The Potential of Eleutherine bulbosa in Inducing Apoptosis and Inhibiting Cell Cycle in Breast Cancer: A Network Pharmacology Approach and In Vitro Experiments.

OBJECTIVE: The objective of this study was to evaluate the potential and mechanisms of phytochemicals in Eleutherine bulbosa (EBE) in inducing apoptosis and inhibiting the cell cycle in breast cancer through a network pharmacology approach and in vitro validation. METHODS: This research employed a literature review approach to identify active anti-cancer compounds and utilized a network pharmacology approach to predict the mechanisms of action of EBE compounds in breast cancer. In addition, in vitro experiments were conducted using MTT method to evaluate the effects of EBE on the cytotoxicity of T47D cells, and the flow cytometry method was employed to determine the impact of EBE on apoptosis and the cell cycle. RESULTS: The network pharmacology analysis revealed that EBE had an impact on 42 genes involved in breast cancer, including 23 important target genes implicated in the pathophysiology of breast cancer. Pathway analysis using the KEGG database showed a close association between EBE and crucial signaling pathways in breast cancer, including P53 signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway, apoptosis and cell cycle. In vitro experiments demonstrated that EBE exhibited moderate anti-cancer activity. Furthermore, EBE demonstrated significant potential in inducing apoptosis in breast cancer cells, with a percentage of apoptotic cells reaching 93.6%. Additionally, EBE was observed to disrupt the cell cycle, leading to a significant increase in the sub G1 and S phases, and a significant decrease in the G2-M and G1 phases. CONCLUSION: EBE has the potential to be an anti-cancer agent through various mechanisms, including apoptosis induction and cell cycle inhibition in breast cancer cells. These findings provide new insights into the potential of EBE as an alternative treatment for breast cancer.

The Effect of Thermal Exposure to Carbon Fiber Filament in the Thermoreceptor Area on the Physiological Response of Hypothermic Baby Rabbits.

Background: The body has a thermoregulation setting where when it gets hot, the body responds by dilating blood vessels or vasodilation, otherwise it gets a cold response, which causes narrowing of blood vessels or vasoconstriction. The thermal conditioning system is a system that can influence the baby in terms of its thermal quality. So that the baby can feel a comfortable environment or not. Skin temperature is a fundamental factor in heat exchange between the body and its environment. Objective: The purpose of this study was to analyze the effect of thermal exposure to carbon fiber filaments in the thermoreceptor area on the physiological response of hypothermic baby rabbits to changes in body temperature, to analyze the time needed for physiological adaptation of the body's skin to occur and to analyze the response of the thermoreceptor area on the head, neck, chest, arms, wrists, soles of the feet, to changes in each local area of the body. Methods: The research method used is pure experimental or laboratory experimental, with a post-test only control group design approach that uses experimental animals as experimental objects. The treatment in this study was using baby rabbits. The Sampling of test animals was carried out using simple random sampling. Statistical analysis was performed using IBM SPSS Statistics version 20. The confidence level was set at 95% by one way ANOVA test. Results: The results showed that the response of the thermoreceptor area to thermal exposure on the neck was the highest with an average of 39.77'. Conclusion: Based on the results of the analysis, it was concluded that there was an effect of thermal exposure to carbon fiber filaments in the thermoreceptor area on the physiological response of hypothermic baby rabbit models to changes in body temperature.

TGF-ß1 Effects on Total Collagen of the New Zealand Rabbit's Urethral Wall (Oryctolagus cuniculus) in Animal Models of Urethral Stricture.

Background: Currently, animal models of urethral stricture are not standardized. Transforming Growth Factor Beta 1 (TGF-ß1) regulates extracellular matrix deposition in homeostatic and pathological responses. Objective: The aim of this study was to present the potential model to be developed as a urethral stricture. Methods: True experimental laboratory research was conducted by using Male New Zealand rabbits (Oryctolagus cuniculus), which were divided into 5 groups; control, placebo, and 3 treatment groups (TGF-ß1 injection of 1 µg, 2 µg, 4 µg). Urethrography, histopathological analysis, and evaluation of total collagen formation of the urethral wall were performed after 6 weeks. Results: An increase in the dose of TGF-ß1 decreased the mean rabbit's urethral lumen diameter (29.3% in the 2µg group and 34% in the 4µg group) compared to controls. Three rabbits decreased as much as ≤ 50% in urethral lumen diameter. Significant increases in total collagen density in the periluminal and peripheral urethral spongiosum were noted by increasing doses of TGF-ß1. The percentage of urethral lumen diameter has a strong negative correlation with periluminal total collagen density (r = -0,798; p = 0,000) and very strong negative correlation with peripheral spongiosa total collagen density (r = -0,748, p = 0,000). Conclusion: TGF-ß1 plays a role in changing total collagen compositions of the rabbit's urethral wall, decreasing the urethral lumen diameter. Further research with increasing doses of TGF-ß1 is needed to determine the effective dose of TGF-ß1 in inducing urethral stricture.

Performance of deep learning in classifying malignant primary and metastatic brain tumors using different MRI sequences: A medical analysis study.

BACKGROUND: Malignant Primary Brain Tumor (MPBT) and Metastatic Brain Tumor (MBT) are the most common types of brain tumors, which require different management approaches. Magnetic Resonance Imaging (MRI) is the most frequently used modality for assessing the presence of these tumors. The utilization of Deep Learning (DL) is expected to assist clinicians in classifying MPBT and MBT more effectively. OBJECTIVE: This study aims to examine the influence of MRI sequences on the classification performance of DL techniques for distinguishing between MPBT and MBT and analyze the results from a medical perspective. METHODS: Total 1,360 images performed from 4 different MRI sequences were collected and preprocessed. VGG19 and ResNet101 models were trained and evaluated using consistent parameters. The performance of the models was assessed using accuracy, sensitivity, and other precision metrics based on a confusion matrix analysis. RESULTS: The ResNet101 model achieves the highest accuracy of 83% for MPBT classification, correctly identifying 90 out of 102 images. The VGG19 model achieves an accuracy of 81% for MBT classification, accurately classifying 86 out of 102 images. T2 sequence shows the highest sensitivity for MPBT, while T1C and T1 sequences exhibit the highest sensitivity for MBT. CONCLUSIONS: DL models, particularly ResNet101 and VGG19, demonstrate promising performance in classifying MPBT and MBT based on MRI images. The choice of MRI sequence can impact the sensitivity of tumor detection. These findings contribute to the advancement of DL-based brain tumor classification and its potential in improving patient outcomes and healthcare efficiency.

Deciphering the Role of TGF-ß1 in Altering Collagen I and Collagen III in the New Zealand Rabbit's (Oryctolagus cuniculus) Urethral Wall in Urethral Stricture Development.

Background: Presently, there's a lack of standardization in animal models used for studying urethral stricture. Transforming Growth Factor Beta 1 (TGF-ß1) is known to regulate the deposition of extracellular matrix in both normal and pathological conditions. This factor holds promise as a potential model for simulating urethral stricture. Objective: This study aims to investigate the impact of Transforming Growth Factor Beta 1 (TGF-ß1) on Collagen I and Collagen III within the urethral wall of New Zealand Rabbits (Oryctolagus cuniculus) in the context of developing urethral stricture in animal models. Methods: We conducted genuine laboratory experiments using Male New Zealand rabbits (Oryctolagus cuniculus), which were categorized into five groups: control, placebo, and three treatment groups (TGF-ß1 injections of 1 µg, 2 µg, 4 µg). After a duration of 6 weeks, we conducted urethrography, histopathological analysis, and assessed the formation of collagen I and collagen III within the urethral wall. Results: Elevating the dosage of TGF-ß1 led to a reduction in the average urethral lumen diameter of rabbits (29.3% in the 2µg group and 34% in the 4µg group) compared to the control group. In fact, three rabbits experienced a decrease of ≤ 50% in their urethral lumen diameter. As the doses of TGF-ß1 increased, we observed significant increases in the density of collagen I, and collagen III in both the periluminal and peripheral regions of the urethral spongiosum. Additionally, there was a tendency for the collagen I/collagen III ratio to decrease in the periluminal region, with collagen III density surpassing that of collagen I. In the peripheral spongiosa area, notable mean differences were observed between the control group, 1T, and 2T groups, with collagen I density tending to be higher than that of collagen III. Furthermore, the percentage of urethral lumen diameter exhibited a robust negative correlation with periluminal collagen I density (r = -0.672, p = 0.001), peripheral spongiosa collagen I density (r = -0.603, p = 0.005), periluminal collagen III density (r = -0.717, p = 0.001), and an exceptionally strong negative correlation with collagen III density of peripheral spongiosa (r = -0.804, p = 0.000). Conclusion: TGF-ß1 exerts an influence on altering the composition of collagen I and collagen III within the urethral wall of rabbits, leading to a reduction in the diameter of the urethral lumen. Further research is warranted to determine the optimal dose of TGF-ß1 required to induce urethral stricture effectively.

Apparent Diffusion Coefficient Values and Dynamic Contrast-Enhanced Magnetic Resonance Perfusion are Potential Predictors for Grading Meningiomas.

Purpose: Distinguishing between high-grade and low-grade meningiomas might be difficult but has high clinical value in deciding precise treatment and prognostic factors. Magnetic resonance imaging (MRI) using apparent diffusion coefficient (ADC) values and dynamic contrast enhancement (DCE) may have a significant role in capturing such complexities. Methods: Data from our hospital database on meningioma patients from January 2020 to December 2021 were obtained. The MRI results of all patients were evaluated for mean ADC value and DCE parameters, including time-signal intensity curves (TIC), maximum signal intensity (SImax), time to maximum signal intensity (Tmax), maximum contrast enhancement ratio (MCER), and slope. Results: In this retrospective analysis, 33 individuals were included. Twenty-eight (84.8%) patients were pathologically diagnosed with low-grade meningioma and five (15.2%) patients with high-grade meningioma. There is a crossover between high- and low-grade meningiomas in conventional MRI. Tumor size, location, shape, necrotic/cystic changes, peritumoral edema, and enhancement patterns did not differ substantially between groups (p = 0.39, 0.23, 0.28, 0.57, 0.56, and 0.33, respectively). The mean ADC and Tmax values of high-grade meningiomas were substantially lower than those of low-grade meningiomas (p = 0.002 and 0.02, respectively). An optimal cut-off of 0.87 × 10-3 mm2s-1 for the mean ADC value (area under the curve [AUC] = 0.94, sensitivity = 80%, specificity = 92.8%) and 42 s for Tmax (AUC = 0.84, sensitivity = 80%, specificity = 89.3%) was suggested. High-grade meningiomas had significantly higher TIC, SImax, MCER, and slope than low-grade meningiomas (p = 0.004, < 0.001, 0.01, and 0.001, respectively). Type IV TIC had a sensitivity of 80% and specificity of 89.3% in distinguishing high-grade meningiomas from low-grade meningiomas. Optimal cut-offs of 940.2 for SImax (AUC = 0.98, sensitivity = 80%, specificity = 96.4%), 245% for MCER (AUC = 0.94, sensitivity = 80%, specificity = 85.7%), and 5% per second for slope (AUC = 0.97, sensitivity = 80%, specificity = 96.4%) were estimated. Conclusion: The ADC value and DCE-MRI parameters (TIC, SImax, Tmax, MCER, and slope) are potential predictors for separating high-grade from low-grade meningiomas.

Comparative estimation of pleural effusion volume based on lateral decubitus position of chest x-ray and CT scan imaging.

Previous study using thoracic phantom for estimating fluid volume has been obtained which represents the case of pleural effusion based on the size of the x-ray radiograph. The models are obtained in the form of three equations, the pleural effusion volume as a function of height, length times the height, and area of the radiograph image. The three models of estimation have high linearity with ratio value more than 0.988, higher than the modelling measurement using ultrasonography modality. The modelling is expected to give a contribution on developing method for helping clinicians estimate the pleural effusion volume as a basic for performing fluid aspiration and to monitor the therapy. However, because modelling is developed using phantoms, then to be applied clinically, further research is needed for its application to patients. The height function model yields correlation value of 0.966 and paired T-test value of 0.892. The height times length function model yields correlation value of 0.982 and paired T-test value of 0.611. The area function model yields correlation value of 0.997 and paired T-test value of 0.647. From the three equations, measurement of estimated pleural effusion volume using area function on chest x-ray lateral decubitus position is the most appropriate equation. Corresponding to the results of the measurement of gold standard using a CT scan. Height measurement is the measurement that is the fastest and easiest in the application. Limitation of the study is it only can be done in right lateral decubitus position of the patient, and also cannot be applied to patients with condition such as post lung surgery, massive subpulmonic/ supradiaphragmatic pleural effusion, empyema, an atypical pleural effusion such as septated, encapsulated, loculated pleural effusion and anatomical deformity, scoliosis, or abnormalities of thoracic cavity.

Multiple spinal intramedullary cavernous angiomas with bleeding episode mimicking an intramedullary tumor.

Intramedullary cavernous angioma is a rare vascular malformation compared to cerebral cavernous malformation. The incidence of cavernous angioma is about 3 - 5% of all central nervous system lesions, 5 - 12% of all spinal vascular lesions, and 1% of all intramedullary lesions in pediatric patients. Although intramedullary cavernous angioma has the same histological picture as cerebral cavernous angioma, the natural history, and surgical approach are different from cerebral cavernous angioma. Due to its location in the eloquent area of the spinal medulla, a slight change in the size of the lesion can affect the neurological function of the patient. We describe a case of an intramedullary cavernous angioma with hemosiderin post bleeding, located in the cervical cord which was initially misdiagnosed as hemorrhagic ependymoma. On whole spine MR imaging we also found an intramedullary cavernous angioma in the lower thoracal cord at the T12 level with mild hemorrhage. Abdominal MRI showed cavernous angiomas in both kidneys. The patient underwent surgical treatment with removal of the lesion in the cervical cord and T12 level, with histopathologic findings consistent with cavernous angioma. No malignancy was detected. Post-surgery, the symptoms gradually improved. Symptomatic intramedullary cavernous angioma tends to bleed repeatedly and being unstable. Early diagnosis and surgical treatment can prevent rebleeding and more severe symptoms.

UBNet: Deep learning-based approach for automatic X-ray image detection of pneumonia and COVID-19 patients.

BACKGROUND: Analysis of chest X-ray images is one of the primary standards in diagnosing patients with COVID-19 and pneumonia, which is faster than using PCR Swab method. However, accuracy of using X-ray images needs to be improved. OBJECTIVE: To develop a new deep learning system of chest X-ray images and evaluate whether it can quickly and accurately detect pneumonia and COVID-19 patients. METHODS: The developed deep learning system (UBNet v3) uses three architectural hierarchies, namely first, to build an architecture containing 7 convolution layers and 3 ANN layers (UBNet v1) to classify between normal images and pneumonia images. Second, using 4 layers of convolution and 3 layers of ANN (UBNet v2) to classify between bacterial and viral pneumonia images. Third, using UBNet v1 to classify between pneumonia virus images and COVID-19 virus infected images. An open-source database with 9,250 chest X-ray images including 3,592 COVID-19 images were used in this study to train and test the developed deep learning models. RESULTS: CNN architecture with a hierarchical scheme developed in UBNet v3 using a simple architecture yielded following performance indices to detect chest X-ray images of COVID-19 patients namely, 99.6%accuracy, 99.7%precision, 99.7%sensitivity, 99.1%specificity, and F1 score of 99.74%. A desktop GUI-based monitoring and classification system supported by a simple CNN architecture can process each chest X-ray image to detect and classify COVID-19 image with an average time of 1.21 seconds. CONCLUSION: Using three hierarchical architectures in UBNet v3 improves system performance in classifying chest X-ray images of pneumonia and COVID-19 patients. A simple architecture also speeds up image processing time.

The association between FOXO3a rs4946936 gene polymorphism and the levels of FOXO3a among chronic granulocytic leukemia patients treated with imatinib mesylate.

Background: The gene  FOXO3a has been elucidated to govern the development of chronic granulocytic leukemia (CGL). Moreover, it has been suggested that the levels of  FOXO3a in circulation are affected by the  FOXO3a rs4946936 gene polymorphism. However, no study has assessed the correlation between the  FOXO3a rs4946936 gene polymorphism and the levels of  FOXO3a. The objective of this study was to assess the association between the  FOXO3a rs4946936 gene polymorphism and the levels of  FOXO3a in CGL patients treated with imatinib mesylate.  Methods: A cross-sectional study was conducted from February 2019 to February 2020. The genotyping of  FOXO3a rs4946936 gene polymorphism was conducted using PCR-RFLP, and the levels of  FOXO3a were assessed using ELISA. The association between the  FOXO3a rs4946936 gene polymorphism and the levels of  FOXO3a were assessed using multiple logistic regression.  Results: A total of 60 CGL patients were assessed in our study. Among them, the CC, CT, and TT genotypes of the  FOXO3a rs4946936 gene polymorphism were 35.0%, 48.3%, and 16.7% respectively. Our calculation revealed that elevated levels of  FOXO3a were found in CGL patients with the CC genotype of the  FOXO3a rs4946936 gene polymorphism. While we failed to clarify the association between either the CT or the TT genotype of  FOXO3a rs4946936 gene polymorphism and the levels of  FOXO3a.  Conclusion: Our study identifies that the CC genotype of the  FOXO3a rs4946936 gene polymorphism affects the elevated levels of  FOXO3a in CGL patients treated with imatinib mesylate.

Diagnostic Test Value of Assessment Adenoid Enlargement with and Without Airway Obstruction Using Lateral Soft Tissues X-ray Compared to Nasoendoscopy.

Adenoid hypertrophy is one of the most important causes of airway obstruction. Skull lateral soft tissues X ray are reliable diagnostic tools for detection adenoid enlargement with or without airway obstruction. Compared to nasoendoscopy that invasive and not available in all hospital. The aim of this study is to evaluate the diagnostic value of Skull lateral soft tissues X ray for assessment adenoid enlargement using Kurien, Cohen and Konak, Fujioka and McNamara methods compared with nasoendoscopy. Analytic observational with cross sectional study. 24 patients suspected adenoid enlargement was performed Skull lateral soft tissues X ray and measured the enlargement with Kurien, Cohen and Konak, Fujioka and McNamara methods. After performed X-ray these patients was been nasoendoscopy. Diagnostic value of Skull lateral soft tissues X ray Kurien methods show sensitivity was 73.6%, specificity 100%, positive predictive value 100%, negative predictive value 50% and accuracy 79.1%. Diagnostic value of Skull lateral soft tissues X ray Cohen and Konak methods show sensitivity was 94.7%, specificity 100%, positive predictive value 100%, negative predictive value 83.3% and accuracy 95.8%. Diagnostic value of Skull lateral soft tissues X ray Fujioka methods show sensitivity was 10.5%, specificity 100%, positive predictive value 100%, negative predictive value 22.7% and accuracy 29.1%. Diagnostic value of Skull lateral soft tissues X ray McNamara methods show sensitivity was 68.4%, specificity 100%, positive predictive value 100%, negative predictive value 45.4% and accuracy 75%. Adenoid enlargement can be measure with Skull lateral soft tissues X ray using Cohen and Konak method that has the highest sensitivity, specificity, and accuration compare another methods and using McNamara methods can predict the airway obstruction.

The Significant Correlation Between the Density of the Cochlea Otic Capsule and Spine in Hearing Loss Patients.

Osteoporosis and osteopenia are systemic disorders that affect all bones. Osteoporosis in the ear bone and cochlea otic capsule contribute to the occurrence of conduction and sensorineural deaf. The osteoporosis prevalence in RSSA is 38%; meanwhile hearing interference in osteoporosis patients is 66.67%. The femur and spine DXA are the golden standard to calculate the bone mineral density. The temporal bone density can be measured with CT scan using the Hounsfield Unit units. There is a hypothesis that the femur bone mass density can illustrate the temporal bone density. This study aimed to analyzes the correlation between the density of the cochlea otic capsule and the ear bone towards the femur and spine density in patients with reduction in bone density. This was a cross-sectional observational type analytic retrospective study analyzing 30 samples of patients with a reduction in bone density that have HRCT Mastoid examination results during 2017 at RSSA Malang's osteoporosis polyclinic. From 30 samples, most were female with an age range of 51-60 years old. The average femur, spine, ear bone and cochlea otic capsule of the osteoporosis group was lower than the osteopenia group. The spine density was significantly correlated with the otic capsule density. There was a positive significant correlation between the spine density towards the otic capsule density. The lower the spine density, the lower the otic capsule became.

The Correlation Between Petrous Part of the Temporal Bone Density and the Internal Auditory Canal Diameter in Sensorineural Hearing Loss Patients with Chronic Renal Failure.

Patients with chronic renal failure often suffer from hearing loss and the most common cause is sensorineural hearing loss. Sensorineural hearing loss can be caused by cochlear otosclerosis with early symptoms such as decreased petrous part of the temporal bone density due to narrowing of the internal auditory canal. Finding a correlation between the petrous part of the temporal bone density and the anteroposterior diameter of the internal auditory canal in sensorineural hearing loss in patients with chronic renal failure. An observational analytic, cross-sectional study, using a consecutive sampling technique. The petrous part of the temporal bone density decreased in patients with chronic renal failure. The anteroposterior diameter of the internal auditory canal remained normal, there was no association with sensorineural loss. There is a significant correlation between the petrous part of the temporal bone density and sensorineural hearing loss in patients with chronic renal failure. High-resolution CT scans of the mastoid can assist clinicians in determining cochlear otosclerosis and the subsequent detection of the early presence of sensorineural hearing loss.

The Role of Brain Magnetic Resonance Imaging (MRI) as an Early Detector of Cognitive Impairment.

BACKGROUND: Along with the increase of the health and prosperity level will affect the life expectancy in Indonesia, there has also been an increase in degenerative disease cases. One of the problems arises is cognitive impairment. The mild version of this impairment is often associated with the increase risk that will eventually lead to dementia. Therefore, early detection of this impairment is necessary. OBJECTIVE: This study is aimed at proving the correlation between Fazekas scale on brain MRI and MoCA-Ina score in defining the degree of cognitive impairment. METHODS: This study employed observational analytic design and cross sectional study for its data collection method. The Fazekas scale on brain MRI of 32 patients was read by 3 radiologist, while the MoCA-Ina scoring was done by a competent neurologist. Both tests were done double blindly. Later on, the correlation between Fazekas scale and MoCA-Ina score would be assessed using Spearman Correlation. RESULTS: Statistical calculation conducted using Spearman Correlation reveals that the coefficient is -0.519 with significant score (P) 0.002, which is smaller than α: 0.05. Therefore, it can be concluded that there is a strong negative correlation between Fazekas scale and MoCA-Ina score. CONCLUSION: Fazekas scale evaluation on brain MRI is necessary to be performed as it helps predicting the decline of one's cognitive function, so that an early therapy can be acted upon to prevent dementia in the future.

Thicker carotid intima-media thickness and increased plasma VEGF levels suffered by post-acute thrombotic stroke patients.

BACKGROUND AND OBJECTIVES: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4) as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT) against plasma VEGF levels in patients with post-acute thrombotic stroke. MATERIALS AND METHODS: CIMT was assessed sonographically using GE Logiq S6 with 13 MHz frequency linear probe. VEGF-A plasma levels were measured using enzyme-linked immunosorbent assay (ELISA) method. Differences among variables were compared statistically. The data were analyzed using Pearson correlation. RESULTS: A total of 25 patients with post-acute thrombotic stroke were identified in days 7 to 90. CIMT thickening was indicated in 88% of patients (1.202 ± 0.312 mm), while an increase in plasma VEGF was identified in all patients (178.28 ± 93.96 ng/mL). There was no significant correlation between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke (p=0.741). A significant correlation was recognized between CIMT and total cholesterol (p=0.029) and low-density lipoprotein (p=0.018). CONCLUSION: There were no significant correlations between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke. However, plasma VEGF increased in patients with thrombotic stroke. CIMT measurement is a promising noninvasive modality to assess the vascular condition of patients with stroke and diabetes, while plasma VEGF cannot specifically assess vascular condition as it can be triggered by ischemic conditions in tissues of the whole body.

Genetic variations in the osteopontin promoters T-443C and G-156GG increase carotid intima-media thickness.

Carotid intima-media thickness (CIMT) is a clear predictor of atherosclerosis. The increase of CIMT is affected by mutations in the osteopontin (OPN) promoters. The purpose of this study was to examine genetic variations in OPN promoters T-443C and G-156GG, identified in Javanese children with ischemic stroke parents, and to investigate their relationship with the increase of CIMT. A case-control analytic study was performed on 20 case and 12 control samples. Case samples were Javanese children aged between 10 to 21 years with ischemic stroke parents. Control samples were children with healthy parents. Mutations of T-443C and G-156GG were determined by employing polymerase chain reaction. Results of sequencing were analyzed using CLC Main Workbench 6.0. CIMT was defined using ultrasound. Genetic variations of T-443C were identified in six samples. Likewise, genetic variations of G-156GG were identified in six samples. Genetic variations in the OPN promoters T-443C and G-156GG were not potential risk factors in an increase of CIMT (P=0.654 and P=0.654). This study proves that genetic variations could be identified at the points of T-443C and G-156GG in children with ischemic stroke parents. Although statistically insignificant, the tendency to increase CIMT occurs in children with genetic variations. Children with ischemic stroke parents have thicker CIMT than children of healthy parents.

Role of Magnetic Resonance Imaging in Differentiating Spondylitis from Vertebral Metastasis.

STUDY DESIGN: Observational analytic design with a cross-sectional approach. PURPOSE: To analyze the suitability of magnetic resonance imaging (MRI) in distinguishing radiology images with a corresponding delineation of spondylitis and vertebral metastasis confirmed by histology results. OVERVIEW OF LITERATURE: MRI is an accurate modality for assessing vertebrae and their disorders. Infections and metastasis are most commonly found in the vertebrae. It is difficult to differentiate between these two disorders both clinically and radiographically, particularly in atypical cases. METHODS: McNemar statistical test was used to analyze the data. Samples were chosen using the consecutive method. There were 35 samples (14 males and 21 females), consisting of 22 samples of spondylitis and 13 samples of metastasis confirmed on histology examination. RESULTS: Nineteen (86%) out of the 22 samples of histological spondylitis were diagnosed as having spondylitis on MRI, whereas all 13 samples of metastasis were 100% accurately diagnosed on MRI. CONCLUSIONS: There was no statistically significant difference between diagnostic radiology using MRI and histological diagnosis with a p=0.250 (p>0.05). In this respect, MRI was more precise in diagnosing metastasis. Typical MRI description of spondylitis was the involvement of anterior vertebrae and components of intervertebral discs, stiffening of discs, paravertebral abscess, and involvement of the vertebral segment sequence. Typical MRI delineation of metastasis was involvement of the anterior posterior vertebral component, paravertebral mass, and skip lesions.

Thicker Carotid Intima Media Thickness in Children with Monocyte Chemoattractant Protein-1: A-2138T and A-2464G Mutation.

Carotid intima media thickness (CIMT) is clearly associated with atherosclerosis. Studies in ischemic stroke patients reveal that there is a significant association between CIMT with monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN) promoter polymorphism. This research aims to explain the effect of MCP-1 and OPN promoter polymorphism toward CIMT changes identified in Javanese Indonesian children. Subjects were 54 children: 27 were from parents with ischemic stroke (cases), and 27 were from healthy parents (controlled). The CIMT was examined by utilizing high resolution B-mode ultrasound. Physical examination and genotyping analysis of MCP-1 promoter were conducted by employing PCR method. Research results indicate that two polymorphisms were obtained, that is, A-2138T and G-2464A, respectively. A-2138T polymorphism was found in 5% of case children and in 14.3% of controlled children. G-2464A polymorphism was found in 5% of case children. CIMT of case children was significantly different from that of controlled children (0.61 ± 0.012 mm versus, 0.52 ± 0.015 mm, P = 0.021). Subjects with MCP-1 promoter polymorphism have 1.471 times higher tendency to have thicker CIMT than subjects with no polymorphism in MCP1 promoter. OPN promoter T-66G was also studied but it did not indicate occurrence of polymorphism in samples.