PurposeWe aimed to evaluate the distribution of individual epidermal growth factor receptor (EGFR) mutation subtypes found in routine cytological specimens.Patients and methodsA retrospective audit was performed on EGFR testing results of 1,874 consecutive cytological samples of newly diagnosed or treatment-naïve Indonesian lung cancer patients (years 2015–2016). Testing was performed by ISO15189 accredited central laboratory.ResultsOverall test failure rate was 5.1%, with the highest failure (7.1%) observed in pleural effusion and lowest (1.6%) in needle aspiration samples. EGFR mutation frequency was 44.4%. Tyrosine kinase inhibitor (TKI)-sensitive common EGFR mutations (ins/dels exon 19, L858R) and uncommon mutations (G719X, T790M, L861Q) contributed 57.1% and 29%, respectively. Approximately 13.9% of mutation-positive patients carried a mixture of common and uncommon mutations. Women had higher EGFR mutation rate (52.9%) vs men (39.1%; p<0.05). In contrast, uncommon mutations conferring either TKI responsive (G719X, L861Q) or TKI resistance (T790M, exon 20 insertions) were consistently more frequent in men than in women (67.3% vs 32.7% or 69.4% vs 30.6%; p<0.05). Up to 10% EGFR mutation–positive patients had baseline single mutation T790M, exon 20 insertion, or in coexistence with TKI-sensitive mutations. Up to 9% patients had complex or multiple EGFR mutations, whereby 48.7% patients harbored TKI-resistant mutations. One patient presented third-generation TKI-resistant mutation L792F simultaneously with T790M.ConclusionRoutine diagnostic cytological techniques yielded similar success rate to detect EGFR mutations. Uncommon EGFR mutations were frequent events in Indonesian lung cancer patients.

Pulmonary Tuberculosis remains as a major health problem in South East (67% vs. 34%, p=0,04) and second month (95% vs. 77%, p=0,18). Improvement in radiographic findings in the group with vitamin D is also higher in the first month (67% vs. 18%, p=0,02) and second month (76% vs. 45%, p=0,06). There is a significant difference in the level of 25-dihidroxyvitamin D between two groups (p=0,00

Tuberculosis remains a serious global health problem despite the widespread use of the vaccine against tuberculosis (TB). Up to now, the only available TB vaccine, Mycobacterium bovis BCG has a very wide efficacy range from 0 until 80 percent protection so the development of a new vaccine is needed. The new protein as a candidate vaccine should be assessed for their immunogenicity. The purpose of this study was to examine whether Mycobacterium tuberculosis 38 kDa recombinant protein could stimulate a cellular immune response especially CD3+T lymphocytes to express IL-2 and IL-4 in PBMC cultures. An experimental laboratory research on cultured PBMC of 3 groups consisting of TB patients, contacts of TB positive and healthy subjects, each group consisted of 8 subjects. All PBMC cultures were induced by Mycobacterium tuberculosis 38 kDa recombinant protein, Purified Protein Derivative (PPD) and without antigen as a control. Expression of IL-2 and IL-4 CD3+ T lymphocytes was measured with flowcytometry. In healthy volunteers and TB contacts there was a significant difference in the expression of IL-2 and IL-4 CD3+ T lymphocytes compared with no any treatment. The highest IL-2 expression was in healthy subjects [8.13 (0.622)] while the highest expression of IL-4 was in TB patients [6.436 (4.586)]. Mycobacterium tuberculosis 38 kDa recombinant protein could induce the expression of IL-2 and IL-4 of CD3+ T lymphocytes in healthy subjects, TB contacts and TB patients and there were a significance differences in the expression of all groups

Background: Tuberculosis is an infectious disease that develop from systemic infection caused by bacterium Mycobacterium tuberculosis complex. Generally, M.tuberculosis spread from one person to another through nuclear droplet air transmission. Although TB has a lower transmission rate compared to another infectious disease, TB still become a global health problem. It is estimated that approximately one third of the world’s population is infected by tuberculosis. Every year it is estimated that there are nine million new cases and close to two million death cases caused by tuberculosis. Case: A 24-year-old female was admitted to the hospital complaining of could not move both of her legs and could not urinate. One month before admission, she was diagnosed with meningitis TB; miliary TB; and meningioma at thoracic vertebrae T11-12 based on physical examination, laboratory examination, Chest X-Ray, Head CT Scan without contrast, and thoracolumbal MRI. When admitted to the hospital, the patient already treated with Fixed Dose Combination of antituberculosis Drugs first category for one and a half month from Turen Primary Healthcare. Then the patient underwent bronchoscopy examination. The result of the anatomical pathology examination showed class two. Then the patient underwent a laminectomy surgery and tumor excision at thoracic vertebrae T11-12. The result of postoperative Anatomical Pathology examination showed a neurofibroma pattern. After surgery, the Physical Medicine and Rehabilitation Department placed thoracic lumbosacral orthoses (TLSO) to the patient. Postoperative evaluation up to three months showed that the patient’s general condition was quite good but still cannot move both of her legs and cannot urinate.

Background: Bascillus Calmette Guѐrin vaccination has not provided protection against TB in adults. ESAT-6/CFP-10 Mtb recombinant protein fusion as a vaccine candidate can stimulate the body's immune response. Interleukin-17, TNF-α and CD4+ play a major role against TB. This study aims to determine that the recombinant protein fusion ESAT-6/CFP-10 Mtb can stimulate TNF-α, IL-17 and CD4+ T cells expression in PBMC culture. Methods: Design of this study is experimental study. Number of research sample per group of 8 subjects. The subjects: healthy, TB contact and TB patients were taken their peripheral blood sample and treated with ESAT-6/CFP-10 Mtb recombinant protein fusion. TNF-α CD4+ T cells were measured by ELISA. Flow cytometry is used to measure IL-17 and CD4+ Tcells. As standard protocol research on tuberculosis vaccine, each subject also treated without antigen and with PPD. Results: There was no significant increase in the administration of ESAT-6/CFP-10 Mtb fusion compared without antigen on TNF-α expression of CD4+ (P=0.202), expression of IL-17 CD4+ (P=0.994) and percentage of CD4+ T cells (P=0.183). ESAT-6/CFP-10 Mtb Fusion was able to stimulate expression of TNF-α CD4+ in healthy subjects (29.91±1.23pg/ml), TB contact (32.21±4.02pg/ml) and TB patients (33.35±8.41 pg/ml). Expression IL-17 CD4+ in healthy subjects (33.24 ± 39.01%), TB contact (23.88 ± 21%) and TB patients (51.93 ± 36%). CD4+ T cell expression in healthy subjects 30.64 ± 7.63%, TB contact 24.58 ± 5.24% and TB patients (40.73±2.63%). Conclusions: ESAT-6/CFP-10 Mtb recombinant proteins fusion may stimulate the production of TNF-α, IL-17 CD4+ and CD4+ T cells in all subject. Expression of TNF-α, IL-17 CD4+ and CD4+ T cells in the healthy group, indicated that the ESAT-6/CFP-10 recombinant protein fusion has the potential as vaccine candidate. (J Respir Indo. 2019; 39(3):160-8)

Tuberculosis remains a serious global health problem despite the widespread use of the vaccine against tuberculosis (TB). Up tonow, the only available TB vaccine, Mycobacterium bovis BCG has a very wide efficacy range from 0 until 80 percent protection sothe development of a new vaccine is needed. The new protein as a candidate vaccine should be assessed for their immunogenicity. Thepurpose of this study was to examine whether Mycobacterium tuberculosis 38 kDa recombinant protein could stimulate a cellularimmune response especially CD3+T lymphocytes to express IL-2 and IL-4 in PBMC cultures. An experimental laboratory research oncultured PBMC of 3 groups consisting of TB patients, contacts of TB positive and healthy subjects, each group consisted of 8 subjects. AllPBMC cultures were induced by Mycobacterium tuberculosis 38 kDa recombinant protein, Purified Protein Derivative (PPD) and withoutantigen as a control. Expression of IL-2 and IL-4 CD3+ T lymphocytes was measured with flowcytometry. In healthy volunteers and TBcontacts there was a significant difference in the expression of IL-2 and IL-4 CD3+ T lymphocytes compared with no any treatment. Thehighest IL-2 expression was in healthy subjects [8.13 (0.622)] while the highest expression of IL-4 was in TB patients [6.436 (4.586)].Mycobacterium tuberculosis 38 kDa recombinant protein could induce the expression of IL-2 and IL-4 of CD3+ T lymphocytes in healthysubjects, TB contacts and TB patients and there were a significance differences in the expression of all groups.

Dutch study shows that Upar expression content is significantly higher in tubercolusis patient