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INDONESIA
Medical Journal of Indonesia
Published by Universitas Indonesia
ISSN : 08531773     EISSN : 22528083     DOI : 10.13181
Core Subject : Health,
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 12 Documents
Search results for , issue "Vol. 22 No. 2 (2013): May" : 12 Documents clear
Callus-derived cells: are they mesenchymal stem cells?
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.528

Abstract

[no abstract available]
Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.530

Abstract

Background: Osteoarthritis (OA) is the most common knee degenerative disease, the number of OA patients increases along with the increase of life expectancy. Distraction arthroplasty is a less invasive alternatif for OA management by releaving mechanical stress while maintaining intermitten joint fluid pressure changes, thus halting the OA destructive cycle and inducing repair. This study aims to evaluate the anatomical and histopathological changes after distraction arthroplasty on osteoarthritic animal models. Methods: The study was performed on 32 goat stiffle joint (16 goats) with mechanically induced OA by lateral meniscectomy. During the study 6 goats were decreased. Distraction arthroplasty was performed using external fixation on 10 knees for 4 weeks, and the contralateral knees left untreated. The knees were anatomically and histopathologically examined using International Cartilage Repair Society (ICRS) staging and Osteoarthritis Research Society International (OARSI) scoring. The differences of the anatomical and histopathological changes are tested for significance using the Wilcoxon test. Results: There was anatomical and histopathological worsening of the OA on treated knees. The anatomical difference assessed using ICRS stage gave median values of 1.5 and 2.5 respectively (p < 0.002). The histopathological difference assessed using OARSI scoring was significant (6 vs 10; p < 0.002). Conclusion: Distraction arthroplasty in OA goat models in this study, worsens the OA instead of inducing repair. Further studies are required to find out a convincing biological basis of distraction arthroplasty as an alternative treatment for OA. (Med J Indones. 2013;22:64-9)
Comparison of fracture site callus with iliac crest bone marrow as the source of plastic-adherent cells
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.531

Abstract

Background: Red marrow has been described as the main source of mesenchymal stem cells although its aspiration and isolation from bone marrow was reported to have significant donor site morbidity. Since secondary bone healing occurs through formation of callus as the result of proliferation and differentiation of mesenchymal stem cells, callus may become alternative source for mesenchymal stem cells. In this study, we compared the number of plastic-adherent cells from fracture site callus and bone marrow of iliac crest after two and four weeks of culture. Methods: Sixteen New Zealand rabbits were fracturized at the femoral shaft. Then, these rabbits were taken care. After two weeks of fracturization, 3 mL iliac crest bone marrow aspiration and callus extraction of eight rabbits were cultured (group I). The other eight rabbits were treated equally after four weeks of fracturization (group II). Simultaneously, the cultures were observed after one and two weeks. Four weeks later, they were harvested. Cells were counted using Neubauer hemocytometer. The average number of cells between the sources and groups were statistically analyzed using the unpaired t-test. Results: In group I, there were 2.6±0.1 x 104 cells in the culture of iliac crest bone marrow aspirate and 2.5 ± 0.1 x 104 cells in culture of callus extract from fracture site (p=0.34). In group II, there were 2.7 ± 0.1 x 104 cells and 2.1 ± 0.1 x 104 cells, respectively (p < 0.001). Conclusion: Fracture site callus at the second week post-fracturization may be potential as source of plastic-adherent cells compared with iliac crest bone marrow.
Serum biomarker profiles of interleukin-6, tumor necrosis factor alpha, matrix-metalloproteinase-2, and vascular endothelial growth factor in endometriosis staging
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.532

Abstract

Background: The focus of this study was to compare serum biomarkers: interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), matrix-metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in endometriosis stage I-II and stage III-IV. Methods: This is a cross-sectional study. Forty endometriosis patients were diagnosed using laparoscopy procedure. Serum sample was taken before the surgery. The serum biomarkers (IL-6, TNF-α, MMP-2, and VEGF) were analyzed with ELISA method at the end of research. Mean of serum biomarkers in endometrosis stage I-II and stage III-IV were compared using unpaired t-test. Variables that show significant mean difference were tested using ROC measurement and the optimal cut-off point was determined. Results: There was no significant difference in mean serum biomarkers level of IL-6, TNF-α, and MMP-2 between endometriosis stage I-II and stage III-IV (1.58 ± 0.78 vs 1.55 ± 0.98 pg/mL, 1.5 ± 0.47 vs 1.49 ± 0.29 pg/mL, and 152.04 ± 27.32 vs 140.98 ± 28.08 ng/mL, respectively). On the other hand, the comparison of VEGF level in endometriosis stage I-II and stage III-IV demonstrated significant difference (289.76 ± 188.13 vs 581.29 ± 512.85 pg/mL (p < 0.05)). Mean difference of VEGF had AUC of 74.5%. Optimal cut-off point for VEGF was 314.75 pg/mL with sensitivity 78.6% and specificity 69.2%. Conclusion: This study showed that serum biomarkers of VEGF level (but not IL-6, TNF-α, and MMP-2) can be used to measure the degree of severity in endometriosis. VEGF level of 314.75 pg/mL represents the cut-off point between lower and higher stage of severity.
Distance between parapatellar portal and intra-articular space for needle positioning in knee osteoarthritis
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.533

Abstract

Background: Intra-articular injection is a common therapeutic procedure in osteoarthritis (OA) that need high accuracy. This study was aimed to measure the distance between parapatellar skin and intra-articular space as a guidance to choose the length of needle needed to perform intra-articular injection. Methods: Twenty one knees MRI were taken from 16 females with knee osteoarthritis. The length of the needle needed to reach intra-articular space was reconstructed by drawing straight line from skin to intra-articular fluid. Paired t-test was using to analyze the mean difference of measurement of left side compare with right side with significant indicator if p-value < 0.05. Results: The entry point on both medial and lateral parapatellar were more cranial than transverse mid-patellar line. On medial portal, the closest distance from skin to intra-articular space is 27.81±7.58 mm. Mean point of entry is 4.46±2.16 mm cranial to mid-patellar line, and 14.20±4.45 mm posterior to the prominence of medial border of patella. On lateral portal, the closest distance from skin to intra-articular space is 16.84±6.79 mm. Mean point of entry is 11.10±5.94 mm cranial to mid-patellar line, and 8.91±3.83 mm posterior to the prominence of lateral border of patella. Conclusion: MRI knee osteoarthritis study showed that the mean distance between skin and intra-articular joint space of medial portal is 27.81±7.58 mm, and lateral portal is 16.84±6.79 mm. The portals on both sides is cranial to midpoint of patella, lateral appears more proximal than medial. This should be put into consideration in choosing needle length and portal projection to increase intra-articular injection accuracy.
The application of human umbilical cord blood mononuclear cells in the management of deep partial thickness burn
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.534

Abstract

Background: Wound healing in burn is a complex process and early complete wound closure still enfaces many problems. Application of stem cells is found to be the future method of wound healing. Among the available sources of allogenic stem cells, umbilical cord blood is quite easy to be obtained, has less ethical issue, and contain multipotent stem cells, which are characterized by low immunogenicity. The study aims to evaluate the potential of human umbilical cord blood mononuclear cells (hUCBMNCs) treatment in the management of deep partial thickness burns. Methods: Twenty patients with deep partial thickness burns were treated with topical application of 2 x 107 hUCBMNCs and silver sulfadiazine (SSD) cream on the comparable wound size in the other sites. The treatments were applied for six times in every two consecutive days. Wound surface area was measured with Visitrak® on day 0, 7, and 11. Pain intensity was evaluated using Wong Baker’s faces scale on each wound dressing change. Histology examination was performed in some samples of collected skin biopsy of the newly re-epithelialized area of hUCBMNCs and SSD-treated wound at the end of treatment. HLA typing is used to evaluate the issue of safety. Wilcoxon signed rank test was used to compare the rate of wound healing. Results: Sixteen patients of hUCBMNCs-treated showed a significant wound closure in faster than SSD-treated; measured on day 7 (p = 0.041) and day 11 (p = 0.021). Number of patients with reduced pain intensity, from approximately scale 3 to 1/0 on day 7 and 11, were higher in hUCBMNCs-treated compared to SSD-treated wound. In spite of the HLA-mismatch, no allergic reaction, rejection, and infection found on hUCBMNCs-treated wound suggested the safety of this therapy. Histology examination found the formation of dermal-epidermal junction and rete ridges equal to the normal skin on hUCBMNCs-treated wounds. Conclusion: hUCBMNCs are effective and safe to promote re-epithelialization in deep partial thickness burns. (Med J Indones. 2013;22:92-9)Keywords: Deep partial thickness burn, mononuclear cells, re-epithelialization, umbilical cord blood
Endoglin concentration in peritoneal fluid of patients with endometriosis
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.535

Abstract

Background: Endoglin is a specific angiogenic factor suspected to involve in the pathogenesis of endometriosis. The aim of this study was to evaluate the significance of endoglin concentration in the peritoneal fluid of patients with endometriosis. Methods: This pilot study was performed between March 2011 and July 2012 at Dr. Wahidin Sudirohusodo Hospital and another private hospital in Makassar, Indonesia. This was an observational, cross-sectional study. All patients undergoing laparoscopy for infertility and other cases with suitable inclusion criteria were asked to answer a questionnaire and had a 5 cc peritoneal fluid sample taken for measurement of peritoneal endoglin concentration using ELISA. Endometriosis stage was classified using ASRM criteria and divided into two groups, mild and severe. All data were analyed using Excel and Spearman correlation analysis. Results: In the endometriosis group peritoneal endoglin concentration ranged between 14.43- 15.65 ng/mL (median 15.04 ng/mL) which is higher than control group 7.42-10.26 ng/mL (median 8.84 ng/mL). A peritoneal endoglin concentration equal to or higher than 11 ng/mL could be used to predict endometriosis. Conclusion: Endoglin concentrations increased proportionally with the severity of endometriosis, and many be used as predictive factor of endometriosis cases. (Med J Indones. 2013;22:88-91)
Metabolic syndrome and Framingham risk score in obese young adults
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.536

Abstract

Background: The increase number of the metabolic syndrome (MetS) among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD) which can be estimated by Framingham risk score (FRS). The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS. Methods: A total of 70 male and female students aged 18-25 years with BMI ≥25 kg/m2 in Faculty of Medicine Universitas Indonesia were selected consecutively. The blood samples used to test fasting blood glucose, total cholesterol, high-density lipoprotein, and triglyceride were examined in Department of Clinical Pathology, Cipto Mangunkusumo Hospital after fasting for 14-16 hours. International Diabetes Federation (IDF) definition was used to diagnose MetS. Univariate and bivariate analysis were done. Results: The prevalence of MetS based on IDF definition was 18.6% among obese young adults. The most associated MetS components was hypertriglyceridemia (OR 12.13; 95% CI 2.92-50.46; p=0.001), followed with high blood pressure (OR 9.33; 95% CI 2.26-38.56; p = 0.001), low-HDL (OR 8.33; 95% CI 2.17-32.05; p=0.003), and impaired fasting glucose (p=0.03). Four subjects had FRS ≥1% and 66 subjects had risk <1%. Increased FRS was not associated with MetS (p=0.154). There was no component of MetS associated with increased FRS. Conclusion: Prevalence of MetS in obese young adults was similar with obese children and adolescents. Although no association of MetS and FRS was found, they are significant predictors for CHD which should not be used separately.
Quality of life after first- and second- eye cataract surgery on community project in Lombok Island, West Nusa Tenggara, Indonesia
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.537

Abstract

Background: This study aims to assess the quality of life and the time trade off-utility value of the first eye cataract surgery and the second eye cataract surgery in Lombok Island-Indonesia. Methods: This was an epidemiologic survey study on community of cataract surgery. Evaluations of quality of life (QoL) and time trade-off (TTO) were performed using questionnaire prior and three weeks after cataract surgeries who had either first (group A) or second eye cataract surgery (group B). Personal data was noted especially on self-care, mobility, socially, and mentally status. Data was analyzed by chi-square test for categorical data and unpaired t-test or Mann-Whitney test for numeric data. Results: A total of 77 subjects was included in this study, there were 50 subjects in group A and 27 subjects in group B. Elements of QoL were improved after surgeries including self care, mobility, social, and mental status in both groups (p < 0.001). The modified TTO was accepted in 35 subjects in group A and 22 subjects in group B. Quality of life was improved in 46 patients in group A, there was further improvement in 22 patients in group B. The degree of patient's expectation was good in 87% of all subjects. Conclusion: Second- eye cataract surgery showed further improvement in QoL despite better outcome of the first- eye cataract surgery. The outcome of cataract surgery conducted was relevant to the patient’s expectation. (Med J Indones. 2013;22:107-13)
Langerhans cell histiocytosis in cervical node in an adult female - a case report
Medical Journal of Indonesia Vol. 22 No. 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v22i2.538

Abstract

A case of Langerhans Cell Histiocytosis (LCH) in a 58 year old woman who presented with bilateral cervical adenopathy without any other complaints is reported. Clinical examination did not reveal any other positive finding except the adenopathy. Histopathological examination confirmed the node to be Langerhans cell histiocytosis. In conclusion, LCH is a rare disease with varied clinical presentation, including cervical adenopathy. Diagnosis should be confirmed by histopathological examination of biopsy specimen. Observation may be an effective management strategy in cases of adult LCH with cervical adenopathy as the only symptom, due to its possible spontaneous regression. (Med J Indones. 2013;22:114-6)

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