AHMAD SURYAWAN, 090810566 D (2013) MEKANISME KUALITAS GENERAL MOVEMENTS BAYI PREMATUR BARU LAHIR BERDASAR PERUBAHAN KADAR HEAT SHOCK COGNATE 70 DAN HEAT SHOCK PROTEIN 70 EKSTRASELULER DI SIRKULASI. Disertasi thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Nowadays, assessment of the quality of general movements (GMs) proven to be effective as a method of early detection of developmental disorders of children. Two main structures in the developing brain which neurons and glial cells plays a critical role, cortical subplate and and its efferent motor connections in the periventricular white matter, already recognized as the putative neural substrate of normal and abnormal GMs. In the last decade, it is become clear that the Hsc70 and Hsp70 may released into extracellular compartment (eHsc70 and eHsp70) and that neurons and glial cells can take them up from blood circulation. It is provide rationale to investigate the role of circulating eHsc70 and eHsp70 in the mechanisms of the quality of GMs. This study aimed to elucidate the mechanisms of normal and abnormal quality of GMs in preterm newborn infants based on the changes of circulating eHsc70 and eHsp70 expressions. An observational and longitudinally study was performed on preterm infants. The assessment of the quality of GMs based on two observers blinded analysis, and divided into two groups, normal and abnormal GMs. The expression of eHsp70 and eHsc70 were taken from blood circulation twice longitudinally, at birth (GMs-Preterm period) and at the age of 3-6 months (GMs-Fidgety period). The ethical clearance was obtained from the Health Research Ethics Committee Dr. Soetomo Hospital. Statistical analysis using Pearson correlation test, t-test,multivariate test, with P value of <0.05 was considered significant, and followed by discriminant analysis. A total of 42 GMs videos from 21 eligible samples of preterm infants were analyzed. The Kappa’s value () of the two observers was 0.857 (excellent). In the GMs-Preterm period, the expression of eHsc70 was higher in GMs-Preterm abnormal (47.947+3.3737 ng/mL) than normal group (44.653+3.0425 ng/mL),P=0,030. There was no differences of the expression of eHsp70 in the GMs-Preterm abnormal (1.696+3.1630 ng/mL) and normal group (1.183+2.5678ng/mL), P=0.687. In the GMs-Fidgety period, there was no differences of theexpression either eHsc70 or eHsp70 in the GMs-Fidgety normal and abnormal group. Simultaneously analyzing of eHsc70+eHsp70 (eHsc/p70) showed the expression of eHsc/p70 in GMs-Fidgety normal (45.967+2.9577 ng / mL) was higher than GMs-Fidgety abnormal group (43.367+0.2810 ng / mL), P = 0.041. The conclusions, the mechanisms of GMs-Preterm could be elucidated by expression of circulating eHsc70 as indicator of necrotic neuronal death pathway,and the mechanisms of GMs-Fidgety could be elucidated by expression of circulating eHsc/p70 as indicator of neuronal survival pathway by physiological process and apoptotic neuronal death pathway.

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