The Indonesian Biomedical Journal

203-16

Authors: Anna Meiliana, Nurrani Mustika Dewi, Andi Wijaya

BACKGROUND: Current cancer drugs and treatments are aiming at eradicating tumor cells, but often are more toxic then effective, killing also the normal cells and not selectively the tumor cells. There is good personalized cancer therapy that involves administration to the cancer-bearing host of immune cells with direct anticancer activity, which called adoptive cell therapy (ACT). A review of the unique biology of T cell therapy and of recent clinical experience compels a reassessment of target antigens that traditionally have been viewed from the perspective of weaker immunotherapeutic modalities. CONTENT: Chimeric antigen receptors (CAR) are recombinant receptors which provide both antigen-binding and T cell-activating functions. Many kind of CARs has been reported for the past few years, targeting an array of cell surface tumor antigens. Their biologic functions have extremely changed following the introduction of tripartite receptors comprising a costimulatory domain, termed second-generation CARs. The combination of CARs with costimulatory ligands, chimeric costimulatory receptors, or cytokines can be done to further enhance T cell potency, specificity and safety. CARs reflects a new class of drugs with exciting potential for cancer immunotherapy. SUMMARY: CAR-T cells have been arising as a new modality for cancer immunotherapy because of their potent efficacy against terminal cancers. They are known to exert higher efficacy than monoclonal antibodies and antibodydrug conjugates, and act via mechanisms distinct from T cell receptor-engineered T cells. These cells are constructed by transducing genes encoding fusion proteins of cancer antigen-recognizing single-chain Fv linked to intracellular signaling domains of T cell receptors.

222-30

Authors: Veronika Maria Sidharta, Elizabeth Henny Herningtyas, Christine Ayu Lagonda, Dilafitria Fauza, Yuyus Kusnadi, Rina Susilowati, Ginus Partadiredja

BACKGROUND: Secretome production by stem cells depends on their culture conditions such as oxygen concentration and the composition of the culture media. In this study, we investigated the secretion of neurotrophic growth factors of human umbilical cord mesenchymal stem cells (hUC-MSCs) in amino acid-rich culture medium and under hypoxic condition. METHODS: hUC-MSCs were cultured in normoxic and various hypoxic (1%, 5%, 10%) conditions in an amino acid-rich culture medium. The end-point parameters (cell proliferation and survival, cell morphology and growth factor secretion) were measured at 3 time-points (48 hours, 72 hours and 96 hours). ELISA-based methods were used for neurotrophic factors detection, including neurotrophic growth factor (NGF), vascular endothelial factor (VEGF), and brain-derived neurotrophic factor (BDNF). RESULTS: NGF secretion was not detectable at any time points both in normoxia and hypoxia. BDNF secretion under normoxia was induced at 48 h time point and reached the highest level at an average of 181.9±13.01 pg/mL at 96 hours, whereas hypoxia exposure to hUC-MSCs only induced the BDNF secretion at low level. VEGF secretion was barely detectable in normoxic condition. However, VEGF secretion reached the highest level at an average of 7707.55±2110.85 pg/mL in 5% hypoxia at 96 hours. CONCLUSION: Combination of amino acid-rich culture medium and hypoxia condition dramatically induced high VEGF secretion by hUC-MSCs, especially at 5% hypoxia, induced mild BDNF secretion and had no effect toward NGF secretion.

236-42

Authors: Sunarno Sunarno, Nyoman Fitri, Nelly Puspandari, Kambang Sariadji

BACKGROUND: There are found some studies which reported the successfull of polymerase chain reaction (PCR) assay to identify Corynebacterium ulcerans and Corynebacterium pseudotuberculosis. This study aimed to describe the dtxR gene profile as a new marker for C. ulceran and C. pseudotuberculosis for the PCR assay. METHODS: Ten C. ulcerans and 35 C. pseudotuberculosis DNA sequences data registered in GeneBank was analyzed by bioinformatic tools. PCR primer was designed based on the concerved region and the gene similarity data. On the other hands, reference strains (C. ulcerans NCTC 12077 and Corynebacterium diphtheriae NCTC 3984) and dtxR gene of C. pseudotuberculosis (synthetic gene) were used in the PCR assay optimization for C. ulcerans and C. pseudotuberculosis identification. RESULTS: The study showed that dtxR genes of both C. ulcerans and C. pseudotuberculosis were more conserve than pld gene, moreover dtxR gene was more specific compared to 16S rRNA gene. PCR assay with dtxR gene as a target could identify C. ulcerans and C. pseudotuberculosis accurately without mispriming, misamplification and misidentification. CONCLUSION: dtxR gene could be used as marker to identify C. ulcerans and C. pseudotuberculosis by PCR assay.

250-5

Authors: Budi Mulyaningsih, Sitti Rahmah Umniyati, Tri Baskoro Tunggul Satoto, Ernaningsih Ernaningsih, Dwi Aris Agung Nugrahaningsih

BACKGROUND: Aedes aegypti is a vector of several pathogens including dengue virus. Vector control is an effective way to break the transmission but unfortunately constant use of insecticides ultimately causes vector resistance. Pyrethroids have been used for about 15 years to combat Ae. aegypti in Yogyakarta Province, Indonesia. Single amino acid substitutions in the voltagegated sodium channel associated with pyrethroid resistance constitute one of the main causative factors of knockdown resistance (kdr). The aim of this study is to detect resistant status to cypermetrine and polymorphism on the voltagegated sodium channel gene of Ae. aegypti from 2 dengue endemic areas in Yogyakarta Province (Yogyakarta city and Sleman district). METHODS: Pyrethroid resistance in Ae. aegypti mosquitoes was detected by using CDC Bottle Bioassay. To detect the polymorphism on the voltage-gated sodium channel gene of Ae. aegypti analyses were conducted by using PCR and direct DNA squencing with primers AaSCF1 and AaSCR4 for S989P, I1011M (or V), L1014F sites, and AaSCF7 and AaSCR7 for the F1534C site. RESULTS: According to bioassay, the results for Ae. aegypti from Yogyakarta city (93% mortality) and Sleman district (88% mortality) suggest the possibility of resistance to cypermethrin. We observed polymorphism on voltagegated sodium channel gene on site F1534C (heterozygous). CONCLUSION: The findings provide early evidence that the use of cypermethrin (pyrethroids) in Yogyakarta city and Sleman district, Yogyakarta Province, Indonesia is reducing its effectiveness to control Ae. aegypti. Recommendations include additional tests for confirmation.

263-9

Authors: Zahra Lak, Akbar Vahdati, Mehdi Nematbakhsh

BACKGROUND: The ureteral obstruction (UO) is the most common clinical disorders. This study was designed to investigate the renoprotective effect of estradiol in unilateral UO (UUO) and reversible UUO (RUUO). METHODS: Eighty-four ovareictomized Wistar rats were assigned into 14 groups. Group 1 was sham operated group. All the groups 2-14 were subject to UUO, however they received additional treatments. Group 2-4 received test substances (vehicle, 0.1 or 0.05 mg/kg of estradiol) and sacrificed after 3 days. Group 5-7 received test substances and after 3 days followed by RUUO (obstruction removal) and after one day post RUUO were sacrificed. Group 8-9 followed by RUUO after 3 days and simultaneously received estradiol and after one day post RUUO were sacrificed. Group 10-12 followed by RUUO after 3 days and simultaneously received test substances and after 3 days post RUUO were sacrificed. Group 13-14 received test substances followed by RUUO and received test substances again and after 3 days post RUUO were sacrificed. RESULTS: The estradiol reduced body weight significantly (p<0.05) in UUO, and the uterus weight (UW) increased significantly by estradiol (p<0.05). The increased serum levels of blood urea nitrogen (BUN) and creatinine (Cr), and kidney weight (KW) induced by UUO (p<0.05) were not attenuated by estradiol. Estradiol treatment did not alter the levels of BUN, Cr, KW, Cr clearance (CrCl), urine sodium excretion and urine flow when compared with control. CONCLUSION: Although the protective role of estradiol in cardiovascular system is well accepted, however our findings suggest that its protection during UUO or after RUUO in renal system cannot be certain.

278-83

Authors: Pati Tangsupati, Kwartarini Murdiastuti

BACKGROUND: Regenerative procedure in periodontal surgery aims to improve the structure and function of the periodontium to be strong enough to support the teeth. Growth factor is essential in the process of tissue regeneration; it can be generated from the activation of Platelet-Rich Plasma (PRP). In this study, collagen was used as PRP activator. PRP release growth factor from the granules when activated. The aim of this study was to evaluate the effect of collagen on PRP activation and the collagen-activated PRP storage to fibroblast proliferation of periodontal ligament (PDL). METHODS: Fibroblasts of PDL were obtained from extracted premolar. PRP were obtained from 100 mL of blood donors using double centrifugation methods. PRP were activated by collagen and subsequently incubated for 24, 48, 72 and 168 hours; after which the lysate was taken. Fibroblasts were divided into 7 groups, which consisted of one unstimulated group as negative control, one group stimulated by PRP lysate, and five groups stimulated with PRP-collagen lysates that had been incubated for 24, 48, 72 and 168 hours. MTT assay was then performed after 1 and 3 days. RESULTS: The proliferation rate of fibroblasts group stimulated by PRP-collagen lysate was higher than the group stimulated by PRP. The storage of collagen-activated PRP for 7 days at 4°C could increase the proliferation rate. CONCLUSION: The activation of collagen on PRP and the stored collaged-activated PRP could increase the fibroblasts proliferation rate of PDL.

290-6

Authors: Septelia Inawati Wanandi, Purnamawati Purnamawati, Alice Tamara, Karina Teja Putri, Daniel Marcellius Simadibrata

BACKGROUND: ALDH1A1 and ALDH1A3, the most renowned isozymes of aldehyde dehydrogenase (ALDH)1, are important in regulating the pluripotency of human mesenchymal stem cells (MSCs) and cancer stem cells (CSCs). The study aimed to analyze the mRNA expression of ALDH1A1 and ALDH1A3 genes in adipose stem cells (ASCs) and umbilical cord stem cells (UCSCs) along with their correlations to Oct-4 mRNA expression. Additionally, the interaction between these proteins was also investigated using in silico study to confirm the pluripotency of both MSCs compared to human breast ALDH+ CSCs. METHODS: This research focused on determining mRNA levels of ALDH1A1, ALDH1A3 and Oct-4 in ASCs and UCSCs using one-step qRT-PCR. The data were then normalized to those in human breast CSCs and 18S rRNA. Oct-4 gene expression was also analyzed to determine the pluripotency of ASCs and UCSCs. The protein-protein interactions were in silico analyzed using String 9.1 software. RESULTS: Relatively, ALDH1A3 was expressed at similar level in ASCs and UCSCs, while ALDH1A1 expression level was significantly higher in ASCs compared to UCSCs. In contrast to ALDH1A3, the expressions of ALDH1A1 in both MSCs were significantly lower than breast CSCs similar to Oct-4 expressions, as also revealed by the in silico data showing the interaction between these proteins. This suggests the role of ALDH1A1 on pluripotency. CONCLUSION: ALDH1A1 and ALDH1A3 were distinctly expressed in UCSCs and ASCs, which might be associated with unique properties of ASCs and UCSCs. This study may contribute to further research in terms of implication of ALDH1A1 and ALDH1A3 expressions towards the properties of MSCs and its application in stem cell therapy.

104-22

Authors: Anna Meiliana, Nurrani Mustika Dewi, Andi Wijaya

BACKGROUND: Atherosclerosis is a leading cause of vascular disease worldwide. During the past several decades, landmark discoveries in the field of vascular biology have evolved our understanding of the biology of blood vessels and the pathobiology of local and systemic vascular disease states and have led to novel disease-modifying therapies for patients. This review is made to understand the molecular mechanism of atherosclerosis for these future therapies. CONTENT: Advances in molecular biology and -omics technologies have facilitated in vitro and in vivo studies which revealed that blood vessels regulate their own redox milieu, metabolism, mechanical environment, and phenotype, in part, through complex interactions between cellular components of the blood vessel wall and circulating factors. Dysregulation of these carefully orchestrated homeostatic interactions has also been implicated as the mechanism by which risk factors for cardiopulmonary vascular disease lead to vascular dysfunction, structural remodeling and, ultimately, adverse clinical events. SUMMARY: Atherosclerosis is a heterogeneous disease, despite a common initiating event of apoB-lipoproteins. Despite of acute thrombotic complications, an adequate resolution response is mounted, where efferocytosis prevents plaque necrosis and a reparative scarring response (the fibrous cap) prevents plaque disruption. However, a small percentage of developing atherosclerotic lesions cannot maintain an adequate resolution response, which leading to the formation of clinically dangerous plaques that can trigger acute lumenal thrombosis and tissue ischemia and infarction.

128-32

Authors: Mashuri, Mustofa Ruhullah, Bayu Diertama Putera, Vicky Pramudinta Mega, Fadillah Alma Putra, Eko Suhartono

BACKGROUND: Ceftazidime was known to cause photosensitization reactions. However, how it plays the role remained unclear. In our study, we aim to investigate the photosensitization effect of ceftazidime in erythrocytes via oxidative stress. METHODS: Samples were divided into six different groups: negative control group, positive control group and four experimental groups with 10%, 20%, 30%, and 40% ceftazidime, respectively. The positive control and experimental groups were exposed to ultraviolet (UV)-light for 2 hours. Superoxide radical, malondialdehyde (MDA), carbonyl compounds (CC) and methemoglobin (Met-Hb) levels were then measured. RESULTS: The results showed a significant increased of superoxide radical, MDA, CC and Met-Hb levels in all experimental groups compared to both negative or positive control groups (p< 0.05). CONCLUSION: In conclusion, our study confirmed the role of ceftazidime as a photosensitizer in erythrocytes via the oxidative stress mechanisms

140-3

Authors: Ferry Sandra, Ketherin

BACKGROUND: Caffeic acid inhibits osteoclastogenesis by downregulating expression of Cathepsin K and Nuclear Factor of Activated T cells (NFATc)1, as well as inhibiting activity of Nuclear Factor kB (NFkB). Meanwhile TNF Receptor-associated Factor (TRAF)6 was not influenced by caffeic acid. In order to investigate further caffeic acid's mechanism in inhibiting osteoclastogenesis, regulation of caffeic acid on p38 Mitogen-activated Protein Kinase (MAPK) was investigated. METHODS: RAW-D cells were pretreated with/without caffeic acid and treated with/without 20 ng/mL RANKL and 1 ng/mL TNFα for 0.2, 1, 6, and 12 hour. Tartrate Resistant Acid Phosphatase (TRAP) staining was performed. Then, western blot analysis was performed to detect p38 MAPK and phosphorylated-p38 MAPK. Resulted protein bands were quantified and statistically analyzed. RESULTS: Under induction of 20 ng/mL RANKL and 1 ng/mL TNF-α, RAW-D cells were successfully differentiated into TRAP+ osteoclast-like polynuclear cells. Under treatment of 20 ng/mL of RANKL and 1 ng/mL of TNF-a for 0.2 or 1 hour, significant (p=0,000, T test) increment of phosphorylated p38 MAPK was observed as compared with control. Pretreatment of 10 μg/mL caffeic acid significantly (p=0.000, T test) suppressed the 20 ng/mL of RANKL and 1 ng/mL of TNF-a-induced phosphorylation of p38 MAPK. CONCLUSION: RANKL and TNF-a are potent osteoclastogenesis inductors in RAW-D cells, meanwhile caffeic acid could inhibit the RANKL and TNFa-induced osteoclastogenesis through p38 MAPK.

148-55

Authors: Steffi Liem, Tina Rostinawati, Ronny Lesmana, Sri Adi Sumiwi, Tiana Milanda, Mutakin Mutakin, Irma Melyani Puspitasari, Jutti Levita

BACKGROUND: Acetaminophen, when used at low doses is a safe drug, but at higher doses it induces apoptosis in hepatoma cells. Arcangelisia flava that grows widely in Kalimantan Island, Indonesia, contains berberine which is effective in protecting the liver. This work was aimed to study the effect of A. flava extract on the modulation of caspase-3 in acetaminophen-induced hepatotoxicity. METHODS: Thirty-five Wistar male rats were divided into groups: I the normal control (water); II the negative control (Arabic gum powder or PGA, 2% in suspension); III the positive control (silymarin); IV-VII (A. flava extract 100, 200, 400, and 800 mg/Kg of body weight (BW), respectively) for 14 days. At day 15th, group II-VII were induced with acetaminophen 1000 mg/Kg of BW per oral for 7 days along with the extracts. At day 22nd, the animals were measured for their serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and gamma-glutamyl transferase (GGT), histological examination, and Western blotting. RESULTS: Acetaminophen elevated the SGOT and SGPT (3x compared to normal group), and GGT (5x compared to normal group) of the animals in group II. Pre-treatment with higher doses of A. flava extract (group VI and VII) significantly prevented the biochemical changes induced by acetaminophen. Normal histology of the liver was showed by group I, III, VII, whereas dilated sinusoids, central vein (CV) lesion, and local haemorrage were observed in group II, IV, V and VI. Western blotting showed an inhibition of caspase-3 expression by A. flava extract in dose-dependent manner. CONCLUSION: A. Higher dose A. flava extract shows hepatoprotective activity by preventing the elevation of serum transaminases and transferase levels. Eventually, no damage in the acetaminophen-induced rat’s liver was observed. This plant modulates the expression of caspase 3 protein in dose-dependent manner.

165-70

Authors: Widhya Aligita, Elis Susilawati, Ika Kurnia Sukmawati, Lusi Holidayanti, Jejen Riswanti

BACKGROUND: Diabetes Mellitus (DM) is a heterogeneous group of disorders characterized by increasing blood glucose levels caused by insufficiency of insulin hormone production and activities. There are significant increases in DM case every year in Indonesia, as a consequent, alternative and better drug is needed to be developed. One of the plants that were often used as traditional medicine for DM in Indonesia was Muntingia carabula L. (kersen) leaf. The aim of this research was to evaluate the antidiabetes activity of M. carabula leaves. METHODS: This study was conducted in vivo by evaluating the antidiabetic activity of M. carabula leaf water extract on two animal models, those are insulin deficiency and insulin resistant model animal. The insulin deficiency animal model was developed by aloxan administration at dose of 50 mg/Kg body weight (bw) intravenously. While the insulin resistance animal model was developed by lipid emulsion administration at dose of 0.42 mL/20 grams bw orally. Both groups were randomly devided into 6 groups, which are negative control group, positive control group, standard drug group (glybenclamide 0.65 mg/Kg bw or metformin 135 mg/Kg bw), and extract groups at dose of 100, 200 and 400 mg/Kg bw. Parameters which were evaluated are fasting blood glucose (FBG) levels for insulin deficiency models and values of constant of insulin tolerance (KITT) for insulin resistant models. RESULTS: In insulin deficient model group, administration of glibenclamide lower the FBG by 43%, furthermore, the extract of M. calabura at doses of 100, 200 and 400 mg/Kg bw also lower the FBG by 13%, 22% and 29%, subsequently. In insulin resistant models, metformin increased the value of KITT from less than 0.5 to 2.91, and administration of the extract at doses of 400, 200 and 100 mg/Kg bw also increased the KITT value to 2.31, 1.57, 1.13, respectively. CONCLUSION: The conclusion was M. carabula leaves water extract with dose of 400 mg/Kg bw had the antidiabetic activities with mechanisms to lower blood glucose level, regenerate pancreatic β cells, and increase insulin sensitivity.

179-83

Authors: Winardi Emmanuel Setiawan, Anggoro Budi Hartopo, Royhan Rozqie

BACKGROUND: Acute myocardial infarction (AMI) is the most common cause of death in the world. One preventive attempt to reduce AMI is early detection of blood lipid profile. A simple method of lipid profile assessment is the measurement of atherogenic index of plasma (AIP), meanwhile more accurate method of lipid profile assessment is the measurement of apolipoprotein B/apolipoprotien A-I (ApoB/ApoAI) ratio. However, whether both measurements are interchangeable is need to be investigated. This study aims to investigate the correlation between AIP value and ApoB/ApoAI ratio in patients with AMI. METHODS: The study design was cross-sectional study. The blood samples of consecutively enrolled AMI patients had been selected after inclusion and exclusion criteria. The blood samples were taken within 24 hours of patient admission to the hospital. The blood concentration of high-density lipoprotein (HDL) and triglycerides (TG) were measured using turbidimetric method. The AIP was calculated as logarithmic of TG/HDL ratio (log10.[TG:HDL]) The concentration of ApoB and ApoAI were measured using immunoturbidimetric method. The correlation between these measurements was analyzed with Pearson correlation test. RESULTS: The blood samples of 76 subjects were collected and analyzed. The subjects were dominated by male (n=67, 88%) and those whose age ≥55 years old (n=54, 71%). The mean ApoB value was 88.66 mg/dL and ApoAI was 97.39 mg/dL. The AIP value was 0.05. The Pearson correlation test between AIP and ApoB/ApoAI ratio showed a significant positive correlation with the strength of correlation was moderate (r=0.51, p-value<0.01). CONCLUSION: There was a significantly positive and moderate correlation between AIP value and ApoB/ApoAI ratio in acute myocardial infarction patients.

16-34

Authors: Anna Meiliana, Nurrani Mustika Dewi, Andi Wijaya

BACKGROUND: Redox and proteotoxic stress contributes to age-dependent accumulation of dysfunctional mitochondria and protein aggregates, and is associated with neurodegeneration. The free radical theory of aging inspired many studies using reactive species scavengers such as alpha-tocopherol, ascorbate and coenzyme-Q to suppress the initiation of oxidative stress. However, clinical trials have had limited success in the treatment of neurodegenerative diseases (NDDs). CONTENT: The misfolding and aggregation of specific proteins is a seminal occurrence in a remarkable variety of NDDs. In Alzheimer’s disease, the two principal aggregating proteins are β-amyloid (Aβ) and tau. The abnormal assemblies formed by conformational variants of these proteins range in size from small oligomers to the characteristic lesions that are visible by optica lmicroscopy, such as senile plaques and neurofibrillary tangles. Pathologic similarities with prion disease suggest that the formation and spread of these proteinaceous lesions might involve a common molecular mechanism, corruptive protein templating. The accumulation of redox modified proteins or organelles cannot be reversed by oxidant intercepting antioxidants and must then be removed by alternative mechanisms. Autophagy serves this essential function in removing damaged or dysfunctional proteins and organelles thus preserving neuronal function and survival. SUMMARY: Senescent cells and their senescence-associated secretory phenotypes (SASPs) may constitute a novel, understudied, and potentially important contributor to neuro-inflammation and subsequent neurodegeneration. Characterization of cellular senescence in the brain could uncover novel therapeutic targets for the prevention and treatment of chronic age-related NDDs.

40-5

Authors: Mutia Latief, Ika Agus Rini, Gita Widya Pradini, Gatot Nyarumenteng Adhipurnawan Winarno, Edhyana Sahiratmadja, Herman Susanto

BACKGROUND: Chronic infection with high-risk type of human papillomavirus (HPV) can cause cervical cancer. Previous studies showed that multiple infections of HPV are found in cervical cancer caused by multiple HPV infections and the most common are HPV-16 and HPV-52. The origin of HPV-16 circulating in Indonesia varies. The purpose of this study was to explore the origin of multiple infections of HPV-52 and HPV-16 in cervical cancer by using a phylogenetic tree. METHODS: During July-November 2010, 100 women were diagnosed with cervical cancer in the Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Only 96 patients were involved in this study. Ninety-six samples of HPV deoxyribonucleic acid (DNA) were isolated from biopsied tissue of cervical cancer. Multiple infections of HPV genotypes HPV-16 and HPV-52 were confirmed by using the linear assay for HPV genotyping test. Afterward,HPV-52L1 gene was amplified by using self-designed primer. L1 gene was also sequenced and analyzed using phylogenetic program (MEGA6.06). RESULTS: The result of phylogenetic tree construction showed that isolated HPV-52 originated from multiple infections of HPV-16 and HPV-52 from cervical cancer patients in Bandung were in a subgroup with isolates originating from EU077219 Canada (America) and KT799980 southwest China (Asia). Isolate HPV-16 in one subgroup with isolates originating from KU951191.1 (Southwest China). CONCLUSION: L1 gene sequence from multiple infections isolated from HPV-16 and HPV-52 from cervical cancer patients in Bandung refers to the variation of L1 gene reported from Canada and southwest China. This proves that Indonesia’s HPV clusters are located in the strains found in America and Asia.

51-5

Authors: Kambang Sariadji, Sunarno Sunarno, Nelly Puspandari, Masri Sembiring

BACKGROUND: Diptheria cases are treated with both anti-diphtheria serum (ADS) and antibiotics. Penicillin and erythromycin are the primary choices for any Corynebacterium diphtheriae (C. diphtheriae) infection. Antibiotic susceptibility pattern of C. diphtheriae has not been reported in Indonesia since 1982. The improper use of antibiotics, as well as, the consumption of antibiotics without prescription, will increase the resistance of C. diphtheriae. This study aims to determine the susceptibility pattern and the effectiveness of C. diphtheriae to several antibiotics. METHODS: A total of 57 C. diphtheriae isolates were recultured by using Blood Agar (BA) and Cystine Tellurite Blood Agar (CTBA). Afterward, these isolates were identified by using API Coryne. The antibiotic susceptibility pattern was determined by using Kirby Bauer Method based on CLSI M45-A2. RESULTS: These studies revealed that as the primary choice of diphtheria cases, 10.5% of C. diphtheriae isolates were resistant to Penicillin and 5.3% were resistant to erythromycin. Seven isolates (12%) showed resistance to more than one antibiotics, such as tetracycline and clindamycin, vancomycin and clindamycin, penicillin and tetracycline, also penicillin and vancomycin. Moreover, 4 isolates (7%) were resistant to 3-5 antibiotics. All isolates were susceptible to moxifloxacin and linezolid. CONCLUSION: Some C. diphtheriae isolates were resistant to penicillin and erythromycin, which are known as the primary choice for the treatment of C. diphtheriae infection. Even though, all isolates susceptible to moxifloxacin and linezolid.

62-5

Authors: Rika Wahyuni Arsianti, Dewy Haryanti Parman, Hendy Lesmana, Muhammad Taufiqqurohman

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a long-term illness that affects the patient's quality of life and requires substantial health care costs. Lifestyle relatedto physical exercise is one of the causes of the increasing prevalence of this disease. However, not all T2DM patients can perform physical exercise because very weak physical conditions such as elderly, spinal cord injury or diabetic secondary complications can be contraindicated when physical exercise performed. The aim of this study is to observe the used of electrical stimulation in T2DM patients. METHODS: The provision of ES to lower extremity muscles was given for 30 minutes in the intervention group. Blood glucose samples were taken before and after the ES intervention. The data collected was statistically analyzed by using paired T-test and expressed in mean±standard error. RESULTS: The ES intervention decrease blood glucose level significantly from 193.03±5.740 mg/dL to 170.66±5.200 mg/dL (p≤0.001) in the last session. CONCLUSION: The effect of ES in lower extremity is shown to be significantly lowers the blood glucose level in T2DM patients.

74-8

Authors: Eko Suhartono, Ari Yunanto, Edi Hartoyo, Nia Kania, Adelia Anggraini Utama, Ratih Kumala Sari, Niarsari Anugrahing Putri, Iskandar Thalib

BACKGROUND: This study was aimed to employ the UV-Visible (UV-Vis) spectrophotometry techniques to detect the changes in the blood of neonatal sepsis (NS) subject for a deeper understanding in the pathomechanism of NS. METHODS: The cross-sectional study was conducted from February to May 2017 in the Neonatology Division, Department of Pediatric, Ulin General Hospital/Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, South Kalimantan, Indonesia. Blood specimens were taken from newborns, of which 15 each of newborns at risk of sepsis and without risk of sepsis. Data were analyzed by using Mann-Whitney U test. RESULTS: The result of this study suggested that there is a significant difference in the average of absorbance ratio parameter using UV-Vis spectrophotometric methods on the case group compared to the control group. Also, there is a significant difference between advanced oxidation protein products (AOPPs) and thiocyanate (SCN) level in newborn at risk of sepsis. CONCLUSION: The present study demonstrated there were significant differences between the average of absorbance ratio parameter for protein and oxy-hemoglobin region using UV-Vis spectrophotometric methods in healthy subjects and newborn at risk of sepsis.