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Determining Acute Leukemia Lineage Using Mie Map Red Blood Cell Nelly Zuroidah; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1747

The determination of myeloid and lymphoid lineage is essential for the diagnosis and therapy of acute leukemia. Immunophenotyping is the gold standard to determine the lineage of acute leukemia, but it is still constrained and relatively expensive. Mie Map RBC in the ADVIA 2120i is a parameter that can give additional information about myeloid and lymphoid lineage but has never been studied before. It is expected that Mie Map RBC can be used to differentiate the lineage of acute myeloid and lymphoid leukemia if immunophenotyping is not present. This study aimed to analyze the diagnostic value of Mie Map RBC with ADVIA 2120i towards immunophenotyping in determining myeloid and lymphoid lineage in acute leukemia. Child and adult patients diagnosed with acute leukemia (n=30) that had peripheral blood smear and bone marrow aspiration with blasts > 20% were examined using ADVIA 2120i. The Mie Map RBC lineage results were compared to the lineage of immunophenotyping. The sensitivity and specificity of the Mie Map RBC myeloid series are respectively 60.00%, 93.33%. The sensitivity and specificity of the Mie Map RBC lymphoid series are respectively 93.33% and 60.00%. The diagnostic accuracy value of Mie Map RBC is 76.67%. The determination of acute leukemia myeloid series lineage has high specificity. If there is no population outside the matrix of Mie Map RBC, it highly suggests myeloid series. On the other hand, the determination of acute leukemia lymphoid series lineage has a relatively low specificity meaning that the population outside the matrix of Mie Map RBC does not always suggest a lymphoid lineage

Thymoquinone Modulates Local MMP-9, IL-10, and IgG in Sciatic Nerve Crush Injury Animal Model Valentinus Besin; Abdul Hafid Bajamal; I Ketut Sudiana; Mangestuti Agil; Jusak Nugraha; Mohammad Hasan Machfoed; Paulus Budiono Notopuro; Naesilla Naesilla
The Indonesian Biomedical Journal Vol 14, No 3 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i3.2011

BACKGROUND: Interleukin (IL)-10 is involved in Wallerian degeneration after peripheral nerve crush injury. Oral thymoquinone was previously observed to decrease local immunoglobulin-G (IgG) in a crush-injured rat model. No study has evaluated the pathway of various thymoquinone dosages on local IgG and IL-10 in this injury.METHODS: This experimental study used 126 Rattus norvegicus Wistar rats that were divided into 18 groups: six groups received a placebo, the other six groups received thymoquinone at 100 mg/kg/day and the last six groups received thymoquinone at 250 mg/kg/day, respectively. Rats were sacrificed at 12, 18, 24, 5x24, 6x24, and 7x24 hours. Matrix metalloproteinase-9 (MMP-9), IL-10, and local IgG levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA). The nuclear factor KappaB (NF-κB) expressions on Schwann cells were examined by flow cytometry. Path analysis was performed using SmartPLS.RESULTS: The path analysis showed that 100mg/kg/day of thymoquinone significantly decreased NF-κB expression. However, NF-κB did not affect local MMP-9, and MMP-9 had no significant relationship with local IL-10 and IgG. Thymoquinone 250 mg/kg/day also significantly inhibited NF-kB expression, decreased local MMP-9, and, in turn, decreased local IL-10 and IgG.CONCLUSION: Administration of oral thymoquinone 250 mg/kg/day decreases local IgG and IL-10 levels via suppressing NF-κB expression and MMP-9 levels.KEYWORDS: thymoquinone, crush injury, IgG, IL-10, MMP-9, NF-κB

THE CORRELATION OF PROCALCITONIN AND MYELOPEROXIDASE INDEX LEVELS IN SEPSIS PATIENTS Sri Rejeki Wulandari; Betty Agustina Tambunan; Paulus Budiono Notopuro; Hardiono Hardiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1451

Sepsis masih menjadi masalah utama di dunia. Europan Society of Intensive Care Medicine (ESICM) dan Society of Critical Care Medicine (SCCM) mengikutsertakan quick Sequential Organ Failure Asssessment (qSOFA) untuk mendiagnosis sepsis. Diperlukan pemeriksaan laboratorium akurat dan cepat selain kultur. Prokalsitonin sebagai penanda spesifik infeksi bakteri. Myeloperoxidase index (MPXI) parameter baru untuk membantu diagnosis sepsis. Penelitian ini bertujuan menganalisis korelasi kadar prokalsitonin dengan MPXI pada pasien sepsis. Jenis penelitian cross sectional observasional. Pengambilan sampel Desember 2017 – Februari 2018. Subjek penelitian terdiri dari 71 pasien sepsis yang dirawat di Ruang Resusitasi, Ruang Observasi Intensif, dan ruang Intensive Care Unit (ICU) RSUD Dr. Soetomo Surabaya berdasarkan kriteria qSOFA dan SIRS. Pemeriksaan prokalsitonin dengan metode CLIA (ADVIA Centaur XP), MPXI dengan metode flowcytometry (ADVIA 2120i) dan kultur menggunakan alat PhoenixTM 100. Kadar prokalsitonin 0,01 ng/mL – 265,16 ng/mL (rerata 16,13 ± 40,91 ng/mL). Nilai MPXI -25,5 – 4,6 (rerata -7,939 ± 4,903). Tidak terdapat korelasi antara kadar prokalsitonin dengan MPXI ( p = 0,604 dan r = - 0,063). Tidak terdapat korelasi kadar prokalsitonin dengan MPXI pada hasil kultur positif (p = 0,675, r = 0,072) dan negatif (p = 0,401, r = - 0,147). Kadar prokalsitonin tidak berkolerasi dengan MPXI pada pasien sepsis

Diagnostic Value of Myeloperoxidase Index in Bacterial Infections Mirna Rahmafindari; Paulus Budiono Notopuro; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1557

Infectious diseases remain a serious problem in Indonesia. Myeloperoxidase (MPO) is a substance released by neutrophils, which activates the synthesis of hypochlorous acid (HOCL) from hydrogen peroxide (H2O2) and chloride ion (Cl-). Hypochlorous acid plays a vital role in the body's defense against infection. Myeloperoxidase Index (MPXI) is a parameter in the hematology analyzer Advia 2120i based on the principle of flow cytometry. This study aimed to determine the diagnostic value of MPXI in patients with bacterial infections. The study was a cross-sectional observational analysis. The samples consisted of a group of patients with bacterial infection and a group of healthy subjects. The specimens used in this study were whole blood + anticoagulant (EDTA) in a purple tube with a volume of 3 mL to determine the MPXI value in both groups using ADVIA 2120i hematology analyzer. The study subjects consisted of a group of patients with bacterial infections (69 patients) and a group of healthy subjects (33 people). Analysis of the MPXI ROC curve with a cut-off â‰¥ -5.8 and < -5.8, showed AUC of 0.323 (CI=95%, p=0.004), sensitivity of 34.8%, specificity of 39.4%, Positive Predictive Value (PPV) of 54.5%, and Negative Predictive Value (NPV) of 22.4%. Due to its low diagnostic value, the MPXI value was not recommended to be used as a diagnostic instrument for bacterial infections. Also, further research was highly needed.

Hemoglobin, Hematocrit, Leukocyte, and Platelet Changes Due To Ultrafiltrationhemodialysis in Chronic Kidney Disease Patients Nathalya Dwi Kartikasari; Paulus Budiono Notopuro; Widodo Widodo; Yetti Hernaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1565

Managing anemia in Chronic Kidney Disease (CKD) patients with hemodialysis (HD) is a challenge to physicians. The present consensus does not address the proper time of blood sampling in HD patients, but higher ultrafiltration (UF) volume (a process of removing fluid excess during HD) may alter hematologic parameters. The objective of this study was to compare some parameters of the Complete Blood Count (CBC); hemoglobin (Hb), hematocrit (Hct), leukocyte (WBC), and platelet counts (Plt) before and after HD. This method was a cross-sectional study performed in the HD Unit, Dr.Soetomo Hospital, including 51 CKD patients selected consecutively, divided into two groups based on the UF volume (2 L and >2 L). Complete blood count pre- and post-HD were measured using Sysmex XN 1000. The results were 25 males and 26 females in this study, age ranged from 20 to 74-year-old, and 36 patients with UF volume >2 L. Only HD with UF >2 L showed significant increases for Hb (9.35g/dL to 10.00 g/dL), Hct (29.80% to 31.15 %), and Plt (209.00x103/µL to 213.00x103/µL) but WBC did not change significantly. These changes were believed to be caused by ultrafiltration. The conclusion was Hb, Hct, and Plt increased significantly with UF â‰¥2 L in HD CKD patients.

Pancytopenia and Progressive Splenomegaly in Patient with Disseminated Histoplasmosis Paulus Budiono Notopuro; Arifoel Hajat; Made Putra Sedana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1621

Disseminated histoplasmosis is a severe manifestation of fungal infection caused by Histoplasma capsulatum. It usually occurs in a patient with an immunodeficiency state. With the increase of HIV infection and the use of immunosuppressant drugs lately, its prevalence also increases. A case of 43 years old female with prolonged fever, pancytopenia, and massive progressive splenomegaly. The diagnosis of disseminated histoplasmosis and the secondary hemophagocytic syndrome was made based on bone marrow examination that showed increased hemophagocytic processes and multipleintracytoplasmic H.capsulatum. She had been treated with Itraconazole 200 mg for three months. In the first month's evaluation, her complete blood count improved without any transfusions, and the size of her spleen size decreased. She had been fully recovered after the completion of 3-month treatment.

Difference Expressions CD34 in Acute Myeloid Leukemia Cell Culture in the Administration of Cytarabine-Daunorubicine Dose Standards Muhammad Saiful Rahman; Paulus Budiono Notopuro; Suprapto Ma'at; Made Putra Sedana; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1623

The cure rate for patients with Acute Myeloid Leukemia (AML) is 20-75%. Standard-dose cytarabine + (SDAC)-daunorubicine gives a remission rate of ± 60%, and the case of relapse is frequently found. In-vivo CD34 expression is a reliable and straightforward test that must evaluate AML patients' response to predict the response of chemotherapy + induction phase accurately. Differences in in-vitro CD34 expression are expected to be able to predict chemosensitivity in AML patients. An experimental post-test-only control group study was conducted from May to December 2019, and 8 AML subjects were found. Peripheral Blood Mononuclear Cells (PBMC) were isolated from peripheral blood samples of patients with AML collected in EDTA tubes. The PBMC isolated from peripheral blood were divided into two groups, and each group contained 106 PBMC cells in culture media. The control group (without treatment) and the SDAC-daunorubicine group were 0 + incubated for 4 hours at 37 C with a 5% CO2 atmosphere. The expression of CD34 was measured using FACSCaliburâ„¢, while + CD34+ percentage was calculated with CellQuestâ„¢ software. The percentage of CD34 in the control, SDAC + DNR, showed a significant difference with p < 0.001. This study showed a significant difference between the control group and the group + administered with the standard dose of cytarabine-daunorubicine with p < 0.001. The average CD34 expression in the + SDAC-DNR treatment group was higher than in the control group. CD34 markers cannot be used as predictors of chemosensitivity in the administration of chemotherapy.

Determining Acute Leukemia Lineage Using Mie Map Red Blood Cell Nelly Zuroidah; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1747

The determination of myeloid and lymphoid lineage is essential for the diagnosis and therapy of acute leukemia. Immunophenotyping is the gold standard to determine the lineage of acute leukemia, but it is still constrained and relatively expensive. Mie Map RBC in the ADVIA 2120i is a parameter that can give additional information about myeloid and lymphoid lineage but has never been studied before. It is expected that Mie Map RBC can be used to differentiate the lineage of acute myeloid and lymphoid leukemia if immunophenotyping is not present. This study aimed to analyze the diagnostic value of Mie Map RBC with ADVIA 2120i towards immunophenotyping in determining myeloid and lymphoid lineage in acute leukemia. Child and adult patients diagnosed with acute leukemia (n=30) that had peripheral blood smear and bone marrow aspiration with blasts > 20% were examined using ADVIA 2120i. The Mie Map RBC lineage results were compared to the lineage of immunophenotyping. The sensitivity and specificity of the Mie Map RBC myeloid series are respectively 60.00%, 93.33%. The sensitivity and specificity of the Mie Map RBC lymphoid series are respectively 93.33% and 60.00%. The diagnostic accuracy value of Mie Map RBC is 76.67%. The determination of acute leukemia myeloid series lineage has high specificity. If there is no population outside the matrix of Mie Map RBC, it highly suggests myeloid series. On the other hand, the determination of acute leukemia lymphoid series lineage has a relatively low specificity meaning that the population outside the matrix of Mie Map RBC does not always suggest a lymphoid lineage

RAPID PROGRESSION OF CLAVICULAR SOLITARY PLASMACYTOMA TO MULTIPLE MYELOMA Hantoro Gunawan; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1398

Solitary plasmacytoma is a monoclonal plasma cell malignancy restricted to one tumor. Fifty percent of cases can progress to Multiple Myeloma (MM). The median time to progression is 19 months. A case about plasmacytoma advancing rapidly to MM within two months from the initial diagnosis is described. A 45-year-old male attended the Surgery Outpatient Clinic with a chief complaint of progressive swelling on the left neck for two months. Physical examination revealed a fixed, solid, 8x8 cm mass on the left supraclavicular. Fine Needle Aspiration Biopsy (FNAB) showed plasmacytoma. Surgical biopsy and immunohistochemistry confirmed the diagnosis of plasmacytoma. Ki67 index was 80%. There was no abnormality in the laboratory examination. Two months later he was admitted to the Internal Ward with anemia and kidney disorder. Serum protein electrophoresis revealed an M-spike. Bone Marrow Aspiration (BMA) showed plasma cell proliferation of 78%, which confirmed the diagnosis of MM. Solitary plasmacytoma can occur on any bone, mostly on axial bones. Solitary plasmacytoma on the clavicle is very rare, with a prevalence of 0.45% of all primary bone tumors. Diagnosis of solitary plasmacytoma relies on tissue biopsy, laboratory, radiology and bone marrow aspiration. Progression of plasmacytoma to MM can be detected from CBC and clinical chemistry results. Serum protein electrophoresis and bone marrow aspiration results confirmed the diagnosis of MM. The high proliferation index (Ki67>8%) and tumor size (>5cm) were the risk factors for the rapid progression of plasmacytoma. Early detection of systemic symptoms is critical in the management of solitary plasmacytoma.

The Difference in Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Lactate Levels Between Sepsis and Septic Shock Patients Who Died in The ICU Dwi Rachmawati; Arie Utariani; Paulus Budiono Notopuro; Bambang Pujo Semedi
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I22023.64-71

Introduction: Sepsis and septic shock are organ dysfunctions caused by the dysregulation of the body's response to infection and are the most common causes of death. Objective: This study aims to describe the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lactate levels in patients with sepsis and septic shock who died in the Intensive Care Unit (ICU). Methods: An observational retrospective study was conducted by examining the medical record data of sepsis and sepsis shock patients who were hospitalized in the ICU of Dr. Soetomo General Academic Hospital Surabaya from January to December 2019. Results: The study sample was 28 patients: 16 with sepsis and 12 with septic shock. Fifteen patients (53.6%) were women. The patients' mean age was 53.18 ± 13.61 years, and most patients (8 patients, 28.6%) belonged to the late adult age group (36-45 years). The most common comorbidities were diabetes mellitus and hypertension (30.8%). The highest incidence of infection in both groups occurred in the lungs (42.9%). Most of the patients had high SOFA scores, in the moderate (7-9) to severe (â‰¥ 10) category (39.3%). Almost all patients (82.1%) were treated for less than one week. The hematological examination within the first 24 hours showed a leukocyte value of 16,995 (Leukocytosis) and a platelet value of 279,500 (Normal). The NLR of septic shock patients (31.38±55.61) was higher than the NLR of sepsis patients (23.75±22.87). The PLR of septic shock patients (534.02±1000.67) was lower than the PLR of patients (802.93±1509.89). Lastly, the lactate levels in septic shock patients (3.84±1.99) were higher than in sepsis patients (1.97±1.06). Conclusion: There were no significant differences in the NLR and PLR values "‹"‹between sepsis and septic shock patients, but there were significant differences in their initial lactate levels.

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