Majalah Kedokteran Andalas
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THE EFFICACY OF BARE SCLERA AND MULTILAYER AMNIOTIC MEMBRANE TRANSPLANTATION (MLAMT) FOR RECURRENT MOOREN’S ULCER
Get PDFAbstrak“Mooren’s Ulcer†adalah ulkus kornea yang bersifat progresif, nyeri, sering berulang sedangkan penyebabnya tidak diketahui. Pada tulisan ini dilaporkan kegunaan tindakan operasi “Bare Sclera conjunctival resection†dengan pemasangan MLAMT pada ulkus Mooren yang diikuti dengan penutupan mata selama 3 hari berturut turut. Pada pasien ini dikerjakan 3 kali operasi yang sama. Kasus adalah seorang wanita berumur 45 tahun dengan Ulkus Mooren yang sudah berulang di pinggir kornea didaerah flap konyungtifa pada mata kanannya sedangkan mata kiri dengan “pthysis bulbiâ€. Visus mata kanan 20/25, mata kiri Nol, pemeriksaan laboratorium normal, saat ini pasien menolak untuk dilakukan operasi. Pasien datang 1 bulan kemudian dengan keadaan yang lebih buruk, dan setuju dioperasi, dilakukan Partial Bare Sclera conjunctival resection dengan MLAMT, pada hari kesembilan setelah operasi sudah terjadi epitelisasi komplit. Empat bulan kemudian ulkus korneanya meluas keparasentral dan superior kornea yang cendrung perforasi, dilakukan operasi kedua dengan tehnik yng sama. Ternyata epitelisasi kornea baru komplit pada hari ketigabelas. Hal yang sangat jelek adalah ditemukan lagi ulkus baru dibagian bawah kornea, sehingga diputuskan untuk langsung melakukan Total Bare Sclera conjunctival resection dan MLAMT, Epitelisasi komplit pada ulkus terjadi pada hari kesembilan. Pengobatan setelah operasi antibiotik tetes mata dan kortikosteroid secara sistemik. Visus mata kanan saat ini 20/40. Dapat disimpulkan bahwa Ulkus Mooren merupakan ulkus kornea yang progresif, dengan transplantasi membrane Amnion dan Bare Sclera dapat memperlama munculnya rekurensi tapi tidak menyembuhkannya.Kata kunci: MLAMT, Bare Sclera, Mooren’s ulcerAbstractMooren’s Ulcer is a progressive, pain corneal disease, which is difficult to be treated with unknown etiology. This Interventional Case Report is aimed at reporting the efficacy of Bare Sclera and (MLAMT) with three days patching for recurrent Mooren’s Ulcer.LAPORAN KASUS84We performed three times Bare Sclera conjunctiva resection with MLAMT on one case of recurrent Mooren’s ulcer. Fourty five years old female with Recurrent Mooren’s ulcer on the right eye, at margin of the conjunctival flap and pthysis bulbi on the left eye. Visual acuity (VA) on the right eye was 20/25. Normal laboratory examinations. In this condition she did not agree for operation. One month later, with worse condition, and we performed partial Bare Sclera with MLAMT. After surgery, the epithelialization was completes on the ninth day. Four months later, the active ulcer was extended to paracentral and superior cornea with impending perforatian. We did second surgery, partial Bare Sclera with MLAMT. After surgery, the epithelialization was completes on the thirteenth day. Unfortunately, we found the new ulcer on the inferior cornea, and then we decided to perform the third surgery, total Bare Sclera and MLAMT, the epithelialization was completes on the ninth day. Post operation, topical antibiotic and systemic corticosteroid. The VA on the right eye was 20/40.We conclude that, Mooren’s ulcer is a progressive corneal disease. Although only one case being reported, MLAMT can reduce the recurrence duration of Mooren’s ulcer, but cannot stop the progressivity. MLAMT could be performed more than once. Total conjunctiva resection can make epithelialization significantly faster than partial resection.Keywords: MLAMT, Bare Sclera, Mooren’s ulce
PENGGUNAAN IV KATETER PADA PENATALAKSAAN EMFISEMA SUBKUTIS
Get PDFAbstrakDilaporkan seorang wanita usia 24 tahun di rujuk ke RSUP DR. M Djamil Padang dengan keluhan utama sesak nafas sejak tiga hari sebelumnya. Sesak nafas disertai oleh pembengkakan pada leher, wajah dan dinding dada. Pada riwayat penyakit sebelumnya didapatkan ia telah menderita asma sejak masa anak-anak.Diagnosis ditegakkan sebagai emfisema subkutis akibat eksaserbasi asma berat. Penatalaksanaan terapi berupa pemasangan kateter abocath no.14F yang telah di modifikasi subkutan.Pasien di rawat selama empat hari, kemudian dibolehkan pulang.Kata kunci: emfisema – asma – IV kateterAbstractTwenty four years old female patient admitted to the hospital with symptom of dyspnea since three days before entered the hospital. Dyspnea was accompanied by swelling in the neck, face and chest wall. She had suffered of asthma since a child.Patient was diagnosed as subcutaneous emphysema due to severe excacerbation of asthma. The treatment was treated with the insertion of modified abocath no. 14F subcutaneously.The patient was hospitalized for 4 days and went home with recovery.Keywords : emphysema – asthma – IV catheterLAPORAN KASU
STATUS MORBIDITAS ANAK PASCA GEMPA DI KECAMATAN SUNGAI LIMAU KABUPATEN PADANG PARIAMAN SUMATERA BARAT
Get PDFAbstrakGempa bumi yang terjadi di Provinsi Sumatera Barat, tanggal 30 September 2009 telah memporak porandakan wilayah Sumatera Barat terutama Kota Padang dan Kabupaten Padang Pariaman. Pasca gempa ini akan mempunyai efek terhadap status kesehatan masyarakat terutama anak-anak.Penelitian ini bertujuan untuk melihat pola penyakit pada anak pasca gempa di Kecamatan Sungai Limau Kabupaten Padang Pariaman, Sumatera Barat.Penelitian ini merupakan penelitian retrospektif, sampel adalah seluruh pasien anak yang berobat ke pos – pos pengobatan IDAI di Kecamatan Sungai Limau.selama 11 hari, mulai dari tanggal 6 sampai dengan 16 Oktober 2009.Sampel berjumlah 508 orang, anak perempuan (53,1%) lebih banyak dari pada anak laki-laki (46,9%). Ada 5 penyakit terbanyak adalah penyakit saluran pernafasan (57,5%), penyakit kulit (13,6%), diare (12,6%), observasi demam (5,1%) dan trauma (2%). Kelompok umur yang terbanyak adalah 5-10 thn (36,2%) disusul oleh usia 1-5 thn (35,4%).Penyakit yang terbanyak adalah penyakit saluran pernafasan disusul dengan penyakit kulit dan diare. Ketiga penyakit ini merupakan penyakit yang disebabkan faktor sanitasi dan higienes, karena terbatasnya sumber air bersih, rusaknya sarana MCK.Kata kunci : morbiditas, anak, pasca gempaAbstractAn earthquake that occurred in West Sumatra on September 30th 2009 had been destroyed the city and caused so many victims, especially in Padang City and Padang Pariaman District. It will be impacted to the health state after disaster, especially in children.This study’s objective is to see the pattern of disease of the children after the earthquake in Sub-district of Sungai Limau, Padang Pariaman District, West Sumatra.A retrospective study was collected from medical record of all the children who went to “Ikatan Dokter Anak Indonesia (IDAI)†medical station in Sungai Limau sub-district during 11 days, starts from October 6th until October 16th 2009.ARTIKEL PENELITIAN121The number of sample is 508 children, girls (53.1%) are greater than boys (46.9%). The top of five disease are acute respiratory infection (57.5%), skin disease(13.6%), diarrhea(12.6%), fever observation (5.1%) and trauma (2%). The dominant ages range is between 5 - <10 years (36.2%), followed by ages 1 - <5 years (35.4%).The dominant disease are acute respiratory infection, skin disease and diarrhea.Key words: morbidity state, earthquake, health disaste
PERUBAHAN NEUROANATOMI SEBAGAI PENYEBAB ADHD
Get PDFAbstrakAttention Deficit Hyperactivity Disorder (ADHD) merupakan suatu kelainan tingkah laku, dan bersifat heterogen yang ditandai dengan gambaran tidak dapat memusatkan perhatian, hiperaktif, dan impulsif sehingga menimbulkan gangguan baik secara akademis maupun interaksi sosial. Penyakit ini dimulai dari masa anak dan dapat terus berkembang sampai dewasa.Sering dengan perkembangan teknologi kedokteran diagnostik dan kedokteran molecular telah ikut membantu pemahaman yang lebih baik mengenai penyakit ini. Pemeriksaan yang dilakukan dengan Computed Tomography-Scan (CT-scan) atau Magnetic Resonance Imaging (MRI) memperlihatkan perubahan volume otak terutama area kortek frontalis, ganglia basalis dan serebrum yang mengecil pada penderita ADHD. Pemeriksaan neurotansmiter otak pada penderita ADHD juga memperlihatkan perubahan. Kadar nor epineprin dan dopamine pada penderita ADHD berkurang dibandingkan dengan individu normal.ADHD diduga melibatkan multifaktorial seperti genetik, lingkungan dan neuroanatomis. Karena itu didalam penanganan terhadap ADHD perlu dilakukan secara komprehensif, berupa pemberian obat-obatan dan intervensi tingkah laku dan nutrisi. Penanganan yang terpadu tersebut akan memberikan hasil yang lebih baik dibandingkan jika hanya mengunakan obat- obatan saja.Tujuan penanganan ADHD meliputi peningkatan daya akademik, kemandirian, perbaikan dalam interaksi, dan peningkatan kontrol diri dan sedapat mungkin ditujukan kausa ADHD tersebut.Kata kunci : Attention Deficit Hyperactivity Disorder (ADHD)AbstractAttention Deficit Hyperactivity Disorder (ADHD) is a common neurobiologic disorder characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity and disrupted academically and socially. This disorder begin in childhood and continue to adulthood.Diagnostic imaging and molecular development has contributed to more understanding of this disease. Computed Tomography-Scan (CT-scan) or Magnetic Resonance Imaging (MRI) examination reveal decreased brain volume especially at frontalis cortec, basal ganglia and cerebrum in ADHD. neurotransmitter change also seen in ADHD, norepineprin and dopamine decreased in ADHD compare to normal persons.ARTIKEL PENELITIAN180ADHD is suggested has multi-factorial etiology, genetic, environment and neuroanatomy change. Comprehensive management is needed which include drugs, behavioral intervention, and nutrition. Compare with only drug therapy, this comprehensive management has better outcome in management ADHD.Goal of management ADHD patient is an increased maximal academic achievement, independency, good social interaction, self control and if possible, it directed to main etiologic factor.Key Words: Attention Deficit Hyperactivity Disorder (ADHD
INFANTILE HYPERTROPHIC PYLORIC STENOSIS (IHPS)
No full textAbstrakInfantile hypertrophic pyloric stenosis (IHPS) adalah kelainan anatomi pada bayi dengan terjadinya hipertropi pada region pilorik yang menimbulkan obstruksi. Diagnosis dapat ditegakkan berdasarkan manifestasi klinis. Pada kasus yang tidak khas dibutuhkan pemeriksaan lebih lanjut. Dilaporkan sebuah kasus IHPS di RS. M. Djamil Padang, anak laki-laki usia 2 bulan. Pasien datang dengan keluhan utama muntah yang tidak proyektil setiap selesai menyusui. Pada pemeriksaan fisik tidak ditemukan massa di abdomen sebagai tanda obstruksi. Dari pemeriksaan barium meal sesuai dengan IHPS dan terbukti saat operasi. Pasien pulang dalam keadaan baik.Kata Kunci : Infantile hypertrophic pyloric stenosis, barium mealAbstractInfantile hypertrophic pyloric stenosis (IHPS) is misleading anatomic in infant with hypertrophy muscle in the pyloric region leads to gastric obstruction. Diagnosed can determine based on the clinical manifestation. In the case that not characterized such as examination in early onset, onset in the younger ex neonate needs more examination to determine the case as IHPS. Reported a case IHPS in Dr. M. Djamil Hospital in infant, boy, 2 month old. He came with chief complain non projectile vomiting after feeding. In physical examination there was no palbable mass on the abdominal as manifestation of obstruction. The result of Barium meal appropriate with IHPS and was improved in operation. The patient was discharged in good condition.Key word : Infantile hypertrophic pyloric stenosis, barium mealLAPORAN KASU
ANALISIS KEBIJAKAN INISIASI MENYUSU DINI (IMD) DAN PEMBERIAN AIR SUSU IBU EKSLUSIF DI RS BERSALIN BUDI KEMULIAAN JAKARTA
Get PDFAbstrakRumah Sakit Bersalin (RSB) Budi Kemuliaan Jakarta adalah salah satu RS Sayang Bayi yang menjalankan Inisiasi Menyusu Dini (IMD) sebagai prosedur yang wajib di kerjakan oleh tenaga penolong saat membantu proses persalinan sejak tahun 2008. Tujuan penelitian ini adalah untuk mengetahui bagiamana kebijakan dan implementasi IMD dan advokasi ASI ekslusif di RS Bersalin Budi Kemuliaan. Studi dilakukan secara kualitatif berdasarkan analisis dokumen-dokumen terkait dan observasi langsung ke lapangan pada trimester terakhir tahun 2013 (Oktober-Desember 2013). Hasil kajian ini memperlihatkan pelaksanaan IMD dan pemberian ASI ekslusif di RS Bersalin Budi Kemuliaan belum optimal karena kurangnya fasilitas pendukung, kejelasan implementasi kebijakan dan advokasi petugas kesehatan. Studi ini menunjukkan bahwa IMD dan ASI ekslusif sangat ditentukan oleh advokasi yang baik dan petunjuk teknis kebijakan yang jelas. Studi ini juga memperlihatkan bahwa kesuksesan pencapaian ASI eksklusif terkait dengan keberhasilan pencapaian IMDAbstractMaternity Hospital (RSB) Budi Kemuliaan Jakarta has implemented friendly hospital Early Initiation of Breastfeeding (EIB) approach as standard procedure for asssisting childbirth process since 2008. This study was carried out to examine the policy and the implementation of EIB and exclusive breastfeeding policy in the Maternity Hospital Budi Kemuliaan. To answer the research objectives, the qualitative study was conducted using document analysis and direct observation from Oktober to Desember 2013. The result of the study revealed that the implementation of EIB and the implementation of exclusive breastfeeding did not reach the target due to lack of supporting factors, advocacy, and clear guideline of the policy. The study also indicated that successful implementation exclusive breasfeeding policy related to successful of EIB
Metilasi DNA dan Peranannya Pada Kanker Payudara Sporadik
Get PDFMetilasi DNA dan Peranannya Pada Kanker Payudara Sporadi
HUBUNGAN KADAR BETA.SITE APP.CLEAVING ENZYME 1, BETA-AMYLOID DAN 4 HYDROXINONENAL PLASMA DENGAN GANGGUAN FUNGSI KOGNITIF PADA PENDERITA PASCASTROKE ISKEMIK
Get PDFBackground: The levet of beta-amyloid (Ap) in the cerebrospinal fluid (CSS) can beused asa marker to detect cognitive impairment, but fhe CSS retrieval technique is invasive. so if r'snecessa4z fo find biomarkers that are relatively easy, cheap and reliable. Therefore, biomarkersthat can be measured in blood is needed.Aims: To determine fhe association of the blood levels of BACE-I, AB and 4HNE with ischemiccognitive functisn after stroke event.Methads: This study was an observational study with cross sectional design using cases andcontrols. A number af 84 patients with ischemic stroke and 42 normal subjecfs as controls wereenrolled. Cognitive function u/as assessed 3 months aftdr stroke event using MoCA-lna testand measurement of blood levels of BACE1-1, 4p40, AP42 and 4HNE was conducted within72 hours of onset of stroke. Regression statistical analysis was used to determine the mostdaminant factars related to the occurrence of impaired cognitive function after stroke event.Resuffs; ln bivariate analysis, we found a significant assocrafion between cognitive impairmentafter stroke with high blood levels of BACE1 (p = 0.004, OR = 1.714), low levels of AB40 (p =A.0001, AR = 14.80) and low /eve/s of AB42 @ = A.U7, OR = 3.44). There was no significantassociation between the blood levels of 4HNE with impaired cognitive function after strokeevent. ln multivariate analysis, we found low low plasma level of 4840, high level of BACE-1,and low level of AB42 were variables strongly related with cognitive impairment after ischemicstroke subsequently based on the strength of correlation.Canclusians: Low levels of 4840, ttigh levels of BACE-I and low ievels of Ap42 are associatedwith the incidence of impaired cagnitive functian after ischemic stroke.M}(A, Volume 37, Nomor.Supl. 2, November 2014MKA, Volume 37, Nomor.Supl. 2, November 2014 http:/imka.fk. u nand.ac. id/ABSTRAKLatar Belakang : Kecacatan pascastroke diperberat oleh terganggunya fungsi kognitif. Metodediagnostik yang tersedia sekarang, tidak cukup sensitif bila digunakan sebagai upaya untukmenemukan gangguan kognitif pascastroke secara dini. Kadar beta-amyloid (AP) di cairanserebrospinal (CSS) dapat dijadikan sebagai penanda telah terjadinya gangguan kognitif,namun teknik pengambilan CSS adalah invasive, sehingga perlu dicari biomarker yang relatifmudah, murah dan dapat dipercaya. Untuk itu perlu dicarai biomarker pada plasma.Tujuan : Untuk mengetahui hubungan kadar BACE-1, AB dan 4HNE plasma dengan fungsikognitif pascastroke iskemik.Metode : Penelitian ini bersifat observasional dengan disain cross sectional, menggunakankasus dan kontrol. Mengikutkan 84 penderita pascastroke iskemik dan 42 subjek normalsebagai kontrol. Fungsi kognitif diperiksa 3 bulan pascastroke dengan test MoCA-lna danpemeriksaan kadar BACEI-1, AF40, AP42 dan 4HNE plasma dalam 72 jam onset stroke.. Analisa regresi statitistik digunakan untuk menetapkan faktor mana yang paling dominanhubungannya dengan terjadinya gangguan fungsi kognitif pascastroke iskemik.Hasil : Pada analisis bivariat, ditemukan hubungan yang bermakna antara gangguan kognitifpascastroke dengan tingginya kadar BACE1 (p=0,004, OR= 4,714), rendahnya kadar AP40(p=0,0001, OR=14,80) dan rendahnya kadar AP42 (p=0,0t7, OR=3,44). Tidak ditemukanhubungan yang bermakna antara kadar 4HNE dengan gangguan fungsi kognitif pascastroke.Pada analisis multivariat, didapatkan rendahnya kadar AB40 dan tingginya kadar BACE-1 plasma sebagai variabel yang kuat hubungannya dengan kejadian gangguan kognitifpascastroke iskemik.Kesimpulan : Rendahnya kadar AB40 dan tingginya kadar BACE-1 plasma berhubungandengan kejadian gangguan fungsi kognitif pascastroke iskemik.6
Migration assay on primary culture isolated from patient's primary breast cancer tissue
Get PDFBackground: Migration is an essential component of breast cancer metastasis, which studyhas been concentrated on culture of established breast cancer cell lines that do not accuratelyrepresent the sophistication and heterogeneity of patient's breast cancer. An attempt toperform migration assay using Boyden Chamber Assay (BCA) on primary culture originatingfrom patient's breast cancer tissue was developed to accommodate upcoming study of breastcancer migration in lndonesian patients.Methods: Pathologically proven primary breast cancer tissue samples were obtained fromCiptomangunkusumo Hospital during core (n=4) and incisional (n=3) biopsies of stage llAup to stage lllA breast cancer patients. Following biopsy, the breast cancer tissue samplesunderwent processings to isolate the cancer cells. These cancer cells were -then resuspendedwithin Dulbecco's modified Eagle's medium (DMEM) ahd cultured in 12-well plate. The growthof primary culture were observed and compared between the core biopsy and the incisionalbiopsy specimens. Optimization of BCA method was later performed to investigate themigration of the breast cancer primary culture towards different experirnental conditions, whichwere control, Fetal Bovine Serum (FBS), and Stromal Derived Factor-l (SDF-1). Two differentnumber of breast cancer cells were tested for the optimization of the BCA, which were 1 x 105and3x105cells.Results: None of the culture performed on core biopsy specimens grew, while one out ofthree incisional biopsy specimens grew until confluence. The one primary culture that grewwas later assesed using BCA to assess its migration index towards different experimentalconditions. Using 1 x 10s breast cancer cells in the BCA , the result of the absorbance level ofmigrated cells showed that the migration towards SDF-1 (0.529) nearly doubled the migrationtowards controlmedium (0.239) and FBS (0.209). Meanwhile, the absorbance levelwas simiiarbetween the control medium (1.050), FBS (1 .103), and SDF-1 (1 .104) when the same test wasrun with 3 x 105 breast cancer cells.Discussion: Breast cancer tissue collected using incisional biopsies hao better chance togrow in primary culture than those collected using core biopsies, possibly due to the differencein the amount of tissue extracted. Consistent with previous research, patient's breast cancercells was shown to migrate more towards the chemokine ligand SDF-1, as compared to controlmedium and FBS. The number of breast cancer cells run in the BCA also affected the result ofthe migration assay, where 1 x 10s cells showed a superiority as compared to 3 x 105 cells inshowing the migration difference between the different experimental conditions.MKA, Volume 37, Nomor.Supl. 2, November 2014ED Yulian dkk"Migration assay on primary culture isolated from patient's primary breast cancer tissueConclusions: This study encourages and facilitates future research to study migration the intrinsic characteristic of individualized patient's breast cancer as well as to assess the change in migration characteristic of breast cancer cells after an in vivo treatment in human
KULTUR PRIMER FIBROBLAS: PENELITIAN PENDAHULUAN
Get PDFAbstrakKultur sel fibroblas banyak digunakan untuk penelitian proses penyembuhan luka dan penuaankulit. Metode ini digunakan untuk melihat perkembangan sel, proliferasi kinetik seluler, sertabiosintesis komponen matriks ekstraseluler. Penelitian pendahuluan ini dilakukan untuk optimasiteknik laboratorium serta berbagai kendala yang didapatkan saat kultur fibroblas. Kultur primerfibroblas dibagi menjadi 2 jenis sampel yaitu sampel yang berasal dari embrio mencit usia 7,5–9,5 hari, dan kulit pasien keloid. Sampel dari embrio mencit dilakukan kultur primer denganmetode dissociated fibroblast. Sampel jaringan keloid dan kulit normal dikultur dengan metodeskin explant. Fibroblas yang berasal dari kultur primer embrio mencit tumbuh baik sehinggadapat dilakukan subkultur dan disimpan di dalam nitrogen cair suhu -198°C. Fibroblas yangberasal dari sampel keloid pertama tumbuh sesuai pola pertumbuhan fibroblas, namun padasampel kedua terdapat kontaminasi Paecilomyces sp. yang merupakan salah satu jenis jamurkontaminan. Sel fibroblas mudah untuk dikultur karena memiliki kemampuan tumbuh danmelekat yang tinggi serta regenerasi cepat, namun penelitian lebih lanjut untuk optimasi teknikkultur dan pencegahan kontaminasi masih dibutuhkan sehingga sel dapat tumbuh baik.AbstractFibroblast cell culture method has been used for wound healing and skin aging studies. Thismethod was used for cell development imaging study, celullar kinetic proliferation andextracelullar matrix component biosynthesis. This preeliminary study was done for laboratoricaltechnic optimation as well as problems appeared in fibroblast culture. Fibroblasts primary culturewas divided into 2 type of samples, from 7.5-9.5-day-mice embryo and keloid-patient skin.Primary culture with dissociated fibroblast method was done for mice embryo sample. Keloidtissue sample and normal skin were cultured with skin explant method. Fibroblasts that weretaken from mice embryo primary culture grew well therefore subculture can be done and kept in -198°C liquid nitrogen storage. Fibroblasts that were taken from first keloid sample grewaccording to fibroblast growth pattern, but, there was contamination with Paecilomyces sp. whichwas one of the contaminating fungi. Fibroblast cells are easy to be cultured as they have growthability and high adhesion capability as well as rapid regeneration, but, further study for culturedtechnical optimation and contamination prevention are still neededthereforethe cells can growwell