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Journal : journal of internal medicine

HUBUNGAN JUMLAH SEL LIMFOSIT T CD8+ PADA ULKUS KAKI DIABETIK DERAJAT 3, 4, 5 DAN ULKUS NON DIABETIK Putu Sutirta Yasa, I Wayan; Sudewa Djelantik, Anak Agung Gde; Suastika, Ketut; Mantik Astawa, Nyoma; Yuatmadja, Ignatius Ferdi
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Diabetes mellitus (DM) is a complex metabolism disorder characterized by a severe chronic hyperglycemia with a largenumber of complications, diabetic foot ulcer (DF) is one of its disastrous progressive complication. It can cause a significantmorbidity if not treated adequately. Diabetic foot ulcer is very difficult to heal as it is generally associated with other co-morbidities,such as vassal complications (peripheral vassal disease) that may cause ischemia sufficient to damage many tissues in thebody. The excess of free radical products induces widespread inflammatory reactions. These conditions may also be exacerbatedby neuropathy and foot injury which directly cause the formation of DF. If the process is followed by infection, the inflammatoryreaction will be more severe. All these events will disrupt the normal immune response to participate in wound healing process.This cross sectional study was performed to determine CD8+ T lymphocyte count in diabetic foot ulcer graded 3, 4, and 5based on Wagner Ulcer Classification System (1989) and to test the hypothesis that CD8+ T cells count in DF grade 3, 4, and 5 islower than non-DM ulcer. As many as 11 patients with DF grade 3, 10 patients with grade 4, 7 patients with grade 5 were includedin this study. Sixteen patients with non-DM ulcer as control group. Red pea-shaped fresh ulcer tissues of lower extremity werecollected from each group for CD8+ T cell lymphocyte count and 2 cc blood were collected from vein for blood glucose examination.The result showed that CD8+ T cell count consistently decreased along with the increase of DF grade. The greatest countwas observed in non-DM ulcer {26/10 field view (10 fv)}, followed respectively by grade 3 (12/10 fv), 4 (8/10 fv), and 5 (6/10fv). Statistical analysis showed the difference in CD8+ T cell count among diabetic foot ulcer groups and foot ulcer non diabeticwas highly significant (p<0.05). The relationship between CD8+ T cell lymphocyte count among groups (Non-DM ulcer, DFgrade 3, 4, 5) based on Spearman Correlation test was 0.84 for CD8+ T cell lymphocyte (r = -0,846, p<0.001).
Co-Authors A. A. G. P. Wiraguna A.A. Wiradewi Lestari A.A.G. Sudewa AAG Budhitresna AAG Putra Ahmad Hamim Sadewa Aida Lousie Tenden Rompis Alberto Agustinho Pereira Da Costa Joao Anak Agung Ayu Mirah Adi Anak Agung Bagus Bramardipa Anak Agung Gede Sudewa Djelantik Anak Agung Keswari Krisnandika Anak Agung Ngurah Subawa Anak Agung Oka Wijaya Anak Agung Sagung Kendran and R. Kusnandi Andika Budi Kurnianto Anwar Santoso Arthawan Arthawan Bayu Setiabudi Berata , I Ketut Chandra Yowani Dewa Ayu Agus Sri Laksmi DWI SURYANTO Dyah Kanya Wati Faiziah - G.A.M.K. Dewi Gusti Ayu Mayani Kristina Dewi Gusti Ayu Yuniati Kencana Gusti Ngurah Narendra Putra Harjana, Ngakan Putu Anom HARTANINGSIH - Hartaningsih . I D. N. Wibawa I Dewa Made Sukrama I Gede Ngurah Harry Wijaya Surya I GEDE PUTU WIRAWAN I Gusti Agung Arta Putra I Gusti Agung Ayu Suartini I Gusti Agung Dewi Sarihati I Gusti Agung Trisna Windiani I Gusti Ayu Putu Eka Pratiwi I Gusti Ketut Suarjana I Gusti Made Krisna Erawan I Gusti Ngurah Kade Mahardika I Gusti Ngurah Sudisma I K. Sukardika I Kadek Swastika I Ketut Berata I Ketut Eli Supartika I Ketut Junitha I Ketut Suada I Ketut Suada I Ketut Suastika I Ketut Suastika I KETUT SUATA I Ketut Suatha I Ketut Suwiyoga I Made Bakta I Made Damriyasa I Made Dwinata I Made Galih Diparayoga I Made Jawi I Made Kardena I Made Subrata I Made Sudarmaja I Made Sukada i Nengah Wandia I Nyoman Agus Bagiada I Nyoman Budi Hartawan I Nyoman Polos I Nyoman Suarsana I Nyoman Suartha I Putu Cahyadi Putra, I Putu Cahyadi I Putu Sudiarta I W. Wita, I W. I Wayan Bebas I Wayan Gorda I Wayan Masa Tenaya I Wayan Megadhana I Wayan Putu Sutirta Yasa I Wayan Suardana I Wayan Wita I.A.P. Apsari I.B.K. Suardana I.H. Utama I.W. Batan Ida Ayu Pasti Apsari Ida Bagus Gede Suparyatha Ida Bagus Kade Suardana Ida Bagus Made Oka Ida Bagus Ngurah Swacita Ida Bagus Oka Winaya Ida Bagus Suardana Ida Bagus Subanada Ignatius Ferdi Yuatmadja Inna Narayani K. Sri Marhaeni Julyasih K. Suata K. Sukardika Kadek Karang Agustina Ketut Budiasa Ketut Santhia Adhy Putra Ketut Suata Ketut Tirtayasa Luh Dewi Anggreni Luh Putu Agustini LUH PUTU AGUSTINI Luh Putu Wrasiati M.D. Rudyanto M.Pd S.T. S.Pd. I Gde Wawan Sudatha . Made Damriyasa, Made Made Oka Ari kamayani, Made Oka Ari Made Wiryana Marissa Divia Dayanti Marson, Fransiska Gratia Sonita Mudinillah, Adam N. T. Suryadhi Ngakan Putu Anom Harjana Ni Luh Putu Eka Diarthini NI LUH PUTU MANIK WIDIYANTI Ni Made Krisna Dewi Ni Made Suaniti NINING HARTANINGSIH Nyoman Agus Bagiada Nyoman Tigeh Suryadi Oka Lely Palagan Senopati Sewoyo Purwitasari, Made Santi Putri, Dilyanti Maya Putri, Rindar Mentari Nusanti Putu Ayu Asri Damayanti Putu Ayu Sisyawati Putriningsih Rasmaya Niruri Rasmaya Niruri S. Soetjiningsih, S. S. Sotjiningsih S.K. Widyastuti sang gede purnama Sewoyo, Palagan Senopati Siti Maryam Soetjiningsih - Soetjiningsih . Sri Kayati Widyastuti Sri Wahjuni SUMARNO Suryadi, Nyoman Tigeh Sutjahjo Suherman, Sutjahjo Suwarno - T. Sari Nindia Tjok Gede Oka Pemayun, Tjok Gede Oka Tjokorda Gde Agung Suwardewa Wayan Tunas Artama Widyasanti, Ni Wayan Helpina Wimpie I Pangkahila Yasunobu Matsumoto Yosevangelika Hutabarat Yoshihiro Hayashi