Klebsiella pneumoniae (K. pneumoniae) is a normal flora in human Gastro Intestinal Tract. This strain of K.pneumoniae are implicated the gram negative bacteria that can cause pneumonia beside urinary tract infection and nosocomial infection. Until now, to identify this bacteria there are seveval methods had been used included staining and culture, Elisa, histologic and serologic that need a long time. The goal of this research is to detect K. pneumoniae with immunocytochemistry methode using antibody of K.pneumoniae and OMP K.pneumoniae as spesific antigen. The design of this reseach was explorative descriptive. The method content of K.pneumoniae isolation, specific antigen of OMP K.pneumoniae isolation, producing antibody anti OMP K.pneumoniae, and detection this bacteria on sputum with immunocytochemistry methode respectivelly. For diagnostic test sensitivity and specificity. Analysis has been used. The result showed that molecular weight of OMP K.pneumoniae was 40 kDa, antibody of OMP K.pneumoniae could identify the OMP K.pneumoniae as antigen and could detect K.pneumoniae on sputum by using Western Blotting and immunocytochemistry. Sensitivity and specificity of this diagnostic test was 90 %, 95 % consequently.Key words : Klebsiella pneumoniae, Outer Membrane Protein, Immunocytochemistry PENDAHULUAN Klebsiella pneumoniae termasuk genus Klebsiella dalam famili Enterobacteriaceae yang merupakan penghuni normal traktus digestivus. Kuman ini dan dapat diisolasi dari tinja manusia atau hewan. Pada manusia, genus Klebsiella dapat merupakan kuman penyebab pneumonia, disamping infeksi lain diluar sistim pernapasan misalnya: infeksi saluran kemih, infeksi nosokomial (1).Pneumonia atau infeksi saluran napas bawah masih merupakan masalah utama dalam bidang kesehatan, baik di negara sedang berkembang maupun yang sudah maju. Di RSUP Persahabatan Jakarta tahun 2000, infeksi saluran napas bawah juga merupakan penyakit utama, sedangkan di Malang pneumonia merupakan salah satu penyebab dari rawat inap utama (2,3).Beberapa survei yang dilakukan di Jakarta dan Malang ternyata dapat diketahui bahwa penyebab pneumonia utama yang diambil dari bahan sputum adalah kuman K. pneumoniae. Soepadi P (1997) menemukan 42,85 % kasus pneumonia di Jakarta disebabkan oleh K. pneumoniae, sedangkan Jabang M (1998) menemukan 36,36% pada kasus pneumonia; Hadiarto M (1997) menemukan 44,4 % pada kasus pneumonia di Jakarta dan Sartono dan Sumarno di Malang (2002) menemukan 19,4%. (2,3) Untuk mengetahui penyebab pneumonia memerlukan waktu beberapa hari sehingga pada pemberian pengobatan awal pneumonia maka diberikan antibiotika secara empiris.Untuk mengidentifikasi kuman penyebab pneumonia dapat digunakan metode-metode: pengecatan dan kultur, Elisa, histologi dan serologi yang semua ini memerlukan waktu yang cukup lama. Pada penelitian ini kami mencoba mendeteksi kuman K. pneumoniae dengan menggunakan imunositokimia dengan dasar deteksi adanya antigen spesifik kuman K. pneumoniae, yang selanjutnya dilakukan tes sensitifitas dan spesifitasn...
Background: Epidermal growth factor (EGFR) is a transmembrane receptor that plays an important role in the development of cancer phenotypes. Some patients with lung cancer have genetic mutations. Several studies have found a close correlation of EGFR gene mutation with 15-20% of lung adenocarcinoma cases. This study aimed to determine the EGFR profile in adenocarcinoma lung cancer patients at Haji Adam Malik General Hospital.Methods: This was a prospective cohort study conducted at Haji Adam Malik General Hospital, Medan. This study used patients data for 3 years, starting from January 1, 2014 to D1ecember 31, 2016. The sample size in this study was 34 patients. The data were then analyzed using SPSS.Results: All patients were adenocarcinoma lung cancer patients with positive EGFR mutation. There were 9 subjects with EGFR mutation in exon 19; 11 subjects with exon 21 L858R mutation; and 3 subjects with exon 21 L861Q mutation. Meanwhile, there were 3 subjects with uncommon EGFR mutations, namely exon 18 mutation. Majority of subjects with exon 19 mutation were male, aged >60 years, smokers with mixed types of cigarettes and severe brinkmann index. In subjects with exon 21 L858R mutation, most of the patients were male, aged 50-60 years, smokers with mixed cigarette types and severe brinkmann index. The same characteristics were also observed in subjects with exon 18 mutation. However, for exon 21 L861Q mutation, the majority of subjects were female with varying ages, and were not smokers. Conclusion: Most of the study subjects profiles were male, aged over 60 years, smokers, with mixed types of cigarettes, and with severe Brinkman Index. The EGFR mutations most commonly occured in exon 21, followed by exon 19 (ins/del exon 19), exon 18, and a combination of 2 exons.
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Introduction: High altitude pulmonary edema (HAPE) is one of the acute, severe, non- cardiogenic disease that could be life threatening, occurs upon either the first or subsequent exposure to high altitude. It is triggered by a shortage of oxygen after ascending high altitude. The most effective therapeutic approach for HAPE is to immediately descend from high altitude and to give oxygenation, maintaining arterial saturation over 90%, as well as letting the patient rest from strenuous physical activity. The use of portable hyperbaric chamber is also deemed effective in certain circumstance, and nifedipine can also be used to treat HAPE, even as additional treatment in condition that the patients had yet to descend and oxygenation is still not administrable. Case Report: We reported a case at Rs. Dr. Saiful Anwar, a 23-year-old male with High Altitude Pulmonary Edema (HAPE). Diagnosis established from anamnesis, physical examination, and laboratory tests. Patient complained shortness of breath when climbing Mt. Semeru, in which the patient reached an altitude of 2700 mdpl in 2 days. Physical examination showed oxygen saturation 46-49% with NRBM 10 lpm, and rhonchi breath sound in all lung areas. Laboratory examination showed leukocytosis, blood gas analysis showed hypocarbia, severe hipoxemia, metabolic acidosis, and type I respiratory failure. Ches XRay showed wide, irregular infiltrate in both lungs. Based on those, the patient was diagnosed with HAPE. In this case, the patient was given oxygenation. Conclusion: In this case, the patient was diagnosed with HAPE based on anamnesis, physical examination, and laboratory tests. Oxygenation given to the patient improved his condition.
Background: Muscle wasting is one of the extrapulmonary manifestation which influence quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients. It caused by imbalance of protein metabolism in skeletal muscle. This study aimed to evaluate the effect of Ophiocephalus striatus extract on neutrophil count, soluble urokinase-type plasminogen activator (suPAR) level, diffusion capacity of lung for carbon monoxide (DLCO) and quality of life in stable COPD patients with muscle wasting. Methods: Clinical pre and post quasi experimental study was conducted to 32 stable muscle-wasted COPD patients from Pulmonary Outpatient Clinic Saiful Anwar Hospital Malang, determined by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016, Bioelectrical impedance analysis (BIA) dengan fat-free mass (FFM)
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