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"Ruang lingkup dan cara penelitian: Metilprednisolon (MPL) merupakan glukokortikoid yang berperan penting dalam respon imun spesifik yaitu efek supresi terhadap sel limfosit T, sehingga digunakan untuk mencegah rejeksi pada pasta transplantasi organ. Untuk pencegahan tersebut diperlukan metilprednisolon dosis tinggi untuk jangka pemberian cukup lama yang dapat menyebabkan efek samping obat yang berat yaitu efek imimosupresi yang kuat. Obat yang diinkorporasikan ke dalam liposom terbukti dapat memberikan efek yang lebih kuat dibandingkan obat babas tetapi MPL tidak terinkorporasi dengan baik dalam liposom sehingga disintesis MPLP. Metilprednisolon palmitat (MPLP) adalah senyawa yang berhasil diinkorporasikan ke dalam liposom membentuk liposom metilprednisolon palmitat (LMPLP). Metilprednisolon palmitat diharapkan dapat menurunkan efek samping yang ditimbulkan. Penelitian ini bertujuan untuk mengetahui efek supresi liposom metilprednisolon palmitat terhadap proliferasi limfosit T subpopulasi CD4+ dan CDS+ yang distimulasi oleh concavalin A. Limfosit dipisahkan dari darah perifer manusia, kemudian dikultur dengan pemberian LMPLP pada konsentrasi 0,4 mM, 0,1 mM dan 0,025 mM dibandingkan MPL pada konsentrasi yang sama. Jumlah limfosit hasil kultur dihitung menggunakan kannar hitung improved Neubauer yang diwarnai dengan trypan blue 0,25 %. Selanjutnya limfosit T subpopulasi CD4+ dan CDS+ dihitung menggunakan antibodi monokional yang dilabel dengan zat warna fluorescein isothiocyanate dan phycoerythrin memakai low-cytometer.Hasil dan kesimpulan: Hasil kultur limfosit in vitro, pemberian LMPLP maupun MPL menyebabkan penurunan jumlah limfosit yang bermakna dibandingkan liposom atau kontrol RPMI, sedangkan pemberian LMPLP menunjukkan kecenderungan memberikan efek supresi terhadap proliferasi limfosit T yang lebih besar dibandingkan MPL walaupun secara statistik tidak berbeda bermakna (p > 0,05). Pemberian LMPLP maupun MPL pada konsentrasi 0,4 mM, 0,1 mM dan 0,025 mM tidak menunjukkan penurunan jumlah sel limfosit T subpopulasi CD4- maupun CD8+ yang berbeda bermakna (p > 0,05). Liposom metilprednisolon palmitat lebih menekan proliferasi sel CD84 dibandingkan CD4. Sedangkan lerhadap rasio jumlah sel limfosit T subpopulasi CD4+/CD8+ diperoleh dosis optimal pada pemberian LMPLP konsentrasi 0,1 mM.

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Scope and methods: Methylprednisolone is a glucocorticoid which is very important in specific immune response, especially in suppression effect to T lymphocyte and it has been used to prevent the rejection of organ transplantation. For that purpose, a high dose of methyprednisolone was used and in long term therapy may have a side effect such strong immunosuppression. Drugs incorporating in liposome give more strong effect that free drugs, but methyprednisolone not good incorporating in liposome. So methylprednisolone palmitate (MPLP) was sinthetized for that purpose. Methylprednisolone palmitate was successfully incorporate in liposome as a liposome methylprednisolone palmitate (L-MPLP). Liposome methylprednisolone palmitate was expected has minimum side effect. The aim of this study is to explore to know the suppression effect of L-MPLP to the subpopulation of CD4+ and CDs+ T lymphocyte proliferation which have been stimulated by concanavalin A. Lymphocyte was isolated from human peripheral blood and cultured in L-MPLP and MPL at the dose of 0,4 mM, 0,1 mM and 0,025 mM. The number of lymphocyte was counted by improved Neubauer and stained with 0,5% tryphan blue. CD4+ and CDs subpopulation of lymphocyte was counted by monoclonal antibody labelled by fluorescein isothiocyanate and phycoerythrin using flow-cytometer.Result and summary: Lymphocyte culture in vitro after administration of L-MPLP or MPL decreased number of lymphocyte significantly compared to liposome or RPMI as control. Although the administration of MPLP showed tendency of the reduction of the presentation of more than MPL but statistically not significance (p > 0,05). The administration of L-MPLP or MPL at the dose of 0,4 mM, 0,1 mM and 0,025 mM not showed a significance decreased of CD4+ and CDs+ subpopulation of T lymphocyte. The has administration of L-MPLP or MPL was not changing CD4+ and CDs+ subpopulation T lymphocyte. Liposome methylprednisolone palmitate could be suppressed the proliferation of CDC more than CD4+ subpopulation T lymphocyte. The optimal dose of L-MPLP to decrease the ratio CD4+ and CDs+ subpopulation T lymphocyte was 0,1 mM."

"ABSTRAKLimfosit darah tepi dari 5 penderita Juvenile Periodontitis /JP, 27 penderita Rapidly Progressive Periodontitis /RPP, dan 10 individu dengan jaringan periodonsium sehat diteliti menggunakan antibodi monoklonal dan flow sitometri dengan fluoresensi. Jumlah relatif dari set CD3+ (I'), CD4+ (T helper Th), CD8+ (F suppressor /Ts atau T cytotoxic /Tc), CD19+ (B), dan set CDI6+CD56+ (Natural Killer /NK) diukur, serta rasio CD4+/CD8+ (Th/Ts) dikalkulasi. Pada penderita JP ditemukan % proporsi set T (62.4 ± 6.1887 vs 69.8 ± 5.6332) dan set NK (21.4 ± 7.37 vs 12.9 ± 6.94) secara statistik berbeda bermakna dibandingkan dengan kelompok kontrol. Pada kelompok RPP % proporsi set T (61.7407 ± 9.3504 vs 69.8 ± 5.6332), sel Th (31.04 ± 7.30 vs 37.7 ± 4.92) dan NK (2030 ± 8.85 vs 12.9 ± 6.94) juga berbeda bermakna dibandingkan dengan kontrolnya. Tetapi rasio Th/Ts kedua kelompok periodontitis tersebut tidak berbeda bermakna. Hasil penelitian ini menunjukkan bahwa gangguan imunoregulasi dan fungsi subpopulasi limfosit penderita orang Indonesia Yang secara klinis terlihat lokal sebagai lesi JP atau RPP dapat dideteksi secara sistemik melalui darah tepinya. Selain itu karakteristik imunobiologik penyakit JP dan RPP bila diperbandingkan terhadap kelompok sehat berbeda pada proporsi sel Th-nya.

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ABSTRACTPeripheral blood lymphocytes from 5 Juvenile Periodontitis /JP, 27 Rapidly Progressive Periodontitis /RPP patients and 10 healthy subjects were examined using a panel of monoclonal antibodies and fluorescence flow cytometry. The relative counts of CD3+ (T) cells, CD4+(T helper /Th) cells, CD8+ (T suppressor /Ts or T cytotoxic /Tc) cells, CDI9+ (B) cells, and CD16+CD56+ (Natural Killer /NK) were assessed, and the CD4+lCD8+ (Th / Ts) ratio was calculated. In the JP patients the % proportion of T cells (62.4 ± 6.1887 vs 69.8 ± 5.6332) and NK cells (21.4 ± 7.37 vs 12.9 ± 6.94) were statistically significant difference to the control group. In the RPP patients the % proportion of CD3+ cells (61.7407 ± 9.3504 vs 69.8 ± 5.6332), CD4+ cells (31.04 ± 7.30 vs 37.7 ± 4,92) and NK cells (20.7 ± 8.85 vs 12.9 ± 6.94) were also statistically significant difference to the control group. But the CD4+/CD8+ (Th/Ts) ratio was not statistically significant in both groups. These results indicate that defect of immunoregulation and subpopulation lymphocyte function of Inclonisian patients which is clinically local as JP or RPP lesions. could detected systemically in their peripheral blood. Beside that, immunobiological characteristics between JP Arid RPP diseases compared to its control group have differed in Th cells subpopulation proportion."

"ABSTRAKUntuk menciptakan penutupan sistem saluran akar yang adekuat diperlukan bahan siler yang berfungsi untuk mengisi celah diantara gutaperca dan dinding saluran akar.Pada pengisian saluran akar sering ditemukan kondisi siler yang keluar dari foramen sehingga berkontak dengan jaringan periapeks dalam waktu yang berkepanjangan.Untuk itu, salah satu persyaratan dari bahan siler saluran akar adalah harus bersifat biokompatibel terhadap jaringan periradikular.Genotoksisitas adalah salah satu faktor penting yang mempengaruhi biokompatibilitas bahan. Siler saluran akar yang digunakan saat ini merupakan bahan kimia yang dapat mengakibatkan kerusakan pada DNA apabila terpapar dalam waktu yang lama.Terdapat berbagai macam bahan siler seperti siler berbasis Resin, Silikon, atau Bioceramik yang masing-masing memiliki kandungan zat yang berpotensi genotoksik. Tujuan penelitian ini adalah untuk mengetahui dan membandingkan potensi genotoksisitas pada siler berbasis Resin, Silikon, dan Bioceramik terhadap DNA sel limfosit manusia dengan menggunakan uji genotoksisitas ?-H2AX selama 1, 3 dan 7 hari. Berdasarkan hasil penelitian diketahui bahwasiler berbasis Resin, Silikon, dan Bioceramik memiliki potensi genotoksik terhadap DNA sel limfosit manusia dengan nilai tertinggi terdapat pada siler berbasis resin, selanjutnya diikuti oleh siler berbasis Silikon dan Bioceramik.

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ABSTRACTTo create an adequate sealing on root canal system, it is requires a sealer that fill the gap between gutta percha and root canal wall. In root canal obturation, it is frequently found that sealer leak to foramen and in contact with periapex tissue in a prolonged time. For that reason, one property that requirement of root canal sealer material is biocompatible to periradicular tissue. Genotoxicity is one of the important factors that affecting the biocompatibility of the material. Root canal sealer used today are chemicals that can cause DNA damage when exposed for long periods of time. There are a wide range of sealers such as Resin based sealer, Silicone based, or Biaceramic based that each have a potentially genotoxic substance. The purpose of this study was to investigate and compare the potential genotoxicity of Resin based Silicone based, and Bioceramic based sealers against human DNA lymphocytes using H2AX assay for 1, 3, and 7 days. Based on the results, it is known that Resin based, Silicone based, and Bioceramic based sealers have genotoxic potential against human DNA lymphocytes with the highest value found in Resin based, followed by Silicone based and Bioceramic based sealers."

"Media yang biasa digunakan untuk kultur sel limfosit manusia adalah Dulbecco's Modified Eagle Medium (DMEM) dengan penambahan Fetal Bovine Serum (FBS) yang mengandung nutrisi bagi kultur sel dan menyediakan beberapa faktor pertumbuhan dan hormon yang penting bagi pertumbuhan sel. Namun penggunaan serum ditemukan dapat mengandung virus dan prion sehingga beresiko terjadinya kontaminasi. Untuk mencapai media kultur yang optimal dan dapat meningkatkan transduksi protein, FBS disubstitusi dengan royal jelly Apis mellifera. Invensi ini bertujuan untuk membuat pengganti Fetal Bovine Serum pada medium pertumbuhan sel limfosit manusia berbahan baku royal jelly. Serbuk royal jelly dibuat dengan cara freeze drying terdiri dari 3 macam, yaitu: royal jelly, soluble royal jelly, dan hydrolisat royal jelly. Kemudian hasil invensi produk digunakan untuk medium kultur sel limfosit selama 24 jam dan 48 jam dengan konsentrasi royal jelly 10%, 7,5%, 5%, dan 2,5% serta diamati perkembanganya pada 24 dan 48 jam. Dilakukan uji MTS untuk mengukur proliferasi sel. Royal jelly tanpa perlakuan memiliki nilai persen viabilitas paling tinggi yaitu 77.15 untuk 24 jam dan 58.44 untuk 48 jam dengan variasi konsentrasi 2.5% Royal jelly

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The media commonly used for human lymphocyte cell culture is Dulbecco's Modified Eagle Medium (DMEM) with the addition of Fetal Bovine Serum (FBS) which contains nutrients for cell culture and provides several growth factors and hormones that are important for cell growth. However, the use of serum was found to contain viruses and prions so there is a risk of contamination. To achieve optimal culture media and increase protein transduction, FBS was substituted with Apis mellifera royal jelly. This invention aims to make a substitute for Fetal Bovine Serum in human lymphocyte cell growth medium made from royal jelly. Royal jelly powder made by freeze drying consists of 3 types: royal jelly, soluble royal jelly, and hydrolyzate royal jelly. Then the results of the product invention were used for lymphocyte cell culture medium for 24 hours and 48 hours with royal jelly concentrations of 10%, 7.5%, 5%, and 2.5% and their development was observed at 24 and 48 hours. MTS test was performed to measure cell proliferation. Royal jelly without treatment had the highest percent viability value, namely 77.15 for 24 hours and 58.44 for 48 hours with a concentration variation of 2.5% Royal jelly"

"Tujuan : Mengetahui korelasi antara kadar vitamin E dengan jumlah limfosit CD4 penderita HIV/ AIDSTempat : Klinik Kelompok Studi Khusus AIDS Fakultas Kedokteran Universitas Indonesia/ RSUPN Dr. Cipto Mangunkusumo, Jakarta.Metodologi : Penelitian potong lintang pada 52 penderita HIV/ AIDS , berusia 20-40 tahun. Data yang diambil meliputi data demografi, infeksi oportunistik, asupan energi asupan lemak dengan metode food recall 1x24 jam, asupan vitamin E dengan food frequency questionnaire (F Q) semikuantitatif, kadar vitamin E plasma dan hitung limfosit CD4. Analisis bivariat dilakukan dengan menggunakan uji korelasi Pearson.Hasil : Subyek terdiri dari 44 orang laki-laki dan 8 orang perempuan, median usia 26 tahun, 75% berpendidikan sedang, 63,5% berpenghasilan di bawah UMP, 59,6% tidak merokok, 80,77% golongan IDU, 82,7% AIDS, 80,8% dengan IO. Rerata IMT 19,53 kg/m2 dan 53,8% termasuk normal , rerata asupan energi 1574,1 ± 198,48 kkal, rerata asupan lemak 31,17 ± 7,26%, median asupan vitamin E 10,00 ± 1,82 mg/ hari, dan 84,6% memiliki asupan vitamin E kurang. Nilai median kadar vitamin E plasma 22,59 (11,08-70,24) µmol/L dan 90,4% subyek memiliki kadar vitamin E normal. Didapatkan korelasi positif bermakna antara asupan lemak dengan kadar vitamin E plasma(r=0.307, p-0.027*) dan antara asupan vitamin E dengan jumlah CD4 (r=0.363, p=0.008*). Tidak ada korelasi antara IMT dengan limfosit CD4 (r-0.210, p=0.135), asupan vitamin E dengan kadar vitamin E plasma (r-0.222, p=0.114), kadar vitamin E plasma dengan jumlah limfosit CD4(r= 0.028, p'.843).Kesimpulan : Tidak terdapat korelasi antara kadar vitamin E plasma dengan jumlah CD4 penderita HIV/ AIDS.

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Objective : To investigate the correlation between plasma vitamin E concentration and the number of CD4 lymphocytes count in HIV/ AIDS patients

Method : This was a cross-sectional study involving 52 HIVIAIDS patients, aged 20-40 years in University of Indonesia AIDS Working Group (POKDIKSUS) Clinic at Dr Ciptomangunkusumo General Hospital Jakarta. Data were collected including demographic characteristic, energy and fat intake by the 24-hour dietary recall method, vitamin E intake using FFQ semi quantitative method, vitamin E plasma concentration and CD4 lymphocytes count. Statistical analysis was carried out using Pearson's correlation test to investigate the correlation between vitamin E plasma concentration and the number of CD4 lymphocytes count in HIVIAIDS patients.

Result : The subjects were comprised 44 men and 8 women with median of age 26 years. 75% of the subjects were in middle education level; 63.5% were earned under Jakarta's minimum wages; 59.6% were non-smoker; 80.77% were IDU; 82.7% were infected by AIDS; and 80.8% with opportunistic infection. The BMI mean was 19.53kg/m2 of which 518% were normal. The mean of daily energy intake was 1574.11 ± 198.48 kcal, the mean of fat intake was 31.17 ± 7.27%, the median of vitamin E intake 10.00 (7.67- 15.38) mgld and 84.6% had a low vitamin E intake. The median value of vitamin E plasma level was 22.59 (11.08-70.24) µmol/L and 90.4% of subjects had normal vitamin E plasma concentration. There was a significant correlation of fat intake with vitamin E plasma concentration (r=0.307, p=0.427*), also of vitamin E intake with CD4 lymphocytes count (r 0.363, p-0.008*). But, there was no correlation of BMI with CD4 lymphocytes count (r0.210, p=0.135), of vitamin E intake with vitamin E plasma concentration (r=0.222, p=0.114), also the concentration of vitamin E plasma with CD4 lymphocytes count (r= 0.028, p=0.843).

Conclusion: No correlation was found between plasma vitamin E concentration and CD4 lymphocytes count in HIV/ AIDS patients.."

"Coronavirus Disease 2019 (COVID-19) merupakan penyakit multisistemik yang melibatkan kaskade imunologi, inflamasi, dan koagulasi. Biomarker di sirkulasi yang dapat memberikan informasi mengenai kondisi inflamasi dan status imun dapat digunakan dalam mendiagnosis dan menilai prognosis pasien COVID-19. Parameter hematologi rutin, mudah dilakukan, biaya terjangkau dan cepat, sehingga diharapkan dapat memberikan informasi awal sistem imun pasien yang dapat dihubungkan dengan outcome penyakit. Nilai RNL, RML dan RTL dapat mendeteksi dini kecurigaan perburukan kondisi pasien COVID-19. Penelitian ini menggunakan desain nested case-control yang melibatkan 206 data subjek yang terdiri atas 141 subjek luaran baik dan 65 subjek luaran buruk. Dijumpai perbedaan bermakna nilai RNL, RML dan RTL antara kelompok luaran baik dan buruk. Nilai titik potong optimal RNL, RML dan RTL berturut-turut adalah ≥5,43; ≥0,46 dan ≥196,34 untuk mendiskriminasi luaran buruk. Area Under Curve (AUC) untuk RNL adalah 0,825 (0,766-0,884), sensitivitas 76,9%, spesifisitas 73,8%; AUC RML 0,763 (0,692-0,833), sensitivitas 73,8%, spesifisitas 68,1% dan AUC RTL 0,617 (0,528-0,705), sensitivitas 63,1%, spesifisitas 60,3%. Usia >30 tahun (OR=2,59; IK95% 1,34-5,02), adanya komorbid (OR=2,21; IK95% 1,28-3,81), RNL ≥5,43 (OR=4,60; IK95% 2,07-10,26) dan RML ≥0,46 (OR=2,09; IK95% 0,93-4,67) berhubungan dengan luaran buruk pasien COVID-19.

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Coronavirus Disease 2019 (COVID-19) is a multisystemic disease involving immunologic, inflammatory, and coagulation cascades. Biomarkers in circulation which can provide information on inflammatory conditions and immune status can be used in diagnosing and assessing the prognosis of COVID-19 patients. Hematology parameters are routinely performed, easy, affordable and fast, so it can provide preliminary information on the patient's immune system that linked to disease outcomes. NLR, MLR and TLR values can detect early suspicion of worsening conditions of COVID-19 patients. This study used a nested case-control design involving 206 subjects data consisting of 141 subjects with good outcomes and 65 subjects poor outcomes. A significant difference was found in the values of NLR, MLR and TLR between the two groups. The optimal cut-off point values of NLR, MLR and TLR were ≥5.43; ≥0.46 and ≥196.34, respectively, to discriminate against poor outcomes. The Area Under Curve (AUC) for NLR was 0.825 (0.66-0.884), sensitivity 76.9%, specificity 73.8%; MLR was 0.763 (0.692-0.833), sensitivity 73.8%, specificity 68.1% and TLR was 0.617 (0.528-0.705), sensitivity 63.1%, specificity 60.3%. Age >30 years (OR=2.59; 95% CI 1.34-5.02), presence of comorbidities (OR=2.21; 95% CI 1.28-3.81), NLR ≥5.43 (OR=4.60; 95% CI 2.07-10.26) and MLR ≥0.46 (OR=2.09; 95% CI 0.93-4.67) were associated with poor outcomes of COVID-19 patients."

"ABSTRAK Latar Belakang: Biokeramik dan silikon merupakan material terbaru yang saat ini telah dipasarkan. Untuk melihat perbandingan antara material tersebut dibutuhkan uji sitogenetik dengan menggunakan resin metakrilat. Tujuan: Melihat perbandingan sitogenetik siler berbahan dasar biokeramik, silikon, dan resin metakrilat terhadap limfosit T. Metode: Menilai mikronukleus dalam 1000 sel binukleat yang terbentuk setelah pemaparan siler resin metakrilat, silikon, dan biokeramik terhadap limfosit T pada hari ke 1, 3 dan 7 hari. Hasil: Nilai mikronukleus siler biokeramik dan silikon lebih rendah dari siler resin metakrilat dengan nilai kemaknaan ABSTRACT Background Bioceramic and Silicone sealer are the latest material that widely commercialized nowadays. Cytogenetic test of bioceramic and silicone sealer need to be verified by testing with methacrylate resin. Purpose To observe cytogenetic of bioceramic, silicone, and methacrylate resin sealer on lymphocyte T. Methods Counting the number of micronuclei after the treats of bioceramic, silicone and metharylate resin sealer on lymphocyte T between 1,3 , adn 7 days. Results Micronuclei score of bioceramic and silicone lower than methacrylate resin with significance value p"

"Sampai saat ini, etiologi simple bone cyst(SBC) masih belum jelas; terdapat sejumlah teori mengenai terbentuknya SBC. Salah satu teori yang paling populer adalah obstruksi vena yang berakibat pada akumulasi cairan. Cairan-cairan ini diketahui mengandung faktor resorptif tulang, diantaranya adalah interleukin-1b(IL-1b) dan prostaglandin E2 (PGE2). Selain itu, parameter rasio limfosit monosit (LMR) saat ini sering dipakai memprediksi prognosis suatu keganasan, namun belum ada data yang berhubungan dengan tumor jinak. Kortikosteroid diketahui memiliki efek inhibitorik pada resorpsi tulang. Penelitian ini bertujuan untuk menganalisis kadar IL-1bdan PGE2 pada pasien SBC yang dilakukan injeksi steroid serial. Desain studi kohort prospektif dilakukan dengan menganalisis cairan kista pasien SBC yang datang ke RSCM pada bulan Januari 2018 sampai Juli 2019. Dilakukan dekompresi dan injeksi metilprednisolon asetat dosis 80-120mg tergantung dari usia dan berat badan subyek. Interval antar injeksi adalah satu bulan. Cairan dianalisis untuk mengukur kadar IL-1bdan PGE2 dengan menggunakan Quantikine ELISA(R&D System, Minnesota, Amerika Serikat), serta dinilai LMR nya. Kriteria penyembuhan tulang dinilai menggunakan kriteria radiologis Chang. Terdapat 4 subjek dalam penelitian kami, dengan median usia 12 (8-18) tahun. Seluruh subjek berjenis kelamin laki-laki. Dua subjek mengalami SBC pada humerus proksimal, dan dua subjek lainnya mengalami SBC pada femur proksimal. Seluruh kista bersifat aktif. Dua subjek sembuh, satu subjek sembuh dengan defek, dan satu subjek mengalami kista persisten. Didapatkan kadar IL-1bpada 3 subjek berada dibawah 3,9 pg/mlpada serial injeksi dan 1 subjek memiliki kadar 6,7, 13,31, dan 5,42 pg/ml.Sedangkan kadarbaselinePGE2 pada4 subjekadalah411, 122,5, 437,99dan 261,49pg/ml.Nilai LMR pada 4 subjek 6,2, 6,54, 5,4 dan 8,13.Terdapat perubahan kadar PGE2 dalam cairan SBC yang dilakukan pada injeksi steroid serial dengan kecenderungan meningkat paska injeksi yang pertama, lalu menurun paska serial injeksi berikutnya.Kadar interleukin IL-1βberada dibawah 3,9pg/mldalam cairan SBC yang dilakukan injeksi steroid serial.Tidak terdapat hubungan LMR dengan proses penyembuhan dan progresivitas lesi SBC

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To date, the aetiology of simple bone cyst (SBC) remains controversial. Several theories regarding its pathogenesis exist, and one of the most popular ones is venous obstruction which leads to fluid accumulation. This fluid contains bone resorptive factor, such asinterleukin-1b(IL-1b) and prostaglandin E2 (PGE2). Corticosteroid is known to possess an inhibitory effect on bone resorption. The objective of this study is to analyze IL-1bdan PGE2 in patients with SBC who treated with serial steroid injection. This prospective study was conducted by analyzing cyst fluid of patients diagnosed with SBC who went to Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the period between January 2018 and July 2019. The subjects underwent decompression, and subsequently they were injected with methylprednisolone acetate. The dose of the steroid varied from 80 to 160 mg according to the subject's age and weight. The interval of each injection was one month. The fluid was analyzed for its IL-1band PGE2 levels by means of Quantikine ELISA (R&D System, Minnesota, United States). Bone healing was evaluated using Chang criteria. A total of 4 subjects (median age: 12 [8-18] years of age) were included in our study. All subjects were male. Two subjects had SBC on the proximal humerus, and the other two had SBC on the proximal femur. All cysts were active. Two subjects healed, one healed with defect, and one had persistent cyst. We found that the IL-1bof3 subjects were below3.9 pg/mlin serial injection, and one subject had IL-1blevels of6.7, 13.31, and5,42 pg/ml.Whereas, the baseline PGE2 levels in four subjects were 411, 122.5, 437.99and261,49pg/ml.TheLMRin four subjects werepada 4 subjek 6.2, 6.54, 5.4 dan 8.13.We found change in PGE2 levels in SBC fluid that was treated with serial steroid injection. We found an increasing trend after the first injection, which was followed by a decreasing trend in the subsequent injection. The IL-1β levels in all timepoint were below3.9pg/ml."

"ABSTRAKPenelitian ini merupakan penelitian eksperimental yang bertujuan mengetahui respon limfosit limpa mencit terhadap kondisi hipoksia relatif dan stres oksidatif karena imunisasi. Imunisasi dilakukan dengan cara induksi suspensi SDMD 2 kepada mencit melalui jalan intraperitoneum. Sampel yang digunakan adalah limfosit limpa mencit Balb/c jantan sebanyak 24 ekor yang dibagi ke dalam 4 kelompok yaitu kelompok kontrol tidak diimunisasi , kelompok 24 jam, 48 jam dan 72 jam. Limpa diambil berturut-turut setelah 0,24,48, dan 72 jam imunisasi. SDMT diperoleh dari darah limpa menggunakan larutan Ficoll 1.084, kemudian limfosit diisolasi dengan metode adheren. Ekspresi protein HIF-1?, HIF-2?, dan Nrf2 menggunakan metode ELISA; ekspresi relatif mRNA HIF-1?, HIF-2? diukur dengan metode qRT-PCR; dan aktivitas enzim GPx diukur dengan metode spektrofotometri. Protein HIF-1? meningkat secara signifikan pada 24 jam pertama setelah imunisasi, kemudian menurun setelah 48 jam dan 72 jam, ekspresi relatif mRNA HIF-1? meningkat setelah 48jam dan 72 jam. Hal ini disebabkan oleh protein HIF-1 distabilkan pada jam ke-24, setelah 48 jam dan 72 jam mRNA tidak ditranslasikan atau protein segera didegradasi. Protein HIF-2? meningkat secara signifikan setelah 72 jam imunisasi, sementara ekspresi relatif mRNA HIF-2? meningkat secara signifikan setelah 24 jam dan 72 jam setelah imunisasi. Hal ini menjelaskan bahwa protein HIF-2 bekerja pada hipoksia kronik. Protein Nrf2 mengalami peningkatan yang tidak signifikan setelah 48 jam. Aktivitas enzim GPx meningkat signifikan pada 24 jam pertama kemudian menurun setelahnya. Kemungkinan setelah 48 jam enzim GPx tidak bekerja sendiri dalam menetralkan radikal bebas, namun dibantu oleh enzim CAT yang juga diatur ekspesinya oleh Nrf2.

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ABSTRACTThis research use experimental method, the aim is to explore the mice rsquo s spleen lymphocytes responses towards relative hypoxia and oxidative stress due to immunization. The immunization performed by injecting 2 sheep red blood cell intraperitoneally. The samples are spleen lymphocytes from 24 male Balb c mice, divided into 4 groups control, 24 hours, 48 hours, and 72 hours group. Spleen was isolated after 0 hour, 24 hours, 48 hours and 72 hours after immunization. PBMC obtained from spleen blood through Ficoll 1.084 separation, then lymphocytes were isolated by adherent method. HIF 1 , HIF 2 and Nrf2 protein expression were analyzed with ELISA method, mRNA expression were analyzed with qRT PCR method, and GPx enzyme activity were analyzed through spectrophotometry. HIF 1 protein elevated significantly 24 hours post immunization and decreased afterwards while HIF 1 mRNA increase significantly after 47 hours and 72 hours post immunization. This result is due to stabilized HIF 1 protein on 24 hours group that give rise to its concentration while its mRNA remain low, while after 48 hours and 72 hours the mRNA expression increase but not translated into protein or the protein sin quickly degraded. HIF 2 protein increased significantly 72 hours post immunizaation while mRNA expression elevated on 24 hours and 72 hours group. This result suit the theory that HIF 2 protein works on chronic hypoxia. Nrf2 protein increase insignificantly on 48 hours post immunization and GPx activity rise significantly after 24 hours immunization and decrease afterwards. This may due to enzyme CAT helps enzyme GPx in neutralize free radical, in which CAT is also regulated by Nrf2 protein."

"Latar belakang: Beberapa studi telah melaporkan bahwa banyak pasien stroke berat mengalami sepsis selama fase akut, hal ini berpengaruh pada luaran yang buruk. Pada stroke, terjadi pergeseran dari predominasi limfosit Th1 yang memiliki karakter proinflamasi menjadi predominasi limfosit Th2 yang dapat mengaktifasi respon antiinflamasi yang dapat berakibat pada menurunnya respon imun terhadap invasi patogen.Tujuan: Penelitian ini bertujuan menilai apakah rasio netrofil terhdap limfosit (RNTL) dapat memprediksi berkembangnya kejadian sepsis pada pasien stroke akut.Metode: melakukan penilaian pada pasien stroke akut yang dirawat di Unit Perawatan Intensif (UPI) RSUP Fatmawati sejak September 2019 sampai Mei 2020.Hasil: Rata–rata RNTL pada pasien stroke akut selama perawatan di UPI 16,8 ± 12,5. Dilakukan uji Mann–Whitney, didapatkan mean rank dari beberapa parameter RNTL seperti RNTL awal, RNTL hari ke–3 , RNTL tertinggi, dan delta RNTL (dRNTL) pada pasien stroke akut di UPI berkaitan dengan kejadian sepsis. Terdapat perbedaan nilai median pada RNTL hari ke–3, RNTL tertingggi, dan dRNTL pada kelompok stroke yang mengalami sepsis dengan kelompok stroke yang tidak mengalami sepsis.Kesimpulan: RNTL diperkirakan dapat menjadi penanda awal yang potensial terjadinya sepsis pada stroke akut, sehingga dapat menghindari keterlambatan diagnosa dan tatalaksana sepsis pasa pasien stroke sakit kritis.

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BACKGROUND: Several studies have reported that many severe stroke patients developed sepsis during their acute phase, which leads to poor outcomes. In stroke, there is a shift from predominant Th1 lymphocytes, which have proinflammatory characteristics, to predominant Th2 lymphocytes which activate anti-inflammatory responses that induce hyporesponsiveness of the immune system against an invasion of pathogen, known as stroke-induced immunodepression syndrome.

AIM: This study aims to examine whether the neutrophils-to-lymphocytes ratio (NLR) could predict the development of sepsis in acute stroke patients.

METHODS: Patients were admitted to Fatmawati hospital intensive care unit from September 2019 to May 2020.

RESULTS: The mean NLR of acute stroke patients during their stay in ICU was 16.8 ± 12.5. We performed Mann– Whitney test, which revealed that the mean rank of several NLR parameters, such as initial NLR, day-3 NLR, highest NLR, and dNLR in stroke patients at ICU, was associated with the incidence of sepsis. The median difference in day-3 NLR, highest NLR, and dNLR in the stroke group with sepsis differed from those of the non-sepsis group.

CONCLUSION: NLR is assumed to have potential as an early predictor to distinguish septic conditions from non- septic conditions, to prevent delay in establishing diagnosis and management of sepsis, especially in acute, critically- ill stroke patients."