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Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
Articles
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Deteksi Natrium/Iodide Symporter (NIS) pada Galur Sel Kanker Payudara SKBR3 dengan Imunositofluoresens

Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Galur sel SKBR3 adalah model kanker payudara positif human epidermal growth factor receptor2 (HER2). Pemberian kemoterapi memperlihatkan respons lengkap hanya pada 50% pasien kanker payudara dengan tipe positif HER2. Kemampuan jaringan tumor menangkap dan mengakumulasi iodium radioaktif dihubungkan dengan ekspresi natrium/iodide symporter (NIS). Tujuan penelitian ini adalah menilai ekspresi dan distribusi NIS pada galur sel SKBR3 serta menilai efek induksi epidermal growth factor (EGF) pada ekspresi NIS menggunakan imunositofluoresens-ISF. Penelitian ini dilakukan di Laboratorium Kultur Sel, Fakultas Kedokteran Universitas Padjadjaran (FKUP) mulai bulan September 2013 sampai dengan April 2014. Sel SKBR3 ditumbuhkan pada plat kultur dan ditunggu hingga konfluen 70%. Sel dibagi atas dua kelompok, yaitu kelompok yang diberi induksi dan kontrol. Induksi EGF diberikan dengan dosis 50 ng/mL. Pemeriksaan ISF menggunakan antibodi primer rabbit polyclonal antibody anti NIS dan antibodi sekunder goat anti rabbit IgG polyclonal antibody. Data hasil pengamatan dinilai secara semikuantitatif. Natrium/iodide symporter tampak terekspresi dan terdistribusi di sitoplasma. Sel yang diinduksi dengan EGF memperlihatkan peningkatan ekspresi NIS di sitoplasma dan distribusinya di membran sel secara bermakna. Sel SKBR3 mengekspresikan NIS yang terdapat di sitoplasma. Induksi EGF meningkatkan ekspresi NIS dan distribusinya di membran sel. Temuan ini dapat mengarah potensi kemampuan sel kanker payudara menangkap dan mengakumulasikan iodium radioaktif. [MKB. 2016;48(1):15–8] Kata kunci: Ekspresi NIS , galur sel SKBR3, kanker payudara, imunositofluoresensDetection of Natrium/Iodide Symporter (NIS) in SKBR-3 Breast Cancer Cell Line Using ImmunocytofluoresenceAbstractSKBR-3 cell line is a breast cancer model for human epidermal growth factor receptor2 (HER2) positive. Only 50% of patients of this type have fully responded to chemotherapy. Natrium iodide symporter expression correlates with the uptake and ability of cells to accumulate radioiodine. The aim of this study was to examine natrium/iodide symporter (NIS) expression and its distribution with and without epidermal growth factor (EGF) treatment using immunocytofluoresence (ICF). This study was conducted at the Cell Culture Laboratory, Faculty of Medicine, Universitas Padjadjaran from September 2013 to April 2014. SKBR3 cells were cultured until 70% confluent. Cells were then divided into two groups: treatment group and control group. The treatment group was treated with EGF 50 ng/mL. Cells were incubated with primary antibody rabbit polyclonal antibody anti-NIS, and then were followed with secondary-antibody goat polyclonal antibody to rabbit. Data from the observation were then assessed semi-quantitatively. Natrium/iodide symporter was seen to be expressed and distributed in the cytoplasm. Cells induced by EGF showed significant increase in NIS expression in cytoplasm and its distribution in cell membrane. It is concluded that the SKBR3 cells express NIS in cytoplasm and that EGF induction increases NIS expression and distribution in cell membrane. This finding leads to a potential ability of breast cancer cells to uptake and accumulate radioiodine. [MKB. 2016;48(1):15–8]Key words: Breast cancer, cell line SKBR-3, immunocytofluoresence, NIS expression DOI: 10.15395/mkb.v48n1.728

Validitas Kidney Injury Molecule-1 Urin Metode Mikro Enzyme-Linked Immunosorbent Assay Sebagai Penanda Dini Gangguan Ginjal Akut pada Sepsis

Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gangguan ginjal akut (GgGA) adalah penurunan fungsi ginjal ditandai peningkatan kreatinin serum ≥0,3 mg/dL atau >1,5 kali dibanding dengan kadar sebelumnya atau penurunan urine output <0,5 mL/jam lebih dari 6 jam. Sepsis merupakan penyebab tersering GgGA (20–50%). Kidney injury molecule-1 (KIM-1) adalah glikoprotein transmembran tipe-1. Kadar KIM-1 urin penderita GgGA akibat sepsis meningkat lebih awal dibanding dengan kreatinin serum. Penelitian bertujuan mengetahui validitas KIM-1 urin sebagai penanda dini GgGA pada sepsis, dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Februari–Mei 2013. Bentuk penelitian observasional analitik khusus dengan rancangan potong lintang. Subjek penelitian adalah penderita sepsis yang didiagnosis klinisi sesuai kriteria The American College of Chest Physician/The Society of Critical Care Medicine 2001, berdasarkan consecutive admission sampling. Metode yang digunakan mikro enzyme-linked immunosorbent assay. Analisis dengan chi-kuadrat, Mann-Whitney, tabel 2x2, dan kurva receiver operating curve untuk menghitung validitas. Subjek terdiri atas 25 penderita sepsis dengan GgGA dan 25 penderita sepsis tanpa GgGA. Kadar KIM-1 urin penderita sepsis dengan GgGA meningkat dibanding dengan tanpa GgGA. Kadar KIM-1 urine cut-off >0,8 ng/mL memiliki sensitivitas 96%, spesifisitas 60%, nilai duga positif 70,6%, nilai duga negatif 93,8%, dan akurasi 78%. Simpulan, sensitivitas KIM-1 urin tinggi, spesifisitas sedang sehingga dapat digunakan sebagai skrining GgGA pada penderita sepsis. [MKB. 2016;48(1):19–25]Kata kunci: GgGA, KIM-1, sepsis, validitas Validity of Urinary Kidney Injury Molecule-1 Using Micro Enzyme-Linked Immunosorbent Assay Method as an Early Marker of Acute Kidney Injury in Sepsis PatientsAAcute kidney injury (AKI) is a rapid decline in renal function marked by increased serum creatinine of ≥0.3 mg/dL or >1.5 times higher than the previous levels or decreased urine output of <0.5 mL/hour for more than 6 hours. Sepsis is the most common cause of AKI (20–50%). Kidney injury molecule-1 (KIM-1) is a type-1 transmembrane glycoprotein. Urinary KIM-1 levels of sepsis patients due to AKI increases earlier than the serum creatinine levels; thus KIM-1 may serve as an AKI marker. This study aimed to determine the validity of urinary KIM-1 as the early marker in sepsis patients with AKI. The study was a specific observational analytical study with cross-sectional design, conducted in Dr. Hasan Sadikin General Hospital Bandung in February–May 2013. Subjects were patients diagnosed with sepsis by clinicians according to the criteria of the The American College of Chest Physician/The Society of Critical Care Medicine 2001 and were selected by consecutive sampling admissions. Urinary KIM-1 levels were measured by micro enzyme-linked immunosorbent assay. The data were analyzed by chi-square, Mann-Whitney, 2x2 tables, and receiver operating curve to measure validity. Subjects consisted of 25 sepsis patients with AKI and 25 sepsis patients without AKI. Urinary KIM-1 level of sepsis patient with AKI increased compared to patients without AKI. Level of urinary KIM-1 with a cut-off of >0.8 ng/mL presented 96% sensitivity, 60% specificity, 70.6% positive predictive value, 93.8% negative predictive value and 78% accuracy. In conclusion, the level of urinary KIM-1 has high sensitivity and moderate specificity thus can be used for AKI screening in sepsis patients. [MKB. 2016;48(1):19–25]Key words: AKI, KIM-1, sepsis, validity DOI: 10.15395/mkb.v48n1.729

Kadar Asam Urat Serum sebagai Biomarker Preeklamsi

Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Preeklamsi masih merupakan masalah kesehatan yang menjadi salah satu penyebab kematian ibu selain akibat perdarahan dan infeksi. Etiologi dan patogenesis preeklamsi belum diketahui pasti. Peningkatan kadar asam urat serum timbul bersamaan dengan peningkatan tekanan darah dan terjadi sebelum timbul proteinuria sehingga dapat dipakai sebagai salah satu biomarker. Tujuan penelitian ini menganalisis perbandingan kadar asam urat serum pada kehamilan in partu normal dengan in partu preeklamsi. Penelitian potong lintang dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2011. Subjek penelitian 45 wanita hamil in partu normal sebagai kelompok kontrol dan 44 wanita in partu dengan preeklamsi sesuai dengan kriteria inklusi dan eksklusi. Kadar asam urat serum pada wanita hamil normal adalah 3,43±0,14 mg/dL. Pada penelitian ini nilai titik potong kadar asam urat serum 4,8 mg/dL dengan nilai sensitivitas 93% dan spesifisitas 80%. Simpulan,kadar asam urat pada in partu preeklamsi lebih tinggi dibandingkan dengan kehamilan normal. Peningkatan kadar asam urat dapat dipertimbangkan sebagai salah satu biomarker preeklamsi, sebaiknya kadar asam urat serum digunakan sebagai pemeriksaan serial pada ibu hamil saat pelayanan antenatal. [MKB. 2013;45(2):98–104]Kata kunci: Biomarker, kadar asam urat, preeklamsiSerum Levels of Uric Acid as a Biomarker in PreeclampsiaPreeclampsia remains a health problem that becomes one of the causes of maternal deaths besides bleeding and infection. The etiology and pathogenesis of preeclampsia are unclear. Increased serum uric acid levels is seen simultaneously with the increase of blood pressure and occurred before the onset of proteinuria. Therefore, the uric acid can be used as a biomarker. The aim of this study was to analyze the serum uric acid levels between normal and preeclampsia pregnancies. The study was conducted in Dr.Hasan Sadikin Hospital Bandung between March and May 2011, using cross sectional study design. Subjects were 45 inpartu normal pregnant women as control and 44 in partu pregnant women with preeclampsia accordance with inclusion and exclusion criteria. Levels of uric acid in normal pregnancy are 3,43 ±0.14 mg/dL. In this study uric acid levels resulting in cut-off levels of 4,8 mg/dL with a sensitivity value of 93%, and specificity 80%. Conclusions: uric acid levels in at term preeclampsia are higher compared with normal pregnancies. Increased levels of uric acid can be considered as one of biomarkers of preeclampsia, hence the serum uric acid levels used as serial examinations in pregnant women during antenatal care. [MKB. 2013;45(2):98–104]Key words: Biomarker, preeclampsia, uric acid level DOI: http://dx.doi.org/10.15395/mkb.v45n2.89

Korelasi Proteinuria Metode Rasio Albumin-Kreatinin Urin dengan Metode Kromatografi pada Preeklamsi

Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Preeklamsi masih merupakan salah satu penyebab utama kematian ibu melahirkan. Pada preeklamsi terjadi kerusakan endotel vaskular ginjal yang menyebabkan proteinuria. Pemeriksaan proteinuria penting dalam diagnosis preeklamsi. Metode rasio albumin-kreatinin urin (uACR) adalah metode pemeriksaan proteinuria yang memiliki korelasi yang baik dengan kadar protein urin 24 jam sebagai baku emas. Metode lain adalah metode kromatografi (carik celup) yang masih secara luas digunakan di berbagai fasilitas kesehatan namun dari berbagai penelitian metode ini memiliki variasi nilai sensitivitas dan spesifisitas yang luas. Tujuan penelitian untuk mengetahui apakah terdapat korelasi yang baik antara hasil pemeriksaan proteinuria metode carik celup dan metode uACR pada penderita preeklamsi. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian adalah wanita hamil penderita preeklamsi yang sesuai dengan kriteria inklusi dan tidak masuk ke dalam kriteria eksklusi. Analisis statistik dilakukan dengan uji korelasi rank Spearman. Subjek penelitian sebanyak 52 orang. Kelompok usia terbanyak adalah 20–34 tahun. Dari uji statistik yang dilakukan, didapatkan korelasi yang baik antara hasil pemeriksaan proteinuria dari kedua metode tersebut (r=0,51; p<0,05). Simpulan, terdapat korelasi yang baik antara hasil pemeriksaan proteinuria metode carik celup dan metode uACR pada penderita preeklamsi, sehingga metode carik celup dapat tetap dipakai. [MKB. 2012;44(4):218–23].Correlation between Urinary Albumin Creatinin Ratio Test and Chromatographic Method in PreeclampsiaPreeclampsia is still one of the major causes of maternal mortality. In preeclamptic renal vascular endothelial damage occurs that leads to proteinuria. Examination of proteinuria is essential in preeclampsia diagnosis. Urinary albumin-creatinine ratio (uACR) is one of proteinuria test methods with good correlation with 24-hour urinary protein as the gold standard. Another method is chromatographic method (dipstick urinalysis) which is still widely used in various health facilities but from various studies it has wide variation of sensitivity and specificity values. The purpose of this study was to determine whether there is a good correlation between the results of the proteinuria examination by dipstick method and uACR method in patients with preeclampsia. The study was conducted at Dr. Hasan Sadikin Hospital Bandung. Subjects were woman with preeclampsia in accordance with inclusion and exclusion criteria. Statistical analysis was performed using Spearman rank correlation test. There were 52 subjects. Thelargest age group was 20–34 years. From the statistical test performed, agood correlation between the results of proteinuria examination from both methods was found. In conclusion, there is a good correlation between the results of dipstick urinalysis method and the method of urinary albumin-creatinine ratio in patients with preeclampsia. Therefore, dipstick urinalysis examination can still be utilized. [MKB. 2012;44(4):218–23]. DOI: http://dx.doi.org/10.15395/mkb.v44n4.139

Perbedaan Kadar Osteoprotegerin Serum Penderita Diabetes Melitus Tipe 2 tanpa dan dengan Penyakit Jantung Koroner

Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Diabetes melitus (DM) tipe 2 merupakan diabetes yang disebabkan oleh resistensi insulin dan atau gangguan sekresi insulin sehingga menyebabkan hiperglikemia yang merupakan penyebab disfungsi endotel. Disfungsi endotel merupakan proses awal aterosklerosis dan merupakan salah satu faktor risiko yang menyebabkan penyakit jantung koroner (PJK). Sampai saat ini angiografi koroner digunakan sebagai baku emas PJK. Pemeriksaan osteoprotegerin (OPG) merupakan pemeriksaan alternatif sebagai penanda disfungsi endotel, kurang invasif, lebih dini, dan murah. Osteoprotegerin berhubungan dengan perkembangan plak arteri pada penderita DM tipe 2. Tujuan penelitian ini mengetahui perbedaan kadar OPG dalam serum penderita DM tipe 2 tanpa dan dengan PJK. Penelitian dilakukan pada September–Desember 2012 di Poliklinik Endokrin dan Instalasi Gawat Darurat RSUP Dr. Hasan Sadikin Bandung. Subjek penelitian sebanyak 102 orang, 51 orang penderita telah didiagnosis oleh klinisi sebagai penderita DM tipe 2 dengan PJK dan 51 orang penderita DM tipe 2 tanpa PJK, berusia 35–75 tahun. Pemeriksaan OPG menggunakan metode enzyme linked immunosorbent assay (ELISA). Bentuk penelitian adalah observasional komparatif dengan rancangan penelitian studi perbandingan potong lintang. Analisis statistik menggunakan uji Shapiro Wilk’s, independent T, dan Mann Whitney. Nilai median kadar OPG serum untuk penderita DM tipe 2 dengan PJK lebih tinggi, yaitu sebesar 6,1 pmol/L dan penderita DM tipe 2 tanpa PJK, yaitu sebesar 2,6 pmol/L (p=0.0001). Simpulan, terdapat perbedaan kadar OPG serum antara kelompok DM tipe 2 tanpa dan dengan PJK. [MKB. 2015;47(4):218–23]Kata kunci: Disfungsi endotel, DM tipe 2, osteoprotegerinDifferences of Osteoprotegerin Levels in Patients with Type 2 Diabetes Mellitus with and without Coronary Arterial DiseaseAbstractType 2 diabetes mellitus (DM) is caused by insulin resistance and/or impaired insulin secretion, thus causing hyperglycemia leading to endothelial dysfunction. Endothelial dysfunction is an early process of atherosclerosis and is one of the risk factors for coronary arterial disease (CAD). Currently, coronary angiography is used as the gold standard for diagnosing CAD. Examination of osteoprotegerin (OPG) is an alternative assay for endothelial dysfunction marker which is less invasive, has the ability to detect earlier, and less expensive. Osteoprotegerin is associated with the development of arterial plaque in patients with type 2 DM. The aim of this study was to determine the differences in serum OPG levels in patients with type 2 DM with and without CAD. The study was conducted in September–December 2012 in the Endocrine Clinic and Emergency Unit of Dr. Hasan Sadikin General Hospital Bandung on 102 patients aged between 35–75 years, with 51 subjects type 2 DM patients with CAD and 51 subjects with type 2 DM without CAD, both diagnosed by clinician. The method used was, OPG enzyme linked immunosorbent assay (ELISA) examination method. The study was an observational cross-sectional comparative study. Statistical analysis was performed using normality test with Shapiro Wilk’s, independent T and Mann Whitney test. The median value for patients with type 2 DM with CAD equaled to 6.1 pmol/L and the value for type 2 diabetic patients without CAD was 2.6 pmol/L. In this study, the OPG levels obtained in patients type 2 DM with CAD were higher than those without CAD. In conclusion, there is a significant difference in OPG levels between type 2 DM with and without CAD groups. [MKB. 2015;47(4):218–23]Key words: Endothelial dysfunction, type 2 diabetes, osteoprotegerin DOI: 10.15395/mkb.v47n4.616