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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 12 Documents
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Search results for , issue "Vol. 25 No. 1 (2016): March" : 12 Documents clear
The effects of colloids or crystalloids on acute respiratory distress syndrome in swine (Sus scrofa) models with severe sepsis: analysis on extravascular lung water, IL-8, and VCAM-1
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1204

Abstract

Background: Acute respiratory distress syndrome (ARDS) is a fatal complication of severe sepsis. Due to its higher molecular weight, the use of colloids in fluid resuscitation may be associated with fewer cases of ARDS compared to crystalloids. Extravascular lung water (EVLW) elevation and levels of interleukin-8 (IL-8) and vascular cell adhesion molecule-1 (VCAM-1) have been studied as indicators playing a role in the pathogenesis of ARDS. The aim of the study was to determine the effects of colloid or crystalloid on the incidence of ARDS, elevation of EVLW, and levels of IL-8 and VCAM-1, in swine models with severe sepsis.Methods: This was a randomized trial conducted at the Laboratory of Experimental Surgery, School of Veterinary Medicine, IPB, using 22 healthy swine models with a body weight of 8 to 12 kg. Subjects were randomly allocated to receive either colloid or crystalloid fluid resuscitation. After administration of endotoxin, clinical signs of ARDS, EVLW, IL-8, and VCAM-1 were monitored during sepsis, severe sepsis, and one- and three hours after fluid resuscitation. Analysis of data using the Wilcoxon test , Kolmogorov-Smirnov test, Mann-Whitney test, unpaired t test.Results: Mild ARDS was more prevalent in the colloid group, while moderate ARDS was more frequent in the crystalloid group. EVLW elevation was lower in the colloid compared to the crystalloid group. There was no significant difference in IL-8 and VCAM-1 levels between the two groups.Conclusion: The use of colloids in fluid resuscitation does not decrease the probability of ARDS events compared to crystalloids. Compared to crystalloids, colloids are associated with a lower increase in EVLWI, but not with IL-8 or VCAM-1 levels.
Expression and specific activities of carbamoyl phosphate synthetase 1 in chronic hypoxic rats
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1213

Abstract

Background: Urea biosynthesis is a very important process in the liver which needs ATP, CO2 and functional mitochondria or aerobic condition. Liver can adapt to hypoxic condition, generally and locally. This study aimed to analyze the effect of chronic hypoxia on liver urea biosynthesis as indicated by the level and specific activity of mRNA of carbamoyl phosphate synthetase 1 (CPS1), a key enzyme in urea biosynthesis in hypoxic rats. Methods: 20 male Sprague-Dawley rats were placed in hypoxic chamber supplied by a mixture of 10% O2 and 90% N2. Five rats were sacrificed at 1, 3, 5, and 7 days after exposure. Liver homogenates were analyzed for HIF-1 (hypoxia inducible factor-1) by ELISA, CPS1 mRNA by real time RT-PCR and CPS1 enzymatic specific activities by Pierson method. Data were analyzed by ANOVA test and Pearson correlation. Results: The HIF-1 in liver increased significantly, as well as CPS1 mRNA and CPS1 enzymatic activities (p<0.05). There was a strong correlation (r=0.618; p<0.01) between the level of CPS1 mRNA and CPS1 enzymatic activities, moderate correlation between HIF-1 and CPS1 mRNA (r=0.419; p<0.05) but no correlation between HIF-1 and CPS1 enzymatic activities. The study indicated that urea biosynthesis in liver was affected by hypoxia and partially under HIF-1 regulation. The study also found increase of urea and NH3 biosynthesis related to proteolysis as indicated by the decrease of total body weight and liver weight. Conclusion: There was an increase in the expression and specific activities of CPS1 in urea biosynthesis as a result of increasing proteolysis in chronic hypoxic condition.
Basal follicle stimulating hormone and leptin on the day of hCG administration predict successful fertilization in in vitro fertilization
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1215

Abstract

Background: Successful pregnancy in in vitro fertilization (IVF) program depends on multiple factors. This study aimed to determine whether age, body mass index (BMI), basal follicle stimulating hormone (FSH), estradiol, and leptin on the day of trigger ovulation with human chorionic gonadotropin (hCG) might be used as predictor for successful oocyte fertilization in in vitro fertilization (IVF) program. Methods: This is a cross sectional study conducted in Yasmin Fertility Clinic, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Forty participating patients underwent IVF program, excluding smokers, patients with diabetic, morbid obesity, and severe oligospermia or azoospermia. Age, BMI, basal FSH, estradiol, leptin on the day of hCG administration, oocyte count on oocyte retrieval, the number of mature oocyte, and fertility rate were analyzed using bivariate and multivariate analysis to determine which eligible factors play role in predicting the successful of fertilization. Results: Significant correlation was found between basal FSH level and serum leptin/oocyte ratio on the day of hCG administration with successful fertilization. We found probability formula as follows: 1/(1+exp –€“(6.2 - 0.4(leptin serum/oocyte ratio) - 0.8(basal FSH)), with 77.8% sensitivity, 77.8% specificity, and AUC levels of 85.6% indicating strong predictability. Probability of successful fertilization related to basal FSH level of 5.90 mIU/mL and leptin serum/oocyte ratio of 3.98. Conclusion: The formula consisting of basal FSH and leptin serum/oocyte ratio on the day of trigger ovulation was capable in predicting the probability of successful fertilization in IVF procedure.
Genetic risk factor APOEε4 associates with plasma amyloid beta in amnestic mild cognitive impairment and alzheimer’s disease
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1255

Abstract

Background: APOEε4 is a strong genetic risk factor for Alzheimer’€™s disease (AD). AD itself has been associated with reduced Aβ clearance from the brain and plasma. Understanding the potential pathogenic link between APOEε4 and plasma Aβ might allow for earlier identification of people at risk of developing AD. The aim of this study is to find out the correlation between APOEε4 and plasma Aβ in amnestic mild cognitive impairment (aMCI) and AD patients. Methods: This is a comparative cross-sectional study of patients attending a memory clinic in Siloam Hospital Lippo Karawaci, Tangerang, during the period of 2013-2014. Subjects were categorized into three categories: normal aging, aMCI, and AD. We performed blood test to examine APOEε4, plasma Aβ4o level, and plasma Aβ42 level. All data analyses were performed using correlation test and logistic regression. Results: Sixty subjects (normal aging = 23, aMCI = 17, AD = 20) were included. There were 19 (31.7%) subjects with APOEε4 positive. Subjects carrying ε4 allele were more likely to have AD by 3.9-fold than subjects with APOE ε4 allele negative. There is a significant difference between the mean of plasma Aβ40 in aMCI group and AD group. We also found correlation between APOEε4 (+) and higher plasma Aβ42 (p<0.05). Conclusion: There is a correlation between APOEε4 and plasma Aβ42 level, which supports the hypothesis that this genetic isoform accelerates the rate and progression of AD through Aβ-dependent pathways.
Avidin inhibits PHA-induced human peripheral blood mononuclear cell proliferation
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1264

Abstract

Background: Cell proliferation occurs not only in normal but also in cancer cells. Most of cell proliferation inhibition can be done by inhibiting the DNA synthesis, notably by intervening the formation of purine or pyrimidine. In purine de novo synthesis, it was assumed that biotin plays a role as a coenzyme in carboxylation reaction, one of the pivotal steps in the purine de novo pathways. The aim of this study was to see the avidin potency to bind biotin and inhibit mitosis.Methods: Peripheral blood mononuclear cell (PBMC) was cultured in RPMI-1640 medium and stimulated by phytohemagglutinin (PHA) in the presence or absence of interleukin-2 (IL-2), with or without avidin. The effect of avidin addition was observed at 24, 48, and 72 hours for cell proliferation, viability, and cell cycle. Statistical analysis was done by one-way ANOVA.Results: Avidin inhibited cell proliferation and viability in culture under stimulation by PHA with and without IL-2. Cell cycle analysis showed that avidin arrested the progression of PBMC after 72 hours of culture. Most cells were found in G0/G1 phase.Conclusion: Inhibition of biotin utilization by avidin binding can halt cell proliferation.
The effect of moderate-intensity acute aerobic exercise duration on the percentage of circulating CD31+ cells in lymphocyte population
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1277

Abstract

Background: The increasing number of circulating CD31+ endothelial progenitor cells is one of the important factors for maintaining vascular homeostasis. Exercise will effectively increase the number of circulating CD31+ endothelial progenitor cells. This study aims to determine the effect of moderate-intensity acute aerobic exercise duration on the percentage of circulating CD31+ cells in untrained healthy young adult subjects. Methods: This study was an experimental study. Untrained healthy volunteers (n=20) performed ergocycle at moderate-intensity (64–€“74% maximum heart rate) for 10 minutes or 30 minutes. Immediately before and 10 minutes after exercise, venous blood samples were drawn. The percentage of CD31+ cells in peripheral blood was analyzed using flow cytometry. Data was statistically analyzed using student t-test. Results: There were no significant differences in the mean percentage of circulating CD31+ cells before and after exercise for 10 minutes and 30 minutes (p>0.05). However, there was a different trend in the percentage of circulating CD31+ cells after exercise for 10 minutes and 30 minutes. In the 10 minutes duration, 50% of subjects showed increase. Whereas in the 30 minutes duration, 80% of subjects showed increase. Conclusion: The percentage of circulating CD31+ cells before and after exercise for 10 minutes was not different compared to 30 minutes. However, data analysis shows that majority of subjects (80%) had increased in the percentage of circulating CD31+ cells after 30 minutes exercise.
A tale of the broken heart: peripartum cardiomyopathy, a case report
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1278

Abstract

Progressive dyspnea following childbirth warrants a prompt suspicion into the diagnosis of peripartum cardiomyopathy, PPCM. Pump failure causes an inadequate cardiac output which ultimately contributes to PPCM high mortality rate; however early airway control, vigilant fluid balance and vasoactive support will substantially reduce the incidence of patients falling into decompensated heart failure. More importantly, it is imperative that these patients are cared in a setting where continuous hemodynamic monitoring is available. This case report serves as a reminder not to focus end-point therapy solely on blood pressure readings, but to observe signs and symptoms of hypoperfusion such as cold clammy skin, cool extremities, decreased urine output and mental status.
Dissolution of large intracardiac thrombus, potential role of the emerging oral fibrinolytic agent
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1311

Abstract

Intracardiac thrombus may persist in some cases even after anticoagulant therapy. This opens a possibility to add a potent thrombolytic agent into therapeutic regimen without increasing bleeding risk any further. Increasing evidence showed a promising efficacy and safety of oral fibrin specific lumbrokinase as a thrombolytic agent. To the best of our knowledge, report of the use of lumbrokinase on intracardiac thrombus is limited. We reported two cases of intracardiac thrombi. In first patient, after two-month therapy with lumbrokinase, the previous 8 cm2 left atrial thrombus was completely disappeared. Second patient had left ventricular thrombus due to low left ventricular ejection fraction caused by coronary artery disease. A significant dissolution in thrombus size on repeated follow-up was found. Both patients did not experience any significant adverse effect. This case series aims to present the potential use of lumbrokinase as as oral antithrombotic therapy in intracardiac thrombus.
Renal evaluation in patients with type 2 diabetes mellitus and its association with diastolic blood pressure
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1329

Abstract

Background: HbA1c is correlated with the estimated glomerular filtration rate (eGFR) and diastolic blood pressure (DBP). Our main objective was to evaluate the trend of biochemical and clinical variables, in relation to the eGFR in patients with type 2 diabetes mellitus (T2DM). Methods: This was a retrospective, longitudinal, and descriptive study, including patients with T2DM, who were cared for from January 2014 until December 2014, at the Clí­nica de Diabetes, Hospital Regional “€œGral. Ignacio Zaragoza", ISSSTE, Mexico City, Mexico. eGFR was calculated using three formulas: the chronic kidney disease –€“ epidemiology collaboration (CKD-EPI), Cockcroft-Gault, and modification of diet in renal disease (MDRD), during two periods of observation, 3 and 6 months. The results were compared by Student t tests or Wilcoxon-Mann-Whitney test depending on the variable distribution. Pearson correlation was employed to determine the relation between the eGFR determined with each formula and the analyzed variables. Results: The mean age was 56.5±11.3 years in the group of 3 months’€™ follow-up (n=110) and 57.1±13.8 years in the group of 6 months’€™ follow-up (n=47). In both groups, the formula with the lowest percentages of cases of CKD was CKD-EPI and the difference of this formula had a basal and final significant positive correlation with the DBP. Conclusion: The CKD-EPI formula showed the lowest percentages of cases of CKD in a short follow-up period, and its difference is consistently associated with the DBP, confirming the importance of controlling the later to mitigate the evolution to CKD.
X-ray radiation effect of C-arm on adipose tissue-mesenchymal stem cell viability and population doubling time
Medical Journal of Indonesia Vol. 25 No. 1 (2016): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v25i1.1335

Abstract

Background: Adipose tissue derived mesenchymal stem cells (AT-MSCs) are relatively easy in isolation procedure compared to bone marrow-derived. Minimally invasive MSC injections need C-arm as guidance that potentially influence the cell viability and doubling time. This study aimsed to determine the effect of C-arm X-ray exposure on AT-MSC viability and population doubling time (PDT). Methods: This experimental study used cryopreserved adipose tissue derived MSCs stored in Stem Cell Medical Technology Integrated Service Unit Cipto Mangunkusumo Hospital. Cells were thawed, propagated, and exposed to varying doses of C-arm X-ray radiation. Stem cell viability was measured, and then the cells were cultured to assess their PDT. Generalized linear models test was used to compare cell viability between post-thaw, post-propagation, post-radiation, post-culture post-radiation, and control and between radiation dose groups. Kruskal-Wallis test assessed PDT between various radiation doses in post-radiation groups. Wilcoxon test was used to assess PDT between pre-radiation and post-radiation groups. Results: Mean confluence period of adipose MSCs post- irradiation was 4.33 days. There was no statistically significant difference in MSC viability after X-ray exposure between pre- and post-irradiation groups (p=0.831). There was no correlation between post-irradiation viability and radiation dose (p=0.138, r=0.503). There were no significant differences in PDT between pre- and post-culture post-irradiation groups and between various radiation doses in post-irradiation groups (p=0.792). Conclusion: MSC viability and PDT were not influenced by radiation exposure up to 32.34 mgray.

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