bluuebunny/crossref_metadata_2025 huggingface dataset:
The Novel DA–CH3 Dual Incretin Restores Endoplasmic Reticulum Stress and Autophagy Impairments to Attenuate Alzheimer-Like Pathology and Cognitive Decrements in the APPSWE/PS1ΔE9 Mouse Model
Authors: Panagaki Theodora , Gengler Simon , Hölscher Christian
Published: September 2018

Alzheimer’s disease (AD) afflicts more than 46.8 million people worldwide, with a newly diagnosed case every 3 seconds and no remission in the disease progression. The discovery of disease-modifying drugs is now on the summit of the neuropharmacological research priorities. The long-lasting derivatives of the insulinotropic incretin hormones—glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)—have repeatedly been shown to cross the blood-brain barrier and counteract an array of deleterious effects across a range of experimental models of neuronal degeneration. Clinical trials for the efficacy of GLP-1 agonists in Alzheimer’s and Parkinson’s diseases have revealed beneficial effects of these anti-diabetic agents in halting neuronal degeneration progression. Herein, we examine whether the chronic treatment with the novel dual GLP-1/GIP receptor agonist DA-CH3 can restore the cognitive decline and AD-like cerebral pathology of the APPSWE/PS1 ΔE9 mouse model at the age of 10 months old. We report that once-a-daily, eight-week intraperitoneal administration of 25 nmol/kg of the novel DA-CH3 dual-incretin analog rescues the spatial acquisition and memory impairments of this murine model that corresponds to the attenuation of the excessive plaque deposition, gliosis and synaptic damage in the APPSWE/PS1 ΔE9 brain. The amelioration of the AD-related pathology reflects the resolution of the endoplasmic-reticulum stress and derailed autophagy that both lay downstream of the rectified Akt signaling. Collectively, our findings endorse the beneficial effects of the incretin-based therapeutic approaches for the neurotrophic support of the AD brain and for the first time associate the incretin-induced neuroprotection with the proteostasis machinery in vivo.
Incidence and Prevalence of Antiepileptic Medication Use in Community-Dwelling Persons with and without Alzheimer’s Disease
Authors: Sarycheva Tatyana , Taipale Heidi , Lavikainen Piia , Tiihonen Jari , Tanskanen Antti , Hartikainen Sirpa , Tolppanen Anna-Maija
Published: September 2018

Background:

Although antiepileptic drugs (AEDs) have a potential for adverse drug reactions in older populations, little is known about their use in relation to Alzheimer’s disease (AD) diagnosis.

Objectives:

In this study, we investigated the incidence and prevalence of AED use in relation to AD diagnosis.

Methods:

The MEDALZ–study includes all Finnish persons who received clinically verified AD diagnoses ( n = 70,718) during 2005–2011 and a matched comparison cohort without AD ( n = 70,718). AD diagnoses were identified from the Special Reimbursement Register. We used the Prescription Register to identify dispensed AEDs. Incident AED users were identified with a one-year washout period 9-10 years before AD diagnosis, and incidence rates per 100 person-years were calculated for each six-month period from nine years before to five years after AD diagnosis. Prevalence was assessed as proportion using AEDs during each six-month time period for incident use.

Results:

Persons with AD were more likely to use AEDs during the study period (4.3%) than persons without AD (3.2%). The incidence and prevalence of AED use was higher among persons with AD and increased around the time of AD diagnosis. Epilepsy diagnoses did not explain these differences. Persons with AD were more likely to use older AEDs.

Conclusion:

Our study highlights the need to balance effective symptom control with the possible risks of treatment.
Effect of light and carbon dioxide on photosynthesis, chlorophyll fluorescence, and fruit yield in strawberry (Fragaria × ananassa Duch.) plants
Authors: Choi Hyo Gil , Kang Nam Jun
Published: September 2018

BACKGROUND:

The use of two-floor bench bed systems to improve the strawberry productivity in Korea is increasing.

OBJECTIVE:

This study aimed to investigate the effect of different combinations of light intensity and carbon dioxide (CO2) concentration on photosynthesis, chlorophyll fluorescence, and fruit yield in strawberry ( Fragaria × ananassa).

METHODS:

A two-floor bench bed system was used for light intensity treatments. CO2 fertilizer was supplied, from December 5 to January 30, when the concentration in a greenhouse fell below 700μmolmol–1, while the control received only ambient CO2.

RESULTS:

Strawberry plants that were grown under high light intensity in the upper bed had a higher photosynthesis rate than plants grown under low light intensity in the bottom bed; however, light intensity had a negligible effect on the stomatal conductance (Sc) and transpiration rate (Tr) of strawberry leaves. In contrast, CO2 fertilization lowered Sc and Tr values in strawberry leaves. Plants grown under low light intensity without CO2 fertilization had the highest chlorophyll fluorescence decrease ratio. Fruit yield was highest in plants grown under high light intensity, with CO2 fertilization having relatively little effect; however, CO2 fertilization stimulated the accumulation of anthocyanins.

CONCLUSIONS:

CO2 fertilization is effective in a two-floor bench bed system.
Privacy implications of room climate data
Authors: Armknecht Frederik , Benenson Zinaida , Morgner Philipp , Müller Christian , Riess Christian
Published: September 2018

Smart heating applications promise to increase energy efficiency and comfort by collecting and processing room climate data. While it has been suspected that the sensed data may leak crucial personal information about the occupants, this belief has up until now not been supported by evidence.

In this work, we investigate privacy risks arising from the collection of room climate measurements. We assume that an attacker has access to the most basic measurements only: temperature and relative humidity. We train machine learning classifiers to predict the presence and number of room occupants and to discriminate between different types of activities. On data that was collected at three different locations, we show that occupancy can be detected from data measured by a single sensor with up to [Formula: see text] accuracy. One can even distinguish between the cases that no, one, or two persons are present with up to [Formula: see text] accuracy. Moreover, the four actions reading, working on a PC, standing, and walking, can be discriminated with up to [Formula: see text] accuracy, which is likewise clearly better than guessing ([Formula: see text]). Constraining the set of actions allows to achieve even higher prediction rates. For example, we discriminate standing and walking occupants with [Formula: see text] accuracy. In addition, we show that the accuracy can be increased in most cases if an attacker has access to measurements from two different sensors located in the same room.

Our results provide evidence that even the leakage of such ‘inconspicuous’ data as temperature and relative humidity can seriously violate privacy.
Recovery from apraxic deficits and its neural correlate
Authors: Kusch M. , Schmidt C.C. , Göden L. , Tscherpel C. , Stahl J. , Saliger J. , Karbe H. , Fink G.R. , Weiss P.H.
Published: September 2018

Background and Objective:

Apraxia is a deficit of motor cognition leading to difficulties in actual tool use, imitation of gestures, and pantomiming object use. To date, little data exist regarding the recovery from apraxic deficits after stroke, and no statistical lesion mapping study investigated the neural correlate of recovery from apraxia. Accordingly, we here examined recovery from apraxic deficits, differential associations of apraxia task (imitation vs. pantomime) and effector (bucco-facial vs. limb apraxia) with recovery, and the underlying neural correlates.

Methods:

We assessed apraxia in 39 patients with left hemisphere (LH) stroke both at admission and approximately 11 days later. Furthermore, we collected clinical imaging data to identify brain regions associated with recovery from apraxic deficits using voxel-based lesion-symptom mapping (VLSM).

Results:

Between the two assessments, a significant recovery from apraxic deficits was observed with a tendency of enhanced recovery of limb compared to bucco-facial apraxia. VLSM analyses revealed that within the lesion pattern initially associated with apraxia, lesions of the left insula were associated with remission of apraxic deficits, whereas lesions to the (inferior) parietal lobe (IPL; supramarginal and angular gyrus) and the superior longitudinal fasciculus (SLF) were associated with persistent apraxic deficits.

Conclusions:

Data suggest that lesions affecting the core regions (and white matter) of the fronto-parietal praxis network cause more persistent apraxic deficits than lesions affecting other regions (here: the left insula) that also contribute to motor cognition and apraxic deficits.
Alterations in mitochondrial membrane potential in peripheral blood mononuclear cells in Parkinson’s Disease: Potential for a novel biomarker
Authors: Qadri Rizwana , Namdeo Manju , Behari Madhuri , Goyal Vinay , Sharma Subhadra , Mukhopadhyay Asok Kumar
Published: September 2018

Background:

Progressive apoptosis in the dopaminergic neurons of substantia nigra lead to Parkinson’s disease. Since neurons require substantially higher supply of energy, their mitochondria have a pivotal status in neuronal survival. These organelles have a key role to play in apoptosis and any impairment thereof may lead to apoptosis mediated cell death.

Objectives:

To evaluate and compare the mitochondrial membrane potential (Δψ) in Parkinson’s disease patients and healthy controls.

Methods:

We evaluated the mitochondrial membrane potential (Δψ) in the peripheral blood mononuclear cells by Flow cytometry using a lipophillic cationic dye JC-1 in Parkinson’s disease patients (N = 61) and healthy controls (N = 37).

Results:

JC-1 fluorescence was measured and represented as percentage positivity i.e., Mean±SEM in FL-2 (representing non-apoptotic aggregates) and FL-1 (indicating apoptotic cell population having depolarized or damaged mitochondria) channels. The ratio of % FL-2 and % FL-1, which is an indicator of cellular mitochondrial membrane potential, was found to be significantly higher in healthy controls (Mean±SEM = 60.48±18.42) as compared to patients (Mean±SEM = 24.30±4.671) in both stimulated and unstimulated conditions.

Conclusions:

Mitochondrial membrane potential is altered and hence its evaluation in peripheral blood mononuclear cells may serve as an early marker of apoptosis in PD and, therefore, may pave way for early interventions. Since Δψ has a role in the maintenance of electrochemical gradient, the disruption of which may lead to neuronal apoptosis, Δψ is intricately nested within etiopathogenesis of PD and may prove to be useful in design of diagnostics, prognostics and therapeutics for PD.
The occlusion effect in bone conducted cVEMP
Authors: Handzel Ophir , Himmelfarb Mordechai
Published: September 2018

BACKGROUND: Vestibular evoked myogenic potentials (VEMP) are transient alteration in tonic activity of muscles elicited by auditory stimulation of the otolithic organs of the ear. VEMP can be triggered by auditory stimulation via air or bone conduction. Occlusion of the external auditory meatus has long been known to decrease thresholds for sound perception medicated by the cochlea. OBJECTIVE: Proof that the occlusion effect is present for bone conducted (BC) cervical VEMPs (cVEMP). METHODS: Measurement of the thresholds and raw amplitudes of BC-VEMPs in twenty healthy adults with the external auditory canal open and occluded. RESULTS: Thresholds for BC-VEMPs were similar for the open vs. the occluded condition. However, amplitudes were statistically significantly higher in the occluded (average 76.34μV) vs. open group (average 69.9μV). CONCLUSIONS: The occlusion effect is present in cVEMPs. This finding, described herein for the first time, has a number of clinical implications such as the surgically altered ear and the use of occluding hearing aids.
Improvement of the detection limit by radon background reduction method
Authors: Tran Thanh Thien , Chau Tao Van , Ferreux Laurent , Lépy Marie Christine
Published: September 2018

This paper describes a simple method to reduce the radon background component applied in environmental studies using gamma spectrometry. The radon component can be reduced by introducing either nitrogen gas or clean air into the detector chamber in order to create a positive pressure and further minimize radon intrusion from outside. This method shows that we can minimize the influence of radon daughter background such as 214Pb, 214Bi and 210Pb (from 238U), 212Pb, 212Bi and 208Tl (from 232Th). By the way, the detection limit of the gamma spectrometry is discussed.
Pneumotoraks dan pneumomediastinum sebagai komplikasi trakeostomi darurat
Authors: Cahyono Arie
Published: September 2018

Background: Tracheostomy is a surgical procedure making an opening into the trachea to provide anairway passage. It can cause complications such as subcutaneous emphysema, pneumothorax andpneumomediastinum. Purpose: To remind ENT specialists and general practitioners about the risk ofpneumothorax and pneumomediastinum in tracheostomy procedure and its management. Case: Wereported one case of 62 years old man who had grade 3 airway obstruction and had to be tracheostomizedand got   subcutaneous emphysema, pneumothorax and pneumomediastinum as complications. Case management:   Water sealed drainage (WSD) was inserted and he also underwent chest physiotherapy.Conclusion: Tracheostomy which was done in emergency can increase the risk of pneumothorax andpneumomedistinum complications, and could be avoided if the patient had come sooner. The insertion ofWSD combined with chest physiotherapy were the treatment of choice for patient with massive pneumothraxand pneumomediastinum after tracheostomy.Key words : tracheostomy, emphysema, pneumothorax, pneumomediastinum. Abstrak : Latar belakang: Trakeostomi adalah tindakan bedah membuat lubang di trakea untuk membebaskan jalan napas. Tindakan ini dapat menyebabkan komplikasi berupa emfisema subkutis, pneumotoraks danpneumomediastinum. Risiko komplikasi meningkat pada trakeostomi darurat. Tujuan: Kasus ini diajukanuntuk membahas pneumotoraks dan pneumomediastinum sebagai komplikasi trakeostomi sehingga dokterumum dan dokter spesialis THT dapat meningkatkan kewaspadaannya. Kasus: Dilaporkan satu kasuslaki-laki 62 tahun yang menderita sumbatan jalan napas grade 3 sehingga perlu tindakan trakeostomidarurat Pasca tindakan terjadi emfisema subkutis disertai pneumotoraks luas dan pneumomediastinum.Penatalaksanaan: Dilakukan pemasangan water sealed drainage (WSD) dan dikombinasikan denganfisioterapi dada. Kesimpulan: Trakeostomi yang dilakukan darurat dapat meningkatkan risiko tejadinyapneumotoraks dan pneumomediastinum, yang dapat dihindari jika pasien lebih cepat didiagnosis.Pemasangan WSDdengan fisioterapi dada merupakan terapi pilihan pada pasien pneumotoraks luas danpneumomediastinum pasca trakeostomi. Kata kunci: trakeostomi, emfisema, pneumotoraks,pneumomediastinum.
Kajian terhadap hasil terapi karsinoma nasofaring berdasarkan EBNA1 dan EBNA2
Authors: Hariwiyanto Bambang , Sastrowiyoto Soenarto , Mubarika Sofia , Masesadji Salugu
Published: September 2018

Background: Nasopharyngeal carcinoma (NPC) is one of the most common among head and neck malignancies, especially in some Asian countries. Epstein-Barr Virus (EBV) is one of the agent causing NPC, expressing many proteins such as Epstein-Barr nucleus antigen (EBNA). Expression of EBNA theoretically influencing therapy KNF outcome. Purpose: To differentiate therapy result between NPC expressed positive EBNA1 and EBNA2 compared with NPC expressed negative EBNA1 and EBNA2. Method: Nested case control study toward 28 complete remission NPC patients and 28 partial remission NPC patients post treatment. Result: There was no significant difference in therapy outcome between NPC with EBNA1 expression =4.90 compared to EBNA1 <4.90 (p: 0.160; OR: 0.222) and there was a significant difference therapy outcome between NPC with expression of EBNA2 =1.30 compared to EBNA2 <1.30 (p: 0.029; OR: 0.289). Conclusion: EBNA2 expression is one of protective agents in NPC post treatment outcome. Keywords: NPC, EBNA1, EBNA2, protective factor   Abstrak :  Latar belakang: Karsinoma nasofaring (KNF) merupakan salah satu keganasan yang di beberapa negara benua Asia merupakan keganasan paling banyak didapatkan di antara keganasan di kepala leher. Keterlibatan infeksi virus Epstein-Barr (EBV) merupakan salah satu faktor penyebab terjadinya KNF. Infeksi EBV mengekspresikan beberapa protein antara lain Epstein-Barr nucleus antigen (EBNA) yang secara teori mempengaruhi onkogenesis termasuk hasil terapi KNF. Tujuan:Menentukan adanya perbedaan hasil terapi antara KNF yang mengekspresikan EBNA1 serta EBNA2 dengan KNF yang tidak mengekspresikan EBNA1 serta EBNA2. Metode: Nested case-controlterhadap 28 penderita KNF yang mengalami remisi sempurna dan yang mengalami remisi parsial pascaterapi KNF. Hasil: Tidak terdapat perbedaan yang bermakna antara hasil terapi KNF yang mengekspresikan EBNA1 =490 dengan KNF yang mengekspresikan <4,90 (p: 0,160; OR: 0,222), dan terjadi perbedaan bermakna antara hasil terapi KNF yang mengekspresikan EBNA2 =1,30 dengan KNF yang mengekspresikan EBNA2 <1,30 (p: 0,029; OR: 0,289). Kesimpulan: Ekspresi EBNA2 merupakan salah satu faktor protektif terhadap keberhasilan terapi KNF. Kata kunci: KNF, EBNA1, EBNA2, faktor protektif
Gambaran ekspresi reseptor estrogen β pada angiofibroma nasofaring belia dengan menggunakan pemeriksaan imunohistokimia
Authors: Anggreani Lenny , Adham Marlinda , Musa Zanil , Lisnawati Lisnawati , Bardosono Saptawati
Published: September 2018

Background: Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign hormonal related fibrovascular tumor which originates from superoposterior area of sphenopalatine foramen. Purpose: To determineER-ß expression of JNA patient at Cipto Mangunkusumo Hospital. Method: Descriptive study to determine ß-estrogen receptor (ER-ß) on 27 JNA patients who had been treated at Oncology Division ENT Departement Cipto Mangunkusumo Hospital between 2001-2008 was conducted. Results: ER-ß expression of JNA in this study is 100%. Based on ER-ß staining intensity, 18.5% gave strong intensity, 29.6% with moderate intensity, and 51.9% with weak intensity. According to positive ER-ß cellular, it consist of three groups: less than 25% positive, 25-50% positive, and more than 50% positive, and the result is 3.7%, 3.7%, and 92.6% respectively. Conclusion: Immunohistochemical examination revealed 100% ER-ß expression. Keywords: Juvenile nasopharyngeal angiofibroma (JNA), ER-ß expression   Abstrak :  Latar belakang: Angiofibroma nasofaring belia (ANB) adalah suatu tumor fibrovaskular jinak, berasal dari area superoposterior foramen sfenopalatina dan diduga berhubungan erat dengan faktor hormonal. Tujuan: Melihat gambaran ekspresi ER-ß pada penderita ANB di RS. Cipto Mangunkusumo. Metode: Penelitian deskriptif untuk melihat gambaran ekspresi reseptor estrogenß (ER-ß) pada 27 kasus angiofibroma nasofaring belia (ANB) yang berobat dari tahun 2001 hingga 2008 di Divisi Onkologi Departemen Telinga Hidung Tenggorok RS. Cipto Mangunkusumo. Hasil:Didapati ekspresi ER-ß pada ANB sebesar 100%. Berdasarkan intensitas pewarnaan terhadap ER-ß didapatkan 18,5% mempunyai intensitas pewarnaan yang kuat, 29,6% intensitas pewarnaannya sedang dan 51,9% memiliki intensitas pewarnaan yang lemah. Tiga koma tujuh persen termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß kurang dari 25%, 3,7% termasuk kelompok dengan jumlah sel 25-50%, dan 92,6% termasuk kelompok dengan jumlah sel yang positif mengandung ER-ß>50%. Kesimpulan: Hasil pemeriksaan imunohistokimia menunjukkan ekspresi ER-ß pada semua kasus (100%). Kata kunci: angiofibroma nasofaring belia (ANB), tumor fibrovaskuler, ekspresi ER-ß
Komplikasi intratemporal dan intrakranial pada otitis media akut anak
Authors: Priyono Harim , Restuti Ratna Dwi , Iswara Andre , Handryastuti Setyo
Published: September 2018

Background: Acute otitis media (AOM) is an acute inflammation in the middle ear caused by various factors such as blockage of Eustachian tube, infection and allergy. Purpose: The case report is to forewarn general practitioners and ENT specialists concerning AOM potentially causes intratemporal and intracranial complications. Case: We report an eleven-years-old girl with acute otitis media with intratemporal complications (labirynthitis and sensorineural hearingloss) and intracranial complication (meningitis). Case management: The recent management of acute otitis media with complications includes  empiric antibiotics, analgesic, anti-inflammatory drugs and miringotomy with ventilation tube insertion. Conclusion: The accuracy of diagnosing AOM with complication depends on the clinical symptomps such as vertigo, fever, seizure, meningism and unconsciousness. The pneumatic otoscopy examination is the gold standard in diagnosing AOM. Our patient was given antibiotics for 14 days, anti- inflamation and myringotomy with ventilation tube insertion procedure. Keywords: acute otitis media, intracranial complications, intratemporal complications    Abstrak :  Latar belakang: Otitis media akut (OMA) merupakan peradangan akut yang berlangsung di telinga tengah akibat berbagai faktor predisposisi seperti sumbatan tuba Eustachius, infeksi dan alergi.Tujuan: Kasus ini diajukan untuk mengingatkan dokter umum maupun spesialis THT mengenali gejala komplikasi OMA pada anak yang mempunyai potensi menimbulkan komplikasi intratemporal dan intrakranial. Kasus: Dilaporkan satu kasus OMA dengan komplikasi intratemporal (labirintitis dan tuli saraf) dan intrakranial (meningitis) pada anak perempuan usia 11 tahun.Penatalaksanaan: Penatalaksanaan otitis media akut dengan komplikasi intrakranial dan intratemporal mencakup pemberian antibiotik empiris, analgetik, anti-inflamasi dan tindakan miringotomi dengan pemasangan pipa ventilasi. Kesimpulan: Ketepatan dalam mendiagnosis OMA dengan komplikasi tergantung pada gejala klinis yang bisa dikenali seperti pusing berputar, demam, kejang, kaku kuduk dan penurunan kesadaran. Pemeriksaan otoskopi pneumatik merupakan gold standard dalam membantu diagnosis. Terapi untuk kasus ini terdiri atas antibiotik selama 14 hari, anti-inflamasi dan tindakan berupa miringotomi dengan pemasangan pipa ventilasi.Kata kunci: otitis media akut, komplikasi intrakranial, komplikasi temporal
Hubungan kadar leptin serum dengan derajat rinitis alergi
Authors: Wahyudiono Ahmad Dian , Retnoningsih Endang , Rahaju Pudji
Published: September 2018

Background: Allergic rhinitis is a global health problem that could impair the patient’s quality of life. Recent studies had showed the role of leptin, a hormone that produced by adipose tissue, on sensitization process which can increase the serum level of B cells and IgE. Purpose: To define the relationship between serum leptin level with the degree of allergic rhinitis based on ARIA and VAS.Methods: This study involved 38 subjects with cross sectional design. Statistical analysis included t-test, logistic regression and Kruskal-Wallis. Results: This study showed serum leptin level has correlation with the degree of allergic rhinitis based on ARIA (p<0.05), specifically on the intensity of allergic rhinitis (p<0.05), but not with the degree of allergic rhinitis based on VAS. Conclusion: Serum leptin level has a role on the degree of allergic rhinitis specifically on the intensity but not on the severity of allergic rhinitis symptoms. Controlling the serum leptin level can be considered as health promotion for patient with allergic rhinitis. Further research focusing on controlling serum leptin level for allergic rhinitis symptoms is recommended. Keywords: allergic rhinitis, serum leptin level, degree of allergic rhinitis   Abstrak :  Latar belakang: Rinitis alergi merupakan masalah kesehatan global dan dapat mengganggu kualitas hidup penderitanya. Beberapa penelitian telah menunjukkan peran leptin, hormon yang diproduksi oleh jaringan lemak, pada proses sensitisasi yang ditandai dengan kemampuan leptin meningkatkan sel B dan IgE. Tujuan: Penelitian ini bertujuan mengetahui hubungan kadar leptin serum dengan derajat rinitis alergi. Metode: Penelitian ini melibatkan 38 subjek dengan desain potong lintang untuk mengetahui hubungan kadar leptin serum dengan derajat rinitis alergi pada penderita rinitis alergi. Analisis statistik yang digunakan adalah uji t, uji regresi dan Kruskal-Wallis.Hasil: Penelitian ini menunjukkan bahwa kadar leptin serum berhubungan dengan derajat rinitis alergi berdasarkan ARIA (p<0,05) khususnya dengan intensitas keluhannya (p<0,05), namun tidak berhubungan dengan derajat rinitis berdasarkan VAS. Kesimpulan: Kadar leptin serum berhubungan dengan derajat rinitis alergi terutama pada intensitas keluhan dan bukan pada beratnya keluhan. Pengendalian kadar leptin serum dapat dipertimbangkan sebagai upaya memperbaiki kesehatan penderita rinitis alergi. Penelitian lebih lanjut yang menekankan pada pengendalian kadar serum leptin disarankan untuk mengendalikan keluhan rinitis alergi. Kata kunci: rinitis alergi, kadar leptin serum, derajat rinitis alergi
Hubungan obstructive sleep apnea dengan penyakit sistem kardiovaskuler
Authors: Cahyono Arie , Hermani Bambang , Mangunkusumo Endang , Perdana Riski Satria
Published: September 2018

Background: Obstructive sleep apnea (OSA) is a disease characterized by periodic upper airway collapse during sleep, which could result in either apnea, hypopnea or both. OSA is very often  undetected but it is strongly associated with variety of medical complication, among others cardiovascular diseases.Purpose: To inform ENT specialists about the pathogenesis and pathophysiology of OSA and its complications. Literature review: Recent data from several studies has documented the association between OSA and cardiovascular disorders such as hypertension, heart failure, arrhytmia and atherosclerosis. The undetectable cardiovascular complication that lead by OSA could make the management of cardiovascular  disorders uneffective. Conclusion: A good understanding can help physicians to diagnose, manage and  prevent cardiovascular complication that caused by OSA. Keywords: obstructive sleep apnea, apnea, hipopnea, cardiovascular disease   Abstrak :  Latar belakang: Obstructive sleep apnea (OSA) adalah suatu penyakit yang ditandai dengan peristiwa kolapsnya saluran napas bagian atas secara periodik pada saat tidur yang mengakibatkan apnea, hipopnea atau keduanya. Gejala klinis OSA sering tidak terdeteksi, namun diduga dapat meningkatkan risiko berbagai macam komplikasi medis antara lain kelainan kardiovaskuler. Tujuan: Agar para ahli THT dapat mengerti mengenai patogenesis dan patofisiologi OSA dan komplikasinya. Tinjauan pustaka: Beberapa penelitian telah menyatakan tentang adanya hubungan antara OSA dengan penyakit kardiovaskuler seperti hipertensi, gagal jantung, aritmia dan arteriosklerosis. Patofisiologi OSA pada komplikasi kardiovaskuler yang sulit dideteksi dapat menyebabkan penatalaksanaan penyakit kardiovaskuler menjadi kurang efektif. Kesimpulan:Pemahaman yang baik dapat membantu menegakkan diagnosis dan melakukan tatalaksana yang tepat untuk mencegah komplikasi kardiovaskuler yang berhubungan dengan OSA.Kata kunci: obstructive sleep apnea, apnea, hipopnea, penyakit kardiovaskuler
Kadar imunoglobulin A sekretori pada penderita tonsilitis kronik sebelum dan setelah tonsilektomi
Authors: Sakka Indo , Sedjawidada Raden , Kodrat Linda , Rahardjo Sutji Pratiwi
Published: September 2018

Background: Infection of the tonsils is a fairly common problem in the population. The complaints among others are pain while swallowing, fever, otitis media, until obstructive sleep apnea. Until now tonsillectomy procedure is still a controversy. For those against it, tonsillectomy is considered decreasing the body’s defense mechanism. Purpose: The goal of the research is to analyze the secretory immunoglobulin A level on the chronic tonsillitis patients before and after tonsillectomy.Method: The research was conducted as a comparative analytic study among the chronic tonsillitis patients before  and after tonsillectomy. Result: The result of this study reveals that the level of secretory Ig A in healthy  subjects were 5358.2200 + 1071.23 ng/ml, in chronic tonsillitis patients before tonsillectomy were 7539.6563 + 2293.07 ng/ml, and after tonsillectomy were 5946.4375 + 2133.13 ng/ml. Conclusion:  The level of s-IgA in chronic tonsillitis prior to tonsillectomy was high and 4 weeks post operation the level of s-IgA decreased, close to the level of normal subjects. Keywords: secretory immunoglobulin A, chronic tonsillitis, tonsillectomy Abstrak :  Latar belakang: Infeksi pada tonsil merupakan masalah yang cukup sering dijumpai. Keluhan yang ditimbulkan berupa nyeri menelan, demam, otitis media, sampai obstructive sleep apnea. Sampai saat ini tonsilektomi masih menimbulkan kontroversi. Bagi yang kontra, tonsilektomi dianggap dapat menurunkan sistem pertahanan tubuh. Tujuan: Mengetahui kadar Imunoglobulin A sekretori (s-IgA) pada penderita tonsilitis kronik sebelum dan setelah tonsilektomi. Metode: Analitik komparatif yang dilakukan pada penderita tonsillitis kronik sebelum dan setelah tonsilektomi. Hasil:Kadar s-IgA individu sehat adalah 5358.2200 + 1071.23 ng/ml, s-IgA penderita tonsilitis kronik sebelum tonsilektomi adalah 7539.6563 + 2293.07 ng/ml, sedangkan s-IgA penderita tonsilitis kronik setelah tonsilektomi adalah 5946.4375 + 2133.13 ng/ml. Kesimpulan: s-IgA penderita tonsilitis kronik sebelum tonsilektomi kadarnya tinggi. Empat minggu setelah operasi, kadar s-IgA turun mendekati kadar s-IgA individu normal. Kata kunci: imunoglobulin A sekretori, tonsillitis kronik, tonsilektomi
Hubungan jenis bakteri aerob dengan risiko tuli sensorineural penderita otitis media supuratif kronis
Authors: Wahyudiasih Dyah Prathiwi , Handoko Edi , Retnoningsih Endang
Published: September 2018

Background: Sensorineural hearing loss (SNHL) as sequelae of chronic supurative otitis media(CSOM) is still debatable. Previous researches had shown the role of bacterial toxin upon the roundwindow membrane which could induce SNHL. Purpose: To find the relationship between the kind ofaerobic bacteria with the risk of SNHL in CSOM patients. Method: This study used cross sectional 2005 toDecember 31design and involved 45 CSOM patients with SNHL in Dr. Saiful Anwar hospital from January 1, 2010. The specimen for microbacterial cultures and sensitivity tests were taken from themastoid antrum during mastoidectomy. Statistical analysis employed Spearman correlation test, t-test,and Mann Whitney. Result: The mean values of bone conduction threshold (BCT) in all of CSOM cases,especially in dangerous type CSOM patients, with bacteria culture showed Staphylococcus aureus werehigher than others bacteria (p<0.05). Conclusion: There was significant relationship between the kindof aerobic bacteria with the BCT averages in CSOM patients, especially dangerous type CSOM patients.s Keywords: CSOM, SNHL, aerobic bacteria, toxin, bone conduction threshold Abstrak :  Latar belakang: Tuli sensorineural yang disebabkan oleh otitis media supuratif kronis (OMSK)mekanismenya belum diketahui secara pasti. Beberapa penelitian telah menunjukkan peran toksin bakterimerusak telinga dalam, sehingga menyebabkan tuli sensorineural. Tujuan: Mengetahui hubungan antarajenis bakteri aerob dengan risiko tuli sensorineural penderita OMSK. Metode: Penelitian ini menggunakandesain cross sectional dengan melibatkan 45 penderita OMSK yang disertai tuli sensorineural di RSUDDr. Saiful Anwar Malang, pada periode 1 Januari 2005-31 Desember 2010. Kultur bakteri diambil dariswab antrum mastoid saat operasi mastoidektomi. Analisis statistik yang digunakan adalah uji Spearman,uji t dan Mann Whitney. Hasil: Rerata ambang hantaran tulang cenderung lebih tinggipadapenderitadengan hasil kultur Staphylococcus aureus dibanding jenis bakteri lainnya. Hal ini berlaku pada penderitaOMSK keseluruhan dan OMSK tipe maligna saja (p>0,05). Kesimpulan: Terdapat hubungan bermaknaantara jenis bakteri aerob dengan rerata ambang hantaran tulang penderita OMSK, khususnya OMSKtipe maligna.   Kata kunci: OMSK, tuli sensorineural, bakteri aerob, toksin, ambang hantaran tulang
Miringoplasti tandur lemak autologus: alternatif pilihan miringoplasti di poliklinik
Authors: Priyono Harim , Widiarni Dini , Yanti Afrina
Published: September 2018

Background : The most common material used for the closure of tympanic membrane perforation istemporalis fascia. However, for a dry, small central perforation, the adipose tissue is a good alternative. Moreover, fat myringoplasty can be performed as an office based procedure in adult patients. Purpose:This paper will discuss the use of adipose tissue for the closure of dry, small perforations of the tympanicmembrane. Cases: A series of cases with tympanic membrane central perforation, three adult patientswith small perforations and one patient with large perforation, underwent fat autograft myringoplasty.The adipose tissue was harvested from the patients’ ear lobe. All of the patients were given decongestan,systemic and topical antibiotics as medication. Follow-ups were performed at seven days, two weeks,and one month after the procedure. Pure tone audiometry was conducted before and one month afterthe procedure. The result showed all of the patients had improvement on hearing function and no post surgical infection.  Conclusion: Fat autograft myringoplasty was conducted as an outpatient clinic procedure with high success rates. This procedure can be performed under local analgesia that causingminimal discomfort. Proper patient selection making it a cost-effective procedure for an alternative ofmyringoplasty.  Keywords: myringoplasty, tympanic membrane perforations, fat autograft Abstrak :  Latar belakang: Jaringan yang digunakan untuk menutup perforasi membran timpani biasanyadipilih fasia temporalis. Akan tetapi, untuk perforasi yang berukuran kecil dan tidak terdapat sekret,jaringan lemak dapat digunakan sebagai bahan alternatif. Keuntungan prosedur miringoplasti denganmenggunakan jaringan lemak ini dapat dilakukan di poliklinik pada pasien dewasa. Tujuan: Makalahini akan membahas tentang kegunaan jaringan lemak untuk menutup perforasi membran timpani yangberukuran kecil dan tidak terdapat sekret. Kasus: Serial kasus empat pasien dewasa dengan perforasisentral membran timpani, tiga orang dengan perforasi kecil dan satu orang dengan perforasi luas.Penatalakasanaan: Semua pasien menjalani miringoplasti dalam analgesi lokal menggunakan tandurlemak autologus daun telinga. Keempat pasien mendapatkan terapi medikamentosa dekongestan oral,antibiotika sistemik dan topikal. Evaluasi dilakukan pada tujuh hari, dua minggu, dan satu bulan setelahprosedur dilakukan.Audiometri nada murni dilakukan sebelum dan satu bulan setelah prosedur dilakukan.Hasil audiometri menunjukkan perbaikan fungsi pendengaran pada keempat pasien dan tidak didapatkan infeksi pasca operasi. Kesimpulan: Miringoplasti tandur lemak autologus dapat dilakukan di poliklinikdalam analgesi lokal dengan tingkat kesuksesan yang tinggi dan hanya menimbulkan rasa sedikit tidaknyaman bagi pasien. Pemilihan pasien yang tepat menjadikan prosedur ini sebagai salah satu teknikalternatif miringoplasti.  Kata kunci: miringoplasti, tandur lemak autologus, perforasi membran timpani
Faktor risiko yang mempengaruhi disfungsi tuba Eustachius pada penderita rinitis alergi persisten
Authors: Rahmawati Novina , Suprihati Suprihati , Muyassaroh Muyassaroh
Published: September 2018

Background: Persistent allergic rhinitis (AR) can lead to Eustachian tuba dysfunction. It could beinfluenced by many factors. Purpose: To prove that AR’s degree, duration, presence of chronic tonsillitisand the use of air conditioner are the risk factors of the Eustachean tube dysfunction in patients withpersistent allergic rhinitis. Method: A cross-sectional study was conducted on patients between 11-54years age who came with persistent AR. Tubal dysfunction was detected by tympanometric examination (MEP negative <-25 mmH2O). The data analysis was analyzed using Chi square test and prevalence ratio. Results: There were 68 subjects. The largest age group was 23-34 years old with mean age is 27.8years. Twenty-six patients (32,8%) with persistent AR had tubal dysfunction. Chi square test for persistentAR’s degree, duration of AR and presence of chronic tonsillitis had no significant relationship with tubaldysfunction. The use of AC was significantly correlated with tubal dysfunction (p>0.05). Multivariatelogistic regression analysis found that it became a risk factor for tubal dysfunction p= 0.019, RP=5.446, CI 95%= 1.321- 22.575. Conclusion: The use of AC becomes a risk factor for tubal dysfunctionin patients with persistent allergic rhinitis. Keywords: persistent allergic rhinitis, Eustachean tube dysfunction, tympanometry Abstrak :  Latar belakang: Rinitis alergi (RA) persisten dapat menimbulkan disfungsi tuba Eustachius. Disfungsituba dapat dipengaruhi oleh beberapa faktor. Tujuan: Membuktikan bahwa derajat RA, lama sakit RA,keberadaan tonsiltis kronik dan pemakaian air conditioner (AC) merupakan faktor risiko terjadinyadisfungsi tuba pada penderita rinitis alergi persisten. Metode: Penelitian dengan metode potong-lintangpada RA persisten usia 11-54 tahun. Disfungsi tuba ditentukan dengan pemeriksaan timpanometri (MEPnegatif/<-25 mmH2O). Analisis hasil dengan uji Chi square dan rasio prevalensi. Hasil: Didapatkan68sampel. Usia terbanyak 23-34 tahun, rerata usia 27,8 tahun. Penderita RA persisten dengan disfungsituba 26 (38,2%). Uji Chi square didapatkan derajat RA persisten, lama sakit dan keberadaan tonsilitiskronik tidak mempengaruhi disfungsi tuba (p>0,05). Analisis regresi logistik multivariate didapatkanpemakaian AC secara independen mempunyai risiko terjadinya disfungsi tuba p=0,019, RP=5,446, CI95%= 1,321-22,575. Kesimpulan: Pemakaian AC merupakan faktor risiko terjadinya disfungsi tubapada penderita rinitis alergi persisten. Kata kunci: rinitis alergi persisten, disfungsi tuba, timpanometri
Penatalaksanan deviasi septum dengan septoplasti endoskopik metode open book
Authors: Budiman Bestari Jaka , Pulungan Muhammad Rusli
Published: September 2018

Background: Septal deviation is a nasal anatomical abnormality which is most commonly found. Septal deviation can occur without any symptom but could also lead to nasal disfunction or deformities that need correction. Septoplasty is a modern concept for the surgical correction of septal defects. Progress in endoscopy has provided a great benefit in septoplasty. Endoscopic septoplasty improves the precision of the operation by better visualization and zooming of the target, therefore reducing the complications of septoplasty. Endoscopic septoplasty with open book method is one of the methods used in septal deviation management. Purpose: To present the management of septal deviation by endoscopic septoplasty with open book method. Case: A case of septal deviation with crest right septum in a male 43 years old. Management: Open book method of endoscopic septoplasty. Conclusion: Management of septal deviation with open book method endoscopic septoplasty gives an excellent exposure to a wide  area of the septum. This condition enhance the effectiveness in the correction of septal abnormality and decreases the complication. Key words: endoscopy, septoplasty, septal deviation, , open book method.   Abstrak :  Latar Belakang: Deviasi septum merupakan kelainan anatomi hidung yang paling banyak ditemukan. Deviasi septum dapat muncul tanpa gejala namun dapat juga mengakibatkan kelainan fungsi hidung maupun kelainan bentuk sehingga perlu dilakukan koreksi. Septoplasti merupakan konsep modern bedah untuk melakukan koreksi kelainan septum. Kemajuan di bidang endoskopi telah memberikan pengaruh yang besar terhadap perkembangan teknik septoplasti. Septoplasti endoskopik meningkatkan ketepatan target operasi dengan visualisasi yang baik dan pembesaran target, sehingga dapat mengurangi komplikasi yang terjadi akibat septoplasti. Septoplasti endoskopik dengan metode open book merupakan salah satu metode yang dipakai dalam penatalaksaan deviasi septum. Tujuan: Mempresentasikan penatalaksanaan deviasi septum dengan septoplasti endoskopik dengan metode open book. Kasus: Satu kasus deviasi septum dengan krista pada septum sebelah kanan pada seorang lakilaki umur 43 tahun. Penatalaksanaan: Septoplasti endoskopik dengan metode open book. Kesimpulan: Penatalaksanaan deviasi septum dengan septoplasti endoskopik metode open book  memberikan pemaparan septum yang baik dan area yang lebih luas. Kondisi ini memberikan kemudahan untuk melakukan koreksi terhadap kelainan septum dan mengurangi komplikasi.   Kata kunci: septoplasti, endoskopi, deviasi septum, , metode open book
Gambaran fungsi penghidu dengan Sniffin’ sticks pada pasien rinitis alergi
Authors: Ardianti Nurul Endah , Irawati Nina , Poerbonegoro Niken Lestari , Bardosono Saptawati
Published: September 2018

Background: Allergic rhinitis (AR) is defined as an inflammation of the lining mucosa of the nose induced by allergen exposure. The olfactory disturbance could affect around 21%-23% of AR patients.Purpose: To determine the olfactory performance of AR patients at the Allergy-Immunology outpatientclinic, ENT Department, Cipto Mangunkusumo Hospital. To find out the mean difference of olfactorythreshold, discrimination, and identification (TDI) score between intermittent AR group and persistent ARgroup, and also to determine the percentage of the AR patient who had olfactory disturbance. Method:Observational descriptive study with cross sectional method to assess the TDI in AR patients using theSniffin’ sticks extended test. Results: The olfactory performance characteristics of AR patients were:threshold score 0,25; discrimination score 7,00; identification score 10,10; TDI score 23,50. There wasno statistical difference of the TDI mean score between intermittent AR group and persistent AR group.In our study, 45% of all AR subjects were reported to have olfactory disturbance. Conclusion: The TDIresults which represent olfactory function of AR patients were lower compared to the healthy subjects. Key words: allergic rhinitis, olfactory function, Sniffin’ sticks  Abstrak :  Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi mukosa hidung akibat pajanan terhadap suatu alergen. Sekitar 21% sampai 23% pasien RA dapat mengalami gangguan penghidu. Tujuan: Mengetahui gambaran fungsi penghidu pada pasien rinitis alergi (RA). Menentukan perbedaan rerata nilai ambang, diskriminasi dan identifikasi (ADI) pada pasien RA intermiten dan persisten, dan mengetahui persentase pasien RA dengan gangguan fungsi penghidu di poliklinik Divisi Alergi-Imunologi, Departemen THT RSCM. Metode: Penelitian observasional dengan metode potong lintang untuk menilai ADI penghidu pada percontoh RA menggunakan pemeriksaan Sniffin’ sticks extended test. Hasil: Didapati karakteristik fungsi penghidu percontoh RA ambang 0,25; diskriminasi 7,00; identifikasi 10,10; nilai ADI 23,50. Tidak didapatkan perbedaan bermakna rerata nilai ADI antara kelompok rinitis alergi persisten dan intermiten. Diperoleh 45% dari seluruh percontoh RA mengalami gangguan fungsi penghidu. Kesimpulan: Nilai ADI yang merupakan fungsi penghidu pasien RA lebih rendah dibandingkan dengan subjek sehat.   Kata kunci: rinitis alergi, fungsi penghidu, Sniffin’ sticks
Korelasi ekspresi Cyclooxygenase-2 (COX-2) dan TNF-α sebagai mediator cancer-related inflammation pada karsinoma nasofaring
Authors: Nurdiansah Firman , Pardede Sujahn Anto , Farhat Farhat , Munir Delfitri , Asnir Rizalina Arwinati , Hasibuan Mangain , Eyanoer Putri Chairani
Published: September 2018

Latar belakang: Karsinoma nasofaring (KNF) adalah suatu karsinoma sel skuamosa yang berasal dari sel epitel nasofaring. Cyclooxygenase (COX) merupakan enzim pada jalur biosintetik dari prostaglandin, tromboksan dan prostasiklin dari asam arakhidonat. Ekspresi seluler COX-2 meningkat di atas normal pada stadium awal karsinogenesis dan selama perkembangan serta pertumbuhan invasif tumor. TNF-α diperlukan untuk proliferasi dan fungsi yang normal dari NK cells, sel T, sel B, makrofag dan sel dendrit. Akan tetapi bukti yang terbarumenunjukkan bahwa TNF-α merupakan suatu mediator utama pada cancer-related inflammation dan juga berperan sebagai tumour-promoting factor.Tujuan: Untuk mengetahui ekspresi COX-2 dan TNF-α sebagai mediator cancer-related inflammation pada KNF. Metode: Penelitian ini bersifat deskriptif secara cross sectional design dengan 30 sampel dilakukan di RSUP. H. Adam Malik Medan. Ekspresi COX-2 dan TNF-α pada KNF diperiksa dengan immunohistokimia. Hasil: Dengan menggunakan Fisher’s exact test tidak ditemukan hubungan yang signifikan antara ukuran tumor primer, ukuran kelenjar getah bening serta stadium klinis dengan ekspresi COX-2 (p > 0,05). Ditemukan hubungan yang signifikan antara ukuran tumor primer dan ekspresi TNF-α (p < 0,05). Tidak ditemukan adanya hubungan antara ukuran kelenjar getah bening dan stadium klinis dengan ekspresi TNF-α (p >0,05). Dengan uji Spearman’s rho didapatkan bahwa COX-2 berkorelasi signifikan dengan TNF-α pada KNF (p <0,05). Kesimpulan: Terdapat korelasi signifikan ekspresi COX-2 dan TNF-α pada KNF.Kata kunci: Karsinoma nasofaring, cyclooxygenase-2, TNF-α.
Hubungan tipe deviasi septum nasi klasifikasi Mladina dengan kejadian rinosinusitis dan fungsi tuba Eustachius
Authors: Toluhula Tanty Tanagi , Punagi Abdul Qadar , Perkasa Muhammad Fadjar
Published: September 2018

Latar belakang: Deviasi septum nasi yang mengubah aliran udara dalam rongga hidung dapat mempengaruhi fungsi drainase dan ventilasi sinus paranasal dan tuba Eustachius. Tujuan: Untuk mengetahui apakah terdapat hubungan antara tipe deviasi septum nasi menurut klasifikasi Mladina dengan kejadian rinosinusitis dan fungsi tuba Eustachius. Metode: Penelitian dengan desain cross sectional ini melibatkan 70 penderita deviasi septum nasi. Dilakukan pemeriksaan nasoendoskopik untuk menentukan tipe deviasi septum berdasarkan klasifikasi Mladina,pemeriksaan CT Scan sinus paranasal potongan koronal untuk menentukan adanya rinosinusitis dan timpanometri untuk menentukan fungsi tuba Eustachius. Data dianalisis menggunakan uji chi square likelihood ratio. Hasil:Hasil penelitian menunjukkan bahwa tipe deviasi septum nasi yang paling banyak ditemukan adalah tipe 5 yaitu dengan orientasi horisontal (38,6%). Kejadian rinosinusitis pada penderita deviasi septum nasi sebanyak 54 kasus (77,1%), tipe timpanogram pada penderita deviasi septum nasi yang terbanyak adalah tipe A (82,9%), sedangkan tipe B (1,4%), tipe C (4,3%) dan mayoritas mengalami gangguan fungsi tuba Eustachius (62,9%). Hasil uji statistik menunjukkan nilai p>0,05 yang berarti tidak didapatkan hubungan yang bermakna antara tipe deviasi septum nasi menurut klasifikasi Mladina dengan kejadian rinosinusitis dan fungsi tuba Eustachius. Kesimpulan: Walau tidakterdapat hubungan yang bermakna antara tipe deviasi septum nasi dengan klasifikasi Mladina namun dari segi jumlah lebih banyak ditemukan rinosinusitis dan gangguan fungsi tuba Eustachius pada penderita deviasi septum nasi. Kata kunci: Deviasi septum, klasifikasi Mladina, rinosinusitis, fungsi tuba Eustachius.