Indonesian Journal of Obstetrics and Gynecology (INAJOG)
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Comparison of Estrogen β Receptor Expression and the Addition of Various Dose of Geistein to HUVEC Endothel Cell which Exposed to Oxidative Stress
Get PDFObjective: To compare β estrogen receptor on HUVEC endothelial
for each Genistein dose addition with β-estradiol physiologic
dose.
Methode: Experimental study performed in Physiology Laboratorium,
Medical Faculty of Brawijaya University Malang, HUVEC
culture exposed by glucose as a dysfunction endothelial model. Endothel collected from female newborn umbilicus was cultured to
make a confluent culture. The culture was divided into 7 groups: 1.
HUVEC without treatment, 2. HUVEC + glucose 33 mM, 3. HUVEC
+ glucose 33 mM + 17β estradiol , 4. HUVEC + glucose 33
mM+ Genistein 2.5 μm. 5. HUVEC + Glucose 33 mM + Genistein
5 μm, 6. HUVEC + Glucose 33 mM + Genistein 7,5 μm, 7. HUVEC
+ Glucose 33 mM + Genistein 10 μm. Culture then was incubated
in 37°C and stained with immunohistochemistry, using primary antibody of β estrogen receptor. The expression was observed on the
-15, 30, 60, 120 and 240th minute. The datas from observation result was analysed with ANOVA test and correlation test.
Result: Estrogen receptor comparison between group 1 was significantly different with group 2, 3, 6, 7 and not significantly different with groups 4, 5. Estrogen receptor between group 2 was significantly different with group 4, 5 but not significantly different
with groups 3, 6, 7. Estrogen receptor comparison between group 3
was significantly different with group 4, 5 and not significantly different with groups 6, 7. Estrogen receptor comparison between
group 4 was significantly different with group 6, 7 and not significantly different with groups 5. Estrogen receptor comparison between group 5 was significantly different with group 6, 7. Estrogen
receptor comparison between group 6 was not significantly different
with group 7. Isoflavon Genistein dose increase on 30, 60 dan 120
minutes will reduce β estrogen receptor expression on endothelial
HUVEC and on 15 and 240 minutes shows that there was no significant correlation with β estrogen receptor expression on endothel
HUVEC.
Conclusion: There was significant expression distinction of ERβ
in glucose induced HUVEC exposed by 17β estradiol compared with
those exposed by Genistein but not in Genistein dose 7.5 and 10 μm.
The lower of Isoflavon Genistein dose in the -30, 60 dan 120 minute
will cause expression of β estrogen receptor in HUVEC endothelial
cell that tends to be higher.
[Indones J Obstet Gynecol 2010; 34-1:24-30]
Keywords: β estrogen receptor, HUVEC, genistein, estradiol
High Calcium and Vitamin D Fortified in Enhancing Postmenapausal Bone Turnover
Get PDFObjective: To compare the effect of consuming vitamin D fortified
high calcium milk (HCM) with placebo milk supplementation’s
effect to bone formation and resorption’s marker to post-menopausal
women in Jakarta, Indonesia, in four months duration.
Methods: This is a double blind randomized control trial to
know the effect of high calcium (1200 mg/day) milk consumption
compared to low calcium milk consumption to the change of bone
turnover’s chemical marker in post-menopausal women in Indonesia.
Participants are women aged more than 55 years, which are patients
of Yasmin Menopause and Osteoporosis Clinic, RSCM. Subject
of study is classified into two groups, the first group was given
two portion (60 g) of high calcium milk (HCM), and other group as
control was given two portion (60 g) of low calcium milk, each day
for 16 weeks. A comparison between the level of bone markers (CTelopeptide (CTX), Peptide Procollagen-I (P1NP), Osteocalcin
(OC)) in week 0, 2, 8 and 16 was done. Post intervention, the result
was statistically calculated with ANOVA and the mean result comparison to subject was analyzed with Tukey-Kramer test.
Results: There are no significant differences between two
groups on age, Body Mass Index (BMI), Bone Mineral Density
(BMD) and calcium intake characteristics. There is CTX (CTelopeptide)
reduce to 34% in two weeks of supplementation to HCM group cohort. OC (Osteocalcin) was also reduced in 16 weeks supplementation to subject group, reduced to 10% on week 2, 18%
on week 8, and 32% on week 16. Peptide Procollagen-I (P1NP) was
reduced to 15% on week 8, and 28% on week 16 in subject group.
High calcium and vitamin D fortified milk that was used, is proven
could improve vitamin D state, reduce PTH level and reduce bone
turnover significantly.
Conclusion: High calcium and vitamin D fortified milk supplementation
gives better result compared to low calcium milk supplementation
in reducing bone turnover in post-menopausal women.
[Indones J Obstet Gynecol 2010; 34-1:31-8]
Keywords: post-menopausal women, high calcium and vitamin
D fortified milk, C-Telopeptide, Peptide Procollagen-I, Osteocalcin,
vitamin D stat
Correlations of Chronic Periodontitis with Preeclampsia and Fetal Birth Weight
Get PDFObjective: Preeclampsia is the main cause of maternal and perinatal mortality and morbidity one of which low birth weight. The cause of preeclampsia is multifactorial, and one of them is infection. High periodontal incidence is found in preeclampsia patients. This study is intended to find correlations between chronic periodontitis with preeclampsia and fetal birth weight.
Method: The study was held in RS Dr. Hasan Sadikin Bandung, RSUD Astana Anyar and RSUD Ujung Berung in December 2010 - February 2011 using case-control study design in two groups,with 26 subjects in each group. The subjects were recorded on age, parity, gestational age, diagnosis, fetal birth weight, and periodontal status. Statistical analysis were performed using chi square test and Rank Spearman’s correlation test.
Result: The characteristics of study subjects in both groups
show no significant difference (p > 0.05). In the preeclampsia group, periodontitis incidence is higher which is 19 (73.08%) compared to control group which is 12 (46.15%). Based on chi square method, there is a significant correlation between periodontitis and preeclampsia with odds ratio value of 3.17 (p = 0.048; p < 0.05; 95%CI (1.19 - 8.41). Based on Rank-Spearman correlation test, there is a moderate negative correlation between periodontitis severity and with fetal birth weight with rs value of = - 0.423 and a p value of 0.002.
Conclusion: Chronic periodontitis incidence is higher in preeclampsia group compared to control group. There’s a moderate negative correlation on periodontitis severity with fetal birth weight. The more severe the periodontitis, the lower the fetal birth weight.
[Indones J Obstet Gynecol 2011; 35-3: 105-9]
Keywords: periodontitis, preeclampsia, fetal birth weigh
Levonorgestrel Concentration in a Single Rod Implant Users for Six Months
Get PDFObjective: This research was conducted to measure levonorgestrel serum concentration Monoplant® after six months of usage.
Method: Thirty healthy women, 20 - 40 years old, and after been proven for fertility, had implants on their body. Levonorgestrel serum levels were measured monthly from the first month to the sixth month.
Result: Levonorgestrel serum concentration was still above 200 pg/ml until the sixth month. First month and second month serum concentration was not recorded while data for the following months were 338.9 pg/ml, 424.8 pg/ml, 320.3 pg/ml, and 337.5 pg/ml.
Conclusion: Levonorgestrel serum concentration in Monoplant® users was still above contraceptive level until six months.
[Indones J Obstet Gynecol 2011; 35-3: 122-7]
Keywords: single rod implant Monoplant®, levonorgestrel serum concentratio
Vitamin C Level in Pregnant Women with Premature Rupture of the Membrane (PROM) and in Women with Normal Pregnancy
Get PDFObjective: To compare vitamin C level in term pregnant women with PROM and in women with normal pregnancy.
Method: This is a cross sectional study, research from July 2010 until June 2011. Inclusion criteria are full term pregnant women with and without PROM. After the diagnosis is confirmed as PROM, mothers blood was taken from mediana cubiti venous to check the vitamin C level and leucocytes in mothers serum. Pregnancy with complication is the exclusion criteria.
Result: There were 52 subjects that fulfilled the acceptance and rejection criteria after divided into 2 groups, the 1st group was with PROM and the 2nd groups were normal. Based on the laboratory examinations,
the mean of vitamin C levels in PROM groups is 0.731
± 0.182 μg/dl and the normal groups is 0.722 ± 0.169 μg/dl, there is no significant difference (p=0.852). Leucocyte examination was done to know whether there was infection or not. The mean value from the PROM groups is 14330.77 ± 6552.90 μg/dl. And from the
normal groups is 12973.08 ± 4160.24 μg/dl, there is significant difference (p=0.377).
Conclusion: There is no significant difference of Vitamin C
level between maternal plasma with PROM and the one without
PROM.
[Indones J Obstet Gynecol 2011; 35-4:173-5]
Keywords: PROM, normal pregnancy, vitamin
Manual Reposition of Uterine Inversion with Hemorrhagic Shock in Minimal Facilities Situation
Get PDFObjective: Reporting management of acute uterine inversion with hemorrhagic shock in minimal facilities situation.
Method: Case report.
Results: Manual reposition in acute uterine inversion was a lifesaving treatment. The decision to do manual reposition with minimal sedation and without any tocolytic could be done in this case, due to minimal facilities situation where there is no operating theater available for ideal uterine reposition.
Conclusion: Uterine inversion can be promptly recognized in the third stage of parturition. Manual manipulation aided by tocolytic with or without anesthetic agents is often successful in correcting the inversion. Shock condition that accompanied the inversion must be vigorously treated, as it would lead to serious maternal morbidity and mortality. Management of acute uterine inversion seems to be depended on the clinical situation and clinical judgment which is very important in every emergency case.
[Indones J Obstet Gynecol 2012; 36-1:48-51]
Keywords: hemorrhagic shock, manual reposition, minimal facilities situation, obstetric complications, uterine inversio
The Outcome on Conservative Surgical Treatment of Adenomyosis
Get PDFObjective: To understand the outcome on conservative surgical
treatment of adenomyosis.
Methods: A retrospective cohort study followed for 2 years from
2010 to 2012 of women with adenomyosis were diagnosed by
transvaginal sonography and confirmed histologically. Subjects divided
into women who were treated by adenomyosis resection
(with/without Osada’s technique) and who were underwent hysterectomy.
Results: After the surgery, as many as 40 patients (81.63%) did not
feel any pain (VAS 0), and 9 patients (18.37%) still felt pain. For the
fertility outcome, we had 8 patients (20.51%) getting pregnant naturally
without any fertility intervention. Two patients (5.13%) had
successfully conceived by IVF. According to the type of surgery, from
8 natural pregnancy, 7 patients (87.50%) was underwent conventional
resection of adenomyosis and 1 patients (12.50%) underwent
Osada’s procedures. Two patients who were conceived by IVF, both
of them were underwent Osada’s resection.
Conclusion: Adenomyosis resection both conservative or Osada’s
procedures actually has a better outcome for relieving pain; therefore,
some patients can still have a child.
Keywords: adenomyosis resection, conventional resection, infertility,
Osada’s procedur
Epidemiology Data of Ovarian Cancer in Dr. Cipto Mangunkusumo Hospital, Jakarta
Get PDFObjective: To describe the incidence of ovarian cancer and its characteristic
in Dr. Cipto Mangunkusumo Hospital in the last 5 years.
Method: This was cross sectional study design. The data was collected
from Gynecology Oncology Division Cancer Registry and Dr.
Cipto Mangunkusumo Hospital medical record from January 2009 to
December 2013; follow up was performed to know the 4-years survival
rate.
Result: There were 98 subjects in this study. The majority incidence
of ovarian cancer was 45-54 years old (33.6%); the incidence of
ovarian cancer decreased with the increased number of parity; the
majority histotype was epithelial (76.5%); and most of them were
diagnosed on advanced stage (55.1%). The 4-year survival rate for
epithelial type was 77%; germinal type was 83.3%; and stromal type
was 100%. Based on therapy, the 4-year survival rate was 84.1% for
surgical only; 83.3% in adjuvant chemotherapy group; and 68.4% in
neoadjuvant chemotherapy. In the group of adjuvant chemotherapy,
there was 63% patients with complete response and 41.2% patients
with complete response in neoadjuvant chemotherapy.
Conclusion: The highest incidence of ovarian cancer in Dr. Cipto
Mangunkusumo Hospital belongs to the age of reproductive women
(≤ 55 years old) with the highest incidence occurs in nulliparity women.
Most of the ovarian cancer cases are diagnosed in advanced
stage (stage III-IV).
[Indones J Obstet Gynecol 2016; 4-2: 101-106]
Keywords: age, histotype, ovarian cancer, parity, response, stage,
survival, treatmen
Efektivitas Tes Pap pada Tes IVA Positif sebagai Usaha Penapisan Dua Tahap dalam Skrining Kanker Serviks
Get PDFTujuan: Mengetahui efektivitas (sensitivitas dan spesifisitas) tes pap
pada tes IVA positif sebagai usaha penapisan dua tahap dalam skrining
kanker serviks.
Bahan dan cara kerja: Uji diagnostik dengan baku emas histopatologi.
Merupakan studi deskriptif, desain penelitian potong lintang.
Populasi penelitian adalah wanita seksual aktif berusia berusia 25 - 45
tahun, de-ngan kriteria eksklusi: (1) penampakan serviks mencurigai
suatu kega-nasan atau memperlihatkan infeksi; (2) pada pemeriksaan tidak
dapat dikenali daerah SSK; (3) dan sudah menjalani pengobatan
atau tindakan pada serviks atau rahim. Dalam kurun waktu bulan Oktober
2004 hingga Maret 2005 dilakukan tes IVA di puskesmas/balkesmas
oleh bidan yang telah mendapatkan pelatihan IVA. Wanita dengan
tes IVA positif dilakukan pemeriksaan lebih lanjut di poliklinik kolposkopi
Departemen Obstetri Ginekologi FKUI-RSCM yakni tes pap dan
kolposkopi, serta biopsi bila ditemukan lesi. Pengolahan dan pembacaan
sediaan pap dan biopsi dilakukan di laboratorium Sitologi dan Patologi
Obstetri dan Ginekologi FKUI RSCM.
Hasil: Telah dilakukan pemeriksaan IVA terhadap 1156 wanita, 1 orang
tidak dimasukkan ke dalam sampel penelitian karena secara makroskopik
didiagnosis sebagai kanker serviks stadium IIA. Dari 1155 didapatkan IVA
negatif 1057 sampel dan IVA positif 98 sampel. Angka positif palsu tes IVA
yang dilakukan Bidan sebesar 50%. Sensitivitas pemeriksaan serial dua tahap
IVA-Pap berdasarkan histopatologi yang dikelompokkan atas ada/tidaknya
lesi intraepitel skuamosa (LIS) adalah 22,45% dan 8,16%, dan
spesifisitasnya adalah 93,88% dan 100%. Sedangkan bila hasil histopatologi
dikelompokkan atas ada tidaknya lesi intraepitel skuamosa derajat
tinggi (LISDT) maka sensitivitasnya adalah 50% dan 25% dan spesifisitasnya
adalah 87,23% dan 96,81%. Faktor-faktor risiko yang mempunyai
hubungan bermakna dengan temuan lesi prakanker serviks (histopatologi
LISDR/LISDT) pada penelitian ini adalah adalah usia saat hubungan seks
pertama kali di bawah 20 tahun, menikah lebih dari 1 kali, pengguna kontrasepsi
pil, keputihan, merokok, dan wanita PSK.
Kesimpulan: Efektivitas pemeriksaan serial dua tahap IVA-Pap lebih
baik daripada pemeriksaan satu tahap, dalam hal spesifisitas dan
menurunnya angka positif palsu. Rendahnya sensitivitas tes pap pada
kasus IVA positif perlu penelitian lebih lanjut, salah satu kemungkinan
adalah karena semua lesi pada penelitian ini adalah lesi-lesi kecil (<
10% area SSK), yang mengakibatkan tingginya angka negatif palsu tes
pap. Spesifisitas pemeriksaan dua tahap IVA-Pap sangat baik, sehingga
bila sensitivitas pemeriksaan serial ini diperbaiki maka dapat digunakan
sebagai alternatif penyaring kasus-kasus lesi prakanker yang akan dikirim/
dirujuk untuk tindak lanjut.
{Maj Obstet Ginekol Indone 2006; 30-3: 164-74]
Kata kunci: tes IVA (Inspeksi Visual dengan Asam Asetat), tes pap,
histopatologi, efektivitas, sensitivitas, spesifisitas
Translokasi AKDR ke dalam Vesika Urinaria Disertai dengan Vesikolithiasis (Laporan Kasus)
Get PDFTujuan: Melaporkan satu kasus translokasi alat kontrasepsi dalam
rahim (AKDR) ke dalam vesika urinaria disertai dengan pembentukan
batu intravesika.
Tempat: Klinik Kesehatan Reproduksi Raden Saleh Jakarta, Departemen
Obstetri dan Ginekologi FKUI/RSCM, Jakarta dan Kamar
Operasi Khusus Departemen Urologi FKUI/RSCM, Jakarta.
Bahan dan cara kerja: Laporan satu kasus, seorang wanita, 43 tahun,
P4A1 dengan translokasi AKDR ke dalam vesika urinaria selama
10 tahun disertai dengan pembentukan batu vesika.
Hasil: Pasien dirujuk oleh SpOG dengan keterangan translokasi
AKDR, disertai keluhan nyeri saat buang air kecil sejak 3 tahun lalu.
Pasien memiliki riwayat dipasang AKDR 10 tahun lalu. Delapan bulan
pasca pemasangan AKDR, uji kehamilan positif dan ia menjalani induksi
haid dan mendapatkan pemasangan AKDR kedua. Saat itu tidak
ditemukan AKDR pertama. AKDR kedua telah dilepaskan 2 tahun yang
lalu. Dari pemeriksaan ultrasonografi tidak didapatkan AKDR intrauterin.
Pemeriksaan foto polos abdomen menunjukkan AKDR di pelvis
minor, 10 cm di anterior promontorium dengan bayangan massa kalsifikasi.
Foto polos pelvis dengan marker menunjukkan AKDR kedua terletak
agak jauh dari AKDR pertama, yang overlapping dengan bayangan
kalsifikasi. Eksplorasi per laparoskopi tidak menemukan AKDR di
rongga pelvis. Dari pemeriksaan sistoskopi tampak AKDR intravesika
yang diselubungi batu. Pasien menjalani litotripsi dan pengambilan
AKDR intravesika dengan sistoskopi. Pasien dirawat selama satu hari
dan pulang dalam keadaan baik.
Kesimpulan: Translokasi AKDR ke dalam vesika merupakan hal
yang jarang dijumpai. AKDR dalam vesika menjadi sarang infeksi dan
proses pembentukan batu. Adanya AKDR intravesika haruslah dipikirkan
jika seorang wanita dengan riwayat pemasangan AKDR mengalami
infeksi saluran kemih berulang dan/atau pembentukan batu vesika.
AKDR intravesika dapat dikeluarkan dengan sistotomi suprapubik atau
sistoskopi.
[Maj Obstet Ginekol Indones 2006; 30-3: 186-90]
Kata kunci: translokasi AKDR, AKDR intravesika, batu vesik