Outcome of minimal invasive surgery approach for spine infection: a systematic review

The concept of minimally invasive surgery has gained increasing popularity in the last several decades, are being introduced as an alternative to limit the surgical complications while achieving best possible outcome. While minimally invasive spine surgery holds promise for lower blood loss, faster patient recovery, shorter hospital stays, and the potential to transition procedures to the ambulatory setting, safety in spinal surgery remains paramount and has (appropriately) tempered some of the enthusiasm for the results of aggressive early adapters. Until now, there has been no literature summarizing the evidence of MIS outcome in treating spondylitis TB of the bone. The purpose of this systematic review was to investigate the outcome of minimal invasive surgery approach for spine infection. authors comprehensively searched PubMed, EMBASE, and Cochrane Library to search for studies about minimally invasive surgery as management of tuberculous spondylitis up to June 7th, 2019. The selection of appropriate studies was performed by independent investigators based on PRISMA guideline. Given the limited number of studies, there was no restriction in terms of patient’s demographics, the specific minimal invasive surgical method, and publication status. Authors identified the method for minimally invasive approach and open approach, the functional outcome, intraoperative outcome, radiological outcome, length of stay, follow up period, and complication. Authors found 81 articles from database. After evaluating full text, 8 articles (346 patients) were found to be eligible. More than 110 patients were treated with open spine surgery, while more than 270 patients were treated using minimally invasive spine surgery the minimal invasive methods were posterior pedicle screws fixation, plate fixation, lateral nail bar fixation, and bilateral pedicle screw fixation. The visualization methods include C-arm fluoroscopy, X-ray fluoroscopy. The follow-up period ranges from 1 to 40 months. The functional outcome were found to be satisfying with minimal complications. MIS yielded satisfactory result in comparison to conventional open surgery for spine infection. More long term future studies should be conducted to in order to search for more solid evidence regarding this claim

Analysis Of Efficiency Of Technical And Factors Affecting In Aromatic Rice Farming In The Seluma Regency

The research objective is to determine the level of technical efficiency and the factors that influence the level of technical inefficiency, to analyze the relationship between input and output in the production process of aromatic rice farming in Seluma regency.Total number of respondents were 73 farmers who planted Aromatic rice. The Cobb Douglass of Frontier Stochastic approach was used, whereas for the factors that influence the inefficiency function as the initial answer of the above analysis results of the production function parameter were obtained through the Maximum Likelihood Estimation (MLE), with an LR value of 14.3620 which was higher than t table 99% (2.39). It had a significant effect on the 99% confidence level. It was seem that, there was no meaning that all aromatic rice farmers in the regency were 100% efficient. It could be seen that the MLE log-likelihood value of 29.9157 was higher than the OLS log-likelihood value of 22.7347. The lowest technical efficiency value was achieved by the farmers by 0.55 and the highest by 0.97.  In the research area, the majority of the use of production factors was efficient, from 73.34% already in the value of efficiency between 0.90-1.00, meaning that 73.34% had approached the maximum efficiency. The result of the disseminated coefficient (R2) of 0.277 could mean a significant effect of 27.7 percent on the inefficiency variable while the remaining 72.3 percent is influenced by other factors not included in this research variable

High expression levels of bone morphogenetic protein-2 and p-glycoprotein related with progressivity in patient with osteosarcoma

Background: Osteosarcoma progression characterized by the presence of metastasis dan local recurrence. Several studies focused on bone morphogenetic protein-2 (BMP-2) and P-glycoprotein as protein that influence the progression of osteosarcoma, which are characterized by metastasis and local recurrence.Methods: This study was a cross sectional analytic study. This study looks at the relationship level of BMP-2 and P-glycoprotein with metastasis and local recurrence in osteosarcoma. Twenty three research subjects are paraffin blocks of osteosarcoma patients and secondary data was conducted through medical records to determine metastasis and local recurrence that occurs in these patients.Results: The result showed significant correlation between BMP-2 and P-glycoprotein with metastasis and local reccurence.Conclusions: BMP-2 and P-glycoprotein positivity as determined by immunohistochemistry, was a strong correlate of more rapid disease progression. It should be taken into consideration to identify a subgroup of osteosarcoma patients with poor outcome at the time of diagnosis. So it might be an important marker in planning innovative chemotherapeutic regimens

Vascular Endothelial Growth Factor (VEGF) on rabbit meniscus injury in the white-white zone expressed higher blood vessels distribution and type 1 collagen bridging post meniscal suturing

Background: Meniscus injury can occur in red - red zone with good prognostic as well as in white - white zone with bad one. General treatment of meniscus injury in white – white is menisectomy. It will destroy the articular surface of the knee joint cartilage. Administration the Vascular Endothelial Growth Factor (VEGF) will increase the proliferation of endothelial cells, fibroblast cells, collagen fibers type 1, and good prognostic for the healing of meniscus injury in white – white zone. Aim: The study aims to explore the effect of VEGF on rabbit meniscus injury. Methods: This research implemented an experimental study with randomized post-test control group design which used 38 male New Zealand Rabbits. There were two groups (18 rabbits as a control group and 18 rabbits as treatment one). They were adapted for one week, then control group had a sharp incision and sutured in white – white zone meniscus only, and treatment group had administration VEGF after done a sharp incision and sutured in white – white zone meniscus. In the next three weeks, all rabbits have been euthanized and then examined the meniscus for the expression of blood vessels distribution and the bridging of collagen type 1 by histopathology and immunohistochemistry examination. Results: The average median number for blood vessels distribution after administration VEGF in the sutured white-white zone was about 11.00 (interquartile range 2.00) and without VEGF was about 5.00 (interquartile range 1.00). In the treatment group with VEGF, 18 rabbits (100%) showed bridging collagen type 1, and the control one showed in 6 rabbits (33.33%). An inferential test for blood vessels distribution in white – white zone meniscus between treatment group with VEGF and control group without VEGF was significantly different (p=0.000). Analysis for bridging collagen type 1 between treatment group with VEGF and control group without VEGF showed significant differences (p=0.000). Conclusion: Administration VEGF on rabbit meniscus injury in the post suturing white-white zone expressed higher blood vessels distribution and bridging collagen type 1 compared with suturing only without VEGF. </p

Kajian Pemilihan Metode Distribusi LNG ke Pembangkit Listrik Tenaga Gas Bintuni

Kementerian Energi dan Sumber Daya alam melalui surat menteri No. 4112/13/MEM.M/2014 memberikan alokasi gas alam sebanyak 20 MMSCFD dari Kilang Liquefied Natural Gas (LNG) Tangguh untuk kelistrikan wilayah Papua. Gas alam akan dibawa ke beberapa lokasi pembangkit di Wilayah Papua, dengan prioritas bintuni sebagai tujuan distribusi LNG tersebut. Pembangkit listrik di bintuni memiliki keluaran daya sebesar 15 MW, dan berada di daerah hulu sungai dengan kedalaman maksimal ± 5 meter pada kondisi pasang. Pada kajian ini akan dilakukan pemilihan metode distribusi gas alam menuju bintuni dengan menggunakan metode Multi Criterion Decision Making (MCDM) dengan Analytical Hirearchy Process (AHP). Selanjutnya dilakukan perancangan desain teknis untuk terminal penerima di Bintuni berdasarkan peraturan yang dikeluarkan National Fire Protection Association (NFPA) edisi 59A mengenai Standard For The Production, Storage, And Handling Of Liquefied Natural Gas. Berdasarkan hasil pemilihan AHP dengan bantuan perangkat lunak Expertchoice Ver.11.0 menunjukan alternatif penggunaan LCT/Barge untuk distribusi LNG dari sumber LNG lebih unggul dibandingkan alternatif pipa gas bawah laut dan kabel transmisi

CHARACTERIZATION OF GLYCOCUNJUGATE DISTRIBUTION IN THE EPIDIDYMIS OF THE JAVAN MUNTJACS (Muntiacus muntjak muntjak)

The presence of glycoconjugates in caput, corpus, and cauda epididymis of the Javan muntjacs was performed using lectin histochemical method. The epididymis organs were obtained from two adult male Javan muntjacs in hard antler stage and then immediately fixed in Bouin’s solution and processed in histological manner. Six types of biotinylated lectins namely Peanut agglutinin (PNA), Soybean agglutinin (SBA), Wheat germ agglutinin (WGA), Ricinus communis agglutinin (RCA), Concanavalin A (Con A), and Ulex europaeus agglutinin I (UEA I) were applied to detect the specific glycoconjugates in the epididymal tissue of muntjacs. The result showed the presence of glycoconjugates were detected by five types of lectins except UEA I in caput, corpus, and cauda epididymis with specific distribution and also the intensity of lectins binding. Glycoconjugates β-galactose, β-glucose, mannose, N-acetyl-galactosamine, N-acetyl-glucosamine, and sialic acid were stained with various intensity in epithelial cells, basal cells, stereocilia, spermatozoa, and stroma of caput, corpus, and cauda epididymis. The presence of sialic acid on the surface of spermatozoa detected by WGA are thought to be play a role on sperm protection during their maturation and transit along epididymal lumen. In conclusion, the difference of glycoconjugates distribution pattern and lectin binding in the epididymal caput, corpus, and cauda of the Javan muntjac indicates the regional differences in epididymal function in spermatozoa maturation

STUDI HISTOKIMIA LEKTIN PADA SEL-SEL SPERMATOGENIK TESTIS MUNCAK (Muntiacus muntjak muntjak) (Lectin Histochemical Study of Testicular Spermatogenic Cells in Muntjak (Muntiacus muntjak muntjak))

The objective of this study was to identify the type of specific glycoconjugates and its distribution in testicular spermatogenic cells in muntjak (Muntiacus muntjak muntjak) based on lectins histochemistry. An adult male muntjak aged 4-5 years old in hard antler period was used in this study. Testicular tissue was fixed in Bouin solution and processed histologically. Histochemistry method was performed using six types biotinylated lectins such as peanut agglutinin (PNA), soybean agglutinin (SBA), wheat germ agglutinin (WGA), ricinus communis agglutinin (RCA), concanavalin A (Con A), and ulex europaeus agglutinin I (UEA I) with 20 µg/ml of concentration for PNA lectins and 15µg/ml for other type of lectins. The results showed that glycoconjugates were detected by all type of lectins except UEA I in testicular spermatogenic cells with variation in distribution pattern and also the intensity of lectins binding. Glycoconjugates β-galactose, β-glucose, mannose, Nacetylgalactosamine, N-acetylglucosamine and sialic acid were stained intensely by lectins in golgy-cap phase and acrosomal phase of spermatids. Glycoconjugate N-acetylgalactosamine was the sugar residues which distributed abundantly that marked by positive reaction with PNA, SBA, and RCA lectins. In conclusion, glycoconjugates are detected in testicular spermatids cells of muntjak indicated that glycoconjugates have an important role in spermatogenesis particularly in spermiogenesis. Key words: glycoconjugates, lectins, spermatid, spermatozoa, muntja

Pemanfaatan limbah padat keramik sebagai alternatif pengembangan bahan penguat pada struktur bodi gerabah

Keramik sebagai produk budaya yang telah diwarisi secara turun menurun, senantiasa berkembang seiring dengan perkembangan masyarakat beserta nilai-nilainya yang semakin dinamis. Perajin atau pengusaha di Bali (Kabupaten Badung, Tabanan, Denpasar dan Gianyar), kondisi kini pada perusahaan keramik modern dan kerajinan gerabah tradisional banyak memproduksi barang keperluan sehari-hari, wisata dan upacara. Kebutuhan produk upacara dianggap perajin tradisional mempunyai pangsa pasar jelas dan memang dibutuhkan untuk upacara ummat Hindu berbahan dari tanah liat (gerabah) tidak tergantikan yang dimungkinkan dipecahkan. Industri keramik atau gerabah perlu ditangani mulai dari proses pengolahan bahan, pembentukan, pembakaran dan sampai produk jadi. Mengingat jenis bahan baku keramik bervariasi dan terdiri beberapa jenis bahan, diantaranya ada yang beracun dan dapat menyebabkan penyakit bila termakan atau terhirup. Pekerja keramik atau perajin gerabah yang setiap hari berhadapan dengan debu dan silika halus berhati-hati atau waspada bisa terserang silikosis. Kebutuhan akan barang keramik semakin meningkat, sudah tentu menguntungkan bagi produsen, namun dalam proses pembuatan produk, pasti ada barang yang gagal produksi (3 – 5 %) dan tidak bisa dipasarkan menjadi barang buangan serta menumpuk menjadi limbah. Dengan fenomena tersebut, peneliti amati dan berupaya memanfaatkan barang buangan atau limbah menjadi bahan bermanfaat. Penelitian ini mengidentifikasi permasalahan mengangkat cara pemanfaatan bahan buangan keramik atau limbah gerabah sebagai bahan pengisi atau penguat pada campuran adonan bahan baku bodi untuk pembuatan produk kerajinan tanah liat bakaran rendah (gerabah). Berdasarkan hasil metode percobaan (eksperimen), diperoleh data bahwa pengaruh pencampuran serbuk limbah keramik bersifat normal dan layak sebagai bahan pengisi, dapat menguragi susut dan sebagai penguat bodi keramik saat dibakar, tentunya bisa juga untuk mengatasi lingkungan. Perlakuan suhu bakar 900°C dengan 1000°C, ternyata ada perbedaan, yaitu rerata suhu bakar 900°C susut bakar mencapai angka 1,03 %; dan peresapan air 16,21 %; serta penampakan visual bertekstur, batangan lurus, berpori, berwarna merah bata dan semu kepucat serta suaranya seperti bengkak. Pada suhu 1000°C susut bakar mencapai 1,21 % dan peresapan air sebesar 16,11 % kondisi bertekstur halus, lurus, berpori, berwarna merah bata pucat dengan suara bengkak. Akibat perlakuan suhu pembakaran berbeda, diketahui sifat-sifat bahan body keramik jenis gerabah yaitu semakin tinggi suhu bakarnya semakin besar pula susut atau pengkerutannya. Demikian pula peresapan air (PA), yang berkaitan dengan keporian body dan kepadatannya. Logikanya semakin panas semakin tinggi susutnya dan semakin kecil ruang keporiannya sehingga semakin kecil daya serap airnya. Cara ini menguntungkan perajin secara ekonomis, karena bahannya campuran tidak lagi membeli dan hanya memanfaatkan limbah atau bahan buangan yang tersedia saja. Juga dapat memberi wawasan keilmuan tentang ilmu bahan keramik. Disarankan, tanah liat yang dicampur bahan limbah keramik atau gerabah , bila dibentuk dengan teknik putar harus berhati-hati karena terasa ditangan seperti amplas, untuk pencegahan gunakan alat pelindung dari plastik atau kain atau kulit. Juga disarankan penggunaan campuran serbuk bahan limbah keramik ini cocok untuk produk seni kreatif karena bertekstur, baik dibentuk langsung dengan dipijat-pijat maupun menggunakan alat terim atau alat cetak. Hasil penelitian ini, selanjutnya akan diterapkan secara khusus ke dalam bentuk desain produk kerajinan keramik yang disempurnakan (baru) dengan memanfaatkan campuran serbuk limbah gerabah pada beberapa perajin, sebagai lanjutan usulan tahun ke dua dengan cara pendampingan perajin dan akan ditampilkan dalam pameran kerajinan. Kata Kunci: Limbah padat keramik, Bahan pengisi, Gerabah, Kerami

Ascorbic acid irrigation during debridement decreased the colony count of Staphylococcus aureus and interleukin-6 blood count in grade ii open fracture of long bones

Background: Infection in open fractures is still a problem that cannot be fully managed. Various types of studies have been conducted to find an effective and efficient solution to wash open fracture wounds. This study compared the effectiveness of ascorbic acid irrigation in reduction of Staphylococcus aureus colony and interleukin-6 (IL-6) serum level as systemic inflammation marker in debridement procedure of grade II Gustilo-Anderson open fracture of long bones.Methods: This study was an experimental study with pre-post-test control group design. This study included 24 subjects aged 15-75 years old with Gustillo-Anderson type II open fractures which were divided into two groups. The treatment group had additional irrigation by using 10 mg/ml ascorbic acid solution during debridement, whereas the control group had debridement only without irrigation with ascorbic acid. The culture and colony count of Staphylococcus aureus and IL-6 serum level was obtained and measured before and after the treatment in both groups. Statistical analysis (Wilcoxon test) was performed to compare the difference of the two parameters (Δ colony count and Δ IL-6) before and after the treatment.Results: There were no significant difference in Δ colony count of Staphylococcus aureus (p=0.308) and ΔIL-6 serum level (p=0.239) between the control group and treatment group.Conclusions: Ascorbic acid irrigation was not proved to decrease the colony count of Staphylococcus aureus and IL-6 serum level in grade II open fracture of long bones