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Abstrak :
Penggunaan DMPS sebagai filler material berdasar pada anggapan bahwa DMPS merupakan biomaterial yang bersifat inert terhadap sistem imun tubuh. Berbagai kasus pada individu dengan injeksi DMPS memicu timbulnya granuloma yang kemudian diikuti oleh fibrosis. Berbagai kemungkinan penyebab mengenai kemunculan respon imun akibat DMPS pun muncul. Mulai dari kontaminasi oleh komponen bakteri, seperti LPS, cara injeksi yang tidak tepat, volume DMPS yang diinjeksikan tidak sesuai hingga mekanisme seluler, seperti oksidasi DMPS, yang menyebabkan molekul tersebut menjadi imunogenik. Data yang didapat dari penelitian ini akan mencoba menjelaskan mekanisme respon imun seluler dari resipien terhadap DMPS yang diinjeksikan dengan metode secara in vitro untuk mengetahui gambaran respon imun yang terjadi di dalam tubuh akibat pajanan DMPS hingga dapat memicu timbulnya granuloma hingga fibrosis. PBMC diambil dari pasien normal dan pasien dengan granuloma akibat injeksi DMPS. Kemudian, dikultur selama 72 jam dengan kelompok perlakuan RPMI sebagai kontrol negatif, PHA dan LPS sebagai kontrol positif, DMPS dan DMPS dengan penambahan plasma autolog. Tujuan dari kultur PBMC tersebut adalah untuk mendapatkan gambaran aktivitas sitokin TNF-a, IFN-g, IL-6, IL13 dan IL-10 yang diperoleh dengan analisis menggunakan Milliplex map kit Luminex serta proliferasi PBMCdengan menggunakan pewarnaan acridine orange. Tidak ada peningkatan proliferasi limfosit maupun monosit yang signifikan (p>0,05) pada kelompok perlakuan DMPS, baik pada pasien normal maupun pasien dengan granuloma. Peran plasma autolog pun tidak teramati dalam meningkatkan proliferasi pada kedua sel. Meskipun demikian, plasma autolog berperan dalam peningkatan aktivitas TNF-a dan IL-6 secara signifikan (p<0,05) sebagai respon terhadap pajanan DMPS, baik pada pasien normal maupun pasien dengan granuloma. Data penelitian ini menunjukkan bahwa DMPS mampu memicu timbulnya inflamasi yang dimediasi oleh aktivitas TNF-a dan IL-6 dan sangat bergantung pada protein plasma setiap individu, meskipun data berupa proliferasi PBMC belum dapat menggambarkan gambaran respon imun terhadap DMPS.

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The use of DMPS as a filler material based on the assumption that DMPS is a biomaterial that is inert to the immune system. Various cases in individuals with DMPS injection, trigger granuloma formation, followed by fibrosis. Possible causes of the emergence of the immune response due to DMPS are appeared. Start from contamination by bacterial components, such as LPS, improper injection method, the volume of injected DMPS does not conform, and cellular mechanisms, such as oxidation of DMPS, which causes that molecule becomes immunogenic. The data obtained from this study may try to explain the mechanism of cellular immune response of DMPS-injected recipients with in vitro-based method to get the description of immune responses that occurs in the body due to exposure of DMPS which can lead to granuloma formation, followed by fibrosis. PBMC is taken from normal patients and patients with granulomas due to injection of DMPS. And then, it was cultured for 72 hours with RPMI treatment as a negative control, PHA and LPS as a positive control, DMPS and DMPS with the addition of autologous plasma. The purpose of the PBMC culture was to describe the activity of TNF-a, IFN-g, IL-6, IL13 and IL-10, which were obtained by analysis using Milliplex map kit Luminex and PBMC proliferation using acridine orange staining. There is no increase in proliferation of lymphocytes and monocytes were significantly (p> 0.05) in the DMPS-treated group, both in normal patients and patients with granulomas. The role of autologous plasma was not observed in the increase both cell proliferation. Nonetheless, autologous plasma had a role in the increased activity of TNF-a and IL-6 significantly (p <0.05) in response to exposure DMPS, both in normal patients and patients with granulomas. The data of this study indicated that DMPS is able to trigger inflammatory activity mediated by TNF-a and IL-6 and it was very dependent on each individual plasma proteins, although the data from proliferation of PBMC has not been able to describe immune response against DMPS.

Abstrak :
Latar belakang. Salah satu penentu manifestasi klinis dengue berat adalah kebocoran plasma. Limfosit dan monosit berperan dalam patogenesis kebocoran plasma infeksi dengue sehingga berpotensi sebagai prediktor kebocoran plasma. Tujuan. Menentukan kemampuan hitung jenis limfosit dan monosit demam hari kedua sebagai prediktor kebocoran plasma pada fase kritis infeksi dengue. Metode. Desain kohort retrospektif pasien rawat inap di RSUPN Cipto Mangunkusumo, RSUP Persahabatan dan RSPAD Gatot Soebroto dari tahun 2010 ̶ 2015, memenuhi kriteria inklusi: berusia > 15 tahun; didiagnosis dengue menurut WHO 1997; dikonfirmasi pemeriksaan NS-1/pemeriksaan serologis anti dengue; memiliki data darah perifer lengkap dan hitung jenis mulai demam hari ke-2; USG abdomen, dan/atau albumin pada fase kritis. Dilakukan analisis Reciever Operating Characteristic Curves (ROC curve) dengan interval kepercayaan (IK) 95% dan multivariat regresi logistik untuk memperoleh model prognostik. Hasil. Terdapat 63 subjek dianalisis. Insidens kebocoran plasma 49%. Nilai absolut limfosit dan nilai absolut monosit demam hari ke-2 berpotensi menjadi prediktor kebocoran plasma pada fase kritis dengan AUC 0,65 dan 0,64. Titik potong optimal nilai absolut limfosit dan nilai absolut monosit yang berpotensi sebagai prediktor kebocoran plasma sebesar 1323 dan 770. Nilai absolut limfosit memiliki sensitivitas 90%, spesifisitas 16%. Nilai absolut monosit memiliki sensitivitas 94%, spesifisitas 34%. Model prognostik nilai absolut monosit dan persentase limfosit meningkatkan AUC menjadi 0,723. Simpulan. Kemampuan prediksi kebocoran plasma nilai absolut limfosit dan nilai absolut monosit demam hari kedua lemah. Namun kemampuan tersebut ditingkatkan menjadi sedang oleh model prognostik yang melibatkan persentase limfosit dan nilai absolut monosit. ......Background. The severity of dengue infection was determined by plasma leakage. Lymphocytes and monocytes played an important role in the pathogenesis of plasma leakage in dengue infection so they potentially used as predictors for plasma leakage in a critical phase of dengue infection. Aim. Determined the percentage and absolute number of lymphocytes and monocytes measured on the second day of fever as a predictors for plasma leakage in a critical phase of dengue infection. Method. The research was retrospective cohort study of inpatients at Cipto Mangunkusumo Hospital, Persahabatan General Hospital and Gatot Subroto Military Hospital Jakarta from 2010 ̶ 2015. The inclusion criteria: age > 15 years, suffering from dengue infection according to the diagnostic criteria of WHO in 1997, confirmed by examination of NS-1 or serological anti-dengue, peripheral blood count and differential leucocyte count during treatment from second day of fever, abdominal ultrasound, and / or albumin in the critical phase. Analyses were performed using ROC curve. Multivariate analysis was performed to elicit prognostic models. Results. We determined 63 subjects. The incidence of plasma leakage was 49%. Absolute number of lymphocytes and monocytes on second day of fever were potentially useful as predictors for plasma leakage. The AUC was 0.65 and 0.644. The optimal cut-off point for absolute number of lymphocytes were 1323, the sensitivity was 90% and the specificity 16%. The cut-off for absolute number of monocytes was 770, the sensitivity was 94%, specificity 34%. We found optimal prognostic model which include percentage of lymphocytes and absolute number of monocytes. It could increase the AUC until 0,723. Conclusion. The absolute number of lymphocytes and monocytes on second day of fever in dengue infections were potentially useful as predictors for plasma leakage in a critical phase of dengue infection. Predictive capability could be increased by prognostic model which include percentage of lymphocytes and absolute number of monocytes as predictors.

Abstrak :
ABSTRAK DNA eksogen merupakan DNA asing yang diintroduksi ke dalam sel dan sebagai dasar pengembangan vaksin DNA. Ekspresi gen pada DNA eksogen masih rendah dalam antigen presenting cell APC yang merupakan target utama dalam penerapan vaksin DNA, seperti monosit. Salah satu cara dalam meningkatkan ekspresi gen pada DNA eksogen adalah menyisipi sekuen internal inisiasi translasi yaitu IRES HIV-1. Oleh karena itu, pada penelitian ini dilakukan penambahan sekuen IRES HIV-1 pada hulu gen DNA eksogen yang akan diekspresikan di sel monosit manusia. DNA IRES HIV-1_eGFP diamplifikasi dari pcDNA5FRT/TO dan disubkloning ke pcDNA3.1 . DNA ditransfeksi ke kultur primer monosit dari darah manusia sehat. Sel berfluoresen, persentase sel, dan intensitas fluoresen diamati masing-masing dengan mikroskop fluoresen, Tali cytometer, dan Glomax. Plasmid pcDNA3.1_IRES HIV-1_eGFP berhasil dikonstruksi dan gen egfp berhasil diekspresikan pada sel monosit manusia. Persentase monosit berfluoresen dibandingkan sel kontrol meningkat dari 5 menjadi 11,54 kelompok pcDNA3.1_eGFP dan 12,9 kelompok pcDNA3.1_IRES HIV-1_eGFP p=0,297 . Intensitas fluoresen eGFP pada kelompok dengan IRES HIV-1 dalam total sel monosit 2,33 dan per monosit 0,069 meningkat signifikan dibandingkan kelompok pcDNA3.1_eGFP dalam total sel monosit 0,08 dan per monosit 0,001 p=0,001 . Oleh karena itu, penambahan IRES HIV-1 terbukti mampu meningkatkan ekspresi gen pada sel monosit secara signifikan.

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ABSTRACT
Exogenous DNA is an transient DNA that is introduced into cells and as a basis for developing DNA vaccines. Gene expression in exogenous DNA is still low in antigen presenting cells APC , which is a major target in the application of DNA vaccines, such as monocytes. One way to increase the expression of gene in exogenous DNA is to insert the internal sequence of translation initiation such as IRES HIV 1. Therefore, in this research, the addition of IRES HIV 1 sequence in the upstream gene of exogenous DNA to be expressed in human monocytes cells. IRES HIV 1 eGFP amplified from pcDNA5FRT TO and subcloned to pcDNA3.1 .. DNA were transfected into the primary culture of monocytes from healthy human blood. Fluorescent cells, cell percentages, and fluorescent intensity were observed with fluorescent microscope, Tali cytometer, and Glomax respectively. The pcDNA3.1 IRES HIV 1 eGFP successfully constructed and transfected in human monocytes cells. The percentage of fluorescent monocytes compared with control cells increased from 5 to 11.54 pcDNA3.1 eGFP group and 12.9 pcDNA3.1 IRES HIV 1 eGFP p 0.297 . The intensity of fluorescent eGFP in the group with IRES HIV 1 in total monocyte 2.33 and each monocyte 0.069 increased significantly compared to pcDNA3.1 eGFP group in total monocyte cell 0.08 and per monocyte 0.001 p 0.001 . Therefore, the addition of IRES HIV 1 has been shown to increase gene expression in monocyte cells significantly

Abstrak :
Sampai saat ini, etiologi simple bone cyst(SBC) masih belum jelas; terdapat sejumlah teori mengenai terbentuknya SBC. Salah satu teori yang paling populer adalah obstruksi vena yang berakibat pada akumulasi cairan. Cairan-cairan ini diketahui mengandung faktor resorptif tulang, diantaranya adalah interleukin-1b(IL-1b) dan prostaglandin E2 (PGE2). Selain itu, parameter rasio limfosit monosit (LMR) saat ini sering dipakai memprediksi prognosis suatu keganasan, namun belum ada data yang berhubungan dengan tumor jinak. Kortikosteroid diketahui memiliki efek inhibitorik pada resorpsi tulang. Penelitian ini bertujuan untuk menganalisis kadar IL-1bdan PGE2 pada pasien SBC yang dilakukan injeksi steroid serial. Desain studi kohort prospektif dilakukan dengan menganalisis cairan kista pasien SBC yang datang ke RSCM pada bulan Januari 2018 sampai Juli 2019. Dilakukan dekompresi dan injeksi metilprednisolon asetat dosis 80-120mg tergantung dari usia dan berat badan subyek. Interval antar injeksi adalah satu bulan. Cairan dianalisis untuk mengukur kadar IL-1bdan PGE2 dengan menggunakan Quantikine ELISA(R&D System, Minnesota, Amerika Serikat), serta dinilai LMR nya. Kriteria penyembuhan tulang dinilai menggunakan kriteria radiologis Chang. Terdapat 4 subjek dalam penelitian kami, dengan median usia 12 (8-18) tahun. Seluruh subjek berjenis kelamin laki-laki. Dua subjek mengalami SBC pada humerus proksimal, dan dua subjek lainnya mengalami SBC pada femur proksimal. Seluruh kista bersifat aktif. Dua subjek sembuh, satu subjek sembuh dengan defek, dan satu subjek mengalami kista persisten. Didapatkan kadar IL-1bpada 3 subjek berada dibawah 3,9 pg/mlpada serial injeksi dan 1 subjek memiliki kadar 6,7, 13,31, dan 5,42 pg/ml.Sedangkan kadarbaselinePGE2 pada4 subjekadalah411, 122,5, 437,99dan 261,49pg/ml.Nilai LMR pada 4 subjek 6,2, 6,54, 5,4 dan 8,13.Terdapat perubahan kadar PGE2 dalam cairan SBC yang dilakukan pada injeksi steroid serial dengan kecenderungan meningkat paska injeksi yang pertama, lalu menurun paska serial injeksi berikutnya.Kadar interleukin IL-1βberada dibawah 3,9pg/mldalam cairan SBC yang dilakukan injeksi steroid serial.Tidak terdapat hubungan LMR dengan proses penyembuhan dan progresivitas lesi SBC ......To date, the aetiology of simple bone cyst (SBC) remains controversial. Several theories regarding its pathogenesis exist, and one of the most popular ones is venous obstruction which leads to fluid accumulation. This fluid contains bone resorptive factor, such asinterleukin-1b(IL-1b) and prostaglandin E2 (PGE2). Corticosteroid is known to possess an inhibitory effect on bone resorption. The objective of this study is to analyze IL-1bdan PGE2 in patients with SBC who treated with serial steroid injection. This prospective study was conducted by analyzing cyst fluid of patients diagnosed with SBC who went to Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the period between January 2018 and July 2019. The subjects underwent decompression, and subsequently they were injected with methylprednisolone acetate. The dose of the steroid varied from 80 to 160 mg according to the subject's age and weight. The interval of each injection was one month. The fluid was analyzed for its IL-1band PGE2 levels by means of Quantikine ELISA (R&D System, Minnesota, United States). Bone healing was evaluated using Chang criteria. A total of 4 subjects (median age: 12 [8-18] years of age) were included in our study. All subjects were male. Two subjects had SBC on the proximal humerus, and the other two had SBC on the proximal femur. All cysts were active. Two subjects healed, one healed with defect, and one had persistent cyst. We found that the IL-1bof3 subjects were below3.9 pg/mlin serial injection, and one subject had IL-1blevels of6.7, 13.31, and5,42 pg/ml.Whereas, the baseline PGE2 levels in four subjects were 411, 122.5, 437.99and261,49pg/ml.TheLMRin four subjects werepada 4 subjek 6.2, 6.54, 5.4 dan 8.13.We found change in PGE2 levels in SBC fluid that was treated with serial steroid injection. We found an increasing trend after the first injection, which was followed by a decreasing trend in the subsequent injection. The IL-1β levels in all timepoint were below3.9pg/ml.

Abstrak :
Coronavirus Disease 2019 (COVID-19) merupakan penyakit multisistemik yang melibatkan kaskade imunologi, inflamasi, dan koagulasi. Biomarker di sirkulasi yang dapat memberikan informasi mengenai kondisi inflamasi dan status imun dapat digunakan dalam mendiagnosis dan menilai prognosis pasien COVID-19. Parameter hematologi rutin, mudah dilakukan, biaya terjangkau dan cepat, sehingga diharapkan dapat memberikan informasi awal sistem imun pasien yang dapat dihubungkan dengan outcome penyakit. Nilai RNL, RML dan RTL dapat mendeteksi dini kecurigaan perburukan kondisi pasien COVID-19. Penelitian ini menggunakan desain nested case-control yang melibatkan 206 data subjek yang terdiri atas 141 subjek luaran baik dan 65 subjek luaran buruk. Dijumpai perbedaan bermakna nilai RNL, RML dan RTL antara kelompok luaran baik dan buruk. Nilai titik potong optimal RNL, RML dan RTL berturut-turut adalah ≥5,43; ≥0,46 dan ≥196,34 untuk mendiskriminasi luaran buruk. Area Under Curve (AUC) untuk RNL adalah 0,825 (0,766-0,884), sensitivitas 76,9%, spesifisitas 73,8%; AUC RML 0,763 (0,692-0,833), sensitivitas 73,8%, spesifisitas 68,1% dan AUC RTL 0,617 (0,528-0,705), sensitivitas 63,1%, spesifisitas 60,3%. Usia >30 tahun (OR=2,59; IK95% 1,34-5,02), adanya komorbid (OR=2,21; IK95% 1,28-3,81), RNL ≥5,43 (OR=4,60; IK95% 2,07-10,26) dan RML ≥0,46 (OR=2,09; IK95% 0,93-4,67) berhubungan dengan luaran buruk pasien COVID-19. ......Coronavirus Disease 2019 (COVID-19) is a multisystemic disease involving immunologic, inflammatory, and coagulation cascades. Biomarkers in circulation which can provide information on inflammatory conditions and immune status can be used in diagnosing and assessing the prognosis of COVID-19 patients. Hematology parameters are routinely performed, easy, affordable and fast, so it can provide preliminary information on the patient's immune system that linked to disease outcomes. NLR, MLR and TLR values can detect early suspicion of worsening conditions of COVID-19 patients. This study used a nested case-control design involving 206 subjects data consisting of 141 subjects with good outcomes and 65 subjects poor outcomes. A significant difference was found in the values of NLR, MLR and TLR between the two groups. The optimal cut-off point values of NLR, MLR and TLR were ≥5.43; ≥0.46 and ≥196.34, respectively, to discriminate against poor outcomes. The Area Under Curve (AUC) for NLR was 0.825 (0.66-0.884), sensitivity 76.9%, specificity 73.8%; MLR was 0.763 (0.692-0.833), sensitivity 73.8%, specificity 68.1% and TLR was 0.617 (0.528-0.705), sensitivity 63.1%, specificity 60.3%. Age >30 years (OR=2.59; 95% CI 1.34-5.02), presence of comorbidities (OR=2.21; 95% CI 1.28-3.81), NLR ≥5.43 (OR=4.60; 95% CI 2.07-10.26) and MLR ≥0.46 (OR=2.09; 95% CI 0.93-4.67) were associated with poor outcomes of COVID-19 patients.

Abstrak :
[ABSTRAK
Latar Belakang: Infeksi merupakan penyebab kematian yang penting pada thalassemia. Peningkatan risiko infeksi disebabkan oleh banyak faktor antara lain karena kelebihan besi dan splenektomi. Penelitian ini bertujuan mengetahui perbedaan fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi serta mengetahui hubungan fungsi fagositosis monosit dengan kadar feritin serum. Metode: Penelitian dilakukan di Departemen Patologi Klinik RSCM, Jakarta pada September 2013 ? Februari 2014. Desain penelitian potong lintang, dengan subjek penelitian pasien thalassemia mayor, terdiri dari 58 subjek pasca splenektomi dan 58 subjek non splenektomi yang telah dilakukan macthing umur dan jenis kelamin. Dilakukan pemeriksaan fagositosis monosit menggunakan E.coli yang telah diopsonisasi dan dilabel FITC sebagai target, (PhagotestTM) dan diperiksa dengan flow cytometry BD FACSCalibur. Kadar feritin serum diperiksa dengan Cobas e 601. Hasil: Median fagositosis monosit pada 58 subjek pasca splenektomi 5,03 (0,17 ? 22,79) %, dan pada 58 subjek non splenektomi 7,09 (0,11 ? 27,24) %, dan nilai p > 0.05. Kadar feritin serum pada subjek pasca splenektomi 6.724 (644,60 ? 21.835) ng/mL dan subjek non splenektomi 4.702,50 (1.381 ? 14.554) ng/mL, dan nilai p < 0.05. Hasil uji korelasi fungsi fagositosis monosit dengan kadar feritin didapatkan r = 0.13 (nilai p = 1.00). Kesimpulan: Tidak terdapat perbedaan bermakna antara fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi. Kadar feritin serum pada pasien thalassemia mayor pasca splenektomi lebih tinggi secara bermakna dibandingkan non splenektomi. Tidak didapatkan hubungan antara fagositosis monosit dengan kadar feritin serum.

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ABSTRACT
Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 ? Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 ? 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 ? 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 ? 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.;Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level., Background : Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level. Methods : The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 – Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601. Result : Median phagocytosis of monocyte was 5,03 (0,17 – 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 – 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 – 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00). Conclusion : There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level.]

Abstrak :
Aspek metabolik komplikasi DM tipe 2, khususnya penyakit kardiovaskular, telah banyak dibahas, namun aspek imunometabolik masih terbatas, sehingga sangat penting untuk memahami peran sistem imun dalam perkembangan komplikasi. Tujuan penelitian ini adalah untuk memahami peran subset monosit (CD14,CD16) dan mediator inflamasinya (IL-1β, IL-10) terhadap risiko penyakit kardiovaskular pada Pasien DM tipe 2. Subset monosit CD14, CD16 diperiksa menggunakan sampel kultur PBMC dan dianalisis menggunakan flow cytometry. Metode Multiplex Immunoassays digunakan untuk mengukur IL-1β, dan IL-10. Hasil penelitian ini, menunjukkan terdapat pola peningkatan subset monosit CD14+, CD16+ pada DM tipe 2, namun tidak berbeda secara signifikan. Peningkatan monosit CD14+,CD16+ lebih dari 6.8% berhubungan dengan peningkatan risiko penyakit kardiovaskular. Rasio mediator inflamasi IL-1β, sebelum dan sesudah stimulasi LPS secara signifikan lebih tinggi pada DM tipe 2 dibandingkan kontrol. Pada kondisi inflamasi, peningkatan IL-10 berespon terhadap stimulasi LPS, namun tidak mampu mengkompensasi peningkatan IL-1β, sehingga kecenderungan menjadi lebih hiperinflamasi pada DM tipe 2. Glukosa puasa merupakan penanda metabolik yang berhubungan dengan peningkatan monosit CD14+,CD16+. ......The metabolic aspects of Type 2 Diabetes (T2D) complications, particularly cardiovascular disease, have been widely discussed, but the immunometabolic aspects are still limited, so it is critical to understand the role of the immune system in the development of complications. The objective of this study is to understand about the role of the monocyte subset (CD14,CD16) and its inflammatory mediators (IL-1β, IL-10) in the risk of CVD in T2D. CD14, CD16 monocyte subset was examined using PBMC culture samples and analyzed using flow cytometry. The Multiplex Immunoassays method was used to measure IL-1β and IL-10. This study shows there is an increase in the CD14+, CD16+ monocyte subset in type 2 diabetes, but it is not significantly related. An increase in CD14+,CD16+ monocytes of more than 6.8% is associated with an increased risk of CVD. The ratio of the inflammatory mediator IL-1β to basal conditions and LPS stimulation was significantly higher in T2D than in controls. In inflammatory conditions, the increase in IL-10 responds to LPS stimulation, but it is unable to compensate for the increase in IL-1β in T2D, so the tendency becomes more hyperinflammatory in type 2 DM. Fasting glucose is a metabolic marker associated with an increase in CD14+,CD16+ monocytes

Abstrak :
Latar Belakang: Sekitar 40% pasien kanker payudara pasca terapi mengalami rekurensi kanker payudara. Sementara itu, masih belum banyak penelitian mengenai faktor prognosis untuk memprediksi kemungkinan rekurensi pada kanker payudara. Tujuan: Mengetahui inter-rasio rasio limfosit-monosit (LMR) dan rasio limfosit-sel darah putih (LWR) sebagai prediktor rekurensi pada kanker payudara. Metode: Penelitian ini dilakukan secara cohort retrospektif dengan melihat rekam medis pasien dari RSCM dan RS MRCC Siloam Jakarta. Peneliti melihat riwayat pasien sejak selesai mendapat terapi dengan rekurensi yang diikuti minimal 3 bulan dan maksimal 7 tahun. Kemudian dilakukan analisis dengan menggunakan uji Chi-square dengan program SPSS for Mac. Hasil: Peneliti mengelompokkan pasien menjadi kelompok inter-rasio LMR/LWR rendah dan tinggi dengan cut-off berupa median senilai 19,67 103/L. Dari 106 sampel yang memenuhi kriteria, didapatkan 52 pasien kelompok rendah dan 54 pasien kelompok tinggi. Hasil yang didapatkan dari analisis kedua kelompok dengan status rekurensi adalah nilai p 0.001 dengan 26 pasien pada kelompok rendah dan 10 pasien pada kelompok tinggi mengalami rekurensi. RR yang didapat adalah 2,7 (95%CI: 3,45 – 5,029) pada inter-rasio LMR/LWR rendah. Kesimpulan: Terdapat hubungan antara inter-rasio LMR/LWR dengan kemungkinan rekurensi pada pasien kanker payudara pasca terapi dan dapat dijadikan salah satu prediktor, dengan kelompok inter-rasio LMR/LWR dibawah cut-off penelitian memiliki resiko lebih tinggi mengalami rekurensi kanker payudara. ......Background: About 40% cancer patients after they finished their first therapy having a recurrence. However, there isn’t many researches on prognostic factors to predict the possibility of recurrence in breast cancer. Objective: This research was done to know inter-ratio of lymphocyte-monocyte ratio (LMR) and lymphocyte-white blood cells ratio (LWR) as the predictor for recurrence in breast cancer. Methods: This study was conducted with cohort retrospective by looking at patient’s medical records at RSCM and MRCC Siloam Hospital Jakarta. Researcher followed patients record after their first therapy finished, and recurrence from 3 months until 7 years later. An analysis was conducted using the Chi-Square test with the SPSS for Mac program. Results: The patients were grouped into patients with low and high LMR/LWR inter-ratio with median (19,67 103/L) as the cut-off. From 106 samples that met the criteria, there were 52 patients in low group and 54 patients in high group. The results obtained from the analysis between low and high LMR/LWR and patient’s recurrence status is p-value 0.001 which means significant, with 26 patients in low group and 10 patients in high group had recurrence. RR for low LMR/LWR inter-ratio is 2,7 (95% CI : 3,45-5,029) in association with breast cancer’s recurrence. Conclusion: There is an association between LMR/LWR inter-ratio and the possibility of recurrence in post-treatment breast cancer patients and can be used as predictor. Patients with LMR/LWR inter-ratio under the study cut-off are at higher risk of getting recurrence.

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Latar belakang: Pasien yang dinyatakan masuk kedalam kategori “Suspect COVID-19” adalah jika seseorang memiliki beberapa tanda yaitu demam, sakit tenggorokkan, batuk, menderita ISPA, dan memiliki kontak dengan pasien yang sudah terkonfirmasi positif COVID-19. Untuk memilah agar ruang gawat darurat digunakan untuk pasien yang cukup parah gejalanya, pihak rumah sakit melakukan identifikasi kepada pasien dengan suspect COVID-19 sehingga mengetahui tatalaksana yang tepat untuk pasien dan mendahulukan pasien yang membutuhkan perawatan intensif. Untuk melihat peluang pasien yang termasuk kategori suspect COVID-19 menjadi terkonfirmasi positif COVID-19 kita dapat meneliti hasil lab darah perifer lengkap pada pasien. Beberapa penelitian melihat morfologi dari masing-masing darah perifer lengkap dimana terlihat adanya abnormalitas morfologi pada pemeriksaan darah perifer lengkap dengan mikroskop. Untuk menjadikan hasil lab darah perifer lengkap sebagai parameter untuk mempresiksi diagnosis, prognosis, dan melihat adanya perubahan hasil lab darah perifer lengkap pasien suspect dengan pasien terkonfirmasi dibutuhkan waktu yang cukup lama jika dilihat dari morfologinya maka dari itu diperlukan analisis kadar dari masing-masing darah perifer. Metode: Penelitian ini menggunakan metode potong lintang komparatif dua kelompok. Subjek merupakan pasien Rumah Sakit Umum Pusat Persahabatan. Data Pasien diperoleh pada Bulan Juni 2021 dimana kasus COVID-19 sedang bertambah cukup pesat hingga Januari 2022 dimana penyebaran COVID-19 mulai surut. Pasien memiliki komorbid seperti diabetes,hipertensi, dan penyakit ginjal kronik. Rekam medis pasien dilihat hanya dari profil darah lengkap yaitu hemoglobin, leukosit, neurofil, limfosit, monosit, dan trombosit. Hasil: Jumlah pasien suspect COVID-19 berjumlah 51 pasien dan jumlah pasien terkonfirmasi COPVID-19 berjumlah 47 pasien. Dilihat dari profil darah perifer lengkap terdapat persebaran jumlah hemoglobin normal sebanyak 50 % dari seluruh subjek penelitian serta jumlah hemoglobin rendah sebanyak 39,7% dari seluruh subjek penelitian. Terdapat persebaran jumlah leukosit normal sebanyak 55,1% dari seluruh subjek penelitian serta jumlah leukosit tinggi sebanyak 35,7% dari seluruh subjek penelitian. Terdapat persebaran jumlah neutrofil tinggi sebanyak 51,0% dan jumlah lelukosit normal sebanyak 42,8% dari seluruh subjek penelitian. Terdapat persebaran jumlah limfosit rendah sebanyak 64,2% dan jumlah limfosit normal sebanyak 31,6% dari seluruh subjek penelitian. Terdapat persebaran jumlah monosit normal sebanyak 59,1% dan jumlah monosit tinggi sebanyak 34,6% dari seluruh subjek penelitian. Terdapat persebaran jumlah normal sebanyak 70,4% dan jumlah trombosit tinggi sebanyak 25,5% dari seluruh subjek penelitian. Hubungan antara profil darah perifer lengkap dengan proporsi pasien suspect COVID-19 dengan pasien terkonfirmasi COVID-19 menunjukkan adanya hubungan (p>0,05). Kesimpulan: Adanya hubungan antara profil darah perifer lengkap pada proporsi pasien suspect COVID-19 dengan pasien terkonfirmasi COVID-19 ......Introduction: Patients who are declared to be in the "Suspect COVID-19" category are if someone has several signs, namely fever, sore throat, cough, suffering from ARI, and has contact with patients who have been confirmed positive for COVID-19. To sort out that the emergency room is used for patients whose symptoms are quite severe, the hospital identifies patients with suspected COVID-19 so that they know the right treatment for patients and prioritize patients who need intensive care. To see the chances of a patient belonging to the suspect category of COVID-19 being confirmed positive for COVID-19, we can examine the results of the complete peripheral blood lab on the patient. Several studies looked at the morphology of each complete peripheral blood where there were morphological abnormalities on complete peripheral blood examination with a microscope. To make the complete peripheral blood lab results as a parameter for predicting diagnosis, prognosis, and seeing any changes in the complete peripheral blood lab results from suspect patients with confirmed patients, it takes quite a long time when viewed from the morphology, therefore it is necessary to analyze the levels of each peripheral blood . Method: This study used a two-group comparative cross-sectional method. The subject is a patient in RSUP Persahabatan. Patient data was obtained in June 2021 where COVID- 19 cases were growing quite rapidly until January 2022 where the spread of COVID-19 began to recede. Patients have comorbidities such as diabetes, hypertension, and chronic kidney disease. The patient's medical record is seen only from the complete blood profile, namely hemoglobin, leukocytes, neurophiles, lymphocytes, monocytes, and platelets. Result: The number of suspected COVID-19 patients is 51 patients and the number of confirmed COPVID-19 patients is 47 patients. Judging from the complete peripheral blood profile, there was a normal distribution of hemoglobin in 50% of all research subjects and 39.7% of low hemoglobin in all research subjects. There is a distribution of normal leukocyte counts as much as 55.1% of all research subjects and high leukocyte counts as much as 35.7% of all research subjects. There was a distribution of high neutrophil counts as much as 51.0% and normal leukocyte counts as much as 42.8% of all research subjects. There was a distribution of 64.2% low lymphocyte count and 31.6% normal lymphocyte count of all research subjects. There was a distribution of the normal monocyte count as much as 59.1% and the high monocyte count as much as 34.6% of all research subjects. There was a normal distribution of 70.4% and a high platelet count of 25.5% of all research subjects. The relationship between complete peripheral blood profile and the proportion of suspected COVID-19 patients with confirmed COVID-19 patients showed a relationship (p>0.05). Conclusion: There is a relationship between complete peripheral blood profile in the proportion of patients suspected of COVID-19 with confirmed patients of COVID-19

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Pendahuluan Kanker paru karsinoma bukan sel kecil (KPKBSK) merupakan jenis kanker paru yang paling sering ditemukan pada pasien lanjut usia. Penuaan dan inflamasi kronis berkaitan dengan patogenesis KPKBSK. Status fungsional, rasio limfosit monosit dan rasio trombosit limfosit diketahui mencerminkan inflamasi kronis dan berkaitan dengan kesintasan lansia dengan KPKBSK stadium IIIB-IV. Tujuan Penelitian ini untuk mengetahui hubungan status fungsional, rasio limfosit monosit dan rasio trombosit limfosit sebagai faktor prognosis kesintasan satu tahun pasien lansia dengan KPKBSK stadium IIIB-IV. Metode Penelitian ini menggunakan desain kohort retrospektif dengan subjek pasien lansia KPKBSK stadium IIIB-IV di RS Kanker Dharmais pada periode Januari 2020 – Juni 2022. Hasil hematologi lengkap, status fungsional yang dievaluasi dengan activity daily living (ADL) Barthel-index didapatkan dari rekam medis. Kesintasan dihitung sejak 1 tahun diagnosis ditegakkan. Faktor perancu, antara lain: diabetes mellitus, anemia, penyakit paru obstruktif kronis dan penyakit ginjal kronis. Data diolah dengan SPSS 20.0 menggunakan uji log rank untuk analisis bivariat dan uji regresi Cox untuk analisis multivariat. Hasil Dari 108 pasien, mayoritas subjek usia 60-69 tahun 74,1%, laki-laki 66,7%, stadium IVB 80,5% dengan histologi adenocarsinoma 75,0%. Hubungan status fungsional dengan kesintasan tidak bermakna secara statistik p 0,540, tetapi hasil hubungan antara rasio limfosit monosit dan rasio trombosit limfosit dengan kesintasan satu tahun pada pasien lansia dengan KPKBSK stadium IIIB-IV (p 0,015 dan p 0,001) bermakna. Pada subanalisis, didapatkan status fungsional pada kelompok dengan kemoterapi dan radioterapi berhubungan dengan kesintasan 1 tahun (p 0,044 dan p 0,009) Kesimpulan Rasio limfosit monosit dan rasio trombosit limfosit preterapi sebagai faktor prognosis kesintasan 1 tahun pasien lansia KPKBSK stadium IIIB-IV, sedangkan status fungsional preterapi tidak bisa digunakan sebagai faktor prognosis kesintasan 1 tahun. ......Introduction Non-small cell lung cancer (NSCLC) is the most common lung cancer found in elderly patients. Aging and chronic inflammation related to its pathogenesis. Functional status, lymphocyte to monocyte ratio and platelet to lymphocyte ratio are known describe chronic inflammatory and have correlation to survival in NSCLC older adult stage IIIB - IV. Objective: This study aims to determine functional status, lymphocyte to monocyte ratio and platelet to lymphocyte ratio as prognostic factor to 1-year survival in elderly patients with NSCLC stage IIIB-IV. Method A survival analysis with cohort retrospective study is used on elderly patients with NSCLC stage IIIB-IV in Dharmais Cancer Hospital between January 2020 – June 2022. Medical record data was obtained, including complete blood count dan functional status that evaluated with activity daily living (ADL) Barthel-index. 1-year survival rate since diagnosis NSCLC. Confounding factors such as diabetes mellitus, anemia, chronic obstructive pulmonary disease and chronic kidney disease. Data processing is done with SPSS 20.0 using log rank method for bivariate analysis and Cox regression method for multivariate analysis. Results In 108 patients, the majority subjects are 60-69 years old 74.1%, male 66.7%, stage IV 80.5% and adenocarcinoma 75.0%. A significant correlation is found between lymphocyte to monocyte ratio and platelet to lymphocyte ratio with 1-year survival rate in elderly with NSCLC stage IIIB-IV (p 0,015 and p 0,001). Functional status doesn’t have significant correlation with 1 year survival p 0.540 but it has correlation at chemotherapy and radiotherapy group (p 0.044 and p 0.009). Conclusion Lymphocyte to monocyte ratio and platelet to lymphocyte ratio pretherapy can be used as prognostic factor for 1-year survival in elderly with NSCLC stage IIIB-IV, but functional status can’t be used as a prognostic factor for 1-year survival in elderly