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All Journal Jurnal Kedokteran Brawijaya Medical Journal of Indonesia The Indonesian Biomedical Journal Indonesian Journal of Cardiology Indian Journal of Forensic Medicine & Toxicology
Askandar Tjokroprawiro
Faculty Of Medicine, University Of Airlangga Jl. Mayjen Prof. Dr. Moestopo, No.47, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia Soewondo, Pradana; Soegondo, Sidartawan; Suastika, Ketut; Pranoto, Agung; Soeatmadji, Djoko W.; Tjokroprawiro, Askandar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.097 KB) | DOI: 10.13181/mji.v19i4.412

Abstract

Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL). Dyslipidemia was reported in 60%  (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most common  complication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territoryConclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in Indonesia. (Med J Indones 2010; 19:235-44)Keywords: DiabCare, DiabCare Indonesia, Diabetes complications, Dyslipidaemia, Glycaemic control, Hypertension.
Regulasi Adipogenesis oleh mTORC1 melalui Jalur ST A T3 Triawanti, Triawanti; Indra, M Rasjad; Tjokroprawiro, Askandar; Sujuti, Hidayat
Jurnal Kedokteran Brawijaya Vol 27, No 3 (2013)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1125.568 KB) | DOI: 10.21776/ub.jkb.2013.027.03.1

Abstract

Obesitas  merupakan  suatu  penyakit  kelebihan  massa  lemak  tubuh  yang  mempunyai  efek  merugikan  bagi  kesehatan.  Pada saat  ini  proses  adipogenesis  menjadi salah  satu  target  terapi  obesitas.  Salah  satu  jalur  yang  diduga  teraktivasi  pada  proses adipogenesis  adalah  melalui aktivasi  ST A T3  yang  salah  satu  jalur  hulunya  melalui protein  mammalian target  of rapamycin complex 1 (mTOR). Penelitian ini bertujuan untuk membuktikan proses adipogenesis melalui jalur ST A T3 yang diaktivasi oleh  mTORC1.  Penelitian  ini  merupakan  penelitian  eksperimental  dengan  rancangan  post  test  only  control.  Untuk penghambatan  mTORC1  digunakan  rapamycin  dan  penghambatan  ST A T3  digunakan  inhibitor  ST A T3  peptide.  Subjek penelitian  adalah  kultur  primer  sel  preadiposit  yang  diambil  dari  lemak  viseral  tikus  putih  Rattus  norvegicus.  Setelah  kultur sel preadiposit dinilai konfluen minimal 70-80% dilakukan induksi diferensiasi dan dibagi menjadi  4 kelompok yakni (K) kontrol  (A):   diberi rapamycin  10  nM,  (B):  diberi  inhibitor  ST A T3  100  µM (C):  diberi  inhibitor  ST A T3  100  µM dan   rapamycin10  nM.  Parameter  yang  diukur  adalah  aktivasi  p70S6K1,  ST A T3,  ekspresi  C/EBPδ,  aktivitas  enzim  Glyserol-3-fosfodehidrogenase  (GPDH)  pada  hari  ke-2,  ke-4  dan  ke-6  serta  gambaran  morfologis  sel  adiposit.  Analisis  statistik menggunakan uji ANOVA, Duncan dan korelasi Pearson dengan tingkat kepercayaan 95%. Hasil penelitian membuktikan terjadi  penghambatan  proses  adipogenesis  karena  penghambatan  aktivasi  p70S6K1,  dan  ST A T3  oleh  rapamycin  dan inhibitor ST A T3.
In-Vitro Differentiation Adipose-Derived Mesenchymal Stem Cells into Pancreatic Progenitor Cells Hermina Novida; Agung Pranoto; Askandar Tjokroprawiro; Sony Wibisono; Purwati
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.v15i2.14752

Abstract

Background: Adult stem cells are currently reliable sources of mesenchymal stem cells for regenerativetherapy, include diabetes mellitus. The aim of this study is to develop endocrine pancreatic progenitor cellscharacterized by Pdx1 and insulin expression from rat adipose-derived mesenchymal stem cells using twosteps in-vitro differentiation.Methods: In this experimental study, ADMSCs were isolated from rat adipose tissue and exposed toinsulinogenic differentiation medium containing nicotinamide, activin A and glucagon-like peptide-1 (GLP1). After induction, the existence of pancreatic progenitor cells (PPCs) was confirmed by immune-stainingassay of Pdx1 and insulin.Results: After three weeks of in-vitro differentiation, expression of Pdx1 and insulin proteins showed upas green in the immunofluorescence assay. Immunofluorescence intensity of Pdx1 was higher in PPCs thanin ADMSCs control (p<0.05). Immunofluorescence intensity of insulin was also higher in PPCs than inADMSCs control (p<0.05). Therefore, in-vitro differentiation was successful to develop PPCs from ratADMSCsConclusion: This study has demonstrated the in-vitro differentiation of ADMSCs into PPCs that expressedPdx1 and insulin
Aloe Gel Enhances Angiogenesis in Healing of Diabetic Wound Djanggan Sargowo; Adeodatus Yuda Handaya; Mohammad Aris Widodo; Diana Lyrawati; Askandar Tjokroprawiro
The Indonesian Biomedical Journal Vol 3, No 3 (2011)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v3i3.152

Abstract

BACKGROUND: Diabetic micro and macroangiophathy lead to the incident of diabetic foot ulcers characterized by an increased number of circulating endothelial cells (CECs) and decreased function of endothelial progenitor cells (EPCs). This fact is correlated with ischemia and diabetic wound healing failure. Aloe vera gel is known to be able to stimulate vascular endothelial growth factor (VEGF) expression and activity by enhancing nitric oxide (NO) production as a result of nitric oxide synthase (NOS) enzyme activity. Aloe vera is a potential target to enhancing angiogenesis in wound healing.OBJECTIVE: The objective of this study was to explore the major role of Aloe vera gel in wound healing of diabetic ulcers by increasing the level of EPCs, VEGF, and endothelial nitric oxide synthase (eNOS), as well as by reducing the level of CECs involved in angiogenesis process of diabetic ulcers healing.METHODS: The experimental groups was divided into five subgroups consisting of non diabetic wistar rats, diabetic rats without oral administration of aloe gel, and treatment subgroup (diabetic rats) with 30, 60 and 120 mg/day of aloe gel doses for 14 days. All subgroups were wounded and daily observation was done on the wounds areas. Measurement of the number of EPCs (CD34), and CECs (CD45 and CD146) was done by flowcytometry, followed by measurement of VEGF and eNOS expression on dermal tissue by immunohistochemical method on day 0 and day 14 after treatment. The quantitative data were analyzed by One-Way ANOVA and Linear Regression, with a cofidence interval 5% and significance level (p<0.05) using SPSS 16 software to compare the difference and correlation between wound diameters, number of EPCs and CECs as well as the levels of VEGF and eNOS.RESULTS: The results of this study showed that aloe gel oral treatment in diabetic wistar rats was able to accelerate the wound healing process. It was shown by significant reduction of wound diameter (0.27±0.02); the increased number of CECs (0.42±0.57), respectively (p<0.05). On the other hand, the wound diameter and eNOS indicators showed significant differences at the dose of 60 mg, while the number of EPCs and CECs and the level of VEGF showed significantly different results at a dose of 120 mg. Aloe gel oral therapy showed a positive indication of wound healing acceleration at the optimum dose range 60-120 mg a day.CONCLUSIONS: Aloe gel is potential to be a herbal therapy candidate for diabetic wound healing through enhancing EPCs homing, decreasing the CECs number, and stimulating the increase of VEGF and eNOS levels,hence proving to be a dominant factor in the angiogenesis process.KEYWORDS: aloe gel, diabetes, wound healing, angiogenesis
Korelasi Antara Kadar Lp-PLA2, MDA, F2-Isp di Serum dan Jaringan Aorta dengan Jumlah Sel Busa dalam Proses Aterogenesis pada Tikus Wistar Retno Susilowati; Djanggan Sargowo; Rasjad Indra; Askandar Tjokroprawiro; Sri Widyarti
Jurnal Kardiologi Indonesia Vol. 33, No. 4 Oktober - Desember 2012
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v33i4.288

Abstract

Background. Atherogenesiswas initiated by cholesterol deposits on foam cell in sub intimae of blood vessel stress oxidation. Atherogenesis in non- hypercolesterolemiausually undergoes an increased level of Lp-PLA2. It, therefore, needs to evaluate the role of Lp-PLA2in the foam cell formation. Aims. To explain the role of Lp-PLA2 in the foam cell forming, to correlate the level of Lp-PLA2 ,MDA, F2-Isp in aorta with foam cell number (FCs) as well as to correlate the level of Lp-PLA2 , MDA, F2-Isp contents in serumwith their contents in aorta and the correlation with FCs.Methods. 30 rats aged 2 months, with their weight averaging from 150-200g,were divided into the control group and the treatment one where the latterwas fed hyperlidemia for 2,8 and 12 weeks. The measurement level of LDL-C,MDA, F2-isp and Lp-PLA2in serum was performedas well as aorta and FCs. Data was analysed using anova, t-Test, path analysis and correlation. Results. Research result indicated that: (1) The level of MDA(a), F2-Isp(s) and Lp-PLA2(s) positively correlated with FCs, Lp-PLA(s)having the highestcorrelation value. (2) Lp-PLA2(a),MDA(s) and F2-Isp(s,a)did not correlate withFCs. (3) There was a positive correlation between Lp-PLA2 with MDA andF2-Isp in both serum and aorta.Conclusion. The enzyme of Lp-PLA2 acts as an activator in forming thefoam cell with stimulated stress oxidation.
Three Dangerous Loops Of Lipoproteine-Associated Phospholipase A2 Activity On Increasing LDL Aterogenecity Retno Susilowati; Djanggan Sargowo; Askandar Tjokroprawiro
Jurnal Kardiologi Indonesia Vol 40 No 3 (2019): Indonesian Journal of Cardiology: July-September 2019
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v40i3.680

Abstract

Background. Hypercholesterolemia is a major classic risk factor for cardiovascular disease, but there are 35%-40% cases of cardiovascular patients have a normal cholesterol levels. Lp-PLA2 is an enzyme that produced and secreted by macrophages as a response to the lipid peroxide formation, especially the platelet activating factor compound and phosphocholine peroxide. Lp-PLA2 is correlated with classic risk factor of cardiovascular disease, although that correlation with number of foam cell at early stage of atherosclerosis is not clear yet. This study aims to determine whether Lp-PLA2 levels correlated with classic risk factors of atherosclerosis and the number of foam cell, and the role of Lp-PLA2 enzyme in foam cells formation.Methods. This study observes the change of Lp-PLA2, F2-Isp, MDA, TC, LDL, HDL levels in rat serum at 3 levels of early atherogenesis, Ath-I, Ath-II and Ath-III were made on the number of foam cells. The number of cells was observed on all aortic cross sectional surfaces, using the Oil-Red-O staining. The LDL-C content was measure using the Fiedwall formula, MDA content was measure by using TBA-test, the observe of F2-isoprostane and Lp-PLA2 followed the procedure Elisa methods. Results. Anova test results among the 3 initial atherosclerotic levels showed a very significant difference (p<0.01) on Lp-PLA2 plasma content. The LSD test results represented an increase in Lp-PLA2 enzyme levels significantly since AthII stage. Path analysis refers that correlation value between the Lp-PLA2and the number of foam cell (r=0.48) were higher than that of the LDL (r=0.42), was neither correlated with MDA nor F2-Isp, the highest correlation occurred between Lp-PLA2 and LDL compared to the others parameters (r = 0.58). Path analysis also showed no correlation between cell numbers with MDA and F2-Isp, but LDL levels are correlated significantly with of oxidative stress markers MDA levels (r = 0.32) and correlated very significantly with F2-Isp (r = 0.69).Conclussion. It can be concluded that elevated levels of Lp-PLA2 increase atherogenecity of LDL, due to increased inflammation, stress oxidation and elevated levels of Lp-PLA2 itself, wich are interconnected with proatherogenic loops.
Co-Authors Agung Pranoto AGUNG PRANOTO Diana Lyrawati Djanggan Sargowo Djanggan Sargowo Djanggan Sargowo Djoko W. Soeatmadji Handaya, A. Yuda Hermina Novida Hermina Novida, Hermina Hidayat Sujuti I Ketut Suastika Jongky H Prajitno, Jongky H M Rasjad Indra Mohammad Aris Widodo Pradana Soewondo Purwati Rasjad Indra Retno Susilowati Retno Susilowati Sidartawan Soegondo Sony Wibisono Sri Widyarti Triawanti Triawanti