Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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The prognostic value of lymph nodes mRNA CXCL12 expression in the breast cancer
No full textPrognosis of breast carcinoma is influenced by age, tumor size, histological grade and type, lymph node status, as well as metastasic status. Chemokine receptor CXCR-4 with its ligand, CXCL-12, may play an important role in metastasis of breast carcinoma. However, the role of CXCL-12 mRNA as a prognostic factor and a therapeutic target of human breast cancer remains controversial. This study aimed to investigate the level of CXCL-12 mRNA expression in lymph nodes of patients with invasive ductal breast carcinoma and the difference within the prognostic factors. Axillary lymph nodes obtained from 50 cases of invasive ductal breast carcinoma, were divided into two groups, with and without lymph node metastasis. Each group consisted of 25 cases. Total RNA was extracted from formalin-fixed paraffin-embedded. The CXCL-12 mRNA expression was examined using qRT-PCR method. The mean differences between the two groups were analyzed using Mann-Whitney test. The differences between CXCL-12 mRNA expression and each prognostic factor ware analyzed using Mann-Whitney comparison test. CXCL-12 mRNA expression was significantly higher in the lymph node of patients with metastasis of breast carcinoma compared to the non-metastasis cases (p<0.01). There were significant differences between CXCL-12 mRNA expression with poorly histological grade (p=0.003), bigger primary tumor size (p=0.005) and age of ≥45 y.o (p=0.012) in the metastatic group, but there were no significant differences between both age of <45 and ≥45 y.o.This study suggests that the higher CXCL-12 mRNA expression level are associated with bigger tumor size and poor differentiation in breast cancer patient with lymph nodes metastasis
Patient prognosis after relief of obstruction
No full textABSTRACTObstructive uropathy may lead to irreversible kidney damage. The insertion of ureteral stent is one of procedure to relief obstruction and prevent further kidney damaged, septicemia as well as urosepsis. A study to evaluate the predictive factor of urinary diversion in improving kidney function is needed. This study aimed to assess prognosis factors post-relief of obstruction in patients with uropathic obstruction focusing on kidney function recovery. This was a retrospective cohort study conducted at An-Nur Private Hospital in Yogyakarta Special Region, Indonesia using the medical record of patients with obstructive uropathy whom underwent DJ Stent insertion from a period of 2011 to 2015. The data of clinical assessment, laboratory and radiologic examination data were collected and analyzed using Chi square or student t test. A total 59 patients with obstructive uropathy aged around 50.9 years whom underwent DJ Stent were involved in this study. The results showed that release of obstruction with the installation of ureteral stents was significantly able to improve kidney function. The duration of obstruction, etiology, and hemoglobin (Hb) levels were associated with creatinine levels, whereas gender, urinary tract infection (UTI) and comorbid were not. In conclusion, prognosis factors of postrelief obstuction are duration of obstruction, etiology of obstruction and Hb levels before the release of obstructio
The effect of long-term high-fat diet in ovariectomized Wistar rat (Rattus norvegicus)study on lipid profile, endothelial nitric oxide synthase(eNOS) dan endhotelin-1 (ET-1) serum
No full textAccumulation of cholesterol in the blood will cause stiffness in arteries and trigger the formation of atherosclerotic lesions. Estrogen has a role as an antioxidant that can prevent the low density lipoprotein(LDL) oxidation. In menopause with high-fat diet, the decrease of estrogen levels will trigger cholesterol accumulation in the blood lead to endothelial dysfunction mediated by endotelin-1 (ET-1) and nitric oxide synthase (eNOS). This study aimed to investigate the effect of long-term high-fat diet on the lipid profile, serum eNOS and ET-1levels on ovariectomized rat. It was experimental using 28 female Wistar rat divided into 4 groups. Group 1 was ovariectomized mice and given a standard diet (OVX-SD), Group 2 was ovariectomized mice and given a high-fat diet (OVX-HFD), Group 3 was not ovariectomized mice and given a standard diet(SHAM-SD) group, and Group 4 was not ovariectomized mice and given a high-fat diet (SHAM-HFD).Lipid profile of blood samples was measured pre- and post-treatment, whereas serum eNOS and ET-1 levels were measured post-treatment using ELISA method. No significantly difference of lipid profileon OVX-HFD group compared to that OVX-SD was observed. The serum eNOSlevel on OVX-HFD(702.11±68.73 pg/mL) was significantly lower than that OVX-SD (857.18±118.08 pg/mL) (p0.05). In conclusion, the serum eNOS levelon ovariectomized rat with long-term high-fat diet is lower than that on ovariectomized rat with standard diet
mRNA expression of CYP17A1, CYP11A1, CYP19A1, HSD3B1 and AKR1C2 in metastatic and non-metastatic prostate cancer patients
No full textThe progression of prostate cancer (PCa) mainly occurs caused by androgens. There is a linkbetween intratumoral steroidogenesis and castration-resistant prostate cancer. This studyaimed to determine the mRNA expression of various steroidogenic enzymes (CYP17A1,CYP11A1, CYP19A1, HSD3B1, and AKR1C2) in metastatic and non-metastatic prostatecancer patients. This study was conducted at the Anatomical Pathology Laboratory andUrologi Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing,Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta from September-November 2017. Samples were taken from 30 paraffin blocks with adenocarcinoma ofprostate, stained with hematoxylin-eosin (HE) and then classified into metastatic and nonmetastaticgroups. Samples then underwent deparaffinization procedure and examinationof mRNA expression of CYP17A1, CYP11A1, CYP19A1, HSD3B1, AKR1C2 genes usingReal-Time PCR. The mean mRNA expressions of CYP11A1, CYP17A1, CYP19A1,HSD3B1, and AKR1C2 genes in the metastatic adenocarcinoma prostate group were 7.08,10.11, 3.94, 4.84 and 3.58, respectively. In the non-metastatic group, the mean mRNAexpressions of CYP11A1, CYP17A1, CYP19A1, HSD3B1, and AKR1C2 genes were 4.62,9.45, 3.46, 2.68 and 4.92, respectively. The mean of mRNA expression of CYP11A1,CYP17A1, CYP19A1, and HSD3B1 genes were higher in the metastatic group than nonmetastaticadenocarcinoma prostate group. However, it was not statistically significant(p>0.05). The highest mRNA expression of steroidogenic enzymes was the CYP17A1gene. In conclusion, the mRNA expressions of CYP17A1, CYP11A1, CYP19A1, HSD3B1were higher in the metastatic prostate cancer patients compared to that in non-metastaticprostate cancer patients but statistically not significant
Relationship between hyperuricemia and erectile dysfunction on hypertension patients
No full textHypertension is a major non-communicable disease worldwide including in Indonesia. It can cuase erectile dysfunction through vasculogenic pathway. Uric acid level could be a promising biomarker to predict erectile dysfunction due to it is related to endothelial dysfunction, microvascular disease, and hypertension. The aim of this study was to evaluate the relationship between hyperuricemia and erectile dysfunction on hypertension patients. This was an observational study with cross-sectional design involving 88 male hypertension patients aged more than 18 years who registered as outpatient in the Bethesda Lempuyangwangi Public Hospital, Yogyakarta. Hyperuricemia was measured using uricase method and erectile dysfunction was measured using IIEF-5 form. The results showed that hyperuricemia (OR=3.89; CI 95% 1.08-15.70; p=0.017), blood pressure (OR=6.84; CI 95% 2.35-20.6; p<0.001), and age (p<0.001) are related with erectile dysfunction on the hypertension patients. Furthermore, logistic regression analysis showed that hyperuricemia, age, and blood pressure simultaneously affect the erectile dysfunction occurance, with good calibration (p=0.167) and discriminative level (0.8604). In conclusion, there is significantly relationship between hyperuricemia and erectile dysfunction on hypertension patients
The protective role of single bulb garlic (Allium sativum L.) towards foam cells and vascular cell adhesion molecules-1 (VCAM-1) on mice (Mus musculus) with high-fat diet
No full text Atherosclerosis is initiated by inflammatory response characterized by the accumulation of lipids in the arteries, causing blockage of blood vessels. The excessive of low-density lipoprotein (LDL) in the blood is a major factor in endothelial dysfunction and results in an inflammatory process. The inflammatory process in atherosclerosis is due to the expression of adhesion molecules, vascular cell adhesion molecules-1 (VCAM-1). This research aimed to evaluate the effect of single bulb garlic oil extract (SGBOE) against VCAM-1 expression in high-fat diet mice. Thirty male mice strain Balb/C were acclimatized for one week. Mice were divided into 6 groups (n=5): normal, high-fat diet (HFD), HFD + simvastatin, and HFD + SBGOE 12.5, 25, and 50 mg/kg BW respectively. HFD was given for 45 days. The SGBOE was given for four weeks orally. The aortic VCAM-1 expression was assayed using the immunohistochemical-flouresencemethod. The result of One-Way ANOVA showed that the treatment influenced significantly (p<0.05). The foam cells increase in the high-fat diet group compared than normal mice. Dose 12,5 mg/kg BW reduces VCAM-1 expression near the normal group. Allicin and S-allyl cysteine (SAC) compounds in single bulb garlic are antioxidant compounds that act to prevent oxidative stress and prevention mechanisms against lipoprotein modification
The predictive factor for conjunctival melanoma recurrence
No full textConjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr. Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location, histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79 years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence
Comparison of corneal endothelial cell count and intraocular pressure in pure-dispersive and dispersive-cohesive viscoelastic protection in phacoemulsification surgery
No full textThere are so many aspects should be regarded when use viscoelastic device during phacoemulsification surgery. The advantages and disadvantages of pure-dispersive viscoelastic and dispersive-cohesive viscoelastic always require more our attention to use it conveniently. The purpose of the study was to compare between pure-dispersive viscoelastic versus dispersive-cohesive viscoelastic in phacoemulsification surgery in that of corneal endothelial cell count and intraocular pressure (IOP) change. This was a cross-sectional study involving 41 eligible patients who underwent phacoemulsification surgery by single operator. Data including characteristics of cataract patients, corneal endothelial cell count and IOP were taken before and after surgery. Data of characteristics of cataract patients were reported descriptively and compared using Anova and t-test. The mean change in corneal endothelial cell count on pure-dispersive viscoelastic group (71.99±71.20 cells/mm²) was lower than that on the dispersive-cohesive viscoelastic group (117.62±78.29 cells/mm²). However, it was not significantly different. The mean change in IOP on pure-dispersive viscoelastic group (0.75±1.626 mmHg) was significantly lower than that on dispersive-cohesive viscoelastic group (1.90±0.995 mmHg) (p=0.000). In conclusion, the increase of IOP in dispersive-cohesive viscoelastic group is higher than that on pure-dispersive viscoelastic group. However, there is no significant difference of the mean change in corneal endothelial cell on the both groups
Critical appraisal of neuropathic pain guidelines in Asia
No full textNeuropathic pain (NP) is type of chronic pain that is common and often difficult to treat. Clinicians may be guided by a number of published guidelines and algorithms for the management of neuropathic pain. It is important for every clinician to know the quality of guidelines. The availability of current guideline in Asian countries is not well understood. Critical appraisal of NP guidelines in Asia has not performed, yet. The aim of this study was to appraise the quality of pharmacological treatment from neuropathic pain guidelines in Asia. Systematic searches were conducted by using combination of keywords i.e NP, Asia, and guideline. Guidelines evaluation was using appraisal of guidelines for research & evaluation II (AGREE II) instrument. The result interpreted as (i) a strongly recommended for use in practice if most domains scored above 50%; (ii) recommended for use with some modification if most domains scored between 30% to 50%; or (iii) not recommended for use in practice if most domains scored below 30%. After matched to inclusion and exclusion criteria there were 5 guidelines left: a guideline from Philippines, China, South Korea, Malaysia and Middle East. All of guidelines are recommended for use with some modification. The guidelines mention that first line treatment for NP are tricyclic antidepressants, selective norepinephrine reuptake inhibitor (SNRI) and alpha 2-delta ligand calcium channel blocker (CCB). Most of the evidences come from peripheral NP. There were limited evidences for the treatment of central neuropathic pain (central post stroke pain and pain after spinal cord injury). All the existing guideline mention, that the first line treatment for neuropathic are the tricyclic antidepressants, SNRI and alpha 2-delta ligand CCB
Genetic polymorphism in DNA base excision repair gene XRCC1among medical radiation workers
No full textX-rays repair cross-complementing group 1 (XRCC1) gene is one of the gene that plays an important role in base excision repair system (BER) and DNA repair both single and double strand breaks. Individuals with XRCC1 exon 10 (Arg399Gln) gene polymorphisms and carrying 399Gln allele variants (A allele) have a greater risk of DNA damage than their wildtype, 399Arg. The aim of this study was to examine the genotype frequencies of single nucleotide polymorphisms (SNPs) of XRCC1 exon 10 among medical radiation workers. This study involved 77 samples from several hospitals in Indonesia. Genotyping of XRCC1 exon 10 gene polymorphism was performed using PCR-RFLP. Individuals carryingA allele had lower frequency than that is carrying their wildtype of 399Arg (0.39 vs. 0.61). The results indicated that 39% of medical radiation workers had a risk of repair efficiency of DNA damage and might influence an individual's risk of cancer. Ionizing radiation induces many types of damage to DNA, requiring multiple repair pathways to restore genomics integrity. Other important genes/pathways, especially those for DNA double-strand break repair, might also play a role and should be further investigated. Furthermore, polymorphisms leading to inefficient DNA repair might also be associated with late reactions to radiotherapy