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CORRELATION PERCENTAGE OF S AND G2/M WITH PERCENTAGE OF LYMPHOBLASTS IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA Erawati Armayani; Yetti Hernaningsih; Endang Retnowati; Suprapto Ma'at Ma'at; I Dewa Gede Ugrasena
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1155

Abstract

Leukemia Limfoblastik Akut (ALL) merupakan keganasan klonal di sumsum tulang/Bone Marrow (BM). Angka bertahan hidup5 tahun saat ini >85%, tetapi 15-20% relaps sehingga perjalanan penyakit jelek. Perjalan penyakit jelek jika setelah tahap induksilimfoblas menetap di Darah Tepi (DT) dan BM >5% serta tahap S BM >6%. Tahap G2/M merupakan petunjuk prognosis ALL anak,selain itu sebagai target pengobatan. Tujuan penelitian menganalisis kenasaban persentase tahap S dan G2/M dengan persentaselimfoblas DT pasien ALL anak sebelum dan sesudah kemoterapi induksi. Jenis penelitian analitik observasional longitudinal (kohor)di ALL anak kasus baru diperiksa sebelum dan sesudah induksi. Persentase limfoblas secara mikroskopis. Persentase fase S dan G2/MflowcytometryBD Facs Callibur. Kenasaban bermakna hanya persentase tahap S dan limfoblas sebelum induksi (r=0,449; p=0,007).Kelainan gen ALL pada ekspresi cyclins dan CDK sehingga hilang kendali checkpoint siklus sel, merangsang transisi tahap G1 menjaditahap S. Persentase tahap S tidak berbeda pada remisi dan meninggal (p=0,138). Persentase tahap G2/M berbeda antara remisi danmeninggal (p=0,006) dan bernasab dengan luaran kemoterapi induksi (koefisien Eta= 0,744), G2/M ≥1,26% meramalkan remisi.Terdapat kenasaban antara persentase siklus sel tahap S dengan persentase limfobas sebelum kemoterapi induksi. Persentase siklus seltahap S memberikan gambaran siklus sel pada sel limfoblas. Terdapat kenasaban antara persentase siklus sel tahap G2/M dengan luarankemoterapi induksi tahap G2/M menjadi faktor peramal luaran kemoterapi induksi ALL. Perlu penelitian lanjutan dengan sampel BM,subtipe dan pengamatan semua tahap kemoterapi.
SINDROMA CUSHING PADA KEHAMILAN Yetti Hernaningsih; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 12, No 1 (2005)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v12i1.837

Abstract

A 32 years old woman, pregnant 24-25 weeks, was admitted to the hospital with complaints of weakness, 6 years amenorrhoe, bruises on the skin and hair loss. Physical examination showed full moon face, buffalo hump, striae lividae, and echymosis. She was diagnosed as Cushing Syndrome with possible etiology adrenal tumor based on laboratory results: glucose intolerance, hypokalemia, increament of plasma cortisol before and after dexamethason supression tests (1352 and 1297 nmol/l), also decreement of plasma ACTH (5 pg/ml). During 22 days hospitalization, the patient’s condition became worse (heart failure, sepsis and shock).
IMMATURE PLATELET FRACTION (IPF) DAN TROMBOPOIETIN DI SIROSIS HATI Esti Rohani; Yetti Hernaningsih; Suprapto Ma’at; Ummi Maimunah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i2.1066

Abstract

Liver cirrhosis remains a major clinical problem worldwide when associated with significant morbidity and mortality due toits complications. The presence of liver cirrhosis state affects the production of TPO influencing the process of thrombopoiesis. Thethrombopoiesis activity can be described by the Immature Platelet Fraction (IPF) value which is young platelets. The immature Plateletfraction value increases when platelet production enhances as well, on the contrary when the production declines, the IPF value is alsodecreased. This study was performed by cross-sectional method using 31 subject samples suffering from liver cirrhosis, consisting of ChildPugh score class A 2 samples (6.4%), Child Pugh score class B 9 samples (29%) and Child Pugh score class C 20 samples (64.6%). Theexamination of TPO levels was done by ELISA method using Humans TPO QuantikineR, the IPF value was examined using Sysmex XE-2100 Hematology Analyzer. The thrombopoietin serum levels in the samples ranged from 23.5 to 96.6 pg/mL with a mean of 45.1pg/mL.The immature Platelet Fraction values varied from 1.7% to 19.1% with a mean of 6.7%. From the statistical analysis, the levels of TPO andIPF at various degrees of the disease severity were not significantly different. There was no significant correlation between the TPO leveland IPF value, r = 0.038, p = 0.837. There was no significant difference between the TPO level and the IPF value in the splenomegaly andnonsplenomegaly state. In conclusion, based on this study no significant correlation was found between the IPF value with thrombopoietinserum levels, as well as the IPF and thrombopoietin levels, and there was no association with the disease severity.
CORRELATION OF BLAST PERCENTAGE TO CD34 OF BONE MARROW IN ALL PEDIATRIC PATIENTS Rahmi Rusanti; Yetti Hernaningsih; Endang Retnowati; Mia Ratwita Andarsini; Andy Cahyadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1156

Abstract

Leukemia Limfoblastik Akut (LLA) adalah penyakit keganasan sel progenitor limfoid yang berasal dari sumsum tulang. Tanda khasdari diagnosis leukemia akut adalah sel blas. Pemeriksaan mikroskopis dilakukan untuk menentukan persentase sel blas pada diagnosisleukemia akut. Immunophenotyping merupakan metode diagnostik yang dapat membantu menegakkan diagnosis pada keganasanhematologi. CD34 merupakan antigen yang sering digunakan untuk identifikasi sel induk hemopoeisis atau blas. Penelitian ini bertujuanuntuk mengetahui kenasaban antara persentase blas dengan ekspresi CD34 di sumsum tulang di pasien leukemia limfoblastik akut anaksebelum dan sesudah pengobatan kemoterapi fase induksi.
COMPARISON OF PERIPHERAL BLOOD ACTIVATED NK CELL PERCENTAGE BEFORE AND AFTER INDUCTION PHASE CHEMOTHERAPY IN PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA Syntia TJ; Endang Retnowati; Yetti Hernaningsih; I Dewa Gede Ugrasena; Soeprapto Ma’at
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1208

Abstract

Leukemia Limfoblastik Akut (LLA) adalah keganasan sel progenitor limfoid yang berasal dari sumsum tulang dan ditandai proliferasileukosit. Kejadian LLA masih tinggi, sehingga perlu diteliti peran sel NK dalam melawan leukemia. Tujuan penelitian adalah untukmengetahui perbedaan persentase sel NK teraktivasi sebelum dan sesudah pengobatan induksi dan hubungan persentase sel NK teraktivasisebelum pengobatan induksi dengan keluaran kemoterapi pasien LLA anak. Penelitian analitik observasional dengan rancang banguncohort prospektif. Subjek penelitian 27 pasien di Ruang Rawat Inap Hemato-Onkologi Anak RSUD Dr. Soetomo Surabaya, antara bulanMaret–Juli 2016. Metode memeriksa flowcytometry menggunakan alat BD FACS CaliburTM reagen Fast Immune CD56FITC/CD69PE/CD45 Per CP No.katalog.5055879. Analisis statistik dengan uji Wilcoxon Signed Rank dan regresi logistik. Terdapat perbedaan bermaknarerata persentase sel NK teraktivasi sebelum pengobatan induksi 0,57% (SB 0,53%) dan sesudahnya 2,01% (SB 1,86%) p=0,000.Menunjukkan peningkatan bermakna sel NK teraktivasi sesudah pengobatan induksi. Kenasaban sel NK teraktivasi sebelum pengobataninduksi dengan keluaran kemoterapi berkurangnya gejala penyakit (remisi) dan meninggal R=0.723 berarti kenasabannya kuat.Peningkatan persentase sel NK teraktivasi sesudah pengobatan induksi disebabkan kerja kemoterapi meningkatkan hasil MICA/B dankerja activating receptors sel NK (NKG2D) yang bersifat sitotoksik yang kuat. Persentase sel NK teraktivasi sebelum pengobatan induksiyang rendah disebabkan mekanisme menghilangnya tumor di LLA. Terdapat perbedaan bermakna persentase sel NK teraktivasi sebelumdan sesudah pengobatan induksi. Hasilnya dapat menjadi peramal keberhasilan pemberian kemoterapi LLA anak. Persentase sel NKteraktivasi sebelum kemoterapi tahap induksi yang tinggi berpengaruh kuat terhadap keluaran kemoterapi berkurangnya gejala penyakitdan sebaliknya bila rendah berpengaruh terhadap kemungkinan yang bersangkutan meninggal. Diperlukan hasil jangka panjang sampaiselesai dalam pengelolaan pemberian pengobatan terkait.
COMPARISON OF FACTOR VIII ACTIVITY IN O AND NON-O BLOOD TYPES Adil Dinata Simangunsong; Yetti Hernaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1197

Abstract

Golongan darah ABO telah dinilai untuk terjadinya berbagai proses penyakit. Penelitian terdahulu menyatakan tingginyakejadian trombosis pada golongan darah non O disebabkan tingginya aktivitas faktor VIII dibandingkan golongan darah O. Metodepenelitian merupakan analitik observasional secara potong lintang. Sampel darah sitrat dengan nilai APTT dan PTT normal tanpamempertimbangkan usia, jenis kelamin dan diagnosis. Aktivitas factor VIII diperiksa menggunakan sysmex CS 2100i. Analisis statistikmengunakan one way Anova untuk golongan darah A, B, O dan uji sampel T independen untuk golongan darah O dan non-O. Darikeseluruhan 30 sampel didapatkan 15 sampel golongan darah non-O dan 15 sampel golongan darah O. Pada golongan darah non-Odidapatkan 8 sampel golongan darah A dan 7 sampel golongan darah B. Terdapat perbedaan aktivitas faktor VIII yang tidak bermaknaantara golongan darah non-O dan O (p=0,277). Pada golongan darah A, B, O, juga didapatkan perbedaan yang tidak bermakna(p=0,108). Aktivitas faktor VIII pada golongan darah non-O lebih tinggi dibandingkan golongan darah O, tetapi tidak didapatkanperbedaan bermakna. Pada golongan darah A,B,O juga tidak didapatkan perbedaan bermakna. Mekanisme yang mendasari hubunganantara golongan darah ABO dengan aktivitas faktor VIII sampai sekarang belum diketahui. Tidak didapatkan perbedaan bermaknaaktivitas faktor VIII antara golongan darah O dan non-O. Diperlukan penelitian dengan jumlah sampel yang lebih banyak dan mengikutsertakan golongan darah AB.
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome Endah Indriastuti; Yetti Hernaningsih; Yulia Nadar Indrasari; Andrianto Andrianto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1609

Abstract

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation MyocardialInfarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature PlateletFraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean PlateletVolume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF andplatelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted inDr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients.The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF andplatelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPFvalues were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients werehigher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. TheMPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differencesbetween STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarctionpatients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using thisparameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarctionpatients than UA patients, which also allowed them to use those parameters to differentiate both conditions.
Cut-Off Value of Procalcitonin in Sepsis and Septic Shock patients at Dr. Soetomo Hospital Shinta Lungit Ambaringrum; Yetti Hernaningsih; Edward Kusuma; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1827

Abstract

Sepsis is a state of life-threatening organ dysfunction caused by dysregulation of the body's response to infection. Organ dysfunction is marked by an increase in SOFA score ≥ 2 or qSOFA score ≥ 2. Septic shock is a subset of sepsis with fairly severe circulatory disorders that can significantly increase mortality. Although the current gold standard diagnosis method for sepsis is bacterial culture, some researchers believe PCT can help identify sepsis severity because bacterial culture requires a relatively long time. This study aims to determine the cut-off point of procalcitonin in patients with sepsis and septic shock. The data taken were secondary data from the medical records of sepsis and septic shock patients in Dr. Soetomo General Hospital from 2017 to 2019. Determination of cut-off PCT for sepsis and septic shock using Receiver Operating Characteristic (ROC) analysis curve. Most sepsis patients were young (18 - 65 years) (69%) (p = 0.331) and male (60%) (p = 0.156). The majority of the clinical sepsis patients have focal infections of the respiratory system (55.17%). Patients with respiratory tract infections who develop sepsis have an OR of 6.182, which means it is six times more likely to develop septic shock. There was a significant difference between septic and non-septic PCT levels (p = 0.000), and there was a positive correlation between PCT and sepsis. The cut-off of procalcitonin in sepsis was 0.6 ng/mL, and the cut-off of procalcitonin in septic shock was 10 ng/mL.
Laboratory Examination in Hemophagocytic Lymphohistiocytosis Wulyansari Wulyansari; Yetti Hernaningsih
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.v28i1.1881

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is derived from the word hemophagocytosis, in which macrophagesinfiltrate tissue extensively, and unspecifically phagocyte blood and bone marrow cells. The deviant activation of cytotoxicCD8+ T-cells causing the release of inflammatory cytokines is the core pathogenesis of HLH. Hemophagocyticlymphohistiocytosis is a regulatory disorder of the immune system, with clinical signs and symptoms of extremeinflammation and cytopenia, hepatitis, and severe and life-threatening central nervous system dysfunction. The name of theHLH disorder was recently proposed to be "Hyperinflammatory Lymphohistiocytosis" (also known as HLH). Enforcement ofHLH diagnosis by the Histiocyte Society based on HLH 2004 updated diagnostic criteria consists of five of the following eightdiagnostic criteria: fever, splenomegaly, cytopenia (two or more of three lineages in peripheral blood), hypertriglyceridemiaor hypofibrinogenemia, hyperferritinemia, hemophagocytes in the bone marrow/lien/lymph, the low or non-existentactivity of Natural Killer (NK) cells, increased sCD25. H-score, MH-score, and systemic Juvenile Idiopathic Arthritis(sJIA)/Macrophage Activated Syndrome (MAS) classification criteria are also used to enforce HLH diagnoses.Hemophagocytic lymphohistiocytosis is challenging to recognize and has a high mortality rate, especially in adults, rangingfrom 42 to 88%. Therefore, immediate diagnosis and therapy are essential. The introduction of HLH triggers is criticalbecause treatment is based on the underlying trigger. Cytokine storms due to Coronavirus Disease 19 (COVID-19) infectionhave significant similarities to the clinical and laboratory findings of HLH. Secondary HLH (sHLH) is suspected in severeCOVID-19 patients, so early diagnosis is potentially made based on the H-score.
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

Abstract

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 ≥2 L in HD CKD patients.
Co-Authors -, Regina Rania Cahya Kusumaningrum Adil Dinata Simangunsong Agil Saputra Alfino Validita Sidiq Ali Hasan, Zulfikar Alifadiningrat, Dianira Hanum Febia Almira, Naufalia Ghina Alpha Fardah Athiyyah Amalia, Yustisia Anang Endaryanto Andi Cahyadi Andrianto Andy Cahyadi Aprianto, Koko Ardhi, Mohammad Saiful Arifa Mustika Arifa Mustika Arifoel Hajat Armayani, Erawati Aryati Aryati Aulia, Fauqa Arinil Awalia Awaliah Baiq Nasha Islaeli Bintoro, Siprianus Ugroseno Yudho Budi Utomo Chelssi Gloria Tessari Cita Rosita Sigit Prakoeswa Citra Amaniah Anhar Danny Meganingdyah Primartati Deasy Fetarayani Desty Indah Sari Dwiyanti Puspitasari, Dwiyanti DYAH FAUZIAH, DYAH Elvan Dwi Widyadi Elvan Dwi Widyadi Endang Retnowati Endang Retnowati Endang Retnowati Erawati Armayani Esti Rohani Farida Nur’Aini Fauqa Arinil Aulia Fita Triastuti Gatot Soegiarto Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Hans Kristian Nugraha, Hans Kristian Hartono Kahar, Hartono Hasan, Helmia Heny Arwati I Dewa Gede Ugrasena Indrasari, Yulia Indriastuti, Endah INGRID SURYANTI SURONO Ire Puspa Wardhani Jusak Nugraha Juwita, Syntia Tanu Kezia Warokka Putri Koko Aprianto Kusuma, Edward Putra Kusumaningrum, Regina Rania Cahya Lazuwardi, Rasya Azka Lefi, Achmad Meiti Muljanti, Meiti Mia Ratwita A Mia Ratwita Andarsini Mochammad Reza Desianto MOCHAMMAD THAHA Muhlisa, Nurul Musholli Himmatun Nabilah Nadya Rinda Eka Rana Narazah Mohd Yusoff Nastasya Nunki Nathalya Dwi Kartikasari Ni Made Rindra Hermawathi Notopuro, Paulus Budiono Novi Ersanto Nugraha, Hans K Nunki, Nastasya Nur‘ Aini, Farida Prasetiyanti, Rinta Puspa Wardhani Puspa Wardhani, Soebagijo Adi Puspitasari, Yessy Putri Rahayu Rahmi Rusanti Rahmi Rusanti, Rahmi RINI RINI Rinta Prasetiyanti Romadhon, Pradana Zaky Rusli, Musofa Ryzky Widi Atmaja Ryzky Widi Atmaja S.Pd. M Kes I Ketut Sudiana . Sellynastiti, Sarah Triwinar Shinta Lungit Ambaringrum Sidarti Soehita Siti Khaerunnisa Soeprapto Ma’at Sri Ratna Dwiningsih Suprapto Ma'at Ma'at Suprapto Ma’at Syntia TJ Tanzilia, May Fanny Teguh Satrio Thengkano, Irwanto Ugroseno Ugroseno Uli Mas'uliyah Indarwati Ummi Maimunah Veithzal Rivai Zainal Wardhani, Puspa Widaninggar Rahma Putri Widodo Widodo Widodo Widodo Widodo Widodo Widodo Widodo Wulyansari Wulyansari Yanuari Primariawan, Relly Yosua Butar Butar Yulia Nadar Indrasari Yusuf, Moch Zaky Firmawan El-Hakim