Oki Suwarsa
Departemen Ilmu Kesehatan Kulit dan Kelamin Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung

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Aktivitas IL-18, IL-4, dan IFN- pada Kultur Limfosit yang Distimulus oleh Staphylococcal enterotoxin B (SEB) sebagai Petanda Eksaserbasi Tingkat Seluler pada Penderita Dermatitis Atopik

Indonesian Journal of Applied Sciences Vol 1, No 3 (2011)
Publisher : Universitas Padjadjaran

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Abstract

Staphylococcus aureus (S.aureus) has an important role in the pathogenesis of atopic dermatitis (AD). These role of S. aureus are related to various proteins such as staphylococcal enterotoxin B (SEB), a potent toxin. Interleukin (IL) -18  is an important regulator for interferon (IFN)g ,a cytokine produced by Th-1, and IL-4 produced by Th-2.  Further studies are still needed to discover the mechanism of SEB in AD, particularly IL-18 level, and its activities towards IL-4 and IFN-g  secretions, in regards of therapeutic strategy. The aim of this study is to analyze the activities of IL-18, IL-4, and IFN-g in the lymphocyte culture from AD patients, stimulated  with  SEB and the association between increased IL-18 level with increased  IL-4 and IFNg level. Twenty AD patients (7 male and 13 female) and twenty healthy subjects (9 male, and 11 female) were involved in this study. Study was done in Dr. Hasan Sadikin General Hospital, Bandung, proceeded by experimental invitro test on the lymphocyte culture stimulated with SEB at Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. The study was performed from 4January until 31March 2010.  Lymphocytes from the peripheral blood of the study group and control group were isolated and cultured, then 3 methods were performed towards the cultured lytmphocyte, i.e., no exposure, exposed to PHA, and exposed to SEB. After being incubated for 72 hour, then IL-18, IL-4, and  IFN-g  levels from the supernatant of the lymphocyte culture were evaluated with ELISA method.Mean IL-18 level in the lymphocyte culture of AD group, with no exposure, exposed to PHA, and exposed to SEB were 54,62 pg/ml, 70,09 pg/ml, and 99,38 pg/ml, respectively, whereas,  in the control group were 33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml, respectively. Mean IL-4 level in the study group were 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, and in the control group were  0,32 pg/ml, 0,78 pg/ml, and 3,02 pg/ml, respectively. Mean IFN-g level in the AD group were 12,75 pg/ml, 351,59 pg/ml, and 1293,17 pg/ml, while in the control group were  19,76 pg/ml, 562,81 pg/ml, and 1419,28 pg/ml, respectively.  IL-18, IL-4, and IFN-g  level in the AD group increased after being stimulated with SEB,  (p<0,05), whereas in the control group increase only occured to IL-4, and IFN-g (p<0,05). There were correlation between increased IL-18 level with increased IL-4 level (p<0,05), however the increased of IL-18 level were not related to increased IFN-g level (p>0,05). The increased  IL-18 level contributed more to the increased of IL-4 level than IFN-g  level  (p<0,05).The result of this study, is only IL-18 level increased in any methods performed, compared to control group (p<0,05). This finding leads to the conclusion that IL-18 level is the marker of AD exacerbation in the cellular level of the AD lymphocyte culture stimulated with SEB.****Staphylococcus aureus (S.aureus) berperan penting pada patogenesis dermatitis atopik (DA). Peran tersebut berhubungan dengan dihasilkannya berbagai protein antara lain toksin poten oleh S. aureus, yaitu staphyloccoccal enterotoxin B (SEB).  Interleukin-18 (IL-18) merupakan regulator penting dari produksi sitokin Th-1 yaitu Interferon-g (IFN-g) dan Th-2 yaitu IL-4. Penelitian untuk mengetahui mekanisme SEB pada DA, khususnya kadar IL-18, dan pengaruh aktivitas IL-18 terhadap sekresi IL-4 dan IFN-g, untuk strategi pengobatan perlu dilakukan. Tujuan penelitian ini adalah untuk menganalisis aktivitas IL-18, IL-4, dan IFN-g pada kultur limfosit yang distimulus oleh SEB pada penderita DA, serta pengaruh kenaikan kadar IL-18 terhadap kenaikan kadar IL-4 dan IFN-g.Penelitian ini dilakukan  pada 20 orang penderita DA (7 laki-laki dan 13 wanita) dan 20 orang sehat (9 laki-laki, dan 11 wanita) di RSUP. Dr. Hasan Sadikin Bandung, merupakan penelitian eksperimental secara invitro pada kultur limfosit yang distimulus oleh SEB di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. Dilakukan isolasi limfosit dari darah perifer kelompok DA dan kontrol, dilanjutkan dengan kultur limfosit, kemudian dilakukan 3 perlakuan yaitu tanpa paparan, dipapar dengan phytohemagglutinin (PHA), dan dipapar dengan SEB. Setelah dieramkan selama 72 jam, kemudian diperiksa kadar IL-18, IL-4, dan IFN-g  dari supernatan kultur limfosit dengan metode ELISA.Kadar IL-18  rata-rata pada kultur limfosit tanpa paparan, paparan PHA, dan paparan SEB kelompok DA  berturut-turut  adalah 54,62 pg/ml, 70,09 pg/ml, dan 99,38 pg/ml.   Sedangkan pada kelompok kontrol berturut-turut adalah   33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml. Kadar IL-4 rata-rata kelompok DA berturut-turut adalah 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, dan pada kelompok kontrol berturut-turut adalah   0,32 pg/ml, 0,78 pg/ml, dan 3,02 pg/ml. Kadar  IFN-g rata-rata kelompok DA  berturut-turut adalah  12,75 pg/ml, 351,59 pg/ml, dan 1293,17 pg/ml, dan pada kelompok kontrol berturut-turut adalah   19,76 pg/ml, 562,81 pg/ml, dan 1419,28 pg/ml.  Pada kelompok DA, kadar IL-18, IL-4, dan IFN-g setelah dipapar SEB, meningkat dibanding dengan sebelum dipapar (p<0,05), sedangkan pada kelompok kontrol hanya kadar IL-4, dan IFN-g yang meningkat (p<0,05). Kenaikan kadar IL-18 berpengaruh terhadap kenaikan kadar IL-4 (p<0,05), tetapi tidak berpengaruh terhadap kenaikan kadar IFN-g  (p>0,05). Kenaikan kadar IL-18 lebih berpengaruh  pada kenaikan kadar IL-4 dibandingkan dengan IFN-g (p<0,05).Pada penelitian ini hanya kadar IL-18 kelompok DA yang meningkat lebih tinggi pada semua perlakuan, dibandingkan dengan kelompok kontrol (p<0,05), sehingga dapat disimpulkan bahwa IL-18 merupakan petanda adanya eksaserbasi tingkat seluler pada kultur limfosit DA yang distimulus oleh SEB.

Efikasi Terapi Kombinasi Salep Kalsipotriol 0,005% dan Klobetasol Propionat 0,05% Dibanding Klobetasol Propionat 0,05% pada Psoriasis Vulgaris

Majalah Kedokteran Bandung Vol 1, No 42 (2010)
Publisher : Majalah Kedokteran Bandung

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Abstract

Psoriasis adalah penyakit eritropapuloskuamosa kronik residif. Obat yang paling sering digunakan untuk terapi penyakit ini adalah kortikosteroid topikal, tetapi penggunaan jangka panjang dapat menyebabkan berbagai efek samping. Kalsipotriol merupakan obat topikal selain kortikosteroid yang memiliki efek samping yang lebih ringan. Tujuan penelitian ini adalah untuk membandingkan skor psoriasis area and severity index (PASI) sebelum dan sesudah pengobatan dengan kombinasi salep kalsipotriol 0,005% dengan salep klobetasol propionat 0,05% dan monoterapi salep klobetasol propionat 0,05% pada penderita psoriasis vulgaris. Skor psoriasis area severity index (PASI), digunakan untuk mengukur berat ringannya psoriasis dan mengevaluasi perbaikan lesi. Desain penelitian adalah uji klinik dengan rancangan acak secara double blind. Uji Mann-Whitney dan Wilcoxon digunakan untuk menganalisis data skor PASI sebelum dan sesudah pengobatan. Penelitian dilakukan di poliklinik I.K. Kulit danKelamin RS. Hasan Sadikin Bandung dari bulan November 2007- Januari 2008 dengan subjek penelitian sebanyak 44 orang yang dibagi dalam dua kelompok. Derajat keparahan penyakit dinilai dengan skor PASI yang dinilai sebelum, satu minggu, dan dua minggu setelah pengobatan. Kesimpulan: Penggunaan terapi kombinasi salep kalsipotriol 0,005% dan klobetasol propionat 0,05% selama dua minggu memiliki efikasi yang lebih baik dibandingkan monoterapi salep klobetasol propionat 0,05%, secara statistik sangat bermakna (p<0,001).Efficacy Combination Therapy of 0.005% Calcipotriol and 0.05%Clobetasol Propionat Compared to 0.05% Clobetasol Propionat Ointment in Psoriasis VulgarisPsoriasis is a chronic relapsing erythropapulosquamous skin disease. Topical corticosteroid is the most common treatment for psoriasis, but it can cause many side effect on longterm used. Calcipotriol ointment is the other topical treatment for psoriasis and has minimal side effect. The study was a double blind randomized clinical trial, compared psoriasis area and severity index score before and after treatment combination therapy of 0.005% calcipotriol ointment 0.05% and clobetasol propionat ointment with 0.05% clobetasol propionat alone. Psoriasis area severity index (PASI) score was used to evaluate severity degree and imprvoment of psoriasis. Mann-Whitney and Wilcoxon test were used for statistical analysis of PASI score before and after treatment. Study was conducted at Dermatology and Venereology outpatient Department of Hasan Sadikin Hospital Bandung period November 2007 to January 2008 with fourty four psoriasis vulgaris patients were enrolled in this study, divided into two groups. The assesment of the severity of skin lesions psoriasis area and severity index was performed at baseline, after one week and two weeks treatment. Conclusion: the use of daily 0.005% calcipotriol ointment combined with 0.05% clobetasol propionate

Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) mulai dijumpai pada penderita dermatitis atopik (DA) derajat sedang hingga berat dan bersifat multiresisten terhadap antibiotik topikal. Gentamisin telah digunakan secara luas, sedangkan mupirosin merupakan pilihan utama eradikasi MRSA. Penelitian ini bertujuan untuk mengetahui kolonisasi MRSA pada penderita DA dan sensitivitasnya terhadap mupirosin dibandingkan dengan gentamisin di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Survei potong lintang analitik dilakukan selama 19 September–31 Oktober 2011 terhadap 22 penderita DA derajat sedang hingga berat sesuai dengan Scoring Atopic Dermatitis objektif dan 22 individu sehat. Seluruh subjek dilakukan pemeriksaan apusan kulit untuk deteksi MRSA dan uji sensitivitas terhadap mupirosin dan gentamisin. Pada kedua kelompok masing-masing didapatkan 10 laki-laki dan 12 perempuan. Pada kelompok penderita DA didapatkan DA derajat sedang (10/22) dan berat (12/22), dengan lesi akut (14/22) dan kronik (8/22). Pertumbuhan S. aureus didapatkan pada 17/22 penderita DA dengan sensitivitas terhadap mupirosin 14/17 dan gentamisin 11/17 penderita. Pada individu sehat tidak didapatkan pertumbuhan koloni S. aureus. Galur MRSA ditemukan pada 3/17 penderita DA dan dianggap berbeda secara bermakna bila dibandingkan dengan individu sehat (p<0,01), galur ini bersifat sensitif terhadap mupirosin pada 2/3 penderita dan seluruhnya resisten terhadap gentamisin. Simpulan, kolonisasi MRSA perlu dicurigai pada penderita DA derajat sedang hingga berat, sehingga perlu pengobatan tambahan antibiotik topikal mupirosin. [MKB. 2013;45(1):36–44]Kata kunci: Dermatitis atopik, gentamisin, MRSA, mupirosinMethicillin-Resistant Staphylococcus aureus in Atopic Dermatitis Patients and Its Sensitivity to Mupirocin Compared to GentamycinMethicillin-resistant Staphylococcus aureus (MRSA) is found in moderate to severe atopic dermatitis (AD) and is multiresistant against topical antibiotic. Gentamycin is widely used while mupirocin is the first line therapy to eliminate MRSA. This research is intended to observe the colonization of MSRA case in AD patients and its sensitivity to mupirocin compared to gentamycin in Dermato-venereology Clinic Dr. Hasan Sadikin General Hospital Bandung. An analytical cross sectional survey was intended from 19th September–31st October 2011 in 22 moderate to severe AD patients based on objective Scoring Atopic Dermatitis and 22 healthy persons. All subjects went through skin-scraping, MSRA was detected and sensitivity test was done for mupirocin and gentamycin. The subjects consisted of 10 boys and 12 girls in both group. Based on severity, 10/22 of AD subjects were in moderate AD and 12/22 were severe AD, 14/22 of AD subjects presented with acute lesions and 8/22 subjects had chronic lesions. In the group of AD patients, 17/22 growth of S. aureus were found with sensitivity against mupirocin 14/17 and gentamycin 11/17. In healthy individual group, no  S. aureus growth was found. Methicillin-resistant Staphylococcus aureus strain in AD patients was observed on 3/17 patients, and this was declared significantly different compared to healthy individuals (p <0.01). The isolates in 2/3 patients were sensitive to mupirocin and all patients were resistant to gentamycin. In conclusion, the patients of moderate to severe AD are prone to MRSA colonization and therefore requires mupirocin topical antibiotic treatment.  [MKB. 2013;45(1):35–43]Key words: Atopic dermatitis, gentamycin, MRSA, mupirocin DOI: http://dx.doi.org/10.15395/mkb.v45n1.203

Validitas Hasil Pemeriksaan Skin Prick Test terhadap Imunoglobulin E RAST Tungau Debu Rumah dan Debu Rumah pada Dermatitis Atopik

Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pada dermatitis atopik (DA) tipe ektrinsik terdapat peningkatan imunoglobulin E (IgE) spesifik terhadap tungau debu rumah (TDR) dan debu rumah (DR) dengan gambaran skin prick test (SPT) positif. Metode penelitian observasional analitik dengan rancangan studi potong lintang, bertujuan untuk mengetahui validitas hasil pemeriksaan SPT terhadap IgE radioallergosorbent testing (RAST) TDR dan DR pada penderita DA, supaya SPT dapat diaplikasikan untuk mendeteksi DA. Penelitian dilakukan selama Agustus–November 2011 di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin RS Dr. Hasan Sadikin Bandung. Uji statistik menggunakan Spearman’s rank correlation. Hasil penelitian menunjukkan SPT TDR yang positif pada DA lebih tinggi dibandingkan dengan non-DA secara statistik bermakna, sedangkan SPT DR yang positif pada DA lebih tinggi dibandingkan dengan non-DA secara statistik tidak bermakna. Nilai positivitas SPT dan IgE RAST terhadap TDR pada DA berbanding lurus, namun tidak terhadap DR. Nilai positivitas SPT TDR pada DA lebih tinggi (15/16) daripada non-DA (5/16) dan nilai positivitas SPT TDR berbanding lurus dengan IgE RAST TDR pada DA dengan Spearman’s rank correlation coefficient 0,541 (p=0,031). Hasil pemeriksaan SPT TDR terhadap IgE RAST TDR pada kelompok DA memberikan validitas yang lebih tinggi dengan sensitivitas 100%, spesifisitas 25%, dan akurasi 81%, dibandingkan SPT DR terhadap IgE RAST DR dengan sensitivitas 43%, spesifisitas 78%, dan akurasi 63%. Simpulan, pemeriksaan SPT TDR dapat dijadikan patokan diagnosis DA, karena hasil pemeriksaan SPT TDR yang positif dapat memberikan arti peningkatan IgE spesifik dengan pemeriksaan IgE RAST TDR. [MKB. 2012;44(3):186–91].Kata kunci: Debu rumah, dermatitis atopik, IgE RAST, skin prick test, tungau debu rumahValidity of Skin Prick Test toward House Dust Mite and House Dust Immunoglobulin E RAST in Atopic DermatitisIn extrinsic type atopic dermatitis (AD) there is an increased of specific immunoglobulin (IgE) towards house dust mites (HDM) and house dust (HD), resulting in positive skin prick test (SPT). The method of this study was cross sectional, analytic-observational, to find validity of SPT toward HDM and HD IgE radioallergosorbent (RAST) in AD patients. The study was held from August to November 2011 in Department of Dermatovenereology Dr. Hasan Sadikin Hospital Bandung. Spearman’s rank correlation coefficient was used for statistical analysis. The results showed positive SPT to HDM in AD patients were statistically significant higher than non-AD. Positive SPT to HD in AD patients were higher than non-AD but statistically non significant. Value of HDM SPT positivity and IgE RAST in AD was directly proportional, but not with HD. There was a higher positivity of HMD SPT in AD patients (15/16) than in non-AD (5/16). Positivity value of HDM SPT was proportional to the HDM IgE RAST in AD patients with Spearman’s Rank correlation coefficient 0.541 (p=0.031). The results of HDM SPT toward HDM IgE RAST in AD patients showed higher validity sensitivity, specificity, and accuracy, 100%, 25% and 81% respectively, while HD SPT toward HD IgE RAST with sensitivity, specificity, and accuracy 43%, 78% and 63% respectively. In conclusions, HDM TDR examination could be used as a marker for AD diagnosis, due to positive HDM TDR examination result could give a meaning of increased specific IgE with RAST IgE examination. [MKB. 2012;44(3):186–91].Key words: Atopic dermatitis, house dust, house dust mites, IgE RAST, skin prick test DOI: http://dx.doi.org/10.15395/mkb.v44n3.207

Imunitas Bawaan pada Kusta: Hubungan Ekspresi Kaspase-1 dengan Interleukin-18 pada Lesi Kulit Pasien Kusta

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Respons imun terhadap Mycobacterium leprae (M. leprae) terdiri atas respons imun bawaan dan didapat. Salah satu enzim yang berperan pada imunitas bawaan adalah kaspase-1 dengan fungsi memecah sitokin proinflamasi prointerleukin (IL)-18 menjadi IL-18 aktif. IL-18 bersama IL-12 secara sinergis akan merangsang produksi interferon (IFN-γ) sehingga timbul respons imun seluler yang bersifat protektif. Tujuan penelitian ini adalah menganalisis korelasi positif ekspresi kaspase-1 dengan IL-18 pada lesi kulit pasien kusta. Penelitian dilaksanakan selama bulan Oktober–Desember 2014 di Poliklinik Morbus Hansen Departemen Ilmu Kesehatan Kulit dan Kelamin serta Laboratorium Imunohistokimia Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian klinis analitik observasional dengan rancangan potong lintang. Subjek penelitian berjumlah 19 pasien kusta yang didapatkan melalui consecutive sampling. Terhadap subjek penelitian dilakukan anamnesis, pemeriksaan fisis, pemeriksaan bakteriologis, dan biopsi plong. Pada jaringan hasil biopsi lesi kulit dilakukan pemeriksaan imunohistokimia ekspresi kaspase-1 dan IL-18 yang dinilai dengan histoscore, kemudian dilakukan analisis korelasi menggunakan uji Rank-Spearman. Pada hasil penelitian ini didapatkan nilai ekspresi histoscore kaspase-1 pada lesi kulit pasien kusta berturut-turut tipe tuberkuloid (TT)=12,00; borderline tuberculoid (BT)=8,33; mid-borderline (BB)=8,00; borderline lepromatous (BL)=4,00; dan lepromatous (LL)=10,67. Nilai histoscore ekspresi IL-18 pada lesi kulit pasien kusta berturut-turut pada tipe TT=9,33; BT=6,50; BB=4,60; BL=4,00; dan LL=9,33. Berdasarkan hasil analisis statistik uji Rank-Spearman pada derajat kepercayaan 95% didapatkan korelasi positif yang bermakna antara ekspresi histoscore kaspase-1 dan IL-18 (rs=0,618; p=0,005). Simpulan penelitian ini adalah terdapat korelasi positif antara ekspresi kaspase-1 dan IL-18 pada lesi kulit pasien kusta. Semakin tinggi ekspresi kaspase-1 pada lesi kulit pasien kusta maka semakin tinggi ekspresi IL-18. [MKB. 2016;48(3):181–6]Kata kunci: Imunitas bawaan, interleukin-18, kaspase-1, kustaInnate Immunity in Leprosy: Correlation between Caspase-1 and Interleukin-18 Expression in Leprosy Patient’s Skin Lesion Immune response against M. leprae contains innate and adaptive immunity. Caspase-1 is one of the enzymes which have a role in innate immunity to activate pro-IL-18 into its active form. IL-18 and IL-12 sinergically enhance the production of IFN-γ which triggers the protective cellular immunity. The aim of this study was to analyze the positive correlation between the expression of caspase-1 and IL-18 in leprosy patients’ skin lesions. The study was conducted from October tol December 2014 at the Dermatology and Venereology, and Immunohistochemistry Laboratory, Pathology Anatomy Department, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung. This was a clinical observational analytical study with cross-sectional design. Subjects were 19 leprosy patients recruited through consecutive sampling. History taking, physical examination, bacteriological examination, and punch biopsy were performed on all subjects. Caspase-1 and IL-18 expressions were examined and measured with histoscore. Correlation analysis was performed using Rank-Spearman test. The histoscore for the expression of caspase-1 in leprosy patients’ skin lesions was as follows: TT type=12.00; BT=8.33; BB=8,00; BL=10.00; and LL=10.67. The histoscore for the IL-18 expression in leprosy patients’ skin lesions were TT type=9.33; BT=4.60; BL=4.00; and LL=9.33. Rank-Spearman analysis with desired confidence level of 95% showed a statistically significant positive correlation between the histoscore of caspase-1 expression and IL-18 expression.(rs=0.618, p=0.005). In conclusion, this study demonstrates a positive corelation between caspase-1 expression and IL-18 expression in leprosy skin lesions. An increase of caspase-1 expression indicates an increase of IL-18 expression. [MKB. 2016;48(3):181–6]Key words: Caspase-1, interleukin-18, innate immunity, leprosy

PENGARUH MEDIA FILM TERHADAP SIKAP IBU PADA DETEKSI DINI KANKER SERVIKS

Jurnal Kesehatan Masyarakat Vol 11, No 1 (2015): JURNAL KESEHATAN MASYARAKAT (KEMAS) JULI 2015
Publisher : Jurusan Ilmu Kesehatan Masyarakat Fakultas Ilmu Keolahragaan

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Abstract

Salah satu cara yang praktis dan murah untuk mencegah terjadinya kanker serviks adalah melalui tes Inspeksi Visual Asam Asetat (IVA). Upaya untuk mempengaruhi sikap ibu pada tes IVA adalah pendidikan kesehatan melalui film. Tujuan penelitian ini adalah untuk mengetahui pengaruh pendidikan kesehatan melalui film terhadap sikap ibu pada tes IVA. Penelitian ini dilakukan pada tahun 2014. Rancangan penelitian ini adalah non randomized within group design. Pengambilan sampel dilakukan dengan teknik consecutive sampling pada 60 responden.  Analisis bivariat yang digunakan pada penelitian ini adalah  uji wilcoxon. Hasil penelitian menunjukkan terdapat pengaruh positif pendidikan kesehatan melalui film terhadap sikap ibu (P<0,05) dengan peningkatan median (rentang) skor sikap dari 44,23 (19,23-75) menjadi 78,85 (25-94,23). Kesimpulan penelitian ini adalah terdapat pengaruh positif pendidikan kesehatan melalui film terhadap sikap ibu. The Visual Inspection with Acetic Acid (VIA) test is a practical and cheaper way to prevent cervical cancer. One way to influence attitude in VIA test is health education based on the movie. The purpose of this study was to determine the effect of health education based on the movie on the attitude,of women in VIA test. The study conducted at 2014. The study design was nonrandomized within group design. The sampling technique was consecutive sampling technique on 60 respondents. The data analysis employed  bivariable analysis with wilcoxon test. This study shows there was a significant positive effect of the health education based on the movie on the mother’s attitude (P<0.05) with median and range attitude score increasing from 44.23 (19.23-75) to 78.85(25-94.23). This study concludes that there is significant positive effect of the health education based on the movie on attitude.

Kadar Interleukin-18 pada Kultur Limfosit Penderita Dermatitis Atopik yang Distimulasi Staphylococcal Enterotoxin B (SEB)

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

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Abstract

Staphylococcus aureus (S. aureus) mempunyai peranan penting pada patogenesis dermatitis atopik (DA). Peran S. aureus tersebut tidak hanya sebagai pencetus DA, tetapi juga menyebabkan inflamasi kronik. Peran tersebut berhubungan dengan dihasilkannya protein antara lain toksin poten oleh S. aureus, yaitu Staphylococcal enterotoxin B (SEB). Interleukin-18 (IL-18) merupakan regulator penting dari produksi sitokin Th-1 yaitu interferon-γ (IFN-γ).  Tujuan penelitian ini adalah mengetahui kadar IL-18 pada kultur limfosit pasien DA yang distimulus dengan SEB. Penelitian ini dilakukan pada 20 orang penderita DA (7 laki-laki dan 13 perempuan) dan 20 orang sehat (9 laki-laki dan 11 perempuan) di Rumah Sakit Dr. Hasan Sadikin Bandung, merupakan penelitian eksperimental secara in vitro pada kultur ilmfosit yang distimulus dengan SEB di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. Terjadi peningkatan kadar IL-18 rata-rata pada kultur limfosit antara sebelum dipapar dan setelah dipapar SEB, baik pada kelompok DA maupun kelompok kontrol. Setelah dilakukan uji statistik perbandingan antara kadar IL-18 rata-rata sebelum dan sesudah dipapar SEB antara kelompok DA dan kontrol, didapatkan hasil kadar IL-18 kelompok DA lebih tinggi bermakna dibanding  dengan kelompok kontrol (p<0,05) sehingga dapat disimpulkan kadar IL-18 meningkat tinggi pada kelompok DA yang dipapar SEB. [MKB. 2015;47(4):249–54]Kata kunci: Dermatitis atopik, interleukin-18 (IL-18), Staphylococcus enterotoxin BInterleukin-18 Levels in Lymphocytes Cultures from Atopic Dermatitis Patients Stimulated by Staphylococcal Enterotoxin BAbstractStaphylococcus aureus (S. aureus) has an important role in the pathogenesis of atopic dermatitis (AD). S. aureus acts as a triggering factor for AD and also causes chronic inflammation. These roles of S. aureus are related to various proteins such as Staphylococcal enterotoxin B (SEB) as a potent toxin. Interleukin-18 (IL-18) is an important regulator of cytokine production of Th-1, which is interferon-γ (IFN-γ). The aim of this study was to reveal the levels of IL-18 in cultured lymphocytes from AD patients exposed by SEB. This study was conducted on 20 people with DA (7 men and 13 women) and 20 healthy volunteers (9 men and 11 women) in dr. Hasan Sadikin General Hospital. The in vitro experimental study on cultured lympocytes exposed with SEB was performed at the Integrated Research and Testing Laboratory of Gadjah Mada University. The average levels of IL-18 in cultured lymphocytes before and after being exposed to SEB increased both in AD group and control group. After the statistical tests was performed on the ratio of the average levels of IL-18 before and after being exposed to SEB between AD and control groups, it was shown that the levels of IL-18 AD group was significantly higher than the control group (p <0.05). Therefore, it can be concluded that the levels of IL-18 increased higher in AD group exposed by SEB. [MKB. 2015;47(4):249–54]Key words: Atopic dermatitis , interleukin-18, Staphylococcal enterotoxin BDOI: 10.15395/mkb.v47n4.620

Quality of Life in Children with Atopic Dermatitis

Althea Medical Journal Vol 4, No 3
Publisher : Althea Medical Journal

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Abstract

Background: Atopic dermatitis (AD) is the most common chronic skin disease in children which caused significant morbidity and impaired quality of life (QoL). The main goal of AD therapy is to prevent flare -ups, prolong remission and increase QoL. Therefore, the study aimed to discover QoL in children with AD.Methods: The study was conducted at Pasundan Public Health Centre, Al Islam General Hospital and Kimia Farma Private Dermatology Clinic, from September to November 2015. This descriptive study used consecutive sampling with 24 outpatients who were admitted to the health facility and diagnosed as AD. A questionnaire on Infant Dermatitis Quality of Life for infants aged 0–4 years, and Children Dermatology Life Quality Index for children aged 5–16 years was used in this study to measure QoL.Results: Out of 24 patients, 9 patients aged 0–4 years had mean score of 4.44±4.36, and 15 patients aged 5–16 years had mean score of 5.80±3.95. Mean SCORAD Objective in patients aged 0–4 and 5–16 was 15.61±7.75 and 17.44±11.Conclusions: The QoL in children with AD vary among patients. Most of the patients have mild-moderate impairment in QoL. 

Aktivitas IL-18, IL-4, dan IFN- pada Kultur Limfosit yang Distimulus oleh Staphylococcal enterotoxin B (SEB) sebagai Petanda Eksaserbasi Tingkat Seluler pada Penderita Dermatitis Atopik

Indonesian Journal of Applied Sciences Vol 1, No 3 (2011)
Publisher : Universitas Padjadjaran

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Abstract

Staphylococcus aureus (S.aureus) has an important role in the pathogenesis of atopic dermatitis (AD). These role of S. aureus are related to various proteins such as staphylococcal enterotoxin B (SEB), a potent toxin. Interleukin (IL) -18  is an important regulator for interferon (IFN)g ,a cytokine produced by Th-1, and IL-4 produced by Th-2.  Further studies are still needed to discover the mechanism of SEB in AD, particularly IL-18 level, and its activities towards IL-4 and IFN-g  secretions, in regards of therapeutic strategy. The aim of this study is to analyze the activities of IL-18, IL-4, and IFN-g in the lymphocyte culture from AD patients, stimulated  with  SEB and the association between increased IL-18 level with increased  IL-4 and IFNg level. Twenty AD patients (7 male and 13 female) and twenty healthy subjects (9 male, and 11 female) were involved in this study. Study was done in Dr. Hasan Sadikin General Hospital, Bandung, proceeded by experimental invitro test on the lymphocyte culture stimulated with SEB at Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. The study was performed from 4January until 31March 2010.  Lymphocytes from the peripheral blood of the study group and control group were isolated and cultured, then 3 methods were performed towards the cultured lytmphocyte, i.e., no exposure, exposed to PHA, and exposed to SEB. After being incubated for 72 hour, then IL-18, IL-4, and  IFN-g  levels from the supernatant of the lymphocyte culture were evaluated with ELISA method.Mean IL-18 level in the lymphocyte culture of AD group, with no exposure, exposed to PHA, and exposed to SEB were 54,62 pg/ml, 70,09 pg/ml, and 99,38 pg/ml, respectively, whereas,  in the control group were 33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml, respectively. Mean IL-4 level in the study group were 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, and in the control group were  0,32 pg/ml, 0,78 pg/ml, and 3,02 pg/ml, respectively. Mean IFN-g level in the AD group were 12,75 pg/ml, 351,59 pg/ml, and 1293,17 pg/ml, while in the control group were  19,76 pg/ml, 562,81 pg/ml, and 1419,28 pg/ml, respectively.  IL-18, IL-4, and IFN-g  level in the AD group increased after being stimulated with SEB,  (p<0,05), whereas in the control group increase only occured to IL-4, and IFN-g (p<0,05). There were correlation between increased IL-18 level with increased IL-4 level (p<0,05), however the increased of IL-18 level were not related to increased IFN-g level (p>0,05). The increased  IL-18 level contributed more to the increased of IL-4 level than IFN-g  level  (p<0,05).The result of this study, is only IL-18 level increased in any methods performed, compared to control group (p<0,05). This finding leads to the conclusion that IL-18 level is the marker of AD exacerbation in the cellular level of the AD lymphocyte culture stimulated with SEB.****Staphylococcus aureus (S.aureus) berperan penting pada patogenesis dermatitis atopik (DA). Peran tersebut berhubungan dengan dihasilkannya berbagai protein antara lain toksin poten oleh S. aureus, yaitu staphyloccoccal enterotoxin B (SEB).  Interleukin-18 (IL-18) merupakan regulator penting dari produksi sitokin Th-1 yaitu Interferon-g (IFN-g) dan Th-2 yaitu IL-4. Penelitian untuk mengetahui mekanisme SEB pada DA, khususnya kadar IL-18, dan pengaruh aktivitas IL-18 terhadap sekresi IL-4 dan IFN-g, untuk strategi pengobatan perlu dilakukan. Tujuan penelitian ini adalah untuk menganalisis aktivitas IL-18, IL-4, dan IFN-g pada kultur limfosit yang distimulus oleh SEB pada penderita DA, serta pengaruh kenaikan kadar IL-18 terhadap kenaikan kadar IL-4 dan IFN-g.Penelitian ini dilakukan  pada 20 orang penderita DA (7 laki-laki dan 13 wanita) dan 20 orang sehat (9 laki-laki, dan 11 wanita) di RSUP. Dr. Hasan Sadikin Bandung, merupakan penelitian eksperimental secara invitro pada kultur limfosit yang distimulus oleh SEB di Laboratorium Penelitian dan Pengujian Terpadu Universitas Gadjah Mada. Dilakukan isolasi limfosit dari darah perifer kelompok DA dan kontrol, dilanjutkan dengan kultur limfosit, kemudian dilakukan 3 perlakuan yaitu tanpa paparan, dipapar dengan phytohemagglutinin (PHA), dan dipapar dengan SEB. Setelah dieramkan selama 72 jam, kemudian diperiksa kadar IL-18, IL-4, dan IFN-g  dari supernatan kultur limfosit dengan metode ELISA.Kadar IL-18  rata-rata pada kultur limfosit tanpa paparan, paparan PHA, dan paparan SEB kelompok DA  berturut-turut  adalah 54,62 pg/ml, 70,09 pg/ml, dan 99,38 pg/ml.   Sedangkan pada kelompok kontrol berturut-turut adalah   33,36 pg/ml, 39,03 pg/ml, dan 54,19 pg/ml. Kadar IL-4 rata-rata kelompok DA berturut-turut adalah 0,32 pg/ml, 1,19 pg/ml, dan 2,43 pg/ml, dan pada kelompok kontrol berturut-turut adalah   0,32 pg/ml, 0,78 pg/ml, dan 3,02 pg/ml. Kadar  IFN-g rata-rata kelompok DA  berturut-turut adalah  12,75 pg/ml, 351,59 pg/ml, dan 1293,17 pg/ml, dan pada kelompok kontrol berturut-turut adalah   19,76 pg/ml, 562,81 pg/ml, dan 1419,28 pg/ml.  Pada kelompok DA, kadar IL-18, IL-4, dan IFN-g setelah dipapar SEB, meningkat dibanding dengan sebelum dipapar (p<0,05), sedangkan pada kelompok kontrol hanya kadar IL-4, dan IFN-g yang meningkat (p<0,05). Kenaikan kadar IL-18 berpengaruh terhadap kenaikan kadar IL-4 (p<0,05), tetapi tidak berpengaruh terhadap kenaikan kadar IFN-g  (p>0,05). Kenaikan kadar IL-18 lebih berpengaruh  pada kenaikan kadar IL-4 dibandingkan dengan IFN-g (p<0,05).Pada penelitian ini hanya kadar IL-18 kelompok DA yang meningkat lebih tinggi pada semua perlakuan, dibandingkan dengan kelompok kontrol (p<0,05), sehingga dapat disimpulkan bahwa IL-18 merupakan petanda adanya eksaserbasi tingkat seluler pada kultur limfosit DA yang distimulus oleh SEB.

Quality of Life in Children with Atopic Dermatitis

Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

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Abstract

Background: Atopic dermatitis (AD) is the most common chronic skin disease in children which caused significant morbidity and impaired quality of life (QoL). The main goal of AD therapy is to prevent flare -ups, prolong remission and increase QoL. Therefore, the study aimed to discover QoL in children with AD.Methods: The study was conducted at Pasundan Public Health Centre, Al Islam General Hospital and Kimia Farma Private Dermatology Clinic, from September to November 2015. This descriptive study used consecutive sampling with 24 outpatients who were admitted to the health facility and diagnosed as AD. A questionnaire on Infant Dermatitis Quality of Life for infants aged 0–4 years, and Children Dermatology Life Quality Index for children aged 5–16 years was used in this study to measure QoL.Results: Out of 24 patients, 9 patients aged 0–4 years had mean score of 4.44±4.36, and 15 patients aged 5–16 years had mean score of 5.80±3.95. Mean SCORAD Objective in patients aged 0–4 and 5–16 was 15.61±7.75 and 17.44±11.Conclusions: The QoL in children with AD vary among patients. Most of the patients have mild-moderate impairment in QoL.