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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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Epinephrine in the tumescent technique for hypospadia surgery
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.495

Abstract

The use of tumescent technique, which contains epinephrine, in penile surgery has not been reported previously. Two patients with hypospadias had reconstructive operation using tumescent technique with a "One-per-Mil" tumescent solution containing epinephrine intra-operatively. The results was a clear operation field, almost bloodless during dissection, and no complication on the penis after epinephrine injection with minimal edema. Apparently, the "One-per-Mil" tumescent solution acts as a natural hydro-dissector creating avascular anatomic tissue planes for easier and more rapid dissection in surgery for hypospadias. We suggest that epinephrine is safe to be injected in penis as a future area of clinical practice. (Med J Indones. 2012;21:175-8)
Parathyroid carcinoma: review of a problematic case
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.496

Abstract

Parathyroid carcinoma (PTCA) is a rare neoplasm that accounts for less than 1% of primary hyperparathyroidism cases. Several clinical and biochemical features can directing to PTCA, but accurate pre and intraoperative diagnosis are still difficult. This study presents a case of PTCA that diagnosed postoperatively with a discussion of microscopic feature. The surgical exploration revealed an enlarged parathyroid mass which invade recurrent laryngeal nerve and right thyroid gland. Histologic features showed tumor nodules separated by thick fibrous band with capsular invasion and local infiltration to adjacent tissues. The final diagnosis of PTCA was made based on clinical feature and specimens examination. (Med J Indones. 2012;21:170-4)
Improving the probability of pregnancy in endometriosis cases: a study in patients undergoing in vitro fertilization
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.497

Abstract

Background: Endometriosis is the most common condition underlying infertility in women. To increase the rate of pregnancy in women with endometriosis, embryo selection is performed during in vitro fertilization. This study aims to prove the effectiveness of embryo selection on the rate of pregnancy in a hospital in Jakarta. Methods: This is a cross sectional clinical epidemiology study, performed on endometriosis patients who visited the hospital between 2007-2009. Patients were diagnosed with endometriosis using the laparoscopy technique. Embryo selection was performed by assessing the morphology and cell count. Results: We were able to collect data from 72 subjects who underwent IVF during this research period. One subject was dropped out of the program due to immaturity of the oocyte. Successful fertilization was achieved for 65 subjects, but two of them did not undergo embryo transfer. Out of all the subjects undergoing embryo transfer, 26 subjects successfully became pregnant (36.1%). In severe endometriosis cases, pregnancy was achieved with excellent quality embryos (50%) and good-moderate quality embryos (16.7%); but the probability of failure to become pregnant was found to be the same (50%). In mild-moderate endometriosis cases, the probability of pregnancy with excellent quality embryos was 39% compared to 25% chance with good-moderate quality embryos. Regarding the number of embryos that were transferred, we have found that the probability of pregnancy was 50% higher when 3 embryos were transferred, compared to 1 or 2 transferred embryos. Conclusion: This study shows that embryo quality and the number of transferred embryos are relevant to increase the probability of pregnancy in patients undergoing IVF. But because the probability of not achieving pregnancy is not significantly different, we need to find another marker that is more sensitive to assess the quality of embryo transfer. (Med J Indones. 2012;21:147-51)
Prognostic factors of neuroinflammation and oxidative stress in brain injury patients at Cipto Mangunkusumo Hospital Jakarta
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.499

Abstract

Background: This study aims to determine the association between neuroinflammation and oxidative stress with prognosis of brain injury patients and the association between neurosurgical procedure with neuroinflammation and oxidative stress condititons. Methods: The study design is a prospective observation of 40 brain injury patients who underwent surgery. IL-6, uric acid, MDA, NR2A antibodies and GSH serum level of pre- and 1 day post-operation on brain injury patients were measured, and their association with GCS, GOS and neurosurgical procedures were analyzed. Results: The post-operative IL-6 serum level showed a downward trend compared to pre-operative value (mean decrease: -190.61 pg/mL). The post-operative IL-6 level was significantly associated with GCS 7 days post-operation (p = 0.006), with OR 24. The post-operative IL-6 serum level was significantly associated with GOS 3 months post-trauma (p = 0.016) with OR 11.6. The post-operative uric acid serum level showed a downward trend compared to pre-operative value (mean decrease: -0.26 mg/dL). There was a significant difference between the mean value of post-operative uric acid serum level in patients with 7 days post-trauma with GCS ≤ 8 (mean: 4.16 mg/dL) and GCS > 8 (mean: 2.71 mg/dL), (p = 0.042). The post-operative MDA serum level showed a downward trend compared to pre-operative value (mean decrease: -0.08 nmol/mL). There is no significant association between MDA serum level, GCS and GOS and no significant association of NR2A antibody and GSH serum level with GCS, GOS and neurosurgical procedure. From the multivariate analysis, the most important neuroinflammatory variable associated with GCS and GOS is IL-6. Conclusion: Neuroinflammation and oxidative stress may have prognostic values in brain-injured patients, in particular IL-6. Neurosurgical procedures may decrease the neuroinflammation process (Med J Indones. 2012;21:152-9)
Correlation of zinc plasma and IgM anti-PGL-1 levels among close contact of leprosy
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.500

Abstract

Background: Previous study showed leprosy patients have low zinc status. Yet the status of zinc in close-contact, which indicated by IgM anti-PGL1 level, have not determined. The aim of the study was to determine the association of zinc plasma and IgM anti-PGL-1 levels among close contact of leprosy patients in Indonesia. Methods: This was an observational study. Subjects were 186 close-contact leprosy patients. Measurement of zinc plasma status used atomic absorption spectrophotometer while examination of IgM anti-PGL1 level used ELISA (Polyclonal rabbit anti human IgM/HRP/(Dako®). Results: The average level of IgM anti-PGL1 and zinc plasma were 804 unit/mL (± 439.4) and 16.6 μmol/L (± 3.5) consecutively. There was significant correlation between zinc plasma and IgM anti-PGL1 (r = - 0.230; p = 0.002). Conclusion: There is a significant correlation between zinc plasma and IgM anti-PGL1 in close contact of leprosy (Med J Indones. 2012;21:166-9)
Distribution of D543N NRAMP1 polymorphism in tuberculosis patients from Kupang, east region of Indonesia
Medical Journal of Indonesia Vol. 21 No. 3 (2012): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i3.501

Abstract

Background: Natural resistance associated macrophage protein (NRAMP) is a proton/ divalent cation transporter which play a role in iron trafficking in the phagosomes. Variations in NRAMP1 gene have been reported to be associated with susceptibility to tuberculosis (TB) because Mycobacterium tuberculosis (MTb), the causative agent of TB, compete with its host to uptake iron for its metabolism. The study aimed to describe the polymorphism of NRAMP among TB patients in Kupang, East Nusa Tenggara. Methods: This is a case-control study, cases were pulmonary TB, new patients, aged 15-55 years with sputum smear positive for acid fast bacili. Control were surrounding neighbours without symptoms and history of TB. All demographic information and blood sample were taken for polymorphism. PCR/RFLP method was performed to explore whether single nucleotide polymorphism D543N of NRAMP1 gene is associated with susceptibility to TB. Results: The study involved 64 pulmonary TB patients and 51 healthy controls. We observed a significant different in the distribution of NRAMP1 genotypes frequencies between TB patients and healthy controls (p = 0.014). Moreover, D543N polymorphism gave significant association only in male subjects. Though the numbers of the subjects are limited, D543N NRAMP1 polymorphism in endemic region in Kupang, the eastern part of Indonesia, seems to be associated with the susceptibility to TB. This is in contrary to studies reported in other part of Indonesia: i.e from west part (Jakarta, Bandung) and central part (Makassar). The population from Kupang may similar genetic background as African population, as Mycobacterium infected in population from Kupang is mostly Mycobacterium africanum. Increasing the number of subjects may enhance the power of the study and possibility to meet Hardy-Weinberg Equilibrium to detect the true associations of this polymorphism in susceptibility to TB. Conclusion: There was a significant difference of polymorphism NRAMP1 which more pronounced among male subjects, however this has not yet fulfilled the Hardy-Weinberg equilibrium. (Med J Indones. 2012;21:160-5)
Evaluating the use of loop-mediated isothermal amplification (LAMP) method for detection of Mycobacterium tuberculosis in Indonesian clinical isolates
Medical Journal of Indonesia Vol. 21 No. 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i4.502

Abstract

Background: Loop-mediated isothermal amplification (LAMP) is a method already claimed as a simple technique to amplify DNA/ RNA using four to six primers as "a set" from conserved sequence of target gene. In this study we optimize the use of LAMP for detection of Mycobacterium tuberculosis in clinical isolates from Indonesia. Methods: Procedures to perform LAMP were optimized, then the method was applied to 122 archieved samples of DNA'™s Mtb from clinical TB patients with Acid Fast Bacilli (AFB) smears positive. The samples were obtained in 2008 from 13 provinces in Indonesia for genotyping study, which then become collections of Center for Biomedical and Basic Technology of Health (CBBTH), NIHRD Indonesia. The optimization tests include sensitivity and specificity tests of several sets primers, which were evaluated using 10-fold serially diluted DNA of Mtb H37Rv and 12 species of Mycobacteria. Three equipments consisted of LAMP turbidimeter, heating block and water bath were compared for its ability in DNA amplification. Detection of M. tuberculosis from clinical isolates used set primers specific for gyrB gene, amplicon was detected with UV fluorescence system. Results: The results showed that the highest sensitivity was obtained using the set primers specific for 16S rRNA and gyrB which could detect 10.0 fg to 1.0 pg genomic DNA of Mtb H37Rv. The set primers specific for gyrB gene was the most specific primers. Application of LAMP using gyrB set primers on Indonesian clinical isolates showed 94.2% (114/121) positivity rate. Conclusion: LAMP method is potentially used in TB diagnosis in Indonesia. (Med J Indones. 2012;21:188-95)
p53 expression in synovial sarcoma and its association with prognostic factors
Medical Journal of Indonesia Vol. 21 No. 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i4.503

Abstract

Background: Synovial sarcoma is an aggressive tumor and has two common histological subtype, biphasic and monophasic. It has SYT-SSX gene fusion that decreases expression of p53 tumor suppressor. The prognosis is associated with mitosis and tumor diameter. Therefore this study conducted to know the pattern of p53 expresion and its association with mitosis, histological subtype, and other prognosis factors. Methods: Twenty synovial sarcoma cases consisted of 4 monophasic and 16 biphasic cases from Cipto Mangunkusumo Hospital-Faculty of Medicine, Universitas Indonesia (CMHospital-FMUI) 2005-2011 were analyzed for association of p53 expression and mitosis as prognostic factor. Haematoxylin-eosin slides were used to count mitosis. Paraffin block materials were used to analyze p53 expression by immunohistochemistry and to detect SYT gene translocation by FISH (Fluorescein in situ Hybridization). Results: The Fisher'™s exact test showed that positive p53 expression was associated with tumor diameter <5 cm although it was not associated with mitosis. The histological subtype has no association with p53 expression and mitosis. Unfortunately, only 7/19 cases were positive for FISH-SYT gene translocation. Conclusion: In synovial sarcoma, p53 expression is associated with tumor diameter. (Med J Indones. 2012;21:196-202)
Serum and urinary neutrophil gelatinase-associated lipocalin as a predictor of rat kidney histopathology in an early ischemia-reperfusion model
Medical Journal of Indonesia Vol. 21 No. 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i4.504

Abstract

Background: The severity of ischemia-reperfusion (I/R) kidney injury is highly correlated with mortality and morbidity rate. Research on human and animal prove that NGAL predicts kidney injury at early phase. The objective of this study is to prove that the increase in serum and urinary NGAL are correlated with kidney tubular epithelial damage, and this increase has occurred in initiation phase, indicated by rat kidney histopathology in an early I/R model. Methods: Twenty eight male Sprague-Dawley rats were divided into 4 groups: 4 hour sham (Sham 4), 8 hour sham (Sham 8), 10 minute ischemia 4 hour reperfusion (I/R 4) and 10 minute ischemia 8 hour reperfusion (I/R 8). Blood, urine and kidney samples were collected. Serum creatinine level was analyzed with Jaffe method, while serum and urinary NGAL level were analyzed with direct sandwich ELISA method. Evaluation of kidney damage were measured semi quantitatively in tissue stained with HE. Further evaluation to confirm cellular changes on kidney was performed by electron microscope and immunohistochemistry. Results: Serum NGAL was found significantly correlated with degree of kidney tissue damage (ρSpearman NGAL serum = 0.701, p < 0.001), also urinary NGAL (ρSpearman = 0.689, p < 0.001). NGAL expression differs significantly between I/R group and sham (t-test, t = -26635.056, p < 0.001), also kidney damage (t-test, t = -5.028, p < 0.001), and serum and urinary NGAL levels (Mann-Whitney, U = 0, p < 0.001). With cutoff points of 136.95 ng/mL and 58.69 ng/mL subsequently for serum and urinary NGAL , it is found that sensitivity = 1, specificity = 1. Conclusion: Elevation of serum and urinary NGAL are significantly correlated with epithelial tubular kidney damage on rat undergoing early ischaemia reperfusion. (Med J Indones. 2012;21:208-13)
The use of lower formalin-containing embalming solution for anatomy cadaver preparation
Medical Journal of Indonesia Vol. 21 No. 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v21i4.505

Abstract

Background: We used cadaver embalming technique with a high concentration of formaldehyde (37% formaldehyde). However, it gives toxic effects which can endanger the technicians, lecturers and students. For that reason, the effective, efficient and safer embalming process is needed; in this article we describe the use of low formalin solution (5-7.5% formaldehyde) to achieve prior purposes. Methods: Cadaver is embalmed by actively pumping low formalin-containing solution (5-7.5%) via femoral arteries. Further methods are detailed in this manuscript. Results: Paler cadaver with more intact and easier to dissect specimen (drier and still moist with no fungal growth) was resulted by using this low formalin technique. Conclusion: The use of low formalin-containing solution in cadaver embalming gave good quality results for anatomy teaching. (Med J Indones. 2012;21:203-7)

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