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INDONESIA
Medical Journal of Indonesia
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 13 Documents
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Search results for , issue "Vol. 16 No. 2 (2007): April-June" : 13 Documents clear
Accuracy of frozen-section combined with imprint and fine needle aspiration biopsy in thyroid nodules
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.257

Abstract

Thyroid malignancy can be found on 5% of thyroid nodules. In order to better managed of thyroid nodules, skills to differentiate benign from malignant cases were needed. Fine needle aspiration biopsy (FNAB) was done preoperatively while frozen section (FS) and imprint cytology (IC) should be done intra-operatively. The objective of this research paper is to evaluate the diagnostic accuracy of FNAB versus frozen section combined with imprint cytology (FS+IC) in thyroid nodules at the Anatomic-Pathology Department FMUI-CM Hospital, Jakarta. This diagnostic test, used data from clinico-pathological records in Anatomic Pathology Department, Faculty of Medicine University of Indonesia / Dr.Cipto Mangunkusumo General Hospital, Jakarta, Indonesia during 1999-2003. Specimens with complete data of FNAB results, data of FS and slides of IC. All formalin fixed`specimens were reevaluated and used as the golden standard. Sensitivity, spesificity and accuracy of FS+IC were higher than FNAB (86.8% vs 73.7% ; 99.0% vs 83.9% ; 94.8% vs 80.5% respectively). If the results of FNAB were concordant with the result of FS+IC, the combined examination yields accuracy of 95.1%. The evaluation of frozen section combined with imprint cytology is very useful, because this examination significantly showed high accuracy in diagnosing thyroid malignancy. (Med J Indones 2007; 16:89-93)Keywords: thyroid nodules, FNAB, frozen section, imprint cytology, accuracy
Biochemical study of CymJ, the putative regulator of cyclodextrin metabolism in Klebsiella oxytoca M5a1
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.258

Abstract

The products of ten genes clustered in two divergently oriented operons are required for the metabolism of cyclic oligoglucosides, the cyclodextrins, by Klebsiella oxytoca. The function of CymJ, the product of the promoter distal gene in one of the operons was studied. Over expression of cymJ in K. oxytoca led to strong reduction of the expression of the cym operons. This repression could be alleviated by addition of high concentration of α-cyclodextrin into the medium. There is a possible relationship between CymJ and CymD since the absence of CymD in a CymD deletion mutant prevented the repression effect of CymJ. An intriguing finding was that the presence of CymJ in large amount in the cell caused severe cell division inhibition leading to retardation of growth. This morphological change was paralleled by a significant increase in the susceptibility of K. oxytoca to ampicillin. (Med J Indones 2007; 16:69-77) Keywords: cym operon, putative regulator, over expression
Hydroxyurea appears beneficial in patients with beta-thalassaemia major and intermedia
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.259

Abstract

Patients with severe inherited β-globin chain disorders may have milder illness if they produce high levels of fetal hemoglobin (HbF). Hydroxyurea (HU) has been shown to enhance HbF levels in patients with sickle cell disease and may be useful in β-thalassemias. We administered HU to 13 patients with β-thalassemia intermedia or major, including 6 splenectomized patients. The patients received escalating doses (10 to 25 mg/kg/d) of HU for around 2 years (median: 21 months, range: 8 - 55 months). Eleven patients responded with an increase in the pre-transfusion HbF levels, from a base line median of 8.0% (2.5 - 61.3%) to 28.0% (6.6 - 49.2%) and 40.7% (4.8 - 72.3%) at 3 months and 18 months post-HU, respectively. A concomitant increment in median hemoglobin levels was noted at 1, 3 and 18 months of HU therapy. Six of 7 transfusion-dependent patients who had an increment of HbF (one with β-thalassemia major) also had reduced transfusion requirement over the 2-year period of HU therapy. Response to HU was also shown by a reduction in spleen size. Apart from oral ulcers that resolved upon dose reduction of HU, no significant toxicity was noted. We conclude that increased HbF production in β-thalassemia patients, with an improvement in erythropoiesis, can be achieved using HU with minimal toxicity. (Med J Indones 2007; 16:78-83) Keywords: fetal hemoglobin (HbF), erythropoiesis, toxicity
Morphological characteristics of leukemia cells in acute myeloblastic leukemia with t(8;21)(q22;q22): possible predictability of t(8;21)
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.260

Abstract

The laboratory systems for chromosomal analysis or the detection of fusion genes are generally not available in Indonesia. Therefore, bone marrow (BM) morphological analysis should be developed and applied to get an accurate diagnosis. In this study the BM smears of eight (8) cases of acute myeloblastic leukemia (AML) which had already been known to have t(8;21)(q22;q22), were morphologically evaluated in order to find out the characteristics, which might be used to predict t(8;21)(q22;q22) or the presence of AML1-ETO(MTG8) fusion gene. All of the cases belonged to AML-M2. The morphological characteristics, indicative of t(8;21) were pink colored cytoplasm in mature neutrophil (75%), neutrophilic myelocytes or metamyelocytes without granules or with scarce granules (2.3%), eosinophilia (eosinophilic myelocytes and metamyelocytes) (above 5%), myelocytes with abundant granules 8.5%, and low percentage of type I blasts (below 10%). These characteristics were not observed in AML-M2 cases without t(8;21) or AML1-ETO(MTG8). The myelocytes with abundant granules have not been described so far, while other characteristics were in line with the findings of Nakamura et al (Leukemia 1997;11:651-55). (Med J Indones 2007; 16:84-8)Keywords: PML-RARA fusion gene, AML1-ETO (MTG8), myelocytes, abundant granul
Clinical application of ultrasound in dermatological cases
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.261

Abstract

Ultrasonography has been recognized as an important diagnostic modality in medicine and has entered the area of clinical dermatology. Its non-invasive characteristics have made it easily use and completely safe. It provides important diagnostic information in evaluating skin tumors. It also outlines the subcutaneous lesions and their relation to its adjacent tissue. Another ultrasound technique is color Doppler which is useful to assess vascularization of skin lesion. In this article, we would like to report ultrasound imaging in some selected cases from our institution. (Med J Indones 2007; 16:113-6)Keywords: Ultrasound, skin tumor, arteriovenous malformation, pseudoaneurysm
Pneumatic displacement without tissue plasminogen activator in premacular subhyaloid hemorrhage
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.262

Abstract

To assess the efficacy and safety of intravitreal injection of Sulfur Hexafluoride (SF6) gas without the use of tissue Plasminogen Activator (tPA) in premacular Subhyaloid Hemorrhage (SHH), 5 eyes of 5 patients with premacular SHH were enrolled. After performing paracentesis of the anterior chamber, 0.3 ml pure SF6 gas was injected through pars plana with a 30 gauge needle. Facedown position was maintained for 5 days. Subhyaloid Hemorrhage was displaced in 4/5 (80%) eyes with a duration of SHH less than 2 weeks. The pre-injection visual acuity of all 5 eyes was finger counting and improved in 4/5 ( 80% ) eyes within 3 days to 7 days post-injection to 6/20 - 6/6. The underlying disease was hypercoagulation in 1 patient, diabetes mellitus in 2 patients, hypertension in 1 patient and unknown in 1 patient. No complications were encountered. In conclusion, SF6 gas injected into the vitreous without the use of tPA, can displace SHH if performed within 14 days of duration, and results in rapid visual recovery. This procedure is proven to be safe. (Med J Indones 2007; 16:104-7) Keywords: subhyaloid hemorrhage, pneumatic displacement, sulfur hexafluoride gas
Primitive Neuro Ectodermal Tumor (PNET) in infant diagnosed by histopathology and immunohistochemistry techniques
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.263

Abstract

Primitive Neuro Ectodermal Tumor (PNET) is rare and difficult to diagnose. A case of PNET was diagnosed based on histopathological and immunohistochemical findings. A 4-month-old infant was admitted to the hospital with a tumor on the midline of his chest wall since he was 3 days old. The tumor was fixed on the chest wall and had ill-defined margin, enlarged over time and reached more than 10 cm in diameter when he was brought to a clinician. Two small ulcers were seen on the skin overlying the tumor. It was diagnosed as soft tissue tumor suggestive of a hemangioma. The tumor was 17 x 13 x 5.5 cm in size, white colored and firm to the touch. Microscopic examination revealed malignant small round cells with round to ovoid nuclei, coarse chromatin and scanty cytoplasm. Most cells were arranged in a solid pattern with scattered Homer-Wright rosettes. The mitotic count was 7/10 HPF, and necrosis was minimal (less than 25%). On immunohistochemical examination, the cells showed weak to moderate immunoreactivity to Vimentin and CD99, but showed negative to weak positive reactivity to NSE and Chromogranin. Based on the clinical features, gross findings, histopathologic and immunohistochemical examinations, the case was diagnosed as a malignant small round cell tumor consistent with PNET / ES (Ewing's Sarcoma). To confirm the diagnosis, cytogenetic examination is suggested. (Med J Indones 2007; 16:108-12) Keywords: PNET, histopathology, immunohistochemistry
Efficacy and safety of galantamine in the treatment of Alzheimer's Disease and Alzheimer's Disease with cerebrovascular (Mixed Dementia) (GAL-DEM-402)
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.264

Abstract

This study was aimed to evaluate the efficacy and safety of Acetylcholinesterase Inhibitor Galantamine (Reminyl®) for patients with Alzheimer's Disease (AD) and Alzheimer's Disease with cerebrovascular Disease (AD+CVD or mixed Dementia). A 6-month open label observational study of Galantamine has been conducted on 28 patients with AD and AD+CVD patients. Primary endpoints were cognitive performance as assessed using the Mini Mental Scale Examination (MMSE), the Restricted Reminding Test), the Neuropsychology Assessment, the Clinical Dementia Rating (CDR) to assess global function and the Neuropsychiatric Inventory (NPI) to assess behavioral symptoms. Patients were also monitored for safety evaluation. Six month Galantamine group had a significant better outcome of cognitive performance, global function and behavioral symptoms compared with the baseline data as were assessed using the MMSE (p<0.05), the Restricted Reminding (p<0.05), the Neuropsychology Assessment (p<0.05), the CDR (p<0.05) and the NPI (p<0.05). Minimal adverse events (32%) were anorexia and nausea. It is concluded that Galantamine has a significant benefit to improve cognitive, global function, behavioral symptoms and only caused minimal adverse events. (Med J Indones 2007; 16:94-100) Keywords: Galantamine, alzheimer, cerebrovascular disease, dementia, AD, AD+CVD
Low education, more frequent of seizure, more types of therapy, and generalized seizure type decreased quality of life among epileptic patients
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.265

Abstract

Persons with chronic disease such as epilepsy, where a cure is not attainable and therapy may be prolonged, quality of life (QoL) has come to be seen as an important goal. The objective of this study was to identify scores of quality of life (QoL related to clinical factors. A cross-sectional study using QOLIE-31 instrument to identify quality of life among ambulatory epileptic patients at Epileptic Clinic of Department of Neurology-Cipto Mangunkusumo Hospital. Samples were taken consecutively from August 2005 to December 2005. Several demographic data as well as clinical were collected. QOLIE-31 components consisted of seizure worry, overall quality of life, emotional well-being, energy/fatigue, cognitive function, medication effect and social function. We found among 145 subjects the total score of QOLIE-31 ranged from 28-95 (mean = 67.6; standard of deviation = 14.55). The total score of QOLIE-31was corelated with low education, more frequent of seizures, antiepileptic drug politherapy and type of generalized seizure. antiepileptic drug politherapy was the most dominant risk factor for lowering total score of QOLIE-31. Our finding was in accordance with previous studies in India, Georgia, South Korea. In additioin we found that education was also a risk factor for total score of QOLIE-31. (Med J Indones 2007; 16:101-3) Keyword: epilepsy, quality of life, QOLIE-31, risk factors
Delayed stool specimen collection during the early and late stages of the Polio outbreak increase the risk of negative Wild Poliovirus laboratory results in some districts in Indonesia
Medical Journal of Indonesia Vol. 16 No. 2 (2007): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v16i2.266

Abstract

In 2005, a wild poliovirus (WPV) outbreak occurred in Indonesia. Some stool specimens from acute flaccid paralysis (AFP) subjects, showed negative laboratory results for WPV. The aim of this study was to identify several risk factors associated with negative WPV laboratory results. A cross-sectional study was conducted on all AFP surveillance stool specimens taken from the three districts where 58.9% of the outbreak cases occurred. Data were obtained from Bandung and Jakarta National Polio Laboratory regarding identity of cases; onset of paralysis; data on specimen collected (timing, dispatched, received, and tested); and results of the tests. In addition, field visits were conducted to the three districts for confirmation of data collecting methods, facilities, and field personnel. The Cox regression method for relative risk (RR) was used for analysis. The prevalence of negative results was 31.5%. Negative results at the beginning of the outbreak (February-April) were 60%, at the end of the outbreak (July-December) were 66.2%, and at the height of the outbreak (May-June) were 15.5%. Negative WPV results were related to delayed specimen collection, origin of district specimen, and the period of specimen collection. Delayed versus on-time stool collection increased the risk of negative results by 70% (adjusted relative risk = 1.70; 95% confidence intervals = 1.01 - 2.88). In conclusion, inappropriate timing of specimen collection, in particular during the early and late stages of the polio outbreak, needs special attention to minimize the risk of negative WPV laboratory results. (Med J Indones. 2007;16:122-6)

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