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Yulinda Arty Laksmita
"Tujuan: Mengevaluasi efek pemberian sitikolin dalam menekan kerusakan retina tikus dengan intoksikasi metanol.
Metode: Lima belas ekor tikus Sprague-Dawley dibagi dalam 5 kelompok yaitu kelompok tanpa perlakuan (A), kelompok metanol yang diobservasi di hari ke-3 (B1) dan ke-7 (B2), serta kelompok metanol dan sitikolin yang diobservasi di hari ke-3 (C1) dan ke-7 (C2). Tikus pada kelompok perlakuan (B dan C) ditempatkan pada inhalation chamber berisi gas N2 O:O2 selama eksperimen, dilanjutkan dengan pemberian metanol via oral gavage dengan dosis inisial 3,2 gr/kg dan dosis tambahan 1,6 gr/kg. Tikus kelompok C mendapat sitikolin via oral gavage dengan dosis 1 gr/kg setiap 24 jam. Enukleasi dilakukan pada akhir eksperimen. Pada preparat retina dilakukan pemeriksaan histopatologi fotoreseptor dan sel ganglion retina, serta imunohistokimia ekspresi bcl-2 dan caspase-3.
Hasil: Densitas sel ganglion tikus terintoksikasi metanol yang mendapat sitikolin lebih tinggi dibandingkan yang tidak mendapat sitikolin di hari ke-3 dan ke-7 (p<0,001). Lapisan ganglion tikus yang mendapat sitikolin tidak setebal lapisan ganglion tikus yang tidak mendapat sitikolin, menandakan edema yang lebih ringan. Tikus dengan sitikolin menunjukkan ekspresi bcl-2 ganglion yang lebih tinggi, serta caspase-3 yang lebih rendah dibandingkan tikus tanpa sitikolin.<
Kesimpulan: Pemberian sitikolin memiliki efek dalam menekan kerusakan lapisan ganglion retina tikus dengan intoksikasi metanol.

Aims: To evaluate effect of citicoline administration in suppressing retinal damage due to methanol intoxication.
Methods: Fifteen Sprague-Dawley rats were divided into five groups including normal group (A), groups with methanol only, observed on day-3 (B1) and day-7 (B2), and groups with methanol and citicoline, observed on day-3 (C1) and day-7 (C2). Rats in group B and C were placed in an inhalation chamber filled with N2 O:O 2 during the experiment, then methanol was administered via oral gavage. Citicoline 1 gr/kg every 24 hours was administered via oral gavage for group C. Enucleation was done and rats retina were prepared for histopathology and immunohistochemistry examination to evaluate photoreceptor morphology, retinal ganglion cell (RGC) density, bcl-2 and caspase-3 expression.
Result: RGC density of citicoline-treated intoxicated rats was higher than no-citicoline intoxicated rats, either on day-3 (p<0.001) or day-7 (p<0.001). Ganglion layer thickness of citicoline-treated intoxicated rats was thinner than no-citicoline intoxicated rats, which means citicoline-treated rats had milder ganglion layer edema. Citicoline-treated rats showed higher bcl-2 and lower caspase-3 expression than no-citicoline rats. No differences was found in photoreceptor findings among groups.
Conclusion: Citicoline administration showed effect in suppressing rat’s retinal ganglion layer damage in methanol intoxication.
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Depok: Fakultas Kedokteran Universitas Indonesia, 2018
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Rani Indira Sari
"Tujuan: Menganalisis efek pemberian sitikolin terhadap kerusakan sel ganglion tikus pada Etambutol Optik Neuropati (EON).
Metode: Penelitian ini merupakan penelitian eksperimental dengan hewan coba tikus. Lima belas ekor tikus Wistar dibagi dalam tiga kelompok yaitu kelompok tanpa perlakuan (A), kelompok etambutol (B), kelompok etambutol dan sitikolin (C). Kelompok B dan C diberikan perlakuan selama 30 hari, kemudian dilakukan pemeriksaan histopatologi untuk menilai densitas sel ganglion retina, dan imunohistokimia untuk menilai ekspresi bcl-2 dan caspase-3.
Hasil: Densitas sel ganglion retina tikus dengan intoksikasi etambutol yang mendapat sitikolin lebih tinggi dibandingkan yang tidak mendapatkan sitikolin (p=0,001). Lapisan ganglion tikus yang mendapat sitikolin lebih tipis dibandingkan yang tidak mendapatkan sitikolin (p=0,005), peningkatan ketebalan lapisan sel ganglion ini karena pembentukan vakuola pada sitoplasma sel ganglion. Tikus dengan sitikolin didapatkan ekspresi bcl-2 ganglion yang lebih tinggi (p=0,001), dan ekspresi caspase-3 yang lebih rendah (p=0,02) dibandingkan tikus yang tidak mendapatkan sitikolin.
Simpulan: Sitikolin memberikan efek proteksi terhadap sel ganglion retina dengan EON, dinilai dari morfologi sel ganglion dan ekspresi caspase-3 dan bcl-2.

Objective: To analyze the effects of citicoline administration on rat ganglion cell damage in Ethambutol Optic Neuropathy (EON).
Method: This study was an experimental study with rat experiments. Fifteen Wistar rats were divided into three groups, the non-treatment group (A), the ethambutol group (B), the ethambutol and citicoline group (C). Group B and C were given treatment for 30 days, then histopathological examination was performed to assess retinal ganglion cell density, and immunohistochemistry to assess bcl-2 and caspase-3 expression.
Result: retinal ganglion cell density of rat with ethambutol intoxication that received citicoline were higher than those who did not get citicoline (p = 0.001). The rat ganglion layer that received citicoline was thinner than those who did not get citicoline (p = 0.005), the increase in thickness of the ganglion cell layer was due to the formation of vacuoles in the cytoplasm of ganglion cells. Rat with citicoline obtained higher bcl-2 ganglion expression (p = 0.001), and lower caspase-3 expression (p = 0.02) than rat that did not get citicoline.
Conclusions: Citicoline have a protective effect on retinal ganglion cells with EON, judged by the morphology of ganglion cells and caspase-3 and bcl-2 expressions.
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Depok: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tesis Membership  Universitas Indonesia Library
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Lumbantobing, Joshua Partogi Ferdinand
"Tujuan: Membandingkan efek sitikolin pada hewan coba model traumatic optic neuropathy(TON) ditinjau dari gambaran histopatologi dan ekspresi imunohistokimia.
Metode: Penelitian dengan desain eksperimental terhadap 4 kelompok hewan coba. Sebanyak 12 mata dari 12 hewan coba kelinci jenis New Zealand White menjalani optic nerve crush injury(ONC) untuk menciptakan model TON. Tindakan ONC dilakukan dengan menggunakan Hartmann Mosquito Clamp. Evaluasi histopatologi berupa pemeriksaan densitas sel ganglion retina dengan pewarnaan hematoksilin-eosin dan pemeriksaan imunohistokimia dengan antibodi bcl-2 serta caspase-3.
Hasil: Densitas sel ganglion retina pada setiap kelompok menunjukkan perbedaan yang bermakna dengan nilai normal. Perbandingan berdasarkan periode waktu, baik periode 3 hari dan 7 hari, menunjukkan perbedaan yang bermakna bila dibandingkan dengan periode yang sama pada subjek tanpa terapi (p<0.001). Pemeriksaan imunohistokimia pada kelompok terapi bila dibandingkan dengan kelompok tanpa terapi menunjukkan peningkatan ekspresi bcl-2 secara signifikan pada hari-3 (p=0.012) dan hari-7 (p=0.046).Pemeriksaan imunohistokimia pada kelompok terapi bila dibandingkan dengan kelompok tanpa terapi menunjukkan penurunan ekspresi caspase-3 secara signifikan pada hari-3 (p=0.046) namun tidak pada hari ke-7 (p=0.072).
Kesimpulan: Pemberian sitikolin mampu menurunkan tingkat kematian sel ganglion retina dibandingkan tanpa terapi pada TON dan didukung dengan peningkatan ekspresi bcl-2 sebagai anti-apoptosis yang bermakna serta penurunan dari ekspresi caspase-3 sebagai pro-apoptosis.

Aims: Comparing citicoline effect in animal model of traumatic optic neuropathy (TON) in histopathology and immunohistochemical evaluation.
Methods: This is an experimental research for 4 groups of animal model. Twelve eyes from 12 New Zealand White rabbits underwent optic nerve crush injury (ONC) to create TON. The ONC was done using the Hartmann Mosquito clamp. Histopathological evaluation of retinal ganglion cell density by hematoxylin-eosin staining and immunohistochemical examination with bcl-2 and caspase-3 antibodies.
Results: Retinal ganglion cell density in each group showed a significant difference when compared with normal values. For comparisons based on the time period, 3 days and 7 days, both showed a significant difference when compared to the non-citicoline subjects in same period (p <0.001). Immunohistochemical examination in citicoline group, when compared to the non-citicoline group, showed a significant increase in bcl-2 expression on day-3 (p = 0.012) and day-7 (p = 0.046). Immunohistochemical examination in the citicoline group, when compared with the non-citicoline group, showed a significant decrease in caspase-3 expression on day-3 (p = 0.046) but not on day-7 (p = 0.072).
Conclusions: Citicoline is able to reduce the rate of retinal ganglion cell death and supported by a significant increase in the expression of bcl-2 as anti-apoptosis and a decrease in caspase-3 expression as pro-apoptosis.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tesis Membership  Universitas Indonesia Library
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Rahmi Budiarti
"Latar Belakang. Endometriosis ditandai dengan pertumbuhan jaringan endometrium di luar uterus, salah satunya disebabkan oleh disregulasi apoptosis sel yang memicu ketahanan sel ektopik. Asam galat dan turunannya pada beberapa penelitian mampu menghambat karsinogenesis pada beberapa cell line kanker. Penelitian kami terdahulu membuktikan asam galat dan turunannya dapat menekan proliferasi sel dan meningkatkan apoptosis sel endometriosis in vitro, namun efeknya terhadap mekanisme jalur apoptosis instrinsik belum di buktikan. Metode. Sel endometriosis berasal dari jaringan endometrium pasien laparaskopi, diisolasi secara enzimatis dan dikultur primer. Sel kultur diberi perlakuan asam galat, heptil galat, oktil galat dengan dosis 51,2 μg/ml, 102,4 μg/ml dan 153,6 μg/ml selama 48 jam, dilanjutkan induksi 10 ng/ml LPS selama 24 jam . Kelompok kontrol hanya di induksi LPS tanpa perlakuan. Ekspresi relatif mRNA Bax, Bcl-2, dan Caspase-3 dinilai dengan qRT-PCR. Hasil. Peningkatan tertinggi ekspresi mRNA Bax dan penekanan tertinggi ekspresi mRNA Bcl-2 pada oktil galat dosis 153,6 μg/ml. Peningkatan ekspresi mRNA Bax, dan penurunan ekspresi mRNA Bcl-2 akan di ikuti dengan peningkatan ekspresi mRNA Caspase-3. Secara statistik tidak terdapat perbedaan bermakna antara kelompok perlakuan dengan ekspresi mRNA Bax, Bcl-2, dan Caspase-3 (p > 0,05). Kesimpulan. Oktil galat, asam galat, dan heptil galat memiliki efek potensial pada mekanisme apoptosis intrinsik.

Background. Endomeriosis characterized by the presence of extrauterine endometrial tissue, one of which caused by disregulation of apoptosis that contribute of endometrial ectopic survival. Our previous research has proven that gallic acid and its derivatives can suppress proliferation and induce apoptosis endometriosis cell in vitro. However, the effect of gallic acid and its derivatives on apoptosis intrinsic pathway mechanism is not proven yet. Method. Endometriosis cell from endometriosis patiens who had undergone laparascopy surgery were isolated by enzimatic reaction and primary cultured. Cultured cells treated by gallic acid, heptyl gallate and octyl gallate each with dosage 51.2 μg/ml, 102.4 μg/ml, 153.6μg/ml for 48 hours, than induced by LPS 10 ng/ml for 24 hours. Parameter research was assessed by qRT-PCR for mRNA expression of Bax, Bcl-2, Caspase-3. Result. Octyl gallate showed more effect to induce apoptosis intrinsic . Endometriosis cell were treated with octyl gallate shown increases of Bax and Caspase3 mRNA expression than decrease of Bcl-2 mRNA expression. Statistically, mean differences are not significant between treatment groups and mRNA expression (p > 0.05). Conclusion. This study exhibited that octyl gallate has a more potential effect on apoptosis intrinsic in endometriosis cell cultures followed by gallic acid and heptyl gallate and their potency as treatment for endometriosis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Tesis Membership  Universitas Indonesia Library
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Nikki Aldi Massardi
"Telah dilakukan penelitian mengenai perbandingan ekspresi miRNA-143 pada serum dan sel eksfoliatif serviks serta hubungannya dengan ekspresi Bcl-2. Penelitian ini bertujuan untuk mengetahui perbedaan tingkat ekspresi miRNA-143 antara sampel serum dengan sampel sel eksfoliatif serta hubungannya dengan gen target Bcl-2. Data tersebut dapat digunakan sebagai informasi untuk pengembangan metode noninvasif untuk diagnosis awal kanker serviks. Penelitian dilakukan dengan mengambil sampel serum dan sampel sel eksfoliatif pada subyek normal dan subyek yang terdeteksi kanker serviks kemudian dianalisis dengan menggunakan qRT-PCR. Sampel pasien kanker serviks sebanyak 15 subyek dan 4 subyek normal digunakan untuk mendapatkan nilai kuantitas relatif ekspresi miRNA-143 dan Bcl-2. Analisis tingkat ekspresi miRNA-143 pada sampel serum menunjukkan nilai rerata yang rendah pada subyek normal dibandingkan pasien kanker serviks. Tingkat ekspresi miRNA-143 pada sampel sel menunjukkan hasil berbeda, dengan semakin tinggi derajat keparahan kanker, didapatkan hasil nilai rerata miRNA-143 yang lebih rendah. Analisis distribusi sampel menunjukkan terdapat perbedaan bermakna antara tingkat ekspresi miRNA-143 pada sampel serum dengan sampel sel p < 0,05; Kruskall Wallis . Hubungan antara miRNA-143 dengan gen target Bcl-2 pada penelitian ini menunjukkan korelasi yang lemah dan tidak signifikan r = -0,101; p > 0.05; Pearson .

Research had been done on the comparison of miRNA 143 expression in serum and exfoliative cervix cells and its relationship with expression of Bcl 2. This study aims to determine differences in the expression levels of miRNA 143 between serum samples and cell exfoliative samples and its relationship with the target gene Bcl 2. Those data can be used as information for the development of non invasive method for the early diagnosis of cervical cancer. The study was conducted by taking samples of serum and cell exfoliative samples in normal subjects and subjects with cervical cancer, then it is analyzed using qRT PCR. 15 samples of cervical cancer patients were obtained, and 4 normal subjects used to obtain the relative expression levels of miRNA 143 and Bcl 2. Analysis of the expression levels of miRNA 143 in the serum samples showed lower average value in normal subjects compared to patients with cervical cancer . MiRNA 143 expression levels in cell samples showed different results with the higher the degree of severity of the cancer, the average value of the miRNA 143 were lower. Analysis of the samples distribution showed that there are significant difference between the expression levels of miRNA 143 in the serum samples with the cell samples p 0.05, Pearson ."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T55649
UI - Tesis Membership  Universitas Indonesia Library
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Irwan Tjandra
"Latar Belakang: Hiperglikemia akut maupun kronis dapat menyebabkanperubahan patalogis pada lapisan serabut saraf retina RNFL . Pada tahap dinilapisan sel ganglion GCs mengalami apoptosis, yang diregulasi oleh proteinBrn3b. Proses ini diketahui terjadi lebih awal sebelum perubahan histopatologispada RNFL terjadi pada diabetes. Proses apoptosis ditandai dengan, peningkatanstres oksidatif, peningkatan NO, NF-??, TNF-?, dan Caspase 3 pada patogenesisglaukoma primer sudut terbuka GPSTa . Asumsi klinis saat ini bahwa penderitadiabetes melitus dalam jangka waktu lama lebih dari 5 tahun kemungkinan besarberisiko terjadinya glaukoma. Namun kenyataannya dalam pengalaman klinistidak semua pasien diabetes melitus dapat terjadi GPSTa. Berdasarkan temuanklinis tersebut diduga ada peran faktor genetik yang mendasari etiologi dariGPSTa pada pasien diabetes melitus.
Tujuan: Mengetahui peran gen Brn3b pada apoptosis di RGCs dan kaitannyadengan perubahan kuantitas NO, Caspase 3, NF-?B, dan TNF-? sebagai prediksiglaukoma dini pada tikus diabetes.
Metode: Penelitian ekperimental in vivo menggunakan tikus jantan SpraqueDawleyusia ge; 2 bulan dengan berat 150-200 gram diambil secara random sejakNopember 2015 hingga Juli 2016. Hewan coba dibagi menjadi 2 kelompok yaitu: kelompok perlakuan diinjeksi intraperitoneal STZ 50 mg/kg dalam 0.01M buffersitrat dalam ph 4.5 dan kelompok kontrol tidak ada perlakuan. Glukosa darahpuasa diperiksa 3 hari setelah injeksi STZ, dan dikonfirmasi ge; 250 mg/dL.Jaringan retina dibagi menjadi dua bagian pada kelompok perlakuan maupunkontrol yakni retina kanan untuk IHK Caspase 3 dan TNF-? dan retina kiridibagi dua bagian yaitu untuk pemeriksaan quantitative Real-time PCR RNAdiekstraksi untuk analisis ekspresi gen Brn3b dan pemeriksaan ELISA NO danNF-?B.
Hasil: Terjadi penurunan ekpresi gen Brn3b pada tikus perlakuandibandingkan ekspresi gen Brn3b kontrol sebesar 1.2677 kali bulan kedua, 1.1348kali bulan keempat, dan 2.4600 kali bulan keenam. Disisi lain terjadi penurunankuantitas NO dan peningkatan kuantitas Caspase 3, NF-?B, dan TNF-?.
Kesimpulan: Ekspresi mRNA Brn3b berbanding terbalik dengan apoptosis padaRGCs. Kuantitas NO, Caspase 3, NF-?B, dan TNF-? dipengaruhi oleh ekspresiBrn3b pada RGCs akibat hiperglikemia pada tikus diabetes.

Background: Acute and chronic hyperglycemia may pathologically changeretinal nerve fiber layer RNFL . At early stage, ganglion cells GCs undergoapoptosis, which is regulated by a Brn3b protein. This change is known to occurat earlier time before retinal histological changes can be detected in diabeticpatients. The apoptosis process is marked by an increase in oxidative stress, a risein NO, NF-??, caspase 3, and TNF-? levels in pathogenesis of primary open angleglaucoma POAG . Current clinical assumption proposes that individualssuffering from diabetes mellitus for more than 5 years have greater risk ofglaucoma. Nonetheless, clinical experience shows that not all diabetic patientsdevelop POAG. Based on clinical examinations it is suspected that there is agenetic factor that caused the etiology of POAG in diabetes mellitus patients.
Purpose: To learn the role of Brn3b gene in apoptosis of RGCs and its effect onthe changing of quantity of NO, Caspase 3, NF-?B, and TNF-? as early predictorof glaucoma in diabetic rats.
Methods: Experimental in-vivo study was carried out using male SpraqueDawleyrats with age ge; 2 months, weighing 150-200 grams. The rats wererandomly selected from November 2015 to July 2016. The animals were dividedinto two groups. Group receiving intraperitoneal injection of STZ 50 mg/kg in0.01M citric buffer and pH 4,5; 2 and control group with no treatment. Fastingblood glucose was checked 3 days after injection of STZ and hyperglycemia wasdetermined as fasting blood glucose ge; 250 mg/dL. Retinal tissue was divided intotwo parts both experimental and control groups respectively : a right retina forIHC Caspase 3 and TNF-? ; b left retina was divided into two parts for thepurpose of quantitative Real-Time PCR test RNA extraction for Brn3b geneexpression analysis and ELISA test NO and NF-?B.
Results: Experimental group showed a decrease in Brn3b expression compared tocontrol group 1.2677-fold lower on 2nd month; 1.1348-fold lower on 4th monthand 2.4600-fold lower on 6th month . On the other hand, there was a decrease ofNO and there was increased of Caspase 3, NF-?B and TNF-? quantity.
Conclusion: The expression of mRNA Brn3b is inversely proportional toapoptosis in RGCs. The quantity of NO, Caspase 3, NF-?B and TNF-? isinfluenced by expression of Brn3b in RGCs caused by hyperglycemia in diabeticrats.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Disertasi Membership  Universitas Indonesia Library
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Gitalisa Andayani
"Retinopati diabetik (DR) merupakan komplikasi mikrovaskular diabetes melitus (DM). Fenofibrat oral dapat mencegah progresivitas DR dengan mekanisme pengaturan kadar lipid lipid-related dan mekanisme lain nonlipid-related, antara lain dengan mencegah disfungsi endotel, mengurangi inflamasi, dan angiogenesis. Penelitian ini bertujuan mengetahui efek fenofibrat oral terhadap ketebalan makula sentral (CMT) dan volume makula, serta pengaruhnya pada kadar penanda biologis serum disfungsi endotel eNOS, inflamasi (VCAM-1), dan angiogenesis (VEGF) pada penyandang DR dengan dislipidemia.
Penelitian prospektif ini menggunakan disain uji klinis acak tersamar ganda dengan membagi subjek menjadi kelompok intervensi simvastatin dan fenofibrat dan kontrol simvastatin dan plasebo. Penelitian berlangsung sejak Nopember 2016 hingga Oktober 2017, di Klinik Vitreo-retina, Departemen Medik Mata ndash;RSCM Kirana, melibatkan 60 mata dari 30 pasien penyandang DR non-proliferatif NPDR dengan dislipidemia. Penelitian pada tiap subjek dilakukan selama tiga bulan dengan evaluasi klinis, foto fundus, dan spectral domain optical coherence tomography (SD-OCT) makula tiap bulan. Pengukuran kadar eNOS, VCAM-1, dan VEGF, serta HbA1c dan profil lipid dilakukan sebelum dan setelah tiga bulan pengobatan.Sebelum intervensi, pada kedua kelompok tidak didapatkan perbedaan karakteristik demografik, klinik, dan penanda biologis serum. Tidak didapatkan perbedaan bermakna pada CMT kelompok simvastatin fenofibrat 248,0 40,4 m dibandingkan kelompok simvastatin plasebo 265,8 40,8 m, namun CMT lebih rendah secara bermakna pada bulan ke-1 pada kelompok simvastatin fenofibrat. Pada subjek dengan edema makula diabetik DME pemberian simvastatin fenofibrat setelah tiga bulan menunjukkan CMT lebih rendah secara bermakna. Volume makula setelah tiga bulan pemberian obat 10086 886,4 m3 pada kelompok simvastatin fenofibrat dan 10307 1058,6 m3 pada simvastatin plasebo. Perbedaan tersebut tidak bermakna, namun pada subjek dengan regulasi glukosa darah yang baik HbA1c 7 didapatkan volume makula lebih rendah pada bulan ke-2. Kadar penanda biologis serum setelah tiga bulan pemberian obat menunjukkan rerata kadar eNOS dan median VEGF sebesar 3878,8 873,33 pg/mL dan 242,8 86 - 1123,3 pg/mL pada kelompok simvastatin fenofibrat, dibandingkan 4031,2 742,56 pg/mL dan 370 134,8 - 810,6 pg/mL pada kelompok simvastatin plasebo, yang tidak berbeda bermakna, namun penurunan kadar VCAM-1 serum lebih besar secara bermakna pada kelompok simvastatin fenofibrat 50,7 pg/mL, 32,5 - 223,4 pg/mL vs. 40,4 pg/mL, 27,9 - 94,2 pg/mL . Pada subjek dengan kontrol glukosa darah ketat HbA1c 6,5 kadar VEGF 128,7 114,5 - 145,2 pg/mL, lebih rendah secara bermakna dibandingkan 423 86 - 1233,3 pg/mL pada subjek dengan HbA1c > 6,5 .Disimpulkan pemberian simvastatin fenofibrat selama tiga bulan pada subjek DR dengan dislipidemia secara umum tidak menurunkan CMT dan volume makula, namun menurunkan CMT khusus pada subjek DR dengan DME. Pemberian simvastatin fenofibrat pada subjek DR tidak mencegah penurunan kadar eNOS, peningkatan kadar VCAM-1 dan VEGF, namun pengendalian gula darah yang baik dapat mencegah peningkatan kadar VEGF. Simvastatin fenofibrat dapat dipertimbangkan sebagai terapi ajuvan pada penyandang DR dengan DME yang disertai dislipidemia. Pengontrolan glukosa yang baik merupakan manajemen utama pada DR.

Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus (DM) due to structural and biochemical changes. Previous studies showed that oral fenofibrate prevents DR progression through lipid-regulating and nonlipid-related mechanisms, including preventing endothelial dysfunction, reducing inflammation and angiogenesis. This study aims to investigate the effects of oral fenofibrate on central macular thickness CMT and macular volume, and on specific biomarkers of endothelial dysfunction eNOS, inflammation VCAM-1 , and angiogenesis VEGF in DR individuals with dyslipidemia.
This is a prospective, double-blind randomized clinical trial, with subjects divided into intervention group simvastatin fenofibrate and control group simvastatin placebo. This study was conducted from November 2016 to October 2017 at the Vitreo-retina Clinic, Department of Ophthalmology ndash; RSCM Kirana, involving 60 eyes from 30 non-proliferative DR patients NPDR with dyslipidemia that met inclusion criteria. Each subject was observed for three months, with monthly clinical evaluation, fundus photo, and macular spectral domain optical coherence tomography SD-OCT . Serum eNOS, VCAM-1, and VEGF biomarkers, as well as HbA1c and lipid profile, were examined before and after intervention.Before intervention, there were no differences in demographic and clinical characteristics, and serum biomarker levels between two groups. After three months of treatment, there was no significant difference between CMT in the intervention group and the control group 248 40.4 ? m vs. 265.8 40.8 ? m , but a significantly lower CMT was observed in the intervention group at the first month. There was also a significantly lower CMT compared to the control group 294 39,2 vs 263 24,4, p=0,045 in eyes with diabetic macular edema DME . Macular volume after three-month treatment was 10086 886.4 ? m3 in the intervention group and 10307 1058.6 ? m3 in the control group, this difference was not significant. However, in all subjects with good blood glucose regulation HbA1c 7 , macular volume in the second month was significantly lower compared to subjects with HbA1c > 7 . Serum biologic marker levels after three-month treatment showed no significant difference between control and intervention group, respectively, in mean eNOS 3878.8 873.33 pg/mL vs 4031.2 742.56 pg/mL and median VEGF levels 242.8 86 - 1123.3 pg/mL vs 370 134.8 - 810.6 pg/mL . Nonetheless, the decrease in VCAM-1 level was significantly higher in the intervention group 50.7 pg/mL, 32.5 - 223.4 pg/mL vs. 40.4 pg/mL, 27.9 - 94.2 pg/mL . In subjects with tighter blood glucose control HbA1c 6.5 , serum VEGF level was 128.7 114.5 - 145.2 pg/mL, which was significantly lower compared to 423 86 - 1233.3 pg/mL in subjects with HbA1c > 6.5 .In conclusion, three-month treatment with simvastatin fenofibrate does not reduce CMT and macular volume in overall DR subjects with dyslipidemia, but it reduces CMT in subjects with DME. Simvastatin fenofibrate treatment in DR subjects does not prevent lowering of serum eNOS levels, elevation of VCAM-1 levels, and elevation of VEGF levels, but tight blood sugar control prevents elevation of serum VEGF. Although good glucose control remains the most essential in the management of DR, simvastatin fenofibrate may be considered as adjuvant therapy for DR with dyslipidemia and DME."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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UI - Disertasi Membership  Universitas Indonesia Library
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Damara Andalia
"ABSTRAK
Latar belakang Glaukoma masih merupakan salah satu penyebab kebutaan
terbesar di dunia. Belakangan ini, ketebalan RFNL dan GCIPL diketahui memiliki
hubungan terhadap perubahan struktural yang disebabkan oleh glaukoma.
Tujuan untuk mengkaji kemampuan diagnostik dari pengukuran ketebalan RFNL
dan GCIPL dalam mendeteksi glaukoma pada tahap awal.
Metode Enam puluh empat mata dengan sudut bilik mata sempit (32 glaukoma,
32 non-glaukoma) dari 48 pasien menjalani pengukuran menggunakan Cirrus
OCT dengan protokol 3,4 mm pemindaian cepat RFNL peripapilar. Pengukuran
dilakukan pada sisi superior, inferior, nasal, temporal dari GCIPL dan RFNL,
begitu juga dengan GCIPL superotemporal, superonasal, inferotemporal,
inferonasal, dan minimal.
Hasil Semua parameter yang diuji pada studi ini menunjukkan angka yang lebih
rendah pada kelompok PACG dibandingkan kelompok PAC. Rerata ketebalan
RFNL dan ketebalan GCIPL inferotemporal masing-masing memiliki nilai
spesifitias dan sensitifitas yang paling baik. Parameter dengan determinan terbaik
adalah ketebalan GCIPL inferotemporal dengan sensitifitas dan spesifitas masingmasing
75%
dan
75%.
Kesimpulan
Ketebalan GCIPL dan RFNL peripapil memiliki potensi besar
sebagai parameter diagnostik seperti skrining dan evaluasi respon terapi.
ABSTRACT
Background Glaucoma remains one of the biggest causes of blindness
worldwide. Recently, RFNL and GCIPL thickness were shown to be correlated
with early structural changes caused by glaucoma.
Objective to evaluate the diagnostic performance of RFNL and GCIPL thickness
measurement in detecting early glaucoma
Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)
of
48
patients underwent peripapillar scanning using Cirrus OCT
using 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurement
includes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well as
superotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL.
Result All parameters studied were significantly thinner in PACG group
compared to PAC group. Mean RFNL thickness and inferotemporal GCIPL has
the highest specificity and sensitivity, respectively, in detecting glaucoma.
Parameter with the best determinant is inferotemporal GCIPL thickness with
sensitivity and specificity, 75% and 71.9%, respectively.
Conclusion Peripapillary RFNL and GCIPL could be a potential diagnostic
parameter in detecting early glaucoma and monitoring therapy response in
glaucoma patients. ;Background Glaucoma remains one of the biggest causes of blindness
worldwide. Recently, RFNL and GCIPL thickness were shown to be correlated
with early structural changes caused by glaucoma.
Objective to evaluate the diagnostic performance of RFNL and GCIPL thickness
measurement in detecting early glaucoma
Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)
of
48
patients underwent peripapillar scanning using Cirrus OCT
using 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurement
includes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well as
superotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL.
Result All parameters studied were significantly thinner in PACG group
compared to PAC group. Mean RFNL thickness and inferotemporal GCIPL has
the highest specificity and sensitivity, respectively, in detecting glaucoma.
Parameter with the best determinant is inferotemporal GCIPL thickness with
sensitivity and specificity, 75% and 71.9%, respectively.
Conclusion Peripapillary RFNL and GCIPL could be a potential diagnostic
parameter in detecting early glaucoma and monitoring therapy response in
glaucoma patients. ;Background Glaucoma remains one of the biggest causes of blindness
worldwide. Recently, RFNL and GCIPL thickness were shown to be correlated
with early structural changes caused by glaucoma.
Objective to evaluate the diagnostic performance of RFNL and GCIPL thickness
measurement in detecting early glaucoma
Method Sixty-four eyes with primary angle closure (32 glaucomatous, 32 nonglaucomatous)
of
48
patients underwent peripapillar scanning using Cirrus OCT
using 3,4 mm protocol fast RNFL peripapillary thickness scan. The measurement
includes superior, inferior, nasal, temporal, mean GCIPL and RFNL, as well as
superotemporal, superonasal, inferotemporal, inferonasal, minimal GCIPL.
Result All parameters studied were significantly thinner in PACG group
compared to PAC group. Mean RFNL thickness and inferotemporal GCIPL has
the highest specificity and sensitivity, respectively, in detecting glaucoma.
Parameter with the best determinant is inferotemporal GCIPL thickness with
sensitivity and specificity, 75% and 71.9%, respectively.
Conclusion Peripapillary RFNL and GCIPL could be a potential diagnostic
parameter in detecting early glaucoma and monitoring therapy response in
glaucoma patients. "
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
"Oral commensal bacterium Streptococcus sanguinis may find in periodontal lesions, deep seated infection, and infective endocarditis that are usually dominated by anaerobes. This bacterium caused cell death on some cells but host responses to this species remained unclear. Objective: This study was aimed to detect cell morphological
change and role of caspase-3 in cell death mechanism induced by S. sanguinis. Methods: HeLa cells as representative model for oral epithelial cells were exposed to 107 cells/ml bacteria for 48 h. Morphological change was observed microscopically after hematoxyline-eosin staining. Expression of active caspase-3 was examined by immunocytochemical analysis after cell stimulation for 36 and 48 h with wild type supragingival S. sanguinis. Doxorubicin (0.5625 μg/ml) was used as positive control for caspase-3 activation. Results: The results showed cell shrinkage of bacterial-treated cells; and active caspase-3 molecules were detected after 36 and 48 hours cell stimulation. Conclusion: This study would suggest cell shrinkage and caspase-3-dependent apoptotic cell death induced by S. sanguinis."
Fakultas Kedokteran Gigi, 2015
pdf
Artikel Jurnal  Universitas Indonesia Library
cover
Erfira
"Tujuan: Mengetahui pengaruh suplementasi 4 g Omega-3 sehari selama 6 minggu terhadap hasil elektrofisiologi retina penderita non proliferative diabetic retinopathy (NPDR) ringan dan sedang. Desain: Uji klinik eksperimental secara acak dan tersamar ganda. Metode: Empat belas penderita NPDR ringan dan sedang mendapatkan suplementasi 4 g Omega-3 sehari (kelompok perlakuan) selama 6 minggu dan empat belas penderita NPDR ringan dan sedang lainnya mendapatkan plasebo (kelompok kontrol). Pemeriksaan Scotopic ERG dan kadar Omega-3 darah dilakukan pra dan pasca-suplementasi. Hasil: Rerata amplitudo gelombang-a scotopic ERG kelompok kontrol dan kelompok perlakuan berturut-turut adalah 143,32 + 62,5 uV dan 195,57 + 53,3 uV, amplitudo gelombang-b sebesar 200,32+78,6 uV dan 233,06 + 53,4 uV, waktu implisit gelombang-a kelompok kontrol dan kelompok perlakuan adalah 20,16 + 1,9 msec dan 19,36+2,8 msec, sedangkan untuk gelombang-b adalah 40,91 5,5 msec dan 40,01 3,9 msec. Kadar Omega-3 darah kelompok kontrol dan kelompok perlakuan berturut turut adalah 974 ng/mg dan 1430,12 ng/mg. Terdapat perbedaan bermakna pada amplitudo gelombang-a (p<0,05) antara kedua kelompok penelitian. Kesimpulan: Pengaruh suplementasi 4 g Omega-3 sehari selama 6 minggu tidak terbukti secara statistik dalam meningkatkan amplitudo gelombang-b dan memendekkan waktu implisit gelombang-b penderita NPDR, tetapi terbukti bermakna secara statistik dalam meningkatkan amplitudo gelombang-a."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T57255
UI - Tesis Membership  Universitas Indonesia Library
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