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All Journal BALI MEDICAL JOURNAL (BMJ) The Indonesian Biomedical Journal Universa Medicina Paediatrica Indonesiana Medicinus : Jurnal Kedokteran SCRIPTA SCORE Scientific Medical Journal Jurnal Ilmu Bedah Indonesia
Eka J. Wahjoepramono
Department Of Neurosurgery, Faculty Of Medicine, Universitas Pelita Harapan, Neuroscience Center, Siloam Hospital Lippo Village, Tangerang, Banten
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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A retrospective study of spontaneous intracranial hemorrhage Wahjoepramono, Eka J.
Universa Medicina Vol 28, No 2 (2009)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2009.v28.69-76

Abstract

Spontaneous intracerebral hemorrhage (SICH) is a serious disease despite progressing medical knowledge. SICH appears suddenly without warning, unlike ischemic strokes that are often preceded by a transient ischemic attack. Outcome is determined by the initial severity of the bleeding; mortality and morbidity of SICH are high. The aim of this study was to describe the characteristics of type, location, and outcome of SICH. A retrospective review was conducted on the records of 2042 cases admitted to a private hospital in Karawaci, Tangerang, between 1 January 1996 to 31 December 2008. Analysis was done on type, location, and the final outcome measures by the Glasgow Outcome Scale (GOS). The results of the study showed that the most prevalent type of SICH was hypertensive stroke, amounting to 1698 cases (83.1%), and the least commonly encountered type was dural fistula totaling  5 cases (0.3%). SICH due to hypertensive stroke frequently occurred in the basal ganglia (50.8%) comprising the putamen, caudate nucleus and globus pallidus. On average, the outcome at the time of dismissal was good, where 105 cases (88.2%) were GOS 4 and 5. SICH requires prompt and appropriate management. Therefore the signs and symptoms of intracranial hemorrhage should be promptly recognized and followed by appropriate ancillary examinations in order to promptly determine the management required, including possible surgical interventions.
MAXIMIZATION OF DNA DAMAGE TO MGMT(+) EGFR(+) GBM CELLS USING OPTIMAL COMBINATION OF TEMOZOLOMIDE-ANTI EGFR MONOCLONAL ANTIBODY NIMOTUZUMAB Inggas, Made Agus Mahendra; Wahjoepramono, Eka J.; Maliawan, Sri; Islam, Andi Asadul
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.158 KB)

Abstract

Background: Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adultswith dismal prognosis due to the unavailability of an effective therapy. Up to now, there had been no definitive studies published on EGFR inhibition therapy as a chemosensitizer for GBM therapy using Temozolomide (TMZ). This study aims to reveal the most effective method and timing to administer TMZ anti EGFR targeted therapy which causes maximal DNA damage on GBM cells. Methods: Various regimens of anti EGFR monoclonal antibody Nimotuzumab (NMZ) was administered in different combinations with TMZ, performed on U87MG MGMT(+) EGFR(+) cells. The effectiveness of the combinations were evaluated by measuring yH2AX levels which reflects the degree of DNA damage. One-way Anova and LSD tests were performed to determine the effects of each treatment with p
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
Isolation of Mesenchymal Stem Cells from Adipose Tissue Harsan Harsan; Silmi Mariya; Andi Asadul Islam; Eka Julianta Wahjoepramono; Irawan Yusuf
The Indonesian Biomedical Journal Vol 7, No 3 (2015)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v7i3.181

Abstract

BACKGROUND: In searching for the best source of stem cells, researcher found adipose stem cells as one of the ideal source due to its easiness in harvesting and its potential for differentiating into other cell lineage.METHODS: We isolated stem cells from adipose tissue, cultured and confirmed its immunophenotype using polymerase chain reaction.RESULTS: Cluster of differentiation (CD)44, CD73, CD90, CD105 were expressed, which represent immunophenotype of mesenchymal stem cells. CONCLUSION: Mesenchymal stem cells can be isolated from adipose tissue. KEYWORDS: adipose, mesenchymal stem cells, isolation, immunophenotype
Surgical aspects of arachnoid cysts: report of 3 cases and brief review Eka J. Wahjoepramono
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4063.387 KB) | DOI: 10.14238/pi48.3.2008.186-92

Abstract

This paper reports two cases with surgicalintervention and another case with non-surgicaltreatment.
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
Experience in the Surgical Management of Two Cases with Acromegaly Eka J Wahjoepramono
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.v35i2.131

Abstract

Acromegaly is a chronic disorder that usually develops over many years due to long term exposure to elevated levels of growth hormone (GH) most typically caused by a somatotrophic cell pituitary adenoma. It has an annual incidence of approximately 3-4 cases / million. A diagnosis of acromegaly is made based on the clinical presentation, biochemical and radiologic finding. The classical feature is the change in appearance and acral enlargement. No single therapy is comprehensively successful in controlling the disease. Surgical, medical and radiation treatments are available for lowering GH and insulin-like growth factor I (IGF-I) hypersecretion, controlling pituitary tumor mass effects, and lowering morbidity.
Intramedullary Spinal Cord Cavernoma: A Case Report and Literature Review Widjaya, Ingrid A; Yunus, Yesaya; Wahjoepramono, Eka Julianta; July, Julius
Medicinus Vol 13, No 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7533

Abstract

Background: Spinal cord intramedullary cavernous malformation (SICM) is kind of rare vascular disease, and the therapeutic strategy is still under debate. Cavernous malformation (CM) can be found throughout the central nervous system (CNS) but only rarely occur within the spinal cord. The purpose of this article is to describe natural history, clinical presentation and outcome of SICM case which treated surgicallyCase Presentation: A 70-year-old healthy woman presented with lower extremity weakness. A posterior laminectomy was performed, and a diagnosis of intramedullary spinal cord cavernous malformation was established. Neurological improvement was seen in one month after surgeryConclusion: Intramedullary CM is a rare disease but one with significant consequences if not managed appropriately. whenever safely feasible, gross total resection is suggested, to prevent rebleeding and further worsened of neurological deficit.
WNT-Activated Medulloblastoma in A 6-Year-Old Boy Prasetyo, Patricia Diana; Wahjoepramono, Eka Julianta
Medicinus Vol 13, No 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7530

Abstract

Background: Medulloblastoma is the most common malignant brain tumor of childhood. Prognosis is mostly favorable, but may be affected by histological and molecular subtypes. Long-term therapy-related morbidity also remains a significant concern.Case Presentation: A 6-year-old boy with brainstem/midline cerebellum tumor. Histopathology found area of necrosis, sheets of malignant undifferentiated round cells with hyperchromatic nuclei and scanty cytoplasm, no nodule and no anaplasia. Immunohistochemistry found p53 wild-type staining pattern along with b-catenin diffuse cytoplasmic and focal nuclear staining. This indicated a diagnosis of WNT-activated medulloblastoma, World Health Organization (WHO) grade IV, with classic histological features.Discussion: WNT-activated medulloblastomas with classic histological features and no anaplasia were reported to have the most favorable prognosis. The current patient showed negative staining for GFAP, Olig2, EMA, H3K27M, EZHIP, and LIN28A, with retained staining for INI1 and BRG1, thus excluding several differential diagnosis such as atypical teratoid/rhabdoid tumor, embryonal tumor with multilayered rosettes, small cell glioblastoma, Ewing sarcoma, high-grade neuroepithelial tumor with BCOR alteration or diffuse midline glioma. Histopathology in combination with immunohistochemical and molecular subtyping of medulloblastoma can help to refine diagnosis, exclude differential diagnosis, and improve counseling in regards to overall prognosis.
Intracranial Solitary Fibrous Tumor in a 25-Year-Old Woman Prasetyo, Patricia Diana; Marisca, Stephanie; Wahjoepramono, Eka J.
Medicinus Vol 13, No 3 (2024): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i3.8890

Abstract

Introduction: Intracranial solitary fibrous tumors (ISFTs) are extremely rare spindle cell tumors originating from dendritic mesenchymal cells expressing CD34 antigens that are usually benign, although malignant transformation had been reported. The knowledge of natural course and prognostic factors of ISFTs is still limited and the tumor is easily misdiagnosed.Case Presentation: An intra-cranial extra-axial tumor tissue resection from a 25-year-old woman was evaluated in the Surgical Pathology Laboratory. Histologic findings (cellular spindle cell tumor with ‘patternless’ pattern, staghorn blood vessels and <5 mitoses per 10 hpf) and immunophenotype (positive for CD34, weakly and focally positive for STAT6) suggested a diagnosis of intracranial solitary fibrous tumor WHO Grade II.Discussion: ISFTs have very low incidence in the CNS and are difficult to distinguish radiologically from meningiomas, thus post operative pathological examination and immunohistochemistry markers evaluations are the mainstay for diagnosis. ISFT is associated with NAB2-STAT6 gene fusion and may exhibits a wide spectrum of histological features. STAT6 immunohistochemistry is considered as one of the most sensitive diagnostic methods, while the evaluation of CD34 expression can be used as alternative diagnostic method despite having lower sensitivity.
Co-Authors Alexander Cahyadi, Alexander Amiruddin Aliah, Amiruddin Andi Asadul Islam Andi Asadul Islam Andi Asadul Islam As'ad, Suryani Beny Atmadja Wirjomartani Budhianto Suhadi Cahyono Kaelan, Cahyono Dewi Purnamasari Gilbert Sterling Octavius Harsan Harsan Harsan Ilham J. Patellongi, Ilham J. Ilhamjaya Patellongi Irawan Yusuf Irawan Yusuf Jan S. Purba, Jan S. Julius July Kusumaningrat, Donald Rinaldi Made Agus Mahendra Inggas, Made Agus Mahendra Marisca, Stephanie Nicholas Gabriel H.R. Prasetyo, Patricia Diana Rocksy F.V. Situmeang, Rocksy F.V. Silmi Mariya Sri Maliawan Sutisna Himawan Syarifuddin Wahid THEO AUDI YANTO, THEO AUDI Vivien Puspitasari, Vivien Widjaya, Ingrid A Yesaya Yunus Yesaya Yunus