Heri Suroto
Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Hospital, Surabaya

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Scalenectomy Anterior as an Option for Thoracal Outlet Syndrome Bari, Yunus Abdul; Rafif Amir, Muhammad; Suroto, Heri; Pradana, Reyhan Pradnya
Journal La Medihealtico Vol. 5 No. 6 (2024): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v5i6.1677

Abstract

The term "thoracic outlet syndrome" (TOS) refers to a collection of conditions that cause compression of the neurovasculature as it leaves the thoracic outlet. The condition was initially identified in 1956. The scalene triangle, the costoclavicular space, and the subcoracoid region are the three spaces where TOS typically occurs. The brachial plexus, the axillary artery and vein, and the subclavian artery and vein are all of the structures involved with TOS. A 38-year-old male presented to the orthopaedic department. He complained about weakness and numbness in her left arm that had been present for 15 years. The complaints had been aggravated over the last 3 years which was exacerbated by activities that required her to lift her arm. The most prevalent causes of TOS are congenital, traumatic, or functional. TOS is classified into three categories based on its clinical presentation: neurogenic (nTOS), venous (vTOS), and arterial (aTOS), with nTOS being the most frequent. Treatment for Thoracal Outlet Syndrome is conservative. However, if conservative treatment does not work well, operative treatment is needed.
Growth Factor Comparison in Cortical Demineralized Bone Matrix that Demineralized Using Chloric and Acetic Acid Edward, Mouli; Mahyudin, Ferdiansyah; Basuki, Mohammad Hardian; Suroto, Heri; Perwira, Ferdiansyah Danang
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.1-9

Abstract

Background: Demineralized bone matrix (DBM) is an alternative biomaterial for which specific acid and immersion time are needed to optimize growth factor preservation. The optimal demineralization protocol for preserving growth factors in DBM remains unclear. This study investigated DBM extraction methods using different acids and immersion times to maintain optimal growth factor preservation.Methods: This in vitro experimental laboratory study used a randomized controlled post-test-only group design. We characterized the Insulin-like growth factor-1 (IGF-1), Bone morphogenetic protein-2 (BMP-2), and Transforming growth factor-β (TGF-β) content of 1 gram of New Zealand White Rabbit cortical bone immersed in 0.6 M hydrochloric acid and 0.5 M acetic acid for 3, 6, and 9 days. We then analyzed the differences in growth factor levels in each acid and performed statistical analysis.Results: IGF-1 levels were higher in DBM demineralized with acetic acid than with hydrochloric acid. BMP-2 and TGF-β levels were higher in DBM demineralized using hydrochloric acid. The concentration of growth factors decreased over time in DBM demineralized using acetic acid. The highest growth factor level was obtained after 6 days of immersion in hydrochloric acid.Conclusion: DBM demineralized with acetic acid yielded higher average IGF-1 levels compared to hydrochloric acid. However, BMP-2 and TGF-β levels were higher with hydrochloric acid. Growth factor levels in hydrochloric acid peaked at 6 days and then decreased. These results suggest that avoiding over-demineralization is important for maintaining growth factor levels. Further research is needed to optimize DBM processing.
Hypergravity as a Possible Way of Bone Tissue Engineering in Osteoblastic Differentiation from Mesenchymal Stem Cells: A Systematic Review Sudrajad, Wisnu; Indrawan, Andre Erica; Kusuma, Devangga; Soetojo, Bagus Wibowo; Suroto, Heri
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 13 No. 2 (2024): October 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v13i2.2024.75-83

Abstract

Background: Tissue engineering development has become a highlight in recent decades. One of the key areas of focus is producing mature bone tissue to overcome orthopedic problems, such as bone defects. Various cultures have been implemented on stem cells; some induce osteoblastic differentiation markers, while others have the opposite effect. Microgravity has been proven in several studies to inhibit the expression of osteogenic differentiation markers. Conversely, hypergravity is expected to have the opposite impact, supporting stem cells in the osteogenesis pathway. Methods: A literature search was conducted using online databases including Sciencedirect, PubMed, and Proquest, covering the period from 2008 to 2022. This search considered only experimental studies published in English. The keywords used in this research were "hypergravity" and "mesenchymal stem cell." All acquired data were processed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (2020). Results: Initially, 190 studies were collected from online databases based on relevant keywords. After screening, 5 studies were included in the final analysis, focusing on hypergravity treatment and its effects on mesenchymal stem cells (MSCs). Conclusion: Hypergravity shows a significant and strong impact on osteoblastic differentiation. This study revealed that a gravity force of 30G and a culture duration of 7 to 14 days are the most optimal combination for inducing osteoblastic differentiation in MSCs.
Predictive Factors of Amputation for Post-Bypass Surgery on Vascular Trauma Patients Kusworo, Afila Reza; Soebroto, Heroe; Suroto, Heri
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3107

Abstract

n Indonesia, most vascular trauma is linked to traffic collisions. According to the Statistics Indonesia (Badan Pusat Statistik, BPS), there were 116,411 accidents in 2019. Limb salvages become important in  vascular trauma, which is performed through, among others, vascular bypass surgery. However, secondary amputation still occurs after vascular bypass. This study aimed to determine the predictors of secondary amputation after vascular bypass due to vascular trauma. This study used descriptive analysis of medical records and univariate analysis. Medical records of patients with vascular trauma underwent vascular bypass in Dr Soetomo Regional Hospital, Indonesia, from January 2018 to December 2020 were collected. Independent variables were age, MESS, time interval between the incident of trauma to the first incision of bypass surgery, penetrating and blunt injury, injured arterial segment, multiple injuries, and obesity. The dependent variable was secondary amputation. Fisher Exact Test was used to analyze the correlation between dependent and independent variables. Results showed a significant difference between patients with a MESS score of >7 and those with a MESS score of  ≤7 (p=0.044), where more patients with a MESS score of >7 experienced secondary amputation. Other variables showed no significant difference (p>0.05). This study concluded that MESS could be used as a predictor of secondary amputation in vascular trauma after vascular bypass. Further studies using multivariate analysis and a larger sample need to be conducted to get further insights on this phenomenon.
Adipose-derived mesenchymal stem cells enhance regeneration in a chronic peripheral sciatic nerve injury Sprague-Dawley rat model Widodo, Wahyu; Dilogo, Ismail Hadisoebroto; Kamal, Achmad Fauzi; Antarianto, Radiana Dhewayani; Wuyung, Puspita Eka; Siregar, Nurjati Chairani; Octaviana, Fitri; Kekalih, Aria; Suroto, Heri; Aprilya, Dina; Canintika, Anissa Feby
Medical Journal of Indonesia Vol. 34 No. 3 (2025): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257780

Abstract

BACKGROUND Obtaining optimal functional outcomes in patients with chronic peripheral nerve injuries (PNIs) remains challenging due to the limited regeneration of the neuromuscular junction (NMJ). Adipose-derived mesenchymal stem cells (AD-MSCs) can differentiate into Schwann-like cells, secrete neurotrophic factors, and recruit native Schwann cells. This study aimed to analyze the effects of AD-MSCs on functional outcomes in a chronic PNI model. METHODS An in vivo study was performed using 20 male Sprague-Dawley rats with chronic PNI of the right sciatic nerve. Rats were divided into two groups: the AD-MSC group (n = 10), receiving human AD-MSC injections in the NMJ; and the control group (n = 10), receiving normal saline injections. Walking track analysis and electrophysiological assessments were performed 8 weeks after the nerve repair. Postmortem gastrocnemius muscle weights and immunohistochemical examinations were also performed. RESULTS The AD-MSCs showed significantly larger fiber diameters than the control group (45.54 [13.1] versus 35.46 [6.64]; p = 0.011). While clinical, electrophysiological, and gastrocnemius muscle weight data suggested a trend toward improved outcomes in the AD-MSCs group, the differences were not statistically significant. CONCLUSIONS AD-MSC implantation may enhance nerve regeneration, as demonstrated by a better outcome profile in the AD-MSCs group.
Umbilical cord mesenchymal stem cells and their secretome in peripheral nerve regeneration: a narrative review promising therapeutic strategy Sumarwoto, Tito; Hadinoto, Seti Aji; Romaniyanto; Rhatomy, Sholahudin; Utomo, Pamudji; Idulhaq, Mujaddid; Santoso, Asep; Suroto, Heri
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 4 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i4.24055

Abstract

The injuries of peripheral nerves remain a substantial clinical challenge because of their limited regenerative capacity, the complexity of nerve repair, and limitations of current treatment strategies. Umbilical cord mesenchymal stem cells (UC-MSCs) and their secretome have shown promise as regenerative treatments due to their distinct biological characteristics. This review explores the possibility of UC-MSCs and their secretome in promoting peripheral nerve regeneration, by their action mechanisms, therapeutic applications, and current preclinical - clinical evidence. UC-MSCs have proven to be capable of support Wallerian degeneration, improving axonal growth, reducing inflammation, and improving functional recovery in both animal models and early clinical studies. Their secretome has been shown to promote neuroprotection and functional repair, avoiding the risks of receiving a direct stem cell transplant. Challenges remain in standardizing UC-MSC-based therapies, ensuring long-term safety, and enhancing delivery strategies. Further clinical trials are needed to determine the efficacy, safety, and scalability of UC-MSC therapies for widespread clinical use. UC-MSCs and their secretome provide a unique, cell-free and cell-based strategy to peripheral nerve regeneration. Future advancements in biomaterial integration, gene editing, and personalized medicine will be essential to implementing these treatments in clinical settings.