The intervertebral disc (IVD) is an important structure in the human body because it functions as... more The intervertebral disc (IVD) is an important structure in the human body because it functions as a weight-bearing. This structure undergoes a process of degeneration like the rest of the body and this process is known as intervertebral disc degeneration (IDD) which is the most common cause of low back pain (LBP). The current common management, either conservative or surgical, is pain-relieving and has not been able to restore degenerated disc optimally. Changes in the IVD microenvironment in IDD conditions make it difficult for the regeneration process to occur. Research to reverse the degeneration process continues to develop, one of them is the use of adipose-derived stem cells (ASCs). ASCs is superior due to the ability to differentiate into several other cells such as adipocytes, chondrocytes, and osteoblasts, it also has ability to act as immunomodulators by stimulating the migration of immune cells to damaged tissues. ASCs becomes a good choice because it is easy to obtain, low donor site morbidity, high proliferation rate, and excellent differentiation abilities. Research on the optimal preparation process for ASCs and their application to various disorders continues to advanced. This study aims to review the potential use of ASCs for regeneration of intervertebral disc degeneration.
Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes seve... more Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes severe functional impairment and disability. Without prompt treatment, prolonged denervation will cause severe muscle atrophy. MyoD, which is expressed by satellite cells, is one of the parameters that relate to the regeneration process in postinjury muscle and it is presumed to determine the clinical outcome following neurotization procedure. This study aims to understand the correlation between time to surgery (TTS) and MyoD expression in satellite cells in the biceps muscle of adult brachial plexus injury patients. Methods Analytic observational study with a cross-sectional design was conducted at Dr. Soetomo General Hospital. All patients with BPI who underwent surgery between May 2013 and December 2015 were included. Muscle biopsy was taken and stained using immunohistochemistry for MyoD expression. Pearson correlation test was used to assess the correlation between MyoD expression with TTS and with age. Results Twenty-two biceps muscle samples were examined. Most patients are males (81.8%) with an average age of 25.5 years. MyoD expression was found to be highest at TTS of 4 months and then dropped significantly (and plateau) from 9 to 36 months. MyoD expression is significantly correlated with TTS (r=-0.895; p = 0.00) but not with age (r=-0.294; p = 0.184). Conclusion Our study found, from the cellular point of view, that treatment of BPI needs to be done as early as possible before the regenerative potential-as indicated by MyoD expression-declined.
Shoulder prostheses designed and used around the world may not fit an Asian shoulder. Normal shou... more Shoulder prostheses designed and used around the world may not fit an Asian shoulder. Normal shoulder morphology in Asian population had been reported, ie, Chinese, Indian, Japanese, and Thai populations, but no data from the Indonesian population. The aim of this study was to evaluate the three-dimensional (3D) morphology of the glenohumeral joint in the normal Indonesian population, identify its normal values, and compare them with those of other populations in the literature. Patients and Methods: Images for analysis were computed tomography (CT) scans of 85 normal shoulders from 71 patients who had CT scans for another diagnosis. Morphometry of the humeral head and glenoid were measured using 3D reconstruction. Gender differences and correlations between age, height, and glenohumeral morphometry were evaluated. Indonesians' glenohumeral morphometry was compared with those of other populations in the literature. Results: In the normal Indonesian population, the mean of humeral head inclination (HHI), height (HHH), diameter in sagittal plane (DS), diameter in frontal plane (DF), radius of curvature in sagittal plane (RS), and radius of curvature in frontal plane (RF) were 134.1°, 15.6mm, 39.3mm, 41.3mm, 20.4mm, and 21.4mm, respectively. The glenoid height (GH), upper width (GUW), lower width (GLW), inclination (GI), and version (GV) mean values were 34.2mm, 18.4mm, 24.5mm, 74.0mm, and 12.3mm, respectively. There was a significant difference in HHH, DS, DF, RS, RF, GH, GUW, GLW between males and females. Except for HHI and GI, glenohumeral morphometry was correlated with patient height. Age was not correlated with any glenohumeral morphometry. Conclusion: In the Indonesian population, males had a larger humeral head and glenoid than females, and the size of the humeral head and glenoid was correlated to body height. Indonesians' humeral head and glenoid sizes were smaller than those of Western populations, but close to those of other Asian populations.
Background. Remnant preservation was developed as a routine procedure for posterior cruciate liga... more Background. Remnant preservation was developed as a routine procedure for posterior cruciate ligament (PCL) reconstruction, but it is not easy. Objectives. Our study aimed to evaluate the outcomes of a minimum 5-years followup of remnant preservation PCL reconstruction. Methods. The study was a prospective cohort analysis of 44 patients who underwent PCL reconstruction with remnant preservation and a minimum 5-years follow-up. Outcome parameters included were modified Cincinnati score, Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, degree of laxity (Posterior Drawer Test), single-leg hop test, and knee x-ray findings. Results. The mean diameter of the hamstring autograft was 8 ± 2.04 mm. The mean of Lysholm knee scores increased from 65.15
Traumatic brachial plexus injury (TBPI) causes severe disabilities to the patients, affecting not... more Traumatic brachial plexus injury (TBPI) causes severe disabilities to the patients, affecting not only upper limb function but also the psychosocial and economic aspects. Free functional muscle transfer (FFMT) is one of the reconstruction modalities for the management of TBPI. The aim of this study is to evaluate the functional outcomes and their correlation to patient factors. Patients and Methods: This is a retrospective study of 131 patients who suffered from complete TBPI (C5-T1) and were treated with the FFMT procedure to restore elbow flexion and wrist extension from 2010 to 2018 in our institution. We evaluated the active range of motion (AROM), muscle power with MRC (Medical Research Council) scale, DASH score, and complications, with a minimum of 12-month follow-up. Results: Following FFMT surgery, elbow flexion was significantly and successfully restored (MRC ≥ 3) in 75.5% of patients with an average AROM of 88.17 ± 41.29°. The wrist extension was restored in 42% of the patients with an average AROM of 20.69 ± 18.72°. There was no correlation between age, side of injury, and time to surgery with the functional outcomes. There was a weak correlation between education level, rehabilitation compliance, and elbow functional outcomes. Conclusion: FFMT is a reliable surgical option to restore elbow flexion in TBPI with a high satisfactory result. Our findings suggested that the FFMT indication is potentially expanded regardless of the patient factors.
Journal of Musculoskeletal & Neuronal Interactions, Dec 1, 2021
Objectives: This research aims to analyze the expression of pro-apoptotic proteins (Bax, p53) and... more Objectives: This research aims to analyze the expression of pro-apoptotic proteins (Bax, p53) and anti-apoptotic protein (Bcl-2) in the nerve roots of the brachial plexus following traumatic brachial plexus injury (TBPI) in the early and late stage. Methods: A total of 30 biopsy samples were taken from the proximal stump of the postganglionic nerve roots of the TBPI patients' brachial plexus from January 2018 until September 2019. The samples were taken from patients within six months of trauma (early stage, group A) and more than six months following trauma (late stage, group B). Bcl-2, Bax, and p53 expressions in each group were measured and compared. Results: We found significant differences in the Bcl-2 (p=0.04), Bax (p<0.0001), p53 (p<0.0001) expressions between group A and B. The Bcl-2/Bax expression ratio in group A and B was 2.26 and 0.22, respectively. Meanwhile, the Bcl-2/p53 expression ratio in group A and B was 1.64 and 0.23, respectively. Conclusion: Apoptosis is inhibited by Bcl-2 activities in the early stage following trauma. In the late stage, a significant decrease of Bcl-2 coupled with a substantial increase of Bax and p53 indicates a continuation of the apoptotic process.
The growth plate is cartilage tissue found at the end of long bones in children, responsible for ... more The growth plate is cartilage tissue found at the end of long bones in children, responsible for longitudinal bone growth. Injuries to the growth plate cartilage often lead to unwanted bony repair, resulting in growth disturbances such as limb length discrepancy and angulation deformity in children. There is currently no clinical treatment that can fully repair an injured growth plate. Tissue engineering is promising for regeneration of growth plate. Adipose-derived stromal vascular fraction highlight the promising potential as tissue engineering therapy for inducing regeneration of injured growth plate and able to reduce the formation of bony repair that can lead to deformity and limb length discrepancy. Using an animal model of growth plate injury, bone bridge formation is evaluated after 28 days using Enzyme-linked Immunoassay, radiology, histopathology and Immunofloresence examination. Radiological analyses performed by evaluation of grey value using ImageJ software and diameter bone bridge measured from the end to end distance between uninjured growth plate evaluated by histopatology examination. Enzyme-linked Immunoassay and immunofloresence are used to evaluate chondrocyte and chondrogenic marker within the defect. The result shows in group with Adipose-derived stromal vascular fraction have a significant lower bone bridge formation compare to positive control group. This current study represents the first work that has utilized this animal model to investigate whether Adipose-derived stromal vascular fraction can be used to initiate regeneration at the injured growth plate.
Background: The hypoxic condition is a physiological norm for various stem cells. The natural mic... more Background: The hypoxic condition is a physiological norm for various stem cells. The natural microenvironment contains lower oxygen pressures. Recent studies reported significant increases in the cultured cells’ proliferation in the presence of a low oxygen pressure. Objective: This study aimed to investigate the optimum oxygen level for rabbit cruciate ligament fibroblast cells culture and Ligament Derived Conditioned Medium/LD-CM (Secretome) preparation in vitro. Materials and methods: Fibroblasts were isolated from the cruciate ligament of the rabbit’s knee. Cultured of rabbit cruciate ligament Fibroblast Cells (fifth passage) were assigned to the slight (5% O2), middle (3% O2), and severe hypoxia (1% O2) groups and the normoxia (21% O2) group. Measurement of growth factors: TGF-β1, PDGF, FGF, and VEGF in LD-CM (Secretome) used an enzyme-linked immunosorbent assay. Results: The highest number of cultured cells were in the 5% O2 group compared to the normoxia, 1 and 3% groups. Th...
In the presented work, the formation of anodic oxide film on Ti-6Al-4V ELI (Extra Low Interstitia... more In the presented work, the formation of anodic oxide film on Ti-6Al-4V ELI (Extra Low Interstitial) alloy in 0.02 M trisodium phosphate (Na3PO4) electrolyte solution using various voltages were investigated. The color produced by the anodizing, the intensity of TiO2 content, the thickness of the oxide layer, and the corrosion rate were examined. It was obtained that the color appearance of Ti-6Al-4V ELI could be changed easily by altering the applied voltages. The higher the voltage applied in the anodizing process, the thicker the titanium oxide layer formed. The corrosion resistance analysis in a Simulated Body Fluid revealed that the non-anodized specimen showed a higher corrosion rate compared to the anodized specimen. The increase of oxide layer thickness leads to a significant decrease in corrosion rate and consequently increases the corrosion resistance. In addition, the anodized sample achieved the highest corrosion resistance at 15 V.
Background: The preconditioning hypoxia for stem cells is a strategy to achieve effective conditi... more Background: The preconditioning hypoxia for stem cells is a strategy to achieve effective conditions for cell therapy, indicate increased expression of regenerative genes in stem cell therapy, and enhance the secretion of bioactive factors and therapeutic potential of their cultured secretome. Objectives: This study aims to explore the response of Schwann-like cells derived from adipose-derived mesenchymal stem cells (SLCs) and Schwann cells rat sciatic nerve-derived stem cells (SCs) with their secretomes under normoxic and hypoxic conditions in vitro. Material and methods: SLCs and SCs were isolated from the adipose tissue and the sciatic nerve of the adult white male rat strain Wistar. Cells were incubated in 21% O2 (normoxic group) and 1%, 3%, and 5% O2 (hypoxic group) conditions. Concentration values of transforming growth factor-β (TGF-β), basic Fibroblast Growth factor (bFGF), brain-derived neurotrophic factor, glial-derived neurotrophic factor, vascular endothelial growth fac...
Intervertebral disk degeneration (IDD) is a chronic condition brought on by various factors and m... more Intervertebral disk degeneration (IDD) is a chronic condition brought on by various factors and mechanisms that have been linked to many deaths and illnesses. The causes of IDD involve multiple processes, including genetics, stress, cellular aging, and changes in nutrition due to the limited blood supply. Animal models play a crucial role in biomedical research and the selection of these models is based on many considerations, including the need for similarities in structure and function with humans. This is important because the etiology and pathogenesis of IDD are complex. Finding the right animal model is not an easy task. In addition to having similarities to humans, these models should also be reliable, reproducible, cost-effective, and easy to maintain. One common method of inducing IDD in animal models is needle puncture. This method is less invasive and time-consuming compared to other methods and allows for precise control over the extent and location of the injury.
(JOINTS) Journal Orthopaedi and Traumatology Surabaya
Background: Demineralized Bone Matrix (DBM) is an alternative biomaterial that needs particular a... more Background: Demineralized Bone Matrix (DBM) is an alternative biomaterial that needs particular acid and a specific time to optimize the growth factors preservation. The best demineralization protocol for preserving growth factors in DBM is currently unavailable. This study aimed to investigate DBM extraction methods using different acids and times to maintain the optimum growth factors.Methods: This in vitro experimental laboratory study used a randomized controlled post-test-only group design. We characterized the IGF-1, BMP2, and TGF-β content of 1 gram of New Zealand White Rabbit cortical bone immersed in 0.6 M hydrochloric and 0.5 M acetic acid at 3, 6, and 9 days. We then analyzed the differences in growth factor levels in each acid and analyzed them statistically.Results: IGF-1 levels were higher in DBM demineralized acetic acid than hydrochloric acid. BMP-2 and TGF-β levels were higher in DBM demineralized using hydrochloric acid. The concentration of growth factors decrease...
Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes seve... more Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes severe functional impairment and disability. Without prompt treatment, prolonged denervation will cause severe muscle atrophy. MyoD, which is expressed by satellite cells, is one of the parameters that relate to the regeneration process in post-injury muscle and it is presumed to determine the clinical outcome following neurotization procedure. This study aims to understand the correlation between time to surgery (TTS) and MyoD expression in satellite cells in the biceps muscle of adult brachial plexus injury patients. Methods Analytic observational study with a cross-sectional design was conducted at Dr. Soetomo General Hospital. All patients with BPI who underwent surgery between May 2013 and December 2015 were included. Muscle biopsy was taken and stained using immunohistochemistry for MyoD expression. Pearson correlation test was used to assess the correlation between MyoD expression wit...
Introduction: Traumatic brachial plexus injury (TBPI) is a debilitating and devastating injury th... more Introduction: Traumatic brachial plexus injury (TBPI) is a debilitating and devastating injury that significantly impacts individuals' quality of life. This study aimed to evaluate the functional outcomes, pain improvement and quality of life after external neurolysis surgery in TBPI patients. Methods: A retrospective study was conducted at Dr Soetomo Hospital in Surabaya, Indonesia. Data of TBPI patients who were operated with external neurolysis surgery from 2003 to 2020 were collected. The functional outcome was measured using disabilities of the arm, shoulder, and hand (DASH) score, the pain assessment with pain visual analog score (VAS) and the quality of life with 36-item short-form (SF-36). The outcomes were also compared between those who had the surgery less or more than 6 months after the injury. Results: A total of 493 TBPI patients were diagnosed between 2003 to 2020. Out of total, 37 patients had external neurolysis surgery, mean age of 31±12.5 years, were included in the analysis. External neurolysis surgery in TBPI patients improved all DASH, VAS and SF-36 scores and these improvements were likely influenced by sex, age, occupation, affected side and the level of the injury. In addition, our data also suggested that the patients who had external neurolysis surgery before 6 months had better outcomes than those after 6 months after the injury in term of DASH, VAS and SF-36 scores. Conclusion: In TBPI cases, earlier external neurolysis surgery could result in better pain reduction, functional outcome and quality of life outcomes.
Background Traumatic brachial plexus injuries (BPIs) in the nerve roots of C5 to T1 lead to the d... more Background Traumatic brachial plexus injuries (BPIs) in the nerve roots of C5 to T1 lead to the devastating loss of motor and sensory function in the upper extremity. Free functional gracilis muscle transfer (FFMT) is used to reconstruct elbow and shoulder function in adults with traumatic complete BPIs. The question is whether the gains in ROM and functionality for the patient outweigh the risks of such a large intervention to justify this surgery in these patients. Questions/purposes (1) After FFMT for adult traumatic complete BPI, what is the functional recovery in terms of elbow flexion, shoulder abduction, and wrist extension (ROM and muscle grade)? (2) Does the choice of distal insertion affect the functional recovery of the elbow, shoulder, and wrist? (3) Does the choice of nerve source affect elbow flexion and shoulder abduction recovery? (4) What factors are associated with less residual disability? (5) What proportion of flaps have necrosis and do not reinnervate? Methods ...
The intervertebral disc (IVD) is an important structure in the human body because it functions as... more The intervertebral disc (IVD) is an important structure in the human body because it functions as a weight-bearing. This structure undergoes a process of degeneration like the rest of the body and this process is known as intervertebral disc degeneration (IDD) which is the most common cause of low back pain (LBP). The current common management, either conservative or surgical, is pain-relieving and has not been able to restore degenerated disc optimally. Changes in the IVD microenvironment in IDD conditions make it difficult for the regeneration process to occur. Research to reverse the degeneration process continues to develop, one of them is the use of adipose-derived stem cells (ASCs). ASCs is superior due to the ability to differentiate into several other cells such as adipocytes, chondrocytes, and osteoblasts, it also has ability to act as immunomodulators by stimulating the migration of immune cells to damaged tissues. ASCs becomes a good choice because it is easy to obtain, low donor site morbidity, high proliferation rate, and excellent differentiation abilities. Research on the optimal preparation process for ASCs and their application to various disorders continues to advanced. This study aims to review the potential use of ASCs for regeneration of intervertebral disc degeneration.
Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes seve... more Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes severe functional impairment and disability. Without prompt treatment, prolonged denervation will cause severe muscle atrophy. MyoD, which is expressed by satellite cells, is one of the parameters that relate to the regeneration process in postinjury muscle and it is presumed to determine the clinical outcome following neurotization procedure. This study aims to understand the correlation between time to surgery (TTS) and MyoD expression in satellite cells in the biceps muscle of adult brachial plexus injury patients. Methods Analytic observational study with a cross-sectional design was conducted at Dr. Soetomo General Hospital. All patients with BPI who underwent surgery between May 2013 and December 2015 were included. Muscle biopsy was taken and stained using immunohistochemistry for MyoD expression. Pearson correlation test was used to assess the correlation between MyoD expression with TTS and with age. Results Twenty-two biceps muscle samples were examined. Most patients are males (81.8%) with an average age of 25.5 years. MyoD expression was found to be highest at TTS of 4 months and then dropped significantly (and plateau) from 9 to 36 months. MyoD expression is significantly correlated with TTS (r=-0.895; p = 0.00) but not with age (r=-0.294; p = 0.184). Conclusion Our study found, from the cellular point of view, that treatment of BPI needs to be done as early as possible before the regenerative potential-as indicated by MyoD expression-declined.
Shoulder prostheses designed and used around the world may not fit an Asian shoulder. Normal shou... more Shoulder prostheses designed and used around the world may not fit an Asian shoulder. Normal shoulder morphology in Asian population had been reported, ie, Chinese, Indian, Japanese, and Thai populations, but no data from the Indonesian population. The aim of this study was to evaluate the three-dimensional (3D) morphology of the glenohumeral joint in the normal Indonesian population, identify its normal values, and compare them with those of other populations in the literature. Patients and Methods: Images for analysis were computed tomography (CT) scans of 85 normal shoulders from 71 patients who had CT scans for another diagnosis. Morphometry of the humeral head and glenoid were measured using 3D reconstruction. Gender differences and correlations between age, height, and glenohumeral morphometry were evaluated. Indonesians' glenohumeral morphometry was compared with those of other populations in the literature. Results: In the normal Indonesian population, the mean of humeral head inclination (HHI), height (HHH), diameter in sagittal plane (DS), diameter in frontal plane (DF), radius of curvature in sagittal plane (RS), and radius of curvature in frontal plane (RF) were 134.1°, 15.6mm, 39.3mm, 41.3mm, 20.4mm, and 21.4mm, respectively. The glenoid height (GH), upper width (GUW), lower width (GLW), inclination (GI), and version (GV) mean values were 34.2mm, 18.4mm, 24.5mm, 74.0mm, and 12.3mm, respectively. There was a significant difference in HHH, DS, DF, RS, RF, GH, GUW, GLW between males and females. Except for HHI and GI, glenohumeral morphometry was correlated with patient height. Age was not correlated with any glenohumeral morphometry. Conclusion: In the Indonesian population, males had a larger humeral head and glenoid than females, and the size of the humeral head and glenoid was correlated to body height. Indonesians' humeral head and glenoid sizes were smaller than those of Western populations, but close to those of other Asian populations.
Background. Remnant preservation was developed as a routine procedure for posterior cruciate liga... more Background. Remnant preservation was developed as a routine procedure for posterior cruciate ligament (PCL) reconstruction, but it is not easy. Objectives. Our study aimed to evaluate the outcomes of a minimum 5-years followup of remnant preservation PCL reconstruction. Methods. The study was a prospective cohort analysis of 44 patients who underwent PCL reconstruction with remnant preservation and a minimum 5-years follow-up. Outcome parameters included were modified Cincinnati score, Lysholm knee score, International Knee Documentation Committee (IKDC) subjective score, degree of laxity (Posterior Drawer Test), single-leg hop test, and knee x-ray findings. Results. The mean diameter of the hamstring autograft was 8 ± 2.04 mm. The mean of Lysholm knee scores increased from 65.15
Traumatic brachial plexus injury (TBPI) causes severe disabilities to the patients, affecting not... more Traumatic brachial plexus injury (TBPI) causes severe disabilities to the patients, affecting not only upper limb function but also the psychosocial and economic aspects. Free functional muscle transfer (FFMT) is one of the reconstruction modalities for the management of TBPI. The aim of this study is to evaluate the functional outcomes and their correlation to patient factors. Patients and Methods: This is a retrospective study of 131 patients who suffered from complete TBPI (C5-T1) and were treated with the FFMT procedure to restore elbow flexion and wrist extension from 2010 to 2018 in our institution. We evaluated the active range of motion (AROM), muscle power with MRC (Medical Research Council) scale, DASH score, and complications, with a minimum of 12-month follow-up. Results: Following FFMT surgery, elbow flexion was significantly and successfully restored (MRC ≥ 3) in 75.5% of patients with an average AROM of 88.17 ± 41.29°. The wrist extension was restored in 42% of the patients with an average AROM of 20.69 ± 18.72°. There was no correlation between age, side of injury, and time to surgery with the functional outcomes. There was a weak correlation between education level, rehabilitation compliance, and elbow functional outcomes. Conclusion: FFMT is a reliable surgical option to restore elbow flexion in TBPI with a high satisfactory result. Our findings suggested that the FFMT indication is potentially expanded regardless of the patient factors.
Journal of Musculoskeletal & Neuronal Interactions, Dec 1, 2021
Objectives: This research aims to analyze the expression of pro-apoptotic proteins (Bax, p53) and... more Objectives: This research aims to analyze the expression of pro-apoptotic proteins (Bax, p53) and anti-apoptotic protein (Bcl-2) in the nerve roots of the brachial plexus following traumatic brachial plexus injury (TBPI) in the early and late stage. Methods: A total of 30 biopsy samples were taken from the proximal stump of the postganglionic nerve roots of the TBPI patients' brachial plexus from January 2018 until September 2019. The samples were taken from patients within six months of trauma (early stage, group A) and more than six months following trauma (late stage, group B). Bcl-2, Bax, and p53 expressions in each group were measured and compared. Results: We found significant differences in the Bcl-2 (p=0.04), Bax (p<0.0001), p53 (p<0.0001) expressions between group A and B. The Bcl-2/Bax expression ratio in group A and B was 2.26 and 0.22, respectively. Meanwhile, the Bcl-2/p53 expression ratio in group A and B was 1.64 and 0.23, respectively. Conclusion: Apoptosis is inhibited by Bcl-2 activities in the early stage following trauma. In the late stage, a significant decrease of Bcl-2 coupled with a substantial increase of Bax and p53 indicates a continuation of the apoptotic process.
The growth plate is cartilage tissue found at the end of long bones in children, responsible for ... more The growth plate is cartilage tissue found at the end of long bones in children, responsible for longitudinal bone growth. Injuries to the growth plate cartilage often lead to unwanted bony repair, resulting in growth disturbances such as limb length discrepancy and angulation deformity in children. There is currently no clinical treatment that can fully repair an injured growth plate. Tissue engineering is promising for regeneration of growth plate. Adipose-derived stromal vascular fraction highlight the promising potential as tissue engineering therapy for inducing regeneration of injured growth plate and able to reduce the formation of bony repair that can lead to deformity and limb length discrepancy. Using an animal model of growth plate injury, bone bridge formation is evaluated after 28 days using Enzyme-linked Immunoassay, radiology, histopathology and Immunofloresence examination. Radiological analyses performed by evaluation of grey value using ImageJ software and diameter bone bridge measured from the end to end distance between uninjured growth plate evaluated by histopatology examination. Enzyme-linked Immunoassay and immunofloresence are used to evaluate chondrocyte and chondrogenic marker within the defect. The result shows in group with Adipose-derived stromal vascular fraction have a significant lower bone bridge formation compare to positive control group. This current study represents the first work that has utilized this animal model to investigate whether Adipose-derived stromal vascular fraction can be used to initiate regeneration at the injured growth plate.
Background: The hypoxic condition is a physiological norm for various stem cells. The natural mic... more Background: The hypoxic condition is a physiological norm for various stem cells. The natural microenvironment contains lower oxygen pressures. Recent studies reported significant increases in the cultured cells’ proliferation in the presence of a low oxygen pressure. Objective: This study aimed to investigate the optimum oxygen level for rabbit cruciate ligament fibroblast cells culture and Ligament Derived Conditioned Medium/LD-CM (Secretome) preparation in vitro. Materials and methods: Fibroblasts were isolated from the cruciate ligament of the rabbit’s knee. Cultured of rabbit cruciate ligament Fibroblast Cells (fifth passage) were assigned to the slight (5% O2), middle (3% O2), and severe hypoxia (1% O2) groups and the normoxia (21% O2) group. Measurement of growth factors: TGF-β1, PDGF, FGF, and VEGF in LD-CM (Secretome) used an enzyme-linked immunosorbent assay. Results: The highest number of cultured cells were in the 5% O2 group compared to the normoxia, 1 and 3% groups. Th...
In the presented work, the formation of anodic oxide film on Ti-6Al-4V ELI (Extra Low Interstitia... more In the presented work, the formation of anodic oxide film on Ti-6Al-4V ELI (Extra Low Interstitial) alloy in 0.02 M trisodium phosphate (Na3PO4) electrolyte solution using various voltages were investigated. The color produced by the anodizing, the intensity of TiO2 content, the thickness of the oxide layer, and the corrosion rate were examined. It was obtained that the color appearance of Ti-6Al-4V ELI could be changed easily by altering the applied voltages. The higher the voltage applied in the anodizing process, the thicker the titanium oxide layer formed. The corrosion resistance analysis in a Simulated Body Fluid revealed that the non-anodized specimen showed a higher corrosion rate compared to the anodized specimen. The increase of oxide layer thickness leads to a significant decrease in corrosion rate and consequently increases the corrosion resistance. In addition, the anodized sample achieved the highest corrosion resistance at 15 V.
Background: The preconditioning hypoxia for stem cells is a strategy to achieve effective conditi... more Background: The preconditioning hypoxia for stem cells is a strategy to achieve effective conditions for cell therapy, indicate increased expression of regenerative genes in stem cell therapy, and enhance the secretion of bioactive factors and therapeutic potential of their cultured secretome. Objectives: This study aims to explore the response of Schwann-like cells derived from adipose-derived mesenchymal stem cells (SLCs) and Schwann cells rat sciatic nerve-derived stem cells (SCs) with their secretomes under normoxic and hypoxic conditions in vitro. Material and methods: SLCs and SCs were isolated from the adipose tissue and the sciatic nerve of the adult white male rat strain Wistar. Cells were incubated in 21% O2 (normoxic group) and 1%, 3%, and 5% O2 (hypoxic group) conditions. Concentration values of transforming growth factor-β (TGF-β), basic Fibroblast Growth factor (bFGF), brain-derived neurotrophic factor, glial-derived neurotrophic factor, vascular endothelial growth fac...
Intervertebral disk degeneration (IDD) is a chronic condition brought on by various factors and m... more Intervertebral disk degeneration (IDD) is a chronic condition brought on by various factors and mechanisms that have been linked to many deaths and illnesses. The causes of IDD involve multiple processes, including genetics, stress, cellular aging, and changes in nutrition due to the limited blood supply. Animal models play a crucial role in biomedical research and the selection of these models is based on many considerations, including the need for similarities in structure and function with humans. This is important because the etiology and pathogenesis of IDD are complex. Finding the right animal model is not an easy task. In addition to having similarities to humans, these models should also be reliable, reproducible, cost-effective, and easy to maintain. One common method of inducing IDD in animal models is needle puncture. This method is less invasive and time-consuming compared to other methods and allows for precise control over the extent and location of the injury.
(JOINTS) Journal Orthopaedi and Traumatology Surabaya
Background: Demineralized Bone Matrix (DBM) is an alternative biomaterial that needs particular a... more Background: Demineralized Bone Matrix (DBM) is an alternative biomaterial that needs particular acid and a specific time to optimize the growth factors preservation. The best demineralization protocol for preserving growth factors in DBM is currently unavailable. This study aimed to investigate DBM extraction methods using different acids and times to maintain the optimum growth factors.Methods: This in vitro experimental laboratory study used a randomized controlled post-test-only group design. We characterized the IGF-1, BMP2, and TGF-β content of 1 gram of New Zealand White Rabbit cortical bone immersed in 0.6 M hydrochloric and 0.5 M acetic acid at 3, 6, and 9 days. We then analyzed the differences in growth factor levels in each acid and analyzed them statistically.Results: IGF-1 levels were higher in DBM demineralized acetic acid than hydrochloric acid. BMP-2 and TGF-β levels were higher in DBM demineralized using hydrochloric acid. The concentration of growth factors decrease...
Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes seve... more Background Brachial Plexus Injury (BPI) is one of the peripheral nerve injuries which causes severe functional impairment and disability. Without prompt treatment, prolonged denervation will cause severe muscle atrophy. MyoD, which is expressed by satellite cells, is one of the parameters that relate to the regeneration process in post-injury muscle and it is presumed to determine the clinical outcome following neurotization procedure. This study aims to understand the correlation between time to surgery (TTS) and MyoD expression in satellite cells in the biceps muscle of adult brachial plexus injury patients. Methods Analytic observational study with a cross-sectional design was conducted at Dr. Soetomo General Hospital. All patients with BPI who underwent surgery between May 2013 and December 2015 were included. Muscle biopsy was taken and stained using immunohistochemistry for MyoD expression. Pearson correlation test was used to assess the correlation between MyoD expression wit...
Introduction: Traumatic brachial plexus injury (TBPI) is a debilitating and devastating injury th... more Introduction: Traumatic brachial plexus injury (TBPI) is a debilitating and devastating injury that significantly impacts individuals' quality of life. This study aimed to evaluate the functional outcomes, pain improvement and quality of life after external neurolysis surgery in TBPI patients. Methods: A retrospective study was conducted at Dr Soetomo Hospital in Surabaya, Indonesia. Data of TBPI patients who were operated with external neurolysis surgery from 2003 to 2020 were collected. The functional outcome was measured using disabilities of the arm, shoulder, and hand (DASH) score, the pain assessment with pain visual analog score (VAS) and the quality of life with 36-item short-form (SF-36). The outcomes were also compared between those who had the surgery less or more than 6 months after the injury. Results: A total of 493 TBPI patients were diagnosed between 2003 to 2020. Out of total, 37 patients had external neurolysis surgery, mean age of 31±12.5 years, were included in the analysis. External neurolysis surgery in TBPI patients improved all DASH, VAS and SF-36 scores and these improvements were likely influenced by sex, age, occupation, affected side and the level of the injury. In addition, our data also suggested that the patients who had external neurolysis surgery before 6 months had better outcomes than those after 6 months after the injury in term of DASH, VAS and SF-36 scores. Conclusion: In TBPI cases, earlier external neurolysis surgery could result in better pain reduction, functional outcome and quality of life outcomes.
Background Traumatic brachial plexus injuries (BPIs) in the nerve roots of C5 to T1 lead to the d... more Background Traumatic brachial plexus injuries (BPIs) in the nerve roots of C5 to T1 lead to the devastating loss of motor and sensory function in the upper extremity. Free functional gracilis muscle transfer (FFMT) is used to reconstruct elbow and shoulder function in adults with traumatic complete BPIs. The question is whether the gains in ROM and functionality for the patient outweigh the risks of such a large intervention to justify this surgery in these patients. Questions/purposes (1) After FFMT for adult traumatic complete BPI, what is the functional recovery in terms of elbow flexion, shoulder abduction, and wrist extension (ROM and muscle grade)? (2) Does the choice of distal insertion affect the functional recovery of the elbow, shoulder, and wrist? (3) Does the choice of nerve source affect elbow flexion and shoulder abduction recovery? (4) What factors are associated with less residual disability? (5) What proportion of flaps have necrosis and do not reinnervate? Methods ...
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