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Abstrak :
Pendahuluan: Beberapa penelitian melaporkan bahwa injeksi PGE2 pada mukosa bukal yang dikombinasikan dengan tekanan ortodonti dapat mempercepat pergerakan gigi, namun mempunyai kekurangan berupa resorpsi yang besar pada tulang alveolar dan akar gigi, serta rasa sakit karena penggunaan jarum suntik. Gel dipilih untuk menggantikan bentuk injeksi. PGE2 dalam bentuk gel dibuat untuk mengatasi kekurangan pemberian PGE2 secara injeksi. Tujuan: untuk melihat kedalaman penetrasi pada lapisan mukosa mulut tikus dan membuktikan bahwa gel PGE2 dapat berpenetrasi pada mukosa mulut tikus berdasarkan observasi hitung jumlah sel-sel PMN. Metode: Desain penelitian adalah eksperimental laboratorik in vivo. Uji efek penetrasi menggunakan 36 ekor tikus Sprague Dawley yang terdiri atas 16 tikus kelompok pengolesan gel PGE2, 16 tikus kelompok pengolesan gel tanpa PGE2 yang dibagi menjadi 1 jam, 2jam, 4 jam dan 8 jam pengolesan (setiap kelompok terdiri atas 4 tikus), serta 4 tikus tanpa perlakuan (normal) untuk validitas kelompok kontrol. Gel PGE2 dosis 25 µg/mL dan gel tanpa PGE2 dioleskan pada mukosa mulut rahang bawah selama 2 menit. Tikus di sacrifice setelah 1 jam, 2 jam, 4 jam dan 8 jam pengolesan. Kemudian dibuat sediaan histologi dengan pewarnaan Hematoxylin dan Eosin. Foto preparat diambil menggunakan OptiLab View. Hitung jumlah sel-sel PMN menggunakan mikroskop cahaya dengan pembesaran 100x untuk melihat kedalaman penetrasi pada lapisan mukosa dan pembesaran 400x untuk hitung jumlah PMN. Hasil: Penetrasi gel PGE2 setelah 1jam, 2 jam, 4 dan 8 jam pengolesan telah mencapai lapisan sub mukosa, di tandai dengan peningkatan jumlah sel-sel PMN. Berdasarkan uji oneway ANOVA menunjukkan tidak ada perbedaan jumlah sel PMN yang bermakna pada mukosa rahang bawah tikus antara kelompok gel tanpa PGE2 dan normal. Terlihat peningkatan jumlah sel-sel inflamasi PMN secara bermakna antara kelompok pengolesan gel PGE2 dengan gel tanpa PGE2. (p=0,001). Kesimpulan : Gel PGE2 dapat berpenetrasi ke mukosa mulut tikus. Kedalaman penetrasi gel PGE2 dapat mencapai submukosa. Efek penetrasi gel PGE2 pada mukosa mulut menunjukkan adanya peningkatan sel-sel PMN setelah 1 jam, 2 jam, 4 jam dan 8 jam pengolesan gel PGE2 dibandingkan kontrol. ......Introduction: Several researchs reported that orthodontic force combined with PGE2 injection on buccal mucosa could accelerate tooth movement. But, it has a adverse effect such as over resorption of alveolar bone and root, also a pain due to needle infiltration. Gel was chosen to substitute injection. PGE2 in a form of gel is made to overcome the negative effects of PGE2 injection. Purpose: The aim of this study was to know the depth of the mucosal layer after PGE2 gel application and to prove that PGE2 gel could penetrate into oral mucosa based on the observation of PMN cells in rats. Methods: The design is laboratory experience in vivo. Penetration test was using 36 rats Sprague Dawley that were divided into 16 rats with topical PGE2 gel , 16 rats with topical gel without PGE2 with 1 hour, 2 hours, 4 hours, and 8 hours of application (each group consists of 4 rats) and 4 rats with no interference (normal) to the validity of the control group. Gel with 25 µg/mL of PGE2 and gel without PGE2 were applied on oral mucosa for 2 minutes. Then, the rats were sacrificed after 1 hour, 2 hours, 4 hours, and 8 hours application. After that, the samples were prepared for histological examination with Hematoxyllin and Eosin. The picture were taken with OptiLab View and PMN cells –count with light microscope, set 100 times of magnification for observation the depth of PGE2 gel penetration and 400 times of magnification for count of PMN cells. Results: It was shown the increase of PMN cells at all blasting in submucosa layer after 1 hour, 2 hour, 4 hour, and 8 hour of PGE2 gel application. ANOVA one-way test showed that there was no significant difference of the amount of PMN cells-count of mandible mucosa of rats between non-PGE2 gel and normal. However, there was significant difference of the amount of PMN cells-count between gel with PGE2 and gel without PGE2 ( p=0,001 ). Conclusion : PGE2 gel could penetrate into rats oral mucosa. The depth of PGE2 gel penetration had reach the submucosa layer. The effect of PGE2 gel in oral mucosa showed PMN cells, 1 hour, 2 hour, 4 hour and 8 hour of topical application of PGE2 gel. The amount of PMN cells-count was significantly increased compared to control.

Abstrak :
Pendahuluan: Pergerakan gigi ortodonti akan merangsang terjadinya proses inflamasi sehingga mengeluarkan mediator inflamasi. Prostaglandin E2 (PGE2) adalah salah satu mediator inflamasi yang dikeluarkan selama pergerakan ortodonti dan berperan dalam resorpsi tulang. Proses inflamasi ini terjadi pada semua pergerakan ortodonti termasuk pada penggunaan sistem self-ligating. Walaupun sistem self-ligating diklaim banyak memiliki keuntungan, termasuk efeknya pada ligamen periodontal, akan tetapi belum ada penelitian secara biomolekular yang membandingkan mediator inflamasi dalam ligamen periodontal. Metode: Duabelas pasien dari klinik ortodonti, FKG-UI, dengan kasus nonekstraksi dan indeks iregularitas pada insisif mandibula sebesar 4-9 mm, mendapatkan perawatan ortodonti dengan sistem self-ligating pasif (Damon Q, Ormco) dan sistem konvensional preskripsi MBT (Agile, 3M). Cairan krevikular gingiva diambil dari sisi labial regio insisif mandibula pada 0 jam (sebagai kontrol), 24 jam, dan 4 minggu. Kadar PGE2 diperiksa menggunakan ELISA. Hasil: Walaupun secara statistik tidak terdapat perbedaan kadar PGE2 pada pemakaian braket self-ligating dibandingkan dengan konvensional pada 0 jam, 24 jam (p=0,815), dan 4 minggu (p=0,534), namun secara deskriptif kelompok selfligating memiliki kadar PGE2 lebih tinggi dari konvensional secara konsisten pada 0, 24jam, dan 4 minggu. Pada waktu 24 jam, kadar PGE2 meningkat dibandingkan saat 0 jam, pada kedua sistem, dan kadar PGE2 pada kelompok self-ligating pasif (302,55±26,33 pg/ mL) lebih besar daripada kelompok konvensional (264,43±83,08 pg/mL). Pada waktu 4 minggu, kadar PGE2 menurun dibandingkan dengan waktu pengambilan 0 jam dan 24 jam, pada kedua kelompok sistem, dan kadar PGE2 pada kelompok self-ligating (236,17±42,63 pg/mL) lebih besar dari kelompok konvensional (208,267±81,83 pg/mL). Kesimpulan: Penelitian kami menyimpulkan bahwa sistem self-ligating memberikan respon selular yang berbeda dibandingkan sistem konvensional. ......Introduction: Inflammation process, as a result of orthodontic tooth movement, will trigger the release of inflammatory mediator. Prostaglandin E2 (PGE2) is one of the inflammatory mediator that is released during the orthodontic movement and plays an important role in bone resorption. These inflammatory process occurred in all orthodontic movement included in orthodontic treatment using self-ligating system. Although self-ligating system?s advantages have been claimed, including the effect of the system in periodontal ligament, there are still no research in biomolecular level comparing the mediator release in periodontal ligament. Objective: The purpose of this study was to examine PGE2 concentration in gingival crevicular fluid (GCF) during initial alignment of anterior mandible, using two different system brackets, passive self-ligating and conventional bracket. Methods: Twelve patients with mandibular incisor irregularities of 4 to 9 mm and prescribed nonextraction cases, from orthodontic clinic, faculty of dentistry, Universitas Indonesia, were having orthodontic treatment. They were divided into 2 groups, each group were using Damon passive self-ligating system (Damon Q, Ormco), and conventionally ligated bracket with MBT?s prescription (Agile, 3M). GCF were taken from labial site of mandibular incisors at 0 hour (served as control), 24 hours, and 4 weeks. PGE2 level was determined using ELISA kit. Results: There was no statistically difference in PGE2 level in self-ligating system group compared with conventional group, at 0, 24 hours, and 4 weeks, but from descriptive view self-ligating group had higher PGE2 levels than conventional at 0, 24 hours, and 4 weeks. At 24 hours, mean of PGE2 level was elevated from 0 hour, in both groups, and mean of PGE2 level was higher in self-ligating group (302,55±26,33 pg/ mL) than conventional group (264,43±83,08 pg/mL). At 4 weeks, mean of PGE2 level was decrease from 0, and 24 hours in both groups, and mean of PGE2 level was still higher in self-ligating group (236,17±42,63 pg/mL) than conventional group (208,267±81,83 pg/mL). Conclusion: Our findings suggest that self-ligating giving difference cellular response than conventional systems during orthodontic tooth movement

Abstrak :
Pendahuluan : Beberapa penelitian melaporkan bahwa injeksi prostaglandin pada mukosa bukal dikombinasikan dengan tekanan ortodonti telah terbukti dapat meningkatkan kecepatan pergerakan gigi. Namun sediaan dalam bentuk injeksi mempunyai kekurangan yaitu resorpsi tulang alveolar dan akar gigi yang besar, serta rasa sakit. Penggunaan PGE2 dalam bentuk gel diharapkan dapat mengatasi kekurangan pemberian PGE2 secara injeksi tersebut. Dalam kedokteran gigi belum ada gel PGE2 dan belum diketahui efek penetrasinya pada tulang alveolar. Tujuan : Untuk membuktikan gel PGE2 dapat berpenetrasi ke tulang alveolar tikus berdasarkan hitung jumlah sel osteoklas. Metode : Desain penelitian adalah eksperimental laboratorik in vivo. Penelitian ini menggunakan 24 ekor tikus Sprague Dawley jantan, dibagi menjadi 12 tikus kelompok : perlakuan (rahang bawah sisi kanan) dan kontrol (rahang bawah sisi kiri) serta 12 tikus kelompok normal. Gel PGE2 dioleskan pada mukosa bukal rahang bawah kanan selama 2 menit dan gel tanpa PGE2 (gel CMC) dioleskan pada mukosa bukal rahang bawah kiri selama 2 menit. Pengolesan gel dilakukan berulang dengan interval jam ke 0, 4 dan 8 pada hari ke 0, 1, 2, 3 dan 4. Tikus disacrifice pada hari ke 1, 3 dan 5. Jumlah osteoklas dihitung pada sediaan histologi dengan pewarnaan Hematoxycillin – Eosin (H&E), menggunakan mikroskop cahaya pembesaran 100X. Hasil : Pada uji one way ANOVA, terdapat peningkatan jumlah osteoklas yang bermakna pada hari ke 1, 3 dan 5 pada kelompok perlakuan dibandingkan kelompok kontrol dan normal. Terdapat perbedaan jumlah osteoklas yang bermakna pada hari ke 1, 3 dan 5 pada kelompok perlakuan. Peningkatan jumlah osteoklas tertinggi terdapat pada hari ke 3 pengamatan. Pada hari ke 5, terdapat penurunan jumlah osteoklas yang bermakna namun masih lebih tinggi dibandingkan hari ke 1. Kesimpulan : Gel PGE2 dapat berpenetrasi mencapai tulang alveolar. Efek penetrasi gel PGE2 pada tulang alveolar menunjukkan adanya peningkatan jumlah osteoklas setelah pengolesan berulang pada hari 1, 3 dan 5 pada kelompok perlakuan dibandingkan kontrol. ...... Introduction: Several studies have reported that injection of prostaglandin on the buccal mucosa combined with orthodontic pressure could increase the speed of tooth movement. But PGE2 injection has disadvantages effect, such as pain, high resorption of alveolar bone and tooth root. PGE2 in form of gel is used to overcome the negative effect of PGE2 injection. In dentistry, until recently there is no PGE2 in form of gel and it’s penetration effect on alveolar bone is still unknown. Objective: To proved that PGE2 gel could penetrate into rat alveolar bone based on osteoclast cell-count. Methods: The study design is an experimental laboratory in vivo. This study, using 24 male Sprague Dawley that were divided into 12 rats with topical PGE2 gel on mandibular right buccal mucosa as a experiment group and mandibular left buccal mucosa with topical gel without PGE2 as a control group. Rats with no interference as a normal group. PGE2 gel and gel without PGE2 were applied on mandibular buccal mucosa for 2 minutes, with interval at 0 hour, 4 hour, and 8 hour of application on days 0, 1, 2, 3 and 4. Then, rats were sacrificed on days 1, 3 and 5. After that, the samples were prepared for histological examination with Hematoxyllin and Eosin (H&E). Osteoclasts cell-count using a light microscope, set 100x magnification. Results: ANOVA one way test showed that there was a significant difference of osteoclasts cell-count on days 1, 3 and 5 in the experiment group compared to control and normal. In experiment group, there were significant differences of osteoclasts cell-count on days 1, 3 and 5. The highest of increasing of osteoclast cell-count were on day 3 observations. On day 5, there was a significant decrease of osteoclasts cell-count, but still higher than day 1. Conclusion: PGE2 gel can penetrate into rats alveolar bone. The effects of topical application of PGE2 gel in alveolar bone showed an increased number of osteoclasts cellcount after repeated applications on days 1, 3 and 5 in the treatment group compared to controls.

Abstrak :
Endometriosis merupakan penyakit ginekologi yang ditandai dengan pertumbuhan jaringan mirip endometrium di luar rongga uterus. Inflamasi kronik pada endometriosis memiliki peranan penting dalam memfasilitasi perkembangan kista endometriosis. Penelitian ini bertujuan untuk menganalisis efektivitas oktil galat dalam menurunkan inflamasi pada tikus Wistar model endometriosis. Sejumlah 30 ekor tikus wistar betina dibagi secara acak ke dalam tiga kelompok. Kelompok pertama dan kedua direkayasa membentuk jaringan endometriosis, sedangkan kelompok ketiga dilaparatomi sebagai kelompok kontrol negatif. Setelah dua bulan, dilakukan laparatomi kedua pada kelompok satu dan dua untuk mengevaluasi pembentukan jaringan endometriosis. Induksi oktil galat diberikan pada kelompok pertama selama satu bulan. Seluruh tikus kemudian dieuthanasia dan jaringan endometriosis kelompok pertama dan kedua, serta jaringan endometrium kelompok ketiga, diambil untuk dianalisis. Pengukuran kadar sitokin TNF-α dan IL-10 dilakukan menggunakan Luminex Multiplex Assay, sedangkan kadar COX-2 dan PGE₂ diukur menggunakan metode ELISA. Analisis beda proporsi menunjukkan bahwa pemberian oktil galat pada kelompok pertama tidak memberikan perubahan kadar TNF-α kategori tinggi yang signifikan, sedangkan kadar COX-2, PGE₂, dan IL-10 kategori tinggi teramati mengalami penurunan signifikan sebesar 22,3%, 55,6%, dan 44,5%, dibandingkan dengan kelompok kedua (p<0,05). Oktil galat diketahui efektif dalam menurunkan mediator inflamasi COX-2 dan PGE₂, serta anti-inflamasi IL-10, yang memicu perbaikan gejala klinis berupa regresi ukuran kista endometriosis. ......Endometriosis is a gynecological disease, characterized by the growth of endometrial-like tissue outside the uterine cavity. Chronic inflammation in endometriosis has an important role in facilitating the development of endometriosis cysts. The present study aimed to analyze the anti inflammatory effect of octyl gallate in endometriosis Wistar rat model. 30 female Wistar rats were divided randomly into three groups. Endometriosis induction was performed in the first and second group, while a sham operation was performed in the third group. Two months later, a second laparotomy was performed in the first and second groups to evaluate endometriosis tissue formation. Octyl gallate was administered via oral gavage to the first group for one month. All rats were sacrificed and endometriosis tissue samples were collected for further analysis. TNF-α and IL-10 levels were measured using Luminex Multiplex Assay, while COX-2 and PGE₂ levels were measured using the ELISA method. The administration of octyl gallate in the first group did not significantly effect TNF-α levels, whereas the high category of COX-2, PGE₂, and IL-10 levels were observed to experience a significant decrease up to 22.3%, 55.6%, and 44.5% compared to the second group (p<0.05). In conclusion, octyl gallate was able to supress the inflammatory mediators, COX-2 and PGE₂, along the anti-inflammatory mediators IL-10, which induced the regression of endometriosis cysts size as an improvement of clinical symptoms.

Abstrak :
Latar belakang: Morbiditas akibat duktus arteriosus paten (DAP) pada neonatus cukup bulan (NCB) cukup tinggi. Peran prostaglandin E2 (PGE2), trombosit (immature platelet fraction, IPF), dan vascular endothelial growth factor (VEGF) pada penutupan DA secara fungsional dan anatomis pada NCB belum banyak diteliti. Patofisiologi terjadinya DAP dapat memengaruhi tata laksana farmakologi dini yang belum terstandardisasi pada NCB. Penggunaan obat antiinflamasi nonsteroid seperti ibuprofen dimungkinkan dapat menghambat jalur sintesis prostaglandin dengan efek samping minimal. Tujuan: Mengkaji peran prostaglandin E2, VEGF, IPF, dan efek pemberian ibuprofen oral dalam proses penutupan DA pada NCB. Metode: Penelitian dilakukan di rumah sakit (RS) Sanglah Denpasar, RS Prima Medika Denpasar, dan RS Umum Daerah Wangaya Denpasar, dalam periode Maret sampai Agustus 2015. Penelitian terdiri dari 2 desain, pertama desain potong lintang pada pasien dengan DAP dan tanpa DAP secara consecutive sampling dan desain kedua uji klinis acak terkontrol ganda pada pasien DAP usia ≥ 48 jam. Pasien dengan DAP kemudian dimasukkan dalam uji klinis, dilakukan randomisasi untuk diberikan perlakuan ibuprofen oral dosis hari pertama 10 mg/kg, hari kedua dan ketiga 5 mg/kg atau plasebo. Pemantauan hemodinamik dan efek samping obat dilakukan selama pemberian perlakuan. Pemeriksaan ekokardiografi, PGE2, VEGF, IPF, dan kreatinin dilakukan pada hari pertama dan keempat pascapemberian perlakuan. Hasil: Terdapat 64 subjek yang diteliti pada desain pertama dan 32 subjek pada desain kedua. Rerata kadar PGE2 lebih tinggi pada kelompok dengan DAP dibanding tanpa DAP, sedangkan rerata kadar VEGF dan IPF tidak berbeda. Ibuprofen oral tidak terbukti menurunkan diameter DA pascaperlakuan, tidak terdapat perbedaan rerata diameter pada kedua kelompok. Terdapat hubungan positif sedang terhadap perubahan kadar PGE2 dengan perubahan diameter DAP pascaperlakuan. Tidak terdapat perubahan hemodinamik atau efek samping akibat pemberian ibuprofen oral atau plasebo pada NCB dengan DAP. Simpulan: Tingginya kadar PGE2 terbukti berperan dalam patensi DA pada NCB. Ibuprofen oral dosis 10 - 5 - 5 mg/kgBB tidak mengecilkan diameter DAP.

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Background: Serious morbidity impact due to patent ductus arteriosus (PDA) in full-term neonates remains high. The functional role of prostaglandin E2 (PGE2), platelet (immature platelet fraction, IPF), and vascular endothelial growth factor (VEGF) has not been studied in the closure mechanism of ductus arteriosus (DA). Understanding of pathophysiology of PDA may influence early pharmacological treatments, which have not been standardized in full-term neonates. The use of non-steroidal anti-inflammatory drugs such as ibuprofen can be beneficial as a pharmacological agent in enhancing the closure of PDA with minimal adverse effects. Objectives: To evaluate the role of prostaglandin E2, VEGF, IPF, and the effect of oral ibuprofen in the process of DA closure in full-term neonates. Methods: This study was conducted in Sanglah General Hospital, Prima Medika Hospital, and Wangaya Hospital Denpasar. The study consisted of two designs, the first was cross-sectional design in subjects with and without PDA using consecutive sampling and the second was double blind randomized controlled trial in full-term infant aged ≥ 48 hours. Subjects with PDA were randomized to oral ibuprofen and placebo administration, in which ibuprofen was given consecutively 10 - 5 - 5 mg/kg. All subjects underwent echocardiography, PGE2, VEGF, and IPF assays. Hemodynamics monitoring was evaluated during trial and adverse effect due to ibuprofen was recorded by measuring urine volume and plasma creatinine level. Results: From March to August 2015, there were 64 subjects recruited for the first design and 32 subjects in the second design. The mean level of PGE2 was higher significantly in the group with PDA than non PDA group, while the mean levels of VEGF and IPF showed no difference. In the second design, oral ibuprofen showed no effect in reducing DA diameter after treatment. There were no differences in mean diameter of DA in both groups before and after treatments. There was moderate positive relationship between levels of PGE2 and the change of PDA diameter. There were neither hemodynamic changes nor adverse effect due to the administration of oral ibuprofen or placebo. Conclusions: A high level of PGE2 appears to play a pivotal role in DA patency of full-term neonates. Administration of oral ibuprofen in 10 - 5 - 5 mg/kg schedule could not induce PDA closure in full-term neonates.