Arthroscopic fixation of chronic bicruciate tibial avulsion fractures: A case report / 中华创伤杂志(英文版)

A cruciate ligament avulsion is a much less common form of injury than a cruciate ligament tear. Simultaneous tibial avulsion fractures of both cruciate ligaments occur even more rarely. Over the last decades, many studies have described arthroscopic fixation of acute cruciate tibial avulsion fractures, but arthroscopic treatment in a late presenting patient has not been reported in the literature. This case report presents a 32-year-old female with a chronic tibial avulsion fracture of both anterior cruciate ligament and posterior cruciate ligament. Simultaneous fixation of both fractures was performed arthroscopically at week four post-injury. At one year of follow-up, the patient had demonstrated full knee range of motion and stable knee with no complaints, and achieved excellent clinical outcomes. Radiographs showed union of both fractures, and the patient had resumed high-impact exercises.

In silico and in vitro anti-inflammatory evaluation of 2,6-bis-(3'-ethoxy, 4'-hydroxybenzylidene)-cyclohexanone, 2,6-bis-(3'-Bromo,4'-methoxybenzylidene)-cyclohexanone, and 2,6-bis- (3',4'-dimethoxybenzylidene)-cyclohexanone

The aim of this research is to design the new mono-carbonyl analogs of curcumin, synthesize the molecules, anddetermine its activity in cyclooxygenase inhibition in vitro and in silico. New design MACs were performed bythe Quantitative Structure–Activity Relationship (QSAR) study using the BuildQSAR program. 2,6-bis-(3ʹ-ethoxy,4ʹ-hydroxybenzylidene)-cyclohexanone, 2,6-bis-(3ʹ-Bromo, 4ʹ-methoxybenzylidene)-cyclohexanone, and 2,6-bis-(3ʹ,4ʹ-dimethoxybenzylidene)-cyclohexanone had been synthesized using aldol condensation reaction. The anti-inflammatoryassay was performed to measure the level of malondialdehyde. In silico studies were carried out to evaluate the activityof cyclooxygenase inhibition in cyclooxygenase-1 and cyclooxygenase-2 specific proteins. Molecular operatingenvironment program was used for protocol docking. The results of the QSAR study reveal the good relationshipof anti-inflammatory activities. The in vitro anti-inflammatory activities of 6-bis-(3ʹ-ethoxy, 4ʹ-hydroxybenzylidene)-cyclohexanone, 2,6-bis-(3ʹ-Bromo, 4ʹ-methoxybenzylidene)-cyclohexanone, and 2,6-bis-(3ʹ,4ʹ-dimethoxybenzylidene)-cyclohexanone indicate the promising potential to inhibit cyclooxygenase enzyme with IC50 13.53 μM, 11.56 μM,and 20.52 μM, respectively. The in silico evaluation showing that O atoms (47, from ketones) of 2,6-bis-(3ʹ-Bromo,4ʹ-methoxybenzylidene)-cyclohexanone interact with ARG120 and TYR355 through H acceptor.

Circulating level of 25(OH)D3 with risk factors of asymptomatic adenoma and proximal non-adenoma colorectal polyps / Níveis circulantes de 25(OH)D3 com fatores de risco de adenoma assintomático e pólipos colorretais proximais sem adenoma

ABSTRACT Background: An inverse association between circulating vitamin D and adenoma risk hasbeen reported, but less is known about proximal inflammatory-hyperplastic polyps.Purpose: To investigate circulating 25(OH)D3and risk factors of proximal inflammatory-hyperplastic and adenoma colorectal polyps.Methods: From January 2017 to June 2019, consecutive asymptomatic average-risk partic-ipants undergoing initial screening colonoscopy. Questionnaires provided information oncolorectal polyp risk factors, and plasma samples were assayed for 25-Hydroxyvitamin-D ­25(OH)D3. The colorectal polyps were assessed, and medical history and demographic datawere obtained from each patient.Results: Of the 220 asymptomatic subjects, the prevalence of proximal inflammatory-hyperplastic polyps and adenoma polyps were 16.8%; 18.1% and 22.2%, respectively.Multivariate analysis revealed that low vitamin D (25(OH)D3< 18 ng/mL, OR = 3.94; 95%CI: 1.81­9.51) and current/former smoking (OR = 6.85; 95% CI: 2.98­15.70), high bodymass index (BMI > 24, OR = 5.32, 95% CI: 2.62­4.71) were independent predictors forproximal inflammatory-hyperplastic colorectal polyps (non-adenoma). Low vitamin D(25(OH)D3< 18 ng/mL, OR = 7.75; 95% CI: 3.19­18.80) and current/former smoking (OR = 3.75;95% CI: 1.30­10.81), age over 60 years old (OR = 2.38, 95% CI: 1.02­5.57), were independentpredictors for adenoma colorectal polyps.Conclusion: Low vitamin D and smoking are common risk factors for both adenomatous andproximal inflammatory hyperplastic polyps. Old age and BMI are additional risk factors forthe development of adenomatous and non-adenomatous colorectal polyps.

RESUMO Background: An inverse association between circulating vitamin D and adenoma risk hasbeen reported, but less is known about proximal inflammatory-hyperplastic polyps.Purpose: To investigate circulating 25(OH)D3and risk factors of proximal inflammatory-hyperplastic and adenoma colorectal polyps.Methods: From January 2017 to June 2019, consecutive asymptomatic average-risk partic-ipants undergoing initial screening colonoscopy. Questionnaires provided information oncolorectal polyp risk factors, and plasma samples were assayed for 25-Hydroxyvitamin-D ­25(OH)D3. The colorectal polyps were assessed, and medical history and demographic datawere obtained from each patient.Results: Of the 220 asymptomatic subjects, the prevalence of proximal inflammatory-hyperplastic polyps and adenoma polyps were 16.8%; 18.1% and 22.2%, respectively.Multivariate analysis revealed that low vitamin D (25(OH)D3< 18 ng/mL, OR = 3.94; 95%CI: 1.81­9.51) and current/former smoking (OR = 6.85; 95% CI: 2.98­15.70), high bodymass index (BMI > 24, OR = 5.32, 95% CI: 2.62­4.71) were independent predictors forproximal inflammatory-hyperplastic colorectal polyps (non-adenoma). Low vitamin D(25(OH)D3< 18 ng/mL, OR = 7.75; 95% CI: 3.19­18.80) and current/former smoking (OR = 3.75;95% CI: 1.30­10.81), age over 60 years old (OR = 2.38, 95% CI: 1.02­5.57), were independentpredictors for adenoma colorectal polyps.Conclusion: Low vitamin D and smoking are common risk factors for both adenomatous andproximal inflammatory hyperplastic polyps. Old age and BMI are additional risk factors forthe development of adenomatous and non-adenomatous colorectal polyps.

Afzelin inhibits migration of MDA-MB-231 cells by suppressing FAK expression and Rac1 activation

Triple-negative breast cancer (TNBC) has the worst prognosis and the highest rate of metastasis among other types ofbreast cancer. These characteristics are supported by the dysregulation of focal adhesion kinase (FAK) and Rac1 whichare the key players of mesenchymal cell migration on TNBC. Afzelin is a secondary metabolite that is contained ina variety of plants. This study explored the anti-migration effect of afzelin and its interaction with FAK and Rac1 onthe highly invasive TNBC cell line, MDA-MB-231. Cell viability was assessed by 3-(4,5-dimethyl 2-thiazolyl)-2,5-diphenyltetrazolium bromide assay, and cell migration was evaluated using in vitro scratch assay. Rac1 activation wasanalyzed using the colorimetric assay, while vinculin and actin filaments were stained through immunofluorescence. Thequantity of total FAK and phosphorylated FAK tyr397 was detected by Western blotting. Afzelin decreased cell viabilityand inhibited two-dimensional cell migration in a dose-dependent manner. Under confocal laser scanning microscopy,vinculin localization at the cell edge demonstrated a reduction of focal adhesion formation by afzelin. Further explorationshowed that afzelin decreased FAK expression but did not affect FAK phosphorylation at tyr397. In addition, afzelindecreased Rac1-GTPase activation, which is a downstream effector of FAK. Taken together, these results suggest thatafzelin suppresses TNBC cell migration, through inhibition of FAK expression and Rac1-GTPase activation.

Clinicopathological Profile of Wilms Tumor of Pediatric Patients in Dr. Sardjito General Hospital, Yogyakarta, Indonesia

@#Introduction: Wilms tumor is the major kidney neoplasm in childhood. Approach to therapy gives a 90% 2-year survival rate. However, the mortality rate in developing countries is relatively still high. Research about the clinicopathological profile of Wilms tumor in Indonesia is very limited. This study aimed to investigate the Wilms tumor patients in an Indonesian setting. Methods: This research was a descriptive observational study using a cross-sectional design. Clinical and pathological data were collected from patients’ medical records in Dr. Sardjito General Hospital, from 2011 to 2016. Results: Twenty-five patients were recruited with 52% female subjects. The mean age at the first diagnosis was 38 months. All patients had unilateral tumors. The tumor size was mostly (67%) equal or more than 10 cm. The most frequent symptom was abdominal mass. Ninety-two percent of patients have favorable histology. Most cases (68%) had triphasic morphology. The most common metastasis site of tumor was the liver, followed by the lung, skeletal bone, and spleen. Eighty-four percent of patients received chemotherapy, 80% received surgery, and 28% received radiotherapy. The gender distribution and the most common metastasis site in this study were different compared to previous studies. Conclusion: The clinicopathological profile of Wilms tumor in Yogyakarta, Indonesia, generally matches with other studies from other countries, except the gender distribution and the most common metastasis site. Further prospective studies regarding the prognosis of the patients are urgently needed.

Epidemiology Profile and Prognostic Factors of Childhood Rhabdomyosarcoma in Indonesia: A Five Year Single Institution Study

@#Introduction: Rhabdomyosarcoma (RMS) is the major soft tissue sarcoma in childhood, correlated with high morbidity and mortality. We defined clinico-epidemiological profiles and prognoses on pediatric RMS patients in Indonesia. Methods: This study was conducted retrospectively by examining all medical records of pediatric RMS patients in Dr. Sardjito Hospital, Yogyakarta, Indonesia, for 5 years from 2011 until 2016. Results: There were 21 RMS patients in this study. The median age of our subjects was 6 years and predominantly under 10 years old (71.4%). There was a greater tendency for the disease in males, with a male to female ratio of 2 : 1. The head and neck region was the primary tumor site (52.4%). The most common histological subtype of tumor was embryonal RMS (85.7%). The most common measured diameter for tumor size was ≤ 5 cm (42.9%). Almost half of the patients received combination therapy, including surgery and chemotherapy (47,6%). Overall survival rate was 71.7%. Conclusion: We concluded that the epidemiological profile and prognostic factors of childhood RMS patients in our center are similar to the world reference data and were clinically associated with the mortality rate of our RMS patients, but the findings were not considered statistically significant.

Combination Artesunate and Tinospora crispa Decreases Ubiquitin, HIF-1α, VEGF and iNOS Expression in Brain of Cerebral Malaria Mice Model

Introduction: Cerebral malaria is the most severe complication of Plasmodium falciparum infection. The pathophysiology of cerebral malaria is still unclear, but it is expected caused by cytoadherence, rosetting, autoagglutinations and abundant pro-inflammatory response that will induce the release of secondary molecules like ubiquitin, HIF-1, VEGF, and iNOS. Aim: To determine the effect of Artesunate and brotowali extract (Tinospora crispa) against the expression of ubiquitin, HIF-1α, VEGF and iNOS in the brain of cerebral malaria mice model. Methods: An experimental study of post-test only control group using CB57BL/6J mice model malaria had been done. Samples were divided into 7 groups: negative control (K-), positive control (K+), Artesunate 32 mg/BWkg/ day (P1), Tinospora crispa 70 mg/BWkg/day (P2), combination Artesunate and Tinospora crispa dose 50 mg/ kgBW (P3), combination Artesunate and Tinospora crispa dose 60 mg/kgBW (P4) and combination Artesunate and Tinospora crispa dose 70 mg/kgBW (P5). Mice model were decapitated at 7th day after infection. Expression of ubiquitin, HIF-1α, VEGF, and iNOS was measured by immunohistochemistry. Result: One Way ANOVA showed different expression of ubiquitin, HIF-1α, VEGF and iNOS among groups. Tukey test showed, there was no significant difference in expression of ubiquitin, VEGF and iNOS among single therapy (Artesunate or Tinospora crispa) with combination therapy (p>0.05). Expression of HIF-1α were significantly different between single therapy (Artesunate or Tinospora crispa) with combination therapy of Artesunate and Tinospora crispa 60 mg/kgBW (p=0.019, p=0.013) and combination therapy of Artesunate and Tinospora crispa 70 mg/kgBW (p=0.034; p=0.023). Pearson correlation showed negative correlation between Tinospora crispa dose and expression of HIF-1α (p=0.001; r=-0.832) and iNOS (p=0.001, r=-0.874). Conclusion: The combination of Artesunate and brotowali (Tinospora crispa) extract generally decreases Ubiquitin, HIF-1 α, VEGF dan iNOS expression of cerebral malaria model although only brain HIF-1α expression gives significant decreasing.

In Silico And In Vitro Assay Of Hgv Analogue As Antibacterial

Objective: The objective of this research was to design a new analogue compound, hexagamavunon (HGV). Methods: New design of analogue compound, HGV, was performed by QSAR study using BuildQSAR program. In this QSAR study, parameterized model (PM3) method using the Polak-Ribière algorithm was applied to calculate the optimal geometric structures of the used compounds. The new analogue compound, HGV had been synthesized using aldol condensation reaction. The assay of antibacterial activities was performed using the dilution method. Molecular operating environment (MOE) program was used for protocol docking. Results: The results of QSAR study reveal the good relationship of antibacterial activities. The in vitro antibacterial activities of 2,6-bis((E)-3,5-dibromo-4-hydroxybenzylidene) cyclohexan-1-one (A113) indicates the good potential to against S. aureus, B. subtilis and E. coli with IC50 27.3 μg/ml, 30.9 μg/ml, 32 μg/ml respectively. This is in accordance with the in silico evaluation showing that 2,6-bis((E)-3,5-dibromo-4-hydroxybenzylidene) cyclohexan-1-one has lower docking score than both amoxicillin and cefoxitin do as the native ligand of receptor 3MZE. Conclusion: Based on in silico and in vitro assay, 2,6-bis((E)-3,5-dibromo-4-hydroxybenzylidene) cyclohexan-1-one (A113) has good antibacterial activities against S. aureus, B. subtilis, and E. coli.

Ischemic cerebrovascular accident and its secondary renal impairment

Background: Renal impairment is one of the most frequent but anticipated potential complications. The objective of this meta-analysis was to evaluate the renal impairment following ischemic cerebrovascular accident (CVA) patients worldwide.Methods: Authors were using meta-analysis. Studies were obtained from several databases like Pubmed, Cochrane, Karger and JNS. Keywords were "renal" or "kidney" and "stroke" and "ischemic". Included studies were full-text observational study or randomized control trial (RCT). Subjects in study were newly diagnosed acute kidney disease (AKI) after ischemic CVA, with age range 18-100 years old. From 425 studies, total 5 studies were eligible for this study.Results: From those 5 studies, it is shown that the pooled risk ratio (RR) for mortality ischemic CVA with AKI was 2.56. AKI appeared insignificantly in both ischemic CVA and intracerebral haemorrhage (ICH) (RR 0.75; p=0.01). The pooled risk ratio had wide heterogeneity (I2 = 0.95) so random effect model was used.Conclusions: Renal impairment and its mortality appeared more frequent in ischemic CVA with AKI. It still needs more multicentre and long-term period researches in the future to get better understanding AKI in ischemic CVA.

Mistaken identity: Eumycetoma masquerading as Squamous cell carcinoma

@#We report a case of eumycetoma in a Filipino patient who presented with a solitary reddish brown, moist, multinodular tumor on the dorsum of the left foot of 2 years duration. Biopsy with Periodic acid Schiff (PAS) & Gomori methenamine silver (GMS) staining, fungal culture, ultrasound and X-ray of the foot were done in our institution which confirmed the diagnosis of eumycetoma. The patient was successfully treated with itraconazole 400/day for 3 months, followed by 200mg/day for the succeeding 9 months, leading to complete resolution of the lesion leaving an atrophic hypopigmented scar. A high index of suspicion supported by diagnostic tests aided in the early detection of the disease which also resulted to complete resolution of the disease.

Prevalence Rate of Adolescent Idiopathic Scoliosis: Results of School-based Screening in Surabaya, Indonesia

Introduction: Scoliosis is a lateral spinal deformity of 10 degrees or more, resulting in a C-shaped or S-shaped curve of the spine. Information about adolescent idiopathic scoliosis (AIS) prevalence rate is important not only for paediatric health care planning strategy but also for parent's awareness. This study aims to find the suitable inclination cut-off angle and the prevalence rate of AIS in Surabaya, Indonesia. Materials and Methods: This is a descriptive crosssectional study conducted in 2010. We performed stratified random sampling of 784 Elementary and Junior High School students in Surabaya between 9-16 years of age. Scoliosis screening was performed by the Adam's forward bending test (FBT). The students with positive FBT were measured for the inclination angle with scoliometer, and then subjected to radiologic examination. Prevalence rate, gender ratio, and the cut-off point value of inclination angle were determined by a descriptive statistics analysis. Results: Adam's forward bending test was positive in 50 students (6,37%). Among them, 23 students (2,93%) four males and 19 females had Cobb angle of ≥10°. The 5° cutoff point value of inclination angle had a 95.6% sensitivity, an 18.5% specificity, a 50% positive predictive value (PPV), and a 83.33% negative predictive value (NPV); while the 7° cut-off point had a 78.26% sensitivity, a 88.88% specificity, a 85.7% PPV, and a 82.7% NPV. Conclusion: The prevalence rate of AIS in Surabaya is 2.93% and the 7° cut-off point of inclination angle is suitable for school-based screening.

Anti-diabetic potential of Urena lobata leaf extract through inhibition of dipeptidyl peptidase IV activity

Objective: To evaluate the anti-diabetic potential of leaf extract from Urena lobata (U. lobata) through dipeptidyl peptidase IV (DPP-IV) inhibitory activity. Methods: U. lobata leaf was extracted in hot water and ethanol. The activity of DPP-IV inhibitor was tested by in vitro study using gly-pro-p-nitroanilide as substrat of DPP-IV and vildagliptin, as standard reference. A product of the reactions between gly-pro-pnitroanilide and DPP-IV, was observed by microplate readers with λ = 405 nm. All data were expressed as mean ± SD and the IC50 value was determined by non linear regression curve fit. Active substances in leaf extract of U. lobata was analyzed by liquid chromatography-mass spectrometry. DPP-IV inhibitory activity of active compounds was evaluated in silico using docking server. Results: The ethanolic extract of U. lobata showed stronger DPP-IV inhibitor activity than water extract with the IC50 values of 1 654.64 and 6 489.88 mg/mL, respectively. Vildagliptin, based on standard reference for DPP-IV inhibitor activity, has IC50 value of 57.44 μg/mL. Based on in silico analysis, mangiferin, stigmasterol and β-sitosterol in U. lobata extract have a strong inhibitory activity on DPP-IV. Conclusions: The results showed that DPP-IV inhibitory activity of U. lobata is related to its active compounds such as mangiferin, stigmasterol and β-sitosterol.

Blood Glucose Reduction by Combination of Andrographis paniculata (Burm. f.) Ness Herbs and Azadirachta indica A. Juss Leaves in Alloxan-Induced Diabetic Rats.

Andrographis paniculata (Burm. f.) Ness and Azadirachta indica A. Juss are Indonesian local plants that are potentially developed as antihyperglycemic agents. This study was aimed to explore antihyperglycemic effect of herbal extract combination of A. paniculata (Burm. f.) Ness and A. indica A. Juss in alloxan-induced rats compared to single extract treatment. Diabetic condition was induced with an intraperitoneal injection of 150 mg/kgBW alloxan monohydrate in the rats. After stable diabetic condition, the rats were administered either with single or extract combination for 15 consecutive days. Blood glucose profiles in both preprandial and postprandial were monitored at the day of 5, 10, and 15. Analysis of blood glucose level was performed using colorimetric method of GOD-PAP. In the study, preprandial and postprandial blood glucose levels of alloxaninduced rats could be decreased after administration of the herbal extract combination of A. paniculata (Burm. f.) Ness and A. indica A. Juss. The extract combination exhibited higher hypoglycemic effects than this of the single extract treatment. In conclusion, the combination of A. paniculata (Burm. f.) Ness and A. indica A. Juss is potential to develop as an antidiabetic agent.

Genotype distribution of T cell receptor β gene in Indonesian nasopharyngeal carcinoma patients.

Background: Nasopharyngeal carcinoma (NPC) is a multifactorial genetic disease, characteristically endemic and shows considerable differences in its geographical distribution. Besides infection with EBV, genetic factors such as polymorphisms of TCR-β gene contribute to the incidence of NPC. This study investigates the association of TCR-β gene polymorphisms with individual susceptibility to develop NPC in Indonesian ethnic groups. Methods: The study was carried out by the PCR-RFLP method using Bgl II restriction enzyme to digest TCR-β gene. The PCR-RFLP analysis of TCR-β gene was used to determine allotypes of TCR-β gene in NPC patients and control among ethnic Chinese and indigenous groups in the population of Indonesia. Results: The results indicate that the distribution of TCR-β gene allotypes between NPC patients and controls are not significantly different (p > 0.05); however, the frequency of A allele tends to increase in NPC patients. The distribution of TCR-β gene allotypes between Chinese ethnic group was not signifi cantly different from indigenous groups (p > 0.05). Conclusion: The distribution of TCR-β gene allele between NPC group and control groups showed no difference. The distribution of TCR-β gene between ethnic Chinese and indigenous groups showed no difference. Polymorphisms of TCR-β gene are not associated with NPC and ethnic groups in Indonesian population.

The difference between mean plasma levels of von Willebrand factor and platelet aggregation in type 2 diabetes mellitus with and without peripheral vascular disease at sardjito general hospital, yogyakarta.

Aim: to determine the differences in mean plasma values of von Willebrand factor and platelet aggregation in type 2 DM patient with or without peripheral arterial disease. Methods: this is a cross-sectional study, conducted from August to December 2006, in Dr. Sardjito General Hospital Yogyakarta, on type 2 DM patients, aged 50 years and above, and signed the informed consent. The exclusion criteria are cardiac failure, renal insufficiency (creatinine clearance <30 ml/minute), malignancy, acute disease, decrease hepatic function, having ulcer or DM gangrene, amputation, taking multivitamine and/or antiplatelet, and smoking. All samples that matched inclusion criteria were divided into 2 groups: with peripheral arterial disease and without peripheral arterial disease. The data of subjects are presented as mean and standard deviation and proportion. Variables with numeric data are analized with the student t-test for normal distribution and with Mann-Whitney U-test for abnormal distribution. Significancy limit was set at p value of <0,05. Statistical analysis was done by using SPSS 11.5 software. Results: there were 17 subjects having PVD. There were no significantly differences of mean vWF plasma levels (140.544 + 76,137% vs. 133.325 + 53,246%) and platelet aggregation (87.741 + 19.886% vs. 93.981 + 10.138%) between type 2 DM with and without PVD (p >0.05). Conclusion: there were no statistically difference in mean vWF plasma levels and platelet aggregation between type 2 diabetes mellitus with and without PVD.

Hypoadiponectinemia: a risk factor for metabolic syndrome.

Aim: to find out correlation between plasma adiponectin levels, insulin resistance and IDF criteria of Mets Patients. Methods: a case-control study was conducted on Native Javanese people from June 2006 to Januari 2007 in Outpatients Clinic of Dr Sardjito Hospital. The case group involved patients aged between 20 to 55 years old. The diagnosis of metabolic syndrome was confirmed according to IDF criteria. Patients without metabolic syndrome with matching age and sex,were taken as control group. Results: there were significant differences between case andh control group for BMI (body mass index) (30.2 +/- 4.1 vs 26.9 +/- 4.7 kg/m2), waist circumference (93.5 +/- 7.9 vs 84.4 +/- 11.5 cm), triglyceride (207.4 +/- 101.8 vs. 119.3 +/- 71.5 mg/dL) , HDL cholesterol (48.6 +/- 9.4 vs. 59.9 +/- 11.8m g/dL), systolic blood pressure (132.8 +/- 17.9mmHg vs 120.6 +/- 13.5 mmHg) and diastolic blood pressure (83.8 +/- 8.5 mmHg vs. 79.4 +/- 10.7), fasting blood glucose (128.3 +/- 40.8 mg/dL vs. 100.7 +/- 29.4 mg/dL), HOMA index (6.7 +/- 17.4 vs. 2.0 +/- 2.0) and adiponectin levels (3.8 +/- 1.4 vs. 5.9 +/- 2.5), respectively. For metabolic syndrome, hypoadiponectinemia showed the OR value of 6.0 (95% CI 2.13 to 16.98); insulin resistance showed the OR value of 5.7 (95% CI 1.3 to 25.02), after adjustment for waist circumference, TG, HLD, blood pressure, fasting blood glucose. Conclusion: hypoadiponectinemia and insulin resistance represent independent risk factors for metabolic syndrome development.

Strongyloidiasis with gastric mucosal invasion presenting with acute interstitial nephritis.

We report an atypical occurrence of invasive Strongyloides stercoralis infection of the stomach mucosa in an elderly female patient from Bangka Island, northwestern Indonesia. The patient presented with severe epigastric pain, edema of the legs, proteinuria and severe hypoalbuminemia. Gastric and duodenal biopsies found eggs, larval and adult forms present in the superficial mucosa with mild inflammation. The Harada-Mori filter paper culture technique revealed S. stercoralis filariform larvae and free-living adult worms, corroborating the diagnosis. The infection was associated with acute interstitial nephritis. The patient showed rapid and dramatic improvement after treatment with mebendazole.

Development of bioassay for pathogenecity testing of Ureaplasma urealyticum as part of host-pathogen communication.

Bioassay of Ureaplasma urealyticum is necessary for detection as well as determination of pathogenic factors in order to understand the pathogenesis of diseases associate with ureaplasma infection. Cultivation and verification of ureaplasma is the first step of this study in the purpose of discovering sensitive method for ureaplasma detection. Cultivation of ureaplasma either in liquid or in solid media are able to detect the existence of ureaplasma in samples analyzed. However, application of PCR using specific primers to be compatible with urease gene (ure) would confirm the presence of ureaplasma. The pathogenicity of ureaplasma is potentially monitored using reporter gene as a marker for gene expression. IceC was chosen as reporter gene for ureaplasma pathogenic determination as the gene has great sensitivity, easily detectable and quantitated in simple method of ice nucleation assay. Transposon 916 (Tn916) was selected as a vector for iceC gene to transform ureaplasma. The application of recombinant Tn916-iceC which is considered as pUI, allow detection of ureaplasma activities when transform ureaplasma is tested by ice nucleation assay. It was expected that ureaplasma transformation is the manifestation of mutagenesis which interfere genes responsible for bacterial pathogenicity, in order pathogenesis of bacterial infection to be analyzed accurately. IgA1 protease is considered to be an important factor for ureaplasma pathogenicity as the enzyme is required for successful colonization. Identification of iga gene and determination of IgA1 protease activity are important for understanding the pathogenesis of ureaplasma infection. Putative iga gene of Mycoplasma genitalium was used as a reference to identify the presence of iga nucleotide sequence in U. urealyticum. Convincing evidence were obtained after PCR amplification of ureaplasma DNA using primers designed to be compatible with putative iga gene of M. genitalium followed by the discovery of 100% sequence homology of amplified ureaplasma iga gene and iga gene of M. genitalium mentioned in establish data. IgA1 protease activity of U. urealytium has been detectable in the cell rather than in media culture, suggesting that IgA1 protease is not secreted out of cell. It was proofed that IgA1 protease is membrane bound enzyme capable of digesting IgA1 in mucosal tissues of various organs and considered as potential virulence factor for ureaplasma that cause disease or gain entry to mucosal membrane. The existence of IgA1 protease activity in bacterial plasma membrane would have implication in ureaplasma management such as diagnosis and therapy of ureaplasma infection.

The association of CAG repeat length polymorphisms of androgen receptor gene and spermatogenesis impairment in several Indonesian men.

Spermatogenesis impairment is the main cause of infertility in men. Androgen is believed to play a critical role in regulating spermatogenesis. Androgen acts by binding to the androgen receptor (AR) which is a protein regulator of DNA transcription. Exon 1 of AR gene contains a CAG repeat length polymorphism and it is believed to interfere AR function. This study includes DNA isolation from peripheral blood and amplification of CAG repeat fragments by PCR method. CAG repeat lengths were determined by electrophoresis on 6% denaturing gel polyacrylamide. We found that the mean CAG repeat lengths were 24,3 ± 3,4 in oligozoospermic/azoospermic men and 22,7 ± 2,7 in normozoospermic men. The difference in CAG repeat length between the two groups was statistically significant (p = 0,031, t-test). Nevertheless, there was no correlation between CAG repeat lengths and sperms concentration (rs = -0,038; p = 0,775). This result suggest that the expansion of CAG repeat length was not the main cause of spermatogenesis impairment.

Single nucleotide polymorphisms of follicle-stimulating hormone receptor promoter and their impacts to the promoter activities.

Women of reproductive ages are varies in their responses to exogenous FSH stimulations. The difference of FSHR genotype due to the polymorphisms in exon 10 is one of its significant factors. To know further whether the core promoter of FSHR is also polymorphic and to know whether those polymorphisms influence the promoter activity, we did polymorphism screening of FSHR promoter to 262 women undergoing IVF/ICSI, followed by functional study to know the impact of polymorphisms to the promoter activity. This study indicated that the core promoter of human FSHR is polymorphic. We found five SNPs at positions –29, –37, –114, –123 and –138 in addition to the variety number of adenines. Polymorphism at position –123 significantly decreased the promoter activity, in contrast, polymorphism at position –37 and –138 significantly increased the promoter activity, whereas polymorphism at position –29, –114 and short adenines stretch did not significantly influence the promoter activity. The differences of the promoter activities due to polymorphisms might change the ovarian sensitivity to FSH.