Tono Djuwantono
Grup Peneliti Sel Punca, Unit Penelitian Kesehatan, Fakultas Kedokteran Universitas Padjadjaran
Articles
19
Documents
Knowledge and attitude of pregnant woman toward umbilical-cord-blood collection

Indonesian Journal of Obstetrics and Gynecology Vol. 34. No 2. April 2010
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: Stem cell technology from umbilical cord blood (UCB) has developed fast as health services. UCB could be used in many kinds of disease. Private UCB bank has been operated in many places all over Indonesia. There’s a need for research to evaluate the knowledge and attitude of pregnant woman towards the act of collecting UCB.Method: This is a cross-sectional study base on question-naire given to 163 pregnant women in three private hospitals in the Bandung City from September - November 2009. The result was analyzed with Rank-spearman correlation and Kruskal-Wallis chisquare.Result: Most respondent were 20 - 29 years old pregnant women (54.6%), with educational level of strata-1 (S-1) (41.1%), with monthly income within 5 - 10 million rupiah (35.6%). This is the second pregnancy or more (42.9%), with gestational age less than 24 weeks (61.3%) and variative obstetric history (59.5%). The average level of knowledge was poor and attitude scale was uncertain (3.4). There is a significant correlation between age (p = 0.008%; CI 95%), level of education (p = 0.0001; CI 95%) and knowledge. There is a significant correlation between gestational age and attitude (p = 0.003; CI 95%). Respondent’s level of knowledge also has a significant correlation with attitude (τs = 0.421; p = 0.0001; CI 95%).Conclusion: This study described the respondent’s poor knowledge will influence their attitudes toward UCB collection, so it is necessary for disseminating more information on UCB as an effort to get better research result on UCB.[Indones J Obstet Gynecol 2010; 34-2: 97-100]Keywords: knowledge level, attitudes, collecting UCB, pregnant woman, the Bandung city Tujuan: Tujuan: Teknologi sel punca yang berasal dari darah tali pusat (DTP) saat ini berkembang dengan pesat untuk pelayanan kesehatan. DTP ini dapat dipergunakan pada berbagai macam penyakit. Beberapa cabang bank DTP swasta telah beroperasi di Indonesia. Sehingga perlu dilakukan penelitian tingkat pengetahuan dan sikap ibu hamil terhadap pengumpulan DTP. Metode: Dilakukan penelitian survey cross-sectional pada 163 orang ibu hamil di tiga rumah sakit swasta Kotamadya Bandung sejak September - November 2009. Kuisioner berupa kuesioner tertutup.Hasil yang di dapat dianalisis dengan menggunakan uji korelasi Rank-Spearman dan uji chi-kuadrat Kruskal-Wallis. Hasil: Karakteristik terbesar responden berusia 20 - 29 tahun (54,6%), berpendidikan S-1 (41,1%), pendapatan perbulan 5 sampai 10 juta rupiah (35,6%). Kehamilan saat ini adalah kehamilan yang ke-2 atau lebih (42,9%), usia kehamilan kurang dari 24minggu (61,3%) dan riwayat obstetri yang bervariasi (59,5%). Rerata tingkat pengetahuan kurang (50,97%) dan skala sikap raguragu (3,4). Didapatkan hubungan bermakna antara usia (p = 0,008%; CI 95%) dan tingkat pendidikan terhadap tingkat pengetahuan (p = 0,0001; CI 95%). Terdapat hubungan bermakna antara usia gestasi dengan sikap responden (p = 0,003; CI 95%). Tingkat pengetahuan responden juga bermakna secara statistikterhadap sikap responden (τs = 0,42; p = 0,000; CI 95%).Kesimpulan: Penelitian ini menggambarkan tingkat pengetahuan responden yang rendah akan mempengaruhi sikap terhadap pengumpulan DTP, sehingga dibutuhkan penyebaran informasi yang lebih baik lagi mengingat manfaat yang didapat melalui penelitian DTP.[Maj Obstet Ginekol Indones 2010; 34-2: 97-100]Kata kunci: tingkat pengetahuan, sikap, pengumpulan darah tali pusat, ibu hamil, Kotamadya Bandung

Embryo Quality: The Most Critical Factor for Pregnancy Rates after day-2, day-3, and day-5 of Embryo Transfer

Indonesian Journal of Obstetrics and Gynecology Vol. 34. No. 4. October 2010
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: To determine the most critical factor on day-2, day-3, and day-5 of embryo transfer in correlation with pregnancy rates.Method: This research is a retrospective study in Aster Fertility Clinic, IVF program- Dr. Hasan Sadikin Hospital, Bandung, Indonesia. One hundred ninety five women enrolled in an IVF program conducted from March 2006 through November 2009 at the Aster Fertility Clinic. Effect of embryo-transfer day and any other factors (including quality of embryo, oocyte quantity, difficulty of embryo transfer technique, and blood or mucus contamination on the catheter) on pregnancy rate in IVF.Results: The mean age of the pregnant group was 34.65 (SD = 3.91), and the mean of the infertility period was 7.25 years (SD = 3.54). There were no siginificant differences in pregnancy rates in the day-2, day-3, and day-5 groups. The most critical factor influencing pregnancy was the total score for the quality of embryos [p = 0.001; OR (CI 95%) = 1.94 (0.91 - 4.08)]. Otherwise, the day of embryo transfer, oocyte quantity, and difficulties in embryo transfer did not affect the pregnancy rate (p > 0.05).Conclusion: Our study suggests that the total score for the quality of the embryos was the most critical factor for the success rate of pregnancy rather than the day of embryo transfer, oocyte quantity, difficulty of embryo transfer technique, or contamination of blood and mucus on the catheter.[Indones J Obstet Gynecol 2010; 34-4: 175-9]Keywords: day of embryo transfer, in vitro fertilization, quality of embryo total score, oocytes quantity, catheter contaminationTujuan: Untuk menentukan faktor yang terpenting pada keberhasilan kehamilan setelah transfer embrio hari ke-2, ke-3 dan ke-5.Metode: Penelitian ini adalah studi retrospektif di klinik Fertilitas Aster, Program IVF- Rumah Sakit Dr. Hasan Sadikin, Bandung, Indonesia. Penelitian ini melibatkan seratus sembilan puluh lima perempuan yang mengikuti program IVF sejak Maret 2006 hingga Nopember 2009. Efek dari waktu (hari) transfer embrio dan faktorfaktor lainnya (termasuk kualitas embrio, jumlah oosit, kesulitan dalam teknik transfer embrio, dan kontaminasi darah atau mukus dalam kateter) terhadap angka keberhasilan kehamilan pada IVF.Hasil: Rata-rata usia perempuan hamil pada penelitian ini 34,65 (SD = 3,91), dan rata-rata periode infertilitas 7,25 (SD = 3,54). Tidak terdapat perbedaan bermakna pada angka kebehasilan kehamilan setelah transfer embrio baik pada hari ke-2, -3 dan -5. Faktor terpenting yang mempengaruhi keberhasilan kehamilan adalah skor total dari kualitas embrio [p = 0,001; OR (CI 95%) = 1,94 (0,91 - 4,08)]. Dilain fihak, waktu transfer embrio, jumlah oosit, kesulitan dalam teknik transfer embrio tidak mempengaruhi kebehasilan kehamilan (p > 0,05).Kesimpulan: Hasil studi kami menunjukkan bahwa faktor terpenting yang mempengaruhi keberhasilan kehamilan adalah skor total dari kualitas embrio dibandingkan dengan waktu transfer embrio, jumlah oosit, kesulitan dalam teknik transfer embrio, atau kontaminasi darah dan mukus dalam kateter.[Maj Obstet Ginekol Indones 2010; 34-4: 175-9]Kata kunci: hari setelah transfer embrio, fertilisasi in vitro, skor total dari kualitas embrio, jumlah oosit, kontaminasi kateter

Diagnostic test modified color Doppler technique sonohisterosalpingografi mediated NaCl 0.9% in contrast to the evaluation of tubal patency

Indonesian Journal of Obstetrics and Gynecology Vol. 32 No. 3 Juli 2008
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objectives: To evaluate tubal patency with modification of color Doppler sonohysterosalpingography technique using 0.9% NaCl as a contrast medium and laparoscopic chromopertubation as gold standard.Setting: Research was conducted at Aster Fertility Clinic and One Day Surgery Operating Theatre, Hasan Sadikin Hospital Bandung.Material and methods: The subjects was 35 patients female infertility with underwent basic infertility assessment. Fifty mililiters of 0.9 % NaCl were injected into uterine cavity using 50 ml syringe and pediatric foley catheter. Color Doppler ultrasonography was used to observe the flow through the uterine cavity and tubal lumen. The results were compared with those which obtained via laparoscopic chromopertubation. The sensitivity, specificity, positive predictive value, and negative predictive value were analyzed.Results: The modification of color Doppler sonohysterosalpingography technique using 0.9% NaCl as a contrast medium has 87.5% sensitivity, 95.5% specificity, 97.7% positive predictive value, and 77.8% negative predictive value. Conclusion: The modification of color Doppler sonohysterosalpingography technique using 0.9% NaCl as a contrast medium as a reliable method for tubal patency evaluation.Keywords: infertility, tubal patency, color Doppler, sonohysterosalpingography.

Effects of Peritoneal Fluid on Sperm Motility and Viability in Endometriosis

Indonesian Journal of Obstetrics and Gynecology Vol. 35. No 1. January 2011
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

Objective: To know the effects of peritoneal fluid on sperm motility and viability in patients with endometriosis. Design/data identification: This was a laboratory experimental study to peritoneal fluid from endometriosis and non-endometriosis patients who underwent surgery in Dr. Hasan Sadikin Hospital and around with endoscopy facility which fulfill inclusion and exclusion criterias. Experiments was performed in ASTER Fertility Clinic, Dr. Hasan Sadikin Hospital.Method: Semen samples were normozoospermic of which has been prepared using swim up method with sperm count 3 x 106/ml. The sperm were exposed to peritoneal fluid from endometriosis and non-endometriosis patients and analyzed at h 0, 1, 3, 6, and 24 to see the difference of sperm motility and viability postincubation with endometriosis peritoneal fluid. The sperm viability was detected using trypan blue 0.4%.Result: Exposure of sperm to peritoneal fluid reduced sperm motility significantly from the h 6 observation (Zw = 2.17; p = 0.03) and the h 24 (Zw = 2.35; p = 0.01). The sperm viability which incubated with endometriosis peritoneal fluid reduced significantly from h 6 observation (Zw = 1.99; p = 0.04) and the h 24 (Zw = 2.55; p = 0.01).Conclusion: The endometriosis peritoneal fluid reduced the motility and viability of the sperm began from the h 6 postincubation. This indicate the possibility of involvement of endometriosis peritoneal fluid to infertility.Keywords: sperm motility, sperm viability, endometriosis

The Comparison of Expression of Cyclin D and Retinoblastoma Mutant Protein in Hydatidiform Mole and in Normal Placenta

Indonesian Journal of Obstetrics and Gynecology Vol. 35. No 4. October 2011
Publisher : Indonesian Journal of Obstetrics and Gynecology

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Abstract

AbstractObjective: To know the expression of cyclin D1 and mutant retinoblastoma in hydatidiform mole and to know the pathogenesis of hydatidiform mole pregnancy.Method: Research specimens were taken from hydatidiform mole trophoblastic tissue in Dr. Hasan Sadikin Hospital and networking. Specimen preparations were stained with Immunohistochemistry and examined under a light microscope without knowing the status of the patient. Significance of the result was tested through the Mann-Whitney test, Fisher exact, and McNeman square test.Result: Significant differences in the expression of cyclin D1 between the hydatidiform mole study groups and normal placental tissue research groups (p<0.001). There were significant differences in the expression of mutant retinoblastoma between the hydatidiform mole study groups and normal placental tissue research groups (p<0.05). There were significant differences between the domination of cyclin D1 and mutant retinoblastoma in hydatidiform mole tissues.Conclusion: The expression of retinoblastoma was found different from normal histopathologically and it was suspected as mutant retinoblastoma. Expression of cyclin D1 as well as mutant retinoblastoma in hydatidiform mole trophoblast tissue increased, with mutant retinoblastoma being more dominant.[Indones J Obstet Gynecol 2011; 35-4:214-7]Keywords: expression of cyclin D1, retinoblastoma mutant, and hydatidiform mole

Akt–the Mammalian Target of Rapamycin (mTOR) Pathway Inhibition Increases Cervical Cancer Cell Chemosensitivity to Active Form of Irinotecan (SN-38)

International Journal of Integrated Health Sciences VOL 1, NO 1, July (2013)
Publisher : International Journal of Integrated Health Sciences

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Abstract

Objective: To investigate the molecular pathway of the cytotoxic effect of SN-38 in human cervical cancer cell lines.Methods: Two human cervical cancer cell lines were treated with various concentrations of irinotecan for 24–72 hours and the sensitivity was analysed using the MTT assay. Apoptosis was further observed through microscopic examinations. The protein expression was determined using Western blot analysis.  Results: CaSki cells demonstrated the highest sensitivity to SN-38, whereas HeLa cells showed the lowest. In cervical cancer cells, SN-38 induced apoptosis through an intrinsic- and extrinsic-pathways. In addition, we showed that SN-38 downregulated the phosphorylation of Akt-mTOR pathways in CaSki cells, but not in HeLa cells. Interestingly, in HeLa cells, which were more suggestive of a resistant phenotype, pre-treatment with LY294002 and rapamycin inhibited activation of Akt-mTOR signaling and significantly enhanced the sensitivity of HeLa cells to SN-38. Conclusions: Irinotecan exerts its anti-neoplastic effects on cervical cancer cells by inducing apoptosis through caspase-cascade. Inhibition of Akt-mTOR, LY294002 and rapamycin, which is targeted to Akt-mTOR pathways, may sensitize irinotecan-resistant cervical cancer cells.Keywords: Akt-mTOR pathways anti-neoplastic drugs, cervix cancer cells, LY294002, rapamycin DOI: 10.15850/ijihs.v1n1.103

Uji Fungsional dan Karakteristik Sel Punca Hematopoetik Hasil Isolasi dari Darah Tali Pusat Manusia Menggunakan Metode Modifikasi Unpad- Aster

Majalah Kedokteran Bandung Vol 43, No 4 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Metode isolasi sel-sel mononuklear/mononuclear cells (MNCs) dari darah tali pusat (DTP) manusia secara konvensional menghasilkan tingkat kontaminasi sel eritrosit yang sangat tinggi. Oleh karena itu, tujuan penelitian ini adalah menilai perbedaan viabilitas dan kontaminasi sel eritrosit dalam populasi MNC DTP pada modifikasimetode isolasi yang kami kembangkan. Penelitian ini juga bertujuan untuk menguji fungsi dan karakteristik populasi MNCs dari DTP manusia sebagai dasar pembangunan bank darah tali pusat di Indonesia. Penelitian dilakukan di Departemen Obstetri dan Ginekologi RS Dr. Hasan Sadikin Bandung periode Januari–Oktober 2010. Isolasi MNCs dengan metode modifikasi (dinamakan modifikasi Unpad-Aster) yang menghasilkan 5,1x106 sel/mL memiliki tingkat kontaminasi sel eritrosit yang lebih rendah dibandingkan dengan metode konvensional. Morfologi sel yang dibiakkan dalam medium unrestricted somatic stem cells (USSCs) tampak seperti sel-sel yang adheren (menempel di dasar), berbentuk sel spindle, dengan cluster of differentiation-90 (CD-90) (antigen leukosit) dan cluster of differentiation-105 (CD-105) yang positif serta dapat berdiferensiasi menjadi sel neuron dan adiposit; sedangkan morfologi untuk cord blood-derived multipotent progenitor cells (CB-MPCs) tampak seperti sel-sel fibroblas dengan cluster of differentiation-45 (CD-45) (antigen hematopoetik) yang positif serta dapat berdiferensiasi menjadi sel neuron. Disimpulkan bahwa metode modifikasi Unpad-Aster memberikan tingkat kontaminasi eritrosit yang lebih rendah dibandingkan dengan metode konvensional. Sel mononuklear yang berasal dari darah tali pusat ini dapat berdiferensiasi menjadi sel-sel neuron dan adiposit. [MKB. 2011;43(4):171–7].Kata kunci: Darah tali pusat (DTP), diferensiasi, karakterisasi, modifikasi Unpad-Aster, sel mononuklearFunctional Test and Characteristic of Hematopoietic Stem Cells Derived from Human Umbilical Cord Blood Using Unpad-Aster’s Modified MethodThe conventional method of mononuclear cells (MNCs) isolation from human umbilical cord blood (UCB) yielded high erythrocyte contamination level. Therefore, the aim of this study was to assess the differences of cell viability and erythrocyte contamination on the population of UCB MNCs in our modified isolation method. This study was also aimed to test the function and characteristic of human MNCs derived from UCB as the basis for the development of UCB banking in Indonesia. The study was conducted in Department of Obstetry and Ginecology >RS Dr. Hasan Sadikin Bandung in period of January–October 2010. The modified isolation method (namely Unpad Aster’s modification) yielded 5.1x106 MNC cell/mL has lower erythrocyte contamination level than conventional method. The morphology of MNCs cultured in unrestricted somatic stem cells (USSCs) medium looked like adhered cells (attached at the surface of culture flask), spindle-shaped cells with positive luster of ifferentiation-90 (CD-90) (leukocyte antigen) and cluster of differentiation-105 (CD-105) and could differentiate into neuronal cells and adipocytes. While the morphology of cord blood-derived multipotent progenitor cells (CB-MPCs) looked like fibroblast cells with positive cluster of differentiation-45 (CD-45) (antigen hematopoietic) and could differentiate into neuronal cells. In conclusions, the Unpad-Aster’s modified isolation method gives lower level of erythrocyte contamination compared with conventional method. Mononuclear cells derived from UCB could differentiate into neuronal cells and adipocytes. [MKB. 2011;43(4):171–7].Key words: Characteristic, differentiation, mononuclear cells (MNCs), umbilical cord blood, Unpad-Aster modification

Cancer Stem Cell: Target Baru Obat Antikanker

Indonesian Journal of Cancer Vol 4, No 3 (2010): Jul - Sep 2010
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Relaps, resistance and metastasis has become prominent problems that oncologists and cancer patients have to dealt with. Various studies have been done previously concluded that there are a subpopulation of cancer cells, identified as cancer stem cell, most likely to be the cause of relaps, resistance and metastasis of cancer. Cancer stem cell is a subpopulation of cancer cells that possess tumorigenicity, hence it can initiate the growth of tumor. Cancer stem cell has been suspected to be originated from normal stem cells reside in mature tissues, or from progenitor cells that gone through some series of alterations on its characteristics, including mutagenic and non-mutagenic changes. As seen in normal stem cells, cancer stem cell is also oftenly found in its inactive state. Therefore, cancer stem cell is not affected when it treated with many chemotherapeutic agents that are targeting cancer cells that proliferate extensively. Eventually, this event leads to the incidence of cancer relaps on cancer patients who already had series of cancer therapy. Based on this knowledge, it can be concluded that the only absolute way to overcome the incidence of metastasis, resistance and relaps on cancer patients, is to targeting cancer stem cell. Therefore, optimization on protocols of cancer stem cell identification and isolation strived continously. Some molecular markers that are oftenly used as a standard on cancer stem cell isolation are CD34, CD44 and CD133. In line with that, isolation methods that are based on sphere formation and the absorption of coloring dye could also be done to obtain cancer stem cell population. This review article would like to explain the nature of cancer stem cell existence, the pathology underlies its formation, characteristics and identification techniques that are commonly used, and challenges that have to be faced by scientists and physicians in order to optimize the application of cancer stem cell theory for the progress of science and patients’ sake.

Effect of Lycopene on Peritoneal Fluid Malondialdehyde Level in Endometriosis

Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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Abstract

Oxidative stress is a factor that contribute in pathogenesis of endometriosis. This condition could also implicated in infertility. Lycopene is a carotenoid that has antioxidant activity. Supplementation of lycopene can reduce oxidative stress in peritoneal fluid of women with endometriosis. This study aims to compare the effect of lycopene on malondialdehyde (MDA) levels in peritoneal fluid of women with endometriosis. It is an experimental study on peritoneal fluid from five women with endometriosis. The result show that lycopene supplementation affecting the MDA levels in peritoneal fluid. MDA levels in peritoneal fluid with lycopene is lower than without lycopene. It conclude that lycopene is proved lowering MDA levels in peritoneal fluid of women with endometriosis. Keywords: endometriosis lycopene, malondialdehyde

Effect of Lycopene on Peritoneal Fluid Malondialdehyde Level in Endometriosis

Journal of Medicine & Health Vol 1, No 1 (2015)
Publisher : Universitas Kristen Maranatha

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Abstract

Oxidative stress is a factor that contribute in pathogenesis of endometriosis. This condition could also implicated in infertility. Lycopene is a carotenoid that has antioxidant activity. Supplementation of lycopene can reduce oxidative stress in peritoneal fluid of women with endometriosis. This study aims to compare the effect of lycopene on malondialdehyde (MDA) levels in peritoneal fluid of women with endometriosis. It is an experimental study on peritoneal fluid from five women with endometriosis. The result show that lycopene supplementation affecting the MDA levels in peritoneal fluid. MDA levels in peritoneal fluid with lycopene is lower than without lycopene. It conclude that lycopene is proved lowering MDA levels in peritoneal fluid of women with endometriosis. Keywords: endometriosis lycopene, malondialdehyde