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"[ABSTRAKLatar belakang dan tujuan: Keloid merupakan pertumbuhan berlebih dari kolagen dermis yang dapat menimbulkan masalah fisis dan psikis bagi penderitanya. Berbagai pilihan terapi telah digunakan untuk pengobatan keloid. Penelitian ini membandingkan efikasi dan efek samping antara kombinasi triamsinolon asetonid (TA) dan 5-fluorouracil (5-FU) dengan TA intralesi pada terapi keloid.Metode: Studi eksperimen dengan desain single blind randomized controlled trial (RCT) terhadap pasien keloid. Penelitian ini melibatkan 2 kelompok, yaitu: kelompok intervensi yang mendapat kombinasi 5-fluorourasil dan triamsinolon asetonid intralesi, dan kelompok kontrol yang mendapat terapi tunggal triamsinolon asetonid intralesi. Kedua kelompok diberi pengobatan 1 kali perminggu selama 8 minggu dan lesi keloid diukur tinggi dan volume.Hasil: Penurunan tinggi dan volume terjadi pada kedua kelompok. Pada penurunan tinggi, respons baik terjadi pada 75% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,403). Sedangkan pada penurunan volume, respons baik terjadi pada 58,3% kelompok intervensi dan 63,6% kelompok kontrol (p = 0,713). Sebanyak 5 dari 24 SP pada kelompok intervensi mengalami efek samping berupa gatal, nyeri ringan, ulkus dangkal, dan telangiektasi. Sedangkan pada kelompok kontrol terdapat 7 dari 22 SP yang mengeluh gatal, nyeri ringan, dan telangiektasi.Kesimpulan: Secara umum, efikasi dan efek samping kombinasi TA dan 5-FU intralesi sebanding dengan TA saja.

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ABSTRACTBackground and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone;Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone, Background and objectives: Keloid are benign growths of dermal collagen that can cause physical and psychological problems for patients. A variety of treatment regimens have been used for treatment of keloids. This study was conducted to compare efficacy and side effects intralesional combination triamcinolone acetonide (TA) with 5-fluorouracil (5-FU) and TA alone for the treatment of keloid.Methods: Experimental study, single blind randomized controlled trial (RCT) for keloid patients. This study involved two groups: intervention group who received intralesional combination TA with 5-FU, and the control group who received intralesional TA alone. Both groups received treatment once a week for 8 weeks and lesions were assessed for height and volume.Results: Both groups showed improvement in height and volume. In height flattening, 75% patients in intervention group had good response, comparing to 63,6% control group (p = 0,403). While in volume reduction, 58,3% patients in intervention group had good response, comparing to 63,6% in control group (p = 0,713). Five out of 24 patients in intervention group had some side effects like itch, mild pain, superficial ulcer, and telangiectasis. While in control group, 7 out of 22 patients had itch, mild pain, and telangiectasis.Conclusions: The overall efficacy and side effects of combination triamcinolon acetonide with 5-fluorouracil was comparable with triamcinolone acetonide alone]"

"ABSTRAKKeloid adalah kondisi abnormal dalam proses penyembuhan luka yang tumbuh menyebar melebihi batas luka normal. Keloid berada dalam kondisi hipoksia relatif yang melibatkan proses adaptasi berupa perubahan lingkungan mikro dari normoksia menjadi hipoksia, termasuk dalam hal ini adalah metabolisme laktat. Monocarboxylate transporters MCTs yang berperan dalam metabolisme laktat pada patogenesis keloid belum jelas dipahami. Oleh karena itu, penelitian ini bertujuan untuk menganalisis metabolisme laktat pada jaringan keloid dengan mengukur ekspresi MCT1 dan MCT4 yang berperan penting dalam transpor laktat melalui membran plasma. Jenis penelitian ini adalah studi observasional deskriptif analitik dengan desain studi potong lintang cross sectional study . Sampel jaringan dan stroma keloid diperoleh dari 3 jaringan keloid dengan metode eksplan dan dibandingkan dengan stroma dari kultur primer dermis preputium sebagai kontrol. Ekspresi mRNA MCT1 dan MCT4 diukur dengan menggunakan quantitative real time-polymerase chain reaction qRT-PCR . Ekspresi protein MCT1 dan MCT4 dideteksi dengan teknik enzyme linked immunosorbent assay ELISA . Kadar laktat ekstraseluler diukur dengan EnzyChromTM L-Lactate Assay Kit. Ekspresi mRNA MCT1 dan MCT4 jaringan dan stroma keloid lebih tinggi bermakna dibandingkan stroma preputium.

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ABSTRACTKeloid is an abnormality of wound healing process that growing spread beyond the limits of normal injury. Keloid is in relative hypoxia condition that involves the adaptation of microenvironmental change from normoxia into hypoxia including lactate metabolism. The role of monocarboxylate transporters MCTs in lactate metabolism of keloid patogenensis still not clearly understood. Therefore, the aim of this study is to analyze lactate metabolism in keloid tissue by measuring the expression of MCT1 and MCT4 as the key player of lactate transport through the plasma membrane as in tumor microenvironment. The type of this research is descriptive analytic observational study with cross sectional study design. Keloid samples derived from 3 keloid tissue culture using explants method and compared with primary cultures of dermis foreskin as a control. MCT1 and MCT4 mRNA expression were measured using real time quantitative polymerase chain reaction qRT PCR. MCT1 and MCT4 protein expression was detected by using enzyme linked immunosorbent assay ELISA . Extracellular lactate levels measured by EnzyChromTM L Lactate Assay Kit. MCT1 and MCT4 mRNA expression of keloid tissues and stromal cells significantly higher compared with foreskin fibroblasts p"

"ABSTRAKPendahuluan: Keloid adalah tumor jinak pada kulit yang ditandai denganpeningkatan deposisi kolagen yang disebabkan oleh tingginya aktivitas danproliferasi fibroblas. Karakteristik utama dari keloid adalah berada pada kondisihipoksia. Hypoxia inducible factor-1alpha HIF-1? dan HIF-2? merupakansubunit faktor transkripsi HIF-1 dan HIF-2 yang berperan penting pada adaptasiterhadap kondisi hipoksia. Kondisi hipoksia juga memicu sel memproduksireactive oxygen species ROS yang dapat ditangkal oleh sitoglobin Cygb . Padakeloid, Cygb juga berperan pada sintesis kolagen. Penelitian lain membuktikanbahwa terdapat situs pengikatan promoter HIF-1 pada hypoxia response element HRE Cygb, sedangkan situs pengikatan HIF-2 pada Cygb belum diketahui. HIF-1? dan HIF-2? juga diketahui berperan menginduksi ekspresi gen yang berperanpada proliferasi. Keduanya diketahui mengatur proliferasi sel pada beberapa jeniskanker. Namun, peran HIF-1? dan HIF-2? terhadap ekspresi Cygb dan proliferasifibroblas pada keloid belum diketahui. Oleh karena itu, penelitian ini bertujuanmengetahui peran HIF-1? dan HIF-2? terhadap ekspresi sitoglobin dan proliferasifibroblas pada keloid, dengan melakukan penghambatan HIF-1? dan HIF-2? padafibroblas keloid menggunakan inhibitor HIF berupa ibuprofen. Metode:Pemeriksaan dilakukan terhadap ekspresi mRNA dan kadar protein HIF-1?, HIF-2?, dan sitoglobin, menggunakan metode qRT-PCR dan ELISA, serta proliferasisel menggunakan metode trypan blue exclussion assay setelah diberi ibuprofendan dibandingkan dengan kontrol yang tidak diinduksi dengan ibuprofen. Hasil:Penghambatan HIF-1? menyebabkan terjadinya penurunan ekspresi mRNA Cygbdan proliferasi fibroblas pada keloid. Hal ini membuktikan bahwa HIF-1?berperan sebagai faktor transkripsi Cygb, dan juga berperan menginduksi ekspresigen yang berperan pada proliferasi fibroblas keloid. Akan tetapi, peran HIF-2?dalam meregulasi sitoglobin dan mempertahankan proliferasi fibroblas keloidbelum berhasil dibuktikan. Kesimpulan: HIF-1? berperan meregulasi eksrepsiCygb dan berperan pada proliferasi fibroblas keloid. Akan tetapi, HIF-2? belumterbukti meregulasi eksrepsi Cygb dan berperan pada proliferasi fibroblas keloid.

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ABSTRACTBackground Keloid is a benign tumor which is characterized by overabbundance of collagen deposition caused by high activity and proliferation offibroblast. The main characteristics of keloid is hypoxia. HIF 1 and HIF 2 aretwo subunits of transcrption factors HIF 1 and HIF 2 which mediate adaptationto hypoxic condition. Hypoxic condition also induces cells to produce reactiveoxygen species ROS which can be scavenged by cytoglobin Cygb . In keloid,Cygb also plays important role in collagen synthesis. Other studies prove thatthere is a binding site of HIF 1 promoter on hypoxia response element HRE ofCygb. Whereas, HIF 2 binding site on HRE of Cygb is not cleraly understood.HIF 1 and HIF 2 also play important role to induce expression of many geneswhich involved in cells proliferation. Both HIF 1 and HIF 2 are known toregulate cells proliferation in many cancer types. However, the role of HIF 1 andHIF 2 to Cygb expression and fibroblast proliferation in keloid is not fullyunderstood. Therefore, the aim of this study is to determine the role of HIF 1 andHIF 2 on Cygb expression and fibroblast proliferation in keloid, by doing aninhibition of HIF 1 and HIF 2 in keloid fibroblast primary culture usingibuprofen as HIF inhibitor. Methods Analysis was conducted by analizing HIF 1 , HIF 2 , and Cygb mRNA expression and protein level using qRT PCR andELISA, and fibroblast proliferation analysis was conducted using trypan blueexclusion assay after given with ibuprofen and compared with control which isnot given with ibuprofen. Results Inhibition of HIF 1 caused a decrease onCygb mRNA expression and fibroblast proliferation on keloid. These findingsprove that HIF 1 acts as transcription factor of Cygb, and also inducesexpression of gene which plays a role on fibroblast proliferation in keloid.However, the role of HIF 2 in regulating and maintaining Cygb expression andfibroblast proliferation in keloid was not succesfully proven. Conclusion HIF 1 regulate Cygb expression and fibroblast proliferation in keloid. However, HIF 2 role on Cygb expression and fibroblast proliferation has not be proven yet."

"Latar belakang: Penuaan paru ditandai dengan perubahan struktur dan fisiologi paru. Secara struktural, terjadi perubahan ketebalan septum interalveolar dan komponen di dalamnya, salah satunya adalah serat kolagen interstisial, sehingga dapat memengaruhi fungsi paru sebagai organ respirasi. Tujuan dari penelitian ini adalah mengetahui korelasi antara jumlah serat kolagen interstitial paru dengan ketebalan septum interalveolar pada penuaan tikus Sprague-Dawley. Metode: Desain penelitian yang digunakan adalah cross sectional analytic correlative. Penelitian ini menggunakan 24 ekor tikus Sprague-Dawley sebagai subjek penelitian. Subjek penelitian terdiri atas empat kelompok usia, yaitu 2 hari, 16 hari, 3-4 bulan, dan >12 bulan yang ditentukan dengan m ± 0.043 μm, dan 0,512 ± 0.020 μm. Uji korelasi non parametrik Spearman (p = 0,03) antara jumlah serat kolagen interstisial dengan ketebalan septum interalveolar menunjukkan nilai koefisien korelasi (r = 0,213). Kesimpulan: Pada penelitian ini disimpulkan bahwa terdapat korelasi yang lemah antara jumlah serat kolagen interstisial paru dengan ketebalan septum interalveolar pada penuaan tikus Sprague-Dawley. Dengan demikian, dapat dipikirkan bahwa serat kolagen interstisial dapat mempengaruhi ketebalan septum interalveolar paru tikus yang menua, meskipun bukan satu-satunya faktor yang mempengaruhi.

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Background: Lung aging is characterized by structure and physiologic changes of the lung. Structurally, the interalveolar septum thickness and all of its components including collagen fiber are change, so that affect the lung function as a respiratory organ. This study is aimed to determine the correlation between the amount of pulmonary interstitial collagen fiber and interalveolar septum thickness on Sprague-Dawley rat aging. Method: The design of this research is cross sectional analytic correlative. The data was taken from the lung tissue preparations of 24 rats in 4 groups based on age, 2 days, 16 days, 3-4 months, and >12 months using single blind randomization technique. The methods of preparation making are based on the literatures. Data that was assessed were the histology of pulmonary interstitial collagen fiber and interalveolar septum. Then, they were analized using SPSS 20.0. Result: Sequentially, the modes of interstitial collagen fiber are 1, 2, 2, and 3; while the interalveolar septum thickness means are 0,436 ± 0.059 μm, 0,399 ± 0.022 μm, 0,474 ± 0.043 μm, and 0,512 ± 0.020 μm. By using non parametric Spearman correlation test (p = 0.03), it was obtained the correlation coefficient (r = 0.213) between the amount of pulmonary interstitial collagen fiber with the interalveolar septum thickness. Conclusion: There is a weak correlation between the amount of pulmonary interstitial collagen fiber with the interalveolar septum thickness of Sprague- Dawley rat aging. Thus, it can be thought that pulmonary interstitial collagen fiber may affects interalveolar septum thickness of rat aging, although it’s not as the only one factor."

"Latar Belakang : Angka kejadian reseksi anastomosis pada kasus intususepsimasih sangat tinggi. Hal ini dikarenakan masih seringnya pasien datang terlambatsetelah 72 jam, kurangnya SDM untuk melakukan reduksi non operatif, dankurangnya penunjang seperti USG untuk menegakkan diagnosa. Penting untukmemperhatikan presisi, tehnik dan mempertimbangkan usus yang tersisa dalammelakukan reseksi anastomosis. Hingga saat ini belum ada standar operasi khususyang dapat menjadi panduan bagi para dokter bedah dalam melakukan reseksiakibat intususepsi. Karena itu, peneliti tertarik untuk mencari batas reseksi yangdiperlukan untuk menghasilkan suatu anastomosis end-to-end yang optimal danrendah tingkat kebocorannya. Penelitian akan dilakukan kepada tikus sebagai pilotstudy sebelum dilakukan penelitian lebih lanjut.Tujuan : Mengetahui batas reseksi usus yang optimal dinilai dari kebocorananastomosis berdasarkan grading kolagen pada batas reseksi tersebut.Metode : Penelitian ini merupakan penelitian eksperimental dengan hewan cobatikus putih Sprague Dawley. Tikus putih dilakukan intususepsi denganmenggunakan stylet, dari proksimal ke distal. Setelah 45 menit, intususepsi direduksi.Tikus putih dikelompokkan dalam tiga kelompok sesuai batas reseksianastomosis, yang kemudian batas reseksi ini dilakukan pemeriksaan gradingkolagen. Setelah 5 hari, dilakukan laparotomi untuk menilai kebocorananastomosis.Hasil : Pada perbandingan grading kolagen dengan reseksi usus didapatkangrading terbanyak pada batas 1 adalah grading 2 (57,1 %), pada batas 2 grading 2(71,4 %) ,batas 3 grading 3 (71,4%).Perforasi terbanyak ditemukan pada grading2 sebanyak 5 sampel. Pada perbandingan batas reseksi dengan perforasididapatkan perforasi terbanyak pada batas 1 (85,7 %)Simpulan : Terdapat perbedaaan grading kolagen pada batas reseksi usus dimanabatas kelompok batas 3 memiliki grading kolagen yang lebih baik ( grade 3 dan 4)sehingga kelompok batas 3 lebih direkomendasikan secara histopatologis.Grading kolagen dapat dinilai untuk melihat kemungkinan perforasi hasilanastomosis. Terdapat faktor-faktor lain yang dapat mempengaruhi kejadianperforasi selain grading kolagen.

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Background : There is still high presentation of intussuseption cases with resection and

anastomose, caused of multi factors as : patient delay more than 72 hours, less on

profesional expert to do non operative reduction and less of examination such as ultra

sound to make a diagnose. That is important to take attention with pretition, tehniques

and less of intestine when do the resection. There is still no operative standard about the

boundary of resection cause of intussuseption, thats why the author want to do the

experimental to find the optimal part of resection with minimal leakage. The experimental

will do on rat as a pilot study.

Aim : How to get the optimal part of resection compared with anastomotic leakege based

on collagen grading.

Method : The experimental test using a Sprague Dawley rat. We make a intussuseption

on gut rat using a styleth from proximal to distal. The release do after 45 minutes. The

rats then separated into three boundaries group, and did resection-anastomose with each

gut from groups were performed a histopatologic test to count collagen grading. Leakage

of anastomose were examinated after 5 days

Result : In comparison between collagen grading and the extent of resection

obtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2

(71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5

sample).in comparison the extent of resection and leakage,the highest is group 1

(85,7%).

Summary : There are differences about collagen gradingin the extent of bowel

resection which is the third group of resection has higher collagen grading (3 and

4 ) and then more recommended as histopatologic exam. Collagen grading could

be marked to see possibilities of anastomotic leakage. There is some factors that

affect a leakage besides collagen grading."

"Latar Belakang: Dibutuhkan waktu 14 hari donor kulit STSG sembuh. Kolagen berperan penting untuk menginduksi penyembuhan luka dan proses epitelisasi lebih cepat. Sementara gliserin menjaga kulit tetap lembab dan mendorong migrasi sel epitel. Penelitian ini dilakukan untuk mengetahui fungsi gel kolagen dan gliserin dalam mempercepat penyembuhan luka pada daerah donor STSG. Bahan dan Metode: Uji coba klinis non-acak dilakukan pada 18 pasien dewasa untuk membandingkan tingkat epitelisasi pada donor STSG antara kombinasi gel kolagen dan gliserin dibandingkan tulle yang dikombinasikan dengan kasa lembab. Luka dinilai pada hari ke 7, 10, dan 14 pascaoperasi. Persentase epitelisasi dievaluasi dan difoto. Setiap foto dianalisis dengan menggunakan program analisis warna Adobe Photoshop. Data dianalisis dengan menggunakan SPSS 20.0 dan diuji dengan independent t-test. Hasil: Delapan belas pasien yang membutuhkan pencangkokan kulit dimasukkan dalam penelitian ini. Terdapat 13 pria dan 5 wanita dengan usia rata-rata 33,34 tahun berkisar 15-50 tahun . Area donor rata-rata adalah 140,89 cm2 berkisar 100-240 cm2 . Persentase tingkat epitelisasi lebih besar dengan menggunakan kombinasi gel kolagen dan gliserin pada hari ke-7 pasca operasi 88,05 , 95 CI 85,75-90,63 vs 77,18 , 95 CI 73,39-81,02 ; p

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Background It usually takes 14 days for the split thickness skin donor site to heal. Collagen plays an important role to induce faster wound healing and epithelialization. Meanwhile, glycerin keeps skin moisturized and promotes epithelial cells migration. This study was conducted to identify the role of combined collagen and glycerin based gel in promoting faster wound healing on split thickness skin graft donor sites.Materials and Methods A non randomized clinical trial was performed on 18 adult patients to compare the dressing for split thickness skin graft donor site epithelialization rate between combination of collagen and glycerin based gel versus tulle grass combined with moist gauze. The wound was assessed on postoperative day 7, 10, and 14. The epithelialization percentage was evaluated and photographed. Each photo was analyzed using Adobe Photoshop color match program. Data was analyzed using SPSS 20.0 and tested with independent t test.Result Eighteen patients requiring skin grafting were included in this study. There were 13 men and 5 women with mean age 33.34 year old ranged 15 50 year old . The average donor area was 140.89 cm2 ranged 100 240 cm2 . Epithelialization rate was greater using combination of collagen and glycerin based gel on postoperative day 7 88.05 , 95 CI 85.75 90.63 vs 77.18 , 95 CI 73.39 81.02 p 0.05 and day 10 96.92 , 95 CI 96.02 97.82 vs 89.22 , 95 CI 87.6 90.85 p 0.05 . Meanwhile, there is no epithelialization rate difference on postoperative day 14 between both dressing types 100 vs 99.72 0.55 , p 0.05Conclusion Although showing better epithelialization rate at day 7 and 10, combination of collagen and glycerin based gel covered gauze showed no difference in the healing of split thickness skin graft donor sites in comparison with tulle grass combined with moist gauze at day 14. Keywords Donor site, STSG, collagen and glycerin based gel, epithelialization. "

"Latar Belakang: Saat ini perawatan pulpa vital mengacu pada konsep minimal intervensi, yaitu dengan meninggalkan lapisan affected dentin saat ekskavasi karena masih terdapat ikatan silang kolagen sehingga dapat dilakukan upaya remineralisasi. Remineralisasi melalui aplikasi material bioaktif Mineral Trioxide Aggregate (MTA) belum dapat menghasilkan karakteristik dentin menyerupai dentin normal karena pembentukan mineral hanya terjadi pada ruang ekstrafibrillar. Penggunaan material analog protein non kolagen dibutuhkan untuk menstabilkan nano Amorphous Calcium Phosphate (ACP) agar dapat memasuki ruang intrafibrillar, salah satunya menggunakan Carboxymethyl Chitosan (CMC).Tujuan: mengevaluasi remineralisasi dentin pada permukaan dentin terdemineralisasi setelah aplikasi material MTA dan material modifikasi MTA-CMC dengan melihat morfologi permukaan dan komposisi ion pada dentin.Metode: remineralisasi dilakukan melalui aplikasi material MTA, MTA-CMC 5% dan 10% selama 14 hari pada permukaan sampel dentin yang terdemineralisasi. Pengamatan morfologi dilakukan dengan Scanning Electron Microscope (SEM) dan konfirmasi komposisi ion dengan Energy Dispersive X-ray Spectroscopy (EDX).Hasil: terdapat perbedaan morfologi pada permukaan dentin setelah dilakukan remineralisasi melalui aplikasi MTA, MTA-CMC 5%, dan MTA-CMC 10% selama 14 hari yang dievaluasi menggunakan SEM. Hasil analisis EDX mengonfirmasi adanya peningkatan kandungan kalsium dan fosfor pada permukaan dentin yang diremineralisasi dengan material MTA-CMC.Kesimpulan: remineralisasi melalui aplikasi material modifikasi MTA-CMC dapat memengaruhi morfologi permukaan dan komposisi ion pada permukaan dentin yang terdemineralisasi.

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Background: Vital pulp treatment refers to the concept of minimal intervention by preserving the affected dentin layer in the excavation process because there are still collagen cross-linked to induce remineralization. Remineralization through the application of bioactive material Mineral Trioxide Aggregate (MTA) produce different dentin characteristics to normal dentin because mineral formation only occurs in the extrafibrillar space. The use of non-collagen protein analog materials is needed to stabilize the nano Amorphous Calcium Phosphate (ACP) to get into the intrafibrillar space, one of which is Carboxymethyl Chitosan (CMC).

Objective: To evaluate dentin remineralization on the surface of demineralized dentin after the application of MTA and MTA-CMC modified material by looking at the surface morphology and ionic composition of the dentin.

Methods: The remineralization was carried out through the application of MTA,MTA-CMC 5%, MTA-CMC 10% materials for 14 days on the surface of demineralized dentin samples. Morphological observations were carried out by Scanning Electron Microscope (SEM) and confirmation of ion composition by Energy Dispersive X-ray Spectroscopy (EDX). Results: there were morphological differences on the dentin surface after remineralization through the application of MTA, MTA-CMC 5%, and MTA-CMC 10% for 14 days which were evaluated using SEM. The results of the EDX analysis confirmed an increase in the content of calcium and phosphorus on the dentin surface remineralized with MTA-CMC material.

Conclusion: remineralization through the application of MTA-CMC modified material can affect the surface morphology and ion composition on the demineralized dentin surface."

"Rangka manusia tersusun atas struktur-struktur seperti: ligamen, tendon, otot, dan organ manusia yang lain. Dalam regenerasi jaringan tulang, rekayasa jaringan memiliki keunggulan dibandingkan metode allograft dan autograft karena hanya menginduksi respon sistem imun minor dan tidak memerlukan operasi kedua untuk mendapatkan tulang donor dari tubuh pasien sendiri yang mana terdapat peningkatan risiko infeksi ketika lebih banyak operasi dilakukan. Salah satu aplikasi rekayasa jaringan adalah pembuatan perancah mirip matriks ekstraseluler yang memberikan dukungan struktural pada sel karena struktur jaringnya. Kolagen adalah salah satu sumber perancah biokompatibel dan memadai untuk rekayasa jaringan untuk regenerasi tulang dalam hal sifat mekanik, struktur pori, permeabilitas, hidrofilisitas dan stabilitas in vivo. Dalam penelitian ini kolagen bersumber dari ikan King Kobia dengan metode ASC dan PSC. Freeze-dryingmerupakan proses pengeringan di mana pelarut dan/atau media suspensi dikristalisasi pada suhu rendah dan selanjutnya disublimasikan dari keadaan padat langsung ke fase uap. Metode ini menghasilkan bahan dengan stabilitas bentuk yang baik sehingga tidak berubah setelah rekonstitusi dengan air. Dalam penelitian ini penulis menambahkan material seng oksida (ZnO) dan titanium oksida (TiO2) yang selanjutnya akan diuji karakteristiknya. Penambahan TiO2 dan ZnO meningkatkan porositas perancah. Dalam penelitian ini ZnO meningkatkan persentase porositas dengan signifikan. Namun, struktur mekanik dari uji tekanan kompresif dan porositas belum menunjukan hasil yang menyerupai penelitian-penelitian sebelumnya. Hal ini mungkin terjadi akibat adanya kesalahan pengukuran volume atau konsentrasi pada proses pencampuran komposit dan ketidaksesuaian spesifikasi liofilisasi. Kedua faktor ini mengubah tekstur dan struktur perancah menjadi mengerut dan menempel pada wadah well-plate.

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The human skeleton is composed of structures such as: ligaments, tendons, muscles, and other human organs. In bone tissue regeneration, tissue engineering has advantages over allograft and autograft methods because it only induces a minor immune system response and does not require a second operation to obtain donor bone from the patient's own body where there is an increased risk of infection when more operations are performed. One application of tissue engineering is the fabrication of extracellular matrix-like scaffolds that provide structural support to cells due to their net structure. Collagen is one source of biocompatible scaffolds and is adequate for tissue engineering for bone regeneration in terms of its mechanical properties, pore structure, permeability, hydrophilicity and in vivo stability. In this study, collagen was sourced from King Cobia fish using the ASC and PSC methods. Freeze-drying is a drying process in which the solvent and/or suspension medium is crystallized at low temperature and then sublimated from the solid state directly into the vapor phase. This method produces a material with good shape stability so that it does not change after reconstitution with water. In this study the authors added zinc oxide (ZnO) and titanium oxide (TiO2) materials which would then be tested for their characteristics. The addition of TiO2 and ZnO increased the porosity of the scaffolds. In this study, ZnO significantly increased the percentage of porosity. However, the mechanical structure of the compressive stress and porosity tests has not shown results that resemble those of previous studies. This may occur due to volume or concentration measurement errors in the composite mixing process and non-compliance with lyophilization specifications. These two factors change the texture and structure of the scaffold to shrink and stick to the well-plate container."

"Penggunaan kalsium fosfat sebagai bahan pengganti tulang sudah banyak diaplikasikan, khususnya pengaplikasian hidroksiapatit karena kemiripannya dengan mineral tulang manusia. Hidroksiapatit merupakan senyawa kalsium fosfat yang paling stabil dan telah banyak digunakan sebagai implan tulang, namun hidroksiapatit memiliki sifat brittle yaitu mudah rapuh dan mempunyai sifat resorbabilitas yang sangat rendah. Untuk memenuhi kebutuhan biomaterial pada jaringan tulang, selain mineral diperlukan material organik sebagai penyusun matriks. Salah satu yang dapat digunakan adalah kolagen yang merupakan protein fungsional yang ada didalam tubuh dan memiliki peran penting dalam menjalankan fungsi tubuh. Kombinasi antara hidroksiapatit dan kolagen memiliki potensi untuk rekayasa jaringan tulang karena kesamaan dan sifat biologis alaminya. Pada penelitian ini komposit hidroksiapatit/kolagen disintesis secara In-situ menggunakan metode iradiasi gelombang mikro dengan daya sebesar 400 Watt selama 10, 20, dan 30 menit. Penggunaan iradiasi gelombang mikro digunakan karena dapat memicu pertumbuhan kristal hidroksiapatit dengan waktu yang relatif cukup singkat dibandingkan dengan metode konvensional seperti konduksi dan konveksi. Pada hasil karakterisasi menggunakan difraksi sinar-x didapatkan pola puncak puncak yang mengindikasikan terbentuknya fasa hidroksiapatit yang di berada pada sudut 2θ 25°, 28°, 32°, 39°, 53° dan bidang miller (002), (210), (300), (310), (004) pada seluruh komposit yang di iradiasi selama 10, 20, dan 30 menit serta diperoleh ukuran kristal sebesar 21,94 - 22,65 nm serta indeks kristalinitas sebesar 0,269 - 0,297. Hasil ini menujukan bahwa semakin lama waktu radiasi yang diberikan maka ukuran kristal serta nilai indeks kristalinitas juga meningkat. Hasil karakterisasi FTIR menandakan adanya karakteristik serapan dari hidroksiapatit dan kolagen pada komposit yang ditandai dengan terdapatnya gugus fosfat (PO4) pada bilangan gelombang 564 cm-1, 603-602 cm-1, 1032 cm-1 dan 961-962 cm-1, gugus karbonat (CO3) pada bilangan gelombang 875-876 cm-1, gugus hidroksil (OH) pada bilangan gelombang 3566 cm-1, Amida A (N-H) pada bilangan gelombang 3423-3442 cm-1, Aminda B (C-H) pada bilangan gelombang 2963-2964 cm-1, Amida I (C=O) pada bilangan gelombang 1646-1650 cm-1, Amida II (N-H) pada bilangan gelombang 1540-1542 cm-1 serta Amida III (C-H) pada bilangan gelombang 1260-1263 cm-1. Hasil karakterisasi menggunakan SEM memperlihatkan bahwa hidroksiapatit telah terpresipitasi dan menyelimuti pori kolagen.

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Calcium phosphate has been widely applied as a bone substitute, especially hydroxyapatite, because of its similarity with human bone minerals. Hydroxyapatite is the most stable calcium phosphate compound, However, hydroxyapatite has brittle properties and very low resorbability. To meet the biomaterials needs of bone tissue, in addition to minerals, organic materials are needed as matrix compounds. Collagen, a functional protein found in the body, can fulfill this role. A hydroxyapatite and collagen combination has the potential to be engineered into bone tissue because of its similarity and natural biological properties. In this study, the hydroxyapatite/collagen composite was synthesized in situ using the microwave irradiation method with a power of 400 Watt for 10, 20, and 30 minutes. Microwave irradiation is used because it can trigger the growth of hydroxyapatite crystals in a relatively short time compared to conventional methods, such as conduction and convection. In the results, using x-ray diffraction, the peak pattern showed the formation of the hydroxyapatite phase indicated at an angle of 2θ 25°, 28°, 32°, 39°, 53° and the miller indices (002), (210), (300), (310), (004) in all composites that were irradiated for 10, 20, and 30 minutes obtained a crystal size of 21.94 nm - 22.65 nm, and a crystallinity index of 0.269 - 0.297. This shows that the longer the composite is exposed to radiation, the crystal size, and value of the crystallinity index also increase. The results of the use of FTIR shows the absorption characteristics of hydroxyapatite and collagen in the composite that were characterized by the presence of a phosphate group (PO4) on wavenumber 564 cm-1, 603-602 cm-1, 1032 cm-1 and 961-962 cm-1, a carbonate group (CO3) on wavenumber 875-876 cm-1, a hydroxyl group (OH) on wavenumber 3566 cm-1, Amide A (N-H) on wavenumber 3423-3442 cm-1, Amide B (C-H) on wavenumber 2963-2964 cm-1, Amide I (C=O) on wavenumber 1646-1650 cm-1, Amide II (N-H) on wavenumber 1540-1542 cm-1, Amide III (C-H) on wavenumber 1260-1263. Characterization using SEM showed that hydroxyapatite had precipitated and covered the collagen pores."

"Latar Belakang: Saat ini, injeksi intravitreal anti-VEGF merupakan tatalaksana medikamentosa lini pertama pada DME. Namun monoterapi bevacizumab dinilai kurang efektif dalam mengobati DME derajat sedang-berat, sehingga meningkatkan jumlah re-injeksi. Selain VEGF, mediator inflamasi juga berperan penting dalam pathogenesis DME. Sehingga diperlukan terapi adjuvant pada kasus dengan respon suboptimal.Tujuan: Mengetahui perbedaan perubahan sensitivitas retina, ketebalan makula sentral (CMT) dan BCVA sesudah dilakukan injeksi intravitreal Bevacizumab dengan kombinasi Triamsinolon Asetonid (TA)  dibandingkan dengan monoterapi Bevacizumab pada pasien dengan edema makula diabetik derajat sedang-berat.Metodologi: Pada studi eksperimental lengan ganda dengan randomisasi blok ini didapatkan sejumlah 28 subjek dengan CMT > 400 mm dibagi menjadi dua kelompok. Subjek pada kelompok intervensi diberikan injeksi kombinasi Bevacizumab 1,25 mg dan TA 2 mg intravitreal, sedangkan subjek kelompok kontrol hanya diberikan injeksi Bevacizumab 1,25 mg. Evaluasi BCVA dan CMT dilakukan pada 1 minggu dan 1 bulan pasca injeksi, evaluasi sensitivitas retina pada 1 bulan pasca injeks, serta peningkatan TIO dan efek samping.Hasil: Pasca 1 bulan injeksi didapatkan penurunan CMT yang lebih besar yang bermakna pada kelompok intervensi (-269,1 (170-413) mm vs -133,6 (50-218) mm, p< 0,001), begitu juga dengan peningkatan sensitivitas retina yang lebih baik pada kelompok intervensi (2,4 (0,02-7,1) dB vs 1,3 (0,16-3,5) dB, p = 0,035). Tidak didapatkan perbedaan bermakna pada luaran BCVA logMAR antar kedua kelompok (0.2 (0-0.5) vs 0.15 (0-0.5)).Kesimpulan: Terapi kombinasi bevacizumab dan TA ini terbukti efektif dan cost-effective sebagai dalam menurunkan edema makula segera dan memperbaiki sensitivitas retina pada pasien DME derajat sedang-berat dan DME persisten.

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Backgrounds: Intravitreal bevacizumab (IVB) monotherapy is less effective in treating moderate-to-severe diabetic macular edema (DME), potentially increasing the number of injections and the risk of permanent vision loss. In addition to VEGF, inflammatory mediators also play an important role in the pathogenesis of DME. Therefore, there is a need for additional treatment options for DME cases with suboptimal response to anti-VEGF therapy.

Objectives: To compare the efficacy and safety of the combination of IVB and triamcinolone acetonide (TA) with IVB monotherapy in treating moderate to severe DME.

Methods: In this double-arm randomized controlled trial study, a total of 28 DME patients with central macular thickness (CMT) >400 mm were assigned into two groups according to the therapeutic method: 1,25 mg of  bevacizumab combined with 2 mg of  TA as the intervention group and 1,25 mg of IVB as the control group. BCVA and CMT were observed at 1 week and 1 month follow-up, retinal sensitivity was observed at 1 month follow-up, as well as increased IOP and other side effects.

Results: CMT reduction after 1 month were higher in the intervention group with statistically significant different (-269,1 mm vs -133,6 mm, p< 0,001) as well as retinal sensitivity improvement also better in the intervention group (2,4 dB vs 1,3 dB, p = 0,035). But there was no statistically different in BCVA changes after 1 month follow-up (0,2 vs 0,15, p= 0,874) between the groups, even though 35,7% of the intervention group has gained more than 10 BCVA letters. No significant increase in IOP were observed at the end of the follow-up.

Conclusions: It is effective and cost-effective to treat moderate-to-severe or persistent DME by utilizing TA as an adjunct to anti-VEGF."