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"The term "Inflammatory Bowel Disease" (IBD) is frequently used to denote two diseases, ulcerative colitis (UC) and Crohn's disease (CD). This condition is frequently recorded in the West, and along with development of diagnostic facilities, is beginning to be more commonly found in Indonesia.The etiology of this disease is still unclear, but it is suspected that environmental, geographic, and genetic factors are involved. Cytokines play a great role in the pathogenesis of IBD, where in IBD there is an unbalance of pro-inflammatory cytokines and inhibitor cytokines. In IBD, there is an increase in pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, IL-8, and alpha TNF in the intestinal mucosa. Such increase significantly correlates with the activity of ulcerative colitis through endoscopic examination,At this moment, forms of therapy for IBD associated with cytokines are being developed, such as ways to inhibit cytokine synthesis, cytokine release, cytokine activity and the cytokine signaling pathway in the target cell."

"Latar Belakang : Wabah pneumonia akibat Corona Disesase 2019 (COVID-19) masih menjadi perhatian nasional maupun global. Wanita hamil termasuk dalam kelompok risiko tinggi/rentan terhadap infeksi COVID-19. Adanya badai sitokin akibat infeksi COVID-19 menyebabkan gejala klinis yang semakin berat. Zinc sebagai salah satu mikronutrien penting yang berpengaruh dalam regulasi produksi sitokin oleh sistem imun tubuh. Kondisi defisiensi zinc pada wanita hamil yang terinfeksi COVID-19 dapat menyebabkan disregulasi dari sistem imun dan menghasilkan badai sitokin yang mengakibatkan sindrom ancaman gagal napas akut dan kematian. Tujuan : Meneliti hubungan kadar zinc serum maternal terhadap kadar sitokin pro- inflamasi interleukin-6 (IL-6) dan interferon gamma (IFN-) pada wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Metode : Penelitian observasional dengan desain studi cross-sectional. Subyek penelitian adalah wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Faktor yang diteliti meliputi kadar zinc, IL-6 dan IFN- serum maternal dan hubungannya kadar zinc serum terhadap kadar IL-6 dan IFN- serum maternal.Hasil : Jumlah total subyek sebanyak 48 orang dibagi menjadi 28 subyek untuk kelompok wanita hamil yang terkonfrimasi COVID-19 gejala ringan-sedang dan 20 subyek dengan gejala berat. Rata-rata usia responden 30,61 tahun untuk kelompok gejala ringan-sedang dan 32,9 tahun untuk kelompok gejala berat. Rata-rata usia kehamilan pada kelompok gejala ringan-sedang lebih tua dibanding kelompok gejala berat (38,1 minggu vs 34,5 minggu).Lama perawatan kelompok dengan gejala berat lebih lama dibanding kelompok gejala ringan-sedang. 60% subyek dari kelompok gejala berat berakhir dengan kematian maternal. Semua subyek dalam penelitian ini mengalami defisiensi zinc. Tidak terdapat perbedaan bermakna kadar zinc serum maternal pada kedua kelompok yaitu 54,0 (34-78) μg/dl untuk kelompok gejala ringan-sedang dan 52,0 (38-97) μg/dl untuk kelompok gejala berat. Terdapat perbedaan bermakna antara kelompok gejala ringan-sedang dengan kelompok gejala berat terhadap kadar IL-6 serum (5,8 (1,5-69,6) pg/ml vs 18,6 (3,8-85,3) pg/ml) dan kadar IFN- serum (0,9 (0,1-16,8) pg/ml vs 9,0 (0,9-21,1) pg/ml). Tidak ada korelasi antara kadar zinc serum maternal dengan kadar IL-6 dan IFN- serum maternal. Kesimpulan : Kadar zinc serum maternal tidak berbeda bermakna diantara kedua kelompok penelitan. Kadar IL-6 dan IFN- serum kelompok gejala berat lebih tinggi dibanding kelompok gejala ringan-sedang. Tidak ada korelasi antara kadar zinc serum dengan kadar IL-6 dan IFN- serum maternal.

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Bacground : The outbreak of Corona Disesase 2019 (COVID-19) is still a national and global concern. Pregnant women are included in the highrisk/susceptibility group for COVID-19 infection. The presence of a cytokine storm due to COVID-19 infection causes increasingly severe clinical symptoms. Zinc is one of the important micronutrients that influence the regulation of cytokine production by the immune system. Zinc deficiency in pregnant women with confirmed COVID-19 can cause dysregulation of the immune system and produce a cytokine storm that results in acute respiratory distress syndrome and maternal death. Objective: To evaluate the relationship between maternal serum zinc levels and the pro- inflammatory cytokines interleukin-6 (IL-6) and interferon-gamma (IFN-) in pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. Methods: A cross-sectional was adopted in this study. The subjects of the study were pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. We measure the maternal serum zinc levels, serum IL-6 and IFN- levels, then we evaluate the relation between the maternal serum zinc levels and the maternal serum IL- 6 and IFN- levels.

Results: The total number of subjects was 48 patiens, divided into 28 subjects for the pregnant women with confirmed COVID-19 with mild-moderate symptoms and 20 subjects with severe symptoms. The average age of the respondents was 30.61 years for the mild-moderate group and 32.9 years for the severe group. The mean gestational age in the mild-moderate group was older than in the severe one (38.1 weeks vs. 34.5 weeks). The length of stay of subjects with severe symptom was longer than the mild-moderate group. 60% cases from the severe group ended in maternal death. All the participants in this study suffered zinc deficiency. There was no significant difference in maternal serum zinc levels between the two study groups (54.0 (34-78) g/dl in mild-moderate group vs 52.0 (38-97) g/dl in severe group). There was a significant difference between mild- moderate vs severe groups in which the serum IL-6 levels were (5.8 (1.5-69.6) pg/ml vs 18.6 (3.8-85.3) pg/ ml) and the serum IFN- levels were (0.9 (0.1-16.8) pg/ml vs. 9.0 (0.9- 21.1) pg/ml). There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels. Conclusion: The maternal serum zinc levels were not significantly different between the two study groups. The maternal serum IL-6 and IFN- levels in the severe group were higher than in the mild-moderate group. There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels."

"ABSTRAK Latar Belakang: Persalinan merupakan suatu proses fisiologis, namun berkaitandengan nyeri dan rasa tidak nyaman. Selain itu induksi persalinan merupakan suatuintervensi dari luar terhadap proses alami kehamilan sehingga menginisiasi terjadinyakontraksi uterus dan dilatasi serviks Saat ini belum ada studi yang membandingkannyeri persalinan spontan dan nyeri induksi persalinan.Tujuan: Mengetahui perbedaan nyeri persalinan spontan dan nyeri induksipersalinan pada kala I dengan his 2-3 kali dalam 10 menit dan lama his 20-40 detik,kala I dengan his 4 kali dalam 10 menit dan lama his lebih dari 40 detik, kala IV dansatu hari pasca persalinan.Metode: Penelitian dengan desain kohort prospektif membandingkan 50 ibupersalinan spontan dan 50 ibu yang menjalani induksi persalinan sesuai dengankriteria inklusi dan eksklusi. Sampel didapatkan dari RS Cipto Mangunkusumo danRS jejaring lainnya periode Juli 2013- September 2013. Intensitas nyeri dinilaidengan Visual Analogue Scale. pada persalinan spontan dan induksi persalinan .Perbandingan data antara dua kelompok dianalisis dengan uji Mann-WhitneyHasil : Didapatkan skor nyeri ibu dengan persalinan spontan dibandingkan induksipersalinan pada kala I his 2-3x/10 menit lama his 20-30 detik (5,00 vs 6,00, nilaitengah semu 38,36 vs 62,64, p <0,001), saat kala I his 4x/10 menit lama his lebihdari 40 detik (10,00 vs 10,00, nilai tengah semu 45,50 vs 55,50, p= 0,013), kala IV(1,00 vs 1,00, nilai tengah semu 44,53 vs 56,48, p 0,020). Sedangkan pada skor nyeriibu satu hari pasca persalinan didapatkan nilai median yang lebih tinggi pada skornyeri pasien dengan persalinan spomtan dan induksi persalinan (1,00 vs 0,00, nilaitengah semu 46,00 vs 55,00, p=0,072) nilai p > 0,05 menunjukkan tak ada perbedaanbermakna.Kesimpulan : Persalinan induksi lebih nyeri dibandingkan persalinan spontan padakala I dengan his 2-3 kali dalam 10 menit dan lama his 20-40 detik, kala I his lebihdari 4x /10 menit lama his lebih dari 40 detik dan kala IV. Pada penilaian satu haripasca persalinan, tidak ada perbedaan bermakna secara statistik pada ibu persalinanspontan dengan induksi persalinan

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ABSTRAK Background:Childbirth is a physiological process, but associated with pain anddiscomfort. In addition, the induced labor is an external stimulation for the naturalprocess of pregnancy as to initiate uterine contractions and cervical dilation.Currently no studies comparing the pain between spontaneous labor and inducedlabor .Objectives:Knowing the difference in spontaneous labor pain and induced labor painduring 2-3 times in 10 minutes of contractions within 10 minutes in the first stage was20-40 seconds length of contractions,4 times of contractions in the first stage wichwas more than 40 seconds length of contraction,in the fourth stage of labor and oneday after the birth.Methods: An analytical cohort study, with 50 women undergoing spontaneous laborand compared with 50 women undergoing induced labor, accordance with theinclusion and exclusion criteria. Samples obtained from Cipto Mangunkusumo andothers networking hospital period July 2013 - September 2013. The Pain intensity inspontaneous labor and induced labor was assessed by Visual Analogue Scale.Comparison of data between the two groups were analyzed with the Mann-WhitneytestResults:Obtained pain scores by VAS compared to women with spontaneous laborand induction of labor respectively, in the first stage with contraction 2-3 times in10 minutes with 20-40 seconds length of contraction (5.00 vs 6.00, mean rank 38.36vs. 62.64 , p <0.001) , in the first stage with contractions 4 time in 10 minutes morethan 40 seconds length of contraction (10.00 vs. 10.00,mean rank 45.50 vs 55.50, p =0.013), fourth stage of labor (1.00 vs. 1.00 , mean rank 44.53 vs. 56.48, p 0.020).While the pain score on one day after the birth (1.00 vs 0.00 , mean rank 46.00 vs.55.00 , p 0,072).Conclusion: Induced labor more painful than spontaneous labor in the first stagewith contraction 2-3 times in 10 minutes with 20-40 seconds length of contraction, thefirst stage with contractions 4 time in 10 minutes more than 40 seconds length ofcontraction and at the fourth stage of labor. On one day after the birth assessment,there was no statistically significant difference at spontaneous labor pain comparedwith induced labor pain."

"ABSTRAKLatar BelakangPersalinan preterm bukan hanya merupakan masalah kesehatan dengan kejadian yang tinggi (11,1%) tetapi juga penyebab tertinggi (30%) kematian bayi di Indonesia. Faktor risikonya antara lain periodontitis dan kemungkinan karies dentis. Hal ini menunjukkan pentingnya kesehatan gigi dan mulut pada saat kehamilan. Namun, perilaku ibu hamil untuk memeriksakan kesehatan gigi dan mulut masih buruk.TujuanMengetahui perbandingan prevalensi periodontitis dan karies dentis serta pengetahuan, sikap, perilaku kesehatan gigi mulut antara ibu dengan persalinan preterm dengan persalinan spontan.MetodePenelitian ini merupakan penelitian potong lintang dengan pendekatan pengambilan sampel seperti kasus kontrol. Kelompok kasus adalah ibu hamil yang mengalami persalinan preterm dan kelompok kontrol adalah ibu hamil yang yang bersalin spontan. Diagnosis periodontitis berdasarkan kriteria Community Periodontal Index (CPI). Diagnosis karies berdasarkan adanya karies pulpa. Penilaian pengetahuan, sikap, dan perilaku kesehatan gigi dan mulut dengan kuisioner. Karakteristik demografik dan variabel perancu dikontrol dengan analisis multivariat.HasilDidapatkan 182 subjek penelitian yang terdiri dari 83 subjek kasus dan 79 pasien kontrol. Prevalensi periodontitis lebih tinggi pada kelompok persalinan preterm namun tidak bermakna sebagai faktor risiko persalinan preterm (55,4 % vs 54,4 %, p 0,089). Prevalensi karies dentis lebih tinggi pada persalinan preterm namun juga tidak bermakna sebagai faktor risiko persalinan preterm (62.7 % vs 59,5 %, p 0,680.). Tidak didapatkan perbedaan bermakna antara pengetahuan, sikap dan perilaku mengenai kesehatan gigi mulut pada ibu hamil kedua kelompok.KesimpulanPrevalensi periodontitis dan karies dentis pada populasi ini cenderung tinggi. Prevalensi tersebut lebih tinggi pada persalinan preterm namun bukan merupakan faktor risiko persalinan preterm pada populasi ini. Tidak terdapat perbedaan bermakna antara pengetahuan, sikap, dan perilaku kesehatan gigi mulut antara pada ibu hamil yang mengalami persalinan preterm dibandingkan kontrol.

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ABSTRACTBackgroundsPreterm labor is not only one of health problems with high incidence (11.1%), but also the most cause of perinatal death (30%) in Indonesia. The risk factors are periodontitis and dental caries which assumed. This condition emerges the importance of oral health during pregnancy. However, the behavior of pregnant women for routine oral health evaluation is poor.ObjectivesTo compare the prevalence of periodontitis and dental caries, knowledge, attitudes, and behaviors about oral health between women with preterm labor and spontaneous labor.MethodsThis study was a cross sectional study with case-control sampling approach. Case group were pregnant women who experience preterm labor and the control group were women with spontaneous labor. Diagnosis of periodontitis was according to Community Periodontal Index (CPI) criteria. Diagnosis of caries was based on the presence of caries pulp. Assessment of knowledge, attitudes, and behaviors of oral health were using questionnaires. Demographic characteristics and confounding variables were controlled using multivariate analysis.ResultsOne hundred and eighty two subjects were obtained, consisted of 83 cases subjects and 79 control subjects. The prevalence of periodontitis was higher but not significant as risk factor for preterm labor (55.4% vs. 54.4%, p 0.089). The prevalence of caries was not significantly different (62.7% vs. 59.5%, p 0.680.). There were no significant differences between knowledge, attitudes and behaviors of oral health in two groups of pregnant women.ConclusionsPrevalence of periodontitis and dental caries were relatively high. Both prevalences were higher among preterm group, but were not significant risk factors in this population. There were no significant differences between knowledge, attitudes, and behaviors of oral health among preterm group and control."

"Pendahuluan: Kondisi permukiman dapat mempengaruhi tingkat pajanan mikroorganisme penduduknya. Penduduk yang tinggal di daerah kumuh memiliki risiko lebih tinggi untuk terpajan mikroorganisme. Penelitian ini bertujuan untuk mengetahui perbedaan ekspresi IFN-γ dan IL-10 pada whole blood culture (WBC) penduduk daerah kumuh dan nonkumuh yang distimulasi oleh phytohemagglutinin (PHA).Metode: Penelitian potong-lintang dilakukan untuk menentukan perbedaan kadar IFN-γ dan IL-10 pada WBC yang berasal dari subjek daerah kumuh dan nonkumuh yang distimulasi dengan mitogen PHA. Data sitokin merupakan data sekunder yang didapatkan dari penelitian utama yaitu “Regulasi Respons Imun Subyek di Permukiman Kumuh: Studi Imunitas Seluler pada Kultur Sel Darah yang Distimulasi Malaria, BCG dan LDL”.Hasil: Kadar IFN-γ pada kondisi basal ditemukan secara signifikan lebih tinggi pada kelompok nonkumuh daripada kelompok kumuh (15,25 [5,00 – 225,00] dan 3,25[2,00 – 11,50] dengan p=0,004). Kadar IL-10 pada kondisi basal secara signifikan lebih tinggi pada kelompok nonkumuh daripada kelompok kumuh (117,75 [88,00 – 191,00] dan 4,00 [3,00 – 121,50] dengan p=0,002). Pascastimulasi PHA, tidak ditemukan perbedaan signifikan pada kadar IFN-γ (8269,31±1679,96 untuk kumuh dan 6906,60±1074,03 untuk nonkumuh, p=0,488), sedangkan kadar IL-10 pascastimulasi PHA secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (1121,20±169,39 dan 335,06±59,54 dengan p=0,001). Rasio IFN-γ terstimulasi/IFN-γ basal secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (2211,97±1698,36 dan 462,14±332,75 dengan p=0,010) dan rasio IL-10 terstimulasi/IL-10 basal juga secara signifikan lebih tinggi pada kelompok kumuh dibandingkan nonkumuh (259,75±214,70 dan 2,67±1,53 dengan p=0,004). Potensi inflamasi dinilai dengan rasio keseimbangan IFN-γ terhadap IL-10, didapatkan potensi inflamasi yang secara signifikan lebih tinggi pada daerah nonkumuh dibandingkan daerah kumuh (2,159±0,49 dan 1,178±0,63 dengan p=0,002). Kedua sitokin menunjukkan korelasi positif yang cukup kuat dan signifikan, terutama terlihat pada kelompok kumuh (R=0,642 dan p=0,002).Kesimpulan: Terdapat perbedaan kadar sitokin IFN-γ dan IL-10 pada kelompok kumuh dan nonkumuh pada kondisi basal. Pascastimulasi PHA perbedaan hanya terlihat pada kadar IL-10. Rasio keseimbangan kedua sitokin di kedua kelompok berbeda, menunjukkan potensi inflamasi kelompok nonkumuh lebih kuat dibandingkan kelompok kumuh. Terdapat korelasi positif antara sitokin IFN-γ dan IL-10 dimana peningkatan IFN-γ akan diikuti dengan peningkatan IL-10, terutama terlihat pada kelompok kumuh.

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Introduction: Living conditions might affect the pathogenic exposure of its population. People that live in rural areas have a higher risk of being exposed to pathogens from their environment. This study aims to determine differences in the expression of IFN-γ and IL-10 in whole blood culture (WBC) of rural and urban dwellers stimulated by phytohemagglutinin (PHA).Method: A cross-sectional study is conducted to define the different expression of IFN-γ and IL-10 in whole blood culture from rural and urban areas stimulated with phytohemagglutinin (PHA). The data were obtained from previous study “Regulation of immune response to people living in the slum area: a study of cellular immunity on Whole Blood Cultures stimulated malaria, BCG and LDL”.Result: The expression of IFN-γ in the condition before stimulation was found to be higher in the urban group than in the rural group (15.25 [5.00—225.00] and 3.25 [2.00— 11.50], p=0.004). Interleukin-10 levels in basal conditions were also found to be higher in the urban group than in the rural group (117.75 [88.00—191.00] and 4.00 [3.00— 121.50], p=0.002). Post-stimulation with PHA, IFN-γ levels were not different in the rural and urban group (8269.31 ± 1679.96 and 6906.60 ± 1074.03, p=0.488), however IL-10 levels were higher in rural group (rural: 1121.20 ± 169.39 and urban: 335.06 ± 59.54, p=0.001). The ratio of each cytokine after stimulation to basal was performed and IFN-γ levels were higher in the rural group compared to urban group (2211.97 ± 1698.36 and 462.14 ± 332.75, p=0.010), IL-10 levels were also higher high in the rural compared to urban groups (259.75 ± 214.70 and 2.67 ± 1.53, p=0.004). The inflammatory potential was assessed by calculating the ratio of IFN-γ to IL-10, a higher inflammatory potential was found in urban areas compared to rural (2.159 ± 0.49 and 1.178 ± 0.63, p=0.002). Both cytokines showed a strong positive correlation, especially seen in the rural group (r=0.642, p=0.002).Conclusion: There are differences in IFN-γ and IL-10 expressions in rural and urban subjects spontaneuosly. After stimulation with PHA, a difference was only seen on IL-10 level. The balanced ratio between IFN-γ and IL-10, which depicts the inflammation potency, is stronger in urban subjects when compared to rural subjects. There is a positive correlation between IFN-γ and IL-10, wherein an increase of IFN-γ will be followed by an increase of IL-10, which shown better in rural subjects.

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"PendahuluanSalah satu tantangan dalam tatalaksana fraktur saat ini adalah rekonstruksi fraktur dengan defek tulang yang luas, di mana dibutuhkannya restorasi alignment dan fiksasi yang stabil untuk keberhasilan rekonstruksi. Pada kasus fraktur dengan defek tulang tidak ada lagi komponen osteoinduksi dan osteokonduktif sehingga diperlukan penggunaan graft tulang ataupun tindakan transport tulang. Walaupun perkembangan teknologi dan kemajuan dalam pembedahan orthopaedi telah berkembang saat ini, hasil akhir dari penyembuhan tulang paska pembedahan pada beberapa kasus fraktur akan mengalami penyembuhan tulang yang kurang baik yang akhirnya akan menyebabkan defek ataupun non-union dari fraktur tersebut.MetodeDesain penelitian adalah studi post test control group design. Sampel yang digunakan adalah dua puluh delapan tikus putih Sprague Dawley yang telah mengalami maturasi skeletal (8-12 minggu), dibagi menjadi empat kelompok, tiap tikus akan dilakukan tindakan fraktur dengan defek tulang pada tulang femur selebar 4mm, kemudian tikus dibagi berdasarkan implantasi yang diberikan, yaitu kelompok kontrol, kelompok implantasi amnion liofilisasi steril, kelompok implantasi xenograft morcalized bovine, dan kelompok implantasi kombinasi amnion dengan xenograft. Hewan coba akan dikorbankan setelah 8 minggu, kemudian dilakukan pemeriksaan radiologis dan histopatologis dari fraktur. Evaluasi radiologis menggunakan skor menurut Lane dan Sandhu, evaluasi histopatologis menggunakan skor menurut Salkeld.HasilBerdasarkan uji statistik non parametrik Kruskal-Wallis terhadap skor radiologis tulang pada minggu ke-8 paska pembedahan didapat nilai p 0,25. Secara statistik dapat diambil kesimpulan bahwa tidak terdapat perbedaan bermakna perbandingan skor radiologis antara empat kelompok tersebut. uji statistik non parametrik Kruskal-Wallis pada skor histopatologis menurut Salkeld minggu ke-8 paska pembedahan didapat nilai p 0,001 secara statistik, dapat diambil kesimpulan bahwa terdapat perbedaan bermakna perbandingan skor histopatologis antara empat kelompok tersebut.KesimpulanSkor radiologis pada implantasi amnion liofilisasi steril dibanding dengan kelompok kontrol pada fraktur dengan defek tulang tidak memberikan perbedaan bermakna, sementara skor histologis memberikan perbedaan percepatan penyembuhan bermakna pada implantasi amnion liofilisasi steril dibanding dengan kelompok kontrol. Skor radiologis dan histologis pada implantasi xenograft morcalized bovine dibanding kelompok kontrol tidak memberikan perbedaan percepatan penyembuhan bermakna. Skor radiologis pada implantasi kombinasi amnion liofilisasi steril dan xenograft morcalized bovine dibanding dengan kelompok kontrol tidak memberikan perbedaan bermakna, sementara skor histologis memberikan perbedaan percepatan penyembuhan bermakna dibanding dengan kelompok kontrol.

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Introduction

One of the current chalenge on fracture treatment is reconstruction of fracture with critical size bone defect, where the restoration of the alignment dan stable fixation for succesfull result is necessary. bone graft or bone transport is usually needed for bone defect reconstruction because there isnt any osteoinductive and osteoconductive component on fracture with bone defect. Although new technologies and advances in orthopaedic surgery have enhanced fracture healing and surgical outcomes, there are fracture that continue to be deficient in bone repair or become non-union.

Methode

The research design is post test control group using twenty eight skeletally matured Sprague Dawley rats, divided into four groups, 4mm sized femoral defects were surgically created in the right femur of 28 rats. 7 rats were ran­domly assigned to each treatment group, in which the femoral defect was filled with sterile lyophilized amnion, morcalized bovine xenograft and combination. In the empty defect group (control group) defects were left empty. Animals were sacrificed at 8 weeks postoperatively. Then the radiologic and histopathologic examination were completed. Radiologic evaluation using Lane and Sandhu score, histologic evaluation using Salkeld score.

Result

Non parametric Kruskal-Wallis statistic analysis for the radiologic score 8 weeks postoperatively reveal p value 0,25 which mean there is no significance difference between four groups. However for the histopathologic score statistic analysis examination reveal the p value 0,001 which mean there are significance differences between four groups. The statistic analysis for histopathologic is then continued with Man Whitney analysis.

Conclusion

Regarding the radiologic score, amniotic membrane has similar radiological score to control, however the histopathologic score is better. Xenograft have similar radiological and histopathological score to the control. Combination of amniotic membrane with xenograft has better histopathological score to control. Although the radiologic score is similar.

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"Glutamat adalah molekul monoamin yang mengatur sel-sel saraf. Senyawa ini juga memiliki reseptor pada sel imun. Regulasi glutamat sel imun termasuk kemotaksis, diferensiasi, proliferasi dan apoptosis. Tujuan dari penelitian ini adalah menentukan produksi sitokin PBMC yang dirangsang dengan glutamat. Sitokin dinilai dengan metode elisa. PBMC dikumpulkan dari 10 donor pria sehat. PBMC 7x105 yang diisolasi dirangsang dengan glutamat atau tidak diobati, diinkubasi selama 24 jam 5% CO2 37 oC dalam media lengkap asam amino, vitamin B kompleks dan ion. Terjadi penurunan sitokin pada kelompok yang distimulasi glutamat daripada kelompok kontrol. Dijelaskan bahwa glutamat berubah menjadi metabolit dalam mitokondria. Sebagai kesimpulan, hasil ini menunjukkan bahwa glutamat memiliki dampak menurunkan produksi sitokin pada PBMC manusia yang sehat.

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Glutamate are monoamine molecules that regulate nerve cells. These compounds also have receptors on immune cells. Glutamate regulation of immune cells include chemotaxis, differentiation, proliferation and apoptosis. Aim of this study is determining cytokine production PBMC stimulated with glutamate. Cytokine was assessed by elisa method. PBMC was collected from 10 healthy male donors. Isolated 7x105 PBMCs were stimulated with Glutamate or untreated, incubated for 24 hours 5 % CO2 37 oC in a complete medium of amino acids, vitamin B complex and ions. A decrease in cytokine in glutamate treated group than control group. It was suggested that Glutamate role as metabolite in mitochondria. As conclusion, these results suggest that glutamate have suppresing impact on cytokine production in healthy human PBMC."

"Latar Belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit infeksi saluran pernapasan yang pertama kali ditemukan di Wuhan. Sejak ditetapkan sebagai pandemi oleh WHO hingga 3 Juli 2021 terdapat sebanyak 183.098.615 kasus terkonfirmasi positif COVID-19 dengan jumlah kematian sebesar 3.964.145 kasus di seluruh dunia. Secara etiologi COVID-19 disebabkan oleh varian coronavirus baru yang dikenal sebagai SARS-CoV-2. Individu yang terinfeksi SARS-CoV-2 sebagian besar mengalami gejala ringan atau asimtomatik. Namun, pada sebagian orang dengan usia lanjut dan mengidap penyakit komorbid manifestasi gejala berat lebih sering ditemui. Salah satu faktor yang berkaitan terhadap manifestasi COVID-19 adalah respons imun host. Molekul sitokin merupakan protein yang berperan untuk mengaktifkan mekanisme perlawanan terhadap virus. Pengetahuan tentang profil imunitas yang diperantarai oleh sitokin dari saluran napas atas masih sangat sedikit sekali yang dipelajari. Penentuan biomarker yang dapat dijadikan penanda keparahan juga perlu untuk diketahui. Metode: Sampel swab NP diperoleh dari pasien terkonfirmasi positif COVID-19. Subjek dibagi menjadi 2 kategori berdasarkan manifestasi COVID-19 gejala ringan dan berat. Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF dianalisis dari sampel swab NP menggunakan Luminex® assay. Hasil: Faktor demografi seperti usia (p=0,024) dan komorbid (p=0,017) secara signifikan berperan dalam menentukan keparahan gejala pada pasien COVID-19. Kadar (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF antara kedua kelompok pasien COVID-19 gejala ringan dan berat tidak berbeda signifikan. Namun demikian, terdapat kecenderungan bahwa kadar (pg/ml) IL-2, IL-4, IL-13, dan GMCSF meningkat pada kelompok pasien COVID-19 gejala berat. Sedangkan, kadar (pg/ml) IL-10 dan IL-17A cenderung menurun pada pasien COVID-19 yang bergejala berat. Selain itu, rasio antara IL-2/IL-10 secara signifikan (p=0,004) lebih tinggi pada pasien COVID-19 gejala berat. Sebanyak 65,7% pasien COVID-19 dengan gejala berat memiliki nilai rasio IL-2/IL-10 yang tinggi. Kesimpulan: Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A dan kemokin GMCSF (pg/ml) dari sampel swab NP dapat terdeteksi menggunakan Luminex® assay. Rasio kadar sitokin IL-2/IL-10 dapat dijadikan sebagai kandidat biomarker keparahan infeksi COVID-19 di masa mendatang.

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Background: Coronavirus disease 2019 (COVID-19) is a respiratory tract infectious disease. Since the outbreak in Wuhan, COVID-19 was declared as a pandemic by WHO. Data from July 3rd, 2021, showed that there have been 183,098,615 confirmed positive cases of COVID-19 with a death toll of 3,964,145 worldwide. Etiologically COVID-19 is caused by the new coronavirus known as SARS-CoV-2. The majority of people infected with SARS-CoV-2 experience mild symptoms or even are asymptomatic. However, for some people with older age and having comorbid diseases, severe manifestations are very common. Host immune response is one of the factors which affect disease severity. Playing a vital role in activating the immune system against viruses, cytokine protein can also contribute to the severity. Currently, very little is known about the profile of cytokine-mediated immunity from the upper respiratory tract. This research is aimed to find a potential candidate of biomarkers to predict severity in the early phase of COVID-19 infections.

Methods: NP swab samples were obtained from patients who were positively confirmed for COVID-19. Subjects were divided into 2 categories based on the manifestation as mild or severe symptoms of COVID-19. Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF were analyzed from NP swab samples using Luminex® assay.

Results: Demographic factors such as age (p=0.024) and comorbidities (p=0.017) significantly played a role in determining severity of COVID-19 patients. The levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF between the two groups of patients with mild and severe COVID-19 symptoms were not significantly different. However, there was a tendency that the levels (pg/ml) of IL-2, IL-4, IL-13, and GMCSF to increase in the group of patients with severe COVID-19 symptoms. Meanwhile, levels (pg/ml) of IL-10 and IL-17A tend to decrease in COVID-19 patients with severe symptoms. In addition, the ratio of IL-2/IL-10 was significantly (p=0.004) higher in severe COVID-19 patients. A total of 65.7% of COVID-19 patients with severe symptoms had high values of IL-2/IL-10 ratio.

Conclusion: Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF from NP swab samples can be detected using the Luminex® assay. The ratio of IL-2/IL-10 cytokine levels can be used as a biomarker candidate to predict severity for COVID-19 infection in the future."

"Infark miokard menyebabkan kematian kardiomiosit dan remodeling jantung pada situasi patologis. Pascainfark jantung tidak mampu mengatasi kehilangan kardiomiosit meskipun telah dilakukan rekanalisasi atau revaskularisasi. Oleh karena itu, diperlukan metode untuk mengembalikan fungsi jantung. Sel punca dapat memperbaharui diri dan berdiferensiasi menjadi berbagai tipe sel namun kesintasannya pada pasien masih rendah. Untuk meningkatkan retensi dan regenerasi sel punca di miokardium dapat digunakan perancah/scaffold dan sistem ko-kultur, namun belum ada penelitian tentang hal tersebut. Penelitian ini bertujuan mengembangkan terapi infark menggunakan injeksi hidrogel transepikardial dan implantasi di epikardial perancah patch membran amnion yang dideselularisasi menggunakan amniotic epithelial cells (AEC) dengan ko-kultur kardiomiosit. Penelitian ini menggunakan post-test only control group design yang dilakukan di Institut Pertanian Bogor dan Fakultas Kedokteran Universitas Indonesia dari Juli 2021–Oktober 2022. Subjek penelitian adalah 15 babi Sus scrofa domesticus usia 2-3 bulan dibagi tiga kelompok: pAEC, pAEC + kardiomiosit, kontrol positif, dan 1 babi sebagai kontrol negatif. Torakotomi dilakukan untuk membuat model infark dengan ligasi arteri proximal branch to left ventricle (PLV) dilanjutkan implantasi pAEC dengan atau tanpa ko-kultur kardiomiosit pada kelompok terapi, kemudian diobservasi selama 6–8 minggu. Luas infark diukur dengan late gadolinium enhancement MRI; remodeling ventrikel kiri dengan ekokardiografi untuk menilai kontraktilitas, fibrosis dengan IHK, kardiomiogenesis dan regulasi apoptosis dengan RT-PCR, angiogenesis dinilai dengan IHK, dan fraksi ejeksi dinilai dengan ekokardiografi. Luas infark menurun pada kedua kelompok terapi (2,5 [2,00–3,00]% dan 3,60 ± 1,34% vs 9,50 ± 1,91%). Pewarnaan HE dan Masson trichrome menunjukkan berkurangnya proses fibrosis pada kedua kelompok, dikonfirmasi dengan hiperekspresi kolagen1 yang padat dan kaku pada kontrol positif dibandingkan kedua kelompok terapi yang memiliki ekspresi kolagen3 lebih dominan. Ekspresi α-smooth muscle actin pada kedua kelompok tampak tersebar menunjukkan penurunan fibrosis dan kontrol positif menunjukkan peningkatan fibrosis. Peningkatan kardiomiogenesis pada kedua kelompok dikonfirmasi dengan peningkatan ekspresi gen cardiac troponin T, gen myosin heavy chain, gen Nkx.2.5, gen c-Kit, dan penanda otot fungsional α-actinin. Penurunan apoptosis dikonfirmasi dengan penurunan ekspresi gen modulator apoptosis p21 dan ekspresi gen p53 yang berarti diferensiasi sel punca tidak bersifat tumorigenik. Regulasi apoptosis melalui ekspresi kaspase-9 tidak berbeda bermakna. Peningkatan angiogenesis dikonfirmasi dengan peningkatan ekspresi von Willebrand Factor dan ekspresi α-smooth muscle actin yang tersebar. Ekokardiografi menunjukkan perbaikan regional wall motion abnormality lebih banyak pada kelompok terapi daripada kontrol positif dan fraksi ejeksi tidak berbeda bermakna antar kelompok. Disimpulkan kombinasi injeksi hidrogel transepikardial dan implantasi di epikardial perancah patch membran amnion yang dideselularisasi dengan ko-kultur AEC dan kardiomiosit dapat mengurangi luas infark dan remodelling ventrikel kiri, serta meningkatkan angiogenesis pada babi model infark.

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Myocardial infarction induces cardiomyocyte death and remodelling a pathological condition. The post-infarct heart is unable to deal with cardiomyocyte loss despite recanalization or revascularization. Therefore, a procedure is required to restore cardiac function. Stem cells can self-renew and specialize into multiple cell types however the survival of stem cells in patients is still poor. To promote the retention and regeneration of stem cells in the myocardium, scaffolds and co-culture systems may be applicated, although there are no study findings on this issue. This study aimed to develop myocardial infarction therapy using transepicardial hydrogel injection and epicardial decellularized amniotic membrane scaffold patch implantation using amniotic epithelial cells (AEC) with cardiomyocyte co-culture. This study used a post-test-only control group design performed at the IPB University and the Faculty of Medicine, Universitas Indonesia, from July 2021 to October 2022. The study subjects were 15 Sus scrofa domesticus pigs aged 2-3 months placed into three groups: pAEC, pAEC + cardiomyocytes, positive control, and 1 pig as a negative control. Thoracotomy was conducted to create an infarct model with the proximal branch to left ventricle (PLV) artery occlusion followed by pAEC implantation with or without cardiomyocyte co-culture in the therapy group, then evaluated for 6–8 weeks. Infarct size was determined by late gadolinium enhancement MRI, left ventricular remodeling by echocardiography to evaluate contractility, fibrosis by IHC, cardiomyogenesis and regulation of apoptosis by RT-PCR, angiogenesis was assessed by IHC, and ejection fraction by echocardiography. Infarct size reduced in both therapy groups (2,5 [2,00–3,00]% and 3,60 ± 1,34% vs 9,50 ± 1,91%). HE and Masson trichrome staining demonstrated decreased fibrosis in both groups, confirmed by hyperexpression of dense and stiff collagen 1 in the positive control compared to the two therapy groups with more dominant collagen 3 expressions. The α-smooth muscle actin expression in both groups seemed to be scattered suggesting reduced fibrosis while the positive control showed increased fibrosis. Increased cardiomyogenesis in both groups was confirmed by increased expression of the cardiac troponin T gene, the myosin heavy chain gene, the Nkx.2.5 gene, the c-Kit gene, and the functional muscle marker α-actinin. The reduction in apoptosis has been confirmed by lower expression of the p21 apoptosis modulator gene and p53 gene expression, which suggests that stem cell differentiation is not tumorigenic. The control of apoptosis by caspase-9 expression was not significantly different. Increased angiogenesis was verified by increased von Willebrand Factor expression and scattered expression of α-smooth muscle actin. Echocardiography showed greater improvement in regional wall motion abnormalities in the therapy groups than in the positive control, and the ejection fraction was not significantly different between groups. It was concluded that the combination of transepicardial hydrogel injection and epicardial decellularized amniotic membrane scaffold patch implantation using AEC with cardiomyocyte co-culture could reduce infarct size and left ventricular remodeling, as well as increase angiogenesis in infarct model pigs."