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Intra Arterial Heparin Flushing Increases Cereberal Blood Flow in Chronic Ischemic Stroke Patients Putranto, Terawan Agus; Yusuf, Irawan; Murtala, Bachtiar; Wijaya, Andi
The Indonesian Biomedical Journal Vol 8, No 2 (2016)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v8i2.204

Abstract

BACKGROUND: Recently, stroke therapy is focused on reperfusion therapies for restoring cerebral blood flow (CBF) and minimizing the undesired effects of neuron ischemia. However, the thrombolytic therapy to restore CBF was restricted with narrow time window. On other hands, not many patients can reach the treatment immediately after the onset of stroke. A wider time window therapy that might increase CBF would probably helpful. This study aims to investigate the CBF improvement after intra arterial heparin flushing (IAHF) therapy in chronic stroke patients.METHODS: A clinical trial was conducted with time sampling. We collected chronic ischemic stroke subjects (with stroke onset ≥30 days) within periods February-September 2015. We investigated CBF before and after IAHF treatment in 75 chronic stroke patients. The difference before and after IAHF treatment in subgroup which is classified with infarct size and lesion area was tested. CBF was measured using MRI Quality Arterial Spin Labeling (qASL) with region of interest around infarct lesion.RESULTS: We found a significant CBF improvement (p<0.001) around infarct area after IAHF treatment with average 10.39mL/100g/min raised. CBF improvement was found in lacunar infarct (p<0.001) and non lacunar (p<0.001), also in infarct in cortical (p<0.05), subcortical (p<0.001) and both area (p<0.05).CONCLUSION: IAHF is associated with increased CBF around infarct area and IAHF probably offers some benefit for chronic stroke.KEYWORDS: IAHF, CBF, chronic stroke, ischemic, lacunar, non lacunar, cortical lesion, subcortical lesion
Study on the influence of adiponectin genetic variants and adiponectin levels among Indonesian women with polycystic ovary syndrome Pangaribuan, Bertha; Yusuf, Irawan; Mansyur, Muchtaruddin; Wijaya, Andi
Medical Journal of Indonesia Vol 21, No 2 (2012): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (737.646 KB) | DOI: 10.13181/mji.v21i2.483

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Background: Insulin resistance and central adiposity are frequent disorders in PCOS women, which are marked by biological marker dysregulation related to this metabolic abnormalities. Association between adiponectin and insulin resistance has been investigated in many studies, while only a few studies were done in PCOS patients. This study is to determine the association of T45G polymorphisms in Indonesian population with PCOS biological markers and their influence to adiponectin serum.Methods: Fifty-two PCOS patients and 52 normal ovulatory women without hyperandrogenism as control subjects were included. Blood samples were collected between day 3 and 5 of a spontaneous menstrual cycle at 7 to 9 am, after overnight fasting. Serum levels of FSH, LH, testosterone, SHBG, glucose, insulin, lipid profile and adiponectin were measured. Insulin resistance was estimated by HOMA-IR, HOMA-β, and SHBG. T45G gene polymorphisms were determined by PCR after genomic DNA was obtained from peripheral blood of patients and control subjects.Results: There were significant difference between PCOS and control group in term of BMI, LH, testosterone, SHBG, and FAI, but not significant to T45G gene polymorphisms frequency distribution. Adiponectin levels were lower in PCOS patients than control. There was an association between insulin resistance with PCOS. Among PCOS patients, no association between adiponectin LH, testosterone, SHBG, and FAI with T45G gene polymorphisms. T45G gene polymorphisms were more frequent in PCOS with low adiponectin levels compared to those with high adiponectin levels, although not significant statistically.Conclusion: T45G gene polymorphisms has no direct association with PCOS biological markers, but its association with adiponectin needs further study. (Med J Indones. 2012;21:83-91)Keywords: Adiponectin, insulin resistance, polycystic ovary syndrome, T45G adiponectin gene
CYP2A6 gene polymorphisms impact to nicotine metabolism Muliaty, Dewi; Yusuf, Irawan; Setiabudy, Rianto; Wanandi, Septelia I.
Medical Journal of Indonesia Vol 19, No 1 (2010): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1042.323 KB) | DOI: 10.13181/mji.v19i1.377

Abstract

Nicotine is a major addictive compound in tobacco cigarette smoke. After being absorbed by the lung nicotine is rapidly metabolized and mainly inactivated to cotinine by hepatic cytochrome P450 2A6 (CYP2A6) enzyme. Genetic polymorphisms in CYP2A6 may play a role in smoking behavior and nicotine dependence. CYP2A6*1A is the wild type of the CYP2A6 gene which is associated with normal or extensive nicotine metabolism. In the CYP2A6 gene, several polymorphic alleles have been reported such as CYP2A6*4, CYP2A6*7, CYP2A6*9, and CYP2A6*10 which are related to decreasing nicotine metabolism activity. The variation of nicotine metabolism activity could alter nicotine plasma levels. Smokers need a certain level of nicotine in their brain and must smoke regularly because of nicotine’s short half-life; this increases the number of smoked cigarettes in extensive metabolizers. Meanwhile, in slow metabolizers, nicotine plasma level may increase and results in nicotine toxicity. This will eventually lower the risk of dependence. (Med J Indones 2010; 19:46-51)Keywords: cotinine, hepatic cytochrome P450 2A6, smoking behavior
Proatherogenic or antiatherogenic high density lipoprotein type in acute coronary syndrome and healthy male person Kaniawati, Marita; Yusuf, Irawan; Bakri, Syakib; Santoso, Anwar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (42.308 KB) | DOI: 10.13181/mji.v19i4.407

Abstract

Aim: To make proatherogenic/antiatherogenic HDL type criteria using Apolipoprotein A-I (ApoA-I), Paraoxonase-1 (PON-1), Neopterin and HDL-cholesterol levels, which may be useful in clinical practice.Methods: This was a case control study recruiting 52 subjects with Acute Coronary Syndrome (ACS) and 30 control healthy subjects. HDL type was classifi ed into antiatherogenic and  proatherogenic based on the levels of ApoA-I, PON-1, Neopterin and HDL-cholesterol. Concentrations of ApoA-I was measured by immunoturbidimetry method, PON-1 was measured by colorimetric method, Neopterin was measured by ELISA, and HDL-C was determined by homogenous method. Univariate logistic regression analysis was done using ACS as a dependent variable and levels of ApoA-I, PON-1, Neopterin andHDL-cholesterol as independent variables. Proatherogenic/ antiatherogenic HDL type was determined by using ApoA-I, PON-1, Neopterin and HDL-cholesterol cut off and odd ratios.Results: Patient’s age was 50.89 + 12.63 year, HDL-C was 39.82 + 9.84 mg/dL, Apo A-1 was 119.77 + 32.05 mg/ dL, PON-1 was 41.26 + 18.19 kU/L, Neopterin was 16.22 + 38.10 nmol/L. Cut offs of ApoA-I, PON-1 and Neopterin successively were 124.5 mg/dL, 40.8 kU/L, and 7.016 nmol/L. On univariate logistic regression analysis showed that OR of ApoA-I, PON-1 and Neopterin respectively were 29.759 (95% CI : 4.074 – 217.382), 1.647 (95% CI : 0.412 – 6.586), 4.317 (95% CI : 1.098 – 16.977). Using scoring system, we concluded that total score &gt; 18 was proatherogenic HDL type, and total score &lt; 18 was antiatherogenic HDL type. With this scoring we found 78.85% had proatherogenic HDL type in ACS population.Conclusions: Dysfunctional HDL or proatherogenic/anti atherogenic  HDL type can be predicted by using ApoA-I– PON-1–Neopterin–HDL-cholesterol scoring system. Those with score of 18 are supposed to have antiatherogenic HDL type, and those with score of &gt; 18 were having proatherogenic HDL type. (Med J Indones 2010; 19:228-34)Keywords: ApoliproteinA-I (ApoA-I), HDL-cholesterol, neopterin, paraoxonase-1 (PON-1), proatherogenic/antiatherogenic HDL
The effects of zinc supplementation on the TNF-α profile and diarrhea in severely malnourished children of low income family As’ad, Suryani; Yusuf, Irawan
Medical Journal of Indonesia Vol 12, No 4 (2003): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.524 KB) | DOI: 10.13181/mji.v12i4.120

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Zinc deficiency has a great impact on growth and development, especially in malnourished children. Zinc is important in both local and systemic immunity. The aim of this study was to assess the impact of zinc supplementation on the cytokine, tumor necrosis factor α (TNF-α), and diarrhea in severely undernourished under-five children of low-income families. A randomized double blind pre-test post-test controlled design was selected. A group of 12-59 month-old children were given local food, and treated as control group (n=60), and another group (n=60) were given local food with 15 mg/5 ml zinc as intervention group. Zinc concentration was measured by atomic absorption spectrophotometer (AAS), and TNF-α concentration was determined by ELISA. Data on nutrient intakes were collected using 24-hour food recall method. The result of the study showed that after zinc intervention, zinc serum increased significantly, and TNF-α concentration decreased along with reduction of the duration and frequency of diarrhea. Zinc concentration increased 87.0% in the intervention group, while in the control group the increase was only 19.6%. There was a significant reduction of both serum and fecal TNF-α concentration after intervention (p&lt;0.05). Severity and duration of diarrhea were reduced significantly in the intervention group compared to the control group (p&lt;0.001). It was concluded that zinc intervention reduced the duration and severity of diarrhea through improvement of immunity, especially local immunity with TNF-α as biomarker. (Med J Indones 2003; 12: 247-51) Keywords: undernourished children, zinc supplementation, diarrhea, TNF-α.
A study on prothrombogenic and antithrombogenic biomarkers in deep vein thrombosis following meta-epiphyseal cancellous bone traumatization in major orthopedic surgeries Hartono, Franky; Yusuf, Irawan; Suhadi, Budhianto; Fachruddin, Andi
Medical Journal of Indonesia Vol 22, No 1 (2013): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.698 KB) | DOI: 10.13181/mji.v22i1.515

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Background: This study was aimed to show differences in the mean values of Collagen I (Col I)/Nitric Oxide (NO), Collagen IV (Col IV)/NO, Tissue Factor (TF)/NO, and P-selectin (P-sel)/NO ratios between patients with DVT and those without DVT, following hip and knee meta-epiphyseal cancellous bone traumatization in major orthopedic surgeries.Methods: This is an observational prospective cohort study on 69 patients aged &gt; 50 years, who had orthopedic surgery without thromboprophylaxis. Examination of serum Col I, Col IV, TF, P-sel, and NO biomarker levels were performed three times, i.e. before surgery, 72 hours and 144 hours after surgery. We looked for the differences in mean levels of biomarkers, and mean ratio values of the prothrombogenic/antithrombogenic (Col I/NO, Col IV/NO, TF/NO, P-sel/NO) at 72 hours and 144 hours post surgery between patients with DVT and those without. DVT events, which were confirmed at 144 hours post surgery by venography (with the exception of 8 cases where color Doppler ultrasound was done due to contrast usage contraindications).Results: DVTs were identified in 18 patients (26.1%). There were significant differences of mean levels in pre-surgical Col IV (p = 0.022) and 72 hours NO (p = 0.014) between patients with and without DVT. In addition, between the same two patient groups, significant differences were found in the mean values of the prothrombogenic/antithrombogenic ratios, i.e. Col IV/NO, TF/NO, and P-sel/NO at 72 hours post-surgery (p = 0.007, p = 0.028, and p = 0.049 respectively), with lower median values that were found in subjects with DVT. At 144-hours post surgery, the only significant ratio difference between the two groups was the mean values of Col IV/NO ratio (p = 0.014) with the median values that were higher than the median values at 72-hours post surgery .Conclusion: The incidence of DVT following traumatization of the meta-epiphyseal cancellous bone after major orthopedic surgeries in hip and knee is influenced by the balance of prothrombogenic and antithrombogenic factors as shown by the significant differences in Col IV/NO, TF/NO and P-sel/NO ratios at 72-hours and Col IV/NO ratio at 144 hours after surgery between DVT positive and DVT negative patients. (Med J Indones. 2013;22:9-15)Keywords: Collagen I, collagen IV, deep vein thrombosis, nitric oxide, orthopedic surgery, P-selectin, tissue factor
LYMPHOCYTE RESPONSE TO Mycobacterium leprae ANTIGENS IN REVERSAL REACTION STATE OF LEPROSY An in vitro study of Lymphocyte Stimulation Index using MTT method Iskandar, Fanny; Yusuf, Irawan; Arif, Mansur; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 4 (2014)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (29.366 KB)

Abstract

Reversal Reaction (RR) in Leprosy is a sudden inflammatory episode in the chronic course of the disease due to rapid change of cellular immunological status. The aim of the study is to measure the in vitro results of Lymphocyte Stimulation Index (LSI) RR leprosy derived lymphocytes after challenged with M.leprae antigens. Twenty three Borderline Leprosy with RR and 11 BorderlineLeprosy patients without RR were included in the study. Peripheral Blood Mononuclear Cells (PBMC) were separated from peripheral blood of these patients using Ficol-Hypaque column and cultured in laboratory. Using the colorimetric tetrazole (MTT) method these lymphocytes were challenged with PHA, Dharmendra antigen (1/100 and 1/10 dilutions), LAM (50 and 100 nanograms). Stimulation Index were calculated and superanatans were collected for measuring the IFN-γ and IL-10 production (ELISA). All of lymphocytesfrom RR patients showed higher Stimulation Index after challenged with the five M.leprae antigens compared to lymphocytes from non RR patients (p &lt;0.05) . IFN-γ and IL-10 also increased but not significant (p&gt;0.05). It is concluded that lymphocytes of leprosy patients during RR state are more sensitive to antigenic stimuli compared to non-RR leprosy patients. Further extended studies areneeded to determine the “cut off” value of lymphocyte Stimulation Index that is useful for clinicians in the field in the prediction of RR before starting anti leprotic treatment.
LYMPHOCYTE RESPONSE TO Mycobacterium leprae ANTIGENS IN REVERSAL REACTION STATE OF LEPROSY Yusuf, Irawan; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 4 (2015)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (585.68 KB) | DOI: 10.20473/ijtid.v5i4.2007

Abstract

Reversal Reaction (RR) in Leprosy is a sudden inflammatory episode in the chronic course of the disease due to rapid change of cellular immunological status. The aim of the study is to measure the in vitro results of Lymphocyte Stimulation Index (LSI) RR leprosy derived lymphocytes after challenged with M.leprae antigens. Twenty three Borderline Leprosy with RR and 11 Borderline Leprosy patients without RR were included in the study. Peripheral Blood Mononuclear Cells (PBMC) were separated from peripheral blood of these patients using Ficol-Hypaque column and cultured in laboratory. Using the colorimetric tetrazole (MTT) method these lymphocytes were challenged with PHA, Dharmendra antigen (1/100 and 1/10 dilutions), LAM (50 and 100 nanograms). Stimulation Index were calculated and superanatans were collected for measuring the IFN-γ and IL-10 production (ELISA). All of lymphocytes from RR patients showed higher Stimulation Index after challenged with the five M.leprae antigens compared to lymphocytes from non RR patients (p <0.05) . IFN-γ and IL-10 also increased but not significant (p>0.05). It is concluded that lymphocytes of leprosy patients during RR state are more sensitive to antigenic stimuli compared to non-RR leprosy patients. Further extended studies are needed to determine the “cut off” value of lymphocyte Stimulation Index that is useful for clinicians in the field in the prediction of RR before starting anti leprotic treatment.
Isolation of Mesenchymal Stem Cells from Adipose Tissue Harsan, Harsan; Mariya, Silmi; Islam, Andi Asadul; Wahjoepramono, Eka Julianta; Yusuf, Irawan
The Indonesian Biomedical Journal Vol 7, No 3 (2015)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v7i3.181

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BACKGROUND: In searching for the best source of stem cells, researcher found adipose stem cells as one of the ideal source due to its easiness in harvesting and its potential for differentiating into other cell lineage.METHODS: We isolated stem cells from adipose tissue, cultured and confirmed its immunophenotype using polymerase chain reaction.RESULTS: Cluster of differentiation (CD)44, CD73, CD90, CD105 were expressed, which represent immunophenotype of mesenchymal stem cells. CONCLUSION: Mesenchymal stem cells can be isolated from adipose tissue. KEYWORDS: adipose, mesenchymal stem cells, isolation, immunophenotype
Lipopolysaccharide Binding Protein, Soluble-Intercellular Adhesion Molecule-1, Procalcitonin, and Protein C Activity and Clinical Outcome in Systemic Inflammatory Response Syndrome (SIRS) or Sepsis Patients Muliaty, Dewi; Yusuf, Irawan; Hermawan, A Guntur
The Indonesian Biomedical Journal Vol 1, No 1 (2009)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v1i1.87

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BACKGROUND: Biochemical markers may be used in diagnosis, prognostic and monitoring treatment and therapy for sepsis patients. In this study we used Lipopolysacharide Binding Protein (LBP), serum-Intercellular Adhesion Molecule-1 (ICAM-1), Procalcitonin (PCT) and protein C activity. LBP is related to lipopolysachharide or gram-negative bacterial endotoxin which bound to LBP and induced inflammatory response. ICAM-1 is associated with endothelial dysfunction in response to systemic inflammatory and septic condition. PCT increased in bacterial infection and in severe systemic inflammatory. Role of Protein C is protecting the intravascular system to systemic inflammation, sepsis and the concomitant intravascular coagulopathy. The aim of this study was to examine the associations between levels of serum LBP, sICAM-1, PCT, and protein C activity with the clinical outcome of SIRS or sepsis patients.METHODS: We included 19 post surgery patients with SIRS criteria from intensive care unit (ICU) and evaluated the level of LBP serum with Chemiliuminescent Enzyme Immunoassay (Diagnostic Product Co.), ICAM-1 with ELISA (R&D System), PCT with immunochromatography (BRAHMS), protein C activity with chromogenic method (Dade Behring). We performed the samples serially at the first admission of patients and after 72 hours. Data were analysed by non-parametric with Wilcoxon test and Mann-Whitney test. Correlation study between biomarkers calculated by Kendall’s tau and Spearman’s rho.RESULTS: Of 19 patients, 9 (47,4%) died and 10 (52,6%) surviving. The level of LBP serum decreased after 72 hours in surviving-sepsis patients, and increased in nonsurviving sepsis patients with significant different levels at 72 hours examination (P<0.05). The level of soluble-ICAM-1 which was high in the first admission showed in non-surviving sepsis patients, but the difference levels was not significant between surviving and non-surviving patients (P>0.05). In all patients were found high level of PCT serum since the first admission examination, decreasing levels were occurred significantly in surviving patients after 72 hours (P<0.05) where high PCT levels were found in non-surviving patients after 72 hours. The median level of plasma protein C activity was low at the first admission especially in non-surviving sepsis patients, the decreasing level was not significantly different after 72 hours (P>0.05) both in surviving and non-surviving patients.CONCLUSIONS: Increasing level of LBP and PCT in sepsis patients showed that those biomarkers useful for predict the clinical outcome in sepsis patients. Decreasing protein C activity level was not a good predictor in worsening clinical outcomes. Soluble ICAM-1 level was not a good marker for predict risk of sepsis severity. LBP and PCT tests were more useful in serially testing from the first admission of sepsis patients, those tests are more faster than bacterial culture.KEYWORDS: Sepsis, SIRS, Lipopolysachharide Binding Protein, soluble- Intercellular Adhesion Molecule-1, Procalcitonin, Protein C