Dwikora Novembri Utomo
Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Airlangga, Dr. Soetomo Academic General Hospital, Surabaya, East Java, Indonesia

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Correlation of Serum Alkaline Phosphatase, Lactate Dehydrogenase, C-Reactive Protein, Blood Deposition Rate, ?-Hcg Expression and Tumor Volume to Lung Metastasis Risk in Osteosarcoma Patients Achmad Fachrizal1, Dwikora Novembri Utomo1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3139

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Osteosarcoma is the most common type of sarcoma that found in bone. The survival rate in osteosarcoma patients was less than 20.00% at the end of 1980 but is currently increasing to over 70.00% for nonmetastatic patients. The objective to analyze the correlation between Lactate Dehydrogenase (LDH), Alkaline Phosphatase (ALP), C-Reactive Protein (CRP), Blood Deposition Rate (LED) , hCG expression and tumor volume with pulmonary metastases in osteosarcoma patients. The subjects were osteosarcoma patients that the data taken from January 2015 to December 2016. The subjects will be clinical, radiological (plain, CT scan thorax, MRI) examinations, serum marker tests consisting of ALP, LDH, CRP and LED and histopathologic staining IHC ?-hCG. The study design was cross-sectional, while the statistical analysis used was normality test, Spearman correlation, chi-square test and logistic regression. The results majority of subjects were male (52.00%) and aged 11-20 years (85.00%). The tumor volume (p = 0.07), LDH levels (p = 0.07), and ALP levels (p = 0.016) were statistically significant for pulmonary metastases with moderate correlation (r = 0.587; 0.587; 0.53). The tumor volume was the most sensitive biomarker to diagnose lung metastasis in osteosarcoma patients (p = 0.171). Conclusion among other protein biomarkers, tumor volume was most sensitive in diagnosing pulmonary metastases. The volume of the tumor will increase the risk of pulmonary metastases in osteosarcoma patients.
Biocompatibility Test of Decellularized Cartilage Bovine Scaffold in Vitro and In Vivo Achmad Fachrizal1, Dwikora Novembri Utomo1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3373

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Background: Incidence of cartilage defects was reported at 65.00% of the routine arthroscopy procedures. Dr.Soetomo Teaching Hospital Network Bank developed a cartilage scaffold from bovine that has been deselularized decellularized cartilage bovine scaffold (DCBS). It takes a study of biocompatibility test to prove that DCBS is not cytotoxic to cells and not generate a host response. Objective: To analyze the biocompatibility of decellularized cartilage bovine scaffold (DCBS) in vivo and in vitro. Methods and Materials: The subjects were experimental rats and experimental with in vitro and in vivo trials. The subjects were treated by toxicity test with MTT assay, irritation test using Draize Scale, acute/ pyogenic systemic toxicity test by observing changes in body weight and temperature, and implantation test by observing fibrous capsule formation and Immunoglobulin G. Data was analyzed by using Kolmogorovsmirnov, Independent T-test, Mutivariate Analysis of Variance (MANOVA), and Mann Whitney. Result: The percentage of viable DCBS (81.78%) and CBS (92.45%) was ?70% of the control; thus, it is non-toxic to the cell. Draize scale in each group was in grade 0. Changes in body weight (p = 0.981) and temperature (p >0.05) had no significant association between groups. There was a significant difference mean of the fibrous capsule (p = 0.000) thickness and no significant difference in the mean number of Immunoglobulin G which was formed at week 1 (p = 0.87) and week 4 (p = 0.63) after implantation between CCBS and DCBS. Conclusion: The biocompatibility test shows that DCBS is compatible as a biomaterial.
The Effect of Allogenic Bone Marrow Mesenchymal Stem Cell - Platelet Rich Plasma (Bmscs - Prp) Intra-Articular Injection Effect on the Regeneration of Full-Thickness Joint Cartilage Defect on Rabbit Ahmad Taufik.S1, Dwikora Novembri Utomo2, Hari Basuki Notobroto3
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3376

Abstract

Introduction: Full thickness cartilage defects are still a problem until present since the handling has not give any satisfactory results. Current handling is performed through cartilage enginering using mesenchymal stem cells alone and or in combination with growth factor. The purpose of this study was to investigate the effect of injection of intra-articular injection of Allogenic bone marrow mesenchymal stem cell - Platelet rich plasma (BMSCs-PRP) on regeneration of full thickness cartilage defect in rabbits. Method: The design of this study is a post-test only control group design using 36 New Zealand white rabbits divided into three groups treated with PRP, BMSCs and BMSCs-PRP. Results are evaluated after 10 weeks. Results: In the evaluation, macroscopic images showed the best healing in the BMSCs-PRP group. Histopathologic examination showed that in the MSCs-PRP group there was a significant increase in the amount of chondrocytes (p = 0.000), cartilage area (p = 0.000), as well as the number of Agecoprogenitor expec- tion cells (p = 0.000) and type 2 collagen (p = 0.000). Conclusions: Intra-articular injections Allogenic bone marrow mesenchymal stem cell (BMSCs-PRP) is able to regenerate and cure full-thickness joint cartilage defects through differentiation of MSCs into condroblasts.
CORRELATION BETWEEN THREE COLUMN CONCEPT CLASSIFICATION AND INTERNAL FIXATION PROCEDURE OF TIBIAL PLATEAU PATIENTS AT DR. SOETOMO HOSPITAL Utomo, Dwikora Novembri; Subiantoro, Januar Ari
JOINTS (Journal Orthopaedi and Traumatology Surabaya) Vol 7, No 1 (2018): April 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i1.2018.1-11

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Background: Tibial Plateau Fracture is one of the most common case seen in orthopaedics and the most classification system used is Schaetzker Classification. This classification is using X ray photograph to classify the fracture and it has limitation to describing a posterior column in tibial plateau fracture since X-ray is a 2D projection. Nowadays surgeon over the world start to using Three Column concept classification because it has a better image of 3D visualization of tibial plateau. Purpose: To know which one classification is more accurate in describing tibial plateau fracture in Dr. Soetomo Hospital period January 2015 until September 2017.Methods: This study is retrospective study, we collected data of patients with Tibial Plateau fracture that has been operated in Dr. Soetomo hospital from January 2015 – September 2017.Results: From the study found 24 patients that match with inclusion criteria. All patients are classified with Schaetzker and Three Column Classification. The most type of fracture based on Schaetzker Classification is Type 2 (7 patients) and based on Three Column Classification is type Three Column (11 patients) and the most action in Three Column type is Internal Fixation with double plate insertion (55 %).Conclusion: Three Column Classification is more accurate to describe type fracture in posterior part than Schaetzker. Three Column Classification is recommended to make easier decision for Tibial Plateau fracture treatment and prevent any loss of correction.
Role of Preconditioning Adipose Mesenchymal Stem Cells in Regeneration Disk: a Review Article Romaniyanto; Hari Basuki Notobroto; Cita Rosita Sigit Prakoeswa; Fedik Abdul Rantam; Dwikora Novembri Utomo; Heri Suroto; Ferdiansyah
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14892

Abstract

Intervertebral disk (IVD) degeneration (IDD) is a degenerative disease and often found in daily practice.The managements that were used so far are only symptomatic and have not been able to solve the diseasecompletely. The use of mesenchymal stem cells (MSCs) has been widely tested as a solution for theregeneration of IVD in IDD. Adipose-derived mesenchymal stem cells (ASCs) are one of the sources ofMSCs which were widely studied as an alternative. One of the factors that can influence the efficiency andcapacity of ASCs in IDD cases is preconditioning. Generally, there were three pre-conditioning strategies ofASCs before being used as therapy, (1) modifying the environment, (2) using Growth Factors, Cytokines,Chemokines, Hormones, (3) using pharmacological and chemical agents. Preconditioning on ASCs canchange its function in various ways. We tried to link all these things together so that we could know the roleof pre-conditioning ASCs in the regeneration disk.
Clinical Evaluation Of Post High Tibial Osteotomy Patients In Regional General Hospitals Dr. Soetomo Surabaya, Husada Utama Hospital Surabaya, Al-Irsyad Hospital Surabaya In 2010 - 2015 Suyenci Limbong; Dwikora Novembri Utomo
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 3, No 2 (2019)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (602.626 KB) | DOI: 10.30651/jqm.v3i2.2590

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ABSTRACT Osteoarthritis (OA) of the knee is a disruption in the knee joint which is characterized by pathological changes in the structure in the knee joint that occur progressively. High Tibial Osteotomy (HTO) is a therapeutic option for treating isolated medial compartment OA in varus genu and one of the routine surgical procedures performed in the orthopedic field. As the number of OA cases increases, the number of high tibial osteotomy (HTO) procedures also increases, so clinical evaluation is needed to see whether HTO can meet patient expectations. This study was a retrospective descriptive study with a sample of patients who had undergone the 2010 to 2015 open wedge high tibial osteotomy (OWHTO) procedure. The evaluation used the Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, and Modified Hospital instruments for Special Surgery Knee Scoring. The data obtained are then grouped and analyzed to calculate the average of each instrument. The results showed a sample of 6 knees consisting of 2 male samples (33.3%) and 4 female samples (66.7%). All samples are over 35 years old. The evaluation results using KOOS scores obtained the mean value of the pain component was 77.7; complaint component = 70.3; daily activity component = 76.2; sports and recreation components = 47.9; and components of quality of life = 74.1. On the SSC score, the average knee score was 70.8 and the average functional score was 61.6. Whereas the HSS score obtained by the average functional score is 81.5. This study produced each score with a good average value. This shows that the choice of the High Tibial Osteotomy operating technique provides satisfactory operating results. So that the High Tibial Osteotomy surgery technique can be an option in the case of Osteoarthritis. With the many choices of types of surgery in patients with Osteoarthritis, the High Tibial Osteotomy can be a good choice for patient satisfaction. Keywords: Osteoarthritis, High Tibial Osteotomy, Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, Modified Hospital for Special Surgery Knee ScoringCorrespondence to: liliosanci@gmail.com ABSTRAK Osteoartritis (OA) lutut adalah gangguan pada sendi lutut yang ditandai oleh perubahan patologis pada struktur di dalam sendi lutut yang terjadi secara progresif. High Tibial Osteotomy (HTO) merupakan pilihan terapi untuk penanganan isolated medial compartement OA pada genu varus dan salah satu prosedur operasi yang rutin dilakukan di bidang orthopedi. Dengan meningkatnya jumlah kasus OA meningkat pula jumlah prosedur high tibial osteotomy (HTO), sehingga perlu dilakukan evaluasi klinis untuk melihat apakah HTO dapat memenuhi harapan pasien. Penelitian ini merupakan penelitian deskriptif retrospektif dengan sampel pasien yang telah menjalani prosedur open wedge high tibial osteotomy (OWHTO) 2010 sampai 2015. Evaluasi menggunakan instrument Knee Society Score, Knee Injury and Ostoarthritis Outcome Score, dan Modified Hospital for Special Surgery Knee Scoring. Data yang didapat selanjutnya dikelompokkan dan dianalisa utk menghitung rata-rata dari masing-masing instrumen. Hasil penelitian didapatkan sampel sejumlah 6 lutut yang terdiri dari 2 sampel laki-laki (33,3%) dan 4 sampel perempuan (66,7%). Semua sampel berusia di atas 35 tahun. Hasil evaluasi menggunakan skor KOOS didapatkan nilai rerata komponen nyeri adalah 77,7; komponen keluhan = 70,3; komponen aktivitas harian = 76,2; komponen olahraga dan rekreasi = 47,9; dan komponen kualitas hidup = 74,1. Pada skor KSS didapatkan rerata knee score adalah 70,8 dan  rerata functional score adala 61,6. Sedangkan pada skor HSS didapatkan rerata functional score adalah 81.5. Penelitian ini menghasilkan masing-masing skor dengan nilai rata-rata yang bagus. Hal ini menunjukkan bahwa pilihan teknik operasi High Tibial Osteotomy memberikan hasil operasi yang memuaskan. Sehingga teknik operasi High Tibial Osteotomy dapat menjadi salah satu pilihan pada kasus Osteoarthritis. Dengan banyaknya pilihan macam operasi pada penderita Osteoarthritis maka High Tibial Osteotomy dapat menjadi satu pilihan yang baik untuk kepuasan pasien. Kata kunci: Osteoartritis, High Tibial Osteotomy, Knee Society Score, Knee Injury and Ostoarthritis Outcome Score, Modified Hospital for Special Surgery Knee ScoringKorespondensi: liliosanci@gmail.com
Collagen Type I and Type II Expression Evaluation on Cartilage Defect Regeneration Treated with Dwikora–Ferdiansyah–Lesmono–Purwati (DFLP) Scaffold Supplemented with Adipose–Derived Stem Cells (ASCs) or Secretome: An In-Vivo Study Adrianto Prasetyo Perbowo; Dwikora Novembri Utomo; Lukas Widhiyanto; Primadenny Ariesa Airlangga; Purwati Purwati
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.4377

Abstract

Abstract Cell-based therapies such as Scaffold, stem cells, and secretome, are one of the alternatives to enhance the regeneration of hyaline-like cartilage in cases of cartilage defects. This study is an in-vivo experiment using animal models, in which we apply a composite of DFLP (Dwikora-Ferdiansyah-Lesmono-Purwati) Scaffold and Adipose-Derived Stem Cells (ASCs) or Secretome to an injury model on the distal femoral trochlea of New Zealand White Rabbits. The animals were divided into four groups: (1) control (K); (2) Scaffold only (S); (3) Scaffold + ASCs (SA); (4) Scaffold + Secretome (SS). Animals were terminated in the 12th week, and an immunohistochemistry (IHC) evaluation for Collagen type I and II were done. Statistical analysis shows that collagen type I IHC between groups shows no significant difference (p = 0.546). Collagen type II IHC shows significant difference between groups (p = 0,016). The findings in this study showed that Scaffold + ASCs group and Scaffold + Secretome have better collagen type II expression compared to the control group. DFLP Scaffold composite with ASCs or Secretome shows potential for cartilage regeneration therapy by increasing type II collagen expression as in hyaline-like cartilage which may be used for regenerative therapy for cartilage defects. Keywords             : DFLP Scaffold; Adipose-Derived Stem Cells (ASCs); Secretome; Collagen Type I; Collagen Type IICorrespondence    : ianperbowo@me.com
Uji Biokompabilitas pada Implan Orthopedi Antara Implan Impor, Implan Lokal dari Material Impor, dan Prototipe Stainless Steel 316L dari Material Lokal Ferdiansyah Mahyudin; Heppy Chandra Waskita; Dwikora Novembri Utomo; Heri Suroto; Tri Wahyu Martanto
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 3, No 1 (2019)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (597.99 KB) | DOI: 10.30651/jqm.v3i1.1612

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ABSTRACT  Demands of orthopedic implants are increasing in Indonesia, but its production are limited and still imported. Stainless steel, especially 316L is one of metal that is used commonly. This research evaluates biocompatibility of stainless steel 316L implant prototype, local implant manufactured using imported stainless steel, and imported stainless steel implant. Cytotoxicity test used mesenchymal human cell with MTT assay. Irritation test, acute toxicity/pyrogenicity test, and implantation test used 24 Wistar rats respectively which were assigned to 4 groups. We evaluate Draize score, weight and rectal temperature changes, and fibrous capsule ring thickness. Cytotoxicity test shows viable cell percentage in stainless steel 316L implant prototype, local implant, and imported implant are 83.7%, 87.5%, and 83.7% respectively. Comparison test using One Way ANOVA shows no significant difference between 3 groups (p>0.05). Iritation test results in 3 groups are grade 0 (no edema and no erythema). Acute toxicity/pyrogenicity test shows no statistically significant difference (p>0.05) among all groups. There is also no significant difference (p>0.05) of fibrous capsule ring thickness on 1 and 4 weeks after implantation. Based on ISO for medical test guide, stainless steel 316L implant prototype is safe and has similar biocompatibility test result compared to local and imported implant.Keywords                   : stainless steel 316L, biocompatibility, orthopaedic implantCorrespondence to    : ferdiansyah@fk.unair.ac.id ABSTRAKKebutuhan implan orthopedi terus meningkat di Indonesia, namun produksinya terbatas dan sebagian besar masih impor dari luar negeri. Stainless steel, utama 316L adalah salah satu metal yang sering digunakan. Penelitian ini mengevaluasi biokompatibilitas dari prototipe implan stainless steel 316L, implan lokal yang diproduksi menggunakan stainless steel impor, dan implan stainless steel impor. Uji sitotoksisitas menggunakan sel mesenkim human dengan MTT assay. Uji iritasi, uji pirogenositas, dan uji implantasi menggunakan 24 tikus Wistar yang terbagi dalam 4 grup. Kami mengevaluasi skor Draize, perubahan berat dan temperatur rektal, dan ketebalan fibrous capsule ring. Uji sitotoksisitas menunjukkan persentase viabilitas sel pada prototipe stainless steel 316L, implan lokal, dan implan impor berturut-turut adalah 83,7%; 87,5%; dan 83,7%. Uji komparasi dengan One Way Anova tidak menunjukkan perbedaan signifikan diantara 3 grup (p>0,05). Hasil uji iritasi 3 grup menunjukkan grade 0 (tidak ada edema dan eritema). Uji pirogenositas tidak menunjukkan perbedaan signifikan pada semua grup (p>0,05). Tidak ada perbedaan signifikan (p>0,05) pula pada ketebalan fibrous capsule ring di minggu ke 1 dan 4 setelah implantasi. Berdasarkan ISO untuk pedoman uji di bidang medis, prototipe stainless steel 316L aman dan memiliki kesamaan hasil uji biokompatibilitas bila dibandingkan dengan implan lokal dan impor.Kata kunci              : stainless steel 316L, uji biokompatibilitas, implan orthopaediKorespondensi       : ferdiansyah@fk.unair.ac.id
Clinical and Functional Outcome of Cervical Degenerative Disc Disease after Operative Treatment at Dr. Soetomo General Hospital Surabaya In 2013-2018 Reyner Valiant Tumbelaka; Dwikora Novembri Utomo; I Ketut Martiana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 5, No 1 (2021)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v5i1.3857

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Backgrounds: Cervical degenerative disc disease is a pathological change in the cervical associated with the degenerative process. Surgery is one of the therapeutic modalities in cases of cervical degenerative disc disease. Post-surgical clinical outcomes are needed to evaluate the results of the actions that have been taken. Methods: This study is an observational retrospective study to evaluate clinical and functional outcomes using Neck Disability Index & SF36 on cervical degenerative disc disease before and after surgery at Dr. Soetomo Hospital Surabaya in 2013-2018. Data is processed using SPSS and compared using the T-test. Results: A total of 12 patients with details of 8 male patients and four female patients who met the inclusion and exclusion criteria in this study. There was a significant decrease in the average NDI score (p = 0.05) before surgery (47.33) compared with after surgery (15.58). There was a significant increase in the average SF36 score (p< 0.05) before surgery (50.75) compared to after surgery (88.16). Conclusions: There is an increase in clinical and functional outcomes in patients with cervical degenerative disc disease who undergo operative treatment.
The potential of mesenchymal stem‐cell secretome for regeneration of intervertebral disc: A review article Romaniyanto Romaniyanto; Cita Rosita Sigit Prakoeswa; Damayanti Tinduh; Hari Basuki Notobroto; Fedik Abdul Rantam; Dwikora Novembri Utomo; Heri Suroto; Ferdiansyah Ferdiansyah
Indonesian Journal of Biotechnology Vol 26, No 2 (2021)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijbiotech.63318

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Low back pain is a crucial public health problem that is commonly associated with intervertebral disc de‐ generation and has vast socio‐economic impact worldwide. Current treatments for disc degeneration are conservative, non‐surgical, or surgical interventions, and there is no current clinical therapy aimed at directly reversing the degeneration. Given the limited capacity of intervertebral disc (IVD) cells to self‐repair, treatment aiming to regenerate IVDs is a topic of interest and mesenchymal stem cells (MSCs) have been identified as having potential in this regeneration. Recent studies have revealed that the benefits of MSC therapy could result from the molecules the cells secrete and that play principal roles in regulating essential biologic processes, rather than from the implanted cells themselves. Therefore, the objective of this study is to review the potential use of the MSC secretome to regenerate IVDs. Current evidence shows that the secretome may regenerate IVDs by modulating the gene expressions of nucleus pulposus cells (upregulation of keratin 19 and downregulation of matrix metalloproteinase 12 and matrix Gla protein) and stimulating IVD progenitor cells to repair the degenerated disc.