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"Dilakukan penelitian untuk memperoleh bukti tentang basil tahan asam (BTA) dalam sumsum tulang (ST) pada pasien dengan tuberkulosis ekstrapulmoner. Pada 50 kasus yang diduga tuberkulosis ekstrapulmoner dilakukan aspirasi ST dari sternum/crista iliaca dan dimasukkan dalam uji klinik pengobatan anti tuberkulosis. Hasilnya menunjukkan bahwa semua kasus yang diteliti bereaksi terhadap pengobatan anti tuberkulosis. Gambaran jangkitan penyakit adalah sebagai berikut: abdomen (20), susunan saraf pusat (19), pericard (5), limfadenopati leher (2), PUO (2), spina (1) dan milier (1). Lima puluh dua persen kasus menunjukkan BTA dalam ST (pada pewarnaan Zn), sedangkan hanya 4% kasus yang menunjukkan BTA pada cairan tubuh lain (cairan serebro spinal/pericardium/ peritoneum). Di samping itu, perubahan sitomorfologik dari ST menunjukkan terjadinya limfositosis (22%), peningkatan sel plasma (80%) dan makrofag (88%), sesuai dengan patologi infeksi yang disertai aktifitas makrofag yang berlebihan. Disimpulkan bahwa aspirasi sumsum tulang mempunyai nilai diagnostik yang definitif dan mungkin berguna apabila pemeriksaan lain belum cukup. (Med J Indones 2002; 11: 148-52)

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This study was undertaken to look for evidence of acid fast bacilli (AFB) in bone marrow (BM) in patients of extrapulmonary tuberculosis. Fifty cases suspected of extrapulmonary tuberculosis underwent bone marrow aspiration from sternum/illiac crest and were put on a therapeutic trial of antituberculosis therapy. All cases taken in the study responded to the therapy. The pattern of involvement were ? abdominal (20), CNS (19), pericardial involvement (5), cervical lymphadenopathy (2), PUO (2), spinal (1) and miliary (1). 52% cases showed evidence of AFB in BM (on Ziehl Neelsen?s (ZN) staining) whereas only 4% of cases showed evidence of AFB in any other body fluid (CSF/pericardium/peritonium). Besides this, cytomorphological changes of BM showed evidence of lymphocytosis (22%), increased plasma cells (80%) and prominence of macrophages (88%), thus signifying infective pathology with macrophage overactivity. So we conclude that bone marrow aspiration has a definite diagnostic value and may prove useful when other investigations are unrewarding. (Med J Indones 2002; 11: 148-52)"

"This monograph aims to cover in depth all aspects of bone marrow lymphoid infiltrates, in the context of their wide spectrum of benign, borderline and malignant expressions. As the bone marrow is no longer considered a selective diagnostic procedure in the field of haematopathology and haematology,but a routine need to other subspecialists, we intend to provide a comprehensive treatise for beginners and experienced practitioners alike who deal with patients that are investigated or treated for lymphomas and lymphoid leukemias, manifest with laboratory or clinical signs suspicious for haematological diseases or show features mimicking haematological conditions."

"Latar belakang: Banyak penelitian yang menggunakan krista iliaka sebgai donor sel punca mesenkimal. Pada kasus fraktur tulang panjang, pengambilan sumsum tulang dari situs fraktur memberikan banyak keuntungan. Akan tetapi, sumsum tulang panjang yang tergolong sebagai sumsum kuning mengandung banyak sel lemak sehingga dipercaya mengandung jumlah sel punca yang lebih sedikit daripada sumsum merah. Karena itu, panelitian ini bertujuan untuk membandingkan potensi sumsum merah dan sumsum kuning sebagai donor sel punca mesenkimal.Metode: Sumsum tulang dari 8 ekor kelinci Flemish giant jantan diaspirasi dari krista iliaka dan batang femur. Sel mononuklear diisolasi dari asprirat dan diekspansi dalam medium DMEM rendah glukosa. Setelah 8 minggu, sel dipanen dan dihitung dengan hemositometer Neubauer. Perbandingan jumlah sel antara kedua situs dianalisis dengan menggunakan uji t-test.Hasil: Setelah 8 minggu, sejumlah rata-rata 2,93±0,91 x 104 dan 3,7±2,50 x 104 sel diperoleh dari kelompok krista iliaka dan batang femur. Tidak ada perbedaan statistik yang bermakna antara kedua kelompok. (p= 0,45).Kesimpulan: Sel yang melekat pada plastik dapat diisolasi dan diekspansi dari krista ilaka maupun batang femur. (Med J Indones 2011; 20:100-4)

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AbstractBackground: Many studies have used iliac crest as the source of mesenchymal stem cells. In cases of long bone shaft fracture, obtaining marrow from the fracture site offers more advantages. Nevertheless, due to the high number of fat cells in long bones, the yellow marrow of long bones is believed to contain lower number of mesenchymal stem cells than red marrow. Therefore the aim of this study is to compare the potency between red and yellow marrow as the donor site for the isolation of mesenchymal stem cell.Methods: Bone marrow of eight giant Flemish rabbits was aspirated from the iliac crest and femoral shaft. Mononuclear cells were isolated from both aspirates and expanded in low glucose DMEM. After eight weeks, the cells were harvested and counted using improved Neubauer hemocytometer. Comparison of the cell number between the two donor sites was then performed by t-test.Results: After 8 weeks, an average number of 2.93±0.91 x 104 and 3.7±2.50 x 104 cells were obtained from the iliac and femoral group respectively. No statistically signifi cant difference was found between those two groups (p= 0.45).Conclusion: Plastic-adherent cells can be isolated and expanded from both iliac crest and femoral shaft. (Med J Indones 2011; 20:100-4)"

"Latar belakang: Periodontitis merupakan penyakit inflamasi kronis dan dikenal dalam berbagai klasifikasi, yaitu periodontitis kronis, periodontitis agresif, necrotizing periodontitis, dan periodontitis sebagai manifestasi penyakit sistemik. Periodontitis agresif ditandai dengan meningkatnya proporsi bakteri Aggregatibacter actinomycetemcomitans, namun belum terdapat studi yang secara spesifik membuktikan interaksi langsung antara sel bone marrow-derived macrophages (BMM) sebagai prekursor sel osteoklas dengan bakteri Aggregatibacter actinomycetemcomitans. Tujuan: Menganalisis interaksi langsung antara sel BMM dengan bakteri Aggregatibacter actinomycetemcomitans. Metode: Sel bone marrow dikultur selama 48 jam untuk menjadi sel BMM dan kemudian diinfeksikan oleh bakteri Aggregatibacter actinomycetemcomitans selama 5, 15, dan 30 menit pada kondisi aerob dan anaerob. Data jumlah koloni bakteri Aggregatibacter actinomycetemcomitans didapatkan melalui uji total plate count (TPC). Analisis kuantitatif melalui uji statistik. Hasil: Terjadi peningkatan bermakna jumlah koloni bakteri pada kelompok bakteri Aggregatibacter actinomycetemcomitans yang berinteraksi dengan sel BMM, dibanding tanpa sel BMM pada kelompok paparan aerob 5 dan 15 menit. Tidak terdapat perbedaan pada jumlah koloni bakteri Aggregatibacter actinomycetemcomitans yang diinfeksi pada kondisi aerob atau anaerob. Tidak ada perbedaan bermakna pada jumlah koloni bakteri Aggregatibacter actinomycetemcomitans yang diinfeksi selama 5 menit, 15 menit, dan 30 menit. Kesimpulan: Interaksi langsung antara sel BMM dengan bakteri Aggregatibacter actinomycetemcomitans memengaruhi proliferasi bakteri Aggregatibacter actinomycetemcomitans. Proliferasi bakteri Aggregatibacter actinomycetemcomitans dipengaruhi oleh kondisi aerobik dan anaerobik, namun tidak dipengaruhi lama waktu infeksi.

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Background: Periodontitis is a chronic inflammatory disease and classified as chronic periodontitis, aggressive periodontitis, necrotizing periodontitis, and periodontitis as a manifestation of systemic disease. Aggressive periodontitis is characterized by an increased in Aggregatibacter actinomycetemcomitans proportion. There has not been any studies that have shown the direct interactions between bone marrow derivedmacrophages cells, as osteoclast precursor cells, with Aggregatibacter actinomycetemcomitans. Purpose: To analyse direct interactions between bone marrowderived macrophages (BMM) cells and Aggregatibacter actinomycetemcomitans. Methods: Bone marrow cells from C57BL/6 mice were cultured for 48 hours in order to differentiate into BMM cells. BMM cells were then infected with Aggregatibacter actinomycetemcomitans for 5 minutes, 15 minutes, and 30 minutes in an aerobic and anaerobic environment. Total plate count of Aggregatibacter actinomycetemcomitans were analysed as a quantitative data using statistical analysis Results: Statistically, significant difference between Aggregatibacter actinomycetemcomitans-infected BMM and control group were observed on 5 minutes and 15 minutes aerobic groups. There were no statistically difference in Aggregatibacter actinomycetemcomitans colony count number between cultures in aerobic or anaerobic environment. No statistically significant difference were found in Aggregatibacter actinomycetemcomitans colony count number between 5, 15, and 30 minutes infection time. Conclusions: Direct interactions between BMM cells and Aggregatibacter actinomycetemcomitans affect Aggregatibacter actinomycetemcomitans proliferation. Bacterial proliferation is affected by aerobic or anaerobic environments, but not infection time"

"Latar belakang: Bakteri A. actinomycetemcomitans merupakan bakteri utama penyebab periodontitis agresif dimana bakteri ini dapat memengaruhi sel tulang sehingga terjadi kehilangan tulang alveolar. Namun, belum ada studi yang mempelajari mengenai interaksi antara bakteri A. actinomycetemcomitans dengan sel osteoklas dan sel di galur diferensiasi sel osteoklas, yaitu sel bone marrow-derived macrophages (BMM) dan sel preosteoklas. Tujuan: Membandingkan interaksi sel BMM dan sel preosteoklas dengan bakteri A. actinomycetemcomitans. Metode: Membuat kultur primer sel osteoklas dari bone marrow cells (BMCs) pada conditioned medium dengan inkubasi selama 48 jam pada suhu 37oC. Setelah diinkubasi, kultur sel BMCs yang telah berdiferensiasi menjadi sel BMM diberi medium yang telah ditambahkan bakteri A. actinomycetemcomitans selama 30 menit dalam kondisi aerob dan anaerob. Kemudian medium disimpan untuk dilakukan kultur dan Total Plate Count untuk mengetahui jumlah koloni bakteri. Lakukan hal yang sama pada sel preosteoklas (setelah kultur diinkubasi selama 48 jam dan diganti mediumnya dan ditambahkan RANKL kemudian diinkubasi kembali selama 24 jam). Hasil: Jumlah koloni hasil interaksi bakteri A. actinomycetemcomitans dengan sel BMM menunjukkan hasil yang tidak signifikan (p > 0.05) sedangkan hasil interaksi bakteri A. actinomycetemcomitans dengan sel preosteoklas menunjukkan hasil yang signifikan (p < 0.05). Perbandingan koloni terkecil adalah pada hasil interaksi bakteri A. actinomycetemcomitans dengan sel BMM pada kondisi aerob (1 : 1,1). Kesimpulan: Interaksi antara bakteri A. actinomycetemcomitans dengan sel BMM dan sel preosteoklas mempengaruhi proliferasi dari bakteri A. actinomycetemcomitans dimana proliferasi bakteri A. actinomycetemcomitans paling tinggi terjadi saat berinteraksi dengan sel BMM pada kondisi aerob.

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Background: A. actinomycetemcomitans is the main bacteria that causes aggressive periodontitis of which this bacteria can affect bone cells resulting in alveolar bone loss. However, there has been no study that have examined the interaction between A. actinomycetemcomitans bacteria and osteoclast lineage cells, namely in bone marrow- derived macrophages (BMM) and preosteoclast cells. Objective: Comparing the interaction of BMM and preosteoclast cells with A. actinomycetemcomitans. Methods: Primary cultures of osteoclasts from bone marrow cells (BMCs) in conditioned medium were performed and incubated for 48 hours at 37oC. After incubation, the cultured BMCs that had differentiated into BMM were given medium that had been infected with A. actinomycetemcomitans for 30 minutes under aerobic and anaerobic conditions. The medium were then isolated and total plate count were performed to determine the number of bacterial colonies. The same procedure were conducted for preosteoclast cells (after the culture was incubated for 48 hours and the medium was changed and RANKL was added and then incubated again for 24 hours). Results: The number of colonies produced by the interaction of A. actinomycetemcomitans with BMM showed insignificant results (p > 0.05), while the results of the interaction of A. actinomycetemcomitans with preosteoclast cells showed significant results (p < 0.05). The smallest colony comparison was the result of the interaction of A. actinomycetemcomitans with BMM under aerobic conditions (1 : 1,1). Conclusion: The interaction between A. actinomycetemcomitans bacteria with BMM and preosteoclast cells affects the proliferation of A. actinomycetemcomitans where the highest proliferation of A. actinomycetemcomitans occurs when interacting with BMM under aerobic conditions."

"Latar belakang: Sumsum tulang merah merupakan sumber utama sel punca mesenkim walaupun penggunaannya menimbulkan morbiditas situs donor. Pengambilan sel punca dari sumsum tulang menyebabkan nyeri dan seringkali sukar dilakukan sehingga membutuhkan sumber alternatif. Karena penyembuhan tulang sekunder terjadi melalui pembentukan kalus hasil proliferasi dan diferensiasi sel punca, kalus mungkin menjadi sumber alternatif pengambilan sel punca mesenkim. Penelitian ini membandingkan jumlah plastic-adherent cells dari kalus dan sumsum tulang setelah dua minggu kultur sel.Metode: Enam belas kelinci Selandia Baru dilakukan prosedur frakturisasi diafisis tulang femur. Lalu, seluruh kelinci dirawat. Selanjutnya, dua minggu pasca-frakturisasi, 3 mL aspirasi sumsum tulang krista iliaka dan ekstraksi kalus situs fraktur pada delapan kelinci dilakukan kultur (kelompok I). Delapan kelinci lainnya dilakukan hal yang sama pada empat minggu pasca-frakturisasi (kelompok II). Seluruh kultur diamati setelah satu dan dua minggu. Setelah empat minggu, kultur dipanen. Jumlah sel dihitung dengan hemositometer Neubauer. Kemudian, perbandingan jumlah sel dianalisis menggunakan uji t tidak berpasangan.Hasil: Pada kelompok I terdapat jumlah sel sebanyak 2,6 ± 0,1 x 104 untuk kultur aspirat sumsum tulang krista iliaka dan 2,5 ± 0,1 x 104 untuk kultur ekstraksi kalus situs fraktur. Tidak terdapat perbedaan bermakna secara statistik antara keduanya (p = 0,34). Sedangkan pada kelompok II didapatkan hasil sebesar 2,7 ± 0,1 x 104 sel dan 2,1 ± 0,1 x 104 sel secara berurutan dan terdapat perbedaan yang bermakna secara statistik antara keduanya (p < 0,001).Kesimpulan: Situs kalus fraktur dua minggu pasca-frakturisasi memiliki potensi sebagai situs donor untuk isolasi dan ekspansi plastic-adherent cells.

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Background: Red marrow has been described as the main source of mesenchymal stem cells although its aspiration and isolation from bone marrow was reported to have significant donor site morbidity. Since secondary bone healing occurs through formation of callus as the result of proliferation and differentiation of mesenchymal stem cells, callus may become alternative source for mesenchymal stem cells. In this study, we compared the number of plastic-adherent cells from fracture site callus and bone marrow of iliac crest after two and four weeks of culture.

Methods: Sixteen New Zealand rabbits were fracturized at the femoral shaft. Then, these rabbits were taken care. After two weeks of fracturization, 3 mL iliac crest bone marrow aspiration and callus extraction of eight rabbits were cultured (group I). The other eight rabbits were treated equally after four weeks of fracturization (group II). Simultaneously, the cultures were observed after one and two weeks. Four weeks later, they were harvested. Cells were counted using Neubauer hemocytometer. The average number of cells between the sources and groups were statistically analyzed using the unpaired t-test.

Results: In group I, there were 2.6 ± 0.1 x 104 cells in the culture of iliac crest bone marrow aspirate and 2.5 ± 0.1 x 104 cells in culture of callus extract from fracture site (p = 0.34). In group II, there were 2.7 ± 0.1 x 104 cells and 2.1 ± 0.1 x 104 cells, respectively (p < 0.001).

Conclusion: Fracture site callus at the second week post-fracturization may be potential as source of plastic-adherent cells compared with iliac crest bone marrow."

"This highly illustrated text book will be an essential guide for surgeons in training, providing step by step approaches to performing Joint Aspiration/Injection, Bone Graft Harvesting and Lower Limb Amputations. Practical guidance will be given on Indications- Preoperative assessment, positioning and preparing the patient, approach required, tips and tricks, closure, postoperative complications, protocol of mobilization and follow-up procedure. All the procedures performed will include numerous intraoperative photographs and illustrations."

"Aneurisma intrakranial sakular terjadi akibat lemahnya dinding pembuluh darah karena hilang atau rusaknya tunika muskularis. Belum ada penelitian yang bertujuan memperkuat dinding aneurisma intrakranial dengan cara menumbuhkan kembali lapisan tunika muskularis. Penelitian-penelitian Mesenchymal Stem Cells (MSC) pada hewan coba berhasil menumbuhkan otot polos vaskular pada aneurisma aorta dan arteri karotis. Diharapkan MSC dapat berperan dalam pembentukan tunika muskularis pada aneurisma intrakranial.Penelitian ini bertujuan menganalisis hubungan pertumbuhan tunika muskularis aneurisma intrakranial pada hewan coba dengan perlakuan pemberian Bone Marrow Mesenchymal Stem Cells (BM MSC) dan manipulasi tekanan darah tikus, dengan penanda SM-actin dan calponin.Sebanyak 40 tikus Wistar diinduksi aneurisma selama 16 minggu. Modifikasi penurunan tekanan darah dan pemberian BM MSC pada minggu ke16, 18. Tikus dialokasi random ke dalam empat kelompok, yaitu hipertensi tanpa BMMSC, normotensi tanpa BMMSC, hipertensi dengan BMMSC, dan normotensi dengan BM MSC. Pada akhir minggu ke18 dilakukan nekropsi untuk pemeriksaan histopatologi, ekspresi SM-actin dan calponin terhadap aneurisma intrakranial, serta penilaian histopatologi pembuluh darah ekstrakranial.Sebanyak 27 tikus memenuhi kriteria sampel dengan 62 aneurisma intrakranial. Pada kelompok dengan pemberian BMMSC didapatkan 8 (53,33%) aneurisma memberikan ekspresi SMα-actin (p = 0,014; OR = 14,86) dan 8 (70,00%) ekspresi calponin (p = 0,008; OR = 7,78). Terdapat 4 (57,14%) aneurisma dengan ekspresi SMα-actin (p = 0,070, OR = 2,33) dan 7 (87,5%) dengan ekspresi calponin (p = 0,01, OR = 42,00) pada kelompok normotensi dengan pemberian BM MSC. Pada keempat kelompok tidak didapatkan perbedaan luas dan tebal tunika media arteri karotis (p = 0,616 dan p = 0,222) dan arteri iliaka (p = 0,452 dan p = 0,325). Pemberian BMMSC berhubungan dengan ekspresi SMα-actin dan calponin positif pada dinding aneurisma, menunjukkan pertumbuhan tunika muskularis. Faktor tekanan darah berhubungan dengan ekspresi calponin namun tidak berhubungan dengan ekspresi SMα-actin. Pemberian BM MSC tidak memberikan efek terhadap tunika media pembuluh darah ekstrakranial.

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Saccular intracranial aneurysm is a weak arterial wall caused by degeneration of tunica muscularis. There is still no research focused on strengthening intracranial aneurysm wall by restoring or regenerating tunica muscularis. The mesenchymal stem cells research in animal model had successfully regenerate vascular smooth muscle in abdominal aorta and carotid artery aneurysm. MSC is expected to have a role in regeneration of tunica muscularis in intracranial aneurysm.The objective of this study is to analyze the association between regeneration of tunica muscularis in intracranial aneurysm by BM MSC administration and blood pressure manipulation with SMα-actin dan calponin marker.Forty male Winstar rats were subjected to intracranial aneurysm induction for sixteen weeks. Then, the rats were randomly assigned into four groups, which were hypertension, normalized blood pressure, bone marrow mesenchymal stem cells BM MSC administration and hypertension group, and normalized blood pressure and BM MSC administration group. At the end of 18th week, all rats were sacrificed and evaluated for histopathology, immunohistochemistry (SMα-actin dan calponin), and extracranial artery structure.Twenty-seven rats with 62 aneurysms were eligible for sample criteria. Eight (53.3%) and fourteen (70.0%) aneurysms in group with BM MSC administration expressed SMα-actin (p = 0.014, OR = 14.86) and calponin (p = 0.008, OR = 7.78). In normotension and BM MSC administration group there were 4 (57.1%) aneurysm with SMα-actin expression (p = 0.070, OR = 2.33) and 7 (87.5%) with calponin expression (p = 0.01, OR = 42.00). There were no significant differences of wall area and thickness of carotid artery (p = 0,616 and p = 0,222) and iliac artery (p = 0.452 and p = 0.325) among four groups. In conclusion BM MSC administration was associated with SMα-actin and calponin expression on aneurysm wall, indicating regeneration of tunica muscularis. BM MSC administration was related to tunica muscularis regeneration, Blood pressure manipulation and BM MSC administration was related to calponin expression but was not related to SMα-actin expression. No effect of BM MSC administration was found on extracranial arteries."