Yenny Surjawan
Faculty of Medicine, University of Hasanuddin, Makasar, Indonesia

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The association of plasminogen activator inhibitor-1 level with ischemic stroke (preliminary study)

Medical Journal of Indonesia Vol 19, No 3 (2010): August
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Aim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke.Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago.Results High PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 – 12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 – 58 years old) than in the older subjects (60 – 84 years old) (20% vs. 9.8 %) (p=0.004).Conclusion The result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association. (Med J Indones 2009;19:158-63)Key words: ischemic stroke, plasminogen activator inhibitor-1, stroke risk factors

The different pattern of blood S100B protein and GFAP concentrations in ischemic stroke

Medical Journal of Indonesia Vol 22, No 4 (2013): November
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: S100B protein and glial fibrillary acidic protein (GFAP) released during ischemia have been associated with stroke. This study aimed to know whether there was a correlation between the concentration of these markers with the severity of neurological deficit in ischemic stroke.Methods: This was a cross-sectional study, which involved 143 ischemic stroke patients who were admitted to hospital not more than 72 hours after the onset and fulfilled the criteria. The concentration of S100B protein and GFAP was determined by ELISA method. Blood level of S100B and GFAP in patient with mild, moderate, and severe stroke were analyzed with Kruskal-Wallis test.Results: There was a significant difference between S100B protein concentration among subjects with mild (median 63.31 ng/L), moderate (median 88.93 ng/L), and severe (median 511.55 ng/L) NIHSS at admission (p < 0.05). A weak significant correlation was found between the severity of NIHSS and the S100B protein concentration. The more severe the NIHSS, the higher the S100B protein concentration (r = 0.351; p < 0.001). Subjects with moderate and severe NIHSS were more frequent to have an intermediate or high level of S100B protein than the subjects with mild NIHSS (OR = 3.9; p < 0.001). The median concentration of GFAP was significantly higher in severe NIHSS subjects (median 0.374 ng/mL) than its concentration in mild (median 0.047 ng/mL) and moderate (median 0.043 ng/mL) NIHSS subjects (p < 0.05).Conclusion: S100B protein concentration was significantly higher in linier relation with the severity of NIHSS, while the GFAP concentration was significantly higher if the NIHSS had been already severe. (Med J Indones. 2013;22:215-20. doi: 10.13181/mji.v22i4.602) Keywords: GFAP, ischemic stroke, NIHSS, S100B protein

GFAP and S100B Protein are Associated with Discharged NIHSS of Anterior Circulation Ischemic Stroke

The Indonesian Biomedical Journal Vol 4, No 2 (2012)
Publisher : The Prodia Education and Research Institute (PERI)

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Abstract

BACKGROUND: Patient with larger ischemic lesion will suffer more severe neurogical deficit. The utility of MRI for lesion size measurement is still limited, therefore additional approach was pursued through examination of markers released by damaged brain cell, GFAP and S100B protein. The aim of this study is to know whether both markers are associated with the neurological deficit of anterior circulation ischemic stroke. METHODS: This observational prospective study enrolled 74 patients with anterior circulation ischemic stroke diagnosis. GFAP and S100B protein were measured with ELISA using blood collected at 48 to 72 hours after onset. The neurological deficit was assessed with NIHSS ad discharged.RESULTS: There was a significant association between GFAP level and discharged NIHSS (p=0.008) with 100% sensitivity and 100% negative predictive value. S100B protein also showed a significant correlation with discharged NIHSS (r=0.488; p=0.000) and this correlation could be described with an equation (OR=1.009; 95% CI=1.0003-1.0188; p=0.044). S100B protein at 78.3215 ng/L would give true prediction as 73.9% (95% CI=62.7%-85.2%, p=0.001). CONCLUSIONS: GFAP and S100B protein that were measured at 48 to 72 hours after onset were significantly associated with NIHSS at discharge. KEYWORDS: GFAP, S100B protein, discharged NIHSS, ischemic stroke

C-Reactive Protein and Matrix Metalloproteinase-9 are Associated with Outcome of Ischemic Stroke

The Indonesian Biomedical Journal Vol 4, No 3 (2012)
Publisher : The Prodia Education and Research Institute (PERI)

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Abstract

BACKGROUND: C-Reactive protein (CRP) and matrix metalloproteinase (MMP)-9 are inflammatory mediators that are often associated with the evolution of stroke. In this study, we aimed to find out whether concentration of these biomarkers were associated with the severity of discharge National Institute of Health Stroke Scale (NIHSS) in ischemic stroke patient.METHODS: In prospective stody, we involved 143 ischemic stroke patient who were admitted to hospital not more than 72 hours after the onset and who met the criteria. The concentration of CRP was assessed by High Sensitivity CRP reagent from Siemens and the concentration of MMP-9 was measure with Quantikine Human MMP-9 (total) Immunoassay from R&D. The outcome of stroke was determined by NIHSS score at discharge.RESULTS: There was a significant correlation between the CRP level and the severity of NIHSS at discharge (r = 0.288, p = 0.000). Subjects with intermediate/high level of CRP had a higher probability to have a moderate or even severe NIHSS (OR = 1.7, p = 0.004). Subjects with high MMP level showed a higher probability to have a severe NIHSS. CONCLUSION: The measurement of CRP and MMP-9 at 48-72 hours after stroke onset were associated with the severity of ischemic stroke based on NIHSS score at discharge.  KEYWORDS: inflammation, CRP, MMP-9, discharged NIHSS

Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

The Indonesian Biomedical Journal Vol 9, No 2 (2017)
Publisher : The Prodia Education and Research Institute (PERI)

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Abstract

BACKGROUND: The mutation spectrums of hemoglobinopathy are different among populations that yield a different result of erythrocyte indices. Calculation of erythrocyte indices with some formula has been reported to differentiate between hemoglobinopathy and non-hemoglobinopathy, but its cut-off should be recalculated specific for each population to gain a better sensitivity and specificity. We aimed to evaluate red blood cell count (RBC), Mentzer index, red cell distribution width (RDW), RDW index (RDWI), Shine and Lal index (S&L) and Green and King index (G&K) to screen hemoglobinopathy in Indonesia.METHODS: A retrospective cross-sectional study was performed on 202 subjects. The diagnosis of hemoglobinopathy was determined based on the results of complete blood count (CBC) data, high-performance liquid chromatography (HPLC) and Hemoglobin H (HbH) inclusion body. The ferritin concentration was checked to determine the status of iron. The erythrocytes indices were analyzed and calculated to predict hemoglobinopathy. RESULTS: A total 202 subjects who met the criteria were involved in this study. Fifty percent showed pure hemoglobinopathy and 4% showed a combination of thalassemia and hemoglobinopathy. The hemoglobin concentration and RBC were significantly higher, and the mean corpuscular volume (MCV) and RDW were significantly lower in hemoglobinopathy compared to iron deficiency. The difference was not significant if the hemoglobinopathy was combined with iron deficiency. By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity.CONCLUSION: The new cut-off of erythrocyte index and its calculation to screen hemoglobinopathy in Indonesia showed a higher sensitivity and specificity, especially for G&K and RDWI with cut-off 73 and 228, respectively. The presence of iron deficiency in hemoglobinopathy could decrease the sensitivity.KEYWORDS: hemoglobinopathy, RBC, Mentzer index, RDW, RDWI, S&L, G&K