Hasil Pencarian  ::  Simpan CSV :: Kembali

"Tujuan: Mendapatkan alat (Mikrokapiler Digital/MD) untuk mengukur viskositas darah dan plasma yang mempunyai presisi dan akurasi yang baik. Mengetahui peran viskositas darah dan plasma yang diukur dengan MD, faktor risiko dan determinan terhadap prognosis stroke iskemik akut berdasarkan National Institute of Health Stroke Scale (NIHSS), Modified Rankin Score (mRS), Interleukin 6 (IL-6), dan neuron-specific enolase (NSE). Penelitian tahap pertama meliputi uji presisi dan akurasi, sedangkan tahap kedua adalah uji prognosis. Subjek penelitian: Subjek untuk uji presisi adalah 40 dewasa sehat yang melakukan Medical Check Up (MCU). Subjek untuk uji akurasi dan prognosis adalah 135 pasien stroke iskemik akut onset ≤ 3 hari, usia 35 – 74 tahun. Pengukuran dan intervensi: Presisi dinilai dengan coefficient of variation (CV), interrater variability Cronbach Alpha dan coefficient of reliability Bland Altman. Akurasi dinilai dengan uji diagnostik. Uji prognosis meliputi analisis bivariat dilanjutkan dengan analisis multivariat cox proportional hazards regression. Hasil: Dari penelitian tahap pertama, didapatkan CV sebesar 0,04, nilai interrater variability Cronbach Alpha dan mean difference Bland Altman adalah baik. Sensitivitas dan spesifisitas MD untuk viskositas darah adalah 88,9 % dan 88,9 %, sedangkan untuk viskositas plasma adalah 100 % dan 84 %. Rumus prediksi untuk konversi viskositas darah MD ke satuan poise adalah y = 0,846x + 0,614, dan untuk viskositas plasma adalah y = 1,072x + (-0,160). Pada uji tahap kedua, didapatkan faktor determinan antara lain: fibrinogen merupakan faktor determinan perubahan viskositas darah dan plasma; viskositas darah merupakan faktor determinan perburukan kondisi klinis (National Institute of Health Stroke Scale/NIHSS dan modified Rankin Scale/mRS); viskositas darah dan diabetes melitus (DM) merupakan faktor determinan prognosis stroke iskemik akut berdasarkan interleukin 6 (IL-6); dan HDL merupakan faktor determinan prognosis stroke iskemik akut berdasarkan neuron specific enolase (NSE). Simpulan: MD memiliki presisi dan akurasi yang baik. Viskositas darah merupakan faktor determinan perburukan kondisi klinis baik akut maupun pasca perawatan.

---

Objectives: To design a simple and portable instrument (Digital Microcapillary) for measuring blood and plasma viscosity values with high precision and accuracy. To assess the roles of these values, the risk and determining factors in predicting the outcome of acute ischemic stroke assessed using National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), interleukin 6 (IL-6), and neuron specific enolase (NSE). The first stage of this study included precision and accuracy tests, while the second stade was the prognostic test.

Research subjects: 40 healthy adults admitted for Medical Check Up (MCU) were recruited for the precision test while the subjects for accuracy and prognostic tests were 135 acute ischemic stroke patients, either inpatients or outpatients, aged 35 - 74 years old, with up to 3 days stroke onset.

Measurement and intervention: The precision was assessed by calculating coefficient of variation (CV), Cronbach Alpha interrater variability, and Bland Altman coefficient of reliability, while the accuracy was assessed using diagnostic test. The prognostic test included bi- and multivariate analyses using Cox proportional hazards regression.

Results: The results of the first stage study were that the CV was 0.04; Cronbach Alpha interrater variability and Bland Altman mean difference values were excellent. The prediction formula used to convert blood viscosity value measured with digital microcapillary to poise unit was y = 0.846x + 0.614, and the formula for plasma viscosity was y = 1.072x + (-0.160). The sensitivity and specificity of Digital Microcapillary for blood viscosity measurement were 88.9 % and 88.9 %, respectively and for plasma viscosity measurement were 100 % and 84 %, respectively. The second stage of the study showed that the variables proven to be the determinants were: fibrinogen as the determinant of blood and plasma viscosity, blood viscosity as the determinant of clinical outcome (NIHSS and mRS), blood viscosity and diabetes mellitus as the determinants of acute ischemic stroke outcome indicated by blood IL-6 level, and HDL as the determinant of acute ischemic stroke outcome indicated by NSE level.

Conclusions: Digital Microcapillary has high precision and accuracy. Blood viscosity is a determining factor in the ischemic stroke outcome, both acute and one month after hospital discharge."

"Cedera saraf perifer, seperti cedera saraf skiatik dapat mengakibatkan disabilitas. Metode pengobatan dalam memicu regenerasi saraf yang mengalami cedera dapat dilakukan melalui terapi berbasis sel punca mesenkimal (SPM) dengan potensi regenerasi dan memicu efek parakrin. Regenerasi saraf skiatik dianalisis secara histologi melalui analisis deskriptif otot gastroknemius tikus galur Sprague– Dawley dengan pewarnaan hematoksilin–eosin dan jumlah kluster neuromuscular junction (NMJ) pada serat otot dengan pewarnaan Palmgren silver. Analisis secara molekuler juga dilakukan untuk mengamati tingkat ekspresi gen esensial yang mampu meregulasi regenerasi dari saraf skiatik dengan qRT-PCR. Kelompok yang digunakan dalam penelitian ini adalah kelompok kontrol (sehat) dan kelompok perlakuan cedera saraf skiatik yang diinjeksikan dengan SPM adiposa manusia. Penelitian dilakukan untuk mengamati pengaruh injeksi SPM adiposa manusia terhadap regenerasi saraf skiatik dari aspek histologi dan mengamati pengaruh injeksi SPM adiposa manusia melalui ekspresi gen Agrin dan PROM1. Hasil penelitian menunjukkan bahwa injeksi SPM adiposa manusia menunjukkan aspek regenerasi histologi pada otot gastroknemius dengan mengurangi tingkat atrofi otot, tetapi belum adanya regenerasi jumlah kluster NMJ yang terbentuk pada serat otot. Ekspresi gen Agrin menurun sebesar 1,1 kali lipat, sedangkan gen PROM1 menurun sebesar 2,1 kali lipat. Uji statistik pada jumlah kluster NMJ dan ekspresi gen Agrin tidak menunjukkan perbedaan nyata antarkelompok, sedangkan ekspresi gen PROM1 menunjukkan adanya perbedaan nyata antarkelompok. Berdasarkan hasil penelitian, injeksi SPM adiposa manusia belum menunjukkan aspek regenerasi pada saraf skiatik.

---

Peripheral nerve injury, such as sciatic nerve injury, can result in disability. Treatment to induce nerve regeneration can be conducted with mesenchymal stem cells (MSC) therapy, which has regenerative potential and triggers paracrine effects. Sciatic nerve regeneration is analyzed histologically through descriptive analysis of the gastrocnemius muscle of Sprague–Dawley strain rat with hematoxylin-eosin staining and the number of neuromuscular junction (NMJ) clusters in muscle fibers with Palmgren silver staining. Molecular analysis is conducted to observe the expression levels of essential genes that can regulate the regeneration of the sciatic nerve using qRT-PCR. The groups used are the control group (healthy) and the treatment group of injection with human adipose tissue derived MSC. This study aims to observe the effect of human adipose tissue derived MSC injection on sciatic nerve regeneration with histological perspective and to observe its effect through the expression of Agrin and PROM1 genes. Results showed that the injection of human adipose tissue derived MSC demonstrates histological regeneration in the gastrocnemius muscle by reducing muscle atrophy. However, there is no regeneration in the number of NMJ clusters formed on muscle fibers. The expression of the Agrin gene decreased by 1.1-fold, while the PROM1 gene decreased by 2.1-fold. Statistical analysis revealed no significant differences in NMJ clusters and Agrin gene expression between groups, but a significant difference was found in PROM1 gene expression. Based on the results, the injection of human adipose tissue derived MSC has not yet shown aspects of regeneration in the sciatic nerve."

"Pendahuluan: Cedera saraf tepi dapat menyebabkan cacat fungsional yang parah. Denervasi yang berkepanjangan menyebabkan perubahan permanen pada organ target sekalipun dilakukan operasi dengan teknik rekonstruksi saraf bedah mikro. Oleh karena itu, banyak penelitian regeneratif telah dilakukan untuk meningkatkan luaran fungsional setelah tindakan rekonstruksi saraf pada cedera saraf tepi.Metode: Dilakukan transeksi komplet saraf iskiadikus tungkai belakang kanan pada 20 tikus Sprague-Dawley jantan. Setiap ujung saraf dijahit ke otot terdekat untuk mencegah pertumbuhan saraf spontan. Setelah 3 minggu denervasi, dilakukan penyambungan saraf dan implantasi sel punca mesenkimal (SPM) ke neuromuscular junction (NMJ) otot gastroknemius pada kelompok perlakuan (n=10). Sepuluh tikus lainnya (kelompok kontrol) menerima plasebo (NaCL). Delapan minggu setelah penyambungan saraf, seluruh sampel dinilai luaran fungsional dengan analisis walking track dan studi neurofisiologi yang dilakukan sebelum terminasi. Berat otot basah dievaluasi kemudian dilakukan pemeriksaan histomorfometri.Hasil dan Diskusi: Denervasi saraf iskiadikus selama tiga minggu menghasilkan model cedera saraf perifer kronis yang secara klinis mengakibatkan gangguan berjalan dan secara histologis menyebabkan degenerasi otot gastroknemius. Tidak ada perbedaan analisis walking track, compound muscle action potential (CMAP) dan berat otot basah antara kedua kelompok. Namun, penyambungan saraf yang dikombinasikan dengan implantasi SPM memberikan gambaran preservasi NMJ dan regenerasi otot yang lebih baik sebagai organ target saraf yang terbukti secara histologis dengan fragmentasi reseptor asetilkolin (AChR) yang jauh lebih rendah, jumlah dan kepadatan AChR yang lebih besar, serta diameter serat otot yang lebih besar.Kesimpulan: Implantasi SPM di NMJ berpotensi menunda degenerasi organ target dan meningkatkan regenerasi

---

Introduction: Peripheral nerve injury is a devastating condition that can lead to severe functional disabilities. Despite the use of advanced microsurgical nerve reconstruction techniques, prolonged denervation causes irreversible changes in target organs. Thus, many regenerative studies have been conducted to increase functional outcomes in animal models.

Methods: Complete sciatic nerve transection was performed on the right hind limb of 20 male Sprague-Dawley rats. Each nerve end was sutured to the approximate muscle at a distance to prevent spontaneous nerve regrowth. After 3 weeks of denervation, the nerve was repaired and mesenchymal stem cells was injected directly to the gastrocnemius neuromuscular junction (NMJ) in MSCs group (n=10) and the rest of the rats (control group) received placebo (normal saline). Clinically, all sample were observed by walking track analysis and a neurophysiology study which was done before termination (8 weeks after nerve repair). Postmortem wet muscle weight was evaluated, and histological examination was performed

Result and Discussion: Three weeks sciatic nerve denervation produce the chronic peripheral nerve injury model which resulted clinically as gait disturbance and histologically as gastrocnemius muscle degeneration. There was no difference in walking track analysis, compound muscle action potential (CMAP) and muscle weight between two groups. However, the delayed nerve repair combined with stem cell implantation gives a better NMJ and muscle regeneration as the nerve target organ that proven histologically with a significantly lesser acetylcoline receptor (AChR) fragmentation, greater AChR amount and density, as well as larger muscle fiber diameter.

Conclusion: Mesenchymal stem cell direct implantation in neuromuscular junction possibly delayed the end organ degeneration and enhanced regeneration proven by a better morphometry profile in MSCs group."

"Pendahuluan: Cedera saraf tepi dapat menyebabkan cacat fungsional yang parah. Denervasi yang berkepanjangan menyebabkan perubahan permanen pada organ target sekalipun dilakukan operasi dengan teknik rekonstruksi saraf bedah mikro. Oleh karena itu, banyak penelitian regeneratif telah dilakukan untuk meningkatkan luaran fungsional setelah tindakan rekonstruksi saraf pada cedera saraf tepi.Metode: Dilakukan transeksi komplet saraf iskiadikus tungkai belakang kanan pada 20 tikus Sprague-Dawley jantan. Setiap ujung saraf dijahit ke otot terdekat untuk mencegah pertumbuhan saraf spontan. Setelah 3 minggu denervasi, dilakukan penyambungan saraf dan implantasi sel punca mesenkimal (SPM) ke neuromuscular junction (NMJ) otot gastroknemius pada kelompok perlakuan (n=10). Sepuluh tikus lainnya (kelompok kontrol) menerima plasebo (NaCL). Delapan minggu setelah penyambungan saraf, seluruh sampel dinilai luaran fungsional dengan analisis walking track dan studi neurofisiologi yang dilakukan sebelum terminasi. Berat otot basah dievaluasi kemudian dilakukan pemeriksaan histomorfometri.Hasil dan Diskusi: Denervasi saraf iskiadikus selama tiga minggu menghasilkan model cedera saraf perifer kronis yang secara klinis mengakibatkan gangguan berjalan dan secara histologis menyebabkan degenerasi otot gastroknemius. Tidak ada perbedaan analisis walking track, compound muscle action potential (CMAP) dan berat otot basah antara kedua kelompok. Namun, penyambungan saraf yang dikombinasikan dengan implantasi SPM memberikan gambaran preservasi NMJ dan regenerasi otot yang lebih baik sebagai organ target saraf yang terbukti secara histologis dengan fragmentasi reseptor asetilkolin (AChR) yang jauh lebih rendah, jumlah dan kepadatan AChR yang lebih besar, serta diameter serat otot yang lebih besar.Kesimpulan: Implantasi SPM di NMJ berpotensi menunda degenerasi organ target dan meningkatkan regenerasi

---

Introduction: Peripheral nerve injury is a devastating condition that can lead to severe functional disabilities. Despite the use of advanced microsurgical nerve reconstruction techniques, prolonged denervation causes irreversible changes in target organs. Thus, many regenerative studies have been conducted to increase functional outcomes in animal models.

Methods: Complete sciatic nerve transection was performed on the right hind limb of 20 male Sprague-Dawley rats. Each nerve end was sutured to the approximate muscle at a distance to prevent spontaneous nerve regrowth. After 3 weeks of denervation, the nerve was repaired and mesenchymal stem cells was injected directly to the gastrocnemius neuromuscular junction (NMJ) in MSCs group (n=10) and the rest of the rats (control group) received placebo (normal saline). Clinically, all sample were observed by walking track analysis and a neurophysiology study which was done before termination (8 weeks after nerve repair). Postmortem wet muscle weight was evaluated, and histological examination was performed

Result and Discussion: Three weeks sciatic nerve denervation produce the chronic peripheral nerve injury model which resulted clinically as gait disturbance and histologically as gastrocnemius muscle degeneration. There was no difference in walking track analysis, compound muscle action potential (CMAP) and muscle weight between two groups. However, the delayed nerve repair combined with stem cell implantation gives a better NMJ and muscle regeneration as the nerve target organ that proven histologically with a significantly lesser acetylcoline receptor (AChR) fragmentation, greater AChR amount and density, as well as larger muscle fiber diameter.

Conclusion: Mesenchymal stem cell direct implantation in neuromuscular junction possibly delayed the end organ degeneration and enhanced regeneration proven by a better morphometry profile in MSCs group."