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Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Published by Universitas Gadjah Mada

ISSN : 01261312 EISSN : 23563931 DOI : http://dx.doi.org/10.19106/JMedSci005303202101

Core Subject : Science,

Immunology & microbiology Neuroscience

Journal of the Medical Sciences (JMedSci) or Berkala Ilmu Kedokteran (BIK) is an international, open-access, and double-blind peer-reviewed journal, published by Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Yogyakarta Indonesia. JMedSci aiming to communicate high-quality articles in the areas of biomedical science from basic to clinical sciences.The journal welcomes papers from original articles, case reports, reviews, and book reviews. All papers published in JMedSci are freely available as downloadable pdf files. The journal began its publication on March 1973 and published quarterly (January, April, July, and October). JMedSci is abstracted and indexed in DOAJ, Crossref, Google Scholar, Sinta, Indonesia One Search. JMedSci is accredited by Directorate of General Higher Education, the Ministry of Research, Technology, and Higher Education, Indonesia

Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)

Articles 41 Documents

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Search results for , issue "Vol 48, No 4 (2016)" : 41 Documents clear

Indonesian medicinal plants as sources of secondary metabolites for pharmaceutical industry Eti Nurwening Sholikhah
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Medicinal plants are widely used in traditional medicine in both underdeveloped anddeveloping countries in the word until now. Some secondary metabolites isolated frommedicinal plants have been developed as modern drugs. New antimalarial artemisinin isan example of modern medicine that developed from Artemisia annua L, a plant usedin China since 4,000 years ago. Indonesia is endowed with a rich natural resource.The biodiversity comprises thousands plant species. Therefore, Indonesian flora andfauna are a remarkable opportunity for the development of secondary metabolites forpharmaceutical industry. The Indonesian National Agency for Drug and Food Control,Republic of Indonesia (Badan Pengawas Obat dan Makanan, Republik Indonesia = BPOMRI) classifies traditional medicine into three classes, namely jamu (Indonesian indigenoustraditional medicine), standardized herbal medicine and phytopharmaca based on itsscientific evidences. The BPOM also determined 9 medicinal plants for focusing researchfor drug development. This paper discusses some secondary metabolites and theirpharmacological activities of the following 9 selected Indonesian medicinal plants namelyPiper retrofractum Vahl, Andrographis paniculata Ness, Curcuma xanthorrhiza, Psidiumguajava L, Syzigium polyanthi, Morinda citrifolia, Guazuma ulmifolia Lamk, Zingiberofficinale, and Curcuma domestica collected from various publications. Furthermore,several modern drugs derived from medicinal plants are also discussed.

Optogenetics, A Futuristic Panacea in Genetics Dito Anurogo; Taruna Ikrar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

AbstractOptogenetics is the constellation of optics, genetics and bioengineering which unites genetic engineering with optics to notice and manage the function of genetically targeted groups of cells with light, often in the intact animal, via light-sensitive microbial membrane proteins (opsins). Light-sensitive genes specifically including the genetically targeted light-gated channels channelrhodopsin-2 (ChR2) and halorhodopsin (NpHR) result in intracellular ion flow during optical illumination. Afterward, the neurons encounter a series of changes resulting from membrane depolarization or hyperpolarization. Although the rooted origins of optogenetics is from neuroscience, it can be potentially applied in neuropsychocardioncology (neurology, psychiatry, oncology, and cardiology).This critical review will explicate a comprehensive summary of the roles of optogenetics in the field of neuropsychocardioncology.Optogenetics can be potentially developed as neuroprosthetics and direct NpHR in the management of spastic movement disorders. Optogenetics can control of larynx muscle contraction in vivo, using both transgenic ChR2 expressing mice and viral transduction of muscle.In epilepsy, the efficacy of optogenetics is proved. Pyramidal cells in the cortex were transduced with halorhodopsin, and photoinhibition of the neurons decreased electrical seizure activity. Optogenetic and DREADD technologies are in their early stages, particularly with respect to PD research or therapy.In autism and schizophrenia, behavioral deficits may arise from elevation in the cellular balance of excitation/inhibition (E/I balance) within neuronal microcircuits. This hypothesis was tested by optogenetically elevating the E/I balance in the medial-prefrontal cortex using a step-function opsin (SSFO), together with red-shifted opsins (C1V1). Increased excitation in excitatory pyramidal neurons, lead to social-cognitive dysfunctioning which are similar to those seen in autism. Cortical gamma oscillations are an indicator of enhanced information processing, which is highly affected in schizophrenic patients.Using optogenetic technology, researchers divulge the characterization of phosphatidylinositol 3-kinase (PI3K) in Rac1-dependent lamellipodial motility in PC-3 prostate cancer cells. PI3K, acting downstream of Rac1, has an important role in the initiation of lamellipodial extension, which underlies prostate cancer cell invasion and metastasis. As in Parkinson, human cells can be engineered to deliver the excitatory (hM3Dq receptor) and/or the inhibitory (hM4Di receptor) form so that cellular activity may be turned up or down.The optogenetic TCU (tandem-cell-unit) strategy can be valuable in appraising tissue graft integration and cell delivery in the myocardium during cardiac tissue repair procedures. Low-energy pacing strategies can be srutinized by optogenetic investigations. Specifically, optical stimulation can be aimed for strategic structures of the conduction system. Optogenetic studies have already contributed to a better understanding of the neural circuits affected in many disorders. A conceptual and mutual understanding of multidisciplinary approaches and collaboration will enable researchers, clinicians, stakeholders, government develop and apply optogenetics in comprehensive medical services and health care.Keywords: optogenetics, opsins, neuropsychocardioncology, SSFO, DREADD, TCU.

The Expression of microRNA-155 and mRNA Hypoxia Inducible Factor Alpha (HIF1A) in the early and advanced stages of ovarian cancer patients blood plasma S.N. Chasanah; A.S. Fitriawan; F.K. Pukan; A.I. Kartika; R, Oktriani; A. Trirahmanto; H. Pradjatmo; T. Aryandono; S.M. Haryana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Ovarian cancer has the problem turned out to be the greatest and almost half the death rate of mortality throughout gynecological malignancy. Ovarian cancer is found in the female reproductive organs and the second most common cancer after cervical cancer. The process of carcinogenesis of ovarian cancer occurs at the molecular level, regulated by microRNA. At in silico research that has been done, it is known that microRNA-155 (miR-155) targeted mRNA HIF1A which is the regulator genes in hypoxia conditions. HIF1A involved in various cancer hallmarks, where some of them have roles in Warburg effect and also as genetical transcription factors in angiogenesis. Regulation of miR-155 and mRNA HIF1A believed to be involved in the process of ovarian cancer progression and thus potentially as minimally invasive biomarker for prognosis. The aim of this study is to determine whether there are differences in the expression of miR-155 and mRNA HIF1A in plasma ovarian cancer patients at the early stage compared with the advanced stage.The samples using blood plasma from ovarian cancer patients RSUP Dr. Sardjito with 32 ovarian cancer patients early stages and 20 ovarian cancer patients advanced stages. Total RNA was isolated from blood plasma samples of ovarian cancer patients. cDNA synthesis from total RNA was performed to obtain cDNA. The expression of miR-155 and HIF1A were calculated using qPCR. qPCR results were analyzed using Biorad CFX Manager Software. The analysis showed that the expression of miR-155 were 2,18 times lower (p-value = 0,018*) in the plasma of advanced stage ovarian cancer compared with early stage, the differences were statistically significant (p value≤ 0,05). Whereas the mRNA expression HIF1A were 2,46 times higher (p-value = 0,039*) in the plasma of advanced stage ovarian cancer compared with early stage, the differences were statistically significant (p value≤ 0,05). This study has proved that miR-155 expression is downregulated and followed by upregulation of mRNA expression HIF1A at an advanced stage ovarian cancer compared with early stage. Keywords: Plasma, stage ovarian cancer, microRNA-155, mRNA HIF1A

Infection, cure and egg reduction rates of soil-transmitted helminth infections after anthelminthic drugs treatment among school children in Kokap, Yogyakarta, Indonesia Fitria Siwi Nur Rochmah; Elsa Herdiana Murhandarwati; Sri Sumarni
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The prevalence of helminthiasis on primary school children in Indonesia is high, around 40-60%. This study aims to assess the impact of treatment and predictors of soil-transmittedhelminth (STH) infections at 3 months after treatment. Population of this study wasstudents of a primary school in Kokap (Sekolah Dasar Negeri/SDN Gunung Agung), KulonProgo, Yogyakarta, determined based on the inclusion and exclusion criteria (n = 65).Stool samples examined using Kato Katz method. Students infected with STH were givenappropriate treatment and stool samples were collected again to determine cure rate (CR)and egg reduction rate (ERR) at 2 week post-treatment and at 3 months post-treatmentto determine incidence of re-infection, new infection or failed treatment. Informationon personal hygiene and sanitation were collected by interview with students of SDNGunung Agung. Treatment with pyrantel pamoat was effective against hookworm andAscaris lumbricoides with CR of 100% and ERR of 100% while treatment with albendazolwas ineffective against Trichuris trichiura (CR = 12.8%, ERR = 62.4%) though theWilcoxon test for T. trichiura showed a significant reduction egg count (epg) before and2 week after treatment (p<0.05). The overall infection rate at 3 months after treatmentwas 35.4% with cases of re-infection, new infection and untreated cases. This result wasnot significantly different with infection rate before treatment (p>0.05). The existence ofdouble infection before treatment showed p value <0.05 (OR = 2) with the prevalence ofSTH infections 3 months after treatment. Bivariate analysis between personal hygiene andenvironmental sanitation with the prevalence of STH infections 3 months after treatmentwas obtained p value >0.05. Presence of re-infection, new infection and untreated casesconfirms that an integrated approach is necessary to control STH infection in Kokap,Kulon Progo, Yogyakarta.

DNA extraction, Polymerase Chain Reaction, and Sequencing : Workshop in Clinical Genetics Sumadi Lukman Anwar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

AbstractDNA extraction, Polymerase Chain Reaction (PCR), and Sequencing are basic methods in molecular biology and genetics. Those there are routinely performed as basic methods in genetic research and currently also for diagnostic lab especially for pathology and human genetics. With the advance in the genetics and clinical service for cancer management, mutation analysis is very important not only for diagnosis but also for prediction of therapeutic response. Detection of KRAS, BRAF, EGFR, and c-KIT mutations is presently performed in almost every molecular pathology lab as part of daily clinical service in cancer management. In this workshop we will discuss tips and tricks for those three basic lab methods. How to improve amount and purity of DNA extraction from blood and tissues, how to avoid DNA degradation during the procedure and storage, how to perform PCR, factors and substance that inhibit polymerases during PCR, how to design effective primer pairs, and how basic theory for sequencing, and interpretation of sequencing will be discussed. Although it has been widely discussed, this workshop is especially important for clinicians who previous do not have hands-on laboratory experience. In addition, number of labs with ability to perform and serve basic genetic and molecular analysis are still limited in Indonesia. With this workshop, we expect to improve knowledge and skill in DNA extraction, PCR, and Sequencing.Keywords : DNA, PCR, sequencing

DNA methylation and expression of Homeobox gene family as diagnostic and prognostic markers in human hepatocellular carcinoma Sumadi Lukman Anwar; Ulrich Lehmann
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACTHomeobox genes consist of a family of evolutionarily conserved genes that play important roles in morphogenesis, embryogenesis, and cell fate determination. Re-expression of embryogenic genes has been associated with carcinogenesis of human cancers. Aberrant expression of homeobox genes has been increasingly found to modulate diverse processes such as cell proliferation, cell death, metastasis, angiogenesis and DNA repair. We studied DNA methylation and expression of homeobox gene family in human hepatocellular carcinoma (HCC), the fifth most common cancer and the third leading cause of cancer mortality worldwide. We performed microarray for comprehensive DNA methylation and gene expression using primary HCC samples and healthy liver tissues. Confirmation using pyrosequencing and RT-PCR was then performed. Clustering both unsupervised and supervised methods using Qlucore software was then performed. Enrichment of homeobox genes both for DNA methylation and gene expression could differentiate HCC and the healthy liver tissues. Profile of homeobox gene methylation could further predict clinical outcome. Inverse correlation between DNA methylation and gene expression was shown (HOXA9, Spearman r=-0.49, p=0.002). Gain of DNA methylation in HOXA9, HOXA13, and MEOX1 correlated with shorter HCC survival (log-rank Mantel-Cox test p=0.02, with median survival 50 and 490 weeks, respectively). We demonstrated potential roles of DNA methylation and gene expression profiles of Homeobox gene family as diagnostic and prognostic marker in patients with HCC.

The role of Clinical Geneticists in Hereditary Cancer Management and Research Hanne Meijers Heijboer
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

AbstractHereditary cancer refers to cancers caused by germline mutations in cancer predisposing genes. These mutations confer a significantly increased risk of cancer, are rare, and are in the majority of cases autosomal dominantly inherited. Since the eighties of last century more than 115 cancer predisposing genes have been identified. In many Western countries genetic testing of patients and families with clustering of cancers started early, and was often performed by clinical geneticists (MDs performed the counselling and pedigree analyses) and by molecular biologists (in laboratories within departments of clinical genetics). It turned out to be a long path to fully realize the promise of cancer predisposing genes. The clinical utility of many cancer genetic tests and subsequent risk reducing interventions has not yet been validated and pitfalls in e.g. misinterpretation of genetic variants showed up. However, without doubt genetic testing for mutations will eventually turn out as a strong tool to save lives from early cancer death and will become part of standard cancer care throughout the developed world. Apart from primary surgical prevention, major progress is to be expected in earlier diagnoses, tailored therapies, and possibly chemoprevention. Ideally researchers, clinical geneticists, molecular biologists, surgeons, oncologists, gynaecologists and other professionals will work together to reach this goal.

Plasma DNA as a potential biomarker for breast cancer detection Dewajani Purnomosari; Ulfah Dian Indrayani; . Irianiwati; Dian Caturini Sulistyoningrum
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Breast cancer is a major malignancy among Indonesian women. It is often diagnosed inthe later stages of cancer, which leads to poor prognosis and survival of the patients.This study investigated plasma DNA concentration as a potential biomarker for breastcancer. The benefit of using this detection is the cost-effectiveness and the samples canbe collected from patients using non-invasive methods. Plasma samples were obtainedfrom healthy controls (n=18) and cancer patients (n=22). Each sample was split intotwo equal portions for DNA isolation using two different methods for the NaI methodand a commercially available kit (Qiagen/ QA) method. The DNA concentration wasdetermined by using a GeneQuant spectrophotometer (Pharmacia). The t-test was usedfor statistical analysis, which was performed using the SPSS 17.0 software. Compared tothe commercial method, extraction using NaI yielded higher DNA concentration, both fromsamples of healthy controls and cancer patients (p=0,008 and p=0.000, respectively).Furthermore, regardless of the isolation method used, the plasma DNA concentrationwas higher in healthy controls than in cancer cases (p=0,032 and p=0.005, for NaIand QA methods, respectively). In conclusion, isolation methods significantly affect DNAconcentrations. The plasma DNA concentration of healthy controls is significantly higherthan those of the cancer cases, suggesting that plasma DNA concentration might be apotential biomarker for breast cancer detection with less invasive sampling method thantissue biopsies.

High Resolution Melting (HRM) Analysis for Genetic Changes in BRCA1/2 gene Samuel J Haryono; I Gusti Bagus Datasena; Ariananda Hariadi; Raymond Mulyarahardj
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Conventional mutation analysis requires a separation step and include single-strand conformational polymorphism (SSCP) analysis, denaturing gradient gel electrophoresis, heteroduplex analysis, denaturing HPLC, and temperature gradient capillary electrophoresis These methods require separation of PCR products on a gel or other matrix, often take hours to perform, and increase the risk of contamination in future reactions because PCR products are exposed to the environment. High Resolution Melting (HRM) can simplify the mutation scanning analysis in BRCA 1/2 gene. DNA from affected patients and family members were amplified with Real-Time PCR reaction and followed by Sanger Sequencing to reconfirm the mutation status if mutation obtained by HRM Method. HRM Method was able to show distinction in differential curves of mutated BRCA 2 gene c.4600T>C, with codon modification of CAT>TAT, when compared to wildtype. To determine point mutation in a sample, this method requires two groups of experimental standards and standard curves. The first standard produced by using samples without mutation (wildtype/negative control) and the second standard produced by using samples with mutation (positive control), that have been confirmed with Sanger Sequencing. The sequencing analysis of the affected patient and the family members showed that a mutation occurred (BRCA2 c.4600T>C) and was segregated in the family history. This mutation caused amino acid alteration in BRCA2 protein (p.H1458Y). HRM Method is an excellent tool to analyze genetic modification of BRCA1/2 genes, especially to investigate co-segregation of mutated genes among family members of affected patient. This method can provide more sensitive results to determine mutation in patient, before using Sanger Sequencing analysis.Keyword: BRCA, HRM, Gene Mutation

Oncoplastic breast surgery in Asia Ava Kwong
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Oncoplastic breast conservation surgery has given a new light to the options of performing breast conserving surgery by combining oncological principles of breast cancer surgery with plastic surgery techniques. The ultimate oncoplastic achievement would be the conversion of what normally would be considered as an oncologic and/or cosmetic failure when using standard techniques of breast conserving surgery into both oncological and cosmetic success and to avoid mastectomy where possible.Most Techniques are fairly well established. However surgical techniques may also need to be adjusted based on the cohorts that the treatment is offered to. For example, for larger breasts, the technique is more forgiving. However for smaller breast, there is still a limitation of the cosmetic outcome when a high percentage of breast volume has been excised no matter how good the technique or the surgeon is.Various aspects of oncoplastic breast surgery technique will be discussed and its applicability to Asian Cohorts.

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