Vol. 20 No. 3, Page 110-143

January 1, 2001

The role of von Willebrand dalam sistem hemostasis

By Pusparini

on Willebrand factor was discovered by Erik A von Willebrand in 1926, among residents of the Aland Island in Finland. vWF is an essential protein in hemostasis. It is a multimeric glycoprotein with mass range from approximately 500 to more than 10,000 kDa. The mature subunit contains 2050 amino acid residues and 22 carbohydrate chains. The vWF gene consists of 180 kilobases and 52 exons. It is located at the tip of the short arm of chromosome 12 regions 12p12-12pter. The vWF synthesis is on the Weibel palade bodies in endothelial cell in a granules of platelets and megakaryocytes. There are two pathways secretion of vWF from endothelial cell, namely a constitutive pathway and regulated pathway. vWF interacts with many structure in the intracellular and extracellular matrix components. It interacts with vessel wall especially in adhesion process with platelets. Platelets have two distinct receptors for vWF; GP Ib and GP IIb-IIIa complex. The other functions, of vWF are factor VIII binding and interaction with another ligand in extracellular matrix.
Language : Indonesia

The role of sildenafil on erectile dysfunction

By Lie T Merijanti

Erectile Dysfunction (ED) is a significant and common medical problem. That can affect a man’s ego and threaten his marriage relationships. There are many options available for the pharmacological treatment of ED, but none as effective like sildenafil. Sildenafil represents a major breakthrough in the management of ED and provides an opportunity to assess men’s overall health. It is the first oral treatment for ED, with efficacy in approximately 60-70% of patients depending on the cause of their ED. Although sildenafil is easy to use and relatively lacks adverse events, but not every man can take this medicine. We must considered it before we give sildenafil to the patients, because a man who take all forms of nitrates is an absolute contraindication for sildenafil.
Language : Indonesia

Therapentic advantages of third generation anthistamines

By Fajar arifin Gunawijaya

The first antihistamines with clinically useful anti-allergic activity were introduced in the early 1940. This first generation antihistamines are among the most widely used drugs in the world and provide symptomatic relief for allergies and the common cold to millions of patients, especially in over the counter combination preparations. Their full potential is limited by the sedation caused by their effects on histamine receptors in the brain. Thirty years later the effects of histamine was separated into group of actions mediated by two distinct reseptors AH1 and AH2. Second generation antihistamines (terfenadine, astemizole, loratadine and cetirizine), which block peripheral H1 receptors without penetrating the blood brain barrier were introduced from 1981 onwards. Although largely successful in this goal, terfenadine and astemizole were found to cause potentially serious ventricular arrythmias. The third generation of antihistamines consist of fexofenadine, norastemizole and descarboethoxy loratadine are natural metabolites of the second generation drugs and possess the clinical efficacy without side-effects on cardiac electrophysiology.
Language : Indonesia

Case study : social phobia

By Ayub Sani Ibrahim

Social phobia is defined as the fear (anxiety) of being judged, critized, and evaluated by other people, with the main sympton anxiety and avoidance. The prevalence of social phobia range between 9,6% to 16% and is rank third in order after substance abuse and major depressions in the psychiatry disorders. Life is difficult for the person with social phobia because they feel they do not fit in with every one else. Little is known about the etiologi of social phobia, but reseach suggests that a complex variety component is involved. A case illustration in this paper show a woman of 32 years of age complaining of tachycardia, cold sweating, gastric pain, headache since 3 years ago. Controlled studies of monoamine oxidase inhibitors (MAOi), selective serotonin reuptake inhibitors (SSRIs), reversible monoamine oxidase inhibitors (RiMA), beta blockers and benzodiazepines demonstrated to be an effective treatment. And additional comprehensive cognitive-behavioral therapy will improve the treatment for social phobia.
Language : English

Risk factors of persistent diarrhea in children under five years of age

By Lannywati Ghani

Persistent diarrhea is still a major health problem in children. It is mentioned that the case fatality rate of persistent diarrhea in under five years of age is about 45%. A case control study was conducted to determine the risk factors for persistent diarrhea such as nutritional status, sex, fat malabsorption, lactose intolerance, stools containing mucus and blood, use of antibiotics, and anemia. Cases were children with persistent diarrhea and control groups were children with acute diarrhea. Persistent diarrhea is defined as an episode which starts acutely but which last at least 14 days. Both cases and controls were diarrhea patient who were hospitalized in the Department of Child Health Cipto Mangunkusumo Hospital from 1st of January 1996 to 31st of December 1996. There were 121 cases and 484 controls. The statistical analysis was done using univariate, bivariate and multivariate logistic regressions. The result showed that potential risk factors are undernutrition, use of antibiotics, stools containing mucus and blood , fat malabsorption, lactose intolerance, and anemia. It is very important to consider those risk factors in the management of children with acute diarrhea in order to prevent persistent diarrhea.
Language : Indonesia