The Role of VEGF and TNF-Alpha on Epithelialization of Diabetic Foot Ulcers after Hyperbaric Oxygen Therapy

BACKGROUND: Around 15-25% of diabetes mellitus (DM) patients will develop diabetic foot ulcers (DFUs) with high morbidity, many studies have been proposed to search the most effective healing techniques. AIM: This study was conducted to demonstrate the ability of hyperbaric oxygen therapy (HBOT) as a complementary therapy in DFUs healing through raising vascular endothelial growth factor (VEGF) levels and suppressing tumour necrosis factor-alpha (TNF-α). METHODS: All patients received the same treatment including wound debridement and wound care, but the patients in the HBOT group, breathed 100% oxygen at 2.4 ATA for 90 minutes in total of 20 sessions (four weeks). RESULT: There were 32 diabetic patients with DFUs Wagner 3-4. VEGF levels after four weeks of HBOT was significantly elevated compared to the control group (p = 0.013). The effect size of VEGF levels was p = 0.005. TNF-α levels after four weeks of therapy were decreased (p = 0.01). Faster epithelialization is seen in the HBOT group (p < 0.001). We also performed path analysis, HBOT had a significant effect on the epithelialization (p < 0.001) and VEGF levels affected the epithelialization process (p = 0.042). CONCLUSION: HBOT administration leads to increased VEGF levels, decreased TNF-α levels, and accelerated wound healing of DFUs patients. HBOT directly aids epithelialization and indirectly through VEGF upsurge and TNF-α downturn

Surgical feed ligation performed in 22 year old female with scalp arteriovenous malformation

Scalp arteriovenous malformation (AVM) are rare conditions that usually need surgical treatment. Its management is difficult because of its high shunt flow, complex vascular anatomy, and possible cosmetic complication. The etiology of scalp AVM may be spontaneous or traumatic. This vascular lesion present as scalp lump or a mass, grotesque, pulsatile mass with a propensity to massive haemorrhage. Various treatment option that have been adopted to treat these lesions include surgical excision, ligation of feeding vessel, trans arterial and transvenous embolization, injection of sclerosant into the nidus and electro thrombosis. A 22-years-old-female referred to cardiothoracic division with a 10 years history of a large fronto-parietal pulsatile reddish soft mass, progressively increasing in size, measuring about 15x6x2 cm, ulcerated area; without any symptoms and history of trauma. Three-dimensional CT angiography demonstrated a mass that was completely within the scalp and prominent vascular that was completely within the scalp and was not associated with bone or periosteum. The feeding arteries were originated from angular artery, supratrochlear artery, left and right superficial temporal artery. Surgical excision and ligation of feeding vessel was performed without complication. With pre-operative appropriate surgical planning, scalp AVM can be excised safely without any major complication. Though some cases may be treated with percutaneous or endovascular embolization, surgery remains the treatment of choice. In the event of scalp ulceration and haemorrhage, total excision is the only option

Karakterisasi Bakteri Asam Laktat yang Diisolasi dari Susu Kuda Bima

The aim of the research was to characterize of the six species of Lactic Acid Bacteria (LAB) indigenous (Lactobacillus acidophilus KBc, Lb. salivarius KBd, Lb. brevis KBa, Lb. delbrueckii KBe, Lb. plantarum KBb and Lactococcus lactis KBf) isolated from the fermented horse milk of Bima. The tests were done to cover safety aspect, ability to survive on low pH condition, bile salt tolerance, ability to adherence and colonization, and effect on cholesterol level reduction. The six LAB species were not pathogen and invasive, and were able to grow well on media which contained bile salt of 0.75 %. Lactobacillus  acidophilus KBc and Lb. brevis KBa had ability to survive on media pH 2.5 for 3 hours and were able to adherence and colonization on gut mucosa epithel. Lactobacillus acidophilus KBc and Lb. brevis KBa had ability to reduce cholesterol level of blood serum of rabbits on hypercholesterolemia condition significantly up to 53.74 % and 51.70 %, respectively. Based on the characterization of the six species LAB, only Lactobacillus acidophilus KBc and Lb. brevis KBa can be used as probiotic.ABSTRAKPada penelitian ini telah dilakukan karakterisasi terhadap enam spesies bakteri asam laktat  (BAL) indigenous (Lac- tobacillus acidophilus KBc, Lb. salivarius KBd, Lb. brevis KBa, Lb. delbrueckii KBe, Lb. plantarum KBb dan Lac- tococcus lactis KBf) yang diisolasi dari susu kuda liar Bima terfermentasi. Pengujian yang dilakukan meliputi aspek keamanan, ketahanan hidup pada media pH rendah, kemampuan tumbuh pada media yang mengandung garam em- pedu, kemampuan menempel dan berkolonisasi, dan efek terhadap penurunan kadar kolesterol serum darah. Keenam spesies BAL tersebut tidak patogen dan invasif, serta dapat tumbuh baik pada media yang mengandung garam empedu 0,75 %. Lactobacillus  acidophilus KBc dan Lb. brevis KBa tahan hidup pada media pH 2,5 selama 3 jam serta dapat menempel dan berkolonisasi pada epitel mukosa usus. Kedua bakteri ini mampu menurunkan kadar kolesterol serum darah kelinci dalam keadaan hiperkolesterolemia secara nyata masing-masing sebesar 53,74 % dan 51,70 %. Berdasar- kan karakterisasi keenam spesies BAL tersebut, Lb. acidophilus KBc dan Lb. brevis KBa dapat dipergunakan sebagai probiotik

LC-MS Based Metabolite Profiling of Ethanolic Extracts from Curcuma domestica Val. varieties Turina-1

It is important to know the metabolite compounds profile of Curcuma domestica Val. varieties Turina-1, as one of the superior varieties of turmeric, so that it can be utilized better. Therefore, the purpose of this research is to study the metabolite profile of ethanol extract of Curcuma domestica Val. Varieties Turina-1. The samples for this research were obtained from BPPT Bogor-Indonesia. These samples were extracted using ethanol (96 %) and then analyzed using UPLC-QToF-MS / MS System (Waters), mass spectrometry: XEVO-G2QTOF (Waters), in ESI positive resolution mode, using gradient method with mobile phase: water, formic acid and acetonitrile. The study found 13 metabolite compounds: Demethoxycurcumin-2 (48.23%), α- Turmerone (19.623%), Curcumin (18.550%), Bisdemethoxycurcumin-3 (9.064%), Curcumin-1, (1.706%), and compounds others with less than 1% (Kaempferol 3-O-glucosyl-rhamnosylgalactoside, Demethoxycurcumin, ar-Turmerone Bisdemethoxycurcumin, a-Terpinolene, LTyrosine and L-Alanine, L-serine). Based on this research, the main metabolite compound contained in the ethanol extract of Curcuma domestica Val. varieties Turina-1 that has the potential as antioxidants is the curcuminoids

OPTIMIZATION OF EXOPOLYSACCHARIDE PRODUCTION BY Lactobacillus casei AL.15

Exopolysaccharide (EPS) is one of the polysaccharides produced from microorganisms. This polysaccharide is usually produced by lactic acid bacteria and it is widely used for food products and pharmaceutical products. EPS are also very useful for stabilizers, emulsifiers, gelling agents, and have a good ability to bind liquids (water). This study aims to determine the optimization point of EPS growth, based on temperature, time, and the amount of glucose used in selective growth media of Lactobacillus casei (L. casei) AL.15, namely de Mann Rogosa Shape Broth (MRSB) media, using Response Surface Method (RSM) design to obtain optimum conditions that are more appropriate to produce EPS. Optimization of EPS production occurred at level -1; -1; 0, temperature 42 °C, incubation time 48 hours, and the addition of 10% glucose. L. casei AL.15 has a good ability to produce EPS at the temperature, time, and amount of glucose obtained. The result obtained under these conditions is 606.03 mg EPS/litre. This method can be used to produce large amounts of EPS and then these characteristics were analyzed

Retrieval of Intravascular Fractured Fragment of Tunnelled Double Lumen Catheter in Hemodialysis Patient

BACKGROUND: Intravascular fractured fragment of double lumen catheter with embolisation is a serious and rare complication. Another serious complication includes infection, thrombosis, arrhythmias, and pulmonary embolism. We report a successful surgical venous cut-down technique in the retrieval of an intravascular fractured fragment of tunnelled double lumen catheter in a hemodialysis patient. CASE REPORT: A 51-year-old female underwent hemodialysis through a tunnelled double lumen catheter and had her arterio-venous graft matured. During retrieval of tunnelled double lumen catheter procedure, the distal part of the catheter was fractured and slipped into the internal jugular vein. Chest radiograph revealed intravascular double lumen catheter extending from the distal part of the right internal jugular vein to right atrium. The procedure of foreign body retrieval was done the next day under general anaesthesia and C-Arm guidance using right internal jugular venous cut-down approach. A right-angle clamp was used to retrieve the fragment without any post-procedure complications. CONCLUSION: Intravascular fractured fragment of double lumen catheter is a dangerous situation as are all the intravascular foreign bodies. The choices of the technique for retrieval of the fractured fragment are varied. It depends on the type and site of a fractured fragment as well as the surgeon experiences

Characterization of Exopolysaccharide Produced by Lactobacillus casei AL15 Isolated from Sap of Arenga pinnata

Exopolysaccharide (EPS) is a polymer of a reducing sugar which has a high molecular weight. This polysaccharide is usually produced by lactic acid bacteria, and has a very large usability for food products and pharmaceutical products. Lactobacillus casei AL15 is a type of lactic acid bacteria isolated from sap of Arenga pinnata and has a great potential to produce EPS. Productivity in producing EPS of L. casei AL15 in MRS broth medium is about 14.1 mg/L. Furthermore, component of carbon was a highest composition of the EPS tested by SEM. The image of SEM showed that the shape of EPS were round to ellipse shape with smooth surface texture and white yellowish color. The spectrum of FTIR produced the wavenumber in the range of 3338 cm-1 – 1056 cm-1. The spectrum indicated the presence of O-H in 3338.78 cm-1, C-H in 2962.66 cm-1, C=O in 1649,14 cm-1 and C-O-C in 1056.99 cm-1. Those bonds indicated that EPS produced by L. casei AL15 was heteropolysaccharide (HePS), since the FTIR spectrum had a same spectrum with sucrose and glucose. This result was also supported by HPLC analysis, which showed that the hydrolyzed EPS was composed by sucrose and glucose. Overall results showed that L. casei EPS AL15 was HePS. Keywords: characterization, exopolysaccharide, Lactobacillus casei AL15, Arenga pinnata

Kajian Atmosfir Terkendali untuk Memperlambat Penurunan Mutu Buah Mangga Arumanis selama Penyimpanan

Arumanis Mango (Mangifera indica L. cv Arumanis) which is one of Indonesia’s tropical fruits having a high potency to be developed as an export commodity. Limited volumes of the fruit have been exported using air cargo and attempts in using sea freights with reefer containers for long distance market had not given convincing result. Therefore, efforts in optimizing the use of a reefer container are essential. Investigations, were performed in order to decelerate the deterioration fruits which involved different combined concentrations of O2 and CO2 gases during storage of Arumanis mango at cold (12+1.5oC) and room (28+2oC) temperatures. Four different combined gases of O2 and CO2, namely 5% O2 and 5 % CO2; 5% O2 and 10% CO2; 10% O2 and 5% CO2; and 10% O2 and 10% CO2 were surged surrounding the fruits stored at the cold and room temperatures. Fruits without treatments with the combined gases were prepared as kontrols. The investigation indicated that the cold temperature of storage was still the best way to slowing down the deterioration of the fruit. There were no significant different effects on the rate of deterioration among the fruits treated with the different combined concentrations of O2 and CO2. The controlled atmospheres, however, were better for storing the fruits compared to those stored without controlled atmosphere.Key words: controlled atmosphere, Arumanis, mang