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Abstrak :
Polarisasi makrofag ke arah tipe 1 (M1) atau tipe 2 (M2) sangat penting dalam perbaikan inflamasi kolon. Penggunaan bahan alam seperti kulit buah delima (Punica granatum L) dalam kıtosan diharapkan dapat menginduksi M2 peritoneal dan memperbaiki kondisi inflamasi kolon. Penelitian ini bertujuan mengetahui perbedaan efek pemberian ekstrak kulit buah delima (Punica granatum L.) dalam nanopartikel kitosan untuk menginduksi polarisasi makrofag peritoneal pada mencit yang diinduksi dekstran sodium sulfat (DSS). Analisis spektrum FTIR dilakukan pada sampel nanopartikel kitosan, sodium tripolifosfat (STTP), pomegranate peel extract (PPE), dan nanopartikel kitosan-PPE. Selanjutnya, mencit Balb/c dibagi secara acak menjadi 6 kelompok: normal, asam elagat 26 mg/kgBB/hari (kontrol positif), DSS 2% b/v (kontrol negatif), nanopartikel kitosanPPE dosis 480 mg/kgBB/hari (P2), nanopartikel kitosan-PPE dosis 240 mg/kgBB/hari (P1), PPE dosis 480 mg/mgBB/hari (P3), semua kelompok diberikan DSS 2% selama 2 siklus kecuali kelompok normal. Pada akhir percobaan, cairan peritoneal diambil dan dianalisis jumlah makrofag M1 dan M2 dengan flow cytometry. Dibandingkan dengan kontrol negatif, nanopartikel kitosan-PPE dengan dosis 240 mg/kgBB tidak menurunkan jumlah makrofag M1, namun meningkatkan jumlah makrofag M2 (p<0,05). Sedangkan nanopartikel kitosan-PPE dan PPE murni dengan dosis yang sama 480 mg/kgBB dapat menurunkan jumlah makrofag M1 dan meningkatkan jumlah makrofag M2 secara bermakna dibandingkan kontrol negatif (p<0,05). ......Macrophage polarization towards type 1 (M1) or type 2 (M2) is critical in the repair of colonic inflammation. The use of natural materials such as pomegranate peel (Punica granatum L) in chitosan is expected to induce peritoneal M2 and improve colon inflammatory conditions. The aims of this study is to compare the effects of pomegranate peel extract (Punica granatum L.) in chitosan nanoparticles on the macrophages polarization in peritoneal fluid of DSS-induced mice. The FTIR spectra of chitosan nanoparticles, sodium tripolyphosphate (STTP), pomegranate peel extract (PPE), and chitosan-PPE nanoparticles was analyzed. In addition, Balb/c mice were randomly separated into 6 groups: normal, elagic acid 26 mg/kgBW/day (positive control), 2% w/v DSS (negative control), chitosan-PPE nanoparticles dose of 480 mg/kgBW/day (P2), chitosan nanoparticles-PPE dose of 240 mg/kgBW/day (P1), and PPE dose of 480 mg/mgBW/day. Flow cytometric analysis was performed on peritoneal fluid at the conclusion of the experiment to determine the number of M1 and M2 macrophages. Compared to the negative control, chitosan-PPE nanoparticles at a dose of 240 mg/kg BW did not decrease the number of M1 macrophages, but increased the number of M2 macrophages (p<0,05). Whereas a dose of 480 mg/kgBW of chitosan-PPE nanoparticles and pure PPE decreased the number of M1 macrophages and raised the number of M2 macrophages significantly compared to negative controls (p<0.05).

Abstrak :
Pendahuluan: Penyakit periodontal di Indonesia merupakan penyakit gigi dan mulut terbesar kedua menurut Riskesdas 2018 dengan prevalensi sebesar 74,1%. Periodontitis merupakan penyakit inflamasi pada gingiva yang disebabkan oleh akumulasi plak akibat bakteri yang salah satunya adalah bakteri Porphyromonas gingivalis. Selain perawatan antibakteri, inflamasi pada periodontitis juga perlu ditangani. Dalam perawatan periodontitis untuk mencegah inflamasi, chlorhexidine dan ibuprofen merupakan agen terapeutik yang umum digunakan. Namun, penggunaan jangka panjang kedua agen tersebut dapat menimbulkan beberapa efek samping dan menunjukkan sitotoksisitas terhadap sel tubuh. Sekarang, sudah mulai ditemukan perawatan alternatif antiinflamasi. Salah satunya adalah propolis yang merupakan zat resin yang berasal dari ekstrak tumbuhan yang dibuat oleh spesies lebah. Propolis sudah terbukti memiliki sifat antiinflamasi dengan mengurangi ekspresi sitokin inflamasi. Di Indonesia sendiri, terdapat berbagai jenis propolis dan salah satunya adalah propolis Heterotrigona itama. Namun, sitotoksisitas propolis H. itama belum banyak diteliti di Indonesia. Dengan itu, tujuan penelitian ini adalah untuk mengetahui tingkat sitotoksisitas obat kumur propolis H. itama 5% sebagai alternatif perawatan periodontitis. Metode: Analisis kualitatif tingkat sitotoksisitas obat kumur propolis H. itama 5% terhadap sel makrofag peritoneal tikus muda secara in vitro melalui gambaran mikroskopis. Hasil analisis kualitatif akan dilakukan skoring berdasarkan panduan ISO 10993-5:2009. Hasil: Obat kumur propolis H. itama 5% memiliki tingkat sitotoksisitas yang tinggi terhadap sel makrofag peritoneal tikus karena adanya penurunan jumlah sel lebih dari 50% pada kultur makrofag berdasarkan gambaran mikroskopis. Obat kumur propolis H. itama memiliki tingkat sitotoksisitas yang lebih tinggi dibandingkan dengan chlorhexidine dan ibuprofen. Kesimpulan: Obat kumur propolis H. itama memiliki tingkat sitotoksisitas tinggi dengan hasil skor 3 dan lebih tinggi dibandingkan dengan chlorhexidine dan ibuprofen berdasarkan panduan ISO 10993-5:2009. Namun, dibutuhkan penelitian lanjut dengan uji sitotoksisitas metode kuantitatif dan uji lanjutan in vivo agar mendapatkan hasil yang lebih akurat. ......Introduction: Periodontal disease is the second largest dental and oral diseases in Indonesia according to Riskesdas 2018 with a prevalence of 74.1%. Periodontitis is an inflammatory disease of the gingiva caused by the accumulation of plaque by bacteria, one of which is Porphyromonas gingivalis. In addition to antibacterial treatment, inflammation in the pathogenesis of periodontitis also needs to be treated. For anti-inflammation treatment in periodontitis, chlorhexidine and ibuprofen are commonly used therapeutic agents. However, long-term use of both agents can cause several side effects and show cytotoxicity to different types of cells in the body. Nowadays, alternative anti-inflammatory treatments are starting to be discovered and used for periodontal diseases. One of them is propolis which is a resinous substance derived from plant extracts made by bee species. Propolis has been proven to have anti-inflammatory properties by reducing the expression of inflammatory cytokines. In Indonesia itself, there are various types of propolis and one of them is the Heterotrigona itama propolis. However, the cytotoxicity grade of H. itama propolis has not been widely studied in Indonesia. Therefore, the aim of this study was to determine the level of cytotoxicity of H. itama propolis mouthwash 5% as an alternative treatment for periodontitis. Methods: Qualitative analysis of the cytotoxicity of H. itama propolis mouthwash towards peritoneal macrophage cells of young mouse in vitro through microscopic images. The results of the qualitative analysis will be scored based on ISO 10993-5:2009 guidelines. Results: H. itama propolis mouthwash 5% has a high level cytotoxicity to mouse peritoneal macrophage cells due to a decrease in cell number of more than 50% in macrophage culture observed from microscopic images. H. itama propolis mouthwash has higher cytotoxicity level compared to chlorhexidine and ibuprofen. Conclusion: H. itama propolis mouthwash has a high level of cytotoxicity with a cytotoxicity score of 3, and is higher compared to chlorhexidine and ibuprofen. However, further research is needed with quantitative cytotoxicity tests and further in vivo tests to get more accurate results.

Abstrak :
Penelitian dilakukan untuk mengetahui aktivitas ekstrak rimpang temu hitam (Curcuma aeruginosaRoxb.) terhadap makrofag, sitokin TNF dan IFN pada tikus Spraque-Dawley betina yang diinduksi dengan7,12-dimetilbenz-()antrasen (DMBA). Ekstrak etanol 96% dibuat secara maserasi. Pengukuran kadar NO makrofag, jumlah sitokin TNF, IFN menggunakan metode ELISA pada panjang gelombang 450nm. Hewan uji dibagi dalam 10 kelompok yaitu kontrol normal, kontrol DMBA, kontrol doksorubisin, kontrol bahan alam (ST), kelompok perlakuan kuratif dan kelompok perlakuan ajuvan. Setiap tikus kecuali kontrol normal diinduksi dengan DMBA 4mg/200gBB, 5 kali diberikan 2x/minggu. Masa inkubasi tumor 8 minggu dengan palpasi seminggu sekali. Delapan minggu berikutnya kelompok perlakuan diberikan ekstrak dalam 3 variasi dosis yaitu 40mg/200gBB, 80mg/200gBB, 160mg/200gBB. Pengambilan darah dilakukan sebelum dan sesudah perlakuan. Perhitungan statistic menggunakan Kruskal Wallis (=0,05) untuk makrofag, dan ANOVA (=0,05) untuk TNF dan IFN. Hasil menunjukkan bahwa ada pengaruh temu hitam terhadap makrofag pada kelompok kuratif dan ajuvan, meski tidak sebesar ST. Terjadi penurunan kadar TNF sebelum dan sesudah pemberian sampel temu hitam, demikian juga pada sitokin IFN. Penurunan kadar TNF dan IFN tidak berbeda bermakna, dapat disebabkan oleh penurunan imunitas non spesifik tikus akibat tingkat keparahan penyakit tumor. Disimpulkan bahwa temu hitam meningkatkan produksi NO makrofag, namun tidak meningkatkan jumlah sitokin TNF dan IFN.

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The objectives of these research are to find out the activity of Curcuma aeruginosarhizome extracts on macrophage, TNF and IFNcytokinesforfemale Spraque-Dawley ratsinduced by dimethylbenz()anthracen (DMBA).Extract yielded from C. aeruginosa rhizomes maceration using 96% ethanol. The amount of NO production ofmacrophage, TNF and IFN concentration counts by ELISA reader on 450 nm. Rats devided into 10 groups of Normal, control of DMBA, control of doxorubicin, control of herbal, curative groups and adjuvant groups. All rats except Normal group induced by DMBA 4 mg/200gBB, 5x for 2x/weeks. Incubation phases were 8 weeks with palpation every week. The next 8 weeks were extracts treatment in 3 dose variation, 40mg/200gBB, 80mg/200gBB, 160mg/200gBB. The first bloods take before extract treatments, and the second after treatments. Statistical analysis for macrophage using Krukal Wallis (=0,05), and ANOVA(=0,05) for TNF and IFN. On macrophage studies, the NO yields onDMBA group and ST group significantly different from KD groups and AD groups. The amounts of TNF after Curcuma aeruginosaextracts treatments lower than the amounts before treatments. Also with IFN, the IFN amounts decreased after treatments. The descendent among all groups are not significantly different. The conclusions areCurcuma aeruginosaincreaseNO production of macrophage, but can?t increased the amounts ofTNF and IFN in serum.

Abstrak :
ABSTRAK
Respon imun makrofag merupakan proses alamiah yang terjadi di dalam tubuh sebagai adaptasi terhadap benda asing/antigen. Makrofag merupakan komponen penting pada respon imun bawaan maupun adaptif, karena berperan pada proses fagositosis serta sebagai antigen presenting cell APC . Pada proses fagositosis makrofag memerlukan O2 dan energi yang tinggi. Penelitian ini bertujuan membuktikan bahwa pada makrofag peritoneum yang diimunisasi terjadi hipoksia relatif dan peningkatan biogenesis mitokondria dalam usaha meningkatkan keperluan energi. Untuk membuktikan terjadi hipoksia diukur ekspresi mRNA dan protein HIF-1? serta HIF-2? yang merupakan protein yang berperan pada respons terhadap hipoksia. Juga diukur ekspresi mRNA dan protein sitoglobin yang merupakan protein pengikat O2. Untuk menilai biogenesis mitokondria diukur kadar protein PGC-1?. 24 ekor mencit BALB/c dibagi menjadi 3 kelompok perlakuan imunisasi dan 1 kelompok kontrol. Hasil penelitian menunjukkan bahwa terjadi hipoksia yang ditunjukkan oleh peningkatan bermakna kadar protein HIF-1? p=0.000, ANOVA dan HIF-2? p=0.035, ANOVA mulai dari 24 jam dan terus meningkat sampai 72 jam setelah imunisasi. Ekspresi protein sitoglobin meningkat mulai 24 jam sampai 72 jam setelah imunisasi p=0.01, ANOVA , sedangkan ekspresi protein PGC-1? meningkat bermakna pada 72 jam setelah imunisasi p=0.047, Kruskal-Wallis . Disimpulkan pada makrofag peritoneum mencit yang diimunisasi terjadi hipoksia dan biogenesis mitokondria. Kata kunci: Sitoglobin; HIF-1?; HIF-2?; Makrofag; PGC-1?

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ABSTRACT
Macrophages rsquo s immune response is natural process that occurs in the body. Macrophages is important in innate and adaptive immunity, due to their role in phagocytosis as well as antigen presenting cell APC . Phagocytosis itself requires O2 and high energy. This study aims to investigate that immunized peritoneal macrophages were in relative hypoxia condition and its mitochondrial biogenesis increased in efforts to provide energy. To confirm hypoxia were calculated by mRNA and protein expression of HIF 1 and HIF 2 . mRNA and protein Cygb expression were also measured as the protein considered binds O2. To assess mitochondrial biogenesis, PGC 1 protein level were measured. 24 male BALB c mice were used and divided into three immunized treatment groups and one control group. The results showed that hypoxia occur, affirm by a significant increase in protein levels of HIF 1 p 0.000, ANOVA and HIF 2 p 0.035, ANOVA ranging from 24 hours and continued to increase until 72 hours. Cygb protein expression also increased from 24 hours to 72 hours p 0.01, ANOVA , whereas the expression of PGC 1 alpha protein increased significantly at 72 hours p 0.047, Kruskal Wallis . In conclusion in immunized mice peritoneal macrophages present itself hypoxia and mitochondrial biogenesis. Keyword Cytoglobin HIF 1 HIF 2 Macrophages PGC 1

Abstrak :
Cedera saraf perifer merupakan beban klinis yang besar. Berbagai modalitas terapi dikembangkan untuk mencapai perbaikan fungsi, salah satunya dengan platelet-rich plasma (PRP). Walaupun PRP sudah diterapkan secara klinis, namun proses intrinsik di dalamnya belum sepenuhnya diketahui. Oleh karena itulah penelitian ini dibuat untuk mengetahui efek pemberian PRP terhadap populasi sel Schwann dan makrofag pada lokasi cedera saraf perifer. Penelitian eksperimental dengan sampel tikus Wistar, terdiri dari tiga kelompok penelitian untuk masing-masing terminasi di hari ke-3 dan hari ke-7, yaitu kontrol, model sciatica, dan model sciatica yang diberi PRP. Model sciatica dilakukan dengan metode crush injury. Fungsi motorik dinilai pada hari ke-3 dan ke-7 menggunakan Sciatic Functional Index (SFI) dan Foot Fault Test (FFT). Ekspresi marker sel Scwann diperiksa dengan imunohistokimia (IHK) SOX10, dan ekspresi marker sel makrofag dengan IHK CD68. Fungsi motorik meningkat pada hari ke-7 (p<0,05), dan populasi sel Schwann meningkat pada hari ke-7 (p<0,05). Pemberian PRP mempengaruhi proses regenerasi saraf perifer model tikus sciatica. ......Peripheral nerve injury is a large clinical burden. Various therapeutic modalities have been developed to achieve improved function, one of which is with platelet-rich plasma (PRP). Although PRP has been applied clinically, the intrinsic processes are not fully understood. For this reason, this study was made to determine the effect of PRP administration on the Schwann cell population and macrophages at the site of peripheral nerve injury. Experimental study with samples of Wistar rats, consisted of three research groups for termination on day 3 and day 7 respectively, namely control, sciatica model, and sciatica model treated with PRP. The sciatica model was performed using the crush injury method. Motor function was assessed on day 3 and 7 using the Sciatic Functional Index (SFI) and Foot Fault Test (FFT). Schwann cell marker expression was examined by SOX10 immunohistochemistry (IHC), and macrophage cell marker expression was examined by CD68 IHC. Motor function increased on day 7 (p<0.05), and the Schwann cell population increased on day 7 (p<0.05). PRP administration affects the process of peripheral nerve regeneration in the sciatica rat model.

Abstrak :
Pendahuluan: Prevalensi neuropati sensorik HIV (NS-HIV) di RS Cipto Mangunkusumo (RSCM) pada tahun 2006 adalah 33%, saat seluruh pasien mendapatkan terapi antiretroviral (ARV) stavudine. Walaupun stavudine tidak digunakan lagi, pasien masih mengeluhkan gejala NS-HIV. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor yang berhubungan dengan NS-HIV dan nyeri neuropatik; kadar kemokin CCL5 plasma dan antibodi IgG CMV pada NS-HIV dan nyeri neuropatik. Tujuan lain adalah untuk mengetahui dan gambaran intra-epidermal nerve fiber density (IENFD) dan makrofag CD14+ perineural pada NS-HIV. Metode: Penelitian potong lintang yang dilakukan di RSCM pada tahun 2015-2017. Didapatkan 197 pasien HIV dalam terapi ARV tanpa stavudin >12 bulan. NS-HIV ditegakkan berdasarkan The AIDS Clinical Trial Group Brief Peripheral Neuropathy Screening Tool (ACTG-BPNST/BPNST), sedangkan nyeri neuropatik dinilai menggunakan kuesioner Douleur Neuropathique 4 (DN4). Dilakukan pengambilan darah untuk mengukur hitung sel T CD4+, viral load, CCL5, antibodi IgG CMV. Dilakukan pemeriksaan nerve conduction study (NCS) dan Stimulated SkIin Wrinkle (SSW) test. Biopsi kulit dilakukan pada 9 pasien NS-HIV dan 5 pasien tanpa NS (NS-) untuk menilai intra-epidermal nerve fiber density (IENFD) dan makrofag CD14+ perineural dan dibandingkan kontrol sehat. Hasil: Prevalensi NS-HIV adalah 14,2% sedangkan prevalensi nyeri neuropatik 6,6%. Faktor yang berhubungan dengan NS-HIV adalah viral load >500 kopi/ml dan meningkatnya usia. Faktor yang berhubungan dengan nyeri neuropatik adalah penggunaan ARV Protease Inhibitor (PI) dan durasi ARV< 2 tahun. Kadar CCL5 plasma dan antibody IgG CMV tidak berhubungan terhadap NS-HIV dan nyeri neuropatik. Median IENFD pada pasien NS-HIV lebih rendah dibandingkan pasien HIV tanpa neuropati (3 vs 5,8 /mm2); median IENFD pasien HIV dengan dan tanpa neuropati sensorik lebih rendah dibandingkan kontrol sehat (11,2/mm2). Empat dari lima pasien NS-HIV dengan INEFD rendah mempunyai hitung CD4+ nadir yang rendah. Makrofag CD14+ dapat diidentifikasi perineural pada pasien NS-HIV dan pasien HIV tanpa neuropati sensorik. Kesimpulan: Prevalensi NS-HIV menurun jauh saat stavudin tidak lagi digunakan. Prevalensi nyeri neuropatik lebih rendah dari prevalensi NS-HIV. Meningkatnya usia dan terdeteksinya viral load berhubungan dengan NS-HIV; PI dan durasi penggunaan ARV yang lebih pendek berhubungan dengan nyeri neuropatik. IENFD pasien HIV lebih rendah dibandingkan kontrol sehat. Pasien NS-HIV dengan IENFD rendah memiliki hitung CD4+ nadir yang rendah. Makrofag CD14+ perineural di epidermis dapat diidentifikasi pada pasien HIV dengan dan tanpa neuropati sensorik.

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Introduction: Prevalence of HIV associated sensory neuropathy (HIV-SN) in Cipto Mangunkusumo Hospital (CMH) was 33% in 2006 where all patients used stavudine. Despite stavudine use has been reduced; some patients still complain the symptom of HIV-SN. This study aimed to explore the prevalence and associated factors of HIV-SN and neuropathic pain; to know plasma CCL5 chemokine level and CMV IgG antibody in HIV-SN and neuropathic pain; to study the pattern of intra-epidermal nerve fiber density (IENFD) and perineural CD14+ macrophage in HIV-SN. Method: It was a cross sectional study carried out at CMH from 2015 until 2017. We tested 197 HIV patients who had antiretroviral treatment (ART) without stavudine for >12 months. The AIDS Clinical Trial Group Brief Peripheral Neuropathy Screening Tool (ACTG-BPNST/BPNST) and Douleur Neuropathique 4 (DN4) questionnaire were used to assess HIV-SN and neuropathic pain respectively. Nerve conduction study (NCS) and Stimulated Skin Wrinkle (SSW) test were performed. The current CD4+ T-cell counts, viral load, CCL5 and IgG CMV antibidoy were measured. Skin biopsy was performed in 5 HIV-SN and 9 HIV-NoSN to assess IENFD and CD14+ macrophage compare to healthy control subjects. Result: The prevalence of HIV-SN was 14.2% and neuropathic pain was 6.6%. Viral load >500 copies HIV-RNA/ml and increasing age were associated with HIV-SN, while protease inhibitor (PI) and ART duration<2 years were associated with neuropathic pain. CCL5 plasma level and CMV IgG antibody were not associated with HIV-SN and neuropathic pain. IENFDs in HIV-SN were lower than HIV-NoSN (3 vs 5.8/mm2, respectively); IENFDs in HIV patients generally were lower than healthy control (11.2/mm2). Four of 5 HIV-SN patients with low IENFD had low nadir CD4+ T-cell count. CD14+ macrophage can be identified around the nerves of both HIV-SN and HIV-NoSN patients. Conclusion: Prevalence of HIV-SN in the era without stavudine is lower. Prevalence of neuropathic pain is lower than prevalence of HIV-SN. Increasing age and detectable viral load are associated with HIV-SN; PI and shorter duration of ART are associated with neuropathic pain. IENFDs in HIV patients are lower than healthy control. HIV-SN patients with low IENFD tend to have low nadir CD4+ T-cell count. CD14+ macrophage is present in both HIV patients with and without sensory neuropathy.

Abstrak :
Introduction: Constant exposure to a variety of microorganisms in domestic environment plays an important role in the shaping of individual immune response mechanism, which can affect one's susceptibility to the diseases. The aim of the study to get an understanding how the exposure of microorganisms in the the different area where the people living might give a contribution to the profile and the regulation of the immune respons after stimulated to malaria, vaccine BCG and oxLDL antigents in PBMC and whole blood cultures, and to evaluate the character of T reg as a mediator to suppress the cell proliferation. Methode: It is an in vitro experimental study performed at Laboratorium Terpadu, Faculty of Medicine Univertas Indonesia, Jakarta in 2013 2014. As a model of infectious diseases is used pathogenic antigents such as Plasmodium falciparum infected red blood cells malaria and bacille calmette gu rin BCG vaccine, and as a modell of inflammatory disease is used non a patonegic antigen, low density lipoprotein LDL . Whole blood cultures is done for 80 blood samples to know how the regulation of immune respons from people living a rural populatin. PBMC cultures is also done to explore macrophages after stimulated to malaria, BCG and LDL. PHA stimulated to the PBMC culture with and without T reg cells to evaluate the character of T reg. T regulatory cells perhaps play the important roles to suppress the immune respons to microorganisms was also done. Results: The profile of the immune respons of the people living in the unslum area is significantly more inflamatif than that in the slum area. The ratio of pro anti inflammation cytokines TNF IL 10 of the people living in the unslum area is significantly higher than that in the slum area. This is marked by increasing of oxLDL accumulationis that is the important point of the low protection to oxLDL of the people living in the unslum area p 0.01 . T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum area marked by increasing not only the expression of IL 10 cytokines but also the sum of T regulatory sells p 0.01 significantly. Conclusion: The immune respons of the people living in the unslum area is more inflamatif and responsive to malaria, BCG vaccine and oxLDL. The character of macrophage of the people living in the slum area is marked by the low ratio of pro anti inflammation cytokines TNF IL 10 to malaria, BCG vaccine and oxLDLstimulations. T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum.