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Sumbing Median (Midline Cleft) Dachlan, Ishandono; Handaya, A. Yuda; Sagiran, Sagiran
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 5, No 2 (2005)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar

Midline Cleft is a midline deformity of the upper lip and nose (Tessier Clasification of Cleft Number 0 ). It is rare and often accompanied by disorder of the central nervous system. Head CT Scan with a better architecture of the brain has a better prognosis and those with poor differentiation of brain die during infancy. The treatment of choice is surgical procedure to correct the deformity by Z-plasty or its modification. The aim of this stydy is to report the management of a midline cleftTwo Cases has been reported, The first case was a 13 year-old girl suffering from a midline upper lip cleft, she visited to Sardjito Hospital because of a cosmetic problem, and she had a good achievements at School, The head CT Scan showed a normal brain architecture. She had undergone an upper lip modification Z- Plasty. The second case was a 2 day-old male baby within absence of collumella and prolabial segment of lip (false median cleft), absence of the premaxilla skeletal and he suffers multiple anomalies, the head CT scan showed poor differentiation of brain.Result of this study showed that the one case has showed a good result after upper lip modification of Z-Plasty, the second case died before treated any surgical operation. It can concluded that midline cleft should be treated with observing other problems or anomalies especially of the brain structure and followed with delicate method of surgical procedure.Sumbing median adalah kelainan median pada bibir atas dan hidung (Klasifikasi Tessier, Cleft Nomor 0). Sumbing median adalah kelainan yang jarang terjadi dan biasanya disertai dengan gangguan sistem syaraf pusat. CT Scan kepala yang menunjukkan struktur otak baik mempunyai prognosis lebih baik, Gambaran struktur otak yang jelek biasanya meninggal pada awal kehidupan atau masa pertumbuhan. Terapi pilihan biasanya berupa prosedur pembedahan untuk mengoreksi kelainan, dengan teknik Z-plasty atau modifikasinya. Tujuan dari kajian ini adalah untuk melaporkan penatalaksanaan dua buah kasus sumbing median.Delaporkan dua kasus sumbing median, kasus pertama wanita usia 13 tahun menderita sumbing pada pertengahan bibir atas, pasien datang ke Rumah sakit Sardjito dengan keluhan kosmetik, pasien mempunyai prestasi yang baik di sekolah. CT Scan kepala menunjukan gambaran otak normal. Pasien dilakukan operasi Z- Plasty pada bibir atas. Kasus ke dua,pasien laki-laki usia 2 hari dengan tidak adanya collumella danprolabial, serta tidak adanya tulang premaxilla, pasien menderita anomali multipel, CT Scan kepala menunjukan gambaran otak yang tidak sempurna.Kasus pertama menunjukan hasil yang baik setelah dilakukan operasi Z-Plasty, kasus kedua meninggal sebelum dilakukan tindakan bedah. Oleh karena itu dapat disimpulkan bahwa penatalaksanaan sumbing median harus memperhatikan anomali lain terutama struktur otak dan perlu mempertimbangkan teknik operasi yang tepat untuk mendapatkan hasil yang baik.

Assessing downgrading of esophageal adenocarcinoma after neoadjuvant chemotherapy: a case report Indrasto Histopaedianto1, Adeodatus Yuda Handaya2*, Hendro Wartatmo2 Adeodatus Yuda Handaya; Indrasto Histopaedianto; Hendro Wartatmo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 1 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Esophageal carcinoma, squamous cell carcinoma, and adenocarcinoma, are a deadly serious malignancy. The delay in diagnosis due to the lack of specific symptoms in the early stages of the disease and the nature of esophageal cancer is very aggressive lead to a poor prognosis with a survival rate of small. Current management of esophageal cancer is recommended multimodal approach in the form of neoadjuvant chemotherapy or combined radiochemotherapy (CRT) and with surgery. In this article, multimodality treatment using chemotherapy and surgery on esophageal adenocarcinoma was reported. A 52-year-old male presented with a total obstruction of the esophagus and was planned to perform temporary gastrostomy for chemotherapy preparation. Gastrostomy found a solid and fixed tumor located in the gastroesophageal junction, with the size of 7 x 6 x 5 cm3. He underwent a chemotherapy using the regimen of 8 cycles paclitaxel without radiotherapy due to the long queue of radiotherapy schedule. After chemotherapy, we re-evaluated and planned to perform surgical removal of the tumor. During surgery, we found a total obstruction along with fibrosis of the esophagus but found no tumor/mass. We performed partial esophagectomy and end to side anastomosis using anastomosis end to side using the CDH25 circular stapler. Surgery was carried out by the thoracoabdominal approach. The patient was discharged on day 12 in a stable condition and was undergoing soft diet. We planned to evaluate the patient using Carcinoembryonic Antigen (CEA) test and Positron Emission Tomography (PET) scan. In conclusion, multimodality treatment using chemotherapy and surgery on a case of one-third distal esophageal adenocarcinoma provides good results.

The effects of duration of mesenteric artery ligation to the ratio of TNF-α/IL-10 in a rat model of acute mesenteric ischemia (AMI) Adeodatus Yuda Handaya; Vicky S. Budipramana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 4 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The mortality rate of acute mesenteric ischemia (AMI) is high due to the delay in diagnosis.Determination of potent biomarker for early AMI is the key in reducing the mortality. As aproinflammatory cytokine, the level of TNF-α might be affected during the ischemia andreperfusion, with the prediction duration of 60-120 min. High TNF-α level may stimulatethe upregulation of IL-10 as an inhibitor of TNF-α. This provides a new opportunity forearly diagnosis of AMI by measuring the ratio between those two cytokines. The purposeof this study was to investigate the effect of duration of the mesenteric artery to theratio of TNF-α/IL-10 in a AMI rat model. This was an experimental study using Wistarrat. We performed mesenteric artery in 28 male rats to produce an AMI model, withligation duration of 0, 30, 60, 90, 120, 150, and 180 minutes. At the end of ligation,blood samples were taken for measurement of TNF-α and IL-10 level using ELISA. For themicroscopic examination of tissue necrosis, intestinal organ samples were taken and madeinto paraffin blocks and stained using Haematoxylin-Eosin. TNF-α increased in minute 120compared to other treatment groups (p<0.05). IL-10 increased in minute 180 comparedto control group (p<0.05). Microscopic examination showed that the duration of ligationaffects the structure and morphology of intestinal mucosa characterized by discolorationof organs along with increasing the ligation duration. Ligation of the superior mesentericartery was found to be significantly increased the TNF-α level and to be compensated byincreasing IL-10. It is assumed that when the IL-10 level, that has protective effect as aninhibitor, higher than TNF-α level as a proinflammatory cytokine on duration 150 minutes,it means no more inflammatory or cells is dead. Therefore TNF-α/IL-10 ratio can be usedas a biomarker candidate of prognosic factor management of AMI.

Sumbing Median (Midline Cleft) Ishandono Dachlan; A. Yuda Handaya; Sagiran Sagiran
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 5, No 2 (2005)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v5i2.1872

Midline Cleft is a midline deformity of the upper lip and nose (Tessier Clasification of Cleft Number 0 ). It is rare and often accompanied by disorder of the central nervous system. Head CT Scan with a better architecture of the brain has a better prognosis and those with poor differentiation of brain die during infancy. The treatment of choice is surgical procedure to correct the deformity by Z-plasty or its modification. The aim of this stydy is to report the management of a midline cleftTwo Cases has been reported, The first case was a 13 year-old girl suffering from a midline upper lip cleft, she visited to Sardjito Hospital because of a cosmetic problem, and she had a good achievements at School, The head CT Scan showed a normal brain architecture. She had undergone an upper lip modification Z- Plasty. The second case was a 2 day-old male baby within absence of collumella and prolabial segment of lip (false median cleft), absence of the premaxilla skeletal and he suffers multiple anomalies, the head CT scan showed poor differentiation of brain.Result of this study showed that the one case has showed a good result after upper lip modification of Z-Plasty, the second case died before treated any surgical operation. It can concluded that midline cleft should be treated with observing other problems or anomalies especially of the brain structure and followed with delicate method of surgical procedure.Sumbing median adalah kelainan median pada bibir atas dan hidung (Klasifikasi Tessier, Cleft Nomor 0). Sumbing median adalah kelainan yang jarang terjadi dan biasanya disertai dengan gangguan sistem syaraf pusat. CT Scan kepala yang menunjukkan struktur otak baik mempunyai prognosis lebih baik, Gambaran struktur otak yang jelek biasanya meninggal pada awal kehidupan atau masa pertumbuhan. Terapi pilihan biasanya berupa prosedur pembedahan untuk mengoreksi kelainan, dengan teknik Z-plasty atau modifikasinya. Tujuan dari kajian ini adalah untuk melaporkan penatalaksanaan dua buah kasus sumbing median.Delaporkan dua kasus sumbing median, kasus pertama wanita usia 13 tahun menderita sumbing pada pertengahan bibir atas, pasien datang ke Rumah sakit Sardjito dengan keluhan kosmetik, pasien mempunyai prestasi yang baik di sekolah. CT Scan kepala menunjukan gambaran otak normal. Pasien dilakukan operasi Z- Plasty pada bibir atas. Kasus ke dua,pasien laki-laki usia 2 hari dengan tidak adanya collumella danprolabial, serta tidak adanya tulang premaxilla, pasien menderita anomali multipel, CT Scan kepala menunjukan gambaran otak yang tidak sempurna.Kasus pertama menunjukan hasil yang baik setelah dilakukan operasi Z-Plasty, kasus kedua meninggal sebelum dilakukan tindakan bedah. Oleh karena itu dapat disimpulkan bahwa penatalaksanaan sumbing median harus memperhatikan anomali lain terutama struktur otak dan perlu mempertimbangkan teknik operasi yang tepat untuk mendapatkan hasil yang baik.

Aloe Gel Enhances Angiogenesis in Healing of Diabetic Wound Djanggan Sargowo; Adeodatus Yuda Handaya; Mohammad Aris Widodo; Diana Lyrawati; Askandar Tjokroprawiro
The Indonesian Biomedical Journal Vol 3, No 3 (2011)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v3i3.152

BACKGROUND: Diabetic micro and macroangiophathy lead to the incident of diabetic foot ulcers characterized by an increased number of circulating endothelial cells (CECs) and decreased function of endothelial progenitor cells (EPCs). This fact is correlated with ischemia and diabetic wound healing failure. Aloe vera gel is known to be able to stimulate vascular endothelial growth factor (VEGF) expression and activity by enhancing nitric oxide (NO) production as a result of nitric oxide synthase (NOS) enzyme activity. Aloe vera is a potential target to enhancing angiogenesis in wound healing.OBJECTIVE: The objective of this study was to explore the major role of Aloe vera gel in wound healing of diabetic ulcers by increasing the level of EPCs, VEGF, and endothelial nitric oxide synthase (eNOS), as well as by reducing the level of CECs involved in angiogenesis process of diabetic ulcers healing.METHODS: The experimental groups was divided into five subgroups consisting of non diabetic wistar rats, diabetic rats without oral administration of aloe gel, and treatment subgroup (diabetic rats) with 30, 60 and 120 mg/day of aloe gel doses for 14 days. All subgroups were wounded and daily observation was done on the wounds areas. Measurement of the number of EPCs (CD34), and CECs (CD45 and CD146) was done by flowcytometry, followed by measurement of VEGF and eNOS expression on dermal tissue by immunohistochemical method on day 0 and day 14 after treatment. The quantitative data were analyzed by One-Way ANOVA and Linear Regression, with a cofidence interval 5% and significance level (p<0.05) using SPSS 16 software to compare the difference and correlation between wound diameters, number of EPCs and CECs as well as the levels of VEGF and eNOS.RESULTS: The results of this study showed that aloe gel oral treatment in diabetic wistar rats was able to accelerate the wound healing process. It was shown by significant reduction of wound diameter (0.27±0.02); the increased number of CECs (0.42±0.57), respectively (p<0.05). On the other hand, the wound diameter and eNOS indicators showed significant differences at the dose of 60 mg, while the number of EPCs and CECs and the level of VEGF showed significantly different results at a dose of 120 mg. Aloe gel oral therapy showed a positive indication of wound healing acceleration at the optimum dose range 60-120 mg a day.CONCLUSIONS: Aloe gel is potential to be a herbal therapy candidate for diabetic wound healing through enhancing EPCs homing, decreasing the CECs number, and stimulating the increase of VEGF and eNOS levels,hence proving to be a dominant factor in the angiogenesis process.KEYWORDS: aloe gel, diabetes, wound healing, angiogenesis

Handsewn perineal rectosigmoidectomy (Altemeier) for complete full-thickness rectal prolapse: a case study Adeodatus Yuda Handaya; Aditya Rifqi Fauzi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 9, No 3, (2018)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/jkki.vol9.iss3.art10

Rectal prolapse is a condition in which the entire rectal wall layers protrude through the anal canal. This condition rarely occurs, and the management is still a challenge for both clinician and patient. Rectal prolapse management can be done transabdominally or transperineally. Full-thickness rectal prolapse in principle should have more attention to the rectum function and anal sphincter to prevent recurrence and erectile dysfunction. The Altemeier transperineal recto-sigmoid resection has become the most common for surgical management of rectal prolapse.We report four cases of rectal prolapse, two males and two females with chief complaints had lumps out from their anus. All patients displayed comorbidities. We performed the handsewn Altemeier procedure. All surgeries resulted in minimal intraoperative bleeding. Patients experienced neither incontinence, postoperative fistula, bleeding nor infection. One month after surgery, no patients experienced a recurrence of their complaints.Handsewn Perineal rectosigmoidectomy for the treatment of complete full-thickness rectal prolapse in patients who are having comorbidity can be considered to be an alternative treatment because the procedure is relatively more accessible, safe, and has fewer complications.

Effectivity of glutathione and curcumin in hepatic fibrosis induced by cholestasis in Wistar rats Rodijaya Putra; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Cholestasis occurs from the accumulation of bile product in the biliary tract due to obstruction of the hepatobiliary tract. Without early interventions, this condition will be continuing as chronic hepatic injury and form hepatic fibrosis, ending in cirrhosis. Glutathione (GSH) and curcumin were known as antioxidants and anti-inflammatory used as a therapeutic agent for the treatment of hepatopathy. This study aims to determine the effectivity of GSH and curcumin in the hepatic fibrosis mechanism induced by cholestasis. Methods: This is an experimental study using Wistar rats. They are divided into three groups of 5 rats each. All the rats regard the choledochus duct ligation surgery, rats without intervention define as first group (control), other rats treated with GSH as the second group and the third group consist of rats treated with curcumin. Data were analyzed using SPSS version 17 for Windows.Results: There was liver injury and hepatic fibrosis induced by cholestasis from this study. This condition was significantly lower in groups treated with GSH and curcumin (p<0.05). Therefore, there was a different result between GSH and curcumin in reducing the process of liver injury and hepatic fibrosis, but the difference was not statistically significant (p>0.05).Conclusion: GSH and curcumin were statistically effective in reducing liver injury and hepatic fibrosis induced by cholestasis. Despite, there were no significant difference results between them in reducing liver injury and hepatic fibrosis.

Pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal pada tikus Wistar galur murni Slamet Rahardja; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Electrical trauma can cause injury to the body tissues it passes through, causing death. The injury is part of the process of cell damage, including the digestive organs. This study aims to determine the effect of the duration of electrical trauma on the nervous system of the gastrointestinal tract histopathologically.Methods: This study was experimental with the research subjects were 24 pure strain Wistar rats, which were divided into 4 groups. The first group is the control group (K) without treatment. Then, group (X) was exposed to electricity for 15 seconds, group (Y) was given exposure for 30 seconds, and group (Z) was exposed to 60 seconds. From the preparations, the number of nerve cells was counted. Data were analyzed with SPSS version 20 for Windows.Results: There was a significant effect on the duration of electrical trauma on the number of the gastrointestinal tract nervous system histopathologically (p<0.05). In the control group (K), the number of nerve cells for the stomach was 91.33±0.60, followed by the ileum (89.50±07.09), and colon (94.33±6.18). In group (X), the number of nerve cells in the stomach was 79.50±11.823, followed by the ileum (62.00±15.31), and colon (78.83±5.04). In group (Y), the number of nerve cells for gastric was 45.33±7.66, followed by ileum (34.00±16.27), and colon (47.17±9.56). Meanwhile, in the group (Z), the number of nerve cells for the stomach was 2.40±0.55, followed by the ileum (1.40±1.52), and colon (1.80±1.10). Thus, there was a significant difference between the study groups (p<0.001).Conclusion: The duration of electrical trauma significantly affects the number of the gastrointestinal tract nervous system histopathologically. Latar Belakang: Trauma listrik dapat menimbulkan perlukaan pada jaringan tubuh yang dilewatinya hingga menyebabkan kematian. Perlukaan tersebut merupakan bagian dari proses kerusakan sel, termasuk pada organ digestif. Penelitian ini bertujuan untuk mengetahui pengaruh lama paparan trauma listrik terhadap sistem saraf traktus gastrointestinal secara histopatologi. Metode: Penelitian ini bersifat eksperimental dengan subyek penelitian adalah 24 ekor tikus Wistar galur murni, yang terbagi dalam 4 kelompok. Kelompok pertama merupakan kelompok kontrol (K) tanpa perlakuan. Kelompok (X) diberi paparan listrik selama 15 detik, kelompok (Y) diberi paparan selama 30 detik, dan kelompok (Z) diberi paparan selama 60 detik. Dari preparat, dilakukan penghitungan terhadap jumlah sel saraf. Data dianalisis dengan SPSS versi 20 untuk Windows.Hasil: Terdapat pengaruh yang bermakna pada lama trauma listrik terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologis (p<0,05). Pada kelompok kontrol (K), jumlah sel saraf untuk gaster adalah 91,33±0,60, diikuti dengan ileum (89,50±07,09), dan kolon (94,33±6,18). Pada kelompok (X), jumlah sel saraf pada gaster adalah 79,50±11,823, diikuti dengan ileum (62,00±15,31), dan kolon (78.83±5.04). Pada kelompok (Y), jumlah sel saraf untuk gaster adalah 45,33±7,66, diikuti dengan ileum (34,00±16,27), dan kolon (47,17±9,56). Sedangkan pada kelompok (Z), jumlah sel saraf untuk gaster adalah 2,40±0,55, diikuti dengan ileum (1,40±1,52), dan kolon (1,80±1,10). Didapatkan perbedaan bermakna antara kelompok penelitian (p<0,001).Kesimpulan: Lama trauma listrik memiliki pengaruh secara bermakna terhadap jumlah sistem saraf traktus gastrointestinal secara histopatologi.

The comparison of Body Mass Index (BMI) and Muscle Mass Index (MMI) as a mortality predictor in patients with malignant jaundice at Dr. Sardjito General Hospital, Yogyakarta, Indonesia Briand Iggreinus Pollah; Adeodatus Yuda Handaya; Agus Barmawi
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Background: Jaundice is found to be a clinical manifestation of malignancy. Around 70% of all jaundice cases are caused by malignancy. Another complication of malignancy is decreasing the Muscle Mass Index (MMI), also called sarcopenia. MMI in malignant jaundice increases the mortality rate. Body Mass Index (BMI) is describing the nutritional status of a person. Due to malnutrition, morbidity and mortality increase. This study aims to compare the MMI and BMI in patients with malignant jaundice to predict the outcome of mortalityMethods: This study is a retrospective cross sectional non-experimental epidemiologic analysis. Samples were taken from medical reports at Sardjito Hospital from April 2019 - March 2020. A CT scan calculated MMI at the third lumbar vertebrae. BMI was evaluated by body weight (kg) divided by height (m) square (kg/m2). Data were analyzed using SPSS version 20 for Windows.Results: Most of respondents were males (55.0%), following by age > 50 (62.5%), stage 3 (62.5%), ASA 2 (92.5%), albumin < 3.5 g/dL (82.5%), CA19-9 > 37 U/ml (57.5%), CEA < 5 ng/ml (62.5%), and total bilirubin > 1.5 mg/dL (90.0%), normal BMI (62.5%), survive (77.5%), and low MMI (72.5%). There was no significant relationship between MMI (OR: 5.71; 95%CI: 0.60-134.12) and BMI (OR: 0.15; 95%CI: 0.02-1.34) to the mortality risk (p>0.05).Conclusion: MMI had a higher incidence of mortality compared to BMI in malignant jaundice. However, there was no significant relationship between MMI and BMI to predict mortality.

Differences of alt-ast level and snail gene expression between patients with metastasis and non-metastasis colorectal cancer Chrisna Budi Satriyo; Hendra Susanto; Adeodatus Yuda Handaya; Nurcahya Setiawan; Imam Sofii; Agus Barmawi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art5

Background: Colorectal cancer (CRC) is a malignant epithelial tumour in the colon and rectum, and its main cause is distant metastasis. The main process of distant metastasis is the epithelial-mesenchymal transition (EMT) that may cause mesenchymal phenotype and malignant capabilities of tumour cells. Then it is regulated by one of transcription factors, the Snail.Objective: This study aims to determine differences between Snail gene expression in CRC that has not metastasized and Snail gene expression in CRC that has metastasized. Methods: The subjects of this study consisted of two groups of patients. The first group consisted of 20 patients with CRC (tumour), and the second group consisted of 12 patients with CRC with metastasis (metastasis tumour). The Snail gene expression was measured in both groups by using the RT-qPCR method and supported by laboratory examination to measure ALT and AST. Then all obtained data were analysed by using a statistical software analysis.Results: This study indicated that there were differences of the Snail gene expression between both the groups, and the highest expression was in the metastatic tumour group with a significance level of 0.002 (p<0.05). This was also supported by AST and ALT which were significantly correlated between both the groups. The correlation value on the AST was 0.506 with a significance level of 0.003, and the ALT correlation value was 0.532 with a significance level of 0.002. Conclusion: This study suggested that the Snail was a potential marker of metastasis in the CRC. Therefore, further research is needed to determine the role of Snail regulation in the CRC metastasis.

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