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THE HIGH PLASMA RETINOL BINDING PROTEIN 4 LEVEL AS A RISK FACTOR CONSEQUENTLY OF TYPE 2 DIABETES MELLITUS OF ABDOMINAL OBESITY Budhitresna, AAG; Suastika, Ketut; Mantik Astawa, Nyoman; Santoso, Anwar
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 5, No. 1 Januari 2011
Publisher : Udayana University

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Abstract

Abdominal obesity (Ab-Ob) related to cardiometabolic risk, that is riskfactor constellation for succeeded cardiovasculer disease and type 2 DiabetesMellitus (DM). That factors such as atherogenic dislipidemia, hypertension,hyperglycemia, protrombotic state, and proinflammation state. Type 2 DMcharacterised by insulin resistance (IR). Plasma levels of retinol binding protein 4(RBP4) that is secreted by adipocytes are increased in insulin resistance (IR) state.Experiment in mice suggest that elevated RBP4 level cause IR. Although theunderlying mechanism is not clearly understood, RBP4 considered playimportance role consequently of type 2 DM in Ab-Ob.This research was carried out to determine the role of high plasma RBP4level as a risk factor consequently of type 2 DM in Ab-Ob. The research wasconducted by cross sectional analytic in 81 patients with Ab-Ob and case controlstudy with matching on 33 patients with Ab-Ob type 2 DM as cases and 33patients with Ab-Ob non type 2 DM as control. The plasma of TNF-?, sTNFR1,and RBP4 levels was measured by ELISA. IR status of the patients wasdetermined by HOMA-IR, whereas the ?-cell function was determined byHOMA-B. Ab-Ob was defined by using criteria for Asian peoples (male WC ? 90cm; female WC ? 80 cm). The result of 81 patients with Ab-Ob showed that bothplasma of TNF-? and sTNFR1 levels were significant positive correlated withplasma RBP4 level (coeficient correlation r = 0,294; p = 0,008 dan r = 0,458; p =<0,001 respectively). In addition, the plasma of RBP4 level significantly positivecorrelation with HOMA-IR (r = 0,450; p = 0,000) and significantly negativecorrelation with HOMA-B (r = -0,564; p = <0,001). In the matched case-controlstudy, it was shown that mean plasma of RBP4 level of type 2 DM group (76,08 ±16,84 ?g/ml) statistically higher than that without type 2 DM group (41,13 ±14,75 ?g/ml) (p = <0,001). The odds ratio higher plasma of RBP4 level was 5,426(CI 95%; 1,343 – 21, 928) statistically significant for increases risk type 2 DM (p= < 0,05). It has been proven that RBP4 was a dominant and consisten risk factor(66.9%, p = < 0.001) which influenced the incidence of type 2 DM in Ab-Ob. It can be concluded that high plasma of RBP4 level have a greater risk tosuffered from type 2 DM compared to low plasma of RBP4 in Ab-Ob. The highplasma of RBP4 level is most dominant and consistent risk factor consequently oftype 2 DM. These mechanism could behind the association between high plasmaof RBP4 level and type 2 DM.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

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Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
HIGH PLASMA TNF-? LEVELS AND MONONUCLEAR CELLS iNOS AND TNF-? EXPRESSION AS RISK FACTORS FOR PAINFUL DIABETIC NEUROPATHY Eko Purwata, Thomas; Suastika, Ketut; Raka Sudewi, A. A.; Widjaja, Djoenaidi
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 2 Juli 2010
Publisher : Udayana University

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Abstract

Painful Diabetic Neuropathy (PDN) is one of the most common and annoyingcomplications of diabetes mellitus. The pathogenesis of PDN is complex and still unclear.Recently it has become clear that nitric oxide (NO) and proinflammatory cytokines playan important role in the pathogenesis and maintenance of pain in PDN. Based on thisphenomenon, this study was conducted to investigate whether the cytokine tumornecrosis factor-alpha (TNF-?) and NO, in this case inducible Nitric Oxide Synthase(iNOS), play a role in PDN pathogenesis.The study was carried in two steps. The first step was a cross sectional and thesecond step was a case-control study. The study was performed in 110 type-2 diabeticpatients. The plasma TNF-? levels were determined by ELISA while the expression ofTNF-? and iNOS in mononuclear cells were analyzed immunohistochemically.Of 110 subjects, 59 patients suffered from Painful DN (case) and the remaining51 patients were Painless DN (control). Cross sectionally, plasma TNF-? levels andimmunoreactivity for iNOS and TNF-? were higher in patients with more severe pain inthe Visual Analog Scale (VAS). There were statistically significant differences (p <0.05) between mild and severe pain in regard to TNF-? level (15.24 pg/ml ± 5.42 vs.20.44 pg/ml ± 10.34 ); to iNOS immunoreactivity (9.72 % ± 8.61 vs. 15.6% ± 11.84); andto TNF-? immunoreactivity (13.0 % ± 9. 48 vs. 20.44% ± 11.75).The case control study showed that TNF-? had an odd ratio of 5.053 [CI 95%(2.241-11.392); p < 0.001]. TNF-? immunoreactivity of 4.125 [CI 95% (1.805-9.425); p< 0.001]; and iNOS immunoreactivity of 3.546 [CI 95% (1.613-7.795); p = 0.002]. There were correlations between TNF-? level, TNF-? and iNOS immunoreactivity andVAS with coefficient correlation: 0.330; 0.285 and 0.275 (p < 0.05) respectively.It is concluded that Diabetic Neuropathy patients with high TNF-? levels, iNOSand TNF-? immunoreactivity of mononuclear cells have higher risk for painful DN thanpainless DN. The higher TNF-? level, iNOS and TNF-? immunoreactivity the moresevere was the pain. This supports the hypothesis that TNF-? and iNOS have role inPDN pathogenesis. The results of this research could be applied as a basic for furtherresearch in pursuit of better management of PDN.
Analysis of Lift and Drag of Mono-foil Hysucat due to Longitudinal Foil-placement Variation Suastika, Ketut; Dikantoro, Regi Y.; Purwanto, Dedi B.; Setyawan, Dony; Putra, Wing H. A.
International Journal of Marine Engineering Innovation and Research Vol 2, No 2 (2018)
Publisher : Institut Teknologi Sepuluh Nopember

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (655.417 KB) | DOI: 10.12962/j25481479.v2i2.3655

Abstract

CFD simulations were conducted to study the effects of a hydrofoil and its relative placement in the longitudinal direction on the total resistance of a mono-foil hysucat (hydrofoil supported catamaran). Three foil positions were considered: (i) precisely below the vessel’s center of gravity, (ii) 3 chord-lengths aft from position 1 and (iii) 6 chord-lengths aft from position 1. At relatively low speed (volumetric Froude number FnV < 1.8), the hydrofoil results in an increase of the total resistance of the hysucat (up to 4.43%). At relatively high speed (FnV > 1.8), the hydrofoil results in a decrease of the total resistance (up to 34.86%). The resistance coefficient first increases, takes a maximum value and then decreases with increasing Froude number. The maximum value is observed at FnV ≈ 1.4 (or Fn ≈ 0.5), consistent with previous observations. The most optimum foil placement is that precisely below the center of gravity of the vessel.
Intact Stability Analysis of Crew Boat with Variation of Deadrise Angle Putranto, Teguh; Suastika, Ketut; Gunanta, Julhari
IPTEK Journal of Proceedings Series No 2 (2017): The 2nd Internasional Seminar on Science and Technology (ISST) 2016
Publisher : Institut Teknologi Sepuluh Nopember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12962/j23546026.y2017i2.2309

Abstract

Abstract¾ As a supporter of offshore supply logistics operations, crew boat moving in high speed needs the hull design that is able to reduce the resistance but the stability is still good. The innovation of hull design carried out have to consider not only in aspect of safety and comfort, but also in aspect of cargo hold capacity. Therefore, this research will analyze the change of deadrise angle to the stability, cargo hold capacity, and resistance. The shift of weight and buoyancy point caused by the change of deadrise angle is calculated by block method. The calculation of cargo hold is carried out by integration of CSA curve. The calculation of ship stability is carried out by using the Krylov I method. If the stability varied by deadrise angle does still fulfill, the next analysis is the resistance. The resistance calculation uses Computational Fluid Dynamics (CFD). The smallest resistance is occurred with deadrise angle 16 degrees which the magnitude is 144.741 kN in speed 24 knots. The output obtained from this research is a recommendation of hull design revealing that crew boat with deadrise angle 6 degrees have an enough cargo hold to take up payload and the stability still fulfills the IMO Regulation.
Analisis Sloshing 2D pada Dinding Tangki Tipe Membran Kapal LNG Akibat Gerakan Rolling di Gelombang Regular Ericson Estrada Sipayung; IKetut Suastika
Jurnal Teknik ITS Vol 5, No 1 (2016)
Publisher : Direktorat Riset dan Pengabdian Masyarakat (DRPM), ITS

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (984.448 KB) | DOI: 10.12962/j23373539.v5i1.15797

Abstract

Pemakaian kapal sebagai sarana distribusi LNG ke berbagai wilayah merupakan salah satu cara yang menguntungkan dan efisien. Penggunaan kapal sebagai sarana distribusi LNG membuat hal-hal yang berhubungan dengan tangki kapal menjadi menarik untuk diteliti. Salah satu yang paling banyak diteliti adalah fenomena sloshing. Simulasi gerakan fluida pada tanki dilakukan dalam time-domain. Gelombang pada saat kapal berlayar di laut tidak dapat diprediksi dengan akurat. Gelombang yang datang dengan sudut hadap 90o (beam sea) dapat menimbulkan gerakan rolling yang sangat berpengaruh pada gerakan fluida di dalam tangki atau sering disebut fenomena sloshing. Gerakan fluida ini menimbulkan gaya berupa tekanan pada dinding tangki berupa dynamic pressure. Tangki jenis membrane banyak digunakan pada kapal LNG. Sehingga, banyak penelitian yang berkaitan dengan tangki membrane. Tangki membrane dimodelkan 3D dengan menggunakan software maxsurf yang berukuran panjang 32.46 m, tinggi 27.32 m dengan lebar moulded belakang 39.17 m, lebar belakang bagian bawah 31.29 m, lebar belakang bagian atas 31.29 m. lebar moulded depan 39.17 m, lebar depan bagian bawah 31.29 m, lebar depan bagian atas 31.29 m. Volume cairan LNG divariasikan dengan 3 (tiga) ketinggian yaitu ketinggian cairan 30% dari tinggi tangki, 50% dari tinggi tangki, dan 80% tinggi tanki. Analisa dilakukan dengan menggunakan software Ansys Fluent dengan metode Computational Fluid Dynamic (CFD). Dari hasil analisa dengan ansys fluent dapat disimpulkan bahwa dynamic pressure terbesar terjadi pada filling level 30% H dalam tanki yaitu sebesar 16513.720 Pa yang terjadi pada bagian kanan dinding tanki pada ketinggian 8,655 m dari dasar tank
Analisis Hambatan Penggunaan Hydrofoil pada Katamaran Menggunakan CFD Regi Yudha Dikantoro; I Ketut Suastika
Jurnal Teknik ITS Vol 7, No 1 (2018)
Publisher : Direktorat Riset dan Pengabdian Masyarakat (DRPM), ITS

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (593.294 KB) | DOI: 10.12962/j23373539.v7i1.28865

Abstract

Simulasi CFD dilakukan untuk mempelajari pengaruh hydrofoil dan pemasangan hydrofoil secara memanjang terhadap hambatan HYSUCAT. Tiga variasi penempatan foil dilakukan yaitu (i) posisi 1 :dibawah center gravity kapal, (ii) 3 panjang chord ke arah stern dari posisi 1, dan (iii) 6 panjang chord ke arah stern dari posisi 1. Pada kecepatan relatif rendah (FnV < 1,8), hydrofoil menambah hambatan katamaran. Sebaliknya pada kecepatan relatif tinggi  (FnV > 1,8), hydrofoil mengurangi hambatan katamaran. Nilai koefisien hambatan meningkat pada awalnya, mencapai nilai maksimum  kemudian  berkurang seiring meningkatnya bilangan Froude. Nilai maksimum terjadi pada FnV ≈ 1.4 (atau Fn ≈ 0,5 ). Posisi peletakkan foil yang paling optimum adalah dibawah CG kapal. 
HUBUNGAN STATUS NUTRISI DENGAN DERAJAT PROTEINURIA PADA PASIEN DIABETES MELITUS TIPE 2 DENGAN KOMPLIKASI NEFROPATI DIABETIK DI RSUP SANGLAH I Gusti Ayu Mardewi; Ketut Suastika
E-Jurnal Medika Udayana Vol 5 No 6 (2016): E-jurnal medika udayana
Publisher : Universitas Udayana

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Abstract

There were 2,1% of Indonesian population with diabetic in 2013. Diabetic nephropathy is the most severe complication with high mortality and morbidity. In diabetic type 2 patient, microalbuminuria was irreversible and 20-40% of the patients will have proteinuria. Proteinuria related to body mass index (BMI). Higher the BMI the more severe the degree of proteinuria in patient with type 2 diabetic. The study conducted to evaluate the nutritional status of the patients and its relation with degree of proteinuria in type 2 diabetic patient with diabetic nephropathy complication. The study was analytic cross sectional study. Subjects were selected using consecutive sampling. Forty-eightsamples were match inclusion criteria, according to subjective global assessment (SGA) 31 of them listed as good nutrition (A), 11 of them suspect malnutrition (B), and 6 of them malnutrition. According to BMI, 3 patients underweight, 30 patients normal, 13 patients overweight, and 2 patients obese I. The distribution of proteinuria degrees were 2 patients negative, 10 patients +1, 12 patients +2, 13 patients +3 and 11 patients +4. The result from chi-square analysis was found, there were no significant association between nutritional statuses according BMI with proteinuria degrees (p=1.00). Also there were no significant association between nutritional status according SGA with proteinuria (p=0.46). The result was caused by some factors such as samples number, factors that affecting proteinuria, and patient’s complication.
Analisis Drag dan Lift pada Variasi Bentuk After Body Kapal Selam Mini dengan Metode Computational Fluid Dynamics Putri Virliani; I Ketut Suastika; Wasis Dwi Aryawan
R.E.M. (Rekayasa Energi Manufaktur) Jurnal Vol 2 No 1 (2017): June
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/r.e.m.v2i1.755

Abstract

One aspect that needs to be studied in submarine design is the hydrodynamic aspect relating to submarine maneuverability. This research begins by calculating the value of drag and lift on the three variations of the after body’s mini submarine. The first variation as the initial design is rudder and stern plane arranged perpendicularly or named the+ Stern. Then for the second variation made changes to the arrangement of rudder and stern plane in the after body of the mini submarine with + Stern arrangement, the rudder arranged each other crossed so that it resembles the letter X and called the X-Stern arrangement. Further, for the third variation, the upper rudder of the X-Stern arrangement is replaced by the upper rudder of the + Sternarrangement so that it resembles the inverted Y letter and is called the Y-Stern arrangement. Drag and lift are calculated numerically by using ANSYS-CFX software. From the calculation of CFD found that the submarine with after-body Y-Stern arrangement has the smallest drag and lift value.
Co-Authors A Santoso A. A. Mas-Putrawati AAG Budhiarta AAG Budhitresna Ade Reza Hariyadi Agung Pranoto Agus Joko Purwanto An Apriyani Tebiary Anak Agung Ayu Mirah Adi Anak Agung Gde Budhiarta Anak Agung Gde Budhiarta Anak Agung Gede Sudewa Djelantik Angga Yustiawan Anwar Santoso Ardi Nugroho Yulianto Aries Sulisetyono Aryana, I Gust Putu Suka Aryawan, Wasis Dwi Askandar Tjokroprawiro Astika, I Nyoman Buana Ma'ruf Buana Ma'ruf Budhiarta, Anak Agung Gde Dedi B. Purwanto Dewa Putu Gede Purwa Samatra Dian Purnamasari Dian Purnamasari Dikantoro, Regi Y. Djoenaidi Widjaja Djoko W. Soeatmadji Dwija Sanjaya Ericson Estrada Sipayung Gede Kambayana Gede Putu Arsana Gede Sukrawan Giles Anthony Thomas Gunanta, Julhari H Taniguchi H. S. Habiba Muhiddin, H. S. Habiba Hari Bagianto I Gusti Agung Dewi Sarihati I Gusti Ayu Mardewi I Gusti Putu Suka Aryana I Ketut Aria Pria Utama I Made Bakta I Made Jawi I Made Jawi I Made Pande Dwipayana I Made Siswadi Semadi I Made Siswadi Semadi I Made Siswadi Semadi I Nyoman Astika I NYOMAN MANTIK ASTAWA I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I Putu Gede Adiatmika I Wayan Mustika I Wayan Mustika I Wayan Putu Sutirta Yasa I Wayan Weta I Wayan Wita Ida Bagus Aditya Nugraha Ida Bagus Ekaputra Ida Bagus Ekaputra, Ida Bagus Ida Bagus Ngurah Wises Ida Bagus Putu Putrawan IGN Gunadi Ignatius Ferdi Yuatmadja IMR Saraswati Iswara, Ni Putu Ayu Astri Prana K Badjra Nadha K Rina K Tangking Widarsa Kadek Ngurah Hariawa Ketut Adi Jaya Sutana Ketut Suata Komang Ayu Kartika Sari Luh Gede Sri Yenny Luh Seri Ani Made Ratna Saraswat MADE RATNA SARASWATI . Made Wardhana Made Wiryana Marisye Christantia N Kajiwara N. K. Niti Susila, N. K. Ni Ketut Rai Purnami Ni Made Suaniti Ni Nyoman Trisna Yuliharti Tersinanda Ni Putu Ayu Astri Prana Iswara Noor Virliantarto Nurhadi Nurhadi Nym Astika Pradana Soewondo Purnami, Ni Ketut Rai Purwanto, Dedi B. Putra, Wing H. A. Putri Virliani Putri Virliani Putri Virliani R. A.T. Kuswardhani R. Prawira Bayu Putra Dewa Raka-Sudewi A. A. Regi Y. Dikantoro Regi Yudha Dikantoro S. Soetjiningsih, S. S., Hantono Setyawan, Dony Sidartawan Soegondo Siorcani, Putu Tasha Sri Trisnawati Sri Trisnawati Sri Yuniari Sri Yuniari, Sri Sutanegara - Sutjahjo Suherman, Sutjahjo Teguh Putranto Thomas Eko Purwata Tuty Kuswardani W Wita Wasis Akriananta Wibowo Harso Nugroho Wibowo Nugroho, Wibowo Wing H. A. Putra Wira Gotera Wisnu Firstdhitama