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All Journal Medical Journal of Indonesia Medicinus : Jurnal Kedokteran
Yesaya Yunus
Department of Surgery, Medical Faculty of Pelita Harapan University, Neuroscience Centre Siloam Hospital Lippo Village Tangerang, Indonesia
Medicine & Pharmacology Public Health

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Cortisol dynamics and endothelin-1/nitric oxide ratio are associated with clinical vasospasme July, Julius; Yunus, Yesaya; Sungono, Veli; As’ad, Suryani; Suhadi, Budhianto; Islam, Andi A.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (520.232 KB) | DOI: 10.13181/mji.v22i3.585

Abstract

Background: Cortisol dynamics in serum might be related to clinical vasospasm, also known as delayed ischemic neurological deficits (DIND). Two vasoactive substances that play a role in pathophysiology of DIND are endothelin-1 (ET1) and nitric oxide (NO), both are proved associated with cortisol. This study aimed to know how cortisol play a role on ET1/NO ratio and its relationship to DIND.Methods: This was a prospective cohort study for the first 14 days after aneurysmal subarachnoid hemorrhage (SAH). Patients with inclusion criteria will be enrolled for blood test before surgery, and post-operative day 2, 4, 7, and 10 (between 8:00-9:00 AM). The blood tests were performed for cortisol, ACTH, CBG, NO, and ET1. Free cortisol is calculated with Coolens equation. Logistic regression was used to see the interaction model and its scale. Bivariate analysis (corelation) was used to see the relationship between total cortisol, free cortisol, NO, ET1, and clinical vasospasm (DIND).Results: Forty-four patients are enrolled into this study (20 male; 24 females). Mean age is 52.02 years (52.02 ± 11.23). There were 29 patients (66%) within  DIND group and 15 patients Non-DIND as the control group. The mean of cortisol level shown is significantly higher in DIND group (35.99 ± 14.24) µg/dL compared to Non-DIND group (19.57 ± 6.19) µg/dL, p < 0.001. The mean of free cortisol level was significantly higher in DIND group (2.06 ± 1.094) µg/dL compared to non-DIND group (0.838 ± 0.365 µg/dL; p < 0.001). The Scatter Plot graph show that correlation of cortisol with ET1/NO ratio started increasing on day 4 and became stronger on day 10.Conclusion: Cortisol is associated with DIND following aneurysmal SAH,  probably through its role in keeping the balance between ET1 and NO level. (Med J Indones. 2013;22:161-6. doi: 10.13181/mji.v22i3.585) Keywords: Cortisol dynamics, delayed ischemic neurological deficits, endothelin-1, nitric oxide
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.
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.
Co-Authors Andi A. Islam As’ad, Suryani Budhianto Suhadi Eka J. Wahjoepramono Julius July Veli Sungono Widjaya, Ingrid A