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"Angka kejadian penyakit vaskuler di Indonesia akhir-akhir ini meningkat. Mungkin hal ini berkaitan dengan perubahan pola makanan. Penyakit peredaran darah otak (PPDO) merupakan salah satu penyakit vaskuler yang dapat mengakibatkan kelumpuhan, cacat mental maupun kematian. Oleh karena itu perlu dilakukan usaha untuk mencegah terjadinya PPDO. Patogenesis PPDO perlu dipahami agar usaha pencegahan dapat herhasil. Penelitian ini bertujuan untuk memhuktikan hahwa pada penderita PPDO, trombosit mengalami aktivasi yaitu terjadi peningkatan kadar β-thromboglobulin (β-TG). Juga ingin diketahui apakah terdapat perbedaan sifat antara trombosit pads orang normal, penderita PPDO perdarahan dan PPDO bukan pendarahan.Subyek penelitian meliputi 46 orang penderita PPDO berumur antara 21 - 84 tahun, yang terdiri atas 23 orang penderita PPDO bukan perdarahan, seorang penderita TIA dan 22 orang penderita PPDO perdarahan Berta 30 orang sehat berumur antara 40 -71 tahun sebagai kontrol. Untuk menilai adanya aktivasi tromhosit dilakukan pemeriksaan kadar β-TG, sedang untuk menilai sifat trombosit ditentukan rasio antara tromboksan B2 (TxB2) : 6 keto prostaglandin Flα (PGF1β). Pemeriksaan B-TG, TxB2 dan PGF1α dikerjakan dengan cara RIA.Hasil penelitian menunjukkan hahwa aktivasi trombosit terjadi pada semua penderita PPDO, tetapi hanya 22 % dari penderita PPDO mempunyai trombosit yang relatif hiperaktif. Pada PPDO hukan perdarahan 26 % menunjukkan trombosit yang relatif hiperaktif sedangkan padaPPDO perdarahan hanya 18 %.Dapat disimpulkan hahwa pada semua penderita PPDO trombosit mengalami aktivasi tetapi trombosit yang relatif hiperaktif hanya dijumpai pada 22 % penderita PPDO. Disarankan agar dilakukan penelitian untuk menilai manfaat pemberian obat antitrombosit pada individu dengan trombosit yang relatif hiperaktif.Determination Of Thromboxan B2, 6-Keto Prostaglandin Flα And β-Thromboglobulin In Cerebro Vascular Disorders PatientsThe prevalence of vascular disease in Indonesia has been increasing recently. This is probably related to the changes in dietary pattern. The cerebro vascular disorders (CVDs) are among the vascular diseases that may result in paralysis, mental deterioration or death. Therefore, efforts ought to he carried out to prevent CVD. It is important to understand the pathogenesis of CVD in order to successfully prevent it.

The main purpose of this study was to prove that platelet is activated in CVD patients. The other aim was to find out whether there is a difference between platelet activity of CVD patients and control group, and between that of non-hemorrhagic CVD and hemorrhagic CVD.

The subjects of this study were 46 CVD patients (aged 21-84 years) consisting of 23 non-hemorrhagic CVD patients, I TIA patient, 22 hemorrhagic CVD patients, and 30 healthy subjects (aged 40 - 71 years) as control group. The presence of platelet activation was determined by measuring the level of β-TG, and the activity of platelet was evaluated by calculating the TxB2 : PGFlα ratio. Measurements of β-TG, TxB2, and PGF1α were done by RIA method.

The result showed that activation of platelet occurred in all of the CVD patients, but only 22% of CVD patients had relative hyperactive platelet. Twenty-six percents of non-hemorrhagic CVD patients had relative hyperactive platelet but only 18% of hemorrhagic CVD patients had it.

It was concluded that platelet activation occurred in all of the CVD patients but only 22% had relative hyperactive platelet. A study to evaluate the benefit of antiplatelet therapy on individu with-relative hyperactive platelet is suggested."

"Thrombopoietin is synthesized in hepatocytes and She kidney. After it enters the blood stream, thrombopoetin is transported to the bone marrow. The receptor for thrombopoietin is known as c-mpl, which is expressed on the surface of platelets, megakaryocytes and Pltiripotent Stem Cells (PSCs). The function of ihrombopoietin is as a regulator of Colony Forming Unit (CFU)-Meg proliferation and as a stimulator for megakaryocyte maturation and platelet production. The plasma concentration ofthmmbopoietin is regulated by the platelet number. During thrombocytopenia, the plasma concentration of thrombopoietin is increased, and the platelet production is stimulated. On the other hand, during thrombncytosis, a large number of platelets will remove thrombopoietin from the circulation and the plasma concentration of thrombopoietin will decrease. The clinical application of thrombopoietin is to stimulate the number of platelets in thromhocytopenia induced by chemotherapy. Two forms of recomhinunl thrombopoietin have been developed for clinical use, i.e.: recombinanl Human Mcgakaryocyte Growth and Development Factor (rHuMGDF) and Polythylene Glycol (PEG)-rHuMGDF. Administration of rHuMGDF is preferred to PEG-rHuMGDF, because the later can stimulate an antibody reaction. In addition, thrombopoietin is also required for the maintenance of PSC, stimulation of PSC proliferation, and mobilization of PSCto peripheral tissues. The concentration of thrombopoietin can be determined by a highly sensitive enzyme-linked immunosorbent assay using a monoclonal antibody. Under normal conditions, the plasma concentration of thrombopoietin ranges from 12 pg/mL to 61 pg/mL."

"Preeklampsia merupakan penyulit kehamilan yang ditandai dengan hipertensi, edema dan proteinuria. Berdasarkan tanda-tanda tersebut, diduga disfungsi endotel memegang peranan dalam patogenesis kedua penyakit tersebut. Penelitian ini bertujuan untuk mengetahui apakah pada preeklampsia terjadi disfungsi endotel dengan memeriksa kadar sVCAM-1, vWF dan fibrin monomer sebagai petanda aktivasi koagulasi. Juga ingin diketahui apakah terdapat hubungan antara disfungsi endotel dengan beratnya penyakit. Desain penelitian potong lintang. Subyek penelitian adalah 30 orang wanita hamil 24 - 42 minggu dengan diagnosis preeklampsia yang bersedia ikut dalam penelitian dan kelompok kontrol terdiri atas wanita hamil aterm. Pemeriksaan kadar sVCAM-1 dikerjakan dengan cara ELISA dengan reagen dari R&D system. Kadar vWF ditentukan dengan cara enzyme linked fluorescent assay (ELFA) dengan reagen dari VIDAS bioMerieux. Fibrin monomer diperiksa dengan cara ethanol gelation test. Rerata dan simpang baku kadar sVCAM-1 pada preeklampsia dan kontrol berturut-turut adalah 576,4 ng/mL dan 58,3 ng/mL serta 375,7 ng/mL dan 43 ng/mL (p<0,05). Sedang rerata dan simpang baku kadar vWF pada preeklampsia dan kontrol berturut turut 305,3% dan 107,4% serta 162,4% dan 33% (p,0,05). Didapatkan korelasi sedang antara kadar sVCAM-1 dengan tekanan sistolik maupun diastolik (r=0,71) dan (r=0,65). Demikian pula antara kadar vWF dengan tekanan sistolik dan diastolik didapatkan korelasi sedang (r=0,67) dan (r=0,77). Fibrin monomer positif didapatkan pada 28 dari 30 penderita preeklampsia sedang pada kelompok kontrol hanya 1 orang yang positif. Hasil penelitian ini menunjukkan bahwa pada preeklampsia terjadi disfungsi endotel. Pada preeklampsia terdapat korelasi antara petanda disfungsi endotel dengan tingginya tekanan darah.

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Endothelial Dysfunction In Preeclampsia. Preeclampsia is a complication of pregnancy characterized by hypertension, edema, and proteinuria. Based on these signs, it is suggested that endothelial dysfunction plays a role in the pathogenesis of preeclampsia. The aims of this study were to know whether endothelial dysfunction occur in preeclampsia by measuring the level of sVCAM-1, von Willebrand factor, and fibrin monomer. The relationship between markers of endothelial dysfunction and blood pressure would also be sought. In this cross-sectional study, 30 women at the 24-42 weeks of pregnancy with preeklampsia, were enrolled and control group comprised of fullterm pregnant women. The level of sVCAM-1 was determined by ELISA method using reagents from R&D system, while vWF level was measured by enzyme linked fluorescent assay (ELFA) using reagent from VIDAS bioMerieux, and fibrin monomer was detected by ethanol gelation test. The mean of sVCAM-1 level in the preeklampsia group and in the control group were 576.4 ng/mL, and 375.7 ng/mL, respectively while the standard deviation were 58.3 ng/mL, and 43 ng/mL, respectively. The mean of vWF level in the preeklampsia group and in the control group were 305.3% and 162.4%, respectively while the standard deviation were 107.4% and 33%, respectively. Moderate correlation were found between sVCAM-1 as well as vWF level with both systolic and diastolic pressure. Fibrin monomer was found in 28 out of 30 subjects of preeclampsia group, but only 1 out of 31 subjects in the control group. The results of this study indicated that endothelial dysfunction occurred in preeclampsia."

"Demam berdarah dengue (DBD) adalah penyakit yang ditandai dengan demam dan perdarahan. Selain itu terdapat efusi pleura yang diduga karena peningkatan permeabilitas vaskular. Berdasarkan tanda tersebut, diduga disfungsi endotel memegang peranan dalam patogenesis demam berdarah dengue.Tujuan penelitian ini adalah untuk mengetahui apakah pada demam berdarah dengue terjadi disfungsi endotel dengan memeriksa kadar sVCAM-1, von Willebrand factor dan petanda aktivasi koagulasi yaitu D dimer. Di samping itu ingin diketahui apakah ada hubungan antara petanda disfungsi endotel dengan beratnya penyakit. Desain penelitian ini potong lintang, kelompok kasus terdiri atas 31 penderita DBD dan kelompok kontrol terdiri atas 30 penderita demam bukan DBD. Kadar sVCAM-1 diperiksa dengan cara ELISA, vWF dengan cara enzyme linked fluorescent assay (ELFA) dan D-dimer dengan cara sandwich enzyme immunoassay.Hasil penelitian menunjukkan bahwa rerata kadar sVCAM-1 pada kelompok DBD dan kelompok kontrol berturut-turut adalah 1323 ng/mL dan 1003 ng/mL, sedangkan simpang bakunya berturut-turut 545 ng/mL dan 576 ng/mL. Rerata kadar vWF pada kelompok DBD dan kontrol berturut-turut 284% dan 327%, dengan simpang baku berturut-turut 130% dan 141%. Kadar sVCAM-1 tidak berkorelasi dengan jumlah trombosit, kadar albumin, kadar D dimer dan beratnya penyakit. Terdapat korelasi lemah antara kadar vWF dengan D dimer dan beratnya penyakit. ( r = 0,472 dan r = -0,450). Kesimpulan: Hasil pemeriksaan sVCAM-1, vWF dan D dimer menunjukkan bahwa pada DBD terjadi disfungsi endotel. Namun tidak ada hubungan antara sVCAM-1 dengan beratnya penyakit, hanya ada hubungan yang lemah antara vWF dengan D dimer maupun beratnya penyakit.

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Endothelial Dysfunction in Dengue Hemorhagic Fever. Dengue hemorrhagic fever (DHF) is characterized by fever, bleeding, and pleural effusion which may be caused by increased vascular permeability. Based on these findings it is assumed that endothelial dysfunction plays a role in the pathogenesis of DHF.The aims of this study was to know whether endothelial dysfunction occurs in DHF by measuring sVCAM-1, vWF, and D dimer. The relationship between endothelial dysfunction and severity of the disease would also be analyzed. This was a cross sectional study which involved 31 DHF patients and 30 non DHF fever patients as control group. The level of sVCAM-1 was determined by ELISA method, vWF by enzyme linked fluorescent assay , and D dimer by sandwich enzyme immunoassay.The results indicated that mean of sVCAM-1 level in DHF group and control group were 1323 ng/mL and 1003 ng/mL, while standard deviation (SD) were 545 ng/mL and 576 ng/mL respectively. The mean of vWF level in DHF group and control group were 284% and 327%, with SD 130% and 141% respectively. The level of sVCAM-1 did not correlate with platelet count, albumin level, D dimer level and severity of disease. There was a weak correlation between vWF level with D dimer and severity of disease ( r = 0,472 and r = -0,450 ).Conclusion: The results of this study indicate that endothelial dysfunction occurs in DHF, but there is no correlation between sVCAM-1 with severity of disease, only a weak correlation between vWF with D dimer and severity of disease is found."