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All Journal International Journal of Integrated Health Sciences Medical Journal of Indonesia The Indonesian Biomedical Journal Paediatrica Indonesiana Medicinus : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia

Julius July

Department Of Neurosurgery, Faculty Of Medicine, Pelita Harapan University, Neuroscience Center, Siloam Hospital Lippo Village, Tangerang, Banten

Author-ID : 293507

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 18 Documents Claim Missing Document

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Articles

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Surgical management of benign peripheral nerve tumors July, Julius; Guha, Abhijit
Medical Journal of Indonesia Vol 17, No 3 (2008): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Peripheral nerve tumors are rare lesions that can arise anywhere in the body and hence have a myriad of wide differential diagnosis. They commonly present as a non-specific mass which is diagnosed as a peripheral nerve tumor at surgery. While these tumors may initially be referred to a wide variety of surgeons, early recognition of the nature of the lesion and appropriate surgical treatment by an expert peripheral nerve surgeon is essential in order to minimize post-operative neurological deficits. The objective of this article is to provide a general management scheme for the most common setting of benign peripheral nerve tumors. (Med J Indones 2008; 17: 163-8)Keywords: Operative technique, Schwannoma, neurofibroma

Benign schwannoma of the radial nerve mimicking cervical radicular pain seok Lee, Dong; July, Julius
Medical Journal of Indonesia Vol 21, No 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Radicular pain on the arm often referred to cervical disc problems. If cervical MRI is normal, then it is necessary to rule out peripheral nerve tumor. A 54-year old man presented with radicular pain in his left arm, investigated for cervical disc problems, with normal cervical MRI. Examination shows a positive Tinelâs sign on the proximal part of his left arm. Focal MRI revealed a lobulated tumor in the radial nerve 1.5 cm in diameter. The patient was operated and the tumor was completely removed. Histopathology confirmed the diagnosis of schwannoma. (Med J Indones. 2012;21:118-20)Keywords: Peripheral nerve tumour, radicular pain, schwannoma, Tinelâs sign

Central nervous system lymphoma: a description and analysis of patientsâ clinical and radiological features July, Julius; Wijaya, Andy; Muliantara, Priscilla; Yuniarti, Mira
Medical Journal of Indonesia Vol 23, No 3 (2014): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Central nervous system (CNS) lymphoma is a rare brain neoplasm. Its incidence has increased these years, so it should be considered in the differential diagnosis for mass lesions in the CNS. The aim of the study was to describe the radiological and clinical features of patients with CNS lymphoma.Methods: The study was a retrospective study. All patients histopathologically confirmed to have CNS lymphoma from November 2008 to December 2013 in Siloam Hospital Lippo Village were included in the study. Medical records and patientsâ MRI results were retrieved to be analyzed.Results: 32 patients were histopathologically diagnosed to have CNS lymphoma. The patients, mean age was 54 Â± 15.01 years with slight male predominance. No patient was immuno compromised (CD4 > 500 cells/ÂµL and leukocyte 5,000-11,000 cells/ÂµL). The median interval between the onset of the initial symptoms and diagnosis is 7 weeks. The most common presenting symptoms were headache, mental changes, and neurological deficits related to the location of lesion. MR images show that most lesions were enhanced with contrast, iso-hypointense in T1 weighted imaging (T1WI), iso- to hypointense with perifocal edema in T2 weighted imaging (T2WI), hyperintense in diffusion weighted imaging (DWI), with the most common location was white matter of cerebral hemisphere on one or more lobes and periventricular area, and the tumor could be single or multiple (24%) without clear edges.Conclusion: Short course of neurological worsening (within weeks) should lead a suspicion toward lymphoma. The characteristics of MR images are markedly enhanced by contrast, iso- to hypointense on T1WI and T2WI, and hyperintense in DWI, involving white matter of cerebral hemisphere and periventricular area.

Cortisol dynamics and endothelin-1/nitric oxide ratio are associated with clinical vasospasme July, Julius; Yunus, Yesaya; Sungono, Veli; As’ad, Suryani; Suhadi, Budhianto; Islam, Andi A.
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Background: Cortisol dynamics in serum might be related to clinical vasospasm, also known as delayed ischemic neurological deficits (DIND). Two vasoactive substances that play a role in pathophysiology of DIND are endothelin-1 (ET1) and nitric oxide (NO), both are proved associated with cortisol. This study aimed to know how cortisol play a role on ET1/NO ratio and its relationship to DIND.Methods: This was a prospective cohort study for the first 14 days after aneurysmal subarachnoid hemorrhage (SAH). Patients with inclusion criteria will be enrolled for blood test before surgery, and post-operative day 2, 4, 7, and 10 (between 8:00-9:00 AM). The blood tests were performed for cortisol, ACTH, CBG, NO, and ET1. Free cortisol is calculated with Coolens equation. Logistic regression was used to see the interaction model and its scale. Bivariate analysis (corelation) was used to see the relationship between total cortisol, free cortisol, NO, ET1, and clinical vasospasm (DIND).Results: Forty-four patients are enrolled into this study (20 male; 24 females). Mean age is 52.02 years (52.02 ± 11.23). There were 29 patients (66%) within DIND group and 15 patients Non-DIND as the control group. The mean of cortisol level shown is significantly higher in DIND group (35.99 ± 14.24) µg/dL compared to Non-DIND group (19.57 ± 6.19) µg/dL, p < 0.001. The mean of free cortisol level was significantly higher in DIND group (2.06 ± 1.094) µg/dL compared to non-DIND group (0.838 ± 0.365 µg/dL; p < 0.001). The Scatter Plot graph show that correlation of cortisol with ET1/NO ratio started increasing on day 4 and became stronger on day 10.Conclusion: Cortisol is associated with DIND following aneurysmal SAH, probably through its role in keeping the balance between ET1 and NO level. (Med J Indones. 2013;22:161-6. doi: 10.13181/mji.v22i3.585) Keywords: Cortisol dynamics, delayed ischemic neurological deficits, endothelin-1, nitric oxide

Isolated petrous apex ectopic craniopharyngioma July, Julius; Wahjoepramono, Eka J.; Himawan, Sutisna; Cahyadi, Alexander
Medical Journal of Indonesia Vol 24, No 4 (2015): December
Publisher : Faculty of Medicine Universitas Indonesia

Primary ectopic craniopharyngioma is a rare entity. Isolated petrous apex bone location has not been reported previously. This study reports a case of 26-year-old male with right abducent nerve palsy. CT and MRI imaging reveal right petrous apex cystic lesion. No sellar or suprasellar region involvement was found. Endoscopic endonasal transphenoid approach has been successfully performed. Histopathology examination confirms the diagnosis of adamantinomatous craniopharyngioma. So far, it’s probably the first case report of primary ectopic craniopharyngioma isolated in the petrous apex. This case report supports the premise that primary ectopic craniopharyngioma is a multifactorial process that starts with an error from migrated embryological cells.

Rare Distal Anterior Choroidal Artery Aneurysm Muhammad Zafrullah Arifin; Julius July; Bilzardy Ferry; Ahmad Faried
International Journal of Integrated Health Sciences Vol 4, No 2 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5345.98 KB)

Objective: To describe a rare patient with ruptur aneurysm case of distal anterior choroidal artery (AChA) and intraventricular hemorrhage. A 56-year old female came to our hospital with chief complaint sudden onset of severe headache and vomiting.Methods: Head computed tomography (CT)-scan and angiography on the lesion was performed at the Department of Radiology, Siloam Hospital, Tangerang, Indonesia.Results: Head CT-scan imaging revealed an intraventricular hemorrhage, primarily in the right lateral ventricle, with slight enlargement of both lateral, 3rd and 4th ventricles. Angiography examination revealed a round vascular lesion at the wall of the posterior cornu of the lateral ventricle and an occlusion of the M1 base segment of the left middle cerebral artery.Conclusions: The lesion, distal AChA aneurysm, at the posterior cornu was reached using an infratemporal lobe approach with the help of neuronavigation. Microsurgical clipping was successfully performed.Keywords: Aneurysm, distal anterior choroidal artery, neuronavigation DOI: 10.15850/ijihs.v4n2.837

Dynamic Pattern of Interleukin-1beta and -10 in Cerebrospinal Fluid following Aneurysmal Subarachnoid Hemorrhage Yesaya Yunus; Julius July; Andi Asadul Islam; Eka Julianta Wahjoepramono; Irawan Yusuf
The Indonesian Biomedical Journal Vol 6, No 2 (2014)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v6i2.35

BACKGROUND: Inflammation following aneurysmal subarachnoid hemorrhage (SAH) is associated with patient outcome. This study aimed to analyze the dynamics pattern of the pro-inflammatory interleukin (IL)-1β and anti-inflammatory cytokine IL-10 in the cerebrospinal fluid (CSF) following aneurysmal SAH.METHODS: This is a prospective observational study. The CSF was collected prior to surgery, and on the 2nd, 4th and 6th days after surgery. The CSF was then analyzed for IL-1β and -10 using enzyme-linked immunosorbent assay. Delayed Ischemic Neurological Deficits (DIND) was determined based on new neurological deficits within the first week after surgery. Data was analysed with T test or Wilcoxon Rank-Sum test to evaluate the pattern of biomarkers between DIND and non-DIND groups.RESULTS: There were 33 patients enrolled in this study, 16 patients (48.48%) who experienced DIND and 17 patients (51.52%) were non-DIND. There were significant increase dynamic levels of IL-10 and -1β in DIND patients (p<0.05).CONCLUSION: Significant increase levels of IL-10 and -1β in CSF after aneurysmal SAH are associated with DIND.KEYWORDS: IL-1β, IL-10, DIND

Diagnostic clues in spontaneous intracranial hemorrhage in babies Julius July; Eka Julianta Wahjoepramono; Beny Atmadja Wirjomartani
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.230-4

Background There has been increasing number of babies detectedwith SIH. In regard to find diagnostic clues for the first-rate babieswho really needs CT scan and referral, simple observation to lookat certain clinical and laboratory findings is needed.Objective To identify diagnostic clues associated with spontaneousintracranial hemorrhage (SIH) in babies.Methods Retrospective observation was carried out among ba-bies with SIH within the last two and a half years. Patients wereexcluded if there was an obvious cause of SIH such as trauma orany underlying disease such as hemophilia. Variables that wereobserved were patient's age, seizure, decreased level of conscious-ness, tensed fontanel, neurological deficits, vomitting, fever(T > 3 7 .SOC), anemia, jaundice, PT and aPTT. All data weredescriptively evaluated.Results There were 53 babies with SIH (31 baby boys, 22 babygirls), forty eight of which (91%) were less than 3 months old.Of those, 50 patients (94%) had seizure as the leading clinicalpresentation, 44 patients (83%) had decreased level of conscious-ness, and 39 patients (74%) had tensed fontanel. PT and aPTTwere prolonged in 39 (74%) cases. The most common lesion wassubdural hematoma (38 cases/72%). Forty-three babies (81 o/o)required neurosurgical intervention. Overall mortality rate was22%.Conclusion Babies with seizure, decreased level of consciousness,tensed fontanel, and prolonged PT and aPTT should be consideredto harbor SIH. They need a CT scan and referral, particularlythose less than three months old. The prognosis is unfavorable,thus early recognition and treatment is needed

Preoperative intralesional injection of triamcinolone acetonide for a large head and neck lymphangioma in a baby: a case report Julius July; Sophie Peeters
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Lymphangiomas (LMs) are uncommon congenital malformations of the lymphatic system, with an estimated incidence of one in 2,000 to 4,000 live births.1 About half of these lesions are diagnosed at birth, and by two years of age, 90% of those with lesions have been diagnosed.2 Histologically, LMs are benign lesions; however, they can pose a serious threat to the patient due to possible growth into surrounding structures, sometimes causing life-threatening complications. Treatment of large head and neck lymphangiomas in young infants is very challenging, due to the risk of surgical complications. Further challenges include the limited volume of blood loss that infants can tolerate, the lack of the option for radiotherapy or radiosurgery, and the high chance of life-threatening complications if the LM is not treated. Here, we report a case of a two-month-old baby girl presenting with a large head and neck lymphangioma. She was successfully treated with intralesional triamcinolone acetonide injections, followed by surgical resection of the lesion.

IL-4: PREDIKTOR ANTI INFLAMASI PADA STROKE ISKEMIK ? Lucia Herminawati; Julius July
Medicinus Vol 5, No 1 (2015): October 2015 - January 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i1.1178

The brain ischemia due to vascular occlusion, especially in the main cerebral artery, could trigger the microglia as a natural immune cell in the brain. These activated microglia will turn up the inflammation cascade in the ischemic area. Interleukin-4 (IL-4) has a vital role in the microglial alteration to become an anti-inflammatory phenotype, which wind up the expression of MHC II and CD11c. Moreover, previous studies has supported that the stimulation of IL-4 in the culture of microglia/macrophage will produce this kind of “alternative” phenotype or neuroprotective phenotype, through the fall of TNF and rise of IGF-1. However, only a few have discussed the role and profile of IL-4 in ischemic stroke. This review article will cover the possibility of IL-4 role as an anti-inflammatory predictor in ischemic stroke.Keywords: Interleukin-4, microglia, ischemic stroke, inflammation

Co-Authors Abhijit Guha Achmad Chumaidi Ahmad Faried Alexander Cahyadi, Alexander Anak Agung Istri Sri Wiadnyani Andi A. Islam Andi Asadul Islam As’ad, Suryani Beny Atmadja Wirjomartani Bilzardy Ferry Budhianto Suhadi Dong seok Lee Eka J. Wahjoepramono Hans Christian Uranus Irawan Yusuf Ivan William Harsono Lucia Herminawati Mira Yuniarti Muhammad Zafrullah Arifin Nathania Victoria Stevina Novita Tirtaprawita Priscilla Muliantara Sophie Peeters Sutisna Himawan Veli Sungono Vivien Puspitasari, Vivien Wiradharma Wiradharma Yesaya Yunus Yesaya Yunus Yesaya Yunus

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