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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 1,648 Documents
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Venous thromboembolism in 13 Indonesian patients undergoing major orthopedic surgery
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.373

Abstract

Aim To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis. Methods This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confirm the symptomatic VTE. These patients were followed up to one month after surgery. Results A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1%) underwent hip fracture surgery (HFS). The median time from injury to surgery was 23 days (range 2 to 197 days), the median duration of surgery was 90 minutes (range 60 to 255 minutes), and the median duration of immobilization was 3 days (range 1 to 44 days). Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2%) at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%), all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study. Conclusion The incidence of asymptomatic (69.2%) and symptomatic (23.1%) VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA), and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted. (Med J Indones 2009; 18: 249-56)
Health status, ability, and motivation infl uenced district hospital nurse performance
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.374

Abstract

Aim To investigate the influence of health status, ability and motivation of nurses'€™ performances in a district hospital. Methods A survey was conducted during May 2009 in a district hospital in West Java, Indonesia. Nurses in the inpatient and outpatient unit and fulfilled inclusion and exclusion criteria were randomly chosen as the unit of analysis. A questionnaire of 18-23 questions was used to measure the indicator of the four variables. The path analysis was performed using multiple regressions for calculating ß as the value of path coefficient between variables, p value and R2. Goodness of fit test was used to calculated Q and W coefficient. Results Test was performed on 125 of 493 nurses with exogenous (independent) and endogenous (intermediate or dependent) variables in the model proposed. The p-value was > 0.05, indicating that the characteristics variation of the subjects did not affect the answers on the endogenous and exogenous variables. The health status, ability, motivation and performance variables showed normal and homogenous distribution. Line equation between variables showed linear relation with p<0.05. Simple correlation score between variables was 0.376 to 0.833. Ability was the biggest variable that influences nurses' performance (44.8%), followed by motivation (33.9%) and health status (21.8%). The influences of the three exogenous variables to nurses'€™ performance were 76.2% and 23.8% which was influenced by other variables. Conclusion Nurses' health status, ability, and motivation influenced their performance. Therefore, these variables can be considered for an intervention to improve the nurses'€™ performance. (Med J Indones 2009; 18: 283-9)
High intensity interior aircraft noise increases the risk of high diastolic blood pressure in Indonesian Air Force pilots
Medical Journal of Indonesia Vol. 18 No. 4 (2009): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v18i4.375

Abstract

Aim To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP) in Indonesian Air Force pilots. Methods A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA) in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ≥ 90 mmHg were compared with contral group with DBP < 79 mmHG. One case matched to 12 controls. Results Out of 567 pilots, 544 (95.9%) had complete medical records. For this analysis there were 40 cases of high DBP and 480 controls for DBP. Pilots exposed to aircraft noise 90-95 dB rather than 70-80 dB had a 2.7-fold increase for high DBP [adjusted odds ratio (ORa) = 2.70; 95% confidence interval (CI ) = 1.05-6.97]. Pilots with resting pulse rates of ≥ 81/minute rather than ≤ 80/minute had a 2.7-fold increase for high DBP (ORa = 2.66; 95% CI = 1.26-5.61). In terms of total flight hours, pilots who had 1401-11125 hours rather than 147-1400 hours had a 3.2-fold increase for high DBP (ORa = 3.18; 95% CI = 1.01-10.03). Conclusion High interior aircraft noise, high total flight hours, and high resting pulse rate, increased risk for high DBP. Self assessment of resting pulse rate can be used to control the risk of high DBP. (Med J Indones 2009; 276: 276-82)
Androgen receptor levels during progression of prostate cancer in the transgenic adenocarcinoma of mouse prostate model
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.376

Abstract

Aim To construct tissue microarrays (TMAs) that consisted of prostate tumours from the transgenic adenocarcinoma of mouse prostate (TRAMP) mice and non-transgenic murine prostates and to assess androgen receptor (AR) levels during progression of prostate cancer in TRAMP mice by immunohistochemistry.Methods Haematoxylin and eosin (H&E) sections from the ventral and dorso-lateral prostate lobes of non-transgenic, intact TRAMP and castrated TRAMP were used to demarcate regions of interest for TMAs construction. The samples on TMAs were used to evaluate AR expression using video image analysis (VIA).Results AR was expressed during cancer progression, but AR levels were reduced or absent in late stage disease. Furthermore, when AR levels were compared in tumours from intact and castrate animals, a significant increase in AR levels was observed following androgen ablation.Conclusion Similar to clinical prostate cancer, in the TRAMP model, prostate tumours evolve mechanisms to maintain AR expression and AR responsive gene pathways following castration to facilitate continued tumour growth. (Med J Indones 2010; 19:5-13)Keywords : androgen ablation therapy, tissue microarrays, haematoxylin and eosin, video image analysis
CYP2A6 gene polymorphisms impact to nicotine metabolism
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.377

Abstract

Nicotine is a major addictive compound in tobacco cigarette smoke. After being absorbed by the lung nicotine is rapidly metabolized and mainly inactivated to cotinine by hepatic cytochrome P450 2A6 (CYP2A6) enzyme. Genetic polymorphisms in CYP2A6 may play a role in smoking behavior and nicotine dependence. CYP2A6*1A is the wild type of the CYP2A6 gene which is associated with normal or extensive nicotine metabolism. In the CYP2A6 gene, several polymorphic alleles have been reported such as CYP2A6*4, CYP2A6*7, CYP2A6*9, and CYP2A6*10 which are related to decreasing nicotine metabolism activity. The variation of nicotine metabolism activity could alter nicotine plasma levels. Smokers need a certain level of nicotine in their brain and must smoke regularly because of nicotine’s short half-life; this increases the number of smoked cigarettes in extensive metabolizers. Meanwhile, in slow metabolizers, nicotine plasma level may increase and results in nicotine toxicity. This will eventually lower the risk of dependence. (Med J Indones 2010; 19:46-51) Keywords: cotinine, hepatic cytochrome P450 2A6, smoking behavior
Cytology technique: development of a simple spot method for cultured cell suspension
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.378

Abstract

Aim To develop a simple spot method to attach cultured cells in suspension on to a glass slide. Methods We compared three approaches using both conventional and special glass slide (Shandon-Polysin), either without additional fetal bovine serum (FBS), or with addition of 3 or 10 μl of FBS to a 20 μl sample (altogether there were six approaches). The slides were examined qualitatively for the background color, boundary color and intactness, and whether there were folded and detached parts. Further, for each slide, the attached intact cells were counted, and the percentage of attached intact cells per number of spotted cells was calculated. The difference in attach intact cells between different approaches was analyzed by ANOVA using SPSS 13.0 for windows. Results There were no significant difference in the percentage of attached intact cells between the six approaches (P= 0.804), though the approach using special glass slide without additional FBS (FBS final concentration 5%) yield the highest percentage of attached intact cells, showed clean background without folded parts. Conclusions We have developed a simple spot method for cultured cell suspension, and the best approach to make spot specimen is using special glass slide with 5% FBS in the cell suspension. (Med J Indones 2010; 19:26-31) Keywords: spot specimen, special glass slide, fetal bovine serum
Gene expression of manganese superoxide dismutase in human glioma cells
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.379

Abstract

Aim This study analyze the MnSOD gene expression as endogenous antioxidant in human glioma cells compared with leucocyte cells as control. Methods MnSOD gene expression of 20 glioma patients was analyzed by measuring the relative expression of mRNA and enzyme activity of MnSOD in brain and leucocyte cells. The relative expression of mRNA MnSOD was determined by using quantitative Real Time RT-PCR and the enzyme activity of MnSOD using biochemical kit assay (xantine oxidase inhibition). Statistic analysis for mRNA and enzyme activity of MnSOD was performed using Kruskal Wallis test. Results mRNA of MnSOD in glioma cells of 70% sample was 0.015–0.627 lower, 10% was 1.002-1.059 and 20% was 1.409-6.915 higher than in leucocyte cells. Also the specific activity of MnSOD enzyme in glioma cells of 80% sample showed 0,064-0,506 lower and 20% sample was 1.249-2.718 higher than in leucocyte cells. Conclusion MnSOD gene expression in human glioma cells are significantly lower than its expression in leucocytes cells. (Med J Indones 2010; 19:21-5) Keywords : MnSOD, glioma, gene expression
Immunogenicity characterization of mononucleated cells originated from umbillical cord blood
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.380

Abstract

Aim Umbilical cord blood mononucleated (UCBMC) cells has been shown to be the stem cells originated from umbilical cord blood. To date, UCBMC has been introduced as an alternative source for stem cells used in autologous and allogeneic transplantations. Several clinical studies have demonstrated that UCBMCs required less stringent selection for HLA matches between donor and recipient with less cases of graft versus host reaction. In this study, UCBMCs are known to contain many stem cells, were characterized and compared to peripheral blood for their immunogenic profile. Methods To elucidate the potential of UCBMC alloreactivity, mixed lymphocyte reaction (MLR) assay was performed. The donor and effectors cells were HLA-typed using PCR method to determine their alloreactivity. Further, to distinguish the level of HLA class I and II expression flowcytometry was done using monoclonal antibodies against those molecules. All the analyse were carried out on UCBMCs and peripheral blood mononucleated cells (PBMCs). Results The result of MLR assay showed that there was less IFN-γ secretion detected in the co-cultured medium in the presence of UCBMCs compared to PBMCs counterpart, indicating less possible rejection of UCBMC. Further, we found that there were only 1-3 alleles of HLA match (out of 8 alleles) among the PBMCs and UCBMCs. By using flowcytometry assay, we could further demonstrate lower HLA Class I expression level with less amount of HLA Class II expressing cells in UCBMC compared to those in PBMCs. Conclusion These findings clearly demonstrate the low immunogenicity of UCBMCs, based on the low level of secreted IFN-γ in the MLR assay, low expression level of HLA Class I, and small population of HLA Class II expressing cells. The outcomes from this study would raise a better understanding in the usage of umbilical cord blood as an alternative source of stem cells for allogeneic transplantation. (Med J Indones 2010; 19:14-20) Keywords: umbilical cord blood, immunogenicity, stem cell
Negative impact of imflammation and insulin resistance on the biogenesis of HDL-c in Indonesian men with metabolic syndrome
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.381

Abstract

Aim To find out the relationship between inflammation and insulin resistance with impaired HDL biogenesis that cause low HDL-c concentrationMethods Using a cross-sectional design, this study involved 163 adult men, aged 25-60 years old with metabolic syndrome (IDF criteria, 2005), without liver and kidney dysfunction. This study was undertaken in Jakarta in the year 2007-2009. Measured indicators were serum apolipoprotein A-1 (apoA-1), prebeta-1 HDL, cholesteryl ester transfer protein (CETP), HDL cholesterol (HDL-c), body weight, height, waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), and triglyceride. The apoA-1/HDL-c ratios were taken as indicator of HDL maturation, whereas CETP/HDL-c and CETP/TG ratios were indicated HDL catabolism. high-sensitivity CRP (hsCRP) and HOMA-IR were taken as indicator of inflammation and insulin resistance, respectively. Data were analyzed by using univariate, bivariate, and multivariate analysis.Results Positive correlations were found between hsCRP and CETP (rs= 0.200, p= 0.042), and CETP/HDL-c ratios (rs= 0.188, p= 0.013). HOMA-IR positively correlated with apoA-1/HDL-c ratios (rs= 0.190, p= 0.016) and negatively correlated with the CETP/TG ratios (rs= -0.162, p= 0.04). Results of general linear model analysis showed that serum hsCRP concentration had the highest contribution to CETP/HDL-c ratios, apoA-1, dan CETP (p= 0.009; 0.016; 0.054, respectively).Conclusions Inflammation and insulin resistance related to dysfunction of HDL biogenesis in men with metabolic syndrome. The inflammation correlated with increased HDL catabolism, whereas the insulin resistance correlated with decreased HDL maturation and increased HDL catabolism. These may lead to low HDL-c concentration. Inflammation had higher contribution to HDL biogenesis factors than insulin resistance. (Med J Indones 2010; 19:36-45)Keywords: hsCRP, HOMA-IR, apoA-1, prebeta-1 HDL, CETP, HDL-c and metabolic syndrome
Prevention of endothelial dysfunction in streptozotocin-induced diabetic rats by Sargassum echinocarpum extract
Medical Journal of Indonesia Vol. 19 No. 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v19i1.382

Abstract

Aim This study aimed to elicit the protective effect of Sargassum echinocarpum extract on endothelial dysfunction in thoracic aorta of streptozotocin-induced diabetic rats. Methods The animals were divided into 5 groups. The first was normal, the second was diabetic non treated animals. The third to fifth groups were the diabetic animals which given Sargassum echinocarpum extract (150; 300, and 450 mg kg-1 body weight, respectively) by oral gavage and extract treatment was given for 12 weeks. Diabetes was induced by single administration of streptozotocin (45 mg kg-1, i.p.), dissolved in freshly prepared 0.1 M citrate buffer, pH 4.5. Diabetes was confirmed ten days latter in streptozotocin induced animals showing blood glucose levels > 200 mg dL-1 (11.1 mmol L-1) as monitored in the blood from tail vein using glucometer. After the treatment period, the blood serum acquired was used for antioxidant enzymes assays and the thoracic aorta was used for vasorelaxation assay. Results There was a significant decrease in the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-px) in diabetic rats (3.31 ± 0.12;67.17 ± 0.62;35.10 ± 0.83) comaped to control rats (9.97 ± 0.12;185.31 ± 0.23;116.38 ± 0.88). Administration of Sargassum extract increased the activity of SOD, CAT, and GSH-px. The diabetic rats exhibit endothelial dysfunction as shown by loss of vasodilatory response to acethylcholine (ACH). This was restored by administration of Sargassum extract. Conclusion Sargassum echinocarpum extract ameliorates oxidative stress and reverses the endothelial dysfunction associated with diabetes. This effect appears to be due to its antioxidant properties. (Med J Indones 2010; 19:32-5) Keywords: oxidative stress, sargassum echinocarpum, endothelium dependent relaxation, thoracic aorta

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