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Pemeriksaan dan Sisi Praktis Merawat Pasien Cedera Kepala Iskandar Japardi
Jurnal Keperawatan Indonesia Vol 7 No 1 (2003): Maret
Publisher : Fakultas Ilmu Keperawatan Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.7454/jki.v7i1.130

AbstrakTrauma kepala menimbulkan masalah yang serius dalam masyarakat kita karena baik morbiditas maupun mortalitasnya masih sangat tinggi. Perawatan pasien trauma kepala adalah masalah yang sangat kompleks dan merupakan tanggung jawab yang berat. Perawatan bedah syaraf adalah suatu fokus baru di bidang perawatan di Indonesia, salah satu sebabnya adalah jumlah institusi medis yang menyediakan tenaga ahli di bidang ini masih sangat sedikit. Di ibukota provinsi pun hanya ada sejumlah kecil Dokter Ahli Bedah Syaraf dengan fasilitas medis yang terbatas. Tulisan ini akan membahas tentang penilaian, intervensi, dan perawatan pasien trauma kepala, terutama pada penderita koma. Pembahasan tersebut mencakup aspek teoritis, patofisiologis, dan psikologis dari perawatan dan mengutamakan pentingnya pendekatan secara multidisipliner.Â AbstractHead injuries cause serious problems within our community, as the morbidity and mortality are still very high. The management of head injury patient is a very complex problem and a serious difficult responsibility. Neurosurgical nursing is a new focus in Indonesian nursing, one of the reasons is that only few medical institutions provide reliable skill in this field. Even in a capital of province, only a few neurosurgeons with restricted medical facilities are available. This article will focus on assessing, intervening and managing head injury patients, especially in the comatous state. It will deal with the theoretical, pathophysiological, and psychological aspects of care and focus on the importance of a multidisciplinary approach.

Peran inhibitor HMG-CoA reduktase dalam penurunan Interleukin6 terhadap hasil akhir klinis penderita kontusio serebri Sabri Ibrahim; Rr. Suzy Indhary; Iskandar Japardi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Background : The cascade of dead cells in response of secondary brain damage is still a major problem in brain injury managementObject : Evaluate HMG-CoA reductase inhibitor as a neuroprotective agent with IL-6 biomarker, to patients with clinical outcome of cerebral contussionMethods : The authors used prospective experimental research on 50 moderate brain injury patients with cerebral contussion appearance in Head CT - Scan, research was done from May 2011 until July 2012. Respondents were divided into two groups; the first group were treated with standard moderate brain injury therapy and the other group were added with HMG-Co A reductase inhibitor (Simvastatin). As parameter, IL-6 biomarker was tested in the first day and the fifth day weekly. Clinical final results (GOS and Barthel’s) were scored monthly and were also noted when the patients left the hospital. Results : Based on this research, the authors found that GOS score in 1 month period with standard therapy is 4.81 (SD 0.39 and the score in patients with HMG added is 4.90 (SD 0.30). Barthel’s score in 1 month period for standard therapy is 95.00 (SD 7.56) and the score for other group is 96.67 (SD 5.55), slightly higher in patients with HMG added (P = 0.616). Decreasing number on IL-6 was commonly found after therapy was added P = 0.295 for the 1st day and P = 0.834 for the 5th day. The researchers were also found that there was weak positive correlation on IL-6 serum during the 1st day with GOS (r = 0.124, P = 0.444) and Barthel’s (r = 0.029, P = 0.852) for 1 month. From the analysis we found P = 0.187 for GOS in 1 month and Barthel’s in 1 month 0.219 with P >0.05. Therefore, there was no correlation IL-6 serum in the 5th day with GOS and Barthel’s in 1 monthConclusions : There was no significant corelation between HMG-CoA reductase inhibitor and the clinical outcome (GOS and Barthel Index).Keywords : cerebral contussion; IL-6; GOS; Barthel’s Inde

Gambaran pewarnaan imunohistokimia S100 pada meningioma di Rumah Sakit Umum Pusat H. Adam Malik Medan Gatot Aji Prihartomo; Abdul Gofar Sastrodiningrat; Iskandar Japardi; Sufida dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction: This study explores and describe the S100 immunohistochemical staining in meningioma.Methods: Sample specimens collected from patients who had meningioma undergo tumor removal surgery in the Adam Malik General Hospital Medan has previously been carried out basic hematoxylin eosin staining and was confirmed as meningioma by Epithelial Membrane Antigene (EMA) imunohystochemical staining. Representative slides are made of paraffin blocks and then performed S100 immunohistochemical staining. Staining intensity (SI) was score on scale 0-3 (from no staining to strong staining). Then viewed the characteristics of gender, age, location of tumor, World Health Organization (WHO) meningioma grade, histopathologictype, and tumor recurrence of meningioma specimens that express S100 immunohistochemical staining.Results: Thirty-one specimens of meningioma classified according to WHO criteria: benign 28/31 (90.3%), atypical 2/31 (6.5%) and anaplastic 1/31 (3.2%). These three criteria are classified according to histopathologic type. Meningothelial meningioma is the most widely histopathological types 17/31 (54.8%). Of the overall sample specimens, only 11/31 (35.5%) specimens expressed S100 immunohistochemical staining, the remaining 20/31 (64.5%) did not express. Of the 11 specimens that express S100 staining, benign meningiomas express 8/28 (28.6%) and fibroblastic meningiomas are the most strong S100 immunohistochemical staining( +3) between all the histopathologic type.Conclusion: In general, the results obtained from this study correspond by previous literature.Keyword: immunohistochemical staining; S100; meningioma

Hubungan antara reseptor progesteron dengan Ki-67 labeling index pada meningioma Steven Tandean; Rr Suzy Indharty; Iskandar Japardi; Sufida dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 1 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Meningiomas are benign tumor and the most prevalent intracranial tumors which recur locally. Their morphologic grading do not always correlate with patient outcome and some of them associated with a less favorable clinical outcome. The incidence in women is approximately twice than in men. Progesterone receptors may play role in the proliferation and grading of meningiomas. Aims of this study isto evaluate the correlation of progesterone receptor status with proliferation marker ki67 in various grades of meningioma.Methods : A retrospective research of 30 paraffin-embedded sections of meningiomas was collected that was done histological typing and grading with hematoxylin and eosin. Immunodetection of Progesterone receptors was conducted with peroxidaseantiperoxidase complex and Ki-67 was achieved by streptavidin-biotin peroxidase complex. Progesterone receptors status considered positive if >50% of nuclei were stained with medium intensity or >10 of tumor cell’s nuclei were strongly stained. The Ki-67 is defined into three groups as no proliferation, low proliferation (<14%), and high proliferation (> 14%). Results : Progesterone receptors were positive in 13/27 (48.1%) of grade I tumors, 1/2 (50%) of grade II tumors, and 0/1 (0%) of grade III tumor. In grade I tumor, negative progesterone receptors with negative Ki-67 was 6/14 (42.9%) and low Ki-67 was 8/16 (57.1%). While, positive progesterone receptors with negative Ki-67 was 7/13 (53.8%), low Ki-67 was 4/13 (30.8%), and high Ki-67 was 2/13 (15.4%). In grade II tumor, negative progesterone receptors with negative Ki-67 and positive progesterone receptors with low Ki-67 expression. In grade III tumor, negative progesterone receptors with negative Ki-67 expression. Conclusion : There was a not significant relationship between Ki-67 and progesterone receptors status, but high Ki-67 expression was only found in positive progesterone receptors. Progesterone receptors may play role in proliferation of meningioma. Keywords : meningioma; progesterone; receptor; Ki-67 antige

Gambaran pewarnaan imunohistokimia p53 pada meningioma di Rumah Sakit Umum Pusat H. Adam Malik Medan Donny dr; Adril Arsad Hakim; Iskandar Japardi; Sufida dr
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Intoduction : P53 is a protein produced by the TP53 gene, this protein is a major tumor suppression pathway of cells. P53 is a 'tumor suppressor gene' which is regarded as the protector of the gene. Although 'p53 pathway' are well known in the pathogenesis of these malignancies, its role in tumorigenesis of meningiomas is still very little understood.This study is intended to get an idea of how p53 expression by immunohistochemistry in patients with meningiomaMethod : The study was conducted with descriptive design. The data was patient’s demographic characteristics and data of tumors. The data was taken from the patient's General Hospital Haji Adam Malik began February 2010-February 2013, the immunohistochemical examination conducted in RS Murni Teguh Memorial.Result : Average patient age 41.2 (SD 11.78) years and mostly female by ratio of 2.3:1. Based on the location of the meningioma, the most common sequence is convexity meningiomas and parasagittal meningiomas (8 patients, 26.7%). Based on the results of histopathology, the highest frequency found was meningothelial type of meningioma by 17 cases (56.7%). Expression of p53 is found in 13.3% of patients who all have male sex. Expression of p53 is found in 25% of recurrent meningioma. Based on the index tumor edema, PTEI, found p53 expression by 50% in meningiomas with PTEI weight, 25% on PTEI moderate, and 5% on PTEI light.Conclusion : p53 expression is only found in the male gender (100%). Picture of p53 expression in recurrent tumors and tumors with a high index of edema seems to be the basis of further research to assess the relationship between these variables. Keywords : meningioma; p53

Hubungan raeseptor estrogen dengan Ki-67 labeling index pada meninagioma intrakranial Abdurrahman Mouza; Iskandar Japardi; Suzy Indharty
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 2 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction : Meningioma occurs more in women than men with ratio 2 : 1. Mitosis of meningioma is stimulatedbyfewgrowth factorsand one of itis estrogen. Expression of estrogen receptor on meningioma showsthat clinical meningioma has characteristic more aggressive. Proliferation Index can be measured by antibody of Mind Bomb (MIB-1) binding Ki-67 antigen. Ki-67 is showed on the cells which proliferating through cells cycle.Relation between estrogen receptor and cell proliferation is interesting because it has controversy.Method : This Study used Cross Sectional method for analising relation between estrogen receptor and Ki-67 in patients have been diagnosed meningioma. This study has been done at general hospital H. Adam Malik Medan and laboratorium of patologi anatomi at Murni Teguh hospital.This study did in Oktober-November 2013.Result : In this study is almost meningioma grade I stained Ki-67 not have mitosis with amount 13 sample (43.3%) or positive mitosis is 14 sample (45%). While immunohistochemistry staining of estrogen receptor on meningioma grade I has 25 negative sample (83.3%) and 14 positive sample (51.8%). All of grade I and II are negative.Relation of these staining was used Chi-Square with limit value p<0.05. This result is p=0.677 that shows no significance relation between estrogen receptor and labeling Index Ki-67.Conclusion : These histopatology have many frequents type that is 16 cases of meningothelial meningioma (53.3%), fibroblastic meningioma, and 4 cases transitional meningioma (13.3%). The result is no relation between estrogen receptor and Ki-67 with p=0.667 (p>0.05).Other results are no relation Ki-67 with age p=0.204 (p>0.05) and sex p=0.121 (p>0.05). Keywords : estrogen receptor, Ki-67, meningioma

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