Suzanna Immanuel
Departement of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Published : 9 Documents
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Postprandial Hypoglycemia Immanuel, Suzanna; Alvina, Alvina
Journal of the Indonesian Medical Association Vol. 59 No. 7 July 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

Postprandial hypoglycemia means hypoglycemia that occurred 2-5 hours after meal, which caused by excessive insulin secretion as a result of after meal increase of blood glucose. In contrast to normal condition blood glucose concentration after 2 hours of meal is higher than fasting. Postprandial hypoglycemia sometimes occurs without symptoms. This issue often raised by doctors that complained about false results from laboratory. In reality this condition happened due to postprandial glucose values not only it can be lower than during fasting but it could result in postprandial hypoglycemia. Symptoms may be observed namely tired, tremor, palpitation, irritability and even syncope. Postprandial hypoglycemia may be caused by drugs (e.g. salicylate, beta-blocker, pentamidine, ACE inhibitor, disophyramide), increased insulin sensitivity, early sign of diabetes mellitus (prediabetes), alcohol intake and post gastrectomy (alimentary hypoglycemia) and idiopathic. Laboratory tests for postprandial hypoglycemia include ambulatory glucose sampling, breakfast test or meal tolerance test. Diagnosis of hypoglycemia postprandial may be build if there are hypoglycemia symptoms after meal with postprandial blood glucose <50 mg/dL.Keywords: Postprandial hypoglycemia, insulin, prediabetes, idiopathic
Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) as a Marker of Coronary Heart Disease Immanuel, Suzanna; Tjiptaningrum, Agustyas
Journal of the Indonesian Medical Association Vol. 60 No. 1 January 2010
Publisher : Journal of the Indonesian Medical Association

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Abstract

Coronary heart disease (CHD) is caused by a narrowing of coronary artery’s lumen as a result of atherosclerosis process on the vessel wall that cause diminished blood flow and oxygen supply to myocardium. On its course, CHD can be progressive and sudden changes from stable to acute condition known as acute coronary syndrome (ACS) often occurred. The sudden changes were associated with acute thrombosis on the eroded, cracked or ruptured atherosclerotic plaque. Plaque rupture is associated with the change a stable plaque to labile and vulnerable plaque. Current laboratory studies also aimed for an early detection of plaque changes before the rupture of atherosclerotic plaque. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a novel plaque destabilization marker that can be detected before the rupture of plaque, ischemia, infarct or necrosis myocardium. Lp-PLA2 also reported as an endothelial dysfunction marker which is the early phase of atherosclerosis and used in risk stratification of ACS. Lp-PLA2 is produced by macrophages, lymphocytes and mast cells. The enzyme hydrolyzes oxLDL and produces lysophosphatidylcholine (lysoPC) and oxidized fatty acid (oxFA). LysoPC and oxFA cause endothelial dysfunction and induce white muscle cells and macrophages apoptosis which in turn lead to necrotic core broadening in the atherosclerotic plaque, thinning of fibrous cap, and plaque destabilization which then can cause plaque rupture. Laboratory tests for Lp-PLA2 can be performed by means of mass or enzyme activity measurement i.e. ELISA for Lp-PLA2 mass measurement as well as photometric or radioimmunoassay for activity measurement. Lp-PLA2 mass measurement reported to be more precise and accurate as a marker of CHD risk compared to the enzyme activity measurement.Keywords: Coronary heart disease, atherosclerosis, Lp-PLA2, LysoPC
Biochemical Markers in Stroke Immanuel, Suzanna; Utami, Lidya
Journal of the Indonesian Medical Association Vol. 59 No. 11 November 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

Stroke is a clinical syndrome marked by sudden partial or total neurologic deficit, due to impaired brain vessels. Stroke is a potentially fatal neurologic emergency with abrupt onset. Prompt and accurate diagnosis is very crucial for a successful management of patients with stroke. Thrombolytic therapy has been proven to improve the outcome in patients with ischemic stroke if administered within 6 hours after onset and after the possibility of intracranial hemorrhage has been eliminated. Recently, some biochemical markers for brain ischemia has been developed, which is expected to be readily available kits for rapid diagnosis of stroke. The markers for the early diagnosis of stroke include GFAP, PARK7, NDKA, NSE, and FABP. GFAP is a specific marker for brain and can be used to distinguish between ischemic and hemorrhagic stroke. Protein S-100B can also be useful as early marker for stroke if used in conjunction with other markers. Biochemical markers can also predict the extent of lesion and outcome. Until now, there is no apparent single biochemical marker which can fulfil the criteria of ideal marker for the diagnosis of stroke. Biochemical markers for stroke are more useful if used together in a panel.Keywords: stroke, biochemical markers, GFAP, S-100B
Natriuretic Peptide (NT-proBNP) Levels From Heart Failure Patients with NYHA Functional Class III and IV in Cipto Mangunkusumo Hospital Immanuel, Suzanna; Legoh, Grace Nerry; Makmun, Lukman H.
Journal of the Indonesian Medical Association Vol. 59 No. 9 September 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

The diagnosis of heart failure is currently made based on clinical symptoms, physical examination and objective data of heart dysfunction. The current gold standard in detecting heart dysfunction is echocardiography. However, it is usually not available in current general practice or rather difficult to be performed in acute and severe conditions. Fast test with acceptable sensitivity and specificity is needed. Currently, several hormones of the natriuretic peptides especially â type natriuretic peptide (BNP) and amino terminal proBrain-type natriuretic peptide (NTproBNP) has been shown very useful in clinical contexts including in the differential diagnosis of acute dyspneu, and in diagnosis, stratification, monitoring, or determining prognosis of heart failure. The aim of the study was to evaluate the level of NT-proBNP according to age, gender and left ventricular ejection fraction in heart failure patients with NYHA functional class III and IV determined by echocardiography. Forty patients were included in the study. The level of NTproBNP increased according to the severity of heart failure. The levels of NT-proBNP in NYHA IV subjects were significantly higher compared to the NYHA III, i.e. 9157 pg/mL to 2559 pg/mL, p<0.05. Increasing NT-proBNP levels according to age were observed in NYHA III and IV, but not in the >75 yrs age group. The levels of NT-proBNP in NYHA III and IV patients with LVEF <40% were higher than patients with LVEF >40-50% i.e. 7316 pg/mL compared to 2797 pg/mL, however, in the NYHA IV patients, it was not statistically significant (p>0.05).Keywords: NT-proBNP, Heart failure, NYHA III and IV, LVEF.
Effect of enhanced external counterpulsation therapy on myeloperoxidase in lowering cardiovascular events of patients with chronic heart failure Rampengan, Starry H.; Setianto, Budhi; Posangi, Jimmy; Immanuel, Suzanna; Prihartono, Judo; Siagian, Minarma; Kalim, Harmani; Inneke, Sirowanto; Abdullah, Murdani; Waspadji, Sarwono
Medical Journal of Indonesia Vol 22, No 3 (2013): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (911.558 KB) | DOI: 10.13181/mji.v22i3.584

Abstract

Background: Chronic heart failure (CHF) is a slowly progressive disease with high morbidity and mortality; therefore, the management using pharmacological treatments frequently fails to improve outcome. Enhanced external counterpulsation (EECP), a non-invasive treatment, may serve as alternative treatment for heart failure. This study was aimed to evaluate the influence of EECP on myeloperoxidase (MPO) as inflammatory marker as well as cardiac events outcome.Methods: This was an open randomized controlled clinical trial on 66 CHF patients visiting several cardiovascular clinics in Manado between January-December 2012. The subjects were randomly divided into two groups, i.e. the group who receive EECP therapy and those who did not receive EECP therapy with 33 patients in each group. Myeloperoxidase (MPO) as inflammatory marker was examined at baseline and after 6 months of observation. Cardiovascular events were observed as well after 6 months of observation. Unpaired t-test was use to analyze the difference of MPO between the two groups, and chi-square followed by calculation of relative risk were used for estimation of cardiovascular event outcomes.Results: MPO measurement at baseline and after 6 months in EECP group were 643.16 ± 239.40 pM and 422.31 ± 156.26 pM, respectively (p < 0.001). Whereas in non EECP group, the MPO values were 584.69 ± 281.40 pM and 517.64 ± 189.68 pM, repectively (p = 0.792). MPO reduction was observed in all patients of EECP group and in 13 patients (48%) of non-EECP group (p < 0.001). Cardiovascular events were observed in 7 (21.21%) and 15 (45.45%) of patients in EECP and non-EECP groups, respectively (p = 0.037).Conclusion: EECP therapy significantly decreased the level of MPO as inflammatory marker and this decrease was correlated with the reduction of cardiovascular events in CHF patients. (Med J Indones. 2013;22:152-60. doi: 10.13181/mji.v22i3.584)Keywords: CHF, cardiovascular events, EECP, myeloperoxidase
The reference range of serum, plasma and erythrocyte magnesium Immanuel, Suzanna; Iriani, Anggraini
Medical Journal of Indonesia Vol 15, No 4 (2006): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (142.091 KB) | DOI: 10.13181/mji.v15i4.246

Abstract

The interest in the clinical importance of serum magnesium level has just recently begun with the analysis and findings of abnormal magnesium level in cardiovascular, metabolic and neuromuscular disorder. Although the serum level does not reflect the body magnesium level, but currently, only serum magnesium determination is widely used. Erythrocyte magnesium is considered more sensitive than serum magnesium as it reflects intracellular magnesium status. According to NCCLS (National Committee for Clinical Laboratory Standards) every laboratory is recommended to have its own reference range for the tests it performs, including magnesium determination. The reference range obtained is appropriate for the population and affected by the method and technique. This study aimed to find the reference range of serum and plasma magnesium and also intracellular magnesium i.e. erythrocyte magnesium by direct method, and compare the results of serum and plasma magnesium. Blood was taken from 114-blood donor from Unit Transfusi Darah Daerah (UTDD) Budhyarto Palang Merah Indonesia (PMI) DKI Jakarta, consisted of 57 male and 57 female, aged 17 – 65 years, clinically healthy according to PMI donor criteria. Blood was taken from blood set, collected into 4 ml vacuum tube without anticoagulant for serum magnesium determination and 3 ml vacuum tube with lithium heparin for determination of erythrocyte and plasma magnesium Determination of magnesium level was performed with clinical chemistry auto analyzer Hitachi 912 by Xylidil Blue method colorimetrically. This study showed no significant difference between serum and heparinized plasma extra cellular magnesium. The reference range for serum or plasma magnesium was 1.30 – 2.00 mEq/L and for erythrocyte magnesium was 4.46 - 7.10 mEq/L. (Med J Indones 2006; 15:229-35)Keywords: Reference range, extracellular magnesium, intracellular magnesium
Role of Glycated Albumin during Pregnancy Immanuel, Suzanna; Ronald, Thoeng; Sumapradja, Kanadi; Setiawati3, Arini
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (77.512 KB) | DOI: 10.32771/inajog.v5i1.459

Abstract

Objective: To determine the glycated albumin profile during pregnancy with normal glycemic status. Methods: We recruited 60 pregnant women between 21 and 36 weeks of gestation. We conducted several laboratory tests, such as glycated albumin, blood glucose, and albumin. These parameters were compared among four groups of gestational age (21-24 weeks, 25-28 weeks, 29-32 weeks, and 33-36 weeks) using ANOVA or Kruskal-Wallis test continued by Post-hoc test. Results: Glycated albumin was not statistically different among the groups. Albumin level of 33-36 weeks of gestation women (3.6 (SD 0.2) g/dl) was lower than 21-24 weeks of gestation women (3.8 (SD 0.2) g/dl). Conclusion: Glycated albumin level is not affected by gestational age. Therefore, glycated albumin may be used as glycemic status indicator during pregnancy from 21 to 36 weeks. [Indones J Obstet Gynecol 2017; 5-1: 16-18] Keywords: HbA1c, glycated albumin, glycemic status, pregnancy
Role of Glycated Albumin during Pregnancy Immanuel, Suzanna; Ronald, Thoeng; Sumapradja, Kanadi; Setiawati3, Arini
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 1, January 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (77.512 KB) | DOI: 10.32771/inajog.v5i1.459

Abstract

Objective: To determine the glycated albumin profile during pregnancy with normal glycemic status. Methods: We recruited 60 pregnant women between 21 and 36 weeks of gestation. We conducted several laboratory tests, such as glycated albumin, blood glucose, and albumin. These parameters were compared among four groups of gestational age (21-24 weeks, 25-28 weeks, 29-32 weeks, and 33-36 weeks) using ANOVA or Kruskal-Wallis test continued by Post-hoc test. Results: Glycated albumin was not statistically different among the groups. Albumin level of 33-36 weeks of gestation women (3.6 (SD 0.2) g/dl) was lower than 21-24 weeks of gestation women (3.8 (SD 0.2) g/dl). Conclusion: Glycated albumin level is not affected by gestational age. Therefore, glycated albumin may be used as glycemic status indicator during pregnancy from 21 to 36 weeks. [Indones J Obstet Gynecol 2017; 5-1: 16-18] Keywords: HbA1c, glycated albumin, glycemic status, pregnancy
Oral glucose tolerance test, hemoglobin glycate and fructosamine blood levels in pregnancy Suryatmadja, Marzuki; Susanto, Anthony; Immanuel, Suzanna; Amelz, Husna; Wiknjosastro, Gulardi H
Medical Journal of Indonesia Vol 1, No 1 (1992): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.v1i1.3533

Abstract

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