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"Indonesian National Committee for human immunodeficiency virus (HIV) and acquired immune deficiency syndrome(AIDS) has reported the significant increase of HIV infected individual in Indonesia. A sensitive accurate diagnosticsare urgently needed to prevent the dissemination of HIV and also to provide a suitable therapy. For this reason, we havedeveloped HIV diagnostic method based on PCR to elucidate this problem. For this research, samples were collectedfrom hospitals and Indonesian Red Cross that consist of samples possesing HIV serological test positive andindeterminate. Ribonucleic Acid (RNA) were isolated from blood plasma. These RNA then were amplified afterReverse transcriptase reaction by using primers which have been designed using env (C2V3C3), Long TerminalRepeats (LTR) (U3) and Capsid gag (p24) as target regions. The obtained results shown 26/34 (76.5%) positive in LTR,10/33 (36.4%) positive in Env and 11/33 (33.3%) positive in p24. These results showed that LTR primers detect HIVmore than other primers. It suggests that LTR could be used as detection target as complement of env and p24 Theseresults need to be explored further by using sequencing method."

"Acquired Immunodeficiency Syndrome (AIDS) merupakan penyakit akibat infeksi Human Immunodeficiency Virus (HIV) yang memiliki jumlah penderita tinggi di Indonesia. Salah satu upaya untuk mencegah bertambahnya jumlah penderita AIDS tersebut ialah dengan penggunaan vaksin. Poliprotein Gag merupakan protein penyusun struktur internal HIV yang dapat digunakan sebagai vaksin karena dapat menginduksi respon imun tubuh. Penelitian telah dilakukan untuk mengekspresikan poliprotein Gag HIV-1 subtipe CRF01_AE yang telah diinsersi ke dalam vektor ekspresi pQE-80L. Ekspresi poliprotein tersebut dilakukan di dalam bakteri Escherichia coli BL21 dan E. coli BL21-CodonPlus (CP) dengan induksi Isoprophyl-β-D-thiogalactopyranoside (IPTG). Pendeteksian poliprotein Gag hasil ekspresi dilakukan dengan metode Sodium Dodecyl Sulphate Polyacrilamide Gel Electrophoresis (SDS-PAGE). Setelah poliprotein berhasil dideteksi, poliprotein Gag kemudian dipurifikasi dengan menggunakan metode kromatografi afinitas Ni2+-NTA di bawah kondisi native. Poliprotein Gag HIV-1 subtipe CRF01_AE dapat diekspresikan dalam E. coli BL21 dan E. coli BL21-CP dengan berat molekul sebesar 55,3 kDa.......Acquired Immunodeficiency Syndrome (AIDS) is a disease caused by infection of Human Immunodeficiency Virus (HIV) which has a high number of people in Indonesia. One of the efforts to prevent the increasing number of AIDS patients is the use of vaccine. Gag polyprotein is a constituent protein of HIV internal structure that can be used as a vaccine because it can induce immune response of the body. Research has been conducted to express the Gag polyprotein HIV-1 subtype CRF01_AE that have been cloned into the pQE-80L expression vector. Polyprotein expression was carried out in Escherichia coli BL21 and E. coli BL21-CodonPlus (CP) with Isoprophyl-β-Dthiogalactopyranoside (IPTG) induction. Detection of Gag polyprotein was performed by Polyacrilamide Sodium Dodecyl Sulphate Gel Electrophoresis (SDS-PAGE) method. After successfully detected, Gag polyprotein then purified using Ni2+-NTA affinity chromatography under native condition. Gag polyprotein HIV-1 subtype CRF01_AE can be expressed in E. coli BL21 and E. coli BL21-CP with molecular weight is 55,3 kDa."

"Sejak berakhirnya Perang Dingin isu-isu non-konvensional mulai mendapat perhatian lebih dibandingkan dengan sebelumnya, salah satunya isu HIV/AIDS. Kasus infeksi terparah terdapat di benua Afrika. Benua Afrika memiliki 63% kasus human immunodefiency virus (HIV)/AIDS dari keseluruhan kasus HIV/AIDS secara global, dengan hanya memiliki 10% dari penduduk dunia secara keseluruhan. Masalah kesehatan diperburuk dengan memprihatinkannya kondisi ekonomi di Afrika, dimana sekitar 80% negara-negara Afrika digolongkan ke dalam negara berpenghasilan rendah (low income countries) dengan pendapatan per kapita kurang dari US$ 2,400 per tahun.Hal tersebutlah yang mendorong hadirnya berbagai jenis bantuan ke Afrika. Amerika Serikat melalui USAID memberikan grant kepada Kenya. Kenya, sebuah negara di kawasan timur Afrika dimana setiap jamnya 16 nyawa terenggut karena HIV/AIDS, tidak luput dari perhatian Amerika Serikat. 14% dari penduduk Kenya usia produktif (15 - 49tahun) menderita HIV positif.Peran serta Amerika Serikat melalui USAID dalam membantu Afrika, kemudian mengalami perubahan ketika Amerika Serikat melalui Presiden George W. Bush mengeluarkan kembali Mexico City Policy atau yang sering disebut sebagai Global Gag Rule pada tanggal 22 Januari 2001. Ketika peran USAID yang besar terganggu dengan putusnya bantuan dana dari USAID kepada NGOs yang bekerja di Afrika dengan pelaksanaan Global Gag Rule, maka dengan sendirinya kebijakan tersebut berpengaruh pada usaha NGOs untuk melawan HIV/AIDS.

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In the post Cold War era, non-conventional issues became more highlighted then before, HIV/AIDS issue is one of them. Africa has 63% human immunodefiency virus (HIV)/AIDS cases globally, with only 10% of the world's citizens. The health problem is worsen with Africa's economic situation, 80% of African countries are low income countries with US$2,400 per person annually.That is the main reason of aid to Africa. United States of America trough USAID gave grant to Kenya. Kenya, a country in east Africa where there are 16 lives taken because of HIV/AIDS, is one of USAID?s focus. 14% of Kenya?s citizens (15 - 49 years old) are HIV positive. The illegal abortion rate is high among Kenyan women from all ages, economic background, and cultural background. Besides that Kenya is the first African country who issued policies on population and family plannung, which started in 1967.America's role trough USAID in helping Kenya changed when United States of America in Bush?s administration reinitiate Mexico City Policy or Global Gag Rule on 22nd January 2001. When the role of USAID is bugged with the cut of funding from USAID to NGOs, automatically it will influence NGOs actions in helping Africa?s health problems. On that note, the fight againts HIV/AIDS is taking it's toll."

"Latar Belakang : Penggunaan spray lidokain dengan obat anestetik intravena merupakan pilihan untuk sedasi pada endoskopi saluran cerna atas. Tetapi terdapat ketidaknyamanan dari pasien mengenai penggunaan spray lidokain. Inhalasi lidokain merupakan pilihan alternatif anestetik lokal. Penelitian ini bertujuan untuk membandingkan keefektifan dari spray lidokain dan inhalasi lidokain pada endoskopi saluran cerna atas. Metoda : 150 pasien yang menjalani endoskopi saluran cera atas dengan sedasi di RSUPN Cipto Mangunkusumo sejak November 2017 hingga April 2018, dengan kesan ASA I-II, BMI 18,5-29,9, dan setuju untuk mengikuti penelitian, dilakukan randomisasi dan dibagi menjadi 2 grup yang akan mendapatkan 1,5 mg/kgbb spray lidokain atau 1,5 mg.kgbb inhalasi lidokain. Untuk sedasi akan diberikan fentanyl 1 mcg.kgbb dan propofol 1,5 mg/kgbb bolus pada kedua grup . Tiap kejadian gag reflex dan penambahan dosis propofol akan dicatat. Hasil : Gag reflex terjadi sebanyak 1,3 % total pasien di grup inhalasi lidokain dan 30,7% pada grup spray lidokain (P<0,001). Rerata rescue dose propofol yang didapatkan pada grup inhalasi lidokain (0,67 ± 5,77 mg/kg) dan (11 ± 17,9 mg/kg) pada grup spray lidokain. Parameter lain seperti usia, jenis kelamin, kategori ASA, BMI didapatkan tidak signifikan. Simpulan : Inhalasi lidokain lebih efektif sebagai anestetik lokal dibandingkan spray lidokain sebagai adjuvan pada endoskopi saluran cerna atas. ......Background : Combination of spray lidocaine and intravenous anesthetic was the choice for upper gastrointestinal endoscopy (UGE). However, spraying lidocaine was found uncomfortable to the patient. Nebulized lidocaine was the alternative for local anesthetic. This study aimed to compare the effectiveness of spraying and nebulized lidocaine for patients undergoing UGE. Methods : 150 patients undergoing UGE under sedation at Cipto Mangunkusumo National Hospital from November 2017 until April 2018, with physical status ASA I-II, BMI 18,5-29,9, and agree to join the experiment, were randomized to receive either 1,5 mg/kg of spray lidocaine or 1,5 mg/kg of nebulized lidocaine. Combined sedation was achieved using fentanyl 1 mcg/kg and Propofol 1,5 mg/kg IV boluses. Every gag reflex occurred and rescue dose of propofol administered were recorded. Result : Gag reflex occurred 1,3% in nebulized lidocaine group and 30,7% occurred in spray lidocaine (P < 0,001). Mean rescue dose of propofol in nebulized lidocaine group (0,67 ± 5,77 mg/kg) and (11 ± 17,9 mg/kg) in spray group. Outcomes parameters including sex, age, ASA category, BMI were statistically unsignificant. Discussion : We think inability of spray lidocaine to resist gag reflex is because the process of spraying should be equal from each side of vocal cord, pharynx and larynx. Nebulization could split the lidocaine into small particle, so the spread of the lidocaine will be spread evenly. Conclusion : Nebulized lidocaine is more effective as local anesthetic than spray lidocaine for adjuvant in UGE."

"Latar belakang: Vaksin HIV-1 berbasis protein Gag diharapkan dapat menstimulus respon imun sel T CD8+ (sitotoksik). Protein Gag yang dihasilkan pada sistem ekspresi prokariota E.coli merupakan antigen yang berfungsi sebagai antigen eksogen. Fusi protein VP22 diharapkan dapat menghantarkan protein GagHIV1 ke sitoplasma sel sehingga berfungsi sebagai antigen endogen. Fusi protein eGFP berperan sebagai marker fluoresen untuk analisis lokalisasi protein sebagai pembuktian secara in vitro bahwa protein rekombinan VP22-eGFP mampu berpenetrasi dan masuk ke dalam sel vero.Metodologi: Sekuens VP22, GagHIV1, dan eGFP diinsersikan ke dalam plasmid pQE80L melalui proses transformasi. Protein rekombinan eGFP, VP22-eGFP, GagHIV1-eGFP, dan VP22-GagHIV1-eGFP diklona dan diekspresikan pada sistem E.coli. Proses purifikasi protein rekombinan dilakukan dengan metode Ni-NTA [QIAGEN]. Lokalisasi protein rekombinan dianalisis dengan menggunakan mikroskop fluoresen konvensional dan konfokal.Hasil: Konstruksi plasmid rekombinan pengekspresi protein eGFP, VP22-eGFP, GagHIV1-eGFP, dan VP22-GagHIV1-eGFP telah berhasil diperoleh dan keakuratan susunan basa nukleotida telah dibuktikan dengan metode sekuensing DNA. Hasil sekuens DNA memperlihatkan open reading frame yang sesuai untuk ekspresi protein rekombinan target. Ekspresi protein rekombinan GagHIV1-eGFP dan VP22-GagHIV1-eGFP dengan sistem E.coli belum berhasil diperoleh, kemungkinan disebabkan oleh ukuran protein yang besar (>60 kDa). Sedangkan protein rekombinan eGFP (31,38 kDa) dan VP22-eGFP (27,02 kDa) telah berhasil diekspresikan dan dipurifikasi. Analisis lokalisasi protein rekombinan VP22-eGFP menunjukkan terdapat fluoresen hijau di sitoplasma dan nukleus sel vero. Sedangkan protein rekombinan eGFP tidak ditemukan fluoresen di dalam sel vero.Kesimpulan: Ekspresi protein rekombinan GagHIV1-eGFP dan VP22-GagHIV1-eGFP dengan sistem E.coli masih perlu dioptimasi. Protein rekombinan VP22-eGFP pada penelitian ini dibuktikan dapat berpenetrasi ke sitoplasma dan inti sel vero. Selain vaksin GagHIV1, plasmid rekombinan pQE80L-eGFP dan pQE80L-VP22-eGFP yang diperoleh pada penelitian ini juga berpotensi untuk pengembangan vaksin sub unit eksogen virus lainnya yang ingin diubah menjadi bersifat endogen.

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Background: HIV-1 vaccine based Gag protein is expected to stimulate the immune response of CD8 + T cells (cytotoxic). Gag protein produced in E.coli prokaryotic expression system serves as an exogenous antigen. Fusion of VP22 protein is expected to deliver Gag HIV1 proteins to the cytoplasm of cell thus functions as an endogenous antigen. Fusion of eGFP protein is performed as a fluorescent marker for localization analysis conducted as the in vitro evidence of VP22-eGFP recombinant protein ability to penetrate and get into vero cell cytoplasm.Methodology: Sequence of VP22, Gag HIV1, and eGFP is inserted into pQE80L plasmid through the transformation method. The eGFP, VP22-eGFP, GagHIV1-eGFP, and VP22-GagHIV1-eGFP recombinant proteins were cloned and expressed in E. coli system. Recombinant protein purification process was conducted using Ni-NTA [QIAGEN]. Localization of recombinant proteins were analyzed using conventional fluorescence and confocal microscopy.Results: Construction of a recombinant plasmid encoding eGFP, VP22-eGFP, GagHIV1-eGFP, and VP22-GagHIV1-eGFP proteins has successfully obtained and the accuracy of the nucleotide base composition has been demonstrated by DNA sequencing. The results of the DNA sequence showed an open reading frame corresponding to the target recombinant protein expression. Expression of GagHIV1-eGFP and VP22-GagHIV1-eGFP recombinant proteins in E. coli system has not successfully obtained, probably due to the large size of the protein (> 60 kDa). While the recombinant protein VP22-eGFP (31,38 kDa) and eGFP (27,02 kDa) was successfully expressed and purified. Localization analysis of VP22-eGFP recombinant protein performs green fluorescent in cytoplasm and nucleus of vero cells. While eGFP recombinant protein in vero cell was not performs green fluorescent.Conclusion: Expression of GagHIV1-eGFP and eGFP-VP22-GagHIV1 recombinant protein in E.coli system still need to be optimized. The VP22-eGFP recombinant protein in this study indicates can penetrate to the cytoplasm and nucleus vero cells. Besides Gag HIV1 vaccines, pQE80L-eGFP and pQE80L- VP22-eGFP recombinant plasmids in this study can be utilized for the development of other viruses exogenous subunit vaccines which would be turned into endogenous."

"Latar Belakang: Skizofrenia merupakan gangguan jiwa berat yang kompleksdengan angka harapan hidup yang rendah karena penyakit kardiovaskular. Orangdengan skizofrenia rentan mengalami sindroma metabolik meskipun tidakmendapat pengobatan antipsikotika. Sebuah penelitian di RSUPN CiptoMangunkusumo menunjukkan prevalensi sindroma metabolik sebanyak 3,3%sampai 68% yang berhubungan dengan stress oksidatif dan berpotensi menurunkanproduksi ATP. Penelitian ini berusaha menjelaskan patofisiologi sindromametabolik pada skizofrenia dan hubungannya terhadap polimorfisme gen GCLCGAG TNR, stres oksidatif dan aktivitas metabolisme seluler.Metode: Penelitian merupakan penelitian observasional analitik. Subjek sebanyak25 pasien skizofrenia dan 25 pasien kontrol sehat dilakukan pengambilan fibroblasdan PBMC kemudian dilakukan pengamatan polimorfisme gen GCLC GAG TNR,stres oksidatif (kadar MDA, MnSOD, GSH, GSSG, dan rasio GSH/GSSG),aktivitas metabolisme seluler (kadar ATP), dan parameter sindroma metabolik(lingkar pinggang, Indeks Massa Tubuh (IMT), LDL-c, HDL-c, TG, HbA1C, dantekanan darah). Hubungan dianalisis dengan uji komparasi atau uji korelasi.Hasil: Terdapat korelasi pada sel fibroblas dengan PBMC yaitu korelasi kuat padaMnSOD (r=0.797) dan korelasi sedang pada GSSG (r=0.581). Didapatkanperbedaan yang bermakna pada kadar stres oksidatif yaitu MDA (p=0.013), GSH(p≤0.001), GSSG (p≤0.001), dan rasio GSH/GSSG (p≤0.001) pada kelompokskizofrenia dan kontrol serta didapatkan hubungan polimorfisme gen GCLC GAGTNR terhadap MDA (p=0.054) dan GSSG (p=0.010) pada kelompok skizofreniatetapi tidak ditemukan perbedaan kadar ATP dan hubungan antara polimorfismeGCLC GAG TNR terhadap kadar ATP. Pada orang dengan skizofrenia didapatkanlingkar pinggang, IMT, LDL-c, dan HDL-c yang lebih rendah(p=0.025;p=0.003;p=0.022;p=0.010) dan TG yang lebih tinggi (p=0.038)dibandingkan kelompok kontrol.Simpulan: Polimorfisme gen GCLC GAG TNR memiliki hubungan terhadap stresoksidatif tetapi tidak ada hubungan terhadap aktivitas metabolisme seluler. Tidakterdapat perbedaan aktivitas metabolisme seluler pada orang dengan skizofreniadan tidak ditemukan hubungan antara metabolisme seluler dengan sindromametabolik. Terjadi perubahan kadar penanda stres oksidatif yang memilikihubungan terhadap sindroma metabolik pada orang dengan skizofrenia......Background: Schizophrenia is a complex severe mental disorder with low lifeexpectancy due to cardiovascular disease. People with schizophrenia is prone tometabolic syndrome even if they do not receive antipsychotic. One study in CiptoMangunkusumo General Hospital showed the prevalence of metabolic syndromeas much as 3.3% to 68% which correlate with oxidative stress and has the potentialto reduce ATP production. This study aims to explain the pathophysiology of themetabolic syndrome in schizophrenia and its relationship to the GCLC GAG TNRgene polymorphism, oxidative stress and metabolic activity.Methods: This research is an observational analytic study. Twenty fiveschizophrenic patients and 25 healthy control patients were admitted to study.Fibroblast and PBMC (peripheral blood mononuclear cell) were taken to measureGCLC GAG TNR gene polymorphism, oxidative stress (levels of MDA, MnSOD,GSH, GSSG, and GSH/GSSG ratio), cellular metabolic activity (ATP levels), andmetabolic syndrome parameters (waist circumference, body mass index (BMI),LDL-c, HDL-c, TG, HbA1C, and blood pressure). Relationship between variableswere analyzed by comparison test or correlation test.Results: There is a correlation in fibroblast cells with PBMC with a strongcorrelation in MnSOD (r=0.797) and a moderate correlation in GSSG (r=0.581).There were significant differences in the levels of oxidative stress, namely MDA(p=0.013), GSH (p≤0.001), GSSG (p≤0.001), and GSH/GSSG ratio (p≤0.001) inthe schizophrenia and control groups. There was correlation found for thepolymorphism of the GCLC GAG TNR gene towards MDA (p=0.054) and GSSG(p=0.010) in the schizophrenia group but found no difference in ATP levels in theschizophrenia and control groups alongside with GCLC GAG TNR polymorphismand ATP levels. In people with schizophrenia, waist circumference, BMI, LDL-c,and HDL-c were lower (p=0.025;p=0.003;p=0.022;p=0.010) and higher TG(p=0.038) than the control group.Conclusion: GCLC GAG TNR gene polymorphism has correlation to oxidativestress but not to cellular metabolic activity. There is no difference in metabolicactivity in people with schizophrenia and no relationship between cellularmetabolism and the metabolic syndrome. There is alteration of oxidative stressmarkers which have an association with metabolic syndrome in people withschizophrenia."