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"[ABSTRAK Latar Belakang : pengukuran VPW dari modalitas foto toraks merupakanpemeriksaan yang non invasif, cepat dan mudah untuk memprediksi kondisihipervolemia. Namun belum terdapat konsensus nilai rerata VPW yang dipakaisecara global, sehingga penggunaan nilai rerata VPW dari penelitian sebelumnyaterhadap populasi diluar populasi penelitian tersebut mungkin tidak relavan. DiIndonesia khususnya di Rumah Sakit Cipto Mangunkusumo belum terdapat datadasar nilai rerata VPW.Tujuan Penelitian: Mengetahui rerata nilai VPW dewasa normal IndonesiaDesain Penelitian: Retrospektif potong lintangMetode: Pengukuran jarak antara tepi terluar arteri subklavia kiri dengan tepiterluar vena kava superior yang melewati bronkus utama kanan (VPW),pengukuran rasio VPW terhadap diameter jantung terluas dan rasio VPW terhadapdiameter terluas rongga toraks. Pengukuran dilakukan pada radiografi toraks PAdari 104 subyek normal yang terdiri dari 52 laki-laki dan 52 perempuan, dihitungrerata dan standar deviasi. Pengukuran serupa juga dilakukan pada topogram CTscan toraks (radiografi toraks AP supine) dan CT scan toraks dari 103 subyekyang terdiri dari 51 laki-laki dan 52 perempuan.Hasil: Pada pemeriksaan toraks PA didapatkan rerata VPW 48,0 mm ± 5,5 mm,rerata VPCR 40,3% ± 4,6 %, dan rerata VPTR 17,2% ± 1,7%. Pada pemeriksaantopogram CT scan didapatkan rerata VPW 50,3 mm ± 6,2 mm, rerata VPTR 45%± 5,1%, dan rerata VPTR 19,8% ± 2,5%. Rerata VPW pada CT scan toraks 50,4 ±6,1 mm. Pengukuran pada foto toraks AP sekitar 10 % lebih besar dibandingkanpada foto toraks PA, dan pengukuranVPW pada foto toraks terbukti memilikiakurasi yang tinggi.Kesimpulan: Rerata VPW pada pemeriksaan foto toraks PA tegak dewasa normalIndonesia adalah 48 ± 5,5 mm, ternyata tidak berbeda bermakna dengan rerataVPW pada populasi barat ( 48 ± 5mm). Rerata VPCR pada foto toraks PAadalah 40,3 % ± 4,6 % dan VPTR adalah 17,2 % ± 1,7 %.

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ABSTRACTBackground: Vascular pedicle width (VPW) is the distance, from a perpendicularline at the takeoff point of the left subclavian artery off the aorta to the point atwhich the superior vena cava. Measurement of VPW on chest x-ray is relativelynon-invasive, fast and easy technique as hypervolemia predictor, but nowordwide consensus has been proposed.Objective: to investigate mean vascular pedicle witdh of Indonesian adultStudy design: Retrospective cross sectionalMethods : VPW is the distance, measure in millimeters, from a perpendicular lineat the takeoff point of the left subclavian artery to the point at which the superiorvena cava crosses the right main bronchus, than calculate VPW ratio to a widesthorizontal diameter of cardiac dan thoracic wall.Results : Data from 104 PA chest x-ray of normal subjects and 103 thoracic CTscan of selected subjects. On PA chest x-ray obtained mean VPW 48,0 mm ± 5.5mm, mean VPCR 40.3% ± 4.6%, and mean VPTR 17.2% ± 1.7%. On CT scantopogram obtained mean VPW 50,3 mm ± 6.2 mm, mean VPTR 45% ± 5.1%, andmean VPTR 19.8% ± 2.5%. On thoracic CT scan obtained mean VPW 50.4 ± 6.1mm. Measurements on the AP chest x-ray about 10% greater than in the PAchest x-ray, and measurement of VPW on conventional chest x-ray aproved tohave high accuracy.Conclusions :The mean VPW on erect chest x-ray of Indonesian adult is 48 ± 5,5mm, no significant different between westerns population ( 48 ± 5mm).;Background: Vascular pedicle width (VPW) is the distance, from a perpendicularline at the takeoff point of the left subclavian artery off the aorta to the point atwhich the superior vena cava. Measurement of VPW on chest x-ray is relativelynon-invasive, fast and easy technique as hypervolemia predictor, but nowordwide consensus has been proposed.Objective: to investigate mean vascular pedicle witdh of Indonesian adultStudy design: Retrospective cross sectionalMethods : VPW is the distance, measure in millimeters, from a perpendicular lineat the takeoff point of the left subclavian artery to the point at which the superiorvena cava crosses the right main bronchus, than calculate VPW ratio to a widesthorizontal diameter of cardiac dan thoracic wall.Results : Data from 104 PA chest x-ray of normal subjects and 103 thoracic CTscan of selected subjects. On PA chest x-ray obtained mean VPW 48,0 mm ± 5.5mm, mean VPCR 40.3% ± 4.6%, and mean VPTR 17.2% ± 1.7%. On CT scantopogram obtained mean VPW 50,3 mm ± 6.2 mm, mean VPTR 45% ± 5.1%, andmean VPTR 19.8% ± 2.5%. On thoracic CT scan obtained mean VPW 50.4 ± 6.1mm. Measurements on the AP chest x-ray about 10% greater than in the PAchest x-ray, and measurement of VPW on conventional chest x-ray aproved tohave high accuracy.Conclusions :The mean VPW on erect chest x-ray of Indonesian adult is 48 ± 5,5mm, no significant different between westerns population ( 48 ± 5mm).;Background: Vascular pedicle width (VPW) is the distance, from a perpendicularline at the takeoff point of the left subclavian artery off the aorta to the point atwhich the superior vena cava. Measurement of VPW on chest x-ray is relativelynon-invasive, fast and easy technique as hypervolemia predictor, but nowordwide consensus has been proposed.Objective: to investigate mean vascular pedicle witdh of Indonesian adultStudy design: Retrospective cross sectionalMethods : VPW is the distance, measure in millimeters, from a perpendicular lineat the takeoff point of the left subclavian artery to the point at which the superiorvena cava crosses the right main bronchus, than calculate VPW ratio to a widesthorizontal diameter of cardiac dan thoracic wall.Results : Data from 104 PA chest x-ray of normal subjects and 103 thoracic CTscan of selected subjects. On PA chest x-ray obtained mean VPW 48,0 mm ± 5.5mm, mean VPCR 40.3% ± 4.6%, and mean VPTR 17.2% ± 1.7%. On CT scantopogram obtained mean VPW 50,3 mm ± 6.2 mm, mean VPTR 45% ± 5.1%, andmean VPTR 19.8% ± 2.5%. On thoracic CT scan obtained mean VPW 50.4 ± 6.1mm. Measurements on the AP chest x-ray about 10% greater than in the PAchest x-ray, and measurement of VPW on conventional chest x-ray aproved tohave high accuracy.Conclusions :The mean VPW on erect chest x-ray of Indonesian adult is 48 ± 5,5mm, no significant different between westerns population ( 48 ± 5mm)., Background: Vascular pedicle width (VPW) is the distance, from a perpendicularline at the takeoff point of the left subclavian artery off the aorta to the point atwhich the superior vena cava. Measurement of VPW on chest x-ray is relativelynon-invasive, fast and easy technique as hypervolemia predictor, but nowordwide consensus has been proposed.Objective: to investigate mean vascular pedicle witdh of Indonesian adultStudy design: Retrospective cross sectionalMethods : VPW is the distance, measure in millimeters, from a perpendicular lineat the takeoff point of the left subclavian artery to the point at which the superiorvena cava crosses the right main bronchus, than calculate VPW ratio to a widesthorizontal diameter of cardiac dan thoracic wall.Results : Data from 104 PA chest x-ray of normal subjects and 103 thoracic CTscan of selected subjects. On PA chest x-ray obtained mean VPW 48,0 mm ± 5.5mm, mean VPCR 40.3% ± 4.6%, and mean VPTR 17.2% ± 1.7%. On CT scantopogram obtained mean VPW 50,3 mm ± 6.2 mm, mean VPTR 45% ± 5.1%, andmean VPTR 19.8% ± 2.5%. On thoracic CT scan obtained mean VPW 50.4 ± 6.1mm. Measurements on the AP chest x-ray about 10% greater than in the PAchest x-ray, and measurement of VPW on conventional chest x-ray aproved tohave high accuracy.Conclusions :The mean VPW on erect chest x-ray of Indonesian adult is 48 ± 5,5mm, no significant different between westerns population ( 48 ± 5mm).]"

"ABSTRAKLatar belakang dan tujuan: Modalitas radiografi toraks merupakan pemeriksaanrutin dan tersedia di hampir setiap rumah sakit. Pengukuran secara kuantitatifberupa vascular pedicle width (VPW), cardiothoracic ratio (CTR) maupunvascular pedicle-thoracic ratio (VPTR) melalui radiografi toraks dapat membantudalam membedakan jenis edema paru dengan mengetahui titik potong rerataVPTR berdasarkan kombinasi VPW dan CTR. Metode: Penelitian dilakukan retrospektif dengan descriptive cross sectional pada100 pasien dengan klinis edema paru yang telah melakukan radiografi toraks diICU Rumah Sakit CiptoMangunkusumo (RSCM) dalam rentang waktu Januari2013 ? Desember 2015. Subjek dibagi menjadi edema kardiogenik dan nonkardiogenik berdasarkan kombinasi pengukuran VPW dan CTR. Kemudiandilakukan pengukuran VPTR dan ditentukan titik potong rerata VPTR, sensitivitasdan spesifisitas berdasarkan kombinasi VPW dan CTR dalam membedakan edemaparu.Hasil: Dari total 100 subjek penelitian di ICU RSCM dengan metode ReceiverOperating Curve (ROC) didapatkan titik potong VPTR sebesar 25,1% dengansentivitas 90,5% dan spesifisitas 86,1% dalam membedakan edema parukardiogenik dan non kardiogenik. Selain itu diperoleh juga proporsi edema parukardiogenik sebesar 21%, sedangkan edema paru non kardiogenik sebesar 79%.Kesimpulan: Titik potong VPTR berdasarkan kombinasi VPW dan CTR memilikisensitivitas dan spesifisitas yang cukup tinggi dalam membedakan edema parukardiogenik dan non kardiogenik.

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ABSTRACTBackground and purpose: Pulmonary edema in critically ill patient werechallenging in intensive care unit (ICU). Radiography of thorax is routineexamination and widely available in almost every hospital. Measurementquantitatively of vascular pedicle width (VPW), cardiothoracic ratio (CTR) andvascular pedicle-thoracic ratio in thorax radiography can help in differentiatingthe type of pulmonary edema through the cut off of VPTR based on combinationVPW and CTR. Methods: Descriptive cross sectional restrospective in 100 patients with clinicallypulmonary edema which have examined by thorax radiography at ICU RSCM inJanuary 2013 to Desember 2015. Subject divided to cardiogenic and noncardiogenic pulmonary edema based on combination VPW and CTR. Then,VPTR were measured and the cut off of VPTR determined based on combinationVPW and CTR in differentiaiting pulmonary edema.Results: From total 100 subject study at ICU RSCM using Receiver OperatingCurve (ROC) metode, the cut off of VPTR is 25,1% with sensitivity 90,5% andspecificity 86,1% in differentiating cardiogenic and non cardiogenic pulmonaryedema. Beside that, the prevalence of cardiogenik pulmonary edema is 21% andnon cardiogenic pulmonary edema is 79%.Conclusion : The cut off of VPTR based on combination VPW and CTR havesignificant sensitivity and specificity in differentiating cardiogenic and noncardiogenic pulmonary edema."

"Latar BelakangHemodialisa membutuhkan suatu akses vaskuler yang fungsional dan adekuat untuk mendapatkan hasil terbaik, bagi Negara berkembang seperti Indonesia tingginya biaya perawatan dan tenaga ahli masih merupakan hal yang harus ditanggapi serius oleh semua pihak. NKF-KDOQI menetapkan tiga Tujuan utama suatu unit hemodialisa antara lain meningkatkan pemakaian AV Fistula, Mengurangi pemakaian kateter hingga 10% dan Deteksi dini dari disfungsi akses vaskuler. Hingga saat ini belum ada gambaran akses vaskular yang terdapat di unit hemodialisa RSUPN Ciptomangunkusumo sehingga dapat dibandingkan dengan guideline, dan diharapkan mendapat masukan untuk pelayanan terbaik bagi pasien. MetodePenelitian ini berupa deskriptif retrospektif, Populasi penelitian adalah pasien gagal ginjal kronikyang menjalani hemodialisa dengan akses vaskuler fistula AV dan kateter vena sentral di RumahSakit Cipto Mangunkusumo pada bulan Mei – Desember 2012. Data dari rekam medis penderitadiketahui mengenai tanggal hemodialisa pertama kali, tanggal pembuatan akses vaskuler pertamakali, jenis akses vaskuler yang digunakan pertama kali serta konversi yang mengikutinya, sertalokasi akses vaskuler tersebut.HasilDidapatkan 234 data pasien yang aktif menjalani hemodialisa di unit hemodialisa RSUPNCiptomangunkusumno Jakarta dari bulan Mei – juni 2012, terdiri dari 146 laki laki dan 88perempuan , rerata umur 49.04 tahun dengan rentang umur 11 tahun sampai 78 tahun. Diantarapasien tersebut , 122 (52.1%) pasien dengan AV fistula, dan pasien yang membuat AV Fistulasebelum hemodialisa pertama hanya pada 7 pasien (1.2%) 1 pasien menggunakan graft PTFE,dengan lokasi tersering untuk AV Fistula adalah Radiocephalica sebanyak 29.4%, 48 pasienmenggunakan central venous catheter, dimana 28 pasien dengan longterm catheter (12%) dansisanya dengan shortterm catheter (8.5%). Direct Puncture digunakan oleh pasien sebagai carayang dipakai pertama kali melakukan hemodialisa, sebanyak 49.6%. dari keseluruhan pasienyang pernah menjalani pemasangan AV fistula mengalami primary failure sebanyak 10.65%, dansecondary failure sebanyak 7.37%.KesimpulanMasalah pada suatu unit hemodialisa tidaklah sederhana dan untuk mencapai suatu hasil yangterbaik diperlukan kerjasama dari sebuah tim multidisiplin vaskular akses yang terdiri dari ahliginjal hipertensi, ahli bedah vaskular, ahli radiologi, dan perawat dialisa. Dengan seorangkoordinator yang berdedikasi tinggi yang selalu memperbaharui data base pasien dan updateterbaru dari perkembangan akses vaskuler.

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Background

A vascular access that mantained to be functioning and adequate is a must to achieve the best

result in haemodialysis procedure. For a developing country like Indonesia, a high cost and

expertise in vascular access maintenance reluctantly a serious issues. NKF-KDOQI has

established three primary goals for a haemodialysis unit to achieve, to increase the placement of

native fistulas as vascular access at initiation of hemodialysis procedure until 65 %, to discourage

catheter insertion until 10% and early detection of vascular access dysfunction. Recently at Cipto

Mangunkusumo hospital, there are no profile of vascular access in haemodialysis unit to figure

out the condition and compare with guideline.

Method

This is a descriptive retrospective study with a CRF (Chronic Renal Failure) patients that undergo

hemodialysis with natve fistula and catheter as their vascular access in Cipto Mangunkusumo

hospital from May to December 2012. Data collected from medical record included dates when

initiates their hemodialysis procedure, diagnose of CRF, creation of fistula or other vascular

access, and complication that has occurred.

Results

From 234 patients that undergo hemodialysis procedure from May to December 2012, there werre

146 male and 81 female, with median age of 49.04 years old and distance within 11 – 78 years

old. Among these patients 122(52%) with fistula an 1 patient with graft but only 7 patients (1.2%)

that use native fistula to initiate their hemodialysis procedure. The most location for fistula were

on left radiocephalic in 29.4% of patients, 48 patients use catheter for their vascular access that

ionclude 12% long term and 8.5 % long term catheter. There were 49.6% patients with direct

venous puncture to initiate their hemodialysis. From all fistulas that created there were 10.65%

primary failure and 7.37% secondary failure.

Conclusion

Problems in hemodialysis unit is not as simple as that, and to achieve the best result require the

concerted effort of multivariariate vascular access team that consist nephrologist, vascular

surgeon, radiologist, and nurse with a chief coordinator that updating vascular access patients

database and its development"

"Latar belakang. Salah satu komplikasi paling umum dari diabetes mellitus (DM) adalah penyakit arteri perifer (PAD). Diperkirakan PAD mempengaruhi sebanyak 20% orang di atas 65 tahun. Banyak faktor yang berhubungan dengan terjadinya PAD. Golongan darah merupakan faktor risiko yang dikatakan mempengaruhi keparahan PAD namun belum banyak diteliti. Penelitian ini bertujuan untuk mengevaluasi hubungan golongan darah ABO dengan derajat keparahan PAD pada pasien DM tipe II.Metode. Studi cross-sectional dilakukan pada pasien DM tipe II yang didiagnosis dengan PAD dan datang ke Rumah Sakit Nasional Cipto Mangunkusumo, Indonesia selama periode Januari 2022 hingga Juni 2022. Diagnosis PAD didasarkan pada pengukuran indeks pergelangan kaki-brakialis. (ABI). Tingkat keparahan PAD dikelompokkan menjadi PAD ringan (ABI 0,7-0,9) dan PAD sedang-berat (ABI <0,7). Pasien dikategorikan menurut golongan darah ABO menjadi golongan darah O dan golongan darah non-O (A, B, dan AB).Hasil. Sebanyak 366 subjek dilibatkan dalam penelitian ini (A = 108, B = 52, AB = 12, O = 194). Tidak ada perbedaan kejadian PAD pada pasien PAD golongan darah O dan non golongan darah O (p = 0,780). PAD lebih parah pada golongan darah non-O (p = 0,041). Faktor risiko PAD yang lebih berat adalah periode diabetes yang lebih lama (OR 10,325 (95% CI 5,108-20,871), p < 0,001) dan hipertensi (OR 4,531 (95% CI 1,665-12,326), p < 0,003).Kesimpulan. Golongan darah ABO tidak berhubungan dengan terjadinya PAD. Golongan darah non-O dikaitkan dengan PAD yang lebih buruk di antara pasien DM tipe II. Faktor risiko lain untuk PAD yang lebih parah adalah periode diabetes dan hipertensi yang lebih lama.

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Introduction. One of the most common complications of diabetes mellitus (DM) is peripheral artery disease (PAD). It is estimated that PAD affects as many as 20% of people over 65 years. Many factors are associated with the occurrence of PAD. Blood type is a risk factor that is said to influence the severity of PAD but has not been widely studied. This study aims to evaluate the relationship between ABO blood group type and the severity of PAD in DM type II patients.

Method. A cross-sectional study was performed on DM type II patients who was diagnosed with PAD and came to Cipto Mangunkusumo National Hospital, Indonesia during the period of January 2022 to June 2022. The diagnosis of PAD was based on the measurement of ankle-brachial index (ABI). The severity of PAD was grouped into mild PAD (ABI 0.7-0.9) and moderate-severe PAD (ABI <0.7). The patients were categorized according to the ABO blood group into O blood type and non-O (A, B, and AB) blood type

Results. A total of 366 subjects were included in the study (A = 108, B = 52, AB = 12, O= 194). There was no difference of PAD occurrence in O blood type and non-O blood type PAD patients (p = 0.780). The PAD was more severe in non-O blood type (p = 0.041). The risk factors of more severe PAD were longer period of diabetes (OR 10.325 (CI95% 5.108-20.871), p < 0.001) and hypertension (OR 4.531 (CI95% 1.665-12.326), p

< 0.003).

Conclusion. The ABO blood type was not associated with the occurrence of PAD. The non-O blood type was associated with worse PAD among DM type II patients. Other risk factors of more severe PAD were longer period of diabetes and hypertension."

"ABSTRAK Latar belakang. Status volume intravaskular hipovolemia atau hipervolemia dapat meningkatkan angka morbiditas dan mortalitas. Baku emas penilaian status volume intravaskular adalah pemeriksaan immunoassay, sifatnya invasif, sulit dan lama sehingga para klinisi mencari teknik yang tidak invasif, mudah dan singkat. Pemeriksaan diameter vena kava inferior IVC dan vascular pedicle width VPW merupakan teknik noninvasif yang mulai dipakai untuk menilai status volume intravaskular. Keuntungan VPW adalah dapat dilakukan pada rumah sakit yang tidak memiliki USG. Uji kesesuaian IVC dan VPW dalam menilai status volume intravaskular hanya pernah dilakukan pada pasien dengan ventilasi mekanik. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil penilaian status volume intravaskular antara teknik ultrasonografi diameter IVC dengan teknik radiografi dada VPW pada pasien napas spontan. Metode. Penelitian ini merupakan uji klinis observasional analitik potong lintang untuk mengetahui kesesuaian hasil penilaian status volume intravaskular pasien di ruang resusitasi IGD antara IVC dengan VPW pada bulan Mei 2018. Didapatkan 40 subjek yang memenuhi kritera penerimaan dan bersedia menandatangani informed consent penelitian. 40 subjek diukur VPW-nya dari hasil radiografi dada oleh sejawat Radiologi di IGD lalu dinilai diameter IVC maksimal, minimal dan reratanya serta collapsibility index-nya oleh peserta PPDS Anestesiologi dan Terapi Intensif. Terdapat 1 subjek yang dikelurkan karena nilai VPW tidak dapat diukur. Analisis data menggunakan analisis Kappa. Hasil. Nilai median diameter IVC 1,1 cm dengan nilai minimum 0,46 cm dan maksimum 3 cm. Nilai median collapsibility index 33 dengan nilai minimum 10,2 dan maksimum 100 . Nilai median VPW 5,7 cm dengan nilai minimum 3,5 cm dan maksimum 10,8 cm. Didapatkan hasil tidak adanya kesesuaian antara diameter rerata IVC dengan VPW koefisien Kappa -0,085 . Tidak terdapat kesesuaian antara diameter maksimal IVC dengan VPW koefisien Kappa -0,123 . Tidak terdapat kesesuaian juga antara collapsibility index dengan VPW koefisien Kappa 0,069 Simpulan. Penilaian status volume intravaskular teknik ultrasonografi diameter IVC tidak sesuai dengan teknik radiografi dada VPW. Kata Kunci: status volume intravaskular; kesesuaian; IVC; VPW ABSTRACT Background. Intravascular volume status hypovolemia or hypervolemia can both increase morbidity and mortality. The gold standard for assessing intravascular volume is immunoassay measurement. It is an invasive measurement, difficult and requires time before a final evaluation is complete. So there is a significant need for a rapid, noninvasive and easy technique to determines volume status. Inferior vena cava IVC and vascular pedicle width VPW are noninvasive and easy technique to measure intravascular volume status. VPW can be done without USG. Compatibility between IVC and VPW had only been done in patient with mechanical ventilation. This study was conducted to see compatibility between IVC diameter and VPW for assessing intravascular volume status in spontaneous patient. Methods. This was a cross sectional analytic study in the emergency room to see compatibility between IVC diameter and VPW for assessing intravascular volume status in spontaneous patient during May 2018. There were 40 subjects who fulfilled inclusion criteria and agreed to sign informed consent. VPW of 40 subjects were assessed by the radiologist then the maximum, minimum, mean diameter and collapsibility index of the IVC were assessed by anesthesiologist resident in the emergency room. There was 1 drop out subject due to VPW can not be measured. We use Kappa analysis for this study.. Results. Median of IVC diameter for this study was 1,1 cm, with minimum diameter was 0,46 cm and maximum was 3 cm. Median of collapsibility index was 33 , with minimum value was 10,2 and maximum was 100 . Median of VPW was 5,7 cm, with minimum outcome was 3,5 cm and maximum was 10,8 cm. We found that there was no compatibility between IVC mean diameter and VPW Kappa coefficent was -0,085 . There was also no compatibility between IVC maximum diameter and VPW Kappa coefficient -0,123 . WE also found there was no compatibility between collapsibility index of IVC and VPW Kappa coefficient 0,069 Conclusion. Assessment intravascular volume status by ultrasonography technique of IVC diameter was not compatible with radiographic technique of VPW. Keywords: intravascular volume status; compatibility; IVC; VPW."

"Tujuan dari penelitian ini adalah untuk menilai terjadinya aktivasi endotel sebagai mekanisme palagenesis pada preeklampsia, dengan melihat pengaruh pajanan serum penderita preeklampsia pada kultur sel endotel vena umbilikalis terhadap produksi VCAM-1.RANCANGAN PENELITIAN: Penelitian ini merupakan studi eksperimental. Kultur sel endotel yang padat (confluent) dipajankan dengan medium yang mengandung 20% serum dad wanita preeklampsia (n = 12) atau wanita hamil normal (n = 12) dengan usia, usia kehamilan dan paritas yang tidak berbeda berrnakna secara statistik. Setelah pajanan selama 24 jam, diukur kadar VCAM-1 terlarut (sVCAM-1) dalam supematan kultur sel endotel dari ke-2 populasi tersebut. Jumlah sel endotel hidup dari kultur sel endotel pasca pajanan dihitung, baik pasca pajanan serum preeklampsia maupun wanita hamil normal. Diukur juga kadar sVCAM-1 dalam medium yang mengandung 20% serum dari wanita yang sama, yang tidak dipajankan dengan preeklampsia.HASIL: Kadar sVCAM-1 dalam supematan kultur setelah pajanan pada 10.000 set endotel selama 24 jam dengan serum preeklampsia (1.366 + 0.714 ng/ml) lebih tinggi secara bermakna (P < 0.05) dibandingkan setelah pajanan dengan serum wanita hamil normal (0.735 + 0.372 nglml). Jumlah sel endotel dari kultur sel endotel setelah pajanan dengan serum preeklampsia (9.00 x 104 + 3.77 x 104) lebih rendah dibandingkan setelah pajanan dengan serum wanita hamil normal (12.67 x 104 + 6.23); tetapi perbedaannya secara statistik tidak bermakna (P > 0.05). Kadar sVCAM-1 dalam medium kuttur yang mengandung 20% serum preeklampsia yang tidak dipajankan pada kultur sel endotel (11.0516 } 5.404 ng/lml) lebih tinggi dibandingkan serum wanita hamil normal (10.417 + 6.870 ng/ml); tetapi perbedaannya secara statistik tidak bermakna (P > 0,05)KESIMPULAN: Pajanan serum penderita preeklampsia pada kultur sel endotel vena umbilicalis menyebabkan terjadinya peningkatan produksi VCAM-1 oleh sel endotel, sehingga dapat disimpulkan bahwa pads preeklampsia terjadi aktivasi endotel akibat adanya suatu zat dalam serum penderita preeklampsia. Kata kunci: Preeklampsia, aktivasi endotel, kultur set endotel vena umbilikalis, Vascular Cell Adhesion Molecule-1.

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The Effect Of Preeclamptic Sera Exposure To Human Umbilical Vein Endothelial Cell Culture To The Production Of Vascular Cell Adhesion Molecul-1 (VCAM-1)OBJECTIVE: To determine endothelial activation as a pathogenic mechanism of preeclampsia, by identifying the effect of preeclamptic sera exposure to human umbilical vein endothelial cell culture on the production of VCAM-1.STUDY DESIGN: The study was an experimental study. Confluent endothelial cell culture exposed to medium with 20 % preeclamptic sera (n=12) on women with normal pregnancy sera (n=12) with the same age, gestational age and parity. After 24-hour of exposure, cultured media were removed for measurement of VCAM-1. The concentration of sVCAM-1 in medium with 20 % sera from the same women that was not exposed to cultured endothelial cell were also measured.RESULTS : The concentration of sVCAM-1 from 10.000 cultured endothelial cells media after 24-hour exposure with preeclamptic sera (1.366 + 0.714 nglml) was significantly higher than exposure with normal pregnant women sera (0.735 + 0.372). The amount of cultured endothelial cells after exposure to preeclamptic sera (9.00 x 104 + 3.77 x 104) was lower than after exposure to normal pregnant women sera (12.67 x 104 + 6.23); but the difference was not statistically significant (P a 0.05). Without exposure to cultured endothelial cells, the concentration of sVCAM-1 in the medium with 20 % preeclamptic sera was higher (11.0516 + 5.404 nglml) than in the medium with 20% sera from normal pregnant women (10.417 + 6.870 nglml), although the difference was not statistically significant (P > 0.05).CONCLUSIONS: Exposure of human umbilical vein endothelial cell culture to preeclamptic sera increased the production of VCAM-1 by the endothelial cells. It was concluded that there was endothelial activation in preeclampsia caused by factor or factors in preeclamptic sera."