukin 10 (IL 10) pada pasien dengan cedera otak traumatik (COT) berat telah didokumentasikan, namun studi tentang kemampuannya untuk memrediksi hasil berdasarkan klasifikasi CT Marshall masih terbatas dan belum jelas. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar serum IL 10 dan klasifikasi CT Marshall pada pasien COT berat. Jenis penelitian ialah observasional analitik dengan desain potong lintang. CT scan digunakan untuk menentukan klasifikasi CT Marshall dan untuk mengategorikan lokasi (ekstra-aksial, intra-aksial, keduanya), hemisfer (garis tengah/ difus, dekstra, sinistra), dan area (frontal, parietal, temporal, oksipital, multipel) otak yang terkena cedera. Sampel darah vena untuk IL 10 diambil kurang dari 24 jam pasca trauma. Usia dan jenis kelamin juga dicatat. Seleksi variabel dilakukan secara bertahap. Digunakan model regresi proporsional odds untuk menilai perubahan klasifikasi CT Marshall terkait dengan kadar IL 10. Hasil penelitian mendapatkan 25 pasien dengan COT berat yang masuk ke Instalasi Rawat Darurat Bedah (IRDB). Rerata IL 10 ialah 107,3 pg/ml (SD 16,2 pg/ml). Pasien didistribusikan hampir seragam dalam empat kategori (cedera difus II, III, V, dan VI) dari klasifikasi CT Marshall. Model regresi akhir terdiri dari IL 10, usia, dan cedera pada area temporal sebagai prediktor. Sebagai kontrol, setiap peningkatan IL 10 sebanyak 10 pg/ml meningkatkan kemungkinan klasifikasi CT Marshall yang lebih tinggi (lebih buruk) sekitar 1,95 (95% CI 1,16-3,30) kali lebih tinggi. Simpulan: IL10 merupakan prediktor potensial untuk klasifikasi CT Marshall pada pasien dengan COT berat. Kata kunci: IL 10, klasifikasi CT Marshall, COT

Hubungan antara skala skor FOUR dan CT Marshall dengan penilaian GCS pada penderita cedera otak akibat trauma Matoha, Jemmy; Prasetyo, Eko; Oley, Maximillian Ch.
JURNAL BIOMEDIK : JBM Vol 8, No 3 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.3.2016.14155

Abstract: Brain injury due to trauma is one of the main causes of deaths among traffic accident cases. This study was aimed to obtain the FOUR score scale and the CT Marshall, as well as to evaluate the relationships between FOUR score scale dan CT Marshall related to GCS in brain injury patients due to trauma. This was a prospective correlation study conducted at the Emergency Unit in Prof. Dr. R. D. Kandou Hospital Manado. There were 58 patients that fulfilled the inclusion criteria, consisted of 41 males (70.7%) and 17 females (29.3%). The correlation test of FOUR score and GCS score showed an X2 value of 77.215 (P < 0.001) meanwhile of the CT Marshall score and GCS score obtained an X2 value of 32.359 (P < 0.001). The correlation between FOUR score and CT Marshall score was tested with Spearman corrrelation test which showed Ï“s= -0.433 (P < 0.001). Conclusion: There was a statistically highly significant strong correlation between FOUR score and GCS score, but a statistically highly significant moderate correlation between CT Marshall and GCS. There was a statistically highly significant negative correlation between FOUR score and CT Marshall score.Keywords: brain injury, trauma, FOUR score scale, CT Marshall, GCSAbstrak: Cedera otak akibat trauma (COT) merupakan salah satu penyebab utama kematian pada kasus-kasus kecelakaan lalu lintas. Penelitian ini bertujuan untuk menilai skala skor FOUR CT Marshall pada penderita cedera otak akibat trauma, dan menilai hubungan antara skala skor FOUR dan CT Marshall dalam menilai GCS pada penderita cedera otak akibat trauma Jenis penelitian ini ialah prospektif dengan pendekatan korelatif yang dilakukan di Intalasi Rawat Darurat Bedah (IRDB) RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 58 pasien yang memenuhi kriteria inklusi, terdiri dari 41 pasien laki-laki (70,7%) dan 17 pasien perempuan (29,3%). Uji statistik mengenai hubungan antara skor FOUR dan skor GCS (Cedera Kepala) mendapatkan X2 = 77,215 (P < 0,001). Uji statistik mengenai hubungan antara CT Marshall dan skor GCS (cedera kepala) mendapatkan X2 = 32,359 (P < 0,001). Pengujian hubungan skor FOUR dan CT Marshall dengan analisis korelasi Spearman mendapatkan Ï“s= -0,433 (P < 0,001). yang menyatakan terdapat hubungan negatif yang sangat bermakna antara skor FOUR dengan CT Marshall. Simpulan: Terdapat hubungan kuat yang sangat bermakna antara skor FOUR dan GCS serta hubungan sedang yang sangat bermakna antara CT Marshall dan GCS. Terdapat hubungan negatif yang sangat bermakna antara skor FOUR dengan CT Marshall.Kata kunci: cedera otak, trauma, skala skor FOUR, CT Marshall, GCS

Hubungan antara fraktur maksilofasial dengan terjadinya lesi intrakranial Tanuhendrata, Anton; Hatibie, Mendy; Oley, Maximillian Ch.; Prasetyo, Eko
Jurnal Biomedik : JBM Vol 8, No 3 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.3.2016.14151

Abstract: Maxillofacial structure is an unprotected part of the head and is easily exposed to blunt trauma. This structure functions as a safety cushion for the brain when a trauma occures. This study was conducted at Prof. Dr. R. D. Kandou Hospital Manado and aimed to obtain the relationship between maxillofacial fracture and intracranial lesion. Subjects were patients at the emergency unit with traffic accident associated with maxillofacial fracture with or without intracranial lelsion. GCS examination and CT scan of the head were performed to evaluate the intracranial lesion and the maxillofacial fracture (mild, moderate, or severe depended on the type of fracture). Data were tabulated and analyzed with Spearman correlation test using SPSS 2.2 program. The results showed that there were 50 patients with maxilllofacial injury, consisted of: 19 patients with mild injury, 25 patients with moderate injury, and 6 patients with severe injury. There were 13 patients with intracranial lesion and 37 patients without intracranial lesion. The Spearman correlation test showed an X2 = 32,60 and a P < 0.0001. Conclusion: There was a significant correlation between maxillofacial fracture and intracranial lesion.Keywords: maxillofacial fracture, intracranial lesionAbstrak: Struktur maksilofasial merupakan bagian dari tubuh yang tidak terlindungi, mudah terpapar oleh trauma tumpul, dan merupakan bantal pengaman untuk otak saat trauma terjadi. Penelitian ini bertujuan untuk mendapatkan hubungan antara fraktur maksilofasial dengan lesi intracranial dan dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Subyek penelitian ialah pasien yang datang ke unit gawat darurat yang mengalami kecelakaan lalu lintas dengan fraktur maksilofasial serta ada atau tidaknya lesi intrakranial. Pemeriksaan GCS serta CT scan kepala dilakukan untuk menilai lesi intrakranial sekaligus menilai fraktur maksilofasial (ringan, sedang, atau berat, tergantung dari jenis fraktur). Data ditabulasi dan diuji kemaknaannya dengan korelasi Spearman menggunakan program SPSS 2.2. Hasil penelitian memperlihatkan dari 50 pasien dengan cedera maksilofasial didapatkan: 19 pasien cedera ringan, 25 pasien cedera sedang, dan 6 pasien cedera berat. Terdapat 13 pasien yang disertai lesi intrakranial, sedangkan yang tanpa lesi intrakranial sebanyak 37 pasien. Uji statistik mendapatkan nilai X2 = 32,60 dengan P <0,0001 yang menunjukkan hubungan bermakna antara fraktur maksilofasial dan lesi intrakranial. Simpulan: Terdapat hubungan bermakna antara fraktur maksilofasial dan lesi intrakranial.Kata kunci: Fraktur maksilofasial, lesi intrakranial

Hubungan antara dinamika suhu tubuh dan leukosit perifer dengan skala skor FOUR penderita cedera otak risiko tinggi Polapa, Mulyoni; Prasetyo, Eko; Oley, Maximillian Ch.
Jurnal Biomedik : JBM Vol 8, No 3 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.3.2016.14154

Abstract: One third of patients died in the hospital are patients with secondary brain injury associated with increased intracranial pressure as the main clinical manifestation. Body temperature, inflammatory response, and brain injury are strongly correlated each other. The responses manifest as hyperthermia, leukocytosis, and disturbances in respiratory and heart rates. Prognosis determination is very important at the time in Intensive Care Unit. FOUR score scale involves four components, as follows: eye response, motor response, brainstem reflexes, and respiration. This study was aimed to obtain the relationship between body temperature dynamic and total peripheral leucocyte with FOUR score in patients with high risk brain injury due to trauma. This was an observational analytical study with a cross sectional design. There were 38 patients that fulfilled the inclusion criteria at Prof Dr. R. D. Kandou Hospital Manado. The relationships between body temperature dynamic and total peripheral leukocyte with FOUR score were statistically analyzed with Pearson regression and correlation analysis (SPSS Version 22.0). The results showed that there was a negative correlation between body temperature dynamic and FOUR score (P = 0.03) meanwhile the correlation between total peripheral leukocyte and FOUR score was not significant (P = 0.420). Conclusion: Body temperature dynamic dan total peripheral leucocyte can be included in the protocol of the management of patients with brain injury.Keywords: brain injury, neuroinflammation, FOUR score, temperature, leucocyteAbstrak: Sepertiga dari pasien meninggal di rumah sakit ialah pasien yang mengalami cedera otak sekunder dengan peningkatan tekanan intrakranial sebagai manifestasi klinik utama. Suhu tubuh, respon inflamasi, dan cedera otak sangat erat kaitannya. Respon ini dimanifestasikan dengan hipertermia, leukositosis, serta gangguan respirasi dan denyut jantung. Penentuan prognosis pada saat perawatan di Unit Perawatan Intensif sangat berperan. Skala skor FOUR (Full outline unresponsiveness) melibatkan penilaian dari empat komponen berikut, yaitu: respon mata, respon motorik, refleks batang otak dan pernapasan. Penelitian ini bertujuan untuk mencari hubungan antara dinamika suhu tubuh dan total leukosit perifer dengan skor FOUR pada pasien cedera otak risiko tinggi karena trauma. Jenis penelitian ini observasional korelatif analitik dengan desain potong lintang. Terdapat 38 pasien cedera otak resiko tinggi yang memenuhi kriteria inklusi di RSUP Prof. Dr. R. D. Kandou Manado. Hubungan antara dinamika suhu tubuh dan total lekosit perifer dengan skor FOUR dianalisis dengan analisis regresi korelasi Pearson menggunakan SPSS Versi 22.0. Hasil penelitian mendapatkan hubungan negatif antara dinamika suhu tubuh dengan skala skor FOUR penderita cedera otak risiko tinggi (P = 0,03) sedangkan hubungan antara leukosit perifer dan skala skor FOUR secara statistik tidak bermakna (P = 0,420). Simpulan: Penilaian dinamika suhu tubuh dan leukosit perifer dapat dijadikan pedoman dalam penatalaksanaan penderita cedera otak.Kata kunci: cedera otak, neuroinflamasi, skor FOUR, suhu, lekosit

Hubungan Kadar Laminin Serum dengan Klasifikasi CT Marshall dan GCS pada Pasien Cedera Otak akibat Trauma Sudarsono, Ferry; Prasetyo, Eko; Oley, Maximillian Ch.; Langi, Fima L. F. G.
e-CliniC Vol 9, No 1 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i1.32477

Â Abstract: Elevated serum laminin levels in patients with traumatic brain injury (TBI) have been documented, but studies on its ability to predict outcomes based on the CT Marshall and Glasgow Coma Scale (GCS) classification are still unclear. This study was aimed to evaluate the relationship between serum laminin levels and Marshall CT as well as GCS classification in COT patients. This was an observational and analytical study with a cross-sectional design. A scan was used to determine the CT Marshall and GCS classification in order to obtain the level of consciousness. Venous blood samples for laminin were drawn less than 24 hours post-trauma. Age and gender were recorded, and the variable selection was carried out gradually. Proportional regression models were used to assess changes in the CT Marshall and GCS classification associated with laminin levels. The result showed that the 32 patients with COT had a mean laminin level of 818.4 pg/mL. Patients were distributed almost uniformly in the six categories of the CT Marshall classification. Furthermore, the final regression model consisted of patients with the CT Marshall IV-VI classification having a serum laminin level of 316.74 pg/mL (95% CI 206.88; 426.60 pg/mL; p<0.001) higher than that of I-III. Meanwhile, after controlling for a number of other variables, the difference increased to 401.06 pg/mL (95% CI 264.84; 563.28 pg/ mL; p<0.001). The individual consciousness levels were measured by using GCS which consist of an inverse relationship with serum laminin levels. Each increase in the mean of GCS rate decreased the laminin value to about 49.10 pg/mL (95% CI 23.33; 74.96 pg/mL; p<0.001). In conclusion, laminin has a significant correlation with the CT Marshall and GCS classifications in patients with COT.Keywords: laminin, traumatic brain injury (TBI)Â Â Abstrak: Peningkatan kadar serum laminin pada pasien dengan cedera otak akibat trauma (COT) telah didokumentasikan, namun studi tentang kemampuannya untuk memrediksi hasil berdasarkan klasifikasi CT Marshall dan GCS (Glasgow Coma Scale) masih terbatas. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dengan klasifikasi CT Marshall dan GCS pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Pemeriksaan CT-scan digunakan untuk menentukan klasifikasi CT Marshall dan GCS digunakan untuk menentukan tingkat kesadaran. Sampel darah vena untuk laminin diambil kurang dari 24 jam pasca trauma. Usia dan jenis kelamin juga dicatat. Seleksi variabel dilakukan secara bertahap. Digunakan model regresi proporsional untuk menilai perubahan klasifikasi CT Marshall dan GCS terkait dengan kadar laminin. Hasil penelitian mendapatkan 32 pasien dengan COT yang masuk ke Instalasi Rawat Darurat Bedah (IRDB). Kadar rerata laminin ialah 818,4 pg/mL. Pasien didistribusikan hampir seragam dalam enam kategori dari klasifikasi CT Marshall. Model regresi akhir terdiri dari penderita dengan klasifikasi CT Marshall IV-VI rata-rata memiliki kadar laminin serum 316,74 pg/mL (95% CI 206,88; 426,60 pg/mL; p<0,001) lebih tinggi daripada mereka dengan kategori I-III. Setelah sejumlah variabel lain dikontrol, selisih tersebut bahkan naik menjadi 401,06 pg/mL (95% CI 264,84; 563,28 pg/mL; p<0,001). Tingkat kesadaran individu, diukur menggunakan GCS, sebaliknya memiliki hubungan terbalik dengan kadar laminin serum. Setiap kenaikan angka GCS rata-rata menurunkan nilai laminin hingga sekitar 49,10 pg/mL (95% CI 23,33; 74,96 pg/mL; p<0,001). Simpulan penelitian ini ialah laminin mempunyai korelasi bermakna dengan klasifikasi CT Marshall dan GCS pada pasien dengan COT.Kata kunci: laminin, cedera otak akibat trauma (COT)

Hubungan Kadar Interleukin 6 dan Interleukin 10 Serum pada Pasien Cedera Otak Berat Akibat Trauma Natsir, Rustandy; Prasetyo, Eko; Oley, Maximillian Ch.; Langi, Fima L. F. G.
Jurnal Biomedik : JBM Vol 13, No 1 (2021): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.13.1.2021.32475

Abstract: The elevated of serum interleukin-6 (IL-6) and interleukin-10 (IL-10) levels in patients with traumatic brain injury (TBI) have been documented. The correlation between levels of serum IL-6 and IL-10 in the early phase could provide an assessment of prognosis and outcome in patients with severe TBI. This study was aimed to obtain the correlation of levels of IL-6 and IL-10 serum in severe TBI patients. This was an observational and analytical study with a cross sectional design. Venous blood samples for serum IL-6 and IL-10 were taken less than 24 hours post injury. Age and sex were recorded and variable selection was carried out gradually. A proportional regression model was used to assess the correlation between IL-6 and IL-10 serum levels. The results showed that there were 20 patients with severe TBI admitted to the Emergency Room. The mean IL-6 serum level was 22.0 pg/mL (SDÂ±4.6 pg/mL) and the mean IL-10 serum level was 105.7 pg/mL (SDÂ±16.7 pg/mL). The levels of the two biomarkers were not significantly different among men and women in the population study. The Pearson correlation test resulted in an r value of 0.46 and a p value of 0.041. The results of the regression modelling presented that increased IL-6 serum level was followed by increased IL-10 serum level of nearly 2 pg/mL (p=0.041). After controlling variations in other variables, the regression coefficient value for this correlation increased up to nearly 3 pg/mL (p=0.001). In conclusion, there is a correlation between the serum level of IL- 6 and IL-10 in patients with severe TBI.Keywords: interleukin 6 (IL-6), interleukin 10 (IL-10), severe traumatic brain injury (TBI)Â Abstrak: Peningkatan kadar interleukin 6 (IL-6) dan interleukin (IL-10) serum pada pasien dengan cedera otak akibat trauma (COT) telah didokumentasikan. Namun, hubungan tingkat keparahan dan mortalitas antara IL-6 dan IL-10 pada fase awal trauma masih perlu diteliti untuk mendapatkan korelasi dan pemahaman lebih baik tentang peran IL-6 dan IL-10 agar dapat dijadikan sebagai penilaian prognosis dan luaran pada pasien dengan COT berat. Penelitian ini bertujuan untuk mengevaluasi hubungan kadar IL-6 dan IL-10 serum pada pasien dengan COT berat. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel darah vena untuk IL- 6 dan IL-10 serum diambil kurang dari 24 jam pasca trauma. Usia dan jenis kelamin dicatat dan seleksi variabel dilakukan secara bertahap. Digunakan model regresi proporsional untuk menilai hubungan kadar IL-6 dan IL-10 serum pada pasien COT berat. Hasil penelitian mendapatkan 20 pasien dengan COT berat yang masuk ke Instalasi Rawat Darurat Bedah (IRDB). Rerata kadar IL-6 serum 22,0 pg/mL (SDÂ±4,6 pg/mL) dan rerata IL-10 serum 105,7 pg/mL (SDÂ±16,7 pg/mL). Kadar serum kedua biomarker ini relatif tidak jauh berbeda pada laki-laki maupun perempuan. Hasil uji korelasi Pearson mendapatkan nilai r= 0,46 dengan p=0,041. Hasil pemodelan regresi mengindikasikan setiap pg/mL peningkatan IL-6 serum pasien COT berat dalam penelitian rata-rata diikuti oleh kenaikan kadar IL-10 serum hampir 2 pg/mL (p=0,041). Setelah pengontrolan variasi variabel lain, nilai koefisien regresi untuk hubungan tersebut naik menjadi hampir 3 pg/mL (p=0,001). Simpulan penelitian ini ialah terdapat hubungan peningkatan kadar IL 6 dan IL-10 serum pada pasien dengan COT berat.Kata kunci: interleukin 6 (IL-6), interleukin 10 (IL-10), cedera otak akibat trauma (COT) berat

Determinant of Complete Blood Count on Long Bone Diaphysis Fractures of Lower Extremity Indrowiyono, Hanny R.; Noersasongko, A. Djarot; Lengkong, Andriessanto; Oley, Maximillian Ch.; Hatibie, Mendy J.; Langi, F.L. Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.34537

Abstrak: Fraktur ekstremitas bawah memiliki prevalensi yang tinggi di antara jenis fraktur lainnya akibat kecelakaan. Pemeriksaan darah lengkap berperan penting dalam proliferasi osteoblas yang merupakan langkah awal dalam penyembuhan tulang. Penelitian ini bertujuan untuk membuktikan hubungan antara penyembuhan tulang dengan determinan darah lengkap dan hubungan determinan darah lengkap dengan jenis fraktur, lokasi fraktur, faktor-faktor demografik, dan parameter darah tepi pada pasien fraktur diafisis tulang panjang ekstremitas bawah. Penelitian ini dilaksanakan di RSUP Prof. Dr. R. D. Kandou, Manado menggunakan studi kohort (analitik observasional) dengan 10 pasien fraktur terbuka (grade I-II) dan 14 pasien fraktur tertutup. Semua pasien dilakukan pemeriksaan fisik dan pemeriksaan laboratorium darah lengkap. Hasil penelitian mendapatkan pasien laki-laki lebih banyak dibanding perempuan, median usia 30 tahun. Hasil analisis regresi mendapatkan perbedaan hasil darah lengkap pada fraktur terbuka dan fraktur tertutup (leukosit dan neutrofil batang) dan hasil bermakna pada perbedaan lokasi fraktur di femur dan tibia. Simpulan penelitian ini ialah penderita fraktur diafisis ekstremitas bawah terbuka memiliki infeksi lebih tinggi dengan ditandai peningkatan leukosit dan neutrofil batangKata kunci: kadar darah lengkap; fraktur diafisis; tulang panjangÂ Abstract: Lower limb fracture has a high prevalence among other types of fractures due to accidents. Complete blood count has an important role in the proliferation of osteoblasts which is the first step in bone healing. This study was aimed to prove the relationship between bone healing and determinants of complete blood count and to prove the relationship between determinants of complete blood count and fracture type, fracture location, demographic factors, and peripheral blood parameters in patients with diaphysis fractures of the long bones of lower extremities. This study was conducted at Prof. Dr. R. D. Kandou Hospital, Manado using a cohort study (observational and analytical) with 10 open fracture patients (grade I-II) and 14 closed fracture patients. All patients were subjected to physical examination and complete blood count laboratory. The results showed that male subjects were predominant and the median age was 30 years. The regression analysis showed that there were differences in complete blood count between open fractures and closed fractures (leukocytes and band neutrophil) and significant differences in the location of fractures in the femur and tibia. In conclusion, leukocyte and segmented neutrophils levels are increased in patients with open lower limb diaphysis fracturesKeywords: complete blood count; long bone; diaphysis fracture

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