Bone Marrow Stem Cell: Sumber & Potensial Aplikasi Klinis

Antusiasme dan kontroversi seputar riset stem cell dimulai oleh dua terobosan penting di bidang ilmu kedokteran, yaitu; keberhasilan melakukan cloning pada domba (Dolly) yang dilakukan oleh Ian Wilmut dan kawan-kawan pada tahun 1997, dan keberhasilan membuat turunan stem cell embryo (Embryonic stem cell lines) oleh James Thomson pada tahun 1998. Tanpa keraguan lagi teknologi ini membuka peluang terobosan baru untuk rekayasa jaringan (tissue engineering) dan transplantasi organ. Kemampuan untuk meremajakan kembali atau bahkan menggantikan organdan jaringan tubuh manusia yang rusak telah lama menjadi impian umat manusia. Stem cell telah menunjukkan potensinya untuk membentuk semua jenis sel dan jaringan pada tubuh manusia. Penelitian-penelitian yang telah dilakukan dewasa ini dengan menggunakan stem cell dewasa maupun embrio, memberikan harapan untuk mengatasi keterbatasan yang dialami selama ini dalam menggantikan organ atau jaringan tubuh yang rusak

Tissue Bank and Tissue Engineering

Abstract Permanent damage on the tissue or organ are still a major problem and chalenge to be solved in the world of medicine. Humankind has tried to solve the problem using technologies available in their respective era since long time ago. We can read from various literature about the efforts already made to replace and consequently heal the damaged tissue or organ. Tissue or organ damage caused by war and many other causes became the main reason of the tissue bank's estabilishment in many parts of the earth. Tissue bank strife to provide safe and high quality products to be used as natural biomaterial for damaged tissue reconstruction in patients. Several processes started from procurement, processing, and finally sterilization has been done to guarantee safe and useful products for the patients in need. In line with the recent technological advancement, especially with the introduction of stem cell usage, tissue and organ reconstruction has entered a new era that will bring greater hope for patients. If the previous methods that used biomaterial only employ dead tissue in the reconstruction procedures, tissue engineering will make the combination between stem cell and biomaterial as scaffold possible, thus enabling the living tissue to be used in reconstruction. This method, albeit still in the process of research, is expected to yield better results

Use of Freeze-Dried Irradiated Bones in Orthopedic Surgery

The development of tissue banks in Indonesia began in around 1990. In 1986, the National Nuclear Energy Agency (BATAN) set up the country's first tissue bank in Jakarta, BATAN Research Tissue Bank (BRTB), and caried out research on the preservation of fresh amnion or fetal membranes by lyophilization and then by sterilization via gamma irradiation. In 1992, Dr Soetomo General hospital, Surabaya, set up a bone bank and started producing frozen bones sterilized by ethylene oxide

Biomaterials in Orthopaedics

In general knowledge, orthopaedic surgery treats the disease and injuries of musculoskeletal system including bone fractures, anomalies, degenerative disease, tumor, and infection. Significant difference in orthopaedic cases occurs between developed and developing countries. In the latter, the majority of cases are caused by injury and infection. Most surgical treatment needs the use of implants can be selected from metals, polymers and ceramics oe their combination. In Indonesia, certain type of orthopaedic implants have been produced locally but still cannot fullfill the high demand. The current technology used by local manufacturers has some limitations in production capacity and product variety mainly for complex implants like arthroplasty. Collaboration in R&D activities on orthopaedic implants is on-going between local manufacturers with universities and goverment institutions under the assistance of orthopaedic surgeons. This collaboration receives a full support from the Indonesian Goverment as it aligns with the national programme on supporting local products and the new general health insurance programme which covers every citizen of Indonesia

Fabrication and characterization of bovine hydroxyapatite-gelatin-alendronate scaffold cross-linked by glutaraldehyde for bone regeneration

Objectives Alendronate are widely used in the treatment of bone disorders characterized by inhibit osteoclast-mediated bone resorption such as Paget’s disease, fibrous dysplasia, myeloma, bone metastases and osteoporosis. In recent studies alendronate improves proliferation and differentiation of osteoblasts, thereby facilitating for bone regeneration. The disadvantages of this class are their poor bioavailability and side effects on oral and intravenous application such as stomach irritation and osteonecrosis in jaw. Thus, local treatment of alendronate is needed in order to achieve high concentration of drug. Bovine hydroxyapatite-gelatin scaffold with alendronate was studied. Glutaraldehyde was used as cross-linking agent, increase the characteristics of this scaffold. The objectives of this study were to manufacture and characterize alendronate scaffold using bovine hydroxyapatite-gelatin and crosslinked by glutaraldehyde. Methods Preparation of cross-linked bovine hydroxyapatite-gelatin and alendronate scaffold with different concentration of glutaraldehyde (0.00, 0.50, 0.75, and 1.00%). The scaffolds were characterized for compressive strength, porosity, density, swelling ratio, in vitro degradation, and cytotoxicity (the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide assay, shorted as MTT assay). Results Bovine hydroxyapatite-gelatin-alendronate scaffold cross-linked with glutaraldehyde showed lower density than without glutaraldehyde. As glutaraldehyde concentration increased, porosity also increased. Eventually, it reduced compressive strength. Swelling ratio and in vitro degradation was negatively dependent on glutaraldehyde concentration. In addition, the scaffold has a good safety by MTT assay. Conclusions Bovine hydroxyapatite-gelatin-alendronate scaffold was fabricated with various concentrations of glutaraldehyde. The presence of glutaraldehyde on bovine hydroxyapatite-gelatin-alendronate is safe and suitable candidate scaffold for bone regeneration

Terapi Stem Cell Pada Penyakit Reumatik

Stem cell, yang didefinisikan sebagai suatu sel yang mempunyai kemampuan ganda untuk memperbaharui diri dan memproduksi progenitor dan jenis-jenis berbeda dari sel terspesialisasi dalam organisme. Sebagai contoh, dalam awal kehidupan manusia, satu sel telur yang dibuahi zigot menjadi dua, dan dua menjadi empat. Dalam tahap-tahap awal ini, setiap masih mungkin menjadi totipoten yang artinya, satu organisme utuh dapat diturunkan dari setiap sel ini. FDalam 5 hingga 7 hari, sekitar 40 sel terbentuk yang menyusun massa sel dalam, dikelilingi oleh suatu lapisan sel luar yang selanjutnya membentuk plasenta. Pada tahap ini, setiap sel pada massa sel dalam mempunyai potensi untuk membentuk semua jenis jaringan dan organ termasuk sel germinal yang artinya, sel ini bersifat pluripoten

Clinical Features In Metastatic Bone Disease With And Without Pathological Fractures: A Comparative Study

Abstract Background: Pathological fracture complications such as impaired clinical features is suspected to increase the mortality in MBD. In Indonesia, the habit of delayed seeking of medical treatment was common and potentially led to pathological fracture. Aim: This study compared the clinical features between MBD with and without pathological fracture. Methods: This was a retrospective study of MBD at Dr. Soetomo General Hospital in 2011-2015. We compared the clinical features by pain in Visual Analog Scale (VAS); general health presentation represented by laboratory findings; and the history of non-medical treatments. Results: 64 patients had MBD were included in this study. 37 (57.8%) of them presented with pathological fractures, and 27 (42.2%) without. Pain was the most common chief complaint (76.5%). No significant difference found between the MBD with and without pathological fracture in all variables (p=0.122; p=0.64; p=0.823; p=0.417, p=1.000 for VAS, hemoglobin, albumin, calcium, and history of non-medical treatment respectively). This probably associated with the therapy and a variety of primary tumors underlying the MBD. However, 6 out of 10 patients with history non-medical treatment presented with fractures. Conclusion: There's no significant difference in clinical features of MBD from both groups, while those with fractures had worse conditions. Keywords: Metastatic bone disease, Pathological fracture, Clinical feature

Graft Tulang & Material Pengganti Tulang (Karaktersitik dan Strategi Aplikasi Klinis)

Sejarah graf tulang telah dimulai sejak zaman kuno, yaitu pada saat bahan-bahan yang digunakan dapat berupa kayu, metal, gading dan material lainnya. Graf tulang sebagai komponen penting ilmu kedokteran modern dimulai lebih kurang 350 tahun yang lalu. Prosedur graf tulang pertama dilakukan oleh dokter dari Belanda pada tahun 1668 yang bernama Jacob van Meekeren. Dokter tersebut melakukan graf tulang pada seorang tentara dengan cedera pada tulang kalvaria, dengan tulang yang diambil dari anjing. Prosedur berjalan sukses dan tulang dapat sembuh, tetapi sayangnya pasien dikucilkan karena memiliki bagian tubuh dari hewan