Comparison of Serum Matrix Metalloproteinase-9 Value in Spondylitis Tuberculous with Degenerative Spine Disease

AIM: We aimed to compare the expression of MMP-9 in TB spondylitis using serum levels in the blood of patients suffering from TB spondylitis and compared to the control group. METHODS: Fourteen subjects were divided into two groups, with seven subjects of spondylitis tuberculous (TB) and seven subjects of degenerative spine disease (DSD) in the period from December 2017 to November 2018, who were included in the inclusion criteria included in this study and blood sampling was taken for examination of serum matrix metalloproteinase (MMP)-9 levels. RESULTS: There were significant differences in serum MMP-9 levels between spondylitis TB (ST) and DSDs with a significance value of 0.002 (p < 0.05) with low serum MMP-9 levels in the ST study group 1857.14 ± 377.96 and mean in the control group 857.14 ± 243.97. There were significant differences in serum MMP-9 levels between ST and DSDs with a significance value of 0.002 (p < 0.05) with low serum MMP-9 levels in the ST study group 1857.14 ± 377.96 and mean in the control group 857.14 ± 243.97. CONCLUSION: Patients suffering from ST have higher serum MMP-9 levels than patients with DSD, although MMP-9 is not a specific marker examination for ST, the results of this study can be suggestive into that can help to evaluate enzyme activity in patients with ST disea

Comparison of Serum Matrix Metalloproteinase-9 Value in Spondylitis Tuberculous with Degenerative Spine Disease

AIM: We aimed to evaluate and compare the expression of MMP-9 in TB spondylitis using serum levels in the blood of patients suffering from TB spondylitis and compared to the control group; in this case, the control group in this study was patients with degenerative diseases of the spine. METHODS: Fourteen subjects were divided into two groups, with seven subjects of spondylitis tuberculous (TB) (ST) and seven subjects of degenerative spine disease (DSD) in the period from December 2017 to November 2018 who were included in the inclusion criteria included in this study and blood sampling was taken for the examination of serum matrix metalloproteinase-9 (MMP-9) levels. RESULTS: There were significant differences in serum MMP-9 levels between ST and DSDs with a significance value of 0.002 (p < 0.05) with low serum MMP-9 levels in the ST study group 1857.14 ± 377.96 and mean in the control group 857.14 ± 243.97. There were significant differences in serum MMP-9 levels between ST and DSDs with a significance value of 0.002 (p < 0.05) with low serum MMP-9 levels in the ST study group 1857.14 ± 377.96 and mean in the control group 857.14 ± 243.97. CONCLUSION: Patients suffering from ST have higher serum MMP-9 levels than patients with DSD, although MMP-9 is not a specific marker examination for ST, the results of this study can be suggestive into that can help to evaluate enzyme activity in patients with ST disease

The Existence of Mycobacterium tuberculosis in Microenvironment of Bone

Mycobacterium tuberculosis is an obligate aerobe bacteria requiring oxygen in its metabolism. In normal condition, bones have pH of 6.9–7.4 and temperature of 37°C. With the composition mentioned, bones fall in the group of tissue with less rich oxygen (<35%) which theoretically means, M. tuberculosis is hard to grow in the bone environment. Bone microliving environment is formed by the cells constructing the bone itself and the active cells which periodically interact with the bone cells. Activation of these cells gives impact to the temperature, pH, gas concentration, and liquid concentration, and at the same time triggers calcium, phosphor, and other minerals to be deposited in the bone. In the process of new bone formation, the osteoblast cells produce matrix and release them to the microenvironment that needs a high concentration of calcium and phosphor. The survival of M. tuberculosis in the microenvironment of bone is reflected in interaction of the bacteria and the non-immune cells, the bacteria and the organic environment, and the bacteria and the inorganic environment. In addition, the immune system also threatens the survival of M. tuberculosis. The results of these interactions will affect the lives of bacteria and has an impact on the bone microenvironment

Realization of Photo-curing Gelatin Hydrogel using a Commercial Projector for Culturing Mesenchymal Cells

This paper investigates the realization of synthetic extracellular matrix with visible light photo-patterning gelatin in a simpler manner. A synthetic extracellular matrix provides an initial attachment for the seeded cells on the experimental substrate such as glass plate or multi-well until they realized their the natural extracellular matrix. Here, a commercial Digital Light Projector (DLP) was used to induce gelatin with Rose Bengal as a crosslinking agent to form the thin layer on the experimental substrate. Various gelatin concentrations from 2%-10% were exposed at different times in order to optimize the patterning process. A geometrical characterization on the patterned gelatin, such as contour measurement and resolution, were taken place. Results showed that the thickness of patterned gelatin was in the range of 10 µm – 60 µm depends on the exposure time of the DLP projector. Moreover, a visual method aided by the Fiji toolbox from NIH ImageJ image processing was used to observe the density and spatial arrangement of the cultured cells on the substrate. Ultimately, biocompatibility using MTT assay was also employed to confirm the viability of the cells on the gelatin substrate. The results show that we are able to control the physical and spatial arrangement of the gelatin substrate, and they with cell viability depend on 6 days of observation. It was found that the gelatin substrate provides faster growth on cultured cells compared to the control study. This finding leads to the possibility to realize the automation system in cell culture technology with an affordable investment

Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity

Computed tomography image analysis for Indonesian total hip arthroplasty designs

Total hip arthroplasty purposes to replace a hip joint damaged by an artificial hip joint. However, the developed products that already exist in the market lead to the mismatch between the hip implant equipment and the patient’s bone morphometric. Besides causing complications, the mismatch also continues to the dislocation effects, fracture, osteolysis, and thigh pain. This paper aims to design a customized hip implant based on real patient data, particularly for Indonesian patient, limited to the acetabular components and stem parts. The computed images were analyzed to estimate the patient proximal femur morphometric; those are the femoral head diameter, neck-shaft angle, mediolateral width, anteroposterior width, neck length and neck width. The experiment has succeeded in designing the acetabular shell with the thickness of 3 mm, the acetabular liner with the thickness of 6 mm, the femoral head between 22.4 to 24.8 mm, the short stem in both the right for 110.656 mm and left femur bone for 111.49 mm; that fit the patient's femur bone. Overall, the proposed steps in designing the customized hip implant in this work, based on image analysis on medical imaging data, can be a standard to be applied for other patient-needs hip arthroplasty implants

The Needs of Current Implant Technology in Orthopaedic Prosthesis Biomaterials Application to Reduce Prosthesis Failure Rate

Today, orthopaedics is still in search for the most reliable biomaterial for prosthesis. The biomaterial needs to have good longevity and other supporting properties in order to maintain low implant failure. An ideal metallic biomaterial should be biocompatible, has similar elastic modulus to that of bone, has excellent resistance to fatigue, corrosion, aseptic loosening, and wear, and has good bone-bonding ability. The success of an implant depends on many factors. Good osseointegration is one of the factors required to reduce the rate of loosening of implants and in order to increase the chance of osseointegration, high stability of implants and early healing process encouragement are needed

Material Selection Techniques for Polymer Hubs of Novel Spinal Stem Cell Introducers using Finite Element and Weighted Property Method

Stem cell studies have progressed significantly in the last decades. Similarly, stem cell therapies have also been applied in clinical settings, includingthe spine. However, stem cells’ delivery to the spinal region requires delicate procedures, demanding reliable introducers in addition to the surgeons' psychomotor skills. The introducer is a tubular sleeve to guide a syringe needle to deliver and draw fluids into and from the body, respectively. To date, there is no introducer dedicated to spinal stem cell deliveries. Our group proposed a dedicated introducer for spinal stem cell therapies, which consists of a needle and a hub (a base part of an introducer for gripping and handling). We focused onthe weighting property method (WPM) to select four polymer candidates for the hub:polystyrene, polycarbonate, polypropylene, and polyethylene. Prior to WPM, the mechanical integrity of the hub candidates was analyzed using the finite element method to determine the von Mises Stress (vMS) values. Accordingly, the vMS for each case and the material was compared with the respective tensile strength (TS), thereby vMS:TS ratio (MTR).MTR was included as one of the properties in WPM, in addition to prices, critical radiation doses, hardness, water absorption, and isopropyl alcohol resistance.According to the WPM calculation, polycarbonate received the highest score, thereby recommended for further introducer fabrications

New Bone Formation in Tuberculous-Infected Vertebral Body Defect after Administration of Bone Marrow Stromal Cells in Rabbit Model

Study DesignPreliminary experimental study using a rabbit spondylitis model.PurposeTo observe the ossification in a micro-environment containing live Mycobacterium tuberculosis transplanted with bone marrow stromal cells (BMSCs) in rabbits.Overview of LiteratureBMSCs differentiate to osteoblasts and then osteocytes during ossification. Mycobacterium tuberculosis does not affect BMSC growth in vitro.MethodsSix rabbits were divided into two groups of three rabbits. One group was positive for spondylitis tuberculosis by culture, polymerase chain reaction (PCR), and histopathologically. The other group was positive by PCR and histopathologically. Both groups were treated using BMSC transplantation and anti-tuberculosis drugs. After 6 weeks, ossification was evaluated by enumerating the number of osteoblasts, osteocytes, and lesion level of calcium.ResultsMean number of osteoblasts was 207.00±31.00 in the first group and 220.33±73.46 in the second group. Mean number of intra-lesions osteocytes was in the first and second group was 18.33±30.04 and 31.00±26.87, respectively. Mean calcium level in the first group and second group was 2.94%±0.89% and 2.51%±0.13%, respectively. Total ossification score in the first and second group was 31.00 and 25.67, respectively.ConclusionsMycobacterium tuberculosis provides support for new bone formation by stimulating intra-lesion calcium metabolism. The microscopic environment containing live Mycobacterium tuberculosis enhances ossification

Optimization Correction Strength Using Contra Bending Technique without Anterior Release Procedure to Achieve Maximum Correction on Severe Adult Idiopathic Scoliosis

Adult scoliosis is defined as a spinal deformity in a skeletally mature patient with a Cobb angle of more than 10 degrees in the coronal plain. Posterior-only approach with rod and screw corrective manipulation to add strength of contra bending manipulation has correction achievement similar to that obtained by conventional combined anterior release and posterior approach. It also avoids the complications related to the thoracic approach. We reported a case of 25-year-old male adult idiopathic scoliosis with double curve. It consists of main thoracic curve of 150 degrees and lumbar curve of 89 degrees. His curve underwent direct contra bending posterior approach using rod and screw corrective manipulation technique to achieve optimal correction. After surgery the main thoracic Cobb angle becomes 83 degrees and lumbar Cobb angle becomes 40 degrees, with 5 days length of stay and less than 800 mL blood loss during surgery. There is no complaint at two months after surgery; he has already come back to normal activity with good functional activity