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"Tujuan penelitian ini ialah :(1) Mempelajari aspek C. botulinum pada pengawetan ikan dengan proses radurisasi, khususnya terhadap bahaya keracunan toksin botulinum;(2) Pengembangan metode penentuan toksin secara in vitro, berdasarkan sifat hambatan aktivitas enzim asetilkolinesterase oleh pengaruh toksin botulinum; (3) Sebagai latar belakang dipelajari pula sebaran tipe-tipe C. botulinum di wilayah perairan Indonesia bagian barat. C. botulinum yang terdapat dalam sampel lumpur dan organisme laut yang berasal dari wilayah perairan Indonesia bagian barat terutama bukan tipe E dan bersifat proteolitik. Pembentukan toksin pada ikan segar yang disimpan pada suhu 10,5 dan 7,400 terjadi sebelum atau setelah ikan menjadi busuk, bergantung pada perlakuan jenis ikan, dosis iradiasi, strain, dan tingkat inokulasi spora. Sedangkan bila penyimpanan dilakukan pada suhu 5,60C pembentukan toksin terjadi setelah ikan menjadi busuk, tanpa mempertimbangkan perlakuan yang digunakan dalam percobaan. Peranan dosis radurisasi berpengaruh hanya terhadap peningkatan daya simpan ikan; sedang perlakuan suhu rendah, selain.meningkatkan daya simpan, juga menghambat proses pembentukan toksin. Pembentukan toksin botulinum tipe B proteolitik pada ikan pindang yang mengandung garam kurang dari 1,0 persen terjadi sebelum atau setelah ikan menjadi busuk, bergantung pada tingkat inokulasi spora. Sedangkan pada sampel yang mengandung garam antara 4-6 persen, pembentukan toksin terjadi setelah ikan menjadi busuk, tanpa mempertimbangkan strain dan tingkat inokulasi spora. Proses radurisasi dan penggaraman bersifat sinergis, baik terhadap peningkatan daya simpan ikan pindang, maupun terhadap penundaan pembentukan toksin. Isolasi dan pemurnian toksin C. botulinum tipe B menghasilkan sekitar 20 ml filtrat, dengan aktivitas spesifik sekitar 1,2x107 MLD per ml (1,0x107 MLD per mg protein). Kromatografi toksin hasil isolasi melalui kolom Sephadex G-200 menunjukkan pola protein berpuncak tunggal, dan mendekati bentuk simetris. Uji electroforesis disk gel poliakrilamid dan uji imunodifusi gel agar, berturut-turut menghasilkan pita protein dan garis presipitasi tunggal. Toksin botulinum bersifat menghambat aktivitas enzim asetilkolinesterase. Pengaruh toksin tipe E (3,0xlO- 3,OxlO-3 mg) dan tipe B (3,0x10-4 - 3,0x10-3mg) terhadap aktivitas enzim 0,175 unit, berturut-turut mengakibatkan hambatan berkisar antara 10-16 dan 17-20 persen. Metode hambatan aktivitas enzim asetilkolinesterase dapat digunakan untuk penentuan kuantitatif toksin dalam ekstrak biakan C. botulinum, tetapi tidak dalam ekstrak ikan yang bersifat toksik.

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The Aspect of Clostridium Botulinum in Fish Preservation by Irradiation and the development of in Vitro Toxin Assay The objectives of this investigation were:(1) To study the aspect of C. botulinum in fish preservation by radurization process especially on botulism hazard; (2) The development of in vitro toxin assay, based on the activity inhibition of acetylcholenesterase, caused by botulinum toxin; (3) distribution of C. botulinum types in western part of Indonesian waters, as the background of the investigation. The presence of C. botulinum in samples of sediment and marine organisms, collected from fishing areas of the western part of Indonesian waters was especially proteolitic non type E. Toxin formation by non-proteolitic strain of C. botulinum type B in fish under storage at 10,5 and 7,4°C was detected before or after the samples were spoiled, depending on fish species, irradiation dose, bacterial strain, and spores inoculum?s level. When the samples were stored at 5,60C, the toxin was detected after the samples was spoiled, regardless the treatments conducted in this experiment. Radurization dose 'caused the extension of storage life, while the effect of storage at low temperatures caused both the extension of storage life and the delayed toxin formation. The toxin formation by proteolytic strain C. botulinum type B in radurized Pindang fish (the salt content less than 1%) was detected before or after the samples were spoiled, depending on the level of spore?s inoculum. Samples with salt content around 4-5%, the toxin were detected after the samples was spoiled, regardless the bacterial strain and spores inoculum level. Radurization process and salt making synergistically extended the storage life and delayed the toxin formation. The isolation and purification of type B toxin resulted in filtrate with spesific activity of 1,2x107 MLD per ml (1,0x107 MLD per mg protein). Chromatography of the filtrate through Sephadex G-200 column showed a single peak pattern. Agar gel immunodiffusion test with filtrate G-200 showed a single precipitation line. Botulinum toxin inhibited the activity of acetylcholenesterase. The effect of type E toxin E (3,0xlO- 3,OxlO-3 mg) and type B toxin B (3,0x10-4 - 3,0x10-3mg) on 0,175-unit enzyme produced the inhibition around 10-16 and 17-20 percent. The acetyicholenesterase activity inhibition method could be applied for quantitative analysis of botulinum toxin in extract culture, but not for fish extract."

"This randomized double-blind placebo-controlled trial aimed to compare the efficacy of daily iron supplementation and multi-micronutrient supplementation both daily and weekly basis on increasing iron status among 284 apparently healthy Indonesian infants aged 6-12 mo. Infants were randomly assigned to receive either daily 1 RDA multi micronutrient supplement (n = 72), weekly 2 RDA multi micronutrient supplement (n = 70), daily ferrous sulphate 10 mg (n = 72), or placebo (n = 70) for wk. Blood hemoglobin, plasma ferritin, plasma zinc, and plasma C-reactive protein concentrations were measured prior to intervention and after 23 wk of supplementation. At baseline, 58.1% of subjects were anemic, 28.2% were iron deficient, and 11.2% were zinc deficient. After 23 wk of supplementation, both daily 1 RDA multi micronutrient and iron supplemented groups had significantly increased blood hemoglobin and plasma ferritin concentration, furthermore reducing the percentage of anemia and iron deficiency. However, the changes of hemoglobin were not significantly different among the treatment groups. Changes of hemoglobin were significantly higher in daily 1 RDA multi micronutrient group than in placebo group when initial blood hemoglobin was low. The change of plasma ferritin concentration in both daily 1 RDA multi micronutrient and iron groups was significantly higher than in other groups. Hemoglobin and ferritin concentrations of weekly 2 RDA multi micronutrient group were not significantly increase, but there were significantly increased in the subjects with low concentration of blood hemoglobin or plasma ferritin. Proportion of infants with zinc deficiency was increased significantly in iron group Daily I RDA multi micronutrient and daily iron supplementation are efficacious in improving the concentration of blood hemoglobin and plasma ferritin and reducing the percentage of infants with anemia and iron deficiency of Indonesian infants aged 6-12 months in a rural community. However, there was an increasing proportion of infants with zinc deficiency in daily iron supplementation. The efficacy of daily 1 RDA multi micronutrient supplementation was higher among the children with blood hemoglobin < 110 g/L Efficacy of weekly 2 RDA multi micronutrient supplementation on the concentration of blood hemoglobin and plasma ferritin of all subjects was not found, but it affected in children with low concentration of blood hemoglobin or plasma ferritin."

"Tujuan. Memperjelas gelombang P untuk mempertajam diagnosis aritmia, menggunakan semprit-larutan garam (SLG) sebagai konektor/konduktor elektrode eksplorasi guna merekam elektrogram venasentral (EGV), pada pasien pascabedah jantung terbuka.Tempat. Unit perawatan intensif bedah pada Pusat Kesehatan Jantung Nasional. Subyek. Pasien pascabedah jantung terbuka yang telah dipasangi elektrode epikardial-atrium-kanan dan kateter venasentral.Metode. Kateter venasentral setiap pasien dihubungkan dengan semprit kacalogam 20 ml hydrosalphyngograph-Riester yang berisi larutan NaCl 3% (sempritlarutan garam). Elektrogram atrial (EGA), EGV (SLG) dan elektrokardiogram (EKG) konvensional sandapan dada, direkam secara simultan menggunakan alat elektrokardiograf 3-saluran (V1-2-3). Dua dokter terpisah mengukur tingginya gelombang atrial/P dan 2 kardiolog terpisah membuat diagnosis aritmia. Jika terjadi perbedaan diagnosis aritmia, seorang kardiolog lain bertindak sebagai validator. Dengan titik potong tinggi gelombang (peak to peak) 0,5 mm, EGV (SLG) dan EKG dibandingkan dengan EGA sebagai baku emas.Hasil. Studi populasi yang terdiri dari 192 pasien berturutan pascabedah jantung terbuka dari Juli 1995 sampai Maret 1997 (n = 1997 pasien). Dalam mendeteksi adanya gelombang P berdasarkan EGA sebagai baku emas, EGV (p = 0,5) lebih sensitif (sensitivitas = 98,9%) dibandingkan dengan EKG konvensional (p = 0,001; sensitivitas = 84,2%), terjadi peningkatan sensitivitas sebesar 14,7% (98,9% - 84,2%). Pada diagnosis aritmia, EGV (SLG) lebih sensitif dari EKG (0,995; 98,7% dibandingkan 0,001; 78,5%), terjadi peningkatan sensitivitas sebesar 20,2% (98,7% - 78,5%).Kesimpulan. EGV (SLG) memperjelas gelombang P dan meningkatkan sensitivitas deteksi aritmia pascabedah jantung terbuka.

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Objectives. To enhance P waves in order to improve the diagnosis of arrhythmia, central venous electrogram (CVEG) using salt-solution syringe procedure, as a potential (connector/conductor) exploring lead, was performed in patients who underwent open heart surgery.Setting. Surgical Intensive Care Unit of the National Cardiac CenterSubjects. After open heart surgery patients in whom the epicardial-right-atrial wire electrode and central venous catheter were installed.Methods. The central venous catheter from each patient was connected with a 20-ml hydrosaiphyngograph-Riester glass-metal syringe containing 3% NaCl solution (salt-solution syringe ). Atrial electrogram (AEG), CVEG using salt-solution syringe procedure, and conventional chest lead ECG were recorded simultaneously using 3-channel (V1-2-3) electrocardiograph machine. Two doctors who were blinded in manner analyzed the recorded atrial (P) waves and 2 cardiologist confirmed the diagnosis of arrhythmia from all patients. If a different diagnosis occurred, the other cardiologist would act as validator. With the cut-off point of 0.5 mm, identification of peak to peak P waves in CEVG using salt-solution syringe and ECG were compared with AEG as a gold standard.Results. The study population consisted of 192 cosecutive patients after open heart surgery from July 1995 to March 1997 (n = 1997 patients). In detecting the presence of P wave, comparing to-the AEG as a gold standard, CVEG using salt-solution syringe procedure (p = 0.5) is more sensitive (sensitivity = 98.9%) than conventional ECG (p = 0.001; sensitivity = 84.2%), increases the sensitivity by 14.7% (98.9% - 84.2%). In the diagnosis of arrhythmia, CVEG using salt solution syringe procedure is more sensitive than ECG (0.995; 98.7% vs 0.001; 78.5%), increases the sensitivity by 20,2% (98.7% - 78.5%).Conclusions. CVEG using salt-solution syringe procedure significantly amplifies P waves and improves the sensitivity in detecting arrhythmia after open heart surgery.;Objectives. To enhance P waves in order to improve the diagnosis of arrhythmia, central venous electrogram (CVEG) using salt-solution syringe procedure, as a potential (connector/conductor) exploring lead, was performed in patients who underwent open heart surgery."

"Objektif : Penyakit Kardiovaskular berawal dari fungsi endotel pembuluh darah yang terganggu, berlanjut menjadi proses aterosklerosis. Mencegah proses aterosklerosis dengan membiasakan tidak merokok/stop merokok disertai olahraga teratur dan/atau pengaruh kerja fisik (trias SOK) adalah upaya preventif pada tingkat endotel. Untuk mengetahui pengaruh trias SOK terhadap daya survival,dilakukan penelitian kohort.Metode: Pada tanggal I Juli 200 dilakukan penelitian kohort historis terhadap sampel MONICA 1988 di tiga kecamatan Jakarta Selatan, serta diikuti sampai 31 Agustus 2001. Sampel dibagi menjadi kelompok trias SOK dan tanpa trias SOK. Dilakukan wawancara, pemeriksaan fisik, gula darah dan kolesterol total serta perekaman EKG pada sampel yang hidup, otopsi verbal pada yang menyaksikan untuk mencari sebab kematian. Aktivitas fisik (kerja fisik dan olahraga perminggu) dikelompokan pada: tidak ada, ringan hampir setiap hari, sedang dan berat minimal 20 menit dua kali atau lebih. Merokok bila tetap merokok, mantan perokok bila telah berhenti 2 tahun atau lebih, tidak merokok bila tetap tidak merokok atau telah berhenti 10 tahun atau lebih. Kriteria hipertensi (JNC-VI), diabetes (gula darah puasa 140 mg/di atau sewaktu 200 mg/di), obesitas (IMT z 29,99 kglm2), EKG memakai kode Minnesota. Analisis statistik memakai suain (adjusted) regesi Cox, 95% interval kepercayaan, Kaplan Meier (daya survival), Log rank (rasio hazard/HR), uji kappa (degree of aggreement), Batas kemaknaan p