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Medical Journal of Indonesia

MJI
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Published by Universitas Indonesia

ISSN : 08531773 EISSN : 22528083 DOI : 10.13181

Core Subject : Health,

Medicine & Pharmacology

This quarterly medical journal is an official scientific journal of the Faculty of Medicine Universitas Indonesia in collaboration with German-Indonesian Medical Association (DIGM) Indexed in: IMSEAR; CAB Abstracts; Global Health; HINARI; DOAJ; DRJI; Google Scholar; JournalTOCs; Ulrichsweb Global Serial Directory; WorldCat; New Jour; Electronic Journals Library; ISJD Accredited (2013-2018) by DIKTI Kemendikbud Republik Indonesia (No:58/DIKTI/Kep/2013)

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Articles 11 Documents

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Search results for , issue " Vol 20, No 4 (2011): November" : 11 Documents clear

Cardiocerebral resuscitation: advances in cardiac arrest resuscitation Mulia, Erwin; Siswanto, Bambang B.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Cardiac arrest remains a leading cause of death in the world. Although advances in emergency cardiac care has been achieved, the survival rate of those non hospitalized hospital cardiac arrest remains low. Update in guidelines for CPR and emergency cardiovascular, their approach to out of hospital cardiac arrest is far from optimal. This provides an opportunity to advocate cardiocerebral resuscitation as an alternative toÂ traditional cardiopulmonary resuscitation for non hospitalized cardiac arrest. Because cardiocerebral resuscitation results in improved survival and cerebral function in patients with witnessed cardiac arrest and a shockable rhythm whom have greatest chance of survival, it should replace CPR especially for non hospitalized cardiac arrest.(Med J Indones 2011; 20:306-9)Keywords: cardiocerebral resuscitation, cardiac arrest,Â cardiopulmonary resuscitation

Working together to reduce maternal and infant mortality in Indonesia: the role of technology Higashi, Mitchell K.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

[No Abstract Available]

Telmisartan inhibits the progression of cardiomyopathy in daunorubicin treated rats: the role of advanced glycation end products Arozal, Wawaimuli; Watanabe, Kenichi; Veeraveedu, Punniyakoti T.; Ma, Meilei; Nafrialdi, Nafrialdi
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: Anthracyclines have been reported to induceÂ cardiotoxicity through mechanisms involving formation ofÂ advanced glycation end-products (AGEs), including pentosidine and NÑ-(carboxymethyl) lysine (CML). We investigated theÂ potential utility of telmisartan (TML), an angiotensin II receptor antagonists (ARB) on anthracycline-induced cardiotoxicity.Methods: Three groups of Sprague-Dawley rats were treated as follows: The first group received daunorubicin (DNR) 3 mg/kgBW every alternating day to reach a cumulative dose of 9 mg/kg DNR . The second group received DNR plus TLM at a dose10 mg/kgBW, by oral gavage for 6 weeks, and the third group served as control group (CTL) which only received vehicle of DNR. Mean blood pressure (MBP) peak left ventricular pressure (LVP), LV end-diastolic pressure (LVEDP), and intra-ventricularÂ contractility (Â±dP/dt) were recorded by using Powerlab instrumentation. Ejection fraction (EF), and fractional shortening (FS) were measured by echocardiography. Expression of receptor of AGE (RAGE), pentosidine and CML were measured byÂ immunohistochemistry and Western blot in LV tissue.Results: DNR treatment was associated with significantÂ weakening of some hemodynamic parameters which couldbe reversed by TML (LVP: 124.3 Â± 6.0; 111 Â± 7; and 115.1 Â± 5.4 mmHg, respectively in CTL, DNR and DNR-TLM groups; LVEDP: 7.5 Â± 0.9; 10.7 Â± 0.3; 8.7 Â± 0.4 mmHg, respectively; +dP/dt: 6813 Â± 541; 4800 Â± 345; 5950 Â± 398 mmHg/s, respectively). The same phenomenons were also observed on echocardiographic parameters (EF: 78.9 Â± 1.8; 59.6 Â± 1.4; 76.2 Â± 2.75 %, resepectively; FS: 42.8 Â± 1.7; 29.1 Â± 1.3; 41 Â± 2.7 %) respectively. Expression of RAGE as well as pentosidine and CML were increased in DNR-rats. TML treatment ameliorated these changes.Conclusion: These results suggested the role of AGE formation in DNR-induced cardiotoxicity and telmisartan could inhibit the progression of cardiac toxicity at least in part by reduction RAGE expressiom. (Med J Indones 2011; 20:255-62)Keywords: advanced glycation end product, anthracyline, cardiotoxicity, daunorubicin, telmisartan

Wolf-Parkinson-White syndrome in young men presenting with palpitation: the pattern of delta waves in predicting location of accessory pathway Cahyaningtias, Miryanti; Rohman, Mohammad S.; Hanafy, Dicky A.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Palpitation is a common presenting symptom in the emergency department. Wolf-Parkinson White (WPW) syndrome is a cardiac conduction disorder that may present with palpitation and lead to sudden cardiac death. WPW could be detected byÂ electrocardiogram (ECG). In this case report, we present two young male patients with WPW syndrome admitted to our hospital with history of repeated and progressive palpitation. ECG of the first patient revealed supraventricular tachycardia which converted to sinus rhythm after propanolol treatment. ECG showed sinus rhythm with delta wave in lead II,III,aVF, V1 suggesting the presence of accessory pathway (AP) in left lateral wall. Electrophysiology study confirmed the presence of AP and radio frequency catheter ablation was successfully done resulted in disappearance of delta on outpatient clinic ECG. Patient has no symptom and he do not have to take medication. ECG of the second patient revealed supraventricular tachycardia with abberancy. After amiodarone infusion, ECG showed sinus rhythm with delta wave in lead I,II,aVL suggesting the presence of accessory pathway in anteroseptal wall. Electrophysiology study and catheter ablation did not perform for this patient because of financial problem, however amidarone has to be taken regularly to prevent the recurrence of supraventricular tachycardia. (Med J Indones 2011; 20:298-301)Keywords: ECG, palpitation, supraventricular tachycardia, Wolf- Parkinson White syndrome

Glaucoma and dry eye disease: the role of preservatives in glaucoma medications Sitompul, Ratna; Nora, Rina L.D.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Glaucoma is a common cause of irreversible blindness with increasing prevalence. Some of glaucoma patients will also experience dry eye. Dry eye is the most frequent side effect related to benzalkonium chloride (BAC)-containing eye dropÂ used for glaucoma patients. In addition, glaucoma and dry eyes have shared risk factors that are old age and female. Dry eye among glaucoma patients need to be treated promptly as it produces discomfort, reduces patientsâ compliance andÂ Â decreases success rate of glaucoma therapy. Dry eye symptoms can be treated by applying preservative-free eye drop, giving combination of preservative containing and preservative-free eye drop to reduce BAC exposure, prescribing artificial tear and conducting surgery to minimize or eliminate the need of topical medication. (Med J Indones 2011; 20:302-5)Keywords: benzalkonium chloride, dry eye, glaucoma

Cloning and expression of pab gene of M. tuberculosis isolated from pulmonary TB patient in E.coli DH5Î± M. Raras, Tri Y.; Lyrawati, Diana
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: Mycobacterium tuberculosis antigen38 is a potent serodiagnostic agent containing two M. tuberculosisspecific B-cell epitopes. The high price of imported diagnostic agents hinders realization of fast clinical TB diagnosis in developing countries. Therefore, we produced recombinant antigen38 (recAg38M) from M. tuberculosis local strain, which might be used to produce economical tuberculosis serodiagnostic kit.Methods: Pab gene that was isolated from pulmonary TB patient in Malang was cloned into a plasmid vector (pGEMTeasy) to construct pMB38. The E.coli DH5Î± clone carrying pMb38 was selected on X-gal medium. The expression of pab was mediated using pPRoExHTc under the control of Trc promoter and E.coli DH5Î± as host.Results: Alignment of the pab sequence from the white E.coli DH5Î± clones with that of M. tuberculosis H37Rv showed 98% homology. The recombinant protein in which the signal peptide has been deleted to prevent the protein being secreted into medium was found in the cytoplasm.Conclusion: pab gene of M. tuberculosis isolated from a TB patient could be expressed in heterologous system in E.coliDH5Î±. (Med J Indones 2011; 20:247-54)Keywords: Mycobacterium tuberculosis, Pab gene expression, recombinant antigen38

Twiddlerâs syndrome in patient with single chamber pacemaker Munawar, Muhammad; Pardede, Ingrid; Munawar, Dian L.; Pambudi, Jimmy
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Twiddlerâs syndrome is a well-known complication of pacemaker treatment. This syndrome is characterized by coiling of the pacemaker lead due to the rotation of pacemaker generator on its long axis. Lead damage could cause lead facture orÂ insulation leakage. The syndrome is also responsible for lead dislodgment, diaphragmatic stimulation, twitching upper arm due to plexus brachial nerve stimulation and loss of capture. Understanding risk factors and preventive measurement is very important. In this case report we present an 84 year-old patient who managed to rotate his single chamber pacemaker generator unintentionally following implantation in which the syndrome occurred within 2 months causing insulation leakage and battery depletion. For the best of our knowledge, this is the first report of twiddlerâs syndrome in Indonesia. (Med J Indones 2011;Â 20:295-7)Keywords: lead damage, long axis rotation, pacemaker, twiddlerâs syndrome

E-cadherin and NM23HI as metastasis predictors for various degrees of histological malignancy in invasive ductal carcinoma Rustamadji, Primariadewi; Tjarta, Ahmad; Cornain, Santoso; Ramli, Muchlis; Soetrisno, Esti
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: This study aims to analyze whether the expressions of E-cadherin and NM23HI can be used as predictors of ductal carcinoma metastasis in various degrees ofÂ malignancies.Methods: Paraffin blocks were obtained from 97 patients with invasive breast ductal carcinoma with malignancy grade 1, 2 and 3 who came to several hospitals in Jakarta and Bandung from 2000 to 2006. Histopathological examinations of hematoxylin eosin slides of primary and secondary tumors were done toÂ diagnose the degree of histological malignancy and metastasis status. Further, immunohistochemistry staining of E-cadherin, NM23HI and cytokeratin were done followed by scoring according to the number of positive cells and staining intensity. TheÂ associations of E-cadherin and NM23H1 expression with the presence of metastasis and grade of histological malignancy were analyzed.Results: Subjects were 29-75 years old (mean: 48.19 years), with most subjects aged 40â45 years old, with malignancy grade 1, 2 and 3 of 18.56%, 45.36% and 36.1% respectively. There was a significant association between E-cadherin and NM23HI expression in primary tumors. The possibility of invasion and metastasis inhibition by positive E-cadherin and NM23HI was 14 and 11 times respectively compared to those with negative E-cadherin and/ or NM23HI expression. The ROC curve showed that E-cadherin (r= 0.755) and NM23HI (r= 0.827) expressions were strongly associated, sensitive and specific as metastasis markers. However, E-cadherin and NM23HI expression didnot show significant association with histological degree of invasive ductal carcinoma.Conclusion: E-cadherin and NM23HI expressions can be used as invasion and metastasis markers, but cannot be used asÂ markers for the degree of histological malignancy of invasive ductal carcinoma. (Med J Indones 2011; 20:263-70)Keywords: Breast cancer, E-cadherin, NM23HI

The validity of rapid test to detect prostate-specific antigen (PSA) in seminal fluid Henky, Henky; Budiningsih, Yuli; Widiatmaka, Wibisana
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: This study was conducted to determine whether the rapid test device can be used to detect PSA in seminal fluid specifically, for solving sexual assault cases.Methods: A cross sectional study has been conducted. A total of 45 samples were taken consecutively. Semen was diluted in serially up to 1:5.000.000 and male urin up to 1:200 using distilled water, whereas female urin was not diluted. Samples were analyzed using rapid test PSA.Results: The proportion of positive results of PSA in seminal fluid, male urin and female urin respectively was 100%, 6.67%, and 0%. Statistically, these differences are highly significant. The analysis revealed that the PSA rapid test device was 100% sensitive and 96.67% specific to detect seminal fluid. The test also have PPV 93.75%, NPV 100%, LR(+) 33.33, LR(-) 0, and AUC 0.983.Conclusion: PSA Rapid Test is very specific and sensitive to detect PSA in seminal fluid. Therefore, this device is suggested for forensic use in sexual assault cases. (Med J Indones 2011; 20:278-82)Keywords: PSA, rapid test, sexual assault

Effect of long-term physical training and detraining on myocyte structure and connective tissue of Wistar ratâs ventricle: preliminary experiment in rats Santoso, Dewi I.S.; Lontoh, Susy O.; Wuyung, Puspita E.; Endardjo, Sutjahjo
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: This study was aimed to evaluate the structural changes of the ventricular myocardium in a physiologicalÂ hypertrophic heart model due to long term aerobic andÂ anaerobic physical training and detraining.Methods: In-vivo experimental study on Wistar rats (8 weeks old), weighing 150-250 grams who were divided into 3 large groups: control group, aerobic exercise group and anaerobic exercise group. Aerobic and anaerobic training were conducted for 4 and 12 weeks. At the end of 4 and 12 weeks of exercising, half of each exercising group was sacrificed to study the morphological and histopathological changes in myocardial structure. The remaining of the groups were given a period of 4 weeks of detraining and sacrificed at the end of the 8th and 16th week.Results: Significant differences in heart weight and leftÂ ventricular wall thickness was found in the 4 weeks of aerobic and anaerobic group compared to the control group (751.0 Â± 36.5 gr and 791.1 Â± 15.8 gr vs 588 Â± 19.4 gr ), (3.34 Â± 0.12 mm and 3.19 Â± 0.1 mm vs 2.80 Â± 0.07 mm). An increase in heart mass weight was observed in both 12 weeks aerobic and anaerobic training group compared to the control group (1030.8 Â± 82.4 gr and 1140.4 + 0.24 gr vs 871.6 Â± 62.0 gr). Heart volume of the 12 weeks aerobic-anaerobic groups showed a significant increase (3.58 Â± 0.31 mm and 4.04 Â± 0.30 mm) compared to the control group (2.82 Â± 0.14 mm). The length of cardiomyocyte was in log 10 to normalize the data. There was a significant increase in the length of the cardiac muscle cells of the 4 weeks aerobic and anaerobic group (1.09Â± 0.08 Î¼m and 1.00Â± 0.12 Î¼m) compared with the control group (0.73Â± 0.1 Î¼m). Width of heart muscle cells in the 4 weeks aerobic-anaerobic group showed a significant increase when compared to the control group (5.38Â± 1.3 Î¼m and 5.5Â± 2.11 Î¼m) vs (2.74Â± 0.53 Î¼m). Significant reduction in the length of cardiac muscle cells in the detrained 4 weeks aerobic group (0.94Â± 0.08 Î¼m) was found when compared to the treatment group (1.09Â± 0.08 Î¼m). Significant differences were found between the length of cardiac muscle cells in the 12 weeks aerobic-anaerobic groups (1.3Â± 0.04 Î¼m and 1.2Â± 0.07 Î¼m) compared to the control group (0.95Â± 0.69 Î¼m). Significant width increments of heart muscle cells was found in the 12 weeks aerobic-anaerobic groups (7.3Â± 1.01 Î¼m and 6.44Â± 0.08 Î¼m) compared to the control group (4.52 Â± 0.91 Î¼m).Conclusion: Long term aerobic and anaerobic training causes an increase in both wall thickness and diameter of the leftÂ ventricular cavity, as well as slight fibrosis. The increase in wall thickness, diameter, and fibrosis diminish during detraining period. (Med J Indones 2011; 20:271-7)Keywords: Aerobic/anaerobic exercise, detraining, fibrosis,Â myocardial structure

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