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"Preeklampsia merupakan penyulit kehamilan yang ditandai dengan hipertensi, edema dan proteinuria. Berdasarkan tanda-tanda tersebut, diduga disfungsi endotel memegang peranan dalam patogenesis kedua penyakit tersebut. Penelitian ini bertujuan untuk mengetahui apakah pada preeklampsia terjadi disfungsi endotel dengan memeriksa kadar sVCAM-1, vWF dan fibrin monomer sebagai petanda aktivasi koagulasi. Juga ingin diketahui apakah terdapat hubungan antara disfungsi endotel dengan beratnya penyakit. Desain penelitian potong lintang. Subyek penelitian adalah 30 orang wanita hamil 24 - 42 minggu dengan diagnosis preeklampsia yang bersedia ikut dalam penelitian dan kelompok kontrol terdiri atas wanita hamil aterm. Pemeriksaan kadar sVCAM-1 dikerjakan dengan cara ELISA dengan reagen dari R&D system. Kadar vWF ditentukan dengan cara enzyme linked fluorescent assay (ELFA) dengan reagen dari VIDAS bioMerieux. Fibrin monomer diperiksa dengan cara ethanol gelation test. Rerata dan simpang baku kadar sVCAM-1 pada preeklampsia dan kontrol berturut-turut adalah 576,4 ng/mL dan 58,3 ng/mL serta 375,7 ng/mL dan 43 ng/mL (p<0,05). Sedang rerata dan simpang baku kadar vWF pada preeklampsia dan kontrol berturut turut 305,3% dan 107,4% serta 162,4% dan 33% (p,0,05). Didapatkan korelasi sedang antara kadar sVCAM-1 dengan tekanan sistolik maupun diastolik (r=0,71) dan (r=0,65). Demikian pula antara kadar vWF dengan tekanan sistolik dan diastolik didapatkan korelasi sedang (r=0,67) dan (r=0,77). Fibrin monomer positif didapatkan pada 28 dari 30 penderita preeklampsia sedang pada kelompok kontrol hanya 1 orang yang positif. Hasil penelitian ini menunjukkan bahwa pada preeklampsia terjadi disfungsi endotel. Pada preeklampsia terdapat korelasi antara petanda disfungsi endotel dengan tingginya tekanan darah.

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Endothelial Dysfunction In Preeclampsia. Preeclampsia is a complication of pregnancy characterized by hypertension, edema, and proteinuria. Based on these signs, it is suggested that endothelial dysfunction plays a role in the pathogenesis of preeclampsia. The aims of this study were to know whether endothelial dysfunction occur in preeclampsia by measuring the level of sVCAM-1, von Willebrand factor, and fibrin monomer. The relationship between markers of endothelial dysfunction and blood pressure would also be sought. In this cross-sectional study, 30 women at the 24-42 weeks of pregnancy with preeklampsia, were enrolled and control group comprised of fullterm pregnant women. The level of sVCAM-1 was determined by ELISA method using reagents from R&D system, while vWF level was measured by enzyme linked fluorescent assay (ELFA) using reagent from VIDAS bioMerieux, and fibrin monomer was detected by ethanol gelation test. The mean of sVCAM-1 level in the preeklampsia group and in the control group were 576.4 ng/mL, and 375.7 ng/mL, respectively while the standard deviation were 58.3 ng/mL, and 43 ng/mL, respectively. The mean of vWF level in the preeklampsia group and in the control group were 305.3% and 162.4%, respectively while the standard deviation were 107.4% and 33%, respectively. Moderate correlation were found between sVCAM-1 as well as vWF level with both systolic and diastolic pressure. Fibrin monomer was found in 28 out of 30 subjects of preeclampsia group, but only 1 out of 31 subjects in the control group. The results of this study indicated that endothelial dysfunction occurred in preeclampsia."

"Demam berdarah dengue (DBD) adalah penyakit yang ditandai dengan demam dan perdarahan. Selain itu terdapat efusi pleura yang diduga karena peningkatan permeabilitas vaskular. Berdasarkan tanda tersebut, diduga disfungsi endotel memegang peranan dalam patogenesis demam berdarah dengue.Tujuan penelitian ini adalah untuk mengetahui apakah pada demam berdarah dengue terjadi disfungsi endotel dengan memeriksa kadar sVCAM-1, von Willebrand factor dan petanda aktivasi koagulasi yaitu D dimer. Di samping itu ingin diketahui apakah ada hubungan antara petanda disfungsi endotel dengan beratnya penyakit. Desain penelitian ini potong lintang, kelompok kasus terdiri atas 31 penderita DBD dan kelompok kontrol terdiri atas 30 penderita demam bukan DBD. Kadar sVCAM-1 diperiksa dengan cara ELISA, vWF dengan cara enzyme linked fluorescent assay (ELFA) dan D-dimer dengan cara sandwich enzyme immunoassay.Hasil penelitian menunjukkan bahwa rerata kadar sVCAM-1 pada kelompok DBD dan kelompok kontrol berturut-turut adalah 1323 ng/mL dan 1003 ng/mL, sedangkan simpang bakunya berturut-turut 545 ng/mL dan 576 ng/mL. Rerata kadar vWF pada kelompok DBD dan kontrol berturut-turut 284% dan 327%, dengan simpang baku berturut-turut 130% dan 141%. Kadar sVCAM-1 tidak berkorelasi dengan jumlah trombosit, kadar albumin, kadar D dimer dan beratnya penyakit. Terdapat korelasi lemah antara kadar vWF dengan D dimer dan beratnya penyakit. ( r = 0,472 dan r = -0,450). Kesimpulan: Hasil pemeriksaan sVCAM-1, vWF dan D dimer menunjukkan bahwa pada DBD terjadi disfungsi endotel. Namun tidak ada hubungan antara sVCAM-1 dengan beratnya penyakit, hanya ada hubungan yang lemah antara vWF dengan D dimer maupun beratnya penyakit.

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Endothelial Dysfunction in Dengue Hemorhagic Fever. Dengue hemorrhagic fever (DHF) is characterized by fever, bleeding, and pleural effusion which may be caused by increased vascular permeability. Based on these findings it is assumed that endothelial dysfunction plays a role in the pathogenesis of DHF.The aims of this study was to know whether endothelial dysfunction occurs in DHF by measuring sVCAM-1, vWF, and D dimer. The relationship between endothelial dysfunction and severity of the disease would also be analyzed. This was a cross sectional study which involved 31 DHF patients and 30 non DHF fever patients as control group. The level of sVCAM-1 was determined by ELISA method, vWF by enzyme linked fluorescent assay , and D dimer by sandwich enzyme immunoassay.The results indicated that mean of sVCAM-1 level in DHF group and control group were 1323 ng/mL and 1003 ng/mL, while standard deviation (SD) were 545 ng/mL and 576 ng/mL respectively. The mean of vWF level in DHF group and control group were 284% and 327%, with SD 130% and 141% respectively. The level of sVCAM-1 did not correlate with platelet count, albumin level, D dimer level and severity of disease. There was a weak correlation between vWF level with D dimer and severity of disease ( r = 0,472 and r = -0,450 ).Conclusion: The results of this study indicate that endothelial dysfunction occurs in DHF, but there is no correlation between sVCAM-1 with severity of disease, only a weak correlation between vWF with D dimer and severity of disease is found."

"Latar belakang: Kondisi hipoksia masih merupakan potensi paling berbahaya pada saat terbang, dan berhubungan dengan angka kejadian kecelakaan pesawat baik saat latihan atau tugas operasi. Deteksi dini terhadap efek fisiologis hipoksia sangat penting untuk mencegah bencana dalam penerbangan sipil dan militer.1Saat ini ada beberapa penelitian mengenai efek fisiologi pada hipobarik hipoksia terutama di bidang vascular. Fungsi endotel perifer vaskular dapat dinilai melalui pengukuran fungsi vasomotor. Tes non-invasif untuk menilainya dapat menggunakan pemeriksaan flow mediated dilation (FMD). Sejauh belum ada penelitian yang mencari hubungan antara fungsi endotel pembuluh darah perifer terhadap hipoksia sebagai acuan awal deteksi dini faktor risiko terjadinya hipoksia hipobarik pada awak pesawat.Tujuan: Untuk mengetahui manfaat pemeriksaan disfungsi endotel terhadap hipoksia hipobarikMetode: Sebanyak 59 awak pesawat TNI AU yang melakukan pemeriksaan kesehatan berkala dan latihan uji latih hipoksia d LAKESPRA SARYANTO dilakukan pemeriksaan FMD kemudian dihubungkan dengan menggunakan uji statisik antara WSE dan FMD.Hasil: Didapatkan proporsi yang mengalami disfungsi endotel sebesar 23.7 %. Sedangkan proporsi subjek dengan WSE yang tidak normal sebesar 32%.Tidak terdapat hubungan bermakna antara disfungsi endotel dengan WSE (p=0,357) dan nilai r = 0,111.Kesimpulan: Tidak terdapat hubungan bermakna antara disfungsi endotel dengan WSE.

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Background: Hypoxia is still the most dangerous potential during flight, and is associated with the incidence of aircraft accidents both during training or operating duty. Early detection of physiological effects of hypoxia is very important to prevent mishap in civil and military flights. Currently there are several studies on the physiological effects of hypobaric hypoxia especially in the vascular. Vascular peripheral endothelial function can be assessed through measurement of vasomotor function. Non-invasive tests to assess can use flow mediated dilation (FMD). As far as there has been no research looking for a relationship between peripheral vascular endothelial function and hypoxia as an initial reference to early detection of risk factors for hypobaric hypoxia in aircrew

Objective: To determine the relationship between endothelial dysfunction examined by FMD against hypoxia with time of useful consciousness (TUC) parameters.

Methods: A total of 59 Indonesian Air Force crews conducting periodic medical examinations and hypoxic training in LAKESPRA SARYANTO were performed FMD examination and analyzed by correlation statistics between FMD and TUC.

Results: There was a proportion of 23.7% endothelial dysfunction. While the proportion of subjects with abnormal TUC was 32%. There was no significant relationship between endothelial dysfunction and TUC (p = 0.357) and r value = 0.111

Conclusion: There is no significant relationship between endothelial dysfunction and time of useful consciousness"

"Latar Belakang : Decompression sickness merupakan masalah kesehatan yang penting bagi penyelam, angka kejadian Decompresion sickness (DCS) atau penyakit dekompresi terjadi pada sekitar 1.000 penyelam Amerika scuba setiap tahun yang dilaporkan oleh DAN. Penelitian A. O. Brubakk dkk, ISB, Medical Technology Center di Norwegia, melaporkan pada penyelam terjadi beberapa gelembung pembuluh darah, peningkatan diameter arteri yang signifikan dari 4,5 ± 0,7-4,8 ± 0,8 mm dan penurunan dari FMD yang signifikan dari 9,2 ± 6,9-5,0 ± 6,7% sebagai tanda terjadinya penurunan fungsi endotel. Subyek penelitian tersebut pada individu sehat yang melakukan penyelaman tunggal dekompresi dengan melakukan penyelaman sesuai prosedur protokol penyelaman yang benar tidak terjadinya DCS atau gejala-gejala penyakit dekompresi. Meskipun secara umum patofisiologi terjadinya DCS dihubungkan dengan terbentuknya gelembung gas pada sirkulasi dan jaringan, sehingga patofisiologi terjadinya DCS tidak hanya terjadi akibat mekanisme obstruksi dari gelembung gas, tetapi akibat mekanisme dyfungsi endotel, dengan demikian maka penliti menggunakan biomarker TNF1alfa sebagai penanda untuk mengetahui terjadinya dyfungsi endotel.Metode : Penelitian menggunakan metode cross over design. Data diperoleh dari kuesioner, pemeriksaan fisik dan laboratorium. Pemeriksaan ekspresi TNF 1alfa menggunakan teknik kuantitatif ELISA sandwich. Data diolah menggunakan IBM SPSS statistik versi 20 untuk Windows. Untuk menilai hubungan penyelaman tunggal dekompresi dengan perubahan kadar TNF 1alfa menggunakan analisis bivariat dengan uji T berpasangan Wilcoxon Untuk menilai hubungan atau korelasi antara kadar TNF 1alfa Pre, Normobarik dan Hiperbarik dilakukan uji korelasi Spearman.Hasil : Terjadi perubahan ekspresi TNF 1alfa (p= 0,003) pada kelompok Normobarik.dan ekspresi TNF 1alfa (p=0,000) pada kelompok Hiperbarik dibandingkan sebelum penyelaman.Kesimpulan dan Saran: Terdapat perubahan kadar TNF 1 alfa pada intervensi penyelaman normobarik dan hiperbarik (p<0,001), dimana nilai rerata/median (0,008±0,038) pada ,kelompok Normobarik, dan 0,013(0,005-0,047) pada kelompok Hiperbarik. Kadar ekspresi TNF 1 alfa meningkat untuk masing-masing keadaan normobarik dan hiperbarik.

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Background: Decompression sickness is an important health problem for divers. The incidence of decompression sickness (DCS) or decompression sickness occurs in about 1,000 Americans scuba divers each year reported by AND. Research Brubakk AO et al, ISB, Medical Technology Center in Norway, reported on divers happened a few bubbles of blood vessels, increasing the diameter of the artery significantly from 4.5 ± 0.7 to 4.8 ± 0.8 mm (mean ± sd ) and a significant decrease of FMD from 9.2 ± 6.9 to 5.0 ± 6.7% as a sign of decline in endothelial function. The subjects of these studies in healthy individuals who perform single dive decompression dives corresponding protocol procedures dive right is not the DCS or symptoms of decompression sickness. Although in general the pathophysiology of DCS associated with the formation of gas bubbles in the circulation and tissues, so the pathophysiology of DCS not only caused by the mechanism of obstruction of gas bubbles, but due to the mechanism of dyfungsi endothelial, and thus penliti using biomarkers TNF1alfa as a marker to identify the occurrence of dyfungsi endothelial ,

Methods: The study used a cross over design methods. Data obtained from questionnaires, physical examination and laboratory. Examination of the expression of TNF 1alfa sandwich ELISA using quantitative techniques. The data is processed using IBM SPSS version 22 for Windows statistics. To assess the relationship single decompression dives with elevated levels of TNF 1alfa using bivariate analysis using Wilcoxon paired T test to assess the relationship or correlation between the levels of TNF 1alfa Pre, Normobarik and Hyperbaric do Spearman correlation test.

Results: There was an increased expression of TNF 1alfa (p = 0.003) on the expression of TNF 1flfa Normobarik.dan group (p = 0.000) in the group Hyperbaric. The correlation between the expression of TNF 1flfa Pre and Nrmobarik (r = 0.831) and the correlation between the expression of TNF 1alfa Pre and Hyperbaric (0,526).

Conclusions and Recommendations: There were significant increases in the hyperbaric group (p <0.001) and in the group normobarik. The correlation between the expression of TNF 1alpa Pre, normo damn Hyperbaric, increased significantly whice.

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"Salah satu zat yang berhubungan dengan disfungsi endotel pada preeklampsia adalah vascular endothelial growth factor (VEGF). Penelitian ini menyelidiki bagaimana kadar VEGF pada kultur sel endotel vena umbilikalis bila dipajankan dengan serum wanita hamil dengan preeklampsia. Kultur sel endotel vena umbilikalis primer dari 12 tali pusat wanita bersalin normal dengan bayi aterm dipajankan dengan 14 serum wanita hamil dengan preeklampsia dan 13 serum wanita hamil normal selama 24 jam. Kadar VEGF diukur dengan metode ELISA. Didapatkan rerata kadar VEGF setelah pemajanan serum selama 24 jam cenderung lebih kecil pada kelompok wanita hamil dengan preeklampsia (3,7 ± 1,74 pg110.000 set) dibandingkan dengan hamil normal (3,99 + 1,79 pg110.000, sel) namun perbedaan tersebut tidak bermakna (p=0,939, p>O,O5). Sabelum pemajanan, kadar VEGF pada 20% serum preeklampsia (33,31 + 0,89 pglml) lebih besar daripada kehamilan normal (32,81 _+ 0,76 pglml) namun tidak berbeda bermakna (p=0,132). Juga didapatkan rerata jumlah sel endotel yang hidup setelah pemajanan cenderung lebih besar pada kelompok wanita hamil dengan preeklampsia (11,00 ± 5,91 x 104 sel/ml) dibandingkan dengan hamil normal (9,85- + 3,96 x 104 sel/ml) namun perbedaan tersebut tidak bermakna (p=0,550, p>0,05). Rerata viabilitas sel endotel lebili besar pada kelompok wanita hamil dengan preeklampsia (70,33 + 24,26 %) dibandingkan dengan hamil normal (68,02 + 16,05 °A) namun perbedaan tersebut tidak bermakna (p=0,981, p>0,05). Kecenderungan ini memperlihatkan adanya peran VEGF pada sel endotel, namun bukan sebagai satu-satunya faktor yang terlibat pada patogenesis preeklampsia. Apakah VEGF yang meningkat pada serum penyandang preeklampsia diakibatkan oleh faktor-faktor dalam serum penyandang dan dihasilkan oleh sel endotel pada penelitian ini belum dapat dibuktikan.

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It has been suggested that VEGF is involved in endothelial dysfunction which observed preeclampsia. This study investigate the production of VEGF during exposure of sera of preeclamptic women for 24 hours in the human umbilical vein endothelial cells culture (HUVEC). Primary HUVEC made from 12 aterm umbilical cords were exposed by 14 sera of preeclamptic women and 13 sera of normotensive pregnant women for 24 hours. Enzyme-linked immunoassay of VEGF was established The results showed VEGF in supernatan HUVEC exposed by preclamptic women sera were lower than normotensive pregnant women sera, with no significantly differences. VEGF level in 20% preeclamptic sera was likely be higher than normotensive pregnant women sera. The number and viability of endothelial cells after the 24 hours exposure of preeclamptic women sera seem to be more higher than normotensive pregnant women. These results suggest that VEGF may have an important role in the endothelial cells, but that they are not the primary factors involved in the pathogenesis of preeclampsia is the increasing level of VEGF in preeclamptic women sera due to factors on the sera and produced by the endothelial cells itself could have not been proved."

"Pendahuluan : Disfungsi endotel terjadi sejak fase awal dari aterosklerosis yaitu pada pasien-pasien hipertensi, diabetes, hiperhomosisteinemia, perokok maupun pada fase lanjut dari aterosklerosis. Kegagalan fungsi endotel pada respons dilatasinya akibat aktifasi eNOS yang menurun. Teh hijau terbukti mampu memperbaiki disfungsi endotel dinilai dari perbaikan forearm blood flow perokok sehat yang belum mengalami PJK.Tujuan Penelitian : Untuk membuktikan bahwa pemberian teh hijau sekali asupan dapat memperbaiki flow mediated dilatation pada pasien-pasien penyakit jantung koroner, yang berarti ada perbaikan disfungsi endotel.Metode : Penelitian dilakukan pada 23 pasien yang terbukti penyakit jantung koroner dari basil kateterisasi, bail( yang sudah menjalani revaskularisasi maupun yang belum. Sampel dibagi menjadi dua kelompok, kelompok pertama mendapatkan teh hijau setelah sebelumnya diperiksa FMDnya serta FMD pasca perlakuan 1,5jam sesudah pemberian teh, kelompok kedua mendapatkan placebo (air putih). Kemudian dilakukan crossover setelah 3-5 hari periode washout, kelompok pertama ganti mendapatkan placebo dengan diperiksa FMD sebelum dan sesudah perlakuan dan kelompok kedua mendapatkan teh hijau. Dilakukan pemeriksaan FMD pada orangorang yang sehat usia kurang dari 25 tahun sebagai kontrol populasi sehat.Hasil : Tidak ada perbedaan bermakna pada karakteristik dasar antara kelompok yang mendapatkan teh hijau dahulu dibandingkan yang mendapatkan placebo dahulu. Sedangkan FMD kelompok baseline kelompok teh 4,80±5,37 berbeda bermakna dibandingkan kontrol sehat 9,15±3,65 (p=0,047) sedangkan FMD baseline sebelum mendapatkan placebo 5,87±3,89 tidak ada perbedaan bermakna dibandingkan FMD baseline pre teh hijau (p=0,398) maupun dibandingkan kelompok kontrol sehat (p=0,082). FMD pasca perlakuan menunjukan perubahan perbaikan yang bermakna pada kelompok teh hijau bila dibandingkan baseline (4,80±5,37 vs 8,68±6,00 p=0.026) sedangkan kelompok placebo menunjukan perubahan perburukan FMD bila dibandingkan pre dan pasca placebo (5,87±3,89 vs 3,34±3,66 p=0,026)_ FMD pasca teh hijau berbeda bermakna bila dibandingkan pasca placebo (8,68±6,00 vs 3,35±3,66 p=0,002). Tidak ada perubahan diameter arteri brachialis kelompok teh hijau maupun placebo (4,60-0,36 vs 4,57±0,41 ; p=0,800 dan 4,57±0,41 vs 4,61±0,36 p=0,601). Tidak ada perubahan tekanan darah sistolik kelompok teh hijau dan placebo (144,78±25,69 vs 146,91±24,76 ; p=0,502 dan 141,30±25,46 vs 139,78±22,99 ; p=0,632). Tekanan darah diastolik kelompok teh hijau dan placebo juga tidak ada perubahan bermakna (86,82±10,55 vs 87,27±9,84; p0,549 dan 83,63±9,24 vs 81,81±8,73; p=0,510). Demikian juga nadi kelompok teh hijau dan kelompok placebo. (67,174±12,492 vs 66,609±11,900; p=0,236 dan 68,043±9,028 vs 66,739±8,247; p=0,127)Kesimpulan : Teh hijau mampu memperbaiki fungsi endotel dinilai dari perbaikan flow mediated dilatation jangka pendek pada pasien-pasien penyakit jantung koroner, dimana efek yang berlawanan justru diperlihatkan air putih, pada penelitian eksperimental dengan design crossover.

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Background : Endothelial dysfunction begins when atherosclerosis developed as what go through on hypertension, diabetes, hyperhomocysteinemia, and also what go through among smoker who hasn't have CAD until end phase of atherosclerosis. Impairment of endothelial function depends on vasodilatation due to the decreasing of eNOS activity. Green tea has been proved to have positive effect in reversing endothelial dysfunction among healthy smoker.

Objectives : to determine the short term effect of green tea on flow mediated dilatation among coronary artery disease patients which repaired the dysfunction of endothelial cells.

Methods : 23 coronary artery disease patients which had been confirmed by coronary angiography joined the study. The sample was divided into two groups, first was the group who took green tea, and the 2nd was the group who took placebo (mineral water). Before treatment, the FMD of both two groups were measured and one hour and half after treatment. After 3-5 days of treatment, both groups were crossover. FMD among healthy group of age Iess than 25 years old was also measured as control group.

Results : There was no significant differences in baseline characteristic between the first group and the 2"d (both received green tea but in different time). FMD after treatment was increased among group who took green tea (4.8015.37 vs 8.6816.00, p=0.026), while FMD among placebo group was decreased (5.8713.89 vs 3.3413.66 p=0.026). There was significant differences of FMD after treatment with green tea and after treatment with placebo (8.68±6.00 vs 3.3513.66 p = 0.002). There was no differences of brachialis artery diameter in both groups (4.6010.36 vs 4.5710.41, p=0.8 and 4.5710.4I vs 4.61±0.36, ptl.601). There was no differences od systolic pressure in both group (144.78 125.69 vs 146.91124.76, p=0.502 and 141.30±25.46 vs 139.78122.99, p=0.632). Also there was no differences of diastolic pressure in both groups (86.82110.55 vs 87.2719.84, p= 0.549 and 83.6319.24 vs 81.8118.73, p=0.510). No differences of heart rate in both groups (67.174112.492 vs 66.609111.900, p=0.236 and 68.043 ±9.028 vs 6633918.247, p=0.127)

Conclusion : From this study we conclude that green tea had positive effect in reversing endothelial dysfunction among coronary artery disease patient by assessing flow mediated dilatation in short time. The group who took placebo showed the paradoxical effect."

"Pendahuluan : Disfungsi endotel merupakan awal timbutnya aterosklerosis yang pada kondisi lanjut akan menychabkan penyakit jantung koroner (PJK). Teh hijau dilaporkan mampu memperbaiki disfungsi endotel karena kandungan katekin yang ada di dalamnya. Penelitian menunjukkan teh hijau mampu meningkatkan produksi prostasiklin pada kultur sel aorta babi.Tujuan penelitian : Untuk mcmbuktikan hahwa pemberian teh hijau sekali minum dapat memberi efek terhadap peningkatan produksi 6-ketoprostaglandin Fl-a sebagai metabolic prostasiklin dan penurunan kadar tromboksan B2 sebagai metabolit tromboksan A2 pada penderita PJK.Metode : Penelitian dilakukan pada 25 penderita yang terhukti PJK dari pemeriksaan angiografi koroner. Sampel dibagi menjadi 2 kelompok. Kelompok 1 mendapat teh hijau terlebih dahulu dan Kelompok l1 mendapat plasebolair putih terlebih dahulu. Setelah masa wash-Put selama 1 minggu, dilakukan cross-over. Dihitung kadar 6-ketoprostaglandin Fl-a sebagai metabolit prostasiklin don tromboksan B2 sebagai metabolit tromboksan A2 sebelum dan sesudah pemberian teh hijau dan plasebo. Dllakukan pemeriksaan kadar 6-ketoprostaglandin Fl-a dan tromboksan B2 pada 20 orang sehat usia 18-25 tabula sebagai acuan nilai normal.Hasil : Didapatkan peningkatan kadar 6-ketoprostaglandin Fl-a yang bermakna pada kedua kelompok. Pada kelompok I sebeiuni pemberian tab hijau kadar 6-ketoprostaglandin Fl -a 5.126 (2.808-6.237) menjadi 6.575 (4.788-7.638) ng/ml (p= 0.012). Pada kelompok plasebo tidak didapatkan peningkatan yang bermakna (p= 0.328). Pada kelompok II kadar 6-ketoprostaglandin Fl-ct sebelum teh hijau 6.044 (2.804-11.693) menjadi 7.212 (4.028-11.175) ng/ml (p= 0.011). Pada plasebo tidak didapatkan peningkatan yang bermakna (p= 0.325). Pada pemeriksaan kadar tromboksan B2 tidak didapatkan penurunan yang bermakna balk pada kelompok I maupun pada kelompok II. Pada kelompok I sebelum pemberian teh hijau 0.472 (0.122-0.630) menjadi 0.092 (0.056-0.135) ng/ml (p= 0.68). Pada kelompok l1 sebelum pemberian teh hijau 0.1 11 (0.029-0.630) meningkat menjadi 0.660 (0.018-0.958) ng/ml (p= 0.055). Hadar 6-ketoprostaglandin F1-u pada penderita PJK lehih rendah secara bermakna dibanding orang sehat (p<0.001). Pada pemeriksaan kadar tromboksan B2 pada penderita PJK lehih rendah secara bermakna dibanding prang sehat (p<0.001)Kesimpulan : pemberian teh hijau sekali minum mampu meningkatkan produksi 6-ketoprostaglandin Fl-a yang merupakan metabolit aktif prostasiklin pada penderita penyakit jantung koroner, akan tctapi tidak memberikan efek penurunan kadar tromboksan B2 yang merupakan metabolit aktiFdari tromboksan A2.

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Introduction : Endothelial dysfunction is an early process of atherosclerosis that in long term will cause coronary artery disease. Green tea has been reported to improve endothelial function because of catechin substance in green tea. Study had showed that green tea could increase the prostacyclin production in bovine aorta cell culture.

Objective :To gain evidence that one time consuming of green tea may increase 6-ketoprostaglandin Fl-a production as a metabolite of prostacyclin and decrease thromboxane B2 production as a metabolite of thromboxane A2 in coronary artery disease patients.

Method : Study has been conducted to 25 patients proven to have coronary artery disease by coronary angiography. Sample was grouped into two groups. Groups I firstly receive green tea and Group II firstly receive placebo (mineral water). After washout period for one week, sample was being cross-overed. The level of 6-ketoprostaglandin Fl-a as a metabolite of prostacyclin and thromboxane B2 as a metabolite of thromboxane A2 were measured before and after green tea and water consumption. We also measure the level of 6-ketoprostaglandin Fl -a and thromboxane B2 in 20 healthy persons aged 18 -25 years old as a normal value.

Result : There were significant increasing level of 6-ketoprostaglandin Fl-a of both groups. In Group I, the level of 6-ketoprostaglandin Fl-a before green tea consumption was 5.126(2.808-6.237) and raised up to 6.575(4.788-7.638) ng/ml(p= 0.012). Meanwhile in placebo group there were no significant increase level of 6-ketoprostaglandin Fl-a (p= 0.328). In group II the level of 6-ketoprostaglandin Fl-a before green tea consumption was 6.044(2.804-11.693) and raised up to 7.212(4.028-11.175) ng/ml (p= 0.011). As for placebo group, there were no significant increase level of 6-ketoprostaglandin F l -a (p= 0.325). Thromboxane B2 measurement result shows no significant decrease both in group I and group H. In group I, thromboxan B2 level before green tea consumption was 0.472(0.122-0.630) and raised up to 0.092(0.056-0_l35) ng/ml(p= 0.68). As for group H, thromboxane B2 level before green tea consumption was 0.111(0.029-0.630) and raised up to 0.660(0.018-0.958) ng/ml (p= 0.055). The level of 6-ketoprostaglandin Fl-a in coronary artery disease patients was significantly bellow healthy persons (p<0.001). The level of thromboxane B2 in coronary atery disease patients were also significantly bellows healthy persons (p<0.001).

Conclusion : One time green tea consumption can increase 6-ketoprostaglandin Fl-a production as an active metabolite of prostacyclin in coronary artery disease patients but does not decrease thromboxan B2 level, an active metabolite of thromboxan A2."

"Kejadian kardiovaskular adalah penyebab kematian utama pada artritis reumatoid AR . Periodontitis diketahui berperan dalam patogenesis disfungsi endotel pada AR. E-selectin merupakan penanda disfungsi endotel yang spesifik dihasilkan oleh endotel. Tujuan penelitian ini adalah mengetahui efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Penelitian ini merupakan uji klinis randomisasi pada penderita AR yang berobat di Poliklinik Reumatologi RSCM periode Maret-Mei 2017. Pengambilan sampel dilakukan secara konsekutif. Randomisasi dilakukan dengan randomisasi blok. Subyek dibagi menjadi kelompok terapi periodontal dan kontrol. Dilakukan Uji t untuk melihat perbedaan selisih E-selectin awal dan akhir studi antara kelompok intervensi dengan kontrol. Periodontitis ditemukan pada 31 subyek 64,5 . Tidak didapatkan perbedaan selisih E-selectin awal dan akhir studi yang signifikan secara statistik antara kelompok intervensi dengan kontrol p=0,303 . Sebagai kesimpulan tidak didapatkan pengaruh terapi periodontal terhadap kadar E-selectin pada pasien AR.

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Cardiovascular event is the main cause of mortality in rheumatoid arthritis RA . Periodontitis is known to be involved in the pathogenesis of endothelial dysfunction in RA. E selectin is a marker of endothelial dysfunction and was expressed specifically in endothelial cells. The objective of this study was to determine the effect of periodontal treatment on E selectin level in RA patients. This was a randomized clinical trial in RA patients visiting Rheumatology Clinic RSCM between March May 2017. Samples were collected using consecutive sampling method. Randomization was done using block randomization. Subjects was divided into nonsugical periodontal treatment group and control group. T test was used to measure the difference of delta E selectin before after study between periodontal treatment group and control. Periodontitis was found in 31 subjects 64,5 . There was no statistically significant difference of delta E selectin before after treatment between periodontal treatment group and control. As a conclusion, periodontal treatment has no effect on E selectin level in RA patients."

"ABSTRACTThe immune system, inflammation and hypertension are related to each other. Innate and adaptive immunity system triggers an inflammatory process, in which blood pressure may increase, stimulating organ damage. Cells in innate immune system produce ROS, such as superoxide and hydrogen peroxide, which aimed at killing pathogens. Long-term inflammation process increases ROS production, causing oxidative stress which leads to endothelial dysfunction. Endothelial function is to regulate blood vessel tone and structure. When inflammation lasts, NO bioavailability decreases, disrupting its main function as vasodilator, so that blood vessels relaxation and vasodilatation are absent. Effector T cells and regulatory lymphocytes, part of the adaptive immune system, plays role in blood vessels constriction in hypertension. Signals from central nervous system and APC activates effector T lymphocyte differentiation and accelerate through Th-1 and Th-17 phenotypes. Th-1 and Th-17 effectors participate in inflammation which leads to increased blood pressure. One part of CD4+ is the regulatory T cells (Tregs) that suppress immune response activation as they produce immunosuppressive cytokines, such as TGF-I and IL-10. Adoptive transfer of Tregs cells can reduce oxidative stress in blood vessels, endothelial dysfunction, infiltration of aortic macrophages and T cells as well as proinflammatory cytokine levels in plasma circulation."

"Aim: to evaluate the role of clinical characteristics, functional markers of vasodilation, inflammatory response, and atherosclerosis in predicting wound healing in diabetic foot ulcer.

Methods: a cohort study (February-October 2010) was conducted from 40 subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each subject underwent at least two variable measurements, i.e. during inflammatory phase and proliferation phase. The studied variables were clinical characteristics, complete peripheral blood count (CBC) and differential count, levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG), marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA, endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery), and marker of vascular calcification (osteoprotegerin/OPG).

Results: median of time achieving 50% granulation tissue in our study was 21 days. There were nine factors that contribute in the development of 50% granulation tissue, i.e. family history of diabetes mellitus (DM), previous history of wound, wound area, duration of existing wound, captopril and simvastatin medications, levels of ADMA, ET-1, and OPG. There were three out of the nine factors that significantly correlated with wound healing, i.e. wound area, OPG levels, and simvastatin medications.

Conclusion: in acute diabetic foot ulcers, wound area and OPG levels had positive correlation with wound healing, whereas simvastatin medications had negative correlation with wound healing."