betty Agustina Tambunan, betty Agustina
Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Airlangga – RSUD Dr.Soetomo Surabaya, Indonesia

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Journal : Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)

INTERFERON GAMMA AND INTERLEUKIN-10 LEVELS IN PBMC OF ACTIVE AND LATENT TUBERCULOSIS PATIENTS AS WELL AS HEALTHY INDIVIDUALS Tedja, I G.A. Wiradari; Nugraha, Jusak; Tambunan, Betty Agustina; Oetami, Fransisca Sri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1309

Abstract

Tuberculosis (TB), an infectious disease caused by a Mycobacterium tuberculosis, is still a health problem in Indonesia, and the world. One of the failures to control the TB epidemic is due to the lack of effective vaccines available today. Protective immune responses to M.tuberculosis are dominated by cellular immunity and less by humoral immunity. IFN-γ, and IL-10 play a role in the protection of against M.tuberculosis, and the pathogenesis of TB. Fusion antigen ESAT-6-CFP-10 has a strong antigenicity to T cells and stimulates specific cellular immune responses, thereby providing benefit in immune responses that are protective against M.tuberculosis infection. The aimed of this study was to know the difference betwen IFN-γ, and IL-10 levels on PBMC culture of active TB, latent TB, and healthy people after ESAT-6-CFP-10 fusion antigen stimulation. This study used an in vitro of quasi experimental design in PBMC cultures of active TB, latent TB, and healthy people groups stimulated by ESAT-6-CFP-10 antigen fusion Mycobacterium tuberculosis. IFN-γ, and IL-10 levels were measured by ELISA method. The results were analyzed by one-way ANOVA. The mean levels of IFN-γ post-stimulation of ESAT-6-CFP-10 fusion antigens did not differ (p=0.359) in the active pulmonary TB group (0.07 - 2114), latent TB (6.84 - 1381) and healthy people 1.88 - 1807.70), as well as the mean levels of IL-10 (p=0.712) in the active pulmonary TB (16.70 - 328.80), latent TB (29.70 - 323.60 ) and healthy people (31.30 - 958). There were no significant differences in levels of IFN-γ and IL-10 in active TB, latent TB, and healthy people after stimulation by fusion antigen ESAT-6-CFP-10. 
Diagnostic Value of Myeloperoxidase Index in Bacterial Infections Mirna Rahmafindari; Paulus Budiono Notopuro; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1557

Abstract

Infectious diseases remain a serious problem in Indonesia. Myeloperoxidase (MPO) is a substance released by neutrophils, which activates the synthesis of hypochlorous acid (HOCL) from hydrogen peroxide (H2O2) and chloride ion (Cl-). Hypochlorous acid plays a vital role in the body's defense against infection. Myeloperoxidase Index (MPXI) is a parameter in the hematology analyzer Advia 2120i based on the principle of flow cytometry. This study aimed to determine the diagnostic value of MPXI in patients with bacterial infections. The study was a cross-sectional observational analysis. The samples consisted of a group of patients with bacterial infection and a group of healthy subjects. The specimens used in this study were whole blood + anticoagulant (EDTA) in a purple tube with a volume of 3 mL to determine the MPXI value in both groups using ADVIA 2120i hematology analyzer. The study subjects consisted of a group of patients with bacterial infections (69 patients) and a group of healthy subjects (33 people). Analysis of the MPXI ROC curve with a cut-off ≥ -5.8 and < -5.8, showed AUC of 0.323 (CI=95%, p=0.004), sensitivity of 34.8%, specificity of 39.4%, Positive Predictive Value (PPV) of 54.5%, and Negative Predictive Value (NPV) of 22.4%. Due to its low diagnostic value, the MPXI value was not recommended to be used as a diagnostic instrument for bacterial infections. Also, further research was highly needed.
NILAI DIAGNOSTIK IgA ANTIVCA ANTIBODI EPSTEIN-BARR DI KARSINOMA NASOFARING Betty Agustina Tambunan; Aryati Aryati; Windu Nafika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1101

Abstract

Early diagnosis of nasopharyngeal carcinoma (NPC) is difficult, so most patients arrived already in an advanced stage. The biopsyas the gold standard for the diagnosis of NPC at an early stage also have limitations. Epstein-Barr virus as the cause of NPC is pavingthe way for early diagnosis was through serological method. The purpose of this study is to know the diagnostic value of IgA antiviralcapsid antigen (VCA) Epstein-Barr antibody for NPC by analyzing it. The samples were NPC patients and others whome have head-neckmalignancies arrived in the Oncology Outpatient Clinic, Dr. Soetomo Hospital. Their sera were examined for IgA antiVCA Epstein-Barrantibody using ELISA method and then analyzed for its diagnostic value using the 2x2 table with a 95% confidence interval. IgA antiVCAcutoff was determined by ROC. The results show that the diagnostic value of IgA antiVCA Epstein-Barr antibody have the sensitivityand specificity around 93.3% and 93.8%, respectively. Positive predict value was 96.6%% and the negative one was 88.2%, while thediagnostic efficiency was 93.5%. The positive likelihood ratio was 14.9 times and the negative was only 0.07. The cut off value of IgAantiVCA according ROC was 13.45 U/mL with AUC 97.9%. Based on this study, can be concluded that IgA antiVCA Epstein-Barr antibodyshowed an excellent validity in supporting the diagnosis of NPC. However, the researchers needed further research to know the obtainableearly stage of NPC.
CORRELATION OF PROCALSITONIN LEVEL WITH SEPSIS DEGREES BASED ON SOFA SCORE Citra Novita; Soeprapto Maat; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1497

Abstract

Background. Sepsis is defined as a life-threatening organ dysfunction condition caused by dysregulation of host response towards infection. Sepsis is one of the leading causes of death in medical emergency. A recent study revealed 18 millions of sepsis occur annually with a mortality rate of 30%, so early diagnosis in assessing sepsis severity is necessary as a guide for early and specific therapy. Organ dysfunction in sepsis patients is associated with high mortality, assessed by Sequential Organ Failure Assessment (SOFA) criteria. Procalcitonin is widely used for diagnosing, monitoring, and prognosis sepsis.Aim This study aimed to analyze the correlation of procalcitonin level with sepsis severity based on SOFA score.  Method. This was an observational cross-sectional study. Samples were collected from December 2017-February 2018 of 72 patients. Each patient was calculated by SOFA score and underwent procalcitonin examination using an immunochromatography method by RAMP. Results. Samples from 72 patients who met the criteria, were analyzed consisting of 37 mailes(51.4%) and 35 females(48.6%), aged 23-77 years, with mean±SD 47.4±14.02 years. The range of SOFA score was 0-16 with mean±SD 6.47±3.61, while procalcitonin levels 0.20-200 ng/mL mean±SD 21.03±14.63 ng/mL. There was a significant correlation between procalcitonin level and SOFA score (r=0.752;p<0.0001).Discussion. This suggests that procalcitonin may illustrate the severity of sepsis patients. The higher the procalcitonin, the more severe the sepsis.Conclusions and recommendations. SOFA score and procalcitonin examinations should be performed routinely in patients with sepsis to assess prognosis (severity) for earlier pretreatment so that the mortality rate can be lowered.
PERCENTAGE OF CD3+ T LYMPHOCYTES EXPRESSING IFN-γ AFTER CFP-10 STIMULATION (Persentase Limfosit T-CD3+ yang Mengekspresikan Interferon Gamma Setelah Stimulasi Antigen CFP-10) Yulia Nadar Indrasari; Betty Agustina Tambunan; Jusak Nugraha; Fransiska Sri Oetami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1181

Abstract

Tuberkulosis (TB) merupakan penyakit infeksi menular, disebabkan oleh Mycobacterium tuberculosis. Respons imun adaptif yangdiperantarai oleh limfosit T berperan sangat penting dalam menyingkirkan bakteri intraseluler. Hasilan sitokin IFN-γ merupakanmekanisme efektor utama dari limfosit T. Pengembangan vaksin yang efektif dalam melawan infeksi TB mempertimbangkan faktor yangmengatur hasilan IFN-γ. CFP-10 merupakan antigen yang disekresikan oleh Mycobacterium tuberculosis. Antigen ini dikenal sebagaikomponen vaksin potensial untuk TB. Tujuan penelitian ini adalah membandingkan respons imun seluler yaitu persentase limfosit T-CD3+yang mengekspresikan IFN-γ setelah dirangsang antigen CFP-10 di pasien TB paru kasus baru, TB laten dan orang sehat. Penelitianini menggunakan desain eksperimen murni di laboratorium secara in vitro pada kultur PBMC pasien TB paru kasus baru, TB latendan orang sehat. Subjek penelitian adalah 8 pasien TB paru kasus baru, 7 TB laten dan 7 orang sehat di RS Khusus Paru Surabaya.Pemeriksaan persentase limfosit T-CD3+ yang mengekspresikan IFN-γ dengan metode Flow cytometry (BD FACSCalibur). Hasil dianalisisdengan Kruskal-Wallis atau ANOVA satu arah. Rerata persentase limfosit T-CD3+ yang mengekspresikan IFN-γ di TB paru kasus barusetelah stimulasi antigen CFP-10 (4,36%) lebih tinggi daripada sebelum stimulasi (3,50%) (nilai P=0,015). Rerata persentase limfositT-CD3+ yang mengekspresikan IFN-γ di TB laten setelah stimulasi antigen CFP-10 (3,96%) lebih tinggi dibandingkan sebelum stimulasi(2,50%) tetapi tidak bermakna (nilai P=0,367). Rerata persentase limfosit T- CD3+ yang mengekspresikan IFN-γ di orang sehat setelahstimulasi (1,66%) lebih rendah daripada sebelum stimulasi (2,89%) tetapi tidak bermakna (nilai P=0,199). Perubahan persentaselimfosit T-CD3+ yang mengekspresikan IFN-γ setelah stimulasi antigen CFP-10 antarkelompok tidak berbeda bermakna (nilai P=0,143).Berdasarkan hasil telitian ini dapat disimpulkan bahwa terdapat peningkatan persentase limfosit T-CD3+ yang mengekspresikan IFN-γdi TB paru kasus baru setelah stimulasi antigen CFP-10. Hal ini menunjukkan limfosit T-CD3+ yang mengekspresikan IFN-γ berperandalam perlindungan terhadap infeksi TB paru.
The Suitability of Compatibility Test Results with Gel Method between Diagnostic Grifols Gel Coombs and Diamed-Identification Tigor Pandapotan Sianturi; Betty Agustina Tambunan
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.v27i1.1605

Abstract

A compatibility test as part of a pre-transfusion test is mandatory to ensure blood compatibility between patients anddonors. Diamed-ID as the first gel-based product is commonly used as a reference for the compatibility test. The presence ofnew products such as DG Gel Coombs encourages research to compare them with reference methods. This study aimed toanalyze the suitability of DG Gel Coombs to Diamed-ID in the compatibility test with the same sample. This cross-sectionalanalytic observational study was conducted during November 2017-February 2018 at the Blood Transfusion Unit Dr.Soetomo Hospital, Surabaya using blood samples (n=40), which met the inclusion and exclusion criteria. Simultaneoustesting of the two products was according to the manufacturing requirements of each product (using different LISS reagentsfor red blood cell suspensions and centrifugation arrangements). The suitability of results was tested with Cohen's kappaand significant differences with McNemar. There was a minimum suitability of DG Gel Coombs to Diamed-ID for majorcompatibility tests, κ 0.307 (95% CI: -0.029-0.643), significance 0.007 (p < 0.05) and moderate for minor, κ 0,678 (95% CI:0.454-0.903), significance <0.0001 (p < 0.05). McNemar's significance was 0.016 (p < 0.05) for major compatibility test and0.031 (p < 0.05) for minor. Referring to Diamed-ID's results, false negatives were found on DG Gel Coombs for majorcompatibility tests (n=7) and minor (n=6). The suitability of results from DG Gel Coombs and Diamed-ID is not strong forcompatibility testing.
CD4+ DAN CD8+ INTERFERON GAMMA TUBERKULOSIS PARU AKTIF DAN TUBERKULOSIS LATEN Betty Agustina Tambunan; John Wiwin; Jusak Nugraha; Soedarsono Soedarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1116

Abstract

Tuberculosis (TB) is a global health problem. Immune response through CD4+ T cells and CD8+T cells is needed to produce Interferongamma (IFN-γ). IFN-gamma is a cytokine that can kill Mycobacterium tuberculosis. Not all individuals will lead to illness or activediseases. The aim of this study was to know the cellular immune response like IFN-gamma expression of T-CD4+ cells and CD8+ cellsbetween active TB with latent TB. The design of the study was cross sectional obervational in a population suffering from active andlatent TB. The subjects consisted of 11 (eleven) active TB patients and 10 (ten) latent TB patients from the Special Pulmonary Hospitaland the Dr Soetomo Hospital, Surabaya. The examination of interferon gamma expression of CD4+ and CD8+ was by Flowcytometrymethod. These results were analyzed by Student t test or Mann-Whitney test. The mean CD4+ percentage of active TB (28.75%) waslower than the latent one (TB) (33.21%) but no significant difference (P value=0.114) was shown. The mean CD8+ percentage ofactive TB (30.46%) was higher than the latent one (TB) (28.87%) but no significant difference (P value=0.481) was found. Themean CD4+IFN-γ percentage of active TB (2.51%) was higher than latent one (TB) (1.10%) and there was a significant difference(P value=0.014). The mean CD8+IFN-γ percentage of active TB (2.91%) was lower than latent one (TB) (4.41%) and there was asignificant difference (P value=0.006). Based on this study, it can be concluded that the mean CD4+IFN-γ percentage of active TB washigher than latent TB and there was a significant difference. The mean of CD8+IFN-γ percentage of latent TB was higher than the activeone (TB). This suggested that CD8+ has a dominant part in latent TB and may be caused by the role of other cytokines, or genetics,nutrition, and body mass index factors.
DETECTION OF MYCOBACTERIUM TUBERCULOSIS WITH TB ANTIGEN RAPID TEST IN PULMONARY TUBERCULOSIS PATIENTS WITH FOUR TYPES OF SPUCTUM SAMPLE PREPARATION Miftahul Ilmiah; IGAA. Putri Sri Rejeki; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 2 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i2.1132

Abstract

Pemeriksaan mikroskopis langsung untuk mendiagnosis TB memiliki banyak keterbatasan. TB Ag Rapid Test Device merupakanmetode pemeriksaan ICT TB yang mendeteksi antigen yang disekresi khas dari Regions of Difference (RD) M.tuberculosis. Penelitiansebelumnya menunjukkan uji sering tidak berjalan dengan baik. Sampel penelitian adalah 30 dahak BTA positif dengan pemeriksaanmikroskopis langsung. Dahak diberikan 4 perlakuan berbeda yaitu: perlakuan rutin sesuai tata langkah perangkat; penambahan0,5 mL NALC 2,5% dan dahak dikocok sesuai tata langkah perangkat; perlakuan vorteks dilanjutkan pemusingan 10.000g suhu 4°C;penambahan 0,5 mL NALC 2,5%, vorteks dilanjutkan pemusingan 10.000g suhu 4°C. Hasil pemeriksaan antigen M.tuberculosis sebagaiberikut: perlakuan kesatu 43,3% positif, perlakuan kedua hasil positif tinggi (96,7%), perlakuan ketiga dan keempat didapatkanhasil positif sebesar 36,7% dan 86,7%. Pemeriksaan Ag menggunakan vorteks-pemusingan dengan pemeriksaan rutin menunjukkankesesuaian sebesar 86,6% (33,3% positif dan 53,5% negatif) dengan nilai Kappa 0,724 (p<0,0001). Perlakuan 2 (penambahan0,5 mL NALC 2,5%) dengan perlakuan 4 (penambahan NALC 2,5%-vorteks-pemusingan) menunjukkan kesesuaian sebesar 90% (86,7%positif dan 3,3% negatif) dengan nilai Kappa 0,366 (p=0,010). Pemberian pretreatment 0,5 mL NALC 2,5% dapat digunakan untukmeningkatkan hasil positif kit TB Ag Rapid Test Device untuk mendiagnosis tuberkulosis paru.
THE ROLE OF CARCINOEMBRYONIC ANTIGEN IN ASSESSING THE SUCCESS OF SURGICAL TREATMENT IN COLORECTAL CANCER BASED ON STAGING Anindya Widyasari; Betty Agustina Tambunanan; Vicky S. Budipramana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 3 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i3.1333

Abstract

Colorectal cancer is the third most common cancer in Indonesia. Determination of staging is needed to determine the treatment of colorectal cancer which has four stages. Carcinoembryonic Antigen (CEA) is a serological marker for monitoring colorectal cancer status, prognostic determination, monitoring of treatment success, detecting early recurrence and spreading. The purpose of this study was to determine the evaluation of successful surgical therapy in colorectal cancer by CEA examination at each stage. Descriptive observational studies were conducted using secondary data of pre and post-surgical colorectal cancer patients examined for CEA and treated at the Dr. Soetomo Hospital from January 2015 to December 2016. The samples obtained from this study were 48 patients, with the most of them at the age of 41-60 years as much as 70.83%. Females were more than males (66.67% vs. 37.33%). The most staging stage, stage 4 was as much as 43,75% followed by stage 3 as much 41.67%, the rest were stage 1 as much as 10.42%, and stage 2 as much as 4,17%. The highest decrease in CEA levels was found in stage 4 by 85%, followed by stage 2 of 53.5%, stage 1 of 43.4% and stage 3 of 33.1% but statistically only the decrease in stage 3 was significant. In stage 1, there was a difference in pre-operative CEA with a mean of 3.09 ng/mL (0.17-5.83 ng/mL) vs. post-operative with a mean of 1.75 ng/mL (0.84-3.14 ng/mL), stage 2 levels of pre-operative CEA with a mean of 3.82 ng/mL (0.15-7.48 ng/mL) vs. post-operative with a mean 1.77 ng/mL (1.46-2.08 ng/mL), stage 3 levels of pre-surgical CEA with a median of 13.85 ng/mL (1.09-71.21 ng/mL) vs. post-operative with a median 9.26 ng/mL (<0.5-68.23 ng/mL), stage 4 pre-surgical CEA levels with a median 183.77 ng/mL (0.54-2861 ng/mL) vs. post-operative with a median 27.28 ng/mL (0.51-155.10 ng/mL). There was a decrease in CEA levels from the total number of patients by 67%, whose CEA levels remained at 12% and as much as 21% of their CEA levels increased. Successful evaluation of surgical therapy in the colon and rectal cancer by CEA examination was still varied at each stage where CEA levels decreased significantly in stage 3.
DIAGNOSTIC VALUE OF CA-125 IN PATIENTS WITH EPITHELIAL OVARIAN CANCER AT THE DR. SOETOMO GENERAL HOSPITAL SURABAYA IN 2016 Kintan Putri; Betty Agustina Tambunan; Willy Sandhika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1380

Abstract

Ovarian cancer is the fourth cancer with most incidence in Indonesian female with 10.238 cases in 20141. Tumor marker CA-125 is assosciated with ovarian cancer, importantly epithelial ovarian cancer. This study aims to find out diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value) of CA-125 among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016. This study used analytic cross sectional method and was performed by evaluating medical records of patients suspected for ovarian malignancy in Dr. Soetomo General Hospital Surabaya in 2016. There were total 97 patients found fit for criteria of inclusion in this study. Tissue histopathological examination confirmed 66 patients have epithelial ovarian malignancy and 31 patients do not. Samples distributed using 35 U/ml as CA-125 upper limit, TP: 54.64%, FP: 19.59%, FN: 13.40%, dan TN: 12.37%. Diagnostic value obtained as follows: sensitivity 80.30%, spesificity 38.71%, positive predictive value 73.61%, negative predictive value 48%, and accuracy 67.01%. Tumor marker associated with ovarian cancer CA-125 has found high in sensitivity but low in specificity among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016.