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BACKGROUND: Breast cancer (BC) is the most common cancer among women worldwide and a leading cause of death in Indonesia. The primary treatment of locally advanced BC is neoadjuvant chemotherapy (NAC). The rapid proliferation of tumor cells in a neoplastic microenvironment is largely due to hypoxia, which also encourages the development of chemoresistant BC. The master regulator of the hypoxia response is hypoxia-inducible factor-1α (HIF-1α). The response evaluation criteria in solid tumors (RECIST) is an objective response metric that demonstrates the efficacy of a NAC based mostly on the size of the tumor. Ca15-3 is the protein product of the MUC1 gene and is the most widely used serum marker in BC. The purpose of this study is to investigate the relationship between HIF-1α and RECIST and between Ca15-3 and RECIST and to assess the relationship among all of them in BC. METHODS: This observational study used the prospective cohort method included 11 patients with histopathologically confirmed BC, specifically invasive ductal carcinoma. We evaluated the changes in HIF-1α and Ca15-3 serum levels using ELISA and measured tumor lesions with RECIST. The procedure was carried out twice. Serum levels were measured at baseline, and after receiving two cycles of NAC (5 weeks). RESULTS: Among the 11 patients included in this study, HIF-1α, Ca15-3, and RECIST decreased significantly after NAC. The changes in RECIST correlated with Ca15-3: each unit decrease in RECIST score was associated with a 0.3-unit decrease in Ca15-3 levels (p = 0.019). CONCLUSIONS: There was a decrease in HIF-1α, followed by a decrease in Ca15-3 and RECIST in response to chemotherapy. There was a statistically significant correlation between Ca15-3 and response to chemotherapy. This study evidences the relationship between factors that shape the local tumor microenvironment.

Introduction: A major public health problem, brain injury can cause disability and death. Managing traumatic brain injury (TBI) can involve surgical interventions (e.g., evacuation and decompressive craniotomy) and/or conservative interventions without surgery (e.g., oxygenation, resuscitation, antibiotics, osmotherapy, and analgesics). Lactate, a biomarker that exerts physiological effects, is sensitive to the lack of oxygen and ischemia in organs such as the brain in both types of interventions. The aim of our study was thus to compare lactate concentrations in patients with closed brain injuries after conservative and surgical interventions. Methods: In a cohort study, lactate concentration between patients with TBI in the conservative versus surgical intervention groups were analyzed using the chi-square test, the independent t test, and Spearman’s correlation test. Results: Lactate concentrations in patients with closed brain injuries at the baseline, 24-hour, and 72-hour blood sampling time points did not significantly differ between conservative and surgical interventions (ρ > 0.05). However, reductions in lactate concentrations after 24 and 72 hours did significantly differ between the intervention groups, despite being more reduced in surgical interventions (ρ = 0.001) than in conservative ones (ρ = 0.002). Lactate concentrations were also significantly lower after 24 and 72 hours in the surgical intervention group for patients with epidural hematoma (EDH, p= 0.001) than ones without EDH (ρ < 0.001). Conclusion: Lactate concentration is a reliable prognostic predictor for assessing the severity of brain injury other than the GCS, another common clinical predictor.

Introduction The matrix metalloproteinase-9 (MMP-9) inhibition is an important target in the treatment of traumatic brain injury. Recent studies have shown that Minocycline may have MMP-9 inhibition activity. This study aims to determine the effect of minocycline in inhibiting MMP-9 in cases of head injury which has not been studied much. Methods This research was conducted using a laboratory experimental method on rats with a post-test control group design. The research was conducted at the Animal Laboratory, Faculty of Medicine, Hasanuddin University for a period of 2 weeks. The research population was rats with traumatic brain injury and rats without traumatic brain injury as controls. The sample size for each group was determined with Federer's formula, the minimum number of samples for each group was 9 experimental animals (a total of 27 mice in this study). Group 1 are control group, group 2(TBI) are rats with a traumatic brain injury, and group 3 are rats with a traumatic brain injury who was given minocycline. Results The mean value of MMP-9 in group 2 (TBI) was 0.610116 ng/ml compared to the control mean value of 0.519300 ng/ml. The mean value of MMP-9 in group 3 (TBI+M) was 0.552674 ng/ml. From the ANOVA test, there was a significant relationship with a p-value = 0.001 There was a statistically significant relationship between the administration of minocycline and the decrease in MMP-9 levels in traumatic brain injury in Wistar rats. Conclusion The level of MMP-9 in Wistar rats with traumatic brain injury who were given minocycline was shown to be significantly lower than that of those without minocycline treatment. This result showed that minocycline has the potential to inhibit the increase of MMP-9 levels in traumatic brain injury.

Background: Increasing resistance to TB drugs raises the challenge of TB eradication. Miana leaves is Indonesian traditional herbal medicine, have antimicrobial, anti-inflammatory, and immunoregulatory action. Not much is known about the effect of Miana on HIF-1α and ICAM-1, the immunoregulators of infection and inflammation. This study aims to elucidate the effect of Miana on HIF-1α and ICAM-1 in M. tuberculosis (Mtb) infected mice. Materials and Methods: This experimental study used Mtb infected Balb/c mice were divided into 4 groups; group 1 is placebo, group 2 is treated with Rifampicin as Anti TB drug, group 3 is treated with Miana, and group 4 is treated with Miana + Anti TB drug. HIF-1α and ICAM-1 serum levels were analyzed using ELISA. Results: There is a significant difference of mean HIF-1α (p= 0.00, F = 114.21) and ICAM-1 (p= 0.00, F = 113.11) between the four groups after treatment. HIF-1α level is significantly lower in anti TB treatment, Miana, and Miana + anti TB treatment compared to placebo (mean difference (MD) 35,764.67, p=0.00; 29,230.98, p=0.000; 38,489.62, p=0.00, respectively). Furthermore, ICAM-1 level is significantly lower in anti TB treatment, Miana, and Miana + anti TB treatment compared to placebo (MD 95,449.68, p=0.00; 79,509.69, p=0.00; 108,672.83, p=0.00, respectively). Conclusion: HIF-1α and ICAM-1 expression was reduced after Miana administration. Miana can be a potential complement to anti-TB treatment but cannot replace rifampicin as anti-TB drugs.

Kanker payudara merupakan penyebab kematian akibat kanker terbanyak pada wanita di seluruh dunia dengan angka kematian sebesar 458.400 wanita setiap tahunnya. Poly-(ADP ribose) polymerase (PARP) dan phosphatidylinositol 3-kinase (PI3K) adalah dua molekul yang memainkan peran penting pada patofisiologi kanker payudara. Metastasis kanker payudara merupakan sebuah proses berkesinambungan yang melibatkan beberapa tahapan penting seperti invasi, angiogenesis, hingga replikasi sel. Sel yang mengalami mutasi pada kanker payudara akan menyebabkan ekspresi yang berlebihan dari PI3K sehingga terjadi replikasi sel yang tidak terkontrol disertai dengan peningkatan matrix metallopeptidase 9 (MMP-9). MMP-9 memiliki peran dalam degradasi matriks ekstraseluler yang penting untuk proses invasi tumor. Di sisi lain, PARP membantu reparasi sel yang mengalami kerusakan sehingga proses replikasi sel kanker dapat terus berlangsung. Terlebih lagi, PARP diketahui memiliki andil besar dalam proses angiogenesis sel kanker. Gabungan dari kedua fenomena tersebut menghasilkan sel kanker dengan kemampuan replikasi dan metastasis yang tinggi.

Background: Researches towards Glioblastoma multiforme therapy (GBM) has been performed, especially in finding the tumor’s genetic cellular expression. The overexpression of EGFR, frequently found in human malignancies, is known to significantly impact cancer cells hallmark traits, such as increased cell survival, proliferation and invasion. This research is performed to figure out the synergistic effect of temozolomide, the main chemotherapy regimen used, and the monoclonal antibody anti-EGFR nimotuzumab in inhibiting the growth of GBM cells in vitro.Methods: We performed cell cultures using GBM U87MG cells and administered nimotuzumab 1000µg/ml and temozolomide 20 µg/ml in different sequences and timings. Inhibition of GBM cell growth is evaluated by measuring Ki-67 and ?H2AX levels using flowcytometry and tested with one-way ANOVA. Data were analyzed using SPSS version 21 for Windows.Results: Levels of Ki-67 were in the control group (23.17±1.72), nimotuzumab monotherapy (15.43±1.70), temozolomide monotherapy (14.80±1.37), simultaneous therapy (10.73±1.19), nimotuzumab 24 hours before temozolomide (10.57±1.05), and nimotuzumab 48 hours before temozolomide (14.47±1.37). The level of ?H2AX is measured in the control group (11.90±1.25), nimotuzumab monotherapy (29.33±1.91), temozolomide monotherapy (28.13±1.58), simultaneous therapy (41.53±3.51), nimotuzumab 24 hours before temozolomide (39.56±2.06), and nimotuzumab 48 hours before temozolomide (35.93±3.56).Conclusion: This research shows that administration of nimotuzumab simultaneously with temozolomide and nimotuzumab 24 hours before temozolomide effectively inhibits the growth of U87MG GBM cells. Inhibition of EGFR expression before temozolomide administration is able to increase DNA damage and inhibit the proliferation of glioma cells.

Introduction: Brain injury is a major cause of death and disability. Computerized Tomography (CT) scanning of the brain is essential for diagnostic screening in need of neurosurgical intervention and also provide information about patient prognosis. Methods: This study is a retrospective study design to assess the comparison of the CT scan scoring system of the head with the prognostic factors of brain injury. Head CT Scans were assessed according to the following Rotterdam and Helsinki CT Scores. All patients were managed according to standard guidelines. Surgery was performed as indicated. The primary objective was mortality assessed using the Glasgow Outcome Scale (GOS) at discharge and 3 months after. Results: Altogether, 60 patients were included. The results of the ROC analysis of the two CT scoring systems, the Helsinki score provided a better sensitivity score> 80% compared to the Rotterdam score, with a positive predictive value of around 74% each for assessing the outcome (GOS) of brain injury patients Conclusions: The Helsinki score scoring system provides a better sensitivity compared to the Rotterdam score

Traumatic brain injury (TBI) is a major cause of death and disability worldwide that imposes a significant burden on both individuals and their families. Many of the symptoms experienced by patients with TBI are thought to be mediated by the neuroinflammatory process that occurs after the primary injury. Therefore, the present study aimed to determine the effect of diphenhydramine HCl (DPM) on serum levels of the inflammatory cytokine tumor necrosis factor-α (TNF-α) after TBI.This was an experimental study with a pre- and post-test control group design. A total of 10 adult Wistar rats were divided into 2 groups, the DPM group and the placebo group. The effect of DPM on serum levels of TNF-α was evaluated at 30 min, 2 h, and 24 h after the induction of experimental TBI in the rats using Marmarou's weight-drop model.TNF-α levels in the DPM group significantly decreased from 0 min to 24 h after TBI (p = 0.004). In the placebo group, TNF-α levels significantly increased from 0 min to 24 h after TBI (p 0.001). Post hoc analysis found that TNF-α levels in the DPM group decreased significantly from 30 min to 2 h and from 2 h to 24 h after TBI (p = 0.019 and p = 0.005, respectively).The results of this study suggest that administration of DPM causes a reduction in serum levels of TNF-α, indicating that DPM has a significant anti-inflammatory effect in experimental rats after TBI.

Neuropathic pain is a major problem whose pathogenesis is not known yet, which makes it difficult to treat. Effective treatment of neuropathic pain usually uses multimodal therapy that takes a long time but causes major health problems, which are commonly found in women over 50 years of age and are generally caused by lumbar radiculopathy due to lumbar spinal stenosis. The narrowing of the spinal canal resembles an ischemic condition that can increase the expression of VEGF in the dorsal root ganglion and then result in shortened walking distance (intermittent claudication). The effect of VEGF is thought to be through binding to VEGFR1 and VEGFR2, whose levels are increased in conditions of hyperalgesia and neuropathic pain. Immune mechanisms play a role in the pathogenesis of neuropathic pain, through the balanced process of pro-inflammatory cytokines and anti-inflammatory cytokines, TGF-β, which are immunosuppressive. MLC901 is a simplified traditional medicine formula from MLC601, which affects the nervous system through three main mechanisms, namely neuroprotection, neuro-regeneration and neuro-restoration. Elevated levels of MLC901 promote angiogenesis. This review discusses the effect of MLC901 on miR30c-5p expression, TGF-β expression, VEGF receptor expression, degree of axon demyelination and changes in neuropathic pain behaviour in experimental animals experiencing neuropathic pain using the circumferential spinal stenosis method. These findings may provide new targets for further scientific research on the molecular mechanisms of neuropathic pain and potential therapeutic interventions.

Program KB, penyuluhan dan penelitian dalam kelas antenatal merupakan salah satu program upaya pencegahan 3 terlalu dan 4 terlambat dan upaya menurunkan angka kematian ibu. Adapun tujuan dari pemberian konseling dan pelayanan KB yang bertujuan meningkatkan pengetahuan dan mampu menyikapi permasalahan yang berhubungan dengan kehamilan dan persalinan yang bertujuan untuk menurunkan angka kematian ibu. Sasaran dalam kegiatan ini adalah ibu hamil, pasangan usia subur di Desa Leang-Leang Kabupaten Maros dengan peserta pemasangan IUD sebanyak 12 orang dan peserta penyuluhan 57 orang. Metode yamg digunakan adalah penyuluhan melalui ceramah dengan menggunakan media reaflek, demonsterasi dan laptop. Kegiatan ini dilakukan untuk meningkatkan kualitas kesehatan ibu hamil dan pasangan usia subur khususnya dalam bidang keluarga berencana dan pendidikan di wilayahnya secara mandiri.

Background Traumatic brain injury is a dangerous life threatening condition. This study examines the role of MLC901 in increasing neurogenesis. The aim of this study was to demonstrate the role of MLC901 in increasing neuron cell (neurogenesis) in rat with traumatic brain injury using the synaptophysin marker. Methods The synaptophysin levels were measured as a marker for neuron cell (neurogenesis) of brain nerve cells in Sprague-Dawley rats aged 10–12 weeks, weighing 200–300 g. All rats (n = 10) were performed as traumatic brain injury using The Modified Marmourou Model, then they were divided into 2 group, one group was given MLC901 (n = 5) and the other group was not given MLC901 (n = 5). The synaptophysin levels in both groups were assessed after 6 weeks and also carried out an examination of immnuhistochemical from the brain tissue of both groups. Results There was an increase in the number of neuron cells as evidenced by synaptophysin ihc staining in the rats given MLC 901 (Neuroaid II) compared to those without MLC 901. Synaptophysin levels were lower in the control group than in the MLC 901 group (81.6, SD: 13.52 vs 118.4, SD: 12.198, p = 0.062). Conclusion These research suggest that MLC901 can increase neurogenesis in traumatic brain injury and also appeared as synaptophysin antibody that binding to cytoplasm of neuronal cells in the rat brain., Highlights • Experimental study on rats with traumatic brain injury to determine the role of MLC 901 in increasing number of neuronal cells (neurogenesis) in rat with traumatic brain injury using the synaptophysin marker. • The synaptophysin levels in both groups were assessed after 6 weeks and also carried out an examination of immnuhistochemical from the brain tissue of both groups. • There was an increase in synaptophysin levels in the rats given MLC 901. • MLC 901 can increase neurogenesis in traumatic brain injury.

BACKGROUND: Some of colorectal cancers (CRCs) are familial, however, heterozygote relatives have approximately 80% lifetime risk of cancer. Risk assessment of CRC’s family could be calculated by direct measurement of mRNA gene expression and Bayesian theorem which is modifying initial background of pedigree risk with additional conditional information. This application has not been reported. METHODS: The cross-sectional translational sequential studies were performed: (1) adenomatous polyposis coli (APC) and MutS homolog (MSH)2 mRNA quantitative RT PCR gene expressions in tissue and whole blood CRC patients; (2) gene expression was determined in matched controls; and (3) pedigree and Bayesian analysis was calculated in the patient’s family of Proband. RESULTS: Fourty CRC and 31 control subjects were enrolled. The mean blood APC level control’s group was 13,261±670 fold-change (fc) and blood MSH2 level was 12,219±756 fc. The cut-off points for hereditary APC was 12,195 fc and MSH2 was 11,059 fc. The mean APC blood level in CRC subject was 11,578±2,638 fc and MSH2 blood level was 11,411±2,912 fc. There were significant differences APC and MSH level between tissue and blood level in CRC. Eight of 40 CRC subjects had a history of familial CRC. Four patients and 10 Probands were available for recurrence risk evaluation of pedigree analysis, RNA PCR quantitative and Bayesian calculation. CONCLUSION: There was determined a cut-off point of hereditary mRNA quantitative expression. The APC and MSH2 levels in CRC subjects were significantly lower than controls. Bayesian analysis allowed for the calculation of relative risk in CRC family members and considered in clinical practice. KEYWORDS: hereditary CRC, APC gene, MSH gene, Bayesian analysis

Background The ability of Mycobacterium tuberculosis to survive intracellularly, provides a cellular adaptive immune response played by specific T cells to defend against tuberculosis. The adaptive immune response to Bacillus of Calmette and Guerin (BCG) immunization is responded to by B cells, T Follicular B helper, T regulatory, restriction CD1, CD8+, CD4+, Th1, Th2, and Th17. BCG immunization can cause a tuberculin test reaction to being positive. The tuberculin test is a method for diagnosing TB infection and for screening individuals for latent infection and assessing the rate of TB infection in a given population. Methods a nested case-control survey was conducted on patients with a diagnosis of TB and parents 0–18 years of age from 3 hospitals in Indonesia during September–November 2019 with a total sample of 69 people undergoing clinical examinations, supporting and diagnosing subjects, blood sampling 1–2 cc for examination mRNA gene Treg, Treg, CD 4+, and CD 8+, then centrifuged at 3000 rpm for 10 min to support blood cells and serum. Results There was a significant relationship between expression of mRNA gene Treg with TST (p = 0,000), Treg with TST (p = 0,000), and CD4+ with TST (p = 0,000). Meanwhile, CD8 + was not significantly associated with TST (p = 0.118). Conclusions It is necessary to check the expression of mRNA gene Treg, Treg, CD4+, and CD8+ with more samples to find the mean value that shows the protective value of further TB., Highlights • The Mantoux tuberculin skin test (TST) is one of the criteria to determine whether a person is infected with Mycobacterium tuberculosis. It is often used to screen individuals for latent infection and assess rates of TB infection in a given population. tuberculin test results with induration diameter> 10 mm were positive regardless of the cause. Patients in this study were children who had been vaccinated against BCG and diagnosed with TB in their early toddler years. It was necessary to see the adaptive immune response that existed when the child was infected with TB. • The main immune response that acts as protection against TB is played by cellular immunity, namely CD4 and CD8 T cells. We thought that if we could find between TST and adaptive immune response, TST could be a prior test to determine prognosis or disease progression. • We found a strong correlation between immune activation and Treg cell frequency in TST positive persons. A higher Treg consentration was found in TST positive subjects. Nevertheless, local immune responses may differ from those in peripheral blood and exploring this interaction in the site of active infection will give important clues about their involvement in protection or pathogenesis . According to our studies the increased Treg cell frequency observed in the blood of people with active tuberculosis is likely a response to inflammation and bacterial burden.

Introduction The combination of stromal vascular fraction (SVF) and platelet-rich plasma (PRP) is effective at increasing the concentration of growth factors including transforming growth factor-β (TGF-β). The increase in this growth factor is expected to accelerate the healing of burns. This study aims to determine the effect of giving a combination of SVFs and PRP on TGF-β levels in the healing process of deep dermal burns. Methods This was an experimental study in 64 rats using a post-test control group design consisting of 1 group of SVFs and PRP combination injection treatment group, 1 group given a topical combination of SVFs and PRP, 1 group given Vaseline, and 1 control group. Results There was a significant difference in TGF-β levels between the deep dermal burns group that was given a combination of SVFs and PRP injection and topical, the Vaseline group, and the control group with p-value, Highlights • The combination of SVFs and PRP is effective at increasing the concentration of growth factors. • Administration of SVFs and PRP by injection was not better than topical at increasing the expression of TGF-β. • The combination of SVFs and PRP increased the level of TGF-β in the healing process rats model.

Introduction Ischemia-Reperfusion Injury (IRI) is a complication following the reperfusion of ischemic tissues; it requires immediate treatment, as it can lead to severe infection and tissue death. The purpose of this study was to demonstrate the ability of Hyperbaric Oxygen Therapy (HBOT) to treat SIRS (Systemic Inflammatory Response Syndrome) caused by IRI and to provide long-term functional assessment for a period of up to 5 years. Case presentation Two cases of avulsions of the hand at the levels of the wrist joint and the medial third forearm, severed by machetes. Both patients were male and in their twenties. Hand replantation was carried out after 30 minutes (medial third forearm case) and 11 hours (wrist joint case) of ischemic time. A couple of days after surgery, both patients experienced SIRS as a result of IRI. The patients were brought to the hyperbaric chamber and received 3 consecutive 90-min sessions of HBOT at 2.4 ATA 3 days in a row. The outcomes were compared in a table with each patient's vital signs and laboratory results, both before and after HBOT. A significant improvement was seen at the follow-ups in vital signs and laboratory results for both patients after HBOT administration. Long-term follow-up also showed satisfying results for hand function, proven by low DASH (Disabilities of the Arm, Shoulder, and Hand) scores. Conclusion HBOT was able to treat SIRS in both patients. Favorable long-term hand function results signify successful extremity replantation., Highlights • Ischemia-Reperfusion Injury (IRI) is a complication following the reperfusion of ischemic tissues. • Two cases of avulsions of the hand that had underwent hand replantation had experienced systemic inflammatory response syndrome (SIRS) due to IRI. • Administration of HBOT has been proven to be an effective treatment for post-hand replantation SIRS.

Objective Glioma is one of the most frequent and disabling primary brain tumour. Patients are not only dealing with survival, but also quality of life, which remains another major concern. Karnofsky Performance Scale (KPS) is one of the most commonly used scale to assess patients' quality of life. A recent scale, known as Neurological Assessment of Neuro-Oncology Scale, has surfaced to examine neurological disability caused by brain tumour. Previous study showed this scale to be superior to KPS in predicting survival. However, these scales have never been used to foresee functional scale improvement during disease progression. We sought to determine whether initial KPS and NANO Scale can predict functional scale improvement 2 months after surgery. Methods Patients with glioma grade II-IV were included in the study. IDH mutation and MGMT methylation were tested. KPS and NANO scale were examined before surgery and 2 months after surgery. Favorable outcome (FO) was defined as improvement in functional scale 2 months after surgery. Patients initial functional scales were analyzed towards favorable outcome. Results Glioma WHO grade II, III and IV was found in 17 patients (36.2%), 3 patients (6.4%) and 27 patients (57.4%) respectively. Median KPS before and 2 months after surgery were 50 (30-80) and 60 (0-100), whereas median NANO scale before and 2 months after surgery were 5 (0-12) and 3 (0-12). Favorable outcome was found in 63.8% (KPS) and 78.7% (NANO Scale). Patients initial functional scales were significantly related to FO. Conclusion Good initial functional scales are 4 to 5 times likely of having a favorable outcome 2 months after surgery.

Introduction The central nervous system (CNS) is the most metabolically active organ characterized by high oxygen demand and relatively low anti-oxidative activity, which makes neurons and glia highly susceptible to damage by reactive oxygen and nitrogen byproducts as well as neurodegeneration. Free radicals are associated with secondary injuries that occur after a primary brain injury. Some of these free radical products include F2-Isoprostane (F2-IsoPs), malondialdehyde (MDA), 4-hydroxy-2-nonenal (4-HNE) and acrolein. Methods In this study we measured serum F2-IsoPs levels as markers of free radical activity in 10–12 week-old male Sprague-Dawley rats weighing 200–300 g, all rats (n = 10) subjected with a head injury according to the modified marmourou model, then divided into 2 groups, one group treated with CAPE (Caffeic Acid Phenethyl Ester) (n = 5) and the other not treated with CAPE (n = 5), serum levels in the two groups were compared starting from day-0 (before brain injury), day-4 and day-7. Results We found lower F2-IsoPs levels in the group that received the CAPE treatment compared to the group that did not receive the CAPE treatment. Conclusion CAPE is capable of significantly reducing oxidative stress in brain injury., Highlights • The central nervous system (CNS) is the most metabolically active organ characterized by high oxygen demand and relatively low anti-oxidative activity. • Free radicals are associated with secondary injuries that occur after a primary brain injury. • Caffeic Acid Phenethyl Ester (CAPE) administration in a rat model with brain injury can reduce the formation of F2-Isoprostane (F2-IsoPs) as an indicator of oxidative stress in blood serum post-trauma.

Introduction Peripheral leukocytes can worsen brain damage due to the release of cytotoxic mediators that interfere the blood brain barrier function. One of the oxidants released by activation leukocyte is hypochlorite acid (HOCl) which is formed through the myeloperoxidase (MPO)-H2O2–Cl- system. The neuroprotective effects of an experimental anti-inflammatory drug Caffeic Acid Phenethyl Ester (CAPE) tested in a Traumatic brain injury (TBI) model using Myeloperoxidase (MPO) analysis. Methods This study compares the acute inflammatory response to TBI over time, as measured by MPO activity. Adult Sprague mice were treated for head trauma with marmarou model. At 24 h before trauma, all animals were blood test (n = 10) to examine MPO, then the animal was divided into 2 groups of injured animals treated with CAPE (n = 5), and those not treated with CAPE (n = 5). We used the MPO test to identify the level of polymorphonuclear leukocytes (PMNL) on day 4 and day 7. Results Showed an increase in PMNL infiltration in CAPE untreated animals, this change significantly (P, Highlights • Peripheral leukocytes can worsen brain damage due to the release of cytotoxic mediators that interfere the blood brain barrier function. • One of the oxidants released by activation leukocyte is HOCl which is formed through the MPO-H2O2–Cl-system. • CAPE administration in mice with traumatic brain injury can inhibit the formation of myeloperoxidase as a marker of accumulated neutrophils. • CAPE can reduce Neutrophil serum levels there by preventing brain damage in TBI.

Introduction: Brain tumor is a neoplasm originating from various type of intracranial tissue. Histopathology is the gold standard to diagnose brain tumor. However, due to its invasive nature, the biopsy procedure poses a substantial risk. Therefore, advanced imaging, such as conventional Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS), has been widely developed to determine brain tumor type. Conventional MRI has been a routine examination for a suspected brain tumor in Indonesia, and with the utilization of MRS, could theoretically improve the diagnostic yield. This study aims to find diagnostic properties of conventional MRI, Choline/Creatine and Choline/NAA ratio extracted from MRS, and as a combined parameter to differentiate brain tumor type.Methods: This cross-sectional study involved 52 patients who underwent conventional MRI, MRS, and histopathology examination for a suspected brain tumor. The cut-off from Dean Criteria of conventional MRI, Choline/Creatine and Choline/NAA ratio to classify tumor type was determined from the ROC curve and then the diagnostic parameters were calculated from cross-tabulation. Also, a novel approach was made with logical-mathematical equation (disjunction/ ˅ / “or” and conjunction/ ˄ / “and”) to combined parameter obtained from MRI and MRS to predict histopathological brain tumor type.Results: Conventional MRI combined with MRS improve diagnostic yield compared to a single parameter with a sensitivity of 87.5%, a specificity of 88.6%, accuracy of 88.5%, PPV of 58.3%, NPV of 97.5%, LR+ of 7.68, dan LR- of 0.1.Conclusion: Combination of conventional MRI and MRS parameter could improve the diagnostic yield in differentiating the type of brain tumor.

Trauma to the extremities is a common major health problem that requires special attention because it can have a dangerous impact on both the viability of the limb and the patient's life. Hyperbaric oxygen therapy is an alternative therapy hypothesized to improve the prognosis in lower extremity trauma.We present a series of 7 cases of lower extremity trauma treated with hyperbaric oxygen therapy: soft tissue loss, neglected chronic burn injury, high-voltage electrical burn, gas gangrene, crush injury, chemical burn, and excoriation with skin loss.Hyperbaric oxygen therapy involves giving 100% oxygen in a chamber at pressures above atmospheric pressure (2-3 atm absolute [ATA]). It can increase oxygen delivery to peripheral tissues with vascular compromise, cytogenic and vasogenic edema, and cellular hypoxia caused by limb trauma.Hyperbaric oxygen therapy has many benefits in lower extremity trauma for wound recovery, preventing complications, and helping patients return to daily activities.

Heterozygote relatives have approximately 80% lifetime colorectal cancer (CRC) risk. mRNA gene expression and Bayesian theorem can calculate CRC’s family risk through the initial pedigree proportion appended with conditional information. The study is the first to report such an application. The present cross-sectional and translational investigation tracked CRC patients’ tissue and blood measurement of adenomatous polyposis coli (APC) and MutS homolog (MSH)2 mRNA quantitative gene expressions, control matching, and ancestral analysis by pedigree and Bayesian theorem. Among 40 CRC patients, mean tissue level and hereditary cutoff of APC are 13,261 (670) fold-change (fc) and 12,195 fc, while 12,219 (756) fc and 11,059 fc for MSH2. A quarter of the CRC patients had a history of familial CRC. Meanwhile, four CRC patients and 10 probands were evaluated for recurrence risk via pedigree, quantitative PCR, and Bayesian analysis. We determined a cutoff point for hereditary mRNA quantitative expression. APC and MSH2 levels in the CRC subjects were significantly lower than controls. The Bayesian analysis builds ways to calculate relative risk in CRC patients’ family members and application in clinical practice.

Neuropathic pain is a major problem to date because of its high prevalence and lack of effective treatment. Neuropathic pain processes can be influenced by many factors and at various levels of the nervous system, including progesterone and the opioid system. The various mechanisms of the effect of progesterone on pain are still controversial, while the effect of progesterone on the activation of the opioid system also needs to be proven. This study aimed to determine the effect of progesterone on pain through the modulation mechanism of the opioid system.This research is a completely randomized experimental study using male wistar rats aged around three months at the Experimental Animal Laboratory, Department of Medical Biochemistry, Faculty of Medicine, Airlangga University.The result was analyzed by using statistical analysis of two independent samples (It was shown that there was a significant difference in the delta (δ) opioid receptor expression between the control group and the progesterone group, which indicated that progesterone causes an increase in the delta (δ) opioid receptor expression in the spinal cord.

The purpose of this study was to analyze the response of inflammatory cytokines interleukin-8 (IL-8) and NF-κB to the closure of skull defect with periosteum as a scaffolding material in bone healing used after surgery.ThirtyHistological examination showed a more well-developed formation of woven bone in the periosteum group. Immunohistochemical examinations showed that the use of periosteum in the closure of skull defects reduced the NF-κB and IL-8 response which affected the ossification process.The experiment showed that the use of periosteum was linked with IL-8 and NF-κB downregulation toward ossification effects at any point throughout the trial. Periosteum usage might be beneficial as a scaffolding material in bone healing for autograft cranioplasty in animal model and could be applied to clinical practice.

How far the role of innate immunity and adaptive immunity do in children who have been BCG vaccinated in controlling the course and the severity of the TB disease has not been completely known. Mycobacterium tuberculosis entry to the body will be recognized by Toll-like receptors found on macrophages, neutrophils, and dendritic cells as part of the innate immune response, after which the dendritic cells will then present the antigen to lymphocyte T0 cells and initiate the adaptive immune response (of which CD4 T cells have an important role in). Was one or were both of these immune responses function well or not in a BCG Vaccinated Children with TB?This study aim to find a better understanding of the role of innate immune response assessed by TLR2/TLR4 mRNA gene expression and serum TLR2/TLR4 levels, while the role of adaptive immune response is assessed by analyzing serum CD4 level in children with TB who have had BCG vaccination.This cross-sectional study was conducted among children with TB at the outpatient and inpatient wards at Bhakti Medicare and Jakarta Islamic Hospital. Expression of mRNA gene was measured using the Boom method and protein serum levels were measured using the ELISA method. The results were analyzed by using the SPSS v.23 program.Sixty-nine children were recruited as subjects. In this study, 68.1% of whom had BCG scars. TLR4 mRNA gene expression was found to be higher than TLR2 mRNA gene expression. Serum CD4 level was found to be highest out of TLR2 and TLR4 level, but serum TLR2 level was higher than TLR4 level. TLR2/TLR4 mRNA gene expression, serum TLR2/TLR4 levels, and CD4 levels in subjects with BCG scar were also found to be significantly higher than in subjects without BCG scar (p 0.001). There was a significant positive correlation between TLR2/TLR4 mRNA gene expression and serum TLR2/TLR4 levels (r = 0.860; r = 0.864; p 0.001) and between serum levels TLR2/TLR4 with serum CD4 levels (r = 0.822; r = 0.832 p 0.001).As early as possible, BCG vaccine administration is needed in endemic countries, but it must be ensured that scars can be formed. It is also important to control Latent TB Infection (LTBI) to prevent transmission and relapse of disease.