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Abstrak :

Latar Belakang: Setiap individu memiliki antigen sel darah merah (SDM) yang unik pada membrannya. Terdapat lebih dari 300 antigen SDM yang dapat membagi darah ke dalam 36 sistem golongan. Adanya variasi pada antigen sel darah merah menyebabkan uji kecocokan darah antara pasien dengan donor wajib dilakukan guna mencegah terjadinya reaksi antara antigen donor dengan antibodi pasien. Pasien thalassemia memerlukan transfusi darah rutin yang dapat meningkatkan risiko terbentuknya aloantibodi, sehingga seringkali sulit untuk menemukan darah donor yang kompatibel. Unit Transfusi Darah (UTD), dalam rangka menjamin keselamatan pasien, harus mampu menyediakan darah donor tanpa antigen yang dapat menyebabkan reaksi transfusi. Pemeriksaan genotipe akan memberikan gambaran variasi antigen SDM donor, sehingga memudahkan pencarian donor yang sesuai untuk resipien.

Tujuan: Mengetahui adanya variasi genotipe antigen SDM pada donor sehingga dapat diupayakan penyerasian antigen darah donor untuk pasien transfusi berulang.

Metoda: Penelitian ini merupakan penelitian deskriptif observasional dengan desain potong lintang. Subyek pada penelitian ini adalah donor untuk pasien thalassemia. Sampel darah donor dikumpulkan untuk dilakukan pemeriksaan golongan darah ABO, Rhesus, ekstraksi DNA, dan genotipe antigen SDM.

Hasil dan Diskusi: Dari total 161 subyek penelitian, distribusi ABO/Rhesus donor adalah 68 subyek O+(42,24%), 43 subyek A+, 41 subyek B+, dan 9 subyek AB+. Setelah dilakukan pemeriksaan genotipe antigen SDM, didapatkan golongan darah dengan genotipe tersering untuk masing-masing golongan darah sebagai berikut Ce (98%) pada Rhesus, k/k (100%) pada Kell, Jk^a/Jk^b (40,76%) pada Kidd, Fy^a/Fy^a (74,84%) pada Duffy, Di^b/Di^b (99,36%) pada Diego, Do^b/Do^b (80,89%) pada Dombrock, Co^a/Co^a (100%) pada Colton, Yt^a/Yt^a (98.09%) pada Cartwright, MN (47,37%), s (86,54%) pada MNS dan Lu^b/Lu^b (100%) pada Lutheran. Pada studi ini juga ditemukan beberapa antigen darah langka seperti cE (1,33%), cEe (2%), CEe (1,33%), Fy^b (1,29%), Di^aDi^b (0,64%), Yt^aYt^b (1,91%), dan S (1,94%). Perlu diperhatikan antigen darah langka yang ditemukan pada donor/ populasi umum, bila ditransfusikan kepada pasien dengan antigen umum, dapat memicu timbulnya antibodi.

Kesimpulan: Pada penelitian ini ditemukan beberapa variasi genotipe antigen golongan darah pada donor, termasuk antigen langka. Perbedaan variasi antigen sel darah merah donor dan pasien dapat menyebabkan timbulnya aloantibodi, terutama pada pasien transfusi berulang. Oleh karena itu, pemeriksaan genotipe antigen SDM diharapkan dapat mengurangi reaksi transfusi dan meningkatkan keamanan pasien, terutama pasien yang membutuhkan transfusi berulang.

Kata kunci: antigen sel darah merah, genotipe, donor, aloantibodi

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Background: Every individual has unique antigens on their red blood cells surface. There are more than 300 antigens of red blood cells that differentiate blood into 36 blood group systems. Due to the variation in antigen of red blood cell, it is a must to perform blood group matching between the patients and donors blood to prevent reactions between the donors antigen and patients antibody in the blood. Thalassemia patients require regular transfusions which resulting in the production of alloantibody, hence making it difficult to find compatible blood. Blood Transfusion Units (UTD) is required to provide blood without antigen that can trigger transfusion reaction to ensure patient safety. Red blood cell antigen genotyping from the donor can describe the variation of red blood cell antigen from the donor.

Aims: To identify the genotype variation of the donor red blood cells antigen, hence optimizing the donors antigen matching in patients with regular transfusion.

Methods: This was a descriptive observational study with cross sectional design. Subjects in this study were donor for thalassemia patients. Blood samples from donors underwent several examinations, such as the ABO blood type testing, Rhesus testing, DNA extraction, and red blood cell antigen genotyping.

Results and Discussions: From a total of 161 research subjects, the distribution of ABO/Rhesus blood grouping are 68 of O+(42,24%), 43 of A+, 41 of B+, and 9 of AB+. From the red blood cell antigen genotyping, variations of red cell antigens were found in several blood group systems as follows, Rhesus, Kidd, Kell, Duffy, MNS, Diego, Dombrock, Colton, Cartwright, and Lutheran. Our findings also shown several rare antigens such as cE (1,33%), cEe (2%), CEe(1,33%), Fy^b (1,29%), Di^aDi^b (0,64%), Yt^aYt^b (1,91%), S (1,94%). It is important to note that rare blood antigens were found in donors/ general population, if blood is transfused to patients, it can trigger the alloantibody production.

Conclusion: Our study found there were genotype variations in the blood antigen of donor, some of them were rare types. The difference of red blood cell antigen between donors and patients may lead to the development of alloantibody, especially in patients who need multiple transfusion. Therefore, red blood cell antigen genotyping is expected to decrease the incidence of transfusion reactions and increase patient safety, especially in patients that required multiple transfusions.

Keywords: Red blood cells antigen, genotyping, donor, alloantibody

Abstrak :
The aim of this paper it to review various scale approaches to the blood flow modelling. Blood motion may be described by three types of mathematical models according to the observed scales or resolutions,namely microscopic,mesoscopic and macroscopic descriptions. The above approaches are discussed together with their advantages and disadvantages. Several results of mesoscopic simulations are presented with particular attention paid to mesoscale semi continuum models suitable for real time blood flow visualisation.

Abstrak :
Kadmium (Cd) banyak digunakan dalam industri, baik sebagai bahan utama maupun sebagai bahan tambahan dalam proses produksi. Akibatnya limbah yang lepas ke lingkungan pada umumnya masih mengandung Cd dan mencemari lingkungan. Melalui mata rantai makanan masuk dan terakumulasi dalam tubuh manusia. Telah diketahui bahwa Cd merupakan salah satu logam yang mempunyai toksisitas tinggi. Pajanan logam Cd secara akutdapat menyebabkan berbagai penyakit, antara lain peneumonia dan edema paru-paru, penyakit paru-paru obstruktif, emfisema, penyakit tubuh ginjal kronis. Selain itu Cd juga mempengaruhi sistem Kardiovaskuler dan tulang, juga mempengaruhi kerentanan penjamu terhadap infeksi. Penelitian ini dilakukan di Laboratorium Puslitbang Farmasi Dep-Kes RI dan Laboratorium Biokimia FKUI dari bulan Agustus 1994 - Desember 1994, bertujuan untuk mengetahui pengaruh pemberian Cd terhadap respon imun pada tikus putih jantan galur Wistar umur 4 bulan. Tikus kelompok perlakuan diberi Cd 20 µg/ekor/hari selama 14 hari. Untuk menyulut respon imun yang mudah dideteksi, baik tikus kelompok kontrol dan perlakuan diimunisasi Sel Darah Merah Domba (SDMD) yang mempunyai sifat antigenik tinggi tetapi tidak patogen. Kemudian dideteksi antibodi-anti SDMD mulai dari minggu ke 0 (sebelum imunisasi) sampai minggu ke 5 setelah imunisasi dengan menggunakan uji hemaglutinasi. Selain itu juga dilihat pengaruhnya terhadap berat badan dan berat limpa pada akhir penelitian. Data hasil penelitian dianalisa dengan uji statistik univariat dan bivariat. Penelitian menunjukan bahwa selama 5 minggu pengamatan rata-rata titer antibodi-anti SDMD kelompok yang diberi perlakuan Cd selalu lebih rendah dari kelompok kontrol. Rata-rata kenaikan berat badan kelompok perlakuan lebih rendah dari kelompok kontrol, dan juga rata-rata berat limpa pada akhir penelitian kelompok perlakuan lebih rendah dari kelompok kontrol. Analisa statistik menunjukan bahwa perbedaan rata-rata titer antibodi-anti SDMD, perbedaan rata-rata kenaikkan berat badan serta perbedaan rata-rata berat limpa adalah bermakna, p < 0,1 ; (α = 0, l). Pemberian Cd dapat menurunkan produksi antibodi-anti SDMD, mengurangi kenaikan berat badan dan berat limpa tikus putih jantan. Penelitian lebih lanjut disarankan agar Cd diberikan dengan dosis yang bervariasi, jumlah sampel yang lebih banyak dan dibedakan menurut kelompok umur dan jenis kelamin, supaya hasilnya dapat digeneralisasi. Mengingat pengaruh pajanan Cd terhadap gangguan kesehatan yang begitu tinggi, sebaiknya pengawasan, pencegahan terhadap pencemaran dan bahayanya lebih ditingkatkan serta dilakukan pemantauan pajanan baik terhadap lingkungan maupun terhadap pekerja yang beresiko.

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Cadmium (Cd) has been used widely in the industry as the leading material or supplementary material for the main product. The wastes of the production process then pollute the environment. Through the food chains the Cadmium is entered the human body and accumulated. It has known that Cd is one of the metals which has a high toxicity. Acute exposure of Cd caused many diseases, i.e. pneumonia and pulmonary edema, chronic obstructive lung disease, emphysema and-chronic renal tubular disease. It is also reported that Cd could effect the skeleton, cardiovascular - system and the defense against infectious. This study had been done in the Pharmacy Laboratory, National Institute of Health Research and Development, Ministry of Health and Bio-chemistry Laboratory of the Medical Faculty of University of Indonesia from August to December 1994, to know the effect of Cd intoxication to the immune response in the 4 months aged white male rats of Wistar strain. The test group of rats received 20 /g of Cd/each/day for exactly 14 days. Both test and control groups received immunization with Sheep Red Blood Cells (SRBC) which has a high antigenicity but non pathogenic to trigger the easy detected immune response. The anti SRBC-antibody was assessed by using hemaglutination teenique periodically every week in six times before and after immunization. The effect of Cd to body weight and spleen weight were also measured. The stastical analyze using univariate and bivariate test. The study shows that in 5 weeks examination, the rate titer of anti SRBC-antibody in test group is lower than control group_ The rate of the increasing of the body weight and the spleen weight in the test group are also lower than control group. There axe significant differences in anti SRBC-antibody, increasing body weight and spleen weight between test group and control group with p<0.1 ;( α =0.1). Cadmium may reduce the anti SRBC-antibody production and the increasing of body weight and spleen weight white male rats. The future study of Cd with variation of doses, larger of samples and differentiation in age group and gender is suggested in order to get the generalize result. Concerning the high effect of Cd exposure to Health, it is suggested to improve the control and prevention against Cd pollution and hazard. Also to improve the monitoring of the exposure of Cd to environment and high risk workers.

Abstrak :
Clustered Red Blood Cells are observed very frequently in the thin blood smear digital images. Separating clustered Red Blood Cells from the single Red Blood Cells and splitting of clustered Red Blood Cells into single Red Blood Cells is a challenging job in the computer-assisted diagnosis of blood for any disorder in many diseases like Complete Blood Count Test, Anemia, Leukemia and Malaria etc. The mentioned problems are highly laborious in manual microscopy for the hematologists. Many techniques currently existing for the solution suffer from both under- and over- splitting problems when highly complex clusters of Red Blood Cells occur. In addition, the existing techniques are not computationally efficient. In this paper, we address the aforementioned problems, firstly by considering the boundaries of the convex hulls of clustered Red Blood Cells and secondly, by splitting the boundaries according to the number of Red Blood Cells in relation to distance measures. Furthermore, we draw circles using a mid-point circle algorithm at each boundary cleavage to give an illusion of the Red Blood Cells. The test results of the proposed technique on a standard online dataset are presented in two ways. Statistically first of all by achieving an average recall of 0.964 and precision of 0.970 while their F-measure achieved is 0.962 as well as secondly through ground truth data with visual inspections.