6-Month Results of Transdiscal Biacuplasty on Patients with Discogenic Low Back Pain: Preliminary Findings

Haktan Karaman, Adnan Tufek, Gonul Olmez Kavak, Sedat Kaya, Zeynep Baysal Yildirim, Ersin Uysal, Feyzi Celik
Abstract: Chronic discogenic pain is one of the leading causes of low back pain; however, the condition is not helped by most non-invasive methods. The results of major surgical operations for these patients are unsatisfactory. Recently, attention has shifted to disk heating methods for treatment. TransDiscal Biacuplasty is one of the minimally invasive treatment methods. The method was developed as an alternative to spinal surgical practices and Intradiscal Electrothermal Therapy for treatment of patients with chronic discogenic pain.
Methods: The candidates for this study were patients with chronic discogenic pain that did not respond to conservative treatment. The main criteria for inclusion were: the existence of axial low back pain present for 6 months; disc degeneration or internal disc disruption at a minimum of one level, and maximum of two levels, in MR imaging; and positive discography. Physical function was assessed using the Oswestry Disability Index when measuring the pain with VAS. Patient satisfaction was evaluated using a 4-grade scale. Follow-ups were made 1, 3, and 6 months after treatment.
Results: 15 patients were treated at one or two levels. The mean patient age was 43.1±9.2 years. We found the mean symptom duration to be 40.5±45.7 months. At the sixth month, 57.1% of patients reported a 50% or more reduction in pain, while 78.6% of patients reported a reduction of at least two points in their VAS values. In the final check, 78.6% of patients reported a 10-point improvement in their Oswestry Disability scores compared to the initial values. No complications were observed in any of the patients.
Conclusions: TransDiscal Biacuplasty is an effective and safe method.
Keywords : discogenic pain, low back pain, transdiscal biacuplasty, intradiscal electrothermal therapy, cool radiofrequency

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Respons Imunitas Yang Rendah Pada Tubuh Manusia Usia Lanjut

Low Immunity Response in the Elderly

Fatmah

Abstract: Aging is related to a number of changes in the immunity function, mainly the reducing of Cell Mediated Immunity (CMI). The immunocompetence of elderly worsen with age including the rate of immune respons against infection. It means that older people have a high risk of getting diseases such as infection, cancer, cardiovascular, autoimmune disorder, or other chronic diseases. All of these diseases occured in elderly due to the immunoglobulin production decrease. Thus, vaccination given to elderly often might not be effective against diseases. Older people who commonly suffer from a decrease of macro and micronutrients will have a low function and response of the immune system. Therefore, malnutrition cases in elderly should have early specific attention including consideration in given vaccination for preventing diseases. Infectious diseases mostly suffered by older people can be prevented or reduced through improving nutrition efforts because the immune system will be improved. If the immune function of the elderly can be improved, the individual quality of life increases and the health cost can be suppressed.

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Faktor-Faktor Yang Mempengaruhi Perilaku Seksual remaja Di Jawa Tengah: Implikasinya Terhadap Kebijakan dan Layanan Kesehatan Seksual Dan Reproduksi

Influences on Youth Sexual Behaviour in Central Java: Implication of Sexual and Reproductive Health Policyand Services

Antono Suryoputro, Nicholas J. Ford, Zahroh Shaluhiyah

Abstract: Indonesian youth nowadays have been experiencing an increasing vulnerability to various kind of healthhazards specially related to reproductive and sexual health, including the growing threat of HIV/AIDS. This paperreports on findings from a study undertaken during the year 2003-2004 among urban youth in Central Java. The studyseeks to identify factors influencing youth sexual behavior and their need for services, in order to derive practical policyfor enhancing youth sexual and reproductive health services. The study involved a total of 2000 samples derived from ayouth population, aged 18-24 years old. A group of 1000 samples was randomly selected from a working youthpopulation through factory employers, whereas the other 1000 samples were from middle class youth among universitystudents. Social learning theory was applied as a base of the conceptual framework of the study with quantitativesurveys and qualitative methods The findings showed that the overall pattern of sexual and reproductive youth healthrisk were relatively low in comparison to that in many other countries, which was partly related to distinctive andpositive characteristics of the culture of the community in Central Java. The findings also showed that self efficacy wasthe strongest influencing factor on youth sexual behavior. Future policies and program development should be addressedto the ways in maintaining young people�s positive norms and values in line with the existing culture and religion byenhancing their self efficacy through school-based sexual and reproductive health education and services. Advocacyshould also be used continuously to address environmental constraints that impede the adoption of healthy reproductivehealth behavior.

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Characteristics of clients nursed in Professional Nursing Model, Psychiatric Unit, Dr. H. Marzuki Mahdi Hospital Bogor

Ice Yulia Wardani, Budi Anna Keliat, Mustikasari

Abstract: Since September 2000, Community and Mental Health Department Faculty of Nursing University of Indonesia, have developed Professional Nursing Practice Model (PNPM) on Psychiatric Nursing at Dr. H. Marzoeki Mahdi Health Hospital. PNPM at Marzoeki Mahdi Hospital is the first PNPM especially for mental health. The study was a quantitative cross sectional study conducted during the period February 4th to July 30th 2001 and covering 79 client. The aim of the study was to identify characteristics of clients at PNPM. It was found that most of the clients were males, aged 20-55 years, living in the area of Jabotabek (Jakarta, Bogor, Tangerang and Bekasi), especially in Bogor, the city of the hospital. Most of them had no job, with a senior high school education whereas the number with unmarried status was nearly the same with the number with married status and belonged to the Sundanese ethnic group. Characteristics of the family were mostly as followed: big family, with more than 2 children, closed communication and family meeting during meals. On health status it was found that clients were admitted to the hospital because of angry/violence, angry/violence and talking/laughing by themselves, whereas the number of clients in the group never nursed in a hospital before were nearly the same as the number in the group ever nursed before, with average length of staying in hospital 9 days. It was revealed that the problem of hallucination was mostly found among the nursing problems. Health education was mostly on efforts to eliminate paranoid problems and Activity Group Therapy was focused on efforts to socialize the clients. The medical diagnosis of most of the clients was paranoid schizophrenia. It was concluded that in this study characteristics of the clients in PNPM was very varied. For optimal nursing criteria of clients at PNPM who should be admitted should be established.

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Fecal Steroid Profile of Female Javan Gibbons (Hylobates moloch) Maintained in Pairing-Typed Cage

Abstract: Estrone conjugate (E1C) and pregnanediol glucuronide (PdG) were predominant steroid metabolites of estrogen and progesterone in feces of most primates and could be used to evaluate ovarian function. These metabolites were determined along with records of genital swelling throughout 3-4 months period from three female Javan Gibbons (Hylobates moloch) maintained in pairing-typed cage at Schmutzer Primate Center, Jakarta (Ullah) and at Taman Margasatwa Taman Sari, Bandung (Donna and Citah). Following methanolic extraction of lyophilized fecal powder, samples were analyzed using enzyme linked immunosorbent assay (ELISA) for E1C and PdG. In all of the three females observed, both hormone profiles did not indicate any regular cycle of ovarian function even though genital swellings were sometimes observed. In one female (Donna) the hormone patterns showed clear signs of cycle irregularities with extended luteal phase of 40 days and erratic pattern of follicular phase. Of the other two females, no ovarian cycle was found. The data indicate that the fecal steroids analysis is a practical and valuable diagnostic tool for providing reliable information on ovarian function in Javan Gibbon. Factors affected reproductive hormonal profile should be taken in consideration in trying to achieve success in captive breeding program for this species.

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Inhibition of Urokinase-Type Plasminogen Activator Expression by Macelignan in Porphyromonas gingivalis Supernatant-Induced Human Oral Epithelial Cells

Abstract: This study was to investigate the effect of macelignan on Porphyromonas gingivalis supernatant-induced uPA expression via regulating mitogen-activated protein kinase (MAPK) and activating protein-1 (AP-1) signaling pathways in human oral epithelial KB cells using casein zymography, Western blotting, reverse transcription-PCR and reporter gene assays. Zymographic analysis of secreted enzymes identified the main caseinolytic band at 54 kDa. Macelignan inhibited the expression of uPA protein and mRNA, as well uPA secretion, in KB cells exposed to P. gingivalis supernatant. Consistent with these findings, macelignan suppressed phosphorylation of p38 and c-Jun N terminal kinase (JNK) in P. gingivalis supernatant-induced KB cells. The levels of c-Fos and phosphorylated c-Jun, which together form AP-1, the transcription factor that is involved in uPA gene expression, were partially reduced by macelignan. Macelignan also blocked P. gingivalis supernatant-induced AP-1 activity in these cells. These results suggest that macelignan decreased P. gingivalis supernatant-induced uPA expression by blocking AP-1 activity, which may be mediated by inhibition of phosphorylation of p38 and JNK in KB cells. Macelignan may potently use for the modulation of periodontal inflammation.

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Incubation Of Denaturated Samples Increased Reproducibility And Quality Of Proteomic Profile Of SELDI-TOF MS

Abstract: Protein profiling with high-throughput proteomic technology, SELDI-TOF, is a new potential tool for diagnosis ofhuman diseases. This advanced technique has increasingly been used for the detection of disease biomarker. However,analytical reproducibility is a significant challenge in SELDI-TOF profiling in order to have confidence in the results.Here, we showed a simple step to improve its analytical performance. IMAC 30-Cu Protein Chip was used to incubatedenaturated samples to increase the number of peak detection and decrease peak intensity coefficient of variation.Incubation of denaturated samples overnight at 4oC increased significantly reproducibility and quality of proteomicprofile of SELDI-TOF MS for IMAC30-Cu ProteinChip. This strategy could be applied to address reproducibility issuein protemictechnology in protein profiling.

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Oxidative Stress In Liver Tissue Of Rat Induced By Chronicsystemic Hypoxia

Abstract: Adaptation mechanism to hypoxia in living organisms increases reactive oxygen species (ROS) formation that couldexceed the capacity of anti oxidant. Gluthatione (GSH) in which highest concentration present in liver, plays animportant role in maintaining the intracellular redox equilibrium and protect tissues from oxidative stress. The aim ofthis study was to observe tissue response of rat that was exposed to chronic systemic hypoxia by analyzing the oxidativestress in liver tissue. Twenty male Sprague-Dawley rats were induced by chronic systemic hypoxia by kept them inhypoxic chamber (10% O2:90% N2) for 1, 3, 7 and 14 day(s). All rats were sacrificed with ether anesthesia afterhypoxia treatment. Liver tissues were analyzed using parameters of oxidative stress, malondialdehyde (MDA) withtBARS test, and endogenous antioxidant, glutathione reduced form (GSH). The study showed that chronic systemichypoxia induction caused oxidative stress in liver tissue, which was shown by increased concentration of MDA in livertissue (nmol/mg liver tissue). Concentration of MDA in liver tissue was increased significantly on day-1, day-3, day-7and day-14 compared to control group (ANOVA, LSD, p<0.05). The differences between day-3, day-7 and day-14 wasnot significant. In contrast, liver GSH content (μg/mg liver protein) was progressively decreased significantly sinceday-1 of hypoxia until the end of experiment (ANOVA, LSD, p<0.05). Statistical analysis revealed that there is a strongcorrelation between MDA and GSH concentration in liver tissue (Pearson = - 0.993). It was concluded that oxidativestress present in liver tissue of rat induced by chronic systemic hypoxia.

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The Potentiality Of ß- Carotene As Free Radicalscavenger:A Study Of The Raise Of Superoxide Production Inmitochondrial Lymphocyte

Abstract: This is a study on carotenoid extracted from ‘Minyak Buah Merah' (Pandanus conoideus) in therapy simulation usinghigh dose of β-carotene on two lymphocytes-that of a healthy subject and a leukemia patient. Superoxide productionin mithocondrial lymphocyte as a result of β-carotene exposure was examined using a flow cytometer. The test findsthat superoxide (a specific mitochondrial free radical) increases easier and faster in leukemic lymphocytes than innormal lymphocytes. The results of the study support previous meta-analysis studies that high dosages of β-caroteneand vitamin E supplements as antioxidant should be discouraged because it increases all-cause mortality.

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Photoelectrochemical Detection Of Dengue-Related Oligonucleotide Sequence Using Anthocyanin As A Intercalating Agent And Electrochromic Material

World Health Organization (WHO) presupposes a confirmation of dengue virus infection diagnosis with two criteria, i.e. clinical and laboratory criteria. One of the basic methods used by most laboratories to diagnose dengue virus is to detect oligonucleotide sequence using a DNA amplification technique. In this research, the measurement of denguerelated oligonucleotide was conducted by photoelectrochemical method. The presence of oligonucleotide sequence in target DNA can be detected by DNA probe that is immobilized on TiO2 electrode. The DNA hybrid is then bound to electrochromic substance like anthocyanin that generates current when it is subjected to light. The photocurrent is directly proportional to the number of target DNA. The aim of this research is to obtain photoelectrochemical system that has sensitivity and high responsiveness toward the change in oligonucleotide concentration, especially the applicability of anthocyanin as a electrochromic substance and intercalating agent. Linearity (R2) generated from the change of current in response to concentration changes of target DNA (in the concentration range of 0.75–3.00 nM) is0.9611. Thus, this method has the potential to be developed to detect the presence of dengue virus in biological sample.

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Diarrhea Risk Factors of Infant and Children Under Five Years in Indonesia: A Systematic Review of Public Health Academic Studies

Diarrhea is one of the national public health problems most researched academically in the school of public health. This systematic review research aimed at exploring risk factors of diarrhea involved 18 academic products in the form of graduate thesis and undergraduate final academic paper of School of Public Health University of Indonesia in the year 2000-2005. The subjects (3884, ranging from 65 to 500) of these academic research products were mothers, infants, and children under age of 5. Data were analyzed univariate & bivariate. Most of the literatures used as reference in these research were old diarrhea reference books, publication from Ministry of Health and previous academic research results (i.e. thesis and final academic paper). None of the research instruments reviewed was tested its validity and its realibility. Risk factors most researched were related to environmental factor, i.e. clean water & toilet. The significant mother's risk factors were knowledge, behaviour and hygiene. The significant children's risk factors were nutritional status & brestfeeding. Environmental risk factors associated with access to clean water were source of clean water (average OR=3.19), risk of being contaminated (average OR=7.89), and ownership of the clean water source (average OR=17.25). By t-test, the differences between thesis and undergraduate final academic paper were number of independent variables & literature references used. Overall, the quality of academic research products is not sufficiently qualified.

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Isolation and function of mouse tissue resident vascular precursors marked by myelin protein zero

Vasculogenesis describes the process of de novo vessel formation from vascular precursor cells. Although formation of the first major vessels, such as the dorsal aorta and cardinal veins, occurs during embryonic vasculogenesis, the contribution of precursor cell populations to postnatal vessel development is not well understood. Here, we identified a novel population of postnatal vascular precursor cells in mice. These cells express the Schwann cell protein myelin protein zero (Po) and exhibit a CD45-CD31-VEcad-c-kit+CXCR4+ surface phenotype. Po+ vascular precursors (PVPs) are recruited into the growing vasculature, and comprise a minor population of arterial endothelial cells in adult mice. Recruitment of PVPs into growing vessels is mediated by CXCL12–CXCR4 signaling, and is enhanced during vascular expansion induced by Notch inhibition. Po-specific ablation of Flk1, a receptor for VEGF, results in branching defects and insufficient arterial patterning in the retina, as well as reduced neovascularization of tumors and ischemic tissues. Thus, in postnatal mice, although growing vessels are formed primarily by angiogenesis from preexisting vessels, a minor population of arterial endothelia may be derived from tissue-resident vascular precursor cells.

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The human Tp53 Arg72Pro polymorphism explains different functional prognosis in stroke

The functional outcome after stroke is unpredictable; it is not accurately predicted by clinical pictures upon hospital admission. The presence of apoptotic neurons in the ischemic penumbra and perihematoma area may account for poor prognosis, but whether the highly variable stroke outcome reflects differences in genetic susceptibility to apoptosis is elusive. The p53 tumor suppressor protein, an important transcriptional regulator of apoptosis, naturally occurs in humans in two variants with single nucleotide polymorphisms resulting in Arg or Pro at residue 72. We show that poor functional outcome after either ischemic or hemorrhagic stroke was linked to the Arg/Arg genotype. This genotype was also associated with early neurological deterioration in ischemic stroke and with increased residual cavity volume in intracerebral hemorrhage. In primary cultured neurons, Arg72-p53, but not Pro72-p53, interacted directly with mitochondrial Bcl-xL and activated the intrinsic apoptotic pathway, increasing vulnerability to ischemia-induced apoptotic cell death. These results suggest that the Tp53 Arg/Arg genotype governs neuronal vulnerability to apoptosis and can be considered as a genetic marker predicting poor functional outcome after stroke.

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