Tono Djuwantono
Grup Peneliti Sel Punca, Unit Penelitian Kesehatan, Fakultas Kedokteran Universitas Padjadjaran

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Akt–the Mammalian Target of Rapamycin (mTOR) Pathway Inhibition Increases Cervical Cancer Cell Chemosensitivity to Active Form of Irinotecan (SN-38) Septiani, Leri; Hidayat, Yudi Mulyana; Effendi, Yusuf Sulaeman; Djuwantono, Tono; Luftimas, Dimas Erlangga; Faried, Ahmad
International Journal of Integrated Health Sciences Vol 1, No 1 (2013)
Publisher : International Journal of Integrated Health Sciences

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Objective: To investigate the molecular pathway of the cytotoxic effect of SN-38 in human cervical cancer cell lines.Methods: Two human cervical cancer cell lines were treated with various concentrations of irinotecan for 24–72 hours and the sensitivity was analysed using the MTT assay. Apoptosis was further observed through microscopic examinations. The protein expression was determined using Western blot analysis.  Results: CaSki cells demonstrated the highest sensitivity to SN-38, whereas HeLa cells showed the lowest. In cervical cancer cells, SN-38 induced apoptosis through an intrinsic- and extrinsic-pathways. In addition, we showed that SN-38 downregulated the phosphorylation of Akt-mTOR pathways in CaSki cells, but not in HeLa cells. Interestingly, in HeLa cells, which were more suggestive of a resistant phenotype, pre-treatment with LY294002 and rapamycin inhibited activation of Akt-mTOR signaling and significantly enhanced the sensitivity of HeLa cells to SN-38. Conclusions: Irinotecan exerts its anti-neoplastic effects on cervical cancer cells by inducing apoptosis through caspase-cascade. Inhibition of Akt-mTOR, LY294002 and rapamycin, which is targeted to Akt-mTOR pathways, may sensitize irinotecan-resistant cervical cancer cells.Keywords: Akt-mTOR pathways anti-neoplastic drugs, cervix cancer cells, LY294002, rapamycin DOI: 10.15850/ijihs.v1n1.103
MODIFIKASI METODE ISOLASI SEL ENDOTEL PEMBULUH DARAH OTAK (EPDO) TIKUS: TEKNIK DASAR KULTUR SEL PRIMER DI BIDANG NEUROSAINS Faried, Ahmad; Zafrullah Arifin, Muhammad; Sutiono, Agung Budi; Halim, Danny; Djuwantono, Tono; Achmad, Tri Hanggono
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Metode konvensional isolasi sel endotel pembuluh darah otak (EPDO) masih tergolong sulit, sehingga upaya mendapatkan populasi murni sel ini adalah tantangan. Pada penelitian ini dilakukan isolasi endotel dari tikus Wistar dan mencit C57/Bl6, berdasarkan protokol the care and use of laboratory animals, Universitas Gunma, Jepang. Modifikasi metode isolasi adalah menggunakan gradasi bovine serum albumin (BSA), bukan Dextran-70 yang umumnya dipakai, untuk memisahkan sel EPDO yang bersatu menjadi sel EPDO tunggal. Penelitian ini dilakukan di laboratorium sel kultur, Universitas Padjadjaran bekerjasama dengan Universitas Gunma, Jepang, Januari 2008?Juni 2009. Uji hasil isolasi dan karakteristik sel EPDO dilakukan dengan teknik imunofloresen. Ekspresi tight junction ZO-1, menunjukkan sel EPDO membentuk selapis sel utuh, rapat, tidak bertumpuk dan kompak, sesuai dengan karakteristik dinding EPDO. Fenotip sel EPDO dikonfirmasi dengan acethylated LDL, faktor von Willebrand dan CD31. Penghancuran kapiler dengan collagenase/dispase masih menghasilkan populasi sel yang terkontaminasi perisit. Kontaminasi dimurnikan dengan menggunakan puromycin, tingkat pemurnian sel EPDO mencapai 98,3%. Simpulan, teknik modifikasi berhasil mengisolasi sel EPDO tikus dan mencit, tanpa melakukan intervensi genetik. Puromycin dapat digunakan untuk memurnikan sel EPDO. [MKB. 2010;42(4):161?8].Kata kunci: Metode modifikasi isolasi sel EPDO, pembuluh sawar otak, teknik pemurnian Isolation Modified-Method of Mouse-Brain Microvessel Endothelial Cells: Primary Cell Culture Technique in NeuroscienceIsolation method to obtain pure BMVECs is hard to be done consistently and remains a challenge. In this study, we isolated BMVECs from Wistar rat and C57/Bl6 mouse from Japan SLC. All procedures performed according to guidelines for the care and use of laboratory animals of Gunma University, Japan. The modification of isolation method was using bovine serum albumin (BSA) gradation, not Dextran-70 in which generally used, to separate clusters of BMVECs into single cell. This study was done at Universitas Padjadjaran, in colaboration with Gunma University, Japan, January 2008?June 2009. Further,characteristic and purification results were proven by imunofluorescene staining. The results showed that staining of tight junction, ZO-1, formed a monolayer, tightly packed, non-overlapping and contact-inhibited BMVECs, as expected for a vessel wall endothelial. ECs phenotype confirmed by acethylated LDL, von Willebrand and CD31. The digestion of capillaries generated contaminating pericytes. Contamination was purified using puromycin and the results considered satisfactory (98.3%). In conclusion, our modification procedure allows the isolation of primary rat and mouse BMVECs, which form an endothelial-like monolayer in few days. Puromycin can be used for purification of primary rat and mouse BMVECs. [MKB. 2010;42(4):161?8].Key words: Blood brain barrier, isolation modified-method of mouse-BMVECs, purification methods DOI: http://dx.doi.org/10.15395/mkb.v42n4.30
Cancer Stem Cell: Target Baru Obat Antikanker HALIM, DANNY; DJUWANTONO, TONO; AHMAD, TRI HANGGONO
Indonesian Journal of Cancer Vol 4, No 3 (2010): Jul - Sep 2010
Publisher : "Dharmais" Cancer Center Hospital

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Relaps, resistance and metastasis has become prominent problems that oncologists and cancer patients have to dealt with. Various studies have been done previously concluded that there are a subpopulation of cancer cells, identified as cancer stem cell, most likely to be the cause of relaps, resistance and metastasis of cancer. Cancer stem cell is a subpopulation of cancer cells that possess tumorigenicity, hence it can initiate the growth of tumor. Cancer stem cell has been suspected to be originated from normal stem cells reside in mature tissues, or from progenitor cells that gone through some series of alterations on its characteristics, including mutagenic and non-mutagenic changes. As seen in normal stem cells, cancer stem cell is also oftenly found in its inactive state. Therefore, cancer stem cell is not affected when it treated with many chemotherapeutic agents that are targeting cancer cells that proliferate extensively. Eventually, this event leads to the incidence of cancer relaps on cancer patients who already had series of cancer therapy. Based on this knowledge, it can be concluded that the only absolute way to overcome the incidence of metastasis, resistance and relaps on cancer patients, is to targeting cancer stem cell. Therefore, optimization on protocols of cancer stem cell identification and isolation strived continously. Some molecular markers that are oftenly used as a standard on cancer stem cell isolation are CD34, CD44 and CD133. In line with that, isolation methods that are based on sphere formation and the absorption of coloring dye could also be done to obtain cancer stem cell population. This review article would like to explain the nature of cancer stem cell existence, the pathology underlies its formation, characteristics and identification techniques that are commonly used, and challenges that have to be faced by scientists and physicians in order to optimize the application of cancer stem cell theory for the progress of science and patients’ sake.
Effect of Lycopene on Peritoneal Fluid Malondialdehyde Level in Endometriosis Astarto, Nanang W.; Djuwantono, Tono; Yelliantty, .
Journal of Medicine and Health Vol 1, No 1 (2015)
Publisher : Maranatha Christian University

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Oxidative stress is a factor that contribute in pathogenesis of endometriosis. This condition could also implicated in infertility. Lycopene is a carotenoid that has antioxidant activity. Supplementation of lycopene can reduce oxidative stress in peritoneal fluid of women with endometriosis. This study aims to compare the effect of lycopene on malondialdehyde (MDA) levels in peritoneal fluid of women with endometriosis. It is an experimental study on peritoneal fluid from five women with endometriosis. The result show that lycopene supplementation affecting the MDA levels in peritoneal fluid. MDA levels in peritoneal fluid with lycopene is lower than without lycopene. It conclude that lycopene is proved lowering MDA levels in peritoneal fluid of women with endometriosis. Keywords: endometriosis lycopene, malondialdehyde
Effect of Lycopene on Peritoneal Fluid Malondialdehyde Level in Endometriosis Astarto, Nanang W.; Djuwantono, Tono; Yelliantty, .
Journal of Medicine and Health Vol 1 No 1 (2015)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (205.562 KB) | DOI: 10.28932/jmh.v1i1.501

Abstract

Oxidative stress is a factor that contribute in pathogenesis of endometriosis. This condition could also implicated in infertility. Lycopene is a carotenoid that has antioxidant activity. Supplementation of lycopene can reduce oxidative stress in peritoneal fluid of women with endometriosis. This study aims to compare the effect of lycopene on malondialdehyde (MDA) levels in peritoneal fluid of women with endometriosis. It is an experimental study on peritoneal fluid from five women with endometriosis. The result show that lycopene supplementation affecting the MDA levels in peritoneal fluid. MDA levels in peritoneal fluid with lycopene is lower than without lycopene. It conclude that lycopene is proved lowering MDA levels in peritoneal fluid of women with endometriosis. Keywords: endometriosis lycopene, malondialdehyde
Analisis Faktor yang Memengaruhi Keberhasilan Kehamilan pada Inseminasi Intrauterin Rachmiawaty, Angghea; Djuwantono, Tono; Sasotya, R. M. Sonny
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 1 Maret 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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AbstrakTujuan: Inseminasi intrauterin (IIU) merupakan prosedur yang umum digunakan dan menjadi pilihan terapi pertama dalam tatalaksana infertilitas, karena dampak risiko yang rendah, implementasi yang mudah, dan harga yang murah. Metode: Penelitian cross-sectional ini dilakukan pada seluruh pasangan yang melakukan prosedur IIU di Poliklinik Aster Rumah Sakit dr. Hasan Sadikin Bandung pada periode 1 Januari 2016 sampai dengan 31 Desember 2016, yang tercatat dalam rekam medik. Variabel penelitian berupa Umur Istri, Umur Suami, Jumlah Sperma, Konsentrasi Sperma, dan Motilitas Sperma, Ketebalan Endometrium, Jumlah Folikel preovulasi, Jenis Stimulasi dan Output. Data dikelola dengan SPSS 24.00. Hasilnya disajikan secara analitik melalui angka dan tabel.Hasil: Diantara 159 pasangan yang melakukan prosedur IIU, terdapat 194 prosedur. Namun hanya 98 subjek yang dapat dievaluasi. Angka kehamilan sebesar 23.5%. Faktor yang mempengaruhi hanya jenis stimulasi ovarium dan jumlah ovum preovulasi yang berhubungan secara signifikan dengan angka kehamilan (p<0,05), umur pasangan, jumlah, konsentrasi, dan motilitas sperma tidak berbeda bermakna.Kesimpulan: Berbagai variabel mempengaruhi keberhasilan dari IIU. Jenis stimulasi ovarium dan jumlah ovum preovulasi berhubungan secara signifikan dengan angka kehamilan (p<0,05). Kata kunci: Inseminasi intrauterin, infertilitas, stimulasi ovariumFactors Analizyng of Influencing for Succeses Pregnancy Rate on Intrauterina InseminationAbstractObjective: intrauterine insemination (IUI) is a procedure widely used in fertility management. However, the effectiveness of IUI treatment is not consistent, and the role of multiple factor affecting successes in IUI has not been clarified.Methods: Cross sectional study was conducted on infertile couples performing IUI. Data from medical record at Aster Clinique Dr. Hasan Sadikin General Hospital at January 1st- December 12th, 2016. Spouse Ages, Sperm Count, Concentration, and Motility, Endometrial Thickness, Number of Preovulatory Follicles, Type of Stimulation and Output are research variables. Data was analyzed by SPSS 24.00. Results: Among 159 couples, there were 194 procedures of IUI. Only 98 subject was evaluated. The pregnancy rate was 23.5%. Only type of ovarian stimulation and number of  preovulatory follicle related significantly  to the pregnancy rate (p < 0.05), spouse age, sperm count, concentration and motility, endometrial thickness did not significantly related to the pregnancy rate (p>0,05)Conclusion: There were many variables may influence success rates of IUI. Type of ovarian stimulation and number of  preovulatory follicle related significantly  to the pregnancy rate (p<0.05). More cohort trials and randomized trials investigating the multiple factors affecting successes in IUI are urgently needed.Keywords: Intrauterine insemination, infertility, ovarian stimulation
Embryo Quality: The Most Critical Factor for Pregnancy Rates after day-2, day-3, and day-5 of Embryo Transfer Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 34, No. 4, October 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: To determine the most critical factor on day-2, day-3, and day-5 of embryo transfer in correlation with pregnancy rates. Method: This research is a retrospective study in Aster Fertility Clinic, IVF program- Dr. Hasan Sadikin Hospital, Bandung, Indonesia. One hundred ninety five women enrolled in an IVF program conducted from March 2006 through November 2009 at the Aster Fertility Clinic. Effect of embryo-transfer day and any other factors (including quality of embryo, oocyte quantity, difficulty of embryo transfer technique, and blood or mucus contamination on the catheter) on pregnancy rate in IVF. Results: The mean age of the pregnant group was 34.65 (SD = 3.91), and the mean of the infertility period was 7.25 years (SD = 3.54). There were no siginificant differences in pregnancy rates in the day-2, day-3, and day-5 groups. The most critical factor influencing pregnancy was the total score for the quality of embryos [p = 0.001; OR (CI 95%) = 1.94 (0.91 - 4.08)]. Otherwise, the day of embryo transfer, oocyte quantity, and difficulties in embryo transfer did not affect the pregnancy rate (p > 0.05). Conclusion: Our study suggests that the total score for the quality of the embryos was the most critical factor for the success rate of pregnancy rather than the day of embryo transfer, oocyte quantity, difficulty of embryo transfer technique, or contamination of blood and mucus on the catheter. [Indones J Obstet Gynecol 2010; 34-4: 175-9] Keywords: day of embryo transfer, in vitro fertilization, quality of embryo total score, oocytes quantity, catheter contamination
Knowledge and attitude of pregnant woman toward umbilical-cord-blood collection Djuwantono, Tono
Indonesian Journal of Obstetrics and Gynecology Volume. 34. No. 2, April 2010
Publisher : Indonesian Socety of Obstetrics and Gynecology

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Objective: Stem cell technology from umbilical cord blood (UCB) has developed fast as health services. UCB could be used in many kinds of disease. Private UCB bank has been operated in many places all over Indonesia. There’s a need for research to evaluate the knowledge and attitude of pregnant woman towards the act of collecting UCB. Method: This is a cross-sectional study base on question-naire given to 163 pregnant women in three private hospitals in the Bandung City from September - November 2009. The result was analyzed with Rank-spearman correlation and Kruskal-Wallis chisquare. Result: Most respondent were 20 - 29 years old pregnant women (54.6%), with educational level of strata-1 (S-1) (41.1%), with monthly income within 5 - 10 million rupiah (35.6%). This is the second pregnancy or more (42.9%), with gestational age less than 24 weeks (61.3%) and variative obstetric history (59.5%). The average level of knowledge was poor and attitude scale was uncertain (3.4). There is a significant correlation between age (p = 0.008%; CI 95%), level of education (p = 0.0001; CI 95%) and knowledge. There is a significant correlation between gestational age and attitude (p = 0.003; CI 95%). Respondent’s level of knowledge also has a significant correlation with attitude (τs = 0.421; p = 0.0001; CI 95%). Conclusion: This study described the respondent’s poor knowledge will influence their attitudes toward UCB collection, so it is necessary for disseminating more information on UCB as an effort to get better research result on UCB. [Indones J Obstet Gynecol 2010; 34-2: 97-100] Keywords: knowledge level, attitudes, collecting UCB, pregnant woman, the Bandung city
Perbedaan Morfologi dan Fragmentasi DNA Sperma sebelum dan sesudah Kriopreservasi dengan Metode Slow Cooling di Klinik Aster RSUP Dr. Hasan Sadikin Bandung Caropeboka, Faizal Arif; Djuwantono, Tono; Tjahyadi, Dian; Effendi, Jusuf Sulaeman; Anwar, Anita Deborah; Siddiq, Amillia
Indonesian Journal of Obstetrics & Gynecology Science Volume 1 Nomor 2 September 2018
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

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AbstrakTujuan: Penelitian ini bertujuan untuk mengetahui perbedaan parameter fragmentasi DNA, morfologi sperma pasca proses pembekuan dengan metode slow cooling. Metode: Penelitian ini merupakan penelitian obervasional analitik dengan pendekatan pre-post design. Subjek penelitian adalah sperma dengan hasil analisis yang normal sesuai dengan standar WHO (n=25). Penelitian dilakukan di Klinik Aster RSUP Dr. Hasan Sadikin Bandung pada bulan Juli hingga Agustus 2017.Hasil: Setelah proses kriopreservasi, terdapat peningkatan fragmentasi DNA tiga kali lipat (nilai p<0,05) dan terdapat penurunan jumlah morfologi normal sebesar 50% (nilai p<0,05).Kesimpulan: Terdapat penurunan kualitas sperma pasca proses kriopreservasi dengan metode slow cooling.Kata kunci: Fragmentasi DNA, morfologi, slow cooling, spermatozoaAbstractObjective: Of this study was to compare sperm quality parameters including DNA fragmentation and morphology after cryopreservation with slow-cooling method.Method: This was an analytical observational study with pre and post design. Subjects were men whose sperm analysis met the WHO criteria of being normal (n=25). The study was conducted at the Aster Clinic of Dr. Hasan Sadikin General Hospital Bandung from July to August 2017.Results: After cryopreservation, there was a three fold increase of DNA fragmentation (with p value <0.05) and a decrease in morphology 50% (with p value <0.05).Conclusion: There is a decrease in sperm quality after cryopreservation with slow-cooling method.Key words: DNA fragmentation, morphology, slow cooling, spermatozoa
Penerapan Senam Selama Hamil dan Efektifitasnya Terhadap Lama Persalinan, Robekan Perineum dan Hasil Luaran Bayi Yanuarita, Sisilia P; Djuwantono, Tono; Sedjati, Adjat; Husin, Farid; Susanto, Herman
Jurnal Pendidikan dan Pelayanan Kebidanan Indonesia (Indonesian Journal of Education and Midwifery Care Vol 3, No 2 (2016): Juni
Publisher : Program Studi Magister Kebidanan FK UNPAD

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Kurangnya latihan fisik (olahraga) dapat menjadi faktor pencetus timbulnya kecemasan dan ketidaksiapan menjalani kehamilan dan persalinan, tidak dapat beradaptasi terhadap nyeri persalinan serta meningkatkan kesulitan dalam proses persalinan dan kelahiran bayi. Seorang ibu hamil yang mengikuti senam hamil akan lebih bugar dan kuat sehingga mempermudah proses persalinan dan kelahiran bayi.Tujuan penelitian untukmenganalisis perbedaan lama persalinan, derajat robekan perineum dan derajat asfiksia antara ibu hamil yang melakukan senam hamil dan ibu hamil yang tidak melakukan senam hamil.Metode penelitian ini menggunakan metode komparatif cross sectional dan teknik sampling secara consecutive.Subjek penelitian adalah ibu hamil yang datang ke kamar bersalin RS Mayapada dan RSUD Kota Tangerang untuk melahirkan. Jumlah sampel  60 orang, terdiri dari 30 ibu hamil yang melakukan senam hamil (perlakuan) dan 30 yang tidak melakukan senam hamil (kontrol) serta memenuhi kriteria inklusi dan eksklusi. Data diolah dan diuji secara statistik menggunakan program komputerisasi, untuk melihat perbedaan antara kedua kelompok tersebut. Hasil penelitian tentang lama persalinan, didapat perbedaan bermakna antara kelompok perlakuan dan kelompok kontrol (p=0,007). Lama persalinan (kala I dan II) > 600 menitpada kelompok perlakuan 13,3% dan kelompok kontrol 43,3%. Pada robekan perineum, didapat perbedaan bermakna antara kelompok perlakuan dan kelompok kontrol (nilai p=0,000). Robekan perineum kelompok perlakuan terbanyak derajat 2 (53%) dan kelompok kontrol terbanyak derajat 3 (47%). Pada derajat asfiksia bayi; menit pertama menunjukkan perbedaan yang bermakna (nilai p=0,001). Bayi dari kelompok perlakuan terbanyak tidak mengalami asfiksia saat lahir (97%), dan bayi kelompok kontrol terbanyak tidak asfiksia (57%) tapi terdapat bayi asfiksia berat (7%).Simpulan dalam penelitian ini adalah senam hamil merupakan pelayanan prenatal efektif membawa dampak positif terhadap ibu hamil dalam menjalani proses persalinan dan kelahiran bayi, dibanding ibu hamil yang tidak melakukan senam hamil. 96,7% lama persalinan lebih singkat, 97% ibu melahirkan mengalami robekan perineum derajat 1-2 dan 97% bayi baru lahir tidak mengalami asfiksia/asfiksia ringan.