Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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The effect povidone-iodine on the wound healing process: A study on fibroblast populated collagen lattice (FPCL) model
No full textPovidone-iodine (PI) 10% solution is an effective antiseptic. However, it appears to be toxic tothe cells involved in wound healing. The aim of this study is to evaluate the toxicity of PI oncultured human fibroblast using fibroblast populated collagen lattice (FPCL) model. The culturedhuman fibroblast was divided into 6 groups i.e. 5 groups were exposed by PI 1, 0.1, 0.01, 0.001and 0.0001%, and 1 group was exposed by phosphate-buffered-saline (PBS). Twenty-four hourslater, the media was washed using PBS. The size of the FPCL media on each group wasobserved over time by serial photographs, which then were measured by Image-J computerprogram. Exposure of 0.1, 0.01, 0.001 and 0.0001 PI caused an obvious reduction of fibroblast’scontraction capability on FPCL media, which described temporary fibroblast injury, that showinga concentration-dependent recovery phenomenon after 48th hour. Furthermore, 1% PI exposureleads to a permanent fibroblast injury. In conclusion, PI exposure in concentration more than0.1% has a permanent toxic effect on fibroblast that clearly observed using a simple FPCLmodel
Prognostic factors for frequent episodic asthma in children
No full textAsthma is a major health problem affecting millions of children worldwide. The prevalence of asthmain children tends to increase annually in the world. Therefore, identification of the prognostic factorsfor episodic asthma is important to perform early prevention of asthma attacks in children. Thestudy was performed to identify the prognostic factors for frequent episodic asthma in children. Thiswas a retrospective cohort study involving asthmatic children who attended the Emergency Unit orOutpatient Clinic of the Department of Pediatrics, Dr. Sardjito General Hospital, Yogyakarta. Theinclusion criteria were asthmatic children aged over 7 years, suffering from asthma over 2 years andgetting agreement from their parents as expressed by signed an informed consent. The exclusioncriteria were children with other chronic obtructive pulmonary diseases beside asthma and childrenwith cardiovascular diseases. Subjects were grouped into two groups i.e. Case Group and ControlGroup. The Case Group was children with frequent episodic asthma while the Control Group waschildren with infrequent episodic asthma. Prognostic factors for episodic asthma were then gatheredby giving a questionnaire to their parents. Regression analysis was used to evaluate the relationshipbetween prognostic factors and episodic asthma. A total of 94 subjects comprising 37 (36.4%)subjects with frequent episodic asthma and 57 (63.6%) subjects with infrequent episodic asthmawere involved in the study. Furthermore, response to initial theraphy was significantly associatedwith frequent episodic asthma (RR= 8.64; 95%CI= 0.47-2.50; p=0.001). Whereas, nutritionalstatus, patients age when asthma diagnosed, exclusive breastfeeding, maternal education, exposureof secondhand smoke and welfare were not (p>0.05). In conclusion, the initial therapy is prognosticfactors for frequent episodic asthma in children
Secondary acute myeloblastic leukemia after adjuvant chemotherapy and radiotherapy in breast cancer: A case report
No full textA rising number of long-term survivors and potential long-term outcome related to the treatment isone of the most important issue due to the advances of management in cancer. The development ofsecondary malignancy has been reported in a number of cohorts. We present a case of breast cancerpatient developing acute myeloid leukemia (AML)- M5 within a relatively short interval of two and ahalf years from her primary treatment with adjuvant chemotherapy with 4 cycles of doxorubicin andcyclophosphamide, followed by 4 cycles of three weekly paclitaxel (AC-T) and radiotherapy. Whatcould be attributed to the occurrence of secondary leukemia in this patient will be discussed
The effect of combination of triamcinolone acetonide and methotrexate on keloidfibroblast activity in dermis equivalent
No full textBackground: Triamcinolone acetonid (TA) intralesion has been a standard treatment for keloids for manyyears, due to its effect in inhibiting collagen synthesis and fibroblast proliferation. However, until now theclinical result is unsatisfactory. Keloid flattening is slow and sometimes adverse reactions may occur.Methotrexate (MTX) is a chemotherapeutic agent having an antiproliferating effect which act as an antifolicacid. Because of this effect, MTX is potential to be used in combination with TA for the treatment inkeloid. Fibroblast populated collagen lattice (FPCL) was a dermal equivalent usually used for fibroblastactivity measurement.Objective: To understand the inhibition of fibroblast keloid activities of MTX in vitro on FPCL contraction,compared to TA and MTX plus TA.Methods: This research used simple parallel multigroups experimental study design, and conducted on thirdpassage keloid fibroblast culture, which was isolated from one patient. Fibroblast was cultivated in collagentype 1 from rat tail (FPCL). Keloid fibroblasts was classified into 16 groups, and treated with 5, 10, 20mM TA, 1.75, 3.5, 7 mM MTX, combination of TA and MTX, and a control negative. FPCL contractionindicating activities of fibroblast was measured using Scion Image software. Mean of FPCL contractionwas analyzed using one way analysis of variance (ANOVA).Results: All treatments could inhibit FPCL contraction until day 2 (p<0.05). The highest inhibition of FPCLwas found in combination of TA 20 mM + MTX 7 mM (p<0.05). The treatment that could inhibit FPCLcontraction until day 3 was only group MTX 3.5 mM + TA 20 mM. This result indicated that a combinationof TA and MTX was stronger in inhibiting keloid fibroblast activities compared with TA and MTX alone.Key words: keloid fibroblast - growth factors - triamcinolone acetonid - methotrexate - FPCL contractio
Serum iron level after ingestion of repeated dose of iron shortly after and 2 hours after meal
No full textBackground: The prevalence of iron deficiency anemia in pregnant women is estimated to be higher than nonpregnant women. Ironsupplementation program has been proven clinicallyto improvethe hemoglobin (Hb)level of pregnant women. The absorption of iron is affected by food, therefore iron has to be given 2 hours after meal. However, in practice, iron was given shortly after meal. The physiologicalchange in pregnant women affects drug absorption, distribution, and eliminationphases. Objective: To understand serum iron level after ingestion of repeated dose of iron shortly after and 2 hours after meal for 12 weeks in trimester 2 pregnant women with iron deficiency anemia. Method: The research design was a phase IIclinical trial. Subjects were 24 trimester 2 pregnant women with iron deficiency anemia, classified into two groups, who were treated as follows: The first group was consisted of 12 women with irondeficiency anemia, treated with twice-a-day ferrous sulphate tablet @300 mg orally,given shortly after meal for 12 weeks; the second group was consisted of 12 women with iron deficiency anemia, treated with twice-a-day ferrous sulphate tablet @300 mg orally, given 2 hours after meal for 12 weeks. Bloodsamples were taken in week 2, 4, 6, 8, 10, and 12 after treatment. Serum (ferric) iron level was measured with Vitros Fe Slides method. Result: Minimum,maximum, and average steady-state ironlevels (Css min, Css max, Css average) of treatment 1 were 104.1 ::I:14.03 ug/dL, 96.44::1:13.22 ug/dL, and 112.38::1:14.03 ug/dL (mean ::I:SEM),respectively; while minimum, maximum, and average steady-state iron levels (Css min, Css max, Css average) of treatment 2 were 125.77::1:9.31 ug/dL, 118.03::1:9.21 ug/dL, and 125.77::1:9.31 ug/dL (mean::l:SEM),respectively. No statistical significant difference was found within treatment in minimumsteady-state level between week 2, 4, 6, 8, 10, 12 after treatment. There was also no significant difference in minimumsteady-state level between treatment groups in week 2, 4, 6, 8, 10, and 12. Conclusion: There were no differences in serum iron level after ingestion of repeated dose of ironshortly after and 2 hours after meal for 12 weeks intrimester 2 pregnant women with iron deficiency anemia
The effect of vitamin C on fibroblast proliferation and VEGFexpression in fibroblast culture
No full textBackground: One of the factors that determine the success of efficient woul')d healing is wound healing rate, that can be achieved by increasingcell proliferation, angiogenesisor neovascularisation,and extracellular matrix production. Dermalfibroblast is a cell that plays an important role in wound healing. Fibroblast proliferation and neovascularisation are critical elements in granular tissue formation. Local hypoxia causes fibroblasts to express HIF-1a that will induce fibroblast VEGFexpression. The nature of vitamin C makes it easily oxidized. The addition of vitamin Con fibroblast culture medium is expected to produce local hypoxia condition that will induce fibroblast expression of HIF-1a, so that the expression of fibroblast VEGFwill be increased. Vitamin C may modulate the growth of various types of cells. The effect of vitamin Con normal fibroblast proliferation and fibroblast VEGFexpression is still unknown. Objective: This study was aimed to know whether vitamin Ccan increase normal human fibroblast proliferation and expression of VEGF. Method: A simple experimental study was conducted by using preputial skin fibroblast culture from 10-year-old donor, subculture passage 3. Fibroblast culture was divided into 6 groups, each group received vitamin C treatment with the dose of 50pg/mL, 100pg/mL, 150pg/mL, 200pg/mL, and 300pg/mL, and one group without treatment acting as control. Measurement of fibroblast proliferation was conducted by spectrophotometer using MTT, and fibroblast expression of VEGFwas measured using ELISA. The average of difference in fibroblast proliferation and VEGFexpression was analyzed with one-way analysis of variance. Result: There was a significant increase in fibroblast proliferation rate in the groups receiving vitamin C with the dose of 200 mg/mL (p = 0.016) and 300 mg/mL (p = 0.005), whereas in the group with the dose of 50 mg/mL, 100 mg/mL and 150 mg/mL there was no significant difference compared to the control (p = 0.933, p = 0.961, P = 0.301, respectively). Average fibroblast VEGFexpression between various concentrations of vitamin C compared to the control showed no significant difference (p > 0.05). Conclusion: Vitamin Ccould be considered to be used as an agent to accelerate wounds healing. Keywords: vitamin C, skin fibroblast culture, fibroblast proliferation, fibroblast VEGFexpressio
The Relation Between the Expression of latent Membrane Protein-1
No full textBackground: In vitro studies reveal that LMP1 induces the expression of many factors for invasion and metastasis. Objective: The aims of this study were to investigate the role of LMP1 expression on the status of Nand M that take place either directly or sequentially through its relation with the expression IL4, IL6. IL 10. IFN-gamma. Gran2yme B and with protease MMP2. MMP9. either in the serum or in the tumour tissue. Methods: Forty one 41 EBER-RISH confirmed NPC cases with parallel serum were used for this study. Immunohistochemistry was used to study the expression of proteins in the tissue. The serum level of proteins were determined with ELISA. Statistical analysis used Lisrel 8.50. Results: No correlation between the expression of LMP1 with the status of Nand M of the tumour either directly or that sequentially took place through the expression of the cytokines and MMPs either in the tumour tissue or the serum level. The serum level of MMP9 was correlated with the serum level of IL6, the status of N. and the expression of IL 10. Status N was correlated with serum level of MMP2. Conclusion: There is a process that sequentially took place through the increase of the cytokines. MMPs, either in the tumour tissue or serum level and N. M status. LMP1 expression was not involved in the process. Key words: NPC - metastasis - MMP - cytokin
The influence of endometriosis peritoneal fluid on the development of mouse embryo in in vitro pre-implantation
No full textBackground: Endometriosis was associated with various immunologic changes detected both in the endometrial eutopic and blood edge sample. Some researchers reported that women with endometriosis have an increased amount of peritoneum fluid. Endometrial environment and peritoneal fluid diffusing to the ovarial tube may affect sperm-ovum interaction, initial phase of embryonic development and reduce endometrial receptability. The correlation between endometriosis and early in vitro embryonic development has been reported in some studies showing controversial results; therefore it is necessary to carry out researches to clarify the influence of endometriosis on the early embryonic development. Objective: to identify the influence of peritoneal fluid of infertile women with endometriosis and normal peritoneum fluid of fertile women on the development of mouse embryo in in-vitro pre-implantation. Methods: Prospective, randomized controlled trial subjects are 2 cells of the Swiss albino strain embryos super-ovulating procedure on mouse, 2 embryonic cells resulted from in-vivo fertilization were taken out and in-vitro culture was done with the exposure of 10% or 2.5% cell-free supernatant peritoneum fluid of infertile women with endometriosis and 10% or 2.5% cell-free supernatant peritoneum fluid of normal fertile women as the control. The blastocyst growth was observed in the 72 hour culture and hatching blastocyst culture in 96 hours. Results: An amount of 231 embryos of 2 cells was obtained. After 72 hours, there were 103 blastocyst cultures in both groups. Blastocyst development rate (BDR) culture with to endometriosis peritoneum fluid exposure was lower compared with the normal peritoneum fluid exposure (32.2% vs 56.9%, RR 0.5, 95% CI: 0.42-0.77). Hatching rate (HRI of blastocyst culture with endometriosis peritoneum fluid was lower than that of normal peritoneum fluid (35.1 % vs 92.4%, RR 0.38, 95%CI: 0.24-0.59). The exposure to 10% endometriosis peritoneum fluid lowered BDR significantly compared with the normal peritoneum fluid, 7.7% vs 43.9% (RR 0.18,95% CI: 0.07-0.42); while the exposure to 2.5 % BDR was significantly different, (64% vs 74%, RR 0.87,95% CI: 0.66-1.13). Exposure to 10% compared to 2.5% normal endometriosis peritoneum fluid showed significantly decreased BDR (p 0.05). There was a significant interaction between type of peritoneum fluid (endometriosis vs normal) and the concentration of peritoneum fluid (10% vs 2.5%1 in decreasing BDR (RR 0.17,95% CI: 0.04-0.65). Conclusion: Exposure to endometriosis peritoneum fluid lowered the blastocyst development rate and hatching rate as compared with that to normal peritoneum fluid on the development of the in- vitro mouse embryo model. Key words: embryonic development - peritoneum fluid - endometriosi
The combination effect of triamcinolone acetonide and tamoxifen citrate on fibroblast populated collagen lattice contractions
No full textBackground: Keloid is caused by fibroblast hyperproliferation stimulated by transforming growth factor-IH ITGF-131 I, and it is usually treated with triamcinolone acetonide (TAl, which has the ability to inhibit TGF131 synthesis. However, the clinical results is still unsatisfied. Another drug that may inhibit keloid fibroblast TGF-131 synthesis is tamoxifen citrate (TCI, but the effect of the combination on keloid fibroblast activities has never been published.Objective: To find out the effect of combined triamcinolone acetonide and tamoxifen citrate on fibroblast keloid activities in vitro.Methods: It was a parallel post-test only study. The third passage keloid fibroblasts were isolated from a patient with keloid, cultivated in collagen lattice, and treated with several combinations of 5, 10, and 20 pM TA and 10, and 20 pM TC. Lattice contractions were measured based on digital image using scion image.Results: Among TA groups, the best inhibition of lattice contraction was found among 20 pM treated group and among TC groups. The best inhibition of lattice contraction was found among 20 pM TC. The best combination was found in the combination of 20 pM TA plus 20 pM TC.Conclusion: The result indicated that a combination of triamcinolone acetonide and tamoxifen citrate had a significant role in suppressing fibroblast activity, better than triamcinolone acetonid or tamoxifen citrate alone.Key words: tamoxifen - triamcinolone - collagen lattice - keloid fibroblast
Diagnostic test of mammography in a palpable mass of the breast
No full textBackground: Breast cancer is the most common cancer in Indonesia after cervical cancer. The diagnosis of breast cancer is based on triple diagnostics, clinical diagnostic, mammograph, and fine needle aspiration biopsy (FNAB). Mammograph is a non-invasive radiologic imaging to demonstrate microcalcification as an early sign of breast cancer.Objective: The aim of this study was to measure the validity of mammograph in a palpable mass of the breast.Methods: Study design for this study was a diagnostic test that compared mammograph with histopatology result as the gold standard. Study was performed between March 2006 and September 2007 in Sardjito General Hospital, Yogyakarta. There were 79 palpable masses of the breast that were included as the subjects of this study. They were mammographed and examined histopatologically. Descriptive analysis with McNemar non parametric test with 2x2 table was performed by a computer software program to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positivelikelihood ratio (positive LR) and negative likelihood ratio (negative LR). .Results: Sensitivity, specificity, PPV, NPV, positive LR and negative LR of mammograph in diagnosing a breast palpable mass were 87.18%,87.50%,87.18%,87,50%,7, and 0.146, respectively Conclusion: Mammograph had a high validity in diagnosing breast palpable masses.Key words: breast palpable mass - mammograph - diagnostic test - validity