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"Latar belakang: Matrix metalloproteinases (MMPs) merupakan protein yang berperan dalam proses inflamasi dan remodeling yang disebabkan oleh infeksi, termasuk tuberkulosis paru (TB), terutama multidrug resistance. Penelitian ini bertujuan untuk mengkorelasikan hubungan antara kadar serum dan polimorfisme MMP-1 dan MMP-9 dengan karakteristik kavitas, seperti jumlah, diameter, ketebalan dinding, dan distribusi fibrosis pada Multidrug-Resistant (MDR) dan Drug-Sensitive (DS) pasien TB.Metode: Penelitian ini menggunakan desain studi potong lintang komparatif. Subyek yang berasal dari pasien rawat jalan RS Abdoel Moelok Lampung Indonesia telah lulus uji etik. Subjek dibagi menjadi dua kelompok, 34 subjek pada kelompok MDR-TB dan 36 subjek pada kelompok DS-TB. Kadar protein serum MMP-1 dan MMP-9 dilakuakn dengan uji ELISA, dan genotipe MMP-1 dan MMP-9 dengan Sequencing metode Sanger. Kemudian kavitas dan fibrosis dievaluasi dengan menggunakan pemeriksaan High-Resolution Computerized Tomography (HRCT) toraks.Hasil: Terdapat perbedaan bermakna jumlah kavitas dengan diameter lebih dari 6, 6 mm, dan tebal kavitas pada pasien TB-MDR dibandingkan dengan pasien TB-DS. Distribusi fibrosis pada segmen paru juga berbeda nyata pada MDR-TB dibandingkan dengan DS-TB. Walaupun kadar MMP-9 pada kelompok MDR-TB lebih tinggi dibandingkan dengan kelompok DS-TB, namun secara statistik tidak terdapat perbedaan yang signifikan dari penelitian yang menunjukkan bahwa terdapat hubungan antara MDR-TB dan DS-TB mengenai jumlah kavitas, diameter kavitas, ketebalan dinding kavitas, serta distribusi fibrosis di segmen paru-paru yang terkena yang dievaluasi dengan HRCT. Penelitian ini mendapatkan frekuensi alel G pada MMP-1 pada populasi Indonesia (Asia) dan adanya hubungan yang signifikan dengan tebal kavitas dengan alel G pada MMP-1 dan alel T pada MMP-9 alelKesimpulan: Tidak terdapat hubungan antara genotipe MMP-1 (-1607G) dan MMP-9 (C1562T) dengan kadar serum MMP-1 dan MMP-9, genotipe MMP 1 pada kedua kelompok penelitian berbeda secara bermakna dan merupakan faktor pencegahan dua kali lipat kejadian MDR-TB. Selain itu, terdapat perbedaan yang substansial dalam ketebalan dinding kavitas antara genotipe G/G MMP-1 1607 T/T MMP-9 pada kedua kelompok penelitian.

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Background: Matrix metalloproteinases (MMPs) are proteins that play a role in the inflammatory and remodeling processes caused by infections, including pulmonary tuberculosis (TB), especially multidrug resistance. This study aims to correlate the relationship between serum levels and polymorphism of MMP-1 and MMP-9 with cavity characteristics, such as number, diameter, wall thickness, and distribution of fibrosis in Multidrug-Resistant (MDR)- and Drug-Sensitive (DS)-TB patients.

Method: This study used a comparative cross-sectional study design. The subjects came from outpatients at Abdoel Moelok Hospital, Lampung Indonesia had passed the ethical test. Subjects were divided into two groups, 34 subjects in the MDR-TB group and 36 subjects in the DS-TB group. The levels of MMP-1 and MMP-9 were carried out by ELISA test, and the genotipes MMP-1 and MMP-9 were determined using PCR-the Sequencing method. In addition, cavities and fibrosis were measured using thoracic High- Resolution Computerized Tomography (HRCT) imaging.

Results: There was a significant difference in the number of cavities with a diameter of more than 6.6 mm, and cavity thickness in MDR-TB patients compared to DS-TB patients. The distribution of fibrosis in the lung segments was also significantly different in MDR-TB compared to DS-TB. Although MMP-9 levels in the MDR-TB group were higher than in the DS-TB group, there was no statistically significant difference from the study, which showed a relationship between MDR-TB and DS-TB regarding the number of cavities, cavity diameter, walls thickness cavity, as well as the distribution of fibrosis in the affected lung segments evaluated by HRCT. This study found the frequency of the G allele in MMP-1 in the Indonesian population (Asia) and a significant relationship with cavity thickness between the G allele in MMP-1 and the T allele in MMP-9.

Conclusion: There is no relationship between the MMP-1 (-1607G) and MMP-9 (C1562T) genotypes with serum levels of MMP-1 and MMP-9, the MMP 1 genotype in the two study groups was significantly different and was a factor preventing twice the incidence MDR-TB. In addition, the two study groups showed substantial differences in cavity wall thickness between the G/G MMP-1 1607 T/T MMP-9 genotypes."

"Latar belakang dan tujuan: Sekuele TB dapat berupa keluhan respirasi yang menetap, risiko infeksi saluran napas berulang dan gangguan fungsional. Berkurangnya kualitas hidup, disabilitas dan besarnya biaya yang harus dikeluarkan oleh sistem penjamin kesehatan merupakan hal lain yang terkait dengan kondisi ini. Peneliti berupaya untuk mengetahui kualitas hidup pasien bekas TB dihubungkan dengan pemeriksaan high resolutioncomputerized tomography scanning (HRCT) toraks danuji faal paru. Metode: Penelitian potong lintang terhadap pasien yang telah menyelesaikan pengobatan TB kategori 1 diinstalasi rawat jalan poliklinik paru RSUP Persahabatan/Departemen Pulmonologi dan Kedokteran RespirasiFKUI Jakartapada tanggal 1 Desember 2016 - 30 Juni 2017.Hasil: Terdapat 32 subjek yang mengikuti penelitian ini, 56,3% diantaranya laki-laki. Sebanyak 57,8% subjek mengalami gangguan kualitas hidup dengan gangguan kualitas hidup terbanyak (24,4%) pada kedua ranah (fisis dan mental). Gangguan ranah fisis yang paling banyak dirasakan adalah rasa nyeri (30,3%), fungsi sosial merupakan ranah mentah yang paling banyak mengalami gangguan (36,4%). Sekuele sedang pada HRCT toraks ditemukan pada 43,8% subjek. Rata-rata KVP 2265 ml (95% CI 2043.73-2495.26) dan rata-rata VEP1 1898 ml (95% CI 1667-2129) dengan kelainan terbanyak restriksi (68,8%). Uji Chi square mendapatkan hubungan tidak bermakna antara hasil HRCT toraks dan kualitas hidup pasien bekas TB (p=0,455). Tidak terdapat hubungan bermakna antara hasil pemeriksaan spirometri dan kualitas hidup (p=0,470). Uji Mann Whitney menunjukkan hubungan bermakna antara VEP1/KVP dan hasil HRCTtoraks (p=0,00).Kesimpulan: Sebagian besar pasien bekas TB mengalami gangguan kualitas hidup yang secara statistik tidak berhubungan dengan luas lesi pada HRCT toraks dan pemeriksaan spirometri. Luas lesi pada HRCT toraks berhubungan dengan nilai VEP1/KVP.

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Introduction: Sequelae of tuberculosis (TB) could arise as a persistent respiratory complaint, risk of recurrent respiratory infections and functional impairment. Reduced quality of life, disability and the cost to be paid by the health insurer system are other things related to this condition. This study aims to determine the quality of life of former TB patients associated with high resolution tomography scanning (HRCT) examination with pulmonary function tests.Method: This study was a cross-sectional study with the subjects were the patients who have completed TB treatment of category 1 in the outpatient Pulmonary Clinic of Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Indonesia, Persahabatan Hospital Jakarta on December 1, 2016 to June 30, 2017.Result: There were 32 subjects in this study. As much as 56.3% of the subjects were men and 57.8% of subjects experienced quality of life disorder. The most quality of life disorder found in the subjects was occured in both sphere, physical and mental quality of life disorder (24.4%). The most perceived physical disturbance was pain (30.3%) and impaired social function was the most problematic crude (36.4%). A sequelae on HRCT of the thorax was found in 43.8% of subjects. Average FVC was 2265 ml (95% CI 2043.73-2495.26) and average FEV1 was 1898 ml (95% CI 1667-2129). Most of the lung function disorder was restriction disorder (68.8%). The chi square test found no significant correlation between HRCT and quality of life of TB patients (p = 0.455). There was no significant correlation between spirometry and quality of life (p=0.470). Mann Whitney test on FEV1/FVC and thorax HRCT found significant correlation (p=0.00).Conclusion: Most of the former TB patients have a quality of life disorder that is statistically unrelated to the extent of the lesions on thoracic CT-Scan and spirometry examination. The area of ​​the lesion on the HRCT of the thorax corresponds to the FEV1/FVC value."

"Latar belakang: Atresia bilier merupakan penyebab paling umum fibrosis hati pada anak, dan menjadi indikasi terbanyak transplantasi hati. Fibrosis hati dapat dinilai dengan pemeriksaan histopatologis dan kuantifikasi skor Laennec. Pemeriksaan biomarker dari darah dan metode pencitraan radiologis merupakan upaya lain untuk menilai derajat fibrosis hati. Penelitian ini dimaksudkan untuk meneliti perbandingan biomarker penanda fibrosis transforming growth factor (TFG-β), matrix metalloproteinase (MMP)-7, dan ultrasonografi (USG) Acoustic Radiation Force Impulse (ARFI) dengan derajat fibrosis berdasarkan pemeriksaan histopatologi. Metode penelitian: Penelitian ini merupakan penelitian desain cross sectional pada pasien anak dengan kolestasis yang dicurigai akibat atresia bilier di ruang rawat anak RSUPN Cipto Mangunkusumo. Data penelitian ini adalah data primer dari anamnesis, pemeriksaan fisik, serta data sekunder dari rekam medis untuk melihat riwayat penyakit pasien. Dilakukan pemeriksan serum biomarker TGF-β dan MMP-7, dan USG ARFI oleh operator yang telah ditentukan. Dibandingkan hasil pemeriksaan TGF-β, MMP-7, USG ARFI dengan hasil skoring fibrosis biopsi hati.Hasil penelitian: Dari total 15 pasien dengan AB, terdapat 6 pasien F2-F3, dan 9 pasien F4 berdasarkan derajat fibrosis biopsi hati. Terdapat peningkatan kadar TGF-β dengan adanya peningkatan derajat fibrosis biopsi hati, namun tidak terdapat hubungan bermakna antara derajat fibrosis hati dengan kadar TGF-β (uji Mann-Whitney, p=0.768). Pada penelitian ini, rerata kadar MMP-7 pada kelompok F2-3 dan F4 menunjukan peningkatan, namun tidak terdapat hubungan yang bermakna (Uji Mann-Whitney, p=0.409). Terdapat hubungan bermakna antara derajat fibrosis hati F2-F3 dengan derajat F4 yang diperoleh berdasarkan hasil USG ARFI dan hasil biopsi hati (p<0,01). Kesimpulan: TGF-β dan MMP-7 merupakan biomarker yang cukup efektif namun memiliki keterbatasan tidak spesifik untuk AB. USG ARFI merupakan pemeriksaan minimal invasive yang efektif untuk menentukan derajat fibrosis.

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Background: Biliary atresia is the most common cause of liver fibrosis and the highest indication for liver transplantation in pediatrics. Liver fibrosis is quantified through Laennec score based on histopathology of liver biopsy. Blood serum biomarkers and radiological examinations are alternative methods that could determine liver fibrosis. This study aimed to compare the significance of serum biomarkers transforming growth factor (TFG-β), matrix metalloproteinase (MMP)-7, and Acoustic Radiation Force Impulse (ARFI) ultrasonography (USG) in determining the degree of liver fibrosis compared to histopathology score from liver biopsy. Method: This was a cross-sectional study, on patients in the pediatric ward at dr. Cipto Mangunkusumo National Hospital, that were admitted with cholestasis with biliary atresia as the suspected etiology. Primary data was obtained through anamnesis, and physical examination, and secondary data was obtained through patients’ medical records. Serum biomarkers TGF-β and MMP-7, and USG ARFI were examined by related experts and results were obtained through medical records. Results of TGF-β, MMP-7, and USG ARFI were compared with fibrosis scores based on liver biopsy.

Result: From a total of 15 patients with AB, there were 6 F2-F3 patients, and 9 F4 patients according to the biopsy results. TGF-β levels showed and increasing trend alongside increase in liver biopsy fibrosis score, however it was not statistically significant (Mann- Whitney test, p=0.768). In this study, there was an increase in MMP-7 levels in F2-3 group compared to f4 group, however there was no statically significant difference (Mann-Whitney test, p=0.409). The ARFI USG results showed significant difference between F2-F3 group and F4 group based on ARFI USG compared to liver biopsy (p<0.01). Conclusion: TGF-β and MMP-7 are effective serum biomarkers, however, lacked specificity to determine fibrosis levels in biliary atresia. A minimally invasive test that is effective in determining the degree of fibrosis can be done through ARFI USG. "

"Latar Belakang: Periodontitis kronis adalah penyakit multifaktorial yang dipengaruhi oleh plak bakteri dan respon inflamasi tubuh dengan matriks metalloproteinase sebagai salah satu molekul inflamasi yang ditemukan meningkat pada penyakit periodontal. Skeling dan penghalusan akar (SPA) telah umum digunakan sebagai pengobatan konvensional atau non-bedah dalam terapi periodontal. Tujuan: Untuk mengevaluasi ekspresi m-RNA matriks metalloproteinase-9 (MMP-9), jumlah Tannerella forsythia (T. forsythia), dan parameter klinis periodontal satu bulan setelah SPA. Metode: Lima puluh gigi dengan poket 4-6 mm dari enam pasien periodontitis kronis dan satu subjek periodontal sehat disertakan dalam penelitian ini. Data penelitian cairan sulkus gingiva diambil dari poket terdalam setiap gigi dengan poket periodontal 4-6 mm untuk mengukur tingkat ekspresi m-RNA MMP-9 dan T.forsythia menggunakan quantitative real time-PCR (qPCR). Kedalaman poket, indeks perdarahan gingiva, dan kehilangan perlekatan klinis diukur pada hari pertama sebagai baseline dan pada hari ke 30. SPA dilakukan pada hari ke-1. Data dianalisis menggunakan program perangkat lunak SPSS 22.0. Hasil: Dibandingkan dengan kontrol, parameter klinis periodontal dan T.forsythia secara signifikan berkurang sementara pengurangan ekspresi m-RNA ­MMP-9 ditemukan tidak signifikan pada hari ke-30 setelah SPA. Kesimpulan: Satu bulan setelah SPA pada periodontitis kronis dengan poket 4-6 mm didapatkan penurunan jumlah T.forsythia dan parameter klinis periodontal secara signifikan dengan ekspresi m-RNA MMP-9 menurun tidak signifikan. Penelitian lebih lanjut dengan periode pengamatan lebih lama diperlukan untuk mengkonfirmasi atau menolak temuan di atas.

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Background: Chronic periodontitis is a multifactorial disease influenced by both bacterial plaque and host inflammatory response with matrix metalloproteinase as one of inflammatory molecules found elevated in periodontal disease. Scaling and root planning (SRP) has been commonly used as conventional or non-surgery treatment in periodontal therapy. Aim: To evaluate m-RNA expression of matrix metalloproteinase-9 (MMP-9), Tannerella forsythia (T. forsythia), and clinical periodontal parameter one month after SRP. Methods: Fifty tooth with pocket 4-6 mm from six CP patients and one periodontally healthy subject was recuited in this study. Gingival crevicular fluid (GCF) were collected from deepest pocket of every tooth with pocket 4-6 mm, the expression level of MMP-9 m-RNA and T.forsythia was measured using quantitative real time-PCR(qPCR). Pocket depth (PD), papilla bleeding index (PBI), and clinical attachment loss (CAL) were measured on day 1 as baseline and on the 30th day. SRP were performed on day 1. Data were analyzed using SPSS 22.0 software program. Results: By comparing to control, the periodontal clinical parameters and T.forsythia were significantly reduced after SRP while the reduction of MMP-9 m-RNA expression was found no significantly after 30th day. Conclusion: Our study show that SRP was clinically effective for CP with 4-6 mm pocket although the expression of MMP-9 m-RNA was not significantly reduced following SRP for one month period. Further studies with longer observation period are needed to confirm or reject the above finding."

"ABSTRAKLatar belakang. MMP (matrix metalloproteinase) merupakan protease yang memiliki peran yang sangat penting pada proses invasi dan metastasis, namun dengan berkembangnya pengetahuan mengenai akivitas MMP dan matriks esktraseluler, MMP dipikirkan ikut berkontribusi dalam lesi-lesi intraepithelial neoplasia serviks. MMP 2 dan MMP 9 merupakan anggota kelompok gelatinase yang sering dilaporkan kaitannya dengan progresifitas lesi kanker serviks, yang umumnya penelitian ini dilakukan pada jaringan. Berbagai penelitian berusaha menginvestigasi lebih lanjut kaitan HPV yang merupakan faktor etiologi utama dari kanker serviks dengan overekspresi MMP 2 dan MMP 9 pada kanker serviks. Tujuan penelitian ini adalah untuk mengetahui hubungan ekspresi MMP 2 dan MMP 9 dengan derajat neoplasia serviks dan infeksi HPV. Bahan dan cara. Penelitian ini dilakukan secara prospektif, menggunakan studi analitik potong lintang dengan mengumpulkan sediaan pap smear berbasis cairan yang telah didiagnosis sesuai dengan klasifikasi Bethesda 2001. Pada kasus yang terdapat kelainan akan dilanjutkan dengan pemeriksaan imunositokimia MMP 2 dan MMP 9. Data sekunder yang dikumpulkan antara lain usia dan hasil pemeriksaan HPV. Hasil. Terdapat hubungan bermakna antara ekspresi MMP2 dan MMP 9 dengan derajat neoplasia serviks (masing-masing p=0,001 dan p=0,000), sebaliknya tidak ditemukan hubungan bermakna antara ekspresi MMP 2 dan MMP 9 dengan infeksi HPV (masing-masing p=0,552 dan p=1,000). Kesimpulan. Ekspresi MMP 2 dan MMP 9 dapat ditemukan pada lesi atipikal, prekanker dan kanker serviks. Tampak proporsi positifitas ekspresi MMP 2 dan MMP 9 yang lebih tinggi pada lesi derajat tinggi dibandingkan pada lesi derajat rendah.

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ABSTRACTBackground. MMPs (matrix metalloproteinase) are proteases that essential for invasion and metastatic process, but with knowledge development about MMPs’s activity and extracellular matrix, MMPs was also thought contributed in cervical intraepithelial lesions. MMP 2 and MMP 9 are the member of gelatinase that often reported associated with cervical cancer progressivity. A lot of studies tried to investigate further whether HPV as the main etiology factor was related with the overexpression of MMP 2 and MMP 9 in cervical neoplasia. The objective is to study the expression of MMP 2 and MMP 9 and its relationship with the degree of neoplasia cervical lesions and HPV infection. Material and methods. This is a prospective analytic cross-sectional study using Liquid base cytology slides that was diagnosed according Bethesda 2001 classification. Cases were reviewed and cases with abnormality were conducted MMP 2 and MMP 9 immunocytochemistry. Age and HPV examination results were also collected. Results. There were significantly association between MMP 2, MMP 9 and degree of neoplasia cervical lesion, with p=0,001 and p=0,000 respectively. There were no statistically association between MMP 2, MMP 9 and HPV infection with p=0,552 and p=1,000 respectively. Conclusion. MMP 2 and MMP 9 expression can occur in atypical, precancer and cancer lesions. It was shown that high grade cervical lesions had higher proporsion of MMP 2 and MMP 9 expression than low grade cervical lesions."

"[ABSTRAK Multi Drug Resitance Tuberculosis (MDR TB) merupakan masalah terbesar dalampencegahan dan pemberantasan TB dunia. Indonesia berada di peringkat 8 dari 27 negaradengan MDR TB terbanyak di dunia. WHO Global Report 2013, memperkirakan pasienMDR TB di Indonesia berjumlah 6.900 pasien. MDR TB adalah penyakit yangdisebabkan oleh Mycobacterium Tuberculosis yang resisten minimal terhadap rifampisindan isoniazid. Penelitian ini berfokus pada bagaimana pengalaman pasien menjalanipengobatan Multi Drugs Resistance Tuberculosis dan seperti apa pasien memaknaipengalamannya tersebut. Desain penelitian kualitatif fenomenologi dipilih untukmendapatkan informasi yang sifatnya individual secara mendalam sesuai pengalaman dankondisi penyakit yang dialami. Partisipan ditentukan dengan tehnik purposive sampling,berjumlah tujuh orang. Tehnik wawancara mendalam dilakukan menggunakan alatperekam dan panduan wawancara semiterstruktur, serta catatan lapangan. Analisa datamenggunakan qualitative content analysis dengan pendekatan Collaizi. Tema yangditemukan sebagai hasil penelitian yaitu : Pemahaman penyakit MDR TB;ketidaknyamanan saat menjalani pengobatan Multi Drugs Resistance Tuberculosis;hambatan penderita untuk sembuh, menerima dukungan, dan harapan pengobatan.Diperlukan studi lebih lanjut untuk mengkaji secara mendalam tema yang telahteridentifikasi pada jumlah partisipan yang lebih banyak dan bervariasi.ABSTRACT Multi Drug Resistant (MDR - TB ) is the biggest problem of TB prevention and

eradication in the world. Indonesia is ranked 8 of 27 countries with MDR-TB in the

world. WHO global reported 2013, estimated MDR-TB patients in Indonesia amounted to

6.900 patient. MDR-TB is caused by Mycobacterium tuberculosis that resistant to at least

rifampicin and isoniazid. This study will focus on how the experience of undergoing

treatment of Multi Drugs Resistance Tuberculosis and patient?s insight of the experience.

Phenomenological qualitative research design was choosen to obtain information that is

significantly individual according to the experience. Participants were determined by

purposive sampling technique to seven people. In-depth interview conducted using a

recorder and semi-structured approach. Themes found as a result of the research : the

understanding of MDR TB; the experience discomfort while undergoing treatment of

Multi Drugs Resistance Tuberculosis; difficulties experienced during treatment; the

support received during treatment; and client expectations. Further study is needed to

profoundly examine the themes that have been identified on more numerous and varied

participants, Multi Drug Resistant (MDR - TB ) is the biggest problem of TB prevention and

eradication in the world. Indonesia is ranked 8 of 27 countries with MDR-TB in the

world. WHO global reported 2013, estimated MDR-TB patients in Indonesia amounted to

6.900 patient. MDR-TB is caused by Mycobacterium tuberculosis that resistant to at least

rifampicin and isoniazid. This study will focus on how the experience of undergoing

treatment of Multi Drugs Resistance Tuberculosis and patient’s insight of the experience.

Phenomenological qualitative research design was choosen to obtain information that is

significantly individual according to the experience. Participants were determined by

purposive sampling technique to seven people. In-depth interview conducted using a

recorder and semi-structured approach. Themes found as a result of the research : the

understanding of MDR TB; the experience discomfort while undergoing treatment of

Multi Drugs Resistance Tuberculosis; difficulties experienced during treatment; the

support received during treatment; and client expectations. Further study is needed to

profoundly examine the themes that have been identified on more numerous and varied

participants]"