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Journal : Narra J

Pneumonectomy for severe post-tuberculosis bronchiectasis: A successful of case report and review of the long-term outcome Zulfa, Putri O.; Habibie, Yopie A.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.222

Abstract

Limited clinical intervention studies highlight the absence of evidence-based international guidelines for effectively managing post-tuberculosis lung disease, emphasizing bronchiectasis. The aim of this study was to describe a case of left pneumonectomy for severe post-tuberculosis cystic bronchiectasis and to provide a review of the post-surgical mortality rate, complications, survival rate, and the patient's quality of life following the pneumonectomy procedure. A 36-year-old Indonesian male smoker presented with worsening breathing difficulties and fever. The patient had a history of pulmonary tuberculosis six years ago and reported negative tuberculosis tests after completing TB treatment. However, lung function of the patient progressively declined over the years. Bronchoscopy, chest X-ray, and high-resolution computerized tomography (CT) scan revealed infected cystic bronchiectasis and identified a prominent left lung collapse with calcification in the left pleura. The patient underwent left pneumonectomy through left posterolateral thoracotomy under general anesthesia. The patient was discharged after seven post-operative days with no eventful course. No further complications were found after a one-year post-surgery follow-up, and the patient returned to normal activities, improved fitness, and was fitter in daily life. Based on the literature review, post-surgical mortality rates of pneumonectomy are acceptable, with bronchopleural fistula, cardiac arrest, and thoracic hemorrhage being common causes. Yet, the chances of a complete cure are high. Complications can occur in approximately one-third of patients, including arrhythmia, pulmonary infection, fever, and wound infections. The overall 5-year survival rate following pneumonectomy is generally favorable. Regarding the quality of life, pneumonectomy can have mixed effects. While it could improve symptoms and quality of life, it may impair the quality of life for certain patients, particularly elderly patients and those with lower preoperative quality of life. Although the post-surgical mortality rate, complications, and long-term survival rates of pneumonectomy are generally satisfactory, the expectation of improved post-surgical quality of life should be discussed with the patient prior to surgery.
Effect of umbilical cord mesenchymal stem cells on hypoxia-inducible factor-1 alpha (HIF-1α) production in arteriovenous fistula (AVF) animal model: A preliminary study Habibie, Yopie A.; Emril, Dessy R.; Azharuddin, Azharuddin; Syahrizal, Dedy
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.225

Abstract

Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that plays a crucial role in cellular responses to hypoxia, such as in the development of intimal hyperplasia, a common complication in arteriovenous fistula (AVF) creation. While the application of umbilical cord mesenchymal stem cells (UC-MSCs) has shown promise in various regenerative medicine applications, including tissue repair and angiogenesis, the effect of UC-MSCs on HIF-1α level in the AVF has not been tested. Therefore, the aim of this study was to evaluate the effect of UC-MSCs administration on HIF-1α levels in the AVF animal model. An experimental study was conducted on 28 local male rabbits (Lepus domestica) using a post-test-only design. The rabbits were divided randomly into four groups: normal rabbit group (negative control), placebo-treated AVF rabbit group (positive control), AVF rabbits treated with in-situ UC-MSCs injection (one dose, 106 UC-MSCs/kg body weight), and AVF rabbits treated with intravenous UC-MSCs (one dose, 106 UC-MSCs/kg body weight (BW). HIF-1α level was measured using ELISA method after 28 days post- treatment. All data were analyzed using the one-way analysis of variance (ANOVA) and continued with the Duncan’s post-hoc test. The data indicated that the levels of HIF-1α were different among all four groups (p<0.001). The post-hoc analysis revealed that the HIF-1α levels in both UC-MSC treated groups were significantly lower compared to untreated AVF rabbits(p<0.05). This study suggests that UC-MSCs could be a promising therapy to prevent and reduce intimal hyperplasia in AVF.
Enhancing neuromuscular recovery after sciatic nerve injury using stem cell therapy: Evidence from a preliminary preclinical study Firlana, Cut R.; Emril, Dessy R.; Dedy Syahrizal; Sartika, Cynthia R.; Lestari, Nova D.; Habibie, Yopie A.
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3018

Abstract

Sciatic nerve injury results in motor dysfunction and muscle atrophy, with limited effective therapies. Umbilical cord–derived mesenchymal stem cells (UC-MSCs) may promote neuromuscular recovery, but their effects on functional and muscle recovery remain unclear. This study aimed to evaluate the effects of UC-MSC therapy on functional and muscle recovery in an animal model of sciatic nerve injury. An animal experimental study with a post-test-only control group was conducted using adult male Wistar rats. Rats were randomly allocated into three groups: sham operation, saline control with sciatic nerve injury, and UC-MSC treatment after sciatic nerve injury. UC-MSCs were administered at a dose of 1×10⁶ cells/kg body weight immediately after nerve injury. Functional recovery was assessed using the extensor postural thrust (EPT) test, and muscle recovery was evaluated using the gastrocnemius muscle index (GMI) post 35 days of observation. Data were analyzed using one-way ANOVA for EPT percentage recovery and Kruskal–Wallis tests for GMI values, followed by post-hoc analysis. Our data indicated there was no significant EPT percentage recovery among the study groups. In contrast, relative gastrocnemius muscle mass was significantly different across groups (p=0.012), with post-hoc analysis demonstrating a significantly higher GMI in the UC-MSC group compared to the saline control group (109.75% vs 81.68%, p=0.003), indicating improved preservation of gastrocnemius muscle mass following UC-MSC therapy. This study highlights that UC-MSC therapy significantly improved gastrocnemius muscle preservation after sciatic nerve injury but did not result in detectable functional motor recovery at the observation time point. These findings suggest that UC-MSCs might exert early structural benefits that may precede functional recovery.