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Abstrak :
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.

Abstrak :
ABSTRAK
Limfosit 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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ABSTRACT
Peripheral 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.

Abstrak :
ABSTRAK
Untuk 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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ABSTRACT
To 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.

Abstrak :
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 ......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

Abstrak :
ABSTRACT
A study was done to investigate the number and function of T cells of underfive children in Kelurahan Kramat, Kecamatan Senen, Jakarta Pusat. Grouping of samples was done based on weight-for-age, into well nourished (normal) children as control, mild-moderate PEM and severe PEM. The number of each group was 15.

The relative number of T cells in mild-moderate PEM and severe PEM were significantly reduced compared to the normal group (P <0.01 , See Figure 13). The relative number of blast-transformation of the severe PEM group compared with the mild-moderate PEB and the severe PEM with the normal group were not significantly different (P>0.05, See Figure 15). The total serum protein in mild-moderate PEM and severe PEM were not significantly different compared to the normal group (P> 0.05, See Figure 16). The protein intake in mild-moderate PEM and severe PEM were significantly reduced compared to the normal group (P<0.01, See Figure 17). The energy intake in mild-moderate PEM and severe PEM were significantly reduced to the normal group (P<0.01, See Appendix 11).

From the facts mentioned above it can be assumed strongly that: Lower protein intake in combination with lower energy intake in mild-moderate PEM and severe PEM are most probably very important factors that cause the reduction of T lymphocyte number in both moderate PEM as well as in severe PEM.

Abstrak :
Tujuan : Mengetahui korelasi antara kadar vitamin E dengan jumlah limfosit CD4 penderita HIV/ AIDS Tempat : 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..

Abstrak :
Latar Belakang : Non-alcoholic fatty liver disease (NAFLD) adalah penyakit hati kronik yang ditandai dengan akumulasi lemak berlebihan di hati. Elastografi Transien (ET) dan metode Controlled Attenuation Parameter (CAP) merupakan metode pemeriksaan non-invasif untuk menilai derajat fibrosis dan steatosis, namun tidak tersedia di seluruh rumah sakit di Indonesia. Rasio Neutrofil Limfosit (RNL) merupakan penanda peradangan sederhana yang berpotensi memprediksi luaran penyakit. Tujuan : Mengetahui nilai diagnostik RNL sebagai indikator derajat keparahan steatosis dan fibrosis NAFLD. Metode : Penelitian ini adalah studi potong lintang menggunakan data sekunder dari data rekam medis tahun 2016-2018. Analisis statistik deskriptif dan analitik berupa uji korelasi, Receiver Operating Curve (ROC) dan Area Under The Curve (AUC) dipakai untuk mengetahui luaran studi. Hasil : Dari 106 subjek penelitian, kebanyakan pasien adalah perempuan (62,3%) berusia rata-rata 57,29 tahun dan menderita sindrom metabolik (77,4%). Sebagian besar pasien memiliki derajat steatosis sedang-berat (66%) dengan rerata ET 6,14 (2,8-18,2). Terdapat korelasi antara nilai CAP (r=0,648; p<0,001) dan ET (r=0,621; p<0,001) dengan RNL. Penggunaan RNL untuk menilai derajat steatosis sedang-berat memiliki titik potong 1,775 dengan sensitivitas, spesifisitas, NDP dan NDN sebesar 81,5%, 80,6%, 89,1%, dan 69,1%; titik potong 2,150 untuk menilai fibrosis signifikan dengan sensitivitas, spesifisitas, NDP dan NDN berurutan sebesar 92.3 %, 87.5%, 70.6%, dan 97.2%. Simpulan : RNL memiliki korelasi positif terhadap derajat steatosis dan fibrosis dengan sensitivitas dan spesifisitas yang tinggi. ......Introduction : Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) is a device and method to examine the degree of fibrosis and steatosis. However, this device is not widely available across Indonesia. Neutrophil and Lymphocyte Ratio (NLR) is a simple marker for inflammation which has a potency to predict disease outcome. Objective : To know the diagnostic value of RNL as the indicator of steatosis and fibrosis severity. Methods : This was a cross-sectional study using secondary data from the medical record, starting from 2016-2018 with the respective inclusion and exclusion criteria. A descriptive and analytic statistic, including correlation test, Receiver Operating Curve (ROC) and Area Under The Curve (AUC) were done to know the outcome of the study. Result: Out of 106 subjects, 62.3% patients were women with aged mean 57.29 years old and 77.4% had metabolic syndrome. Most patients had average-severe steatosis degree (66%) with the mean of ET mean 6.14 (2.8-18.2). There was a positive correlation between CAP and TE compared with NLR with r = 0.647 (p<0.001) and r = 0.621 (p<0.001) respectively. The use of NLR to assess moderate-severe steatosis has a cutoff point of 1.775 with sensitivity, specificity, PPV and NPV of 81,5%, 80,6%, 89,1%, and 69,1%; cutoff point 2,150 to assess significant fibrosis with sensitivity, specificity, PPV and NPV of 92.3 %, 87.5%, 70.6%, 97.2% respectively. Conclusion : NLR has a positive correlation with the degree of steatosis and fibrosis with high sensitivity and specificity.

Abstrak :
Latar belakang. Salah satu penentu manifestasi klinis dengue berat adalah kebocoran plasma. Limfosit dan monosit berperan dalam patogenesis kebocoran plasma infeksi dengue sehingga berpotensi sebagai prediktor kebocoran plasma. Tujuan. Menentukan kemampuan hitung jenis limfosit dan monosit demam hari kedua sebagai prediktor kebocoran plasma pada fase kritis infeksi dengue. Metode. Desain kohort retrospektif pasien rawat inap di RSUPN Cipto Mangunkusumo, RSUP Persahabatan dan RSPAD Gatot Soebroto dari tahun 2010 ̶ 2015, memenuhi kriteria inklusi: berusia > 15 tahun; didiagnosis dengue menurut WHO 1997; dikonfirmasi pemeriksaan NS-1/pemeriksaan serologis anti dengue; memiliki data darah perifer lengkap dan hitung jenis mulai demam hari ke-2; USG abdomen, dan/atau albumin pada fase kritis. Dilakukan analisis Reciever Operating Characteristic Curves (ROC curve) dengan interval kepercayaan (IK) 95% dan multivariat regresi logistik untuk memperoleh model prognostik. Hasil. Terdapat 63 subjek dianalisis. Insidens kebocoran plasma 49%. Nilai absolut limfosit dan nilai absolut monosit demam hari ke-2 berpotensi menjadi prediktor kebocoran plasma pada fase kritis dengan AUC 0,65 dan 0,64. Titik potong optimal nilai absolut limfosit dan nilai absolut monosit yang berpotensi sebagai prediktor kebocoran plasma sebesar 1323 dan 770. Nilai absolut limfosit memiliki sensitivitas 90%, spesifisitas 16%. Nilai absolut monosit memiliki sensitivitas 94%, spesifisitas 34%. Model prognostik nilai absolut monosit dan persentase limfosit meningkatkan AUC menjadi 0,723. Simpulan. Kemampuan prediksi kebocoran plasma nilai absolut limfosit dan nilai absolut monosit demam hari kedua lemah. Namun kemampuan tersebut ditingkatkan menjadi sedang oleh model prognostik yang melibatkan persentase limfosit dan nilai absolut monosit. ......Background. The severity of dengue infection was determined by plasma leakage. Lymphocytes and monocytes played an important role in the pathogenesis of plasma leakage in dengue infection so they potentially used as predictors for plasma leakage in a critical phase of dengue infection. Aim. Determined the percentage and absolute number of lymphocytes and monocytes measured on the second day of fever as a predictors for plasma leakage in a critical phase of dengue infection. Method. The research was retrospective cohort study of inpatients at Cipto Mangunkusumo Hospital, Persahabatan General Hospital and Gatot Subroto Military Hospital Jakarta from 2010 ̶ 2015. The inclusion criteria: age > 15 years, suffering from dengue infection according to the diagnostic criteria of WHO in 1997, confirmed by examination of NS-1 or serological anti-dengue, peripheral blood count and differential leucocyte count during treatment from second day of fever, abdominal ultrasound, and / or albumin in the critical phase. Analyses were performed using ROC curve. Multivariate analysis was performed to elicit prognostic models. Results. We determined 63 subjects. The incidence of plasma leakage was 49%. Absolute number of lymphocytes and monocytes on second day of fever were potentially useful as predictors for plasma leakage. The AUC was 0.65 and 0.644. The optimal cut-off point for absolute number of lymphocytes were 1323, the sensitivity was 90% and the specificity 16%. The cut-off for absolute number of monocytes was 770, the sensitivity was 94%, specificity 34%. We found optimal prognostic model which include percentage of lymphocytes and absolute number of monocytes. It could increase the AUC until 0,723. Conclusion. The absolute number of lymphocytes and monocytes on second day of fever in dengue infections were potentially useful as predictors for plasma leakage in a critical phase of dengue infection. Predictive capability could be increased by prognostic model which include percentage of lymphocytes and absolute number of monocytes as predictors.

Abstrak :
ABSTRAK
Sepsis merupakan penyakit umum di perawatan intensif dan hampir 1/3 pasien yang dirawat di ICU adalah pasien sepsis. Banyak penelitian dilakukan untuk mencari penanda sepsis yang handal dan jumlah apoptosis limfosit mulai banyak diteliti sebagai penanda sepsis. Apoptosis limfosit terjadi mulai 24 jam pertama setelah onset sepsis. Saat ini belum terdapat data yang menunjukkan dapat digunakannya jumlah apoptosis limfosit sebagai penanda prognostik sepsis. Tujuan penelitian ini adalah mengetahui dapat tidaknya jumlah apoptosis limfosit digunakan sebagai penanda prognostik pada pasien sepsis berat

Desain penelitian adalah uji prognosis secara prospektif, terdiri dari 30 pasien sepsis berat dibagi berdasarkan mortalitas 14 hari, yaitu 15 pasien hidup dan 15 pasien meninggal. Diagnosis sepsis berdasarkan modifikasi definisi sepsis oleh International Sepsis Definitions Conference 2001. Jumlah apoptosis limfosit dihitung menggunakan metode flowcytometry dengan reagen antibodi monoklonal CD45 berlabel PerCP, Annexin V berlabel FITC, dan Propidium Iodide. Pada kedua kelompok tersebut dicatat data karakteristik subyek dan dilakukan penghitungan jumlah apoptosis limfosit

Rerata jumlah apoptosis limfosit pada kelompok pasien hidup adalah 0,992% dengan simpang baku 0,44% dan rerata jumlah apoptosis limfosit pada kelompok pasien meninggal adalah 1,5853% dengan simpang baku 0,57%. Jumlah apoptosis limfosit pada kedua kelompok berbeda bermakna dengan nilai p 0,004. Ditentukan nilai cut-off jumlah apoptosis limfosit 0,97%untuk menentukan prognosis pasien sepsis, dengan AUC 0,791 (IK 95% 0,631 ? 0,951), sensitivitas 86,7%, dan spesifisitas 60%. Kurva Kapplan Meier berdasarkan nilai cut-off 0,97% menunjukkan gambar yang memenuhi asumsi proporsional hazard dengan rasio hazard 0,182 (IK 95% 0,041 - 0,814), p = 0,026. Kami menyimpulkan jumlah apoptosis limfosit pasien sepsis berat dapat digunakan untuk memprediksi pasien yang meninggal dilihat dari mortalitas 14 hari, dengan nilai AUC sedang. Cut-off jumlah apoptosis limfosit 0,97% dapat digunakan sebagai cut-off dalam tatalaksana pasien sepsis berat

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ABSTRACT
Sepsis is a common illness in intensive care, almost 1/3 of patients admitted to the ICU were sepsis patients. There are plenty of researches to find a reliable marker of sepsis and the number of apoptotic lymphocytes began widely studied as a marker of sepsis. Apoptosis of lymphocytes occurred from the first 24 hours after the onset sepsis. There are currently no data on whether the number of apoptotic lymphocytes can be used as a prognostic marker of sepsis. The purpose of this study was to determine whether the number of apoptotic lymphocytes can be used as a prognostic marker in patients with severe sepsis

This was a prospective prognosis study, consisting of 30 severe sepsis patients grouped based on 14-day mortality, 15 patients are survivors and 15 patients are nonsurvivors. The diagnosis of sepsis is based on a modified definition of sepsis by the International Sepsis Definitions Conference 2001. The number of apoptotic lymphocytes was calculated using flowcytometry with PerCP-labeled anti-CD45 monoclonal antibody, FITC-labeled Annexin V, and Propidium Iodide. In both groups, characteristics of subjects were recorded and the number of apoptotic lymphocytes was calculated.

The mean of apoptotic lymphocytes in the survivor group is 0.992% with a standard deviation of 0.44%, and the mean of apoptotic lymphocytes in the nonsurvivor group is 1.5853% with a standard deviation of 0.57%. The difference between the two groups is significant with p = 0.004. This study yields an apoptotic lymphocytes cut-off value of 0.97% to determine prognosis of severe sepsis patients, with AUC of 0.791 (CI 95% from 0.631 to 0.951), 86.7% sensitivity and 60% specificity. Kapplan Meier curve based on the 0.97% cut-off demonstrates that hazard proportion is fulfilled with hazard ratio of 0.182 (95% CI 0.041 to 0.814) and p= 0.026. It is concluded that the number of apoptotic lymphocytes in severe sepsis patients can be used to predict nonsurvivors based on 14-day mortality, with moderate AUC. The apoptotic lymphocytes cut-off value of 0.97% can be used as a cut-off for severe sepsis patient management

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ABSTRAK
Penelitian 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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ABSTRACT
This 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.