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Wilia Candra
Gambaran kadar fibrin monomer pada gestational hypertension dan preeklampsia = Description of fibrin monomer levels in gestational hypertension and preeclampsia
"ABSTRAK
Hipertensi merupakan kelainan yang umum dijumpai pada kehamilan.
Sekitar 70% wanita hamil mengalami gestational hypertension dan preeklampsia.
Disfungsi endotel pada preeklampsia menyebabkan permukaan endotel yang
nontrombogenik menjadi trombogenik sehingga dapat terjadi aktivasi koagulasi.
Preeklampsia meningkatkan keadaan hiperkoagulabel yang sudah ada pada
kehamilan normal. Gestational hypertension pada wanita hamil adalah hipertensi
yang tidak memenuhi kriteria preeklampsia. Hampir setengah dari pasien dengan
gestational hypertension akan berkembang menjadi preeklampsia. Fibrin
monomer merupakan petanda aktivasi koagulasi yang digunakan pada keadaan
pretrombotik oleh karena terbentuk terlebih dahulu pada keadaan hiperkoagulabel
daripada D-dimer yang terbentuk setelah fibrinolisis. Tujuan penelitian adalah
mendapatkan gambaran fibrin monomer pada gestational hypertension dan
preeklampsia. Penelitian ini adalah penelitian potong lintang pada 30 wanita
hamil gestational hypertension dan 30 wanita hamil preeklampsia yang dilakukan
pada Oktober sampai November 2015. Pemeriksaan FM menggunakan reagen
STA-Liatest memakai koagulometer STA Compact Analyzer. Kadar fibrin
monomer pada gestational hypertension didapatkan mean 4,61 µg/mL dengan
standar deviasi 0,86 µg/mL. Kadar fibrin monomer pada preeklampsia didapatkan
median 10,5 µg/mL dengan mean 11.99 µg/mL dan rentang 6,12 ? 23,26 µg/mL.
Didapatkan perbedaan bermakna kadar fibrin monomer pada gestational
hypertension dan preeklampsia dengan nilai p<0,001.
ABSTRACT
Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
;Hypertension is a common disorder in pregnancy. Approximately 70% of
pregnant women is gestational hypertension and preeclampsia. Endothelial
dysfunction in preeclampsia causes the endothelial surface of the nonthrombogenic
be thrombogenic so it can activated coagulation. Preeclampsia
increase hypercoagulability state in normal pregnancy. Gestational hypertension is
a hypertension in pregnancy who do not meet the criteria of preeclampsia. Nearly
half of patients with gestational hypertension develop into preeclampsia. Fibrin
monomers are used for coagulation activation marker on the prethrombotic state
therefore formed before on hypercoagulability state hiperkoagulabel than D-dimer
formed after fibrinolysis. The objective of this study is to gain description of
fibrin monomer levels and it was a cross-sectional study 30 pregnant women with
gestational hypertension and 30 pregnant women with preeclampsia. The study
was conducted in October and November 2015. Examination of fibrin monomer
using the reagent STA-Liatest and analyzer STA Compact. Mean of fibrin
monomer in gestational hypertension was 4.61 µg/mL with standard deviation
was 0.86 µg/mL. Median of fibrin monomer in preeclampsia was 10.5 µg / mL
with range was 6.12 to 23.26 µg/mL. Fibrin monomer levels found significant
differences in gestational hypertension and preeclampsia with p <0.001.
"
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Adityo Widaryono
Efektivitas minosiklin ointment 2,1% dan etilendiaminatetrasetat gel 24% sebagai bahan root surface conditioning = Effectivity of minocycline ointment 2,1% and ethilendiaminatetracetate gel 24% as root surface conditioning agent
"[Latar Belakang: Regenerasi periodontal diawali dengan perlekatan bekuan fibrin yang stabil. Tujuan: Mengamati perbedaan tingkat perlekatan bekuan fibrin pada permukaan akar yang dilakukan root surface conditioning dengan menggunakan minosiklin dan EDTA. Metode: Tiga puluh buah permukaan akar gigi dibagi dalam tiga kelompok yaitu kelompok minosiklin, kelompok EDTA dan kelompok kontrol salin. Pada permukaan akar gigi dilakukan aplikasi darah segar dan dibiarkan berkoagulasi, bekuan fibrin di evaluasi dengan Scaning Electron Microscope. Hasil Penelitian: Tidak terdapat perbedaan bermakna antara bekuan fibrin kelompok minosiklin dengan EDTA (p=0,759). Kesimpulan: Bahan EDTA dan minosiklin menghasilkan kepadatan bekuan fibrin yang sama pada permukaan akar gigi.
Background: Periodontal regeneration starts with a stable fibrin clots on the root surface. Objective: To observe the differences of fibrin clots on root surface with root surface conditioning using Minocycline and EDTA. Method: Thirty root surfaces divided into three groups. Minocycline group, EDTA group and saline group as control. Fresh human blood dropped on the surface and allow to coagulate. Fibrin clots were evaluated using Scanning Electron Microscope. Result: The result showed no significant difference between minocycline and EDTA application (p=0,759) Conclusion: EDTA and minocycline showed equal capability in producing fibrin clots on the root surface;Background: Periodontal regeneration starts with a stable fibrin clots on the root surface. Objective: To observe the differences of fibrin clots on root surface with root surface conditioning using Minocycline and EDTA. Method: Thirty root surfaces divided into three groups. Minocycline group, EDTA group and saline group as control. Fresh human blood dropped on the surface and allow to coagulate. Fibrin clots were evaluated using Scanning Electron Microscope. Result: The result showed no significant difference between minocycline and EDTA application (p=0,759) Conclusion: EDTA and minocycline showed equal capability in producing fibrin clots on the root surface;Background: Periodontal regeneration starts with a stable fibrin clots on the root surface. Objective: To observe the differences of fibrin clots on root surface with root surface conditioning using Minocycline and EDTA. Method: Thirty root surfaces divided into three groups. Minocycline group, EDTA group and saline group as control. Fresh human blood dropped on the surface and allow to coagulate. Fibrin clots were evaluated using Scanning Electron Microscope. Result: The result showed no significant difference between minocycline and EDTA application (p=0,759) Conclusion: EDTA and minocycline showed equal capability in producing fibrin clots on the root surface, Background: Periodontal regeneration starts with a stable fibrin clots on the root surface. Objective: To observe the differences of fibrin clots on root surface with root surface conditioning using Minocycline and EDTA. Method: Thirty root surfaces divided into three groups. Minocycline group, EDTA group and saline group as control. Fresh human blood dropped on the surface and allow to coagulate. Fibrin clots were evaluated using Scanning Electron Microscope. Result: The result showed no significant difference between minocycline and EDTA application (p=0,759) Conclusion: EDTA and minocycline showed equal capability in producing fibrin clots on the root surface]"
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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Yahya Darmawan
Penentuan monomer fibrin untuk deteksi koagulasi intravaskuler diseminata dalam obstetri
"Secara umum di negara maju 95% wanita hamil mendapat pertolongan dokter dan 50% di antaranya ditolong oleh dokter ahli Obstetri dan Ginekologi, tetapi dinegara yang sedang berkembang pertolongan oleh dokter ahli Obstetri dan Ginekologi hanya 1% selebihnya mendapat bantuan bidan, perawat dan dukun beranak.
Di Indonesia angka morbiditas dan mortalitas maternal maupun perinatal masih tinggi. Sebagai contoh angka kematian maternal di Indonesia pada tahun 1986 masih berkisar antara 400-450 per 100.000 kelahiran hidup, sedangkan di negara ASEAN lainnya seperti Malaysia 69 per 100.000 kelahiran hidup, Filipina 142 per 100.000 kelahiran hidup, Thailand 100 per 100.000 kelahiran hidup dan bahkan Singapura sudah mencapai 5 per 100.000 kelahiran hidup. Salah satu penyebab kematian ibu ini adalah perdarahan obstetrik disamping preeklampsia/eklampsia dan infeksi.
I dan kawan kawan melaporkan bahwa di12 rumah sakit pendidikan di Indonesia antara 1977-1980 didapatkan angka kematian ibu terdiri dari perdarahan 30,4%, infeksi 22,2% dan pre/eklampsia 16,3%. Sedangkan Agustina selama tahun 1981-1982 di Rumah Sakit Hasan Sadikin Bandung menemukan proporsi komplikasi obstetrik sebagai berikut: perdarahan 37,5%, preeklampsia/eklampsia 28,5% dan infeksi 19,7%. Sukirna melaporkan bahwa selama tahun 1988 di Rumah Sakit Cipto Mangunkusumo Jakarta kematian maternal terdiri atas Preeklampsia/eklampsia 46,15%, perdarahan 33,3% dan infeksi 7,69%.
Perdarahan obstetrik mempunyai penyebab bermacam macam, salah satu penyebab perdarahan adalah koagulasi intravaskular diseminata (KID) yang dapat pula disebabkan oleh patologi pendarahan. KID merupakan suatu keadaan di mana mekanisme pembekuan dan fibrinolisis bekerja pada saat yang bersamaan. KID bukan merupakan suatu penyakit tetapi merupakan suatu penyulit dari patologi solusio plasentae, preeklampsia, kematian janin, atonia uteri, robekan jalan lahir, sisa plasenta dan kelainan pembekuan darah.
Kekerapan KID belum diketahui pasti tetapi beberapa penulis mencoba untuk mengungkapkannya di antaranya Phillips (1975) di Amerika Serikat yang mendapatkan 24,3% dari kasus kematian janin, 17,6% dari 34% kasus syok septik, dan 19% kasus preeklampsia /eklampsia. Di Indonesia Hudono (1981) mengatakan bahwa komplikasi obstetrik yang paling sering disertai penyulit ini adalah solusio plasentae (10-30%)?."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 1991
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Hemastia Manuhara H.
Modifikasi preparasi platelet rich fibrin dalam mempercepat epitelisasi luka donor pada pasca panen tandur kulit = Modification of platelet rich fibrin preparation on accelerating epithelialization process on donor site after skin grafting
"Pendahuluan: Salah satu konsentrat faktor pertumbuhan autologus terbaru yang dapat mempercepat proses penyembuhan luka dan meningkatan bioaviabilitas adalah platelet rich fibrin (PRF). Belum ada penelitian aplikasi PRF di luka pasca panen tandur kulit dapat mempercepat proses epitelisasi.
Metode: Studi multipel measure dengan general linear model adalah untuk mengevaluasi luka pasca panen tandur kulit, luka pasca panen tandur kulit dibagi menjadi dua kelompok dengan atau tanpa aplikasi PRF pada area tersebut. Untuk mengevaluasi epitelisasi luka di lokasi donor, kami memberikan perawatan luka yang sama pada kedua sisi dan evaluasi foto analisis pada hari ke 1,3, 7, 14 dan 30 menggunakan perangkat lunak ImageJ. Data yang diperoleh dianalisis dengan SPSS 20.0. Nilai P lebih rendah dari 0,05 dianggap signifikan.
Hasil: Penggunaan PRF telah membuktikan kemampuannya untuk mempercepat proses epitelialisasi proses penyembuhan situs donor p 0,000. Reaksi inflamasi kelompok PRF (hiperemik, nyeri, hipertermia, dan edema) di situs donor berkurang.
Kesimpulan: Aplikasi PRF akan memperbaiki kondisi luka, khususnya dengan menyediakan faktor pertumbuhan di lingkungan luka yang membantu mempercepat proses epitelisasi dan menghasilkan manajemen luka yang efektif.
Introduction: One of the newest concentrate autologous growth factors for wound healing process is platelet rich fibrin (PRF), used to accelerating wound healing process. PRF application on donor site after skin grafting would accelerated epithelialization process.
Methods: This multiple measure with general linear model study is to evaluate after harvesting, donor site defect was divided into two groups with or without PRF application. To evaluate of epithelialization of donor site wound, we give same treatment of wound care of both side and evaluated at day 1,3, 7, 14 and 30 using ImageJ software. Data obtained were analyzed with SPSS 20.0. The P-values lower than 0.05 considered as significant.
Result: The use of PRF has proven its ability to accelerate the epithelialization process of donor site healing process p 0,000. Inflammation reaction of PRF group (hyperemic, pain, hyperthermia, and edema) on donor site wound less.
Conclusion: PRF application would improve the condition of the wound, in particular by providing growth factor in the wound environment that help accelerate the epithelialization process and resulting in cost effective wound management."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58613
UI - Tesis Membership  Universitas Indonesia Library
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Airina
Evaluasi gambaran Radiografis Periapikal pada perawatan Bedah Poket Infraboni menggunakan Platelet Rich Fibin dan kombinasi dengan Cangkok Tulang = Periapikal Radiograph evalution of Alveolar Bone height before and after flap operation with Platelet Rich Fibrin and combination with Bone Graft / Airina
"ABSTRAK
Abstrak. Inovasi terbaru untuk mendapatkan regenerasi jaringan periodontal adalah dengan bahan platelet rich fibrin (PRF) dan cangkok tulang. Penelitian ini merupakan penelitian eksperimental klinis. Tujuan: Mengevaluasi perbedaan tinggi tulang alveolar pada terapi bedah flep poket infraboni menggunakan Platelet rich fibrin dan kombinasi dengan cangkok tulang. Metode penelitian: Evaluasi radiografis periapikal sebelum dan sesudah perawatan menggunakan PRF dan kombinasi dengan cangkok tulang Hasil: secara statistik, terdapat perbedaan tinggi tulang yang bermakna pada terapi bedah poket infraboni dengan PRF dan kombinasi dengan cangkok tulang. Kesimpulan: Platelet rich fibrin dan kombinasi dengan cangkok tulang memiliki hasil yang sama pada evaluasi radiografis ketinggian tulang secara statistik
ABSTRACT
Abstract. The new innovation to enhance periodontal tissue regeneration are using PRF and bone graft material. The study was clinical experimental. Purpose:To evaluate the difference of alveolar bone heigh on periodontitis therapy using PRF and combination with bone graft.Research methods: periapical radiograph evaluation before and after periodontitis therapy using PRF compare to combination with bone graft. by assessing alveolar bone height. Results: Statistically, there were no significant difference between alveolar bone height on periodontitis therapy PRF compare to combination with bone graft. Conclusion: PRF and combination with bone graft has the same result statictically in radiographic evaluation of alveolar bone height."
2013
T32781
UI - Tesis Membership  Universitas Indonesia Library
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Nazzla Camelia Maisarah
Perawatan bedah flep dengan aplikasi kombinasi platelet rich fibrin dan cangkok tulang pada kasus periodontitis kronis = Open flap treatment using platelet rich fibrin and bonegraft for chronic periodontitis / Nazzla Camelia Maisarah
"ABSTRAK
Tujuan penelitian ini menganalisis penyembuhan jaringan periodontal sesudah flep dengan aplikasi PRF dan cangkok tulang serta PRF saja. Metode: Empat belas sampel Periodontitis kronis dibedah flep dan diamati perbaikan status periodontal 3 dan 6 bulan paska flep. Hasil: Perbaikan tingkat perlekatan kelompok PRF dan cangkok tulang lebih baik dari kelompok PRF. Tidak ada perbedaan poket dan perdarahan gingiva yang lebih baik pada PRF dan cangkok tulang dibandingkan PRF. Kesimpulan: Ada perbedaan perbaikan tingkat perlekatan serta tidak ada perbedaan perbaikan poket dan perdarahan gingiva antara PRF dan cangkok tulang dibandingkan dengan PRF saja.
ABSTRACT
This study is to analyze periodontal tissue healing after flap using platelet rich fibrin and bonegraft and PRF only. Methode: Fourteen samples with chronic periodontitis were treated by flap and the periodontal status were evaluated at 3 and 6 month after treatment. Result: Attachment level healing in PRF and bonegraft is better than PRF group. Pocket depth and bleeding on probing were not better in PRF and bonegraft than PRF. Conclusion: There is a difference on attachment level and there are no difference on pocket and bleeding on probing between both of group."
2013
T32922
UI - Tesis Membership  Universitas Indonesia Library
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Setyo Budi Premiaji Widodo
Perbandingan Lem Fibrin Sintesis Mandiri Dan Lem Fibrin Komersial Menggunakan Uji Thromboelastograf = Comparative Study Of Fibrin Glues Using Thromboelastograph Assay: Cryoprecipitate Glue And Two-component Fibrin Glue
"Pendahuluan: Lem fibrin telah secara rutin digunakan dalam prosedur bedah saraf. Substansi ini dapat diperoleh dengan beberapa metode, dua yang paling populer adalah lem fibrin komersial (LK) yang siap pakai dan lem fibrin sintesis mandiri (SM). Studi ini membantu dokter bedah memilih lem yang sesuai dengan kebutuhan mereka, berdasarkan perbandingan sifat lekat mereka dalam pengukuran yang terstandar. Metode: lem fibrin komersial yang siap pakai dan lem fibrin sintesis mandiri diuji dengan uji tromboelastograf. Kenormalan distribusi data diuji dengan Shapiro-Wilk. Uji perbandingan dilakukan menggunakan uji Mann Whitney. Hasil: SM memiliki waktu reaksi (R) yang lebih lama daripada LK, dengan median 17,4 (12,3-20,1) menit dibandingkan dengan 0,2 menit, nilai p <0,001. SM memiliki nilai K (K) yang lebih lama daripada LK, dengan median 2,2 (2,0-2,8) menit dibandingkan dengan 0,8 menit, nilai p <0,001. SM memiliki amplitudo maksimum kekuatan (MA) yang lebih rendah daripada LK, dengan median 67,4 (63,9-69,4)% dibandingkan dengan 87,4 (80,9-92,5)%, nilai p <0,001. Secara kualitatif, LK memiliki trombus yang lebih pejal sedangkan trombus SM terikat pada cangkir TEG sampai akhir uji. Kesimpulan: Penulis menyarankan menggunakan SM untuk menutup perdarahan atau kebocoran yang tidak memiliki tekanan tinggi karena memiliki MA yang lebih rendah. Teknik premixed dapat digunakan untuk mengatasi R dan K yang lebih lama.
Introduction: Fibrin glues have been used routinely in Neurosurgery procedures. This substance can be obtainad by several method, two most popular are ready-to–use two-component fibrin glue and cryoprecipitate glue. However, the popularity between two products are not equal. This study help surgeon choose better glue suitable to their need, based on comparison of their adhesive properties in standarized measurement. Methods: cryoprecipitate glue (CG) and two-component fibrin glue (TG) was tested by thromboelastograph assay analyzer. The data’s normality of distribution was tested by Shapiro-Wilk. The comparison test was done using Mann Whitney test.
Results: CG has longer reaction time (R) than TG, with a median of 17.4 (12.3-20.1) minutes compared to 0.2 minutes, p value <0.001. CG has longer K value (K) than TG, with a median of 2.2 (2.0-2.8) minutes compared to 0.8 minutes, p value <0.001. CG has lower maximum amplitude of strength (MA) than TG, with a median of 67.4(63.9-69.4)% compared to 87.4(80.9-92.5)%, p value <0.001. Qualitatively, TG had more solid clot and CG’s clot attached to the TEG cup until the end of the test.
Conclusion: Authors recommend using CG to seal bleeding or leakage without high tension due to its lower MA. Premixed technique is more suitable to overcome longer R and K."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Ronald Winardi Kartika
Peran kombinasi asam hialuronat dan advanced platelet rich fibrin pada angiogenesis luka kaki diabetes: kajian pada IL-6, VEGF, PDGF dan indeks granulasi = Role of the combination of hyaluronic acid and advanced platelet rich fibrin on angiogenesis of wound DM through IL-6, VEGF, PDGF and granulation index
"Luka kaki diabetes (LKD) adalah salah satu komplikasi diabetes melitus (DM). Terapi LKD adalah perawatan luka dan growth factor (GF) seperti advanced-platelet rich fibrin (A-PRF). Penyandang DM memiliki GF rendah, untuk mengoptimalkan GF yang dilepaskan oleh PRF, ditambahkan asam hialuronat (AH). Penelitian ini bertujuan menganalisis pengaruh A-PRF + AH terhadap penyembuhan LKD dengan mengkaji VEGF, PDGF, IL-6, dan indeks granulasi. Desain penelitian randomized control trial, dilaksanakan pada bulan Juli 2019 −Maret 2020 di RSPAD Gatot Soebroto dan RSUD Koja, Jakarta. Subjek penyandang LKD yang mengalami luka kronik, kriteria Wagner II, luas luka < 40 cm2. Subjek diambil berdasarkan rule of thumb dan dibagi tiga secara acak yaitu kelompok terapi topikal A-PRF + AH (n = 10), A-PRF (n = 10) dan kontrol NaCl 0,9% (n = 10). Pada kelompok A-PRF + AH dan A-PRF dilakukan pemeriksaan VEGF, PDGF, IL-6 dari usap LKD dan fibrin gel sedangkan kontrol hanya diperiksa usap LKD. Biomarker dan Indeks Granulasi (IG) diperiksa hari ke-0, ke-3, ke-7. Khusus IG pengukuran ditambah hari ke-14. Data dianalisis menggunakan SPSS versi 20 dengan uji Anova atau Kruskal Wallis. Pada kelompok A-PRF + AH, kadar VEGF usap LKD hari ke-0 adalah 232,8 meningkat menjadi 544,5 pg/mg protein pada hari ke-7. Pada kelompok A-PRF tejadi peningkatan dari 185,7 menjadi 272,8 pg/mg protein, namun kelompok kontrol terjadi penurunan dari 183,7 menjadi 167,4 pg/mg protein. Kadar PDGF usap LKD kelompok A-PRF + AH hari ke-0 adalah 1,9 pg/mg protein, meningkat menjadi 8,1 pg/mg protein hari ke-7, kelompok A-PRF dari 1,7 meningkat menjadi 5,4 pg/mg protein dan kontrol dari 1,9 meningkat menjadi 6,4 pg/mg protein. Kadar IL-6 usap LKD kelompok A-PRF + AH hari ke-0 adalah 106,4 menjadi 88,7 pg/mg protein hari ke-7, pada A-PRF dari 91,9 menjadi 48,8 pg/mg protein dan kontrol dari 125,3 menjadi 167,9 pg/mg protein. IG kelompok A-PRF + AH hari ke-0 adalah 42,1% menjadi 78,9% dan 97,7% hari ke-7 dan ke-14, pada kelompok A-PRF dari 34,8% menjadi 64,6% dan 91,6%. Kelompok kontrol dari 35,9% menjadi 66,0% dan 78,7% hari ke-7 dan ke-14. Pada kelompok A-PRF + AH dibandingkan A-PRF dan NaCl didapatkan peningkatan bermakna kadar VEGF pada hari ke-3 (p = 0,011) dan hari ke-7 (p < 0,001). Kadar IL-6 menurun bermakna (p = 0,041) pada hari ke-7 saja. Namun persentase IG meningkat bermakna pada hari ke-3 (p = 0,048), ke-7 (p = 0,012) dan hari ke-14 (p < 0,001). Disimpulkan penambahan AH pada A-PRF meningkatkan VEGF (marker angiogenesis) dan IG (tanda klinis penyembuhan luka), serta menurunkan IL-6 (marker inflamasi) secara bermakna sehingga mempercepat penyembuhan LKD.
Diabetic foot ulcer (DFU) is one of complications of diabetes mellitus (DM). Advance wound treatment in DFU such as growth factors (GF) including Advanced-Platelet Rich Fibrin (A-PRF) topical has been developed . People with DM have low GF, so to optimize GF hyaluronic acid (AH) is added. This study analyzed the combination of A-PRF + AH combination in DFU recovery by examining VEGF, PDGF, IL-6, and granulation index (IG). The study used a randomized control design, done from July 2019−March 2020 at the Gatot Soebroto Army Hospital and Koja District Hospital, Jakarta. Subjects were DFU patients who had chronic wounds, area < 40 cm2 and Wagner II criteria. Subjects were recruited according to the rule of thumb and were randomly divided into three groups namely topical A-PRF + AH (n = 10), A-PRF (n = 10) and control NaCl 0.9% groups (n = 10). The A-PRF + AH and A-PRF groups underwent VEGF, PDGF, and IL-6 examinations of the DFS swabs and fibrin gel while the controls could only underwent the DFU swabs. Biomarkers and Granulation Index (GI) were measured on day 0, 3rd, 7th. Special GI measurements were added on day 14. Data were analyzed using SPSS version 20 with the Anova and Kruskal Wallis test. In the A-PRF + AH group the VEGF level from swab DFU day 0 was 232,8 pg/mg protein increase to 544,5 pg/mg protein on day 7. In the A-PRF group VEGF increase from 185,7 to 272,8 pg/mg protein and control decrease from 183.7 to 167.4 pg/mg protein. Increasing of PDGF levels in group A-PRF + AH day 0 was from 1,9 pg/mg protein to 8,1 pg/mg day 7, group A-PRF from 1,7 increased to 5,4 pg/mg protein and control from 1,9 to 6,4 pg/mg protein. Decreasing of IL-6 level of DFU swab in group A-PRF + AH day 0 was 106,4 pg/mg protein to 88,7 pg/mg protein day 7, in group A-PRF from 91,9 to 48,8 pg/mg protein and control from 125,3 to 167,9 pg/mg protein. The granulation index of DFU group A-PRF + AH on day 0 was 42,1% increased to 78,9% and 97,7% days 7 and 14. In the A-PRF group increased from 34,8% to 64,6 % and 91,6%. and controls from 35,9% to 66,0% and 78,7% on days 7 and 14. On the 7th day the VEGF level of the A-PRF + AH group increased significantly (p < 0.001), while IL-6 decreased and the granulation index increased significantly with p level of p = 0.041 and p = 0.012 respectively, compare with other group. It was concluded that on day 7 the AH to A-PRF increases VEGF (a marker of angiogenesis) and GI (a clinical sign of wound recovery), as well as a decrease in IL-6 (a marker of inflammation) which fully increase in DFU. "
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Disertasi Membership  Universitas Indonesia Library
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Januar Chrisant Fladimir Makabori
Evaluasi implantasi eksosom sel punca mesenkimal asal tali pusat dan Platelet Rich Fibrin (PRF) pada defek krisis tulang panjang di tikus sprague dawley = Evaluation of exosome from umbilical cord mesenchymal stem cell and Platelet-Rich Fibrin (PRF) implantation in critical bone defects in sprague dawley rats
"Pendahuluan: Defek tulang kritis adalah hilangnya struktur tulang yang melebihi ukuran kritis kemampuan tulang untuk beregenerasi. Pencangkokan tulang autologus sebagai terapi standar diperlukan pada defek tulang yang luas. Namun, hal ini dikaitkan dengan berbagai morbiditas. Penggunaan eksosom dari sel punca mesenkimal tali pusat (SPM- TP) dan PRF cukup menjanjikan dan berpotensi menjadi alternatif untuk mencapai penyembuhan defek tulang kritis.
Metode: Penelitian ini merupakan penelitian eksperimental post-test only control group design dengan menggunakan 30 ekor tikus Sprague Dawley yang berusia 8-12 minggu dengan berat badan sekitar 250-300 gram. Tikus-tikus tersebut kemudian dibagi menjadi 5 kelompok perlakuan, yaitu hidroksiapatit (HA) dan cangkok tulang (kelompok I), HA, cangkok tulang, dan PRF (kelompok II), HA, cangkok tulang, dan eksosom dari UC-MSC (kelompok III), HA, cangkok tulang, PRF, dan eksosom dari UC-MSC (kelompok IV), serta HA, PRF, dan eksosom dari UC-MSC (kelompok V). Pada setiap tikus, defek tulang femur 5mm dibuat dan difiksasi secara internal menggunakan ulir kawat K 1,0-1,2 mm. Pada minggu keempat masa tindak lanjut, pemeriksaan RT-PCR dilakukan untuk menilai kadar BMP-2 dan chordin, serta pemeriksaan histomorfometri untuk mengukur persentase area osifikasi, area fibrosis, dan area void. Analisis statistik dilakukan dengan menggunakan uji ANOVA satu arah dan uji post-hoc untuk menentukan signifikansi hasil.
Hasil: Pada pemeriksaan RT-PCR, ekspresi gen BMP-2 tertinggi ditemukan pada kelompok I (1,0 - 1,5; median 1,2), diikuti oleh kelompok II (0,2 - 1,2; median 0,5), kelompok IV (0,3 - 0,7; median 0,4), kelompok III dan kelompok V. Sementara itu, ekspresi gen chordin tertinggi terdapat pada kelompok III (0 - 50), diikuti oleh kelompok lainnya dengan nilai yang sama. Namun, analisis deskriptif menunjukkan tidak ada korelasi yang signifikan antara tingkat BMP-2 dan chordin pada defek tulang kritis, dengan nilai p masing-masing 0,096 dan 0,690. Analisis statistik menunjukkan hasil yang signifikan untuk BMP-2 (p = 0,017) sementara chordin (p = 0,269) dan analisis histomorfometri untuk area osifikasi, fibrosis, dan inflamasi kronis (jaringan granulasi), dan area kosong tidak menunjukkan signifikansi statistik (p = 0,591, p = 0,581, p = 0,196).
Diskusi: Penggunaan PRF dan eksosom dari SPM-TP secara terpisah menunjukkan hasil yang berbeda, dimana PRF menunjukan hasil yang baik pada osteogenesis dan
eksosom dari SPM-TP menunjukan hasil lebih tinggi dalam pembentukan jaringan fibrosis, dan inflamasi kronis (jaringan granulasi). Pada beberapa penelitian, PRF terbukti meningkatkan kadar BMP-2 dan diferensiasi osteoblas, sehingga mempercepat proses osteogenesis. Namun, penggunaan eksosom dan PRF secara bersamaan belum diteliti pengaruhnya terhadap defek tulang kritis. Dalam penelitian ini, hasil yang berlawanan ditemukan daripada hasil yang diharapkan, dengan kadar BMP-2 yang relatif rendah pada kelompok perlakuan kombinasi dibandingkan dengan kelompok lain, dan adanya peningkatan kadar chordin pada kelompok perlakuan kombinasi. Hal ini menunjukkan bahwa kombinasi PRF dan eksosom dari SPM-TP dapat menghasilkan efek negatif pada osteogenesis.
Kesimpulan: Secara terpisah, PRF telah terbukti memiliki efek positif pada osteogenesis, sedangkan eksosom dari SPM-TP menunjukan hasil lebih tinggi dalam pembentukan jaringan fibrosis, dan inflamasi kronis (jaringan granulasi). Kombinasi keduanya dalam penelitian ini, tidak memberikan efek positif terhadap regenerasi defek tulang kritis.
Introduction: Critical bone defect is a loss of bone structure that exceeds the critical size of the bone's ability to regenerate. Autologous bone grafting as the standard therapy is needed in extensive bone defects. However, it is associated with various morbidities. The use of exosome from umbilical cord mesenchymal stem cell (UC-MSC) and PRF is promising and has the potential to be an alternative to achieve healing of critical bone defects.
Methods: This study was an experimental post-test only control group design using 30 Sprague Dawley rats aged 8-12 weeks, weighing about 250-300 grams. They were then divided into 5 treatment groups, namely hydroxyapatite (HA) and bone graft (group I), HA, bone graft, and PRF (group II), HA, bone graft and exosome from UC-MSC (group III), HA, bone graft, PRF, and exosome from UC-MSC (group IV), and HA, PRF, and exosome from UC-MSC (group V). In each rat, a 5mm femoral bone defect was created and internally fixated using a 1.0-1.2 mm K-wire threaded. At the fourth week of follow- up, RT-PCR examination was performed to assess BMP-2 and chordin levels, as well as histomorphometry examination to measure the percentages of ossification area, fibrotic area, and void area. Statistical analysis was conducted using one-way ANOVA and post- hoc tests to determine the significance of the results.
Results: In the RT-PCR examination, the highest BMP-2 gene expression was found in group I (1.0 - 1.5; median 1.2), followed by group II (0.2 - 1.2; median 0.5), group IV (0.3 - 0.7; median 0.4), group III and group V. Meanwhile, chordin gene expression was highest in group III (0 - 50), followed by the other groups with similar values. However, descriptive analysis showed no significant correlation between BMP-2 and chordin levels in critical bone defects, with p values of 0.096 and 0.690 each. Statistical analysis showed significant results for BMP-2 (p = 0.017) while chordin (p = 0.269) and histomorphometry analysis for ossification, fibrotic, and void area showed no statistical significance (p = 0.591, p = 0.581, p = 0.196, respectively).
Discussion: The use of PRF and exosomes from SPM-TP separately showed different results, where PRF showed good results in osteogenesis and exosomes from SPM-TP showed higher results in fibritic tissue formation. However, the use of both exosomes and PRF together has not been studied for their effect on critical bone defects. In this study, the opposite results were found instead of the expected results. This may indicate that the combination of PRF and exosome from UC-MSC could possibly yield a negative effect on osteogenesis.
Conclusion: The combination of PRF and exosome from UC-MSC did not yield positive effect on the outcomes examined in this study."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Rambert, Glady Inri
Gambaran Fibrin Monomer pada Kehamilan = Fibrin Monomer Profile in Pregnancy
"Kehamilan diketahui sebagai salah satu faktor risiko utama terjadinya tromboemboli baik di arteri maupun vena, yang bisa meningkat sebanyak 4 sampai 5 kali. Venografi merupakan baku emas untuk diagnosis DVT namun karena invasif, tidak dilakukan pada wanita hamil. Thrombin Anti Thrombin complex (TAT) dan D-dimer (DD) adalah pemeriksaan yang secara klinis berguna untuk prediksi dan diagnosis trombosis. Namun kadar TAT dan DD akan meningkat dalam situasi yang bervariasi termasuk kehamilan.
Penelitian ini bertujuan untuk mendapatkan gambaran kadar fibrin monomer pada kehamilan trimester 1, 2, dan 3. Terdapat 31 sampel masing-masing pada trimester 1, 2, dan 3. CV kontrol normal dan abnormal pemeriksaan fibrin monomer adalah 7.43% dan 3.51%. Kadar fibrin monomer menunjukkan distribusi tidak normal dengan nilai p = 0.001 (<0.05) sehingga data disajikan dalam nilai median dan nilai rentang. Berdasarkan nilai cutt off 6.0 μg/mL maka peningkatan kadar fibrin monomer dijumpai hanya pada trimester 3 yaitu sebesar 3.2%.
Tidak terdapat perbedaan yang bermakna antara trimester 1 dan 2 (p=0.491), sedangkan antara trimester 1 dan 3 berbeda bermakna (p=0.004), begitu juga antara trimester 2 dan 3 (p=0.031), sehingga dapat dikatakan fibrin monomer kadarnya pada kehamilan relatif tetap.
Background: Pregnancy is known as a risk factor for thromboembolism at arterial and venous, which could rise as much as 4 to 5 times .Venography is the gold standard for the diagnosis of DVT, but because it is invasive, so it is not done on pregnant women. Thrombin anti-thrombin complex (TAT) and D-dimer, which are the clinical examination useful for the prediction and diagnosis of thrombosis. However, the concentration of TAT and D-dimer will be increased in various conditions, including pregnancy.
Aim: This study is to gain preview on the fibrin monomer for the first, second and third trimester of pregnancy.
Methods: A cross sectional study. There was 31 samples, respectively the first, second and third trimester of pregnancy. CV of normal and abnormal control of fibrin monomer was 7.43% and 3.51 %. Levels of fibrin monomer showed the abnormal distribution, with p = 0.001 (> 0.05), so data are presented as median values and value ranges. Based on the cut-off value of 6 μg/mL, then increased levels of fibrin monomer was only found in third trimester , which was 3.2%.
Result: There were no significant differences between the first and the second trimester of pregnancy (p = 0.491). There were significant differences between the first and third trimester of pregnancy (p=0.004) as well as between the second and third of pregnancy (p=0.031). Thus, fibrin monomer level was relatively constant during pregnancy.
Conclusion: fibrin monomer is relatively constant during pregnancy compared to D-dimer."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tugas Akhir  Universitas Indonesia Library
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