RIWAYAT PENGGUNAAN HERBAL SEBAGAI FAKTOR RISIKO TERHADAP KETERLAMBATAN MELAKUKAN PENGOBATAN PADA PENDERITA KANKER PAYUDARA DI SURAKARTA

Niluh Ayu Anissa Hanum, G0012149, 2016. Riwayat Penggunaan Herbal Sebagai Faktor Risiko Terhadap Keterlambatan Melakukan Pengobatan pada Penderita Kanker Payudara di Surakarta. Skripsi. Fakultas Kedokteran, Universitas Sebelas Maret, Surakarta. Latar Belakang: Kanker payudara merupakan suatu keganasan yang sering ditemukan pada wanita. Kejadian kanker payudara sebagian besar ditemukan telah mencapai stadium lanjut, yaitu 43% untuk stadium III dan 26% untuk stadium IV, yang memiliki ketahanan hidup yang lebih rendah. Tingkat pengetahuan, grade, tingkat pendidikan formal, penghasilan, jarak ke RS, dan rasa takut berobat dinilai berperan dalam keterlambatan pengobatan, termasuk juga di dalamnya riwayat penggunaan alternatif. Namun untuk riwayat penggunaan alternatif berupa herbal sebagai faktor risiko keterlambatan pengobatan belum jelas diketahui. Penelitian ini bertujuan untuk mengetahui apakah riwayat menggunakan herbal merupakan faktor risiko keterlambatan pengobatan pada penderita kanker payudara di Surakarta. Metode: Studi kasus-kontrol dilakukan pada penderita kanker payudara di RSUD Dr. Moewardi dan RSU Kasih Ibu Surakarta. Melalui fixed disease sampling, diperoleh 116 sampel, tetapi hanya 100 sampel yang memenuhi kriteria insklusi dan ekskusi. Sampel terdiri atas 46 penderita kanker payudara yang mengalami keterlambatan pengobatan sebagai kelompok kasus dan 54 penderita kanker payudara yang tidak mengalami keterlambatan pengobatan sebagai kelompok kontrol. Data stadium dan grade kanker didapatkan dari rekam medik, sedangkan data yang lainnya didapatkan dari wawancara pasien. Analisis dilakukan secara bivariat dengan uji chi square dan secara multivariat dengan regresi logistik. Hasil: Dalam analisis bivariat didapatkan hubungan bermakna antara keterlambatan pengobatan dengan riwayat menggunakan herbal, dengan p = 0,002 dan OR = 3,69. Analisis pada confounding factor juga didapatkan hubungan yang bermakna pada tingkat pengetahuan (p = 0,014; OR = 3,28) dan rasa takut berobat (p = 0,013; OR = 2,86). Sedangkan dalam analisis multivariat didapatkan bahwa tingkat pengetahuan rendah (p = 0,016; OR = 3,699) merupakan faktor risiko yang paling signifikan untuk keterlambatan pengobatan pada kanker payudara yang disusul oleh riwayat penggunaan herbal (p = 0,031; OR = 2,749) Simpulan: Riwayat penggunaan herbal terbukti merupakan faktor risiko terjadinya keterlambatan melakukan pengobatan pada penderita kanker payudara di Surakarta. Kata Kunci: Riwayat Penggunaan Herbal, Keterlambatan Pengobatan, Kanker Payudar

Printing and Mailing for the Brand: An Exploratory Qualitative Study Seeking to Understand Internal Branding and Marketing Within University and Extension Communication Services Units

Investment of employees in a brand can lead to greater public understanding and positive impressions of a brand by external stakeholders. However, this can be challenging in public organizations with multiple brand segments and a large number of employees spread across great distance with limited funds for marketing. While previous work has looked at Extension agents, faculty, and volunteers’ brand perceptions, no studies have looked at communication services employees’ investment in the brand. The purpose of this qualitative study was to discover how well employees in a university and Extension printing and mail entity understood the Extension brand and their investment in the brand. Research questions that guided this study were: 1) What perceptions and investment do communication services employees have in the Extension brand? And 2) what are employees’ perceptions of the organization’s branding and marketing efforts? Each of the 18 interviews included a series of questions focusing on employees’ story related to Extension and employees’ thoughts on branding and marketing efforts. Results in this study with communication services employees indicate these employees are not invested in the brand with the majority having little to no understanding of the mission of Extension. This contradicts previous research with employees in other brand segments of Extension. Implications of this work include a need for training on the Extension mission for communication services employees, a shift in culture to encourage investment in the brand, and inclusion of all Extension employees in the mission of Extension

Pemanfaatan Fly Ash sebagai Adsorben Karbon Monoksida dan Karbon Dioksida pada Emisi Kendaraan Bermotor

Karbon monoksida (CO) dan karbon dioksida (CO ) merupakan polutan utama dari emisi kendaraan bermotor. Dampak CO bagi kesehatan manusia adalah kemampuannya mengikat haemoglobin darah sehingga menurunkan kapasitas darah mengikat oksigen. Sebagai gas rumah kaca, CO berdampak pada Perubahan iklim. Maka perlu diupayakan pengendalian emisi CO dan CO dari kendaraan bermotor. Salah satu alternatifnya adalah dengan memanfaatkan limbah fly ash sebagai adsorben. Penelitian ini bertujuan untuk menganalisis kemampuan fly ash PLTU Suralaya sebagai adsorben CO dan CO dari emisi kendaraan bermotor dengan parameter massa, diameter, dan waktu kontak, serta menghitung penurunan emisi CO dan CO setelah penyerapan oleh adsorben fly ash. Metode penelitian adsorben ini menggunakan 3 variasi massa (100, 200, 300 gram), 3 variasi diameter (100, 200, 300 mesh), dan variasi rentang waktu kontak (0–20 menit). Pengujian dilakukan dengan memasukkan adsorben ke dalam knalpot uji yang dipasang di ujung knalpot existing kendaraan, lalu uji emisi dilaksanakan tanpa dan dengan adsorben. Hasil penelitian menunjukkan bahwa adsorben dengan penyerapan maksimum pada diameter 300 mesh dan massa 300 gram. Sedangkan waktu kontak adsorben maksimum selama 12 menit untuk CO dan 14 menit untuk CO . Penurunan emisi dari pemasangan adsorben pada knalpot kendaraan bermotor dapat mencapai 81,65% untuk CO dan 65,15% untuk CO

Retrograde diastolic blood flow in the aortic isthmus is not a simple marker of abnormal fetal outcome in pregnancy complicated by IUGR – a pilot study

Aim: To evaluate the relation between retrograde diastolic blood flow in the aortic isthmus and adverse perinatal outcome in fetuses with IUGR. Materials and Methods: The study included 33 fetuses with IUGR defined as the estimated fetal weight and abdominal circumference under the 10th percentile for a given gestational age. The Doppler examination of the blood flow in the aortic isthmus, umbilical artery, umbilical vein, middle cerebral artery, uterine arteries and ductus venosus was performed regularly. The study population was further divided into two subgroups, depending on the aortic isthmus blood flow direction, i.e. with and without retrograde isthmic diastolic flow. Furthermore, the relation between Doppler blood flow parameters and determinants of the perinatal outcome was analyzed. The perinatal outcome was reported as adverse if any of the following occurred: umbilical cord blood pH < 7,2; 5-minute Apgar score < 7; respiratory distress syndrome, intraventricular hemorrhage (III/IV grade); necrotizing enterocolitis; sepsis; intrauterine or neonatal death. Results: There was no statistically significant difference in the incidence of adverse perinatal outcome between the antegrade and retrograde isthmic blood flow groups. Moreover, the study showed no statistically significant relationship between the retrograde blood flow in the aortic isthmus and the prevalence of abnormal flow in the analyzed vessels. Conclusion: Retrograde diastolic blood flow in the aortic isthmus presents a low sensitivity and low predictive value in predicting the adverse perinatal outcome in pregnancies complicated with IUGR

p53-Dependent Transcriptional Responses to Interleukin-3 Signaling

p53 is critical in the normal response to a variety of cellular stresses including DNA damage and loss of p53 function is a common feature of many cancers. In hematological malignancies, p53 deletion is less common than in solid malignancies but is associated with poor prognosis and resistance to chemotherapy. Compared to their wild-type (WT) counterparts, hematopoietic progenitor cells lacking p53 have a greater propensity to survive cytokine loss, in part, due to the failure to transcribe Puma, a proapoptotic Bcl-2 family member. Using expression arrays, we have further characterized the differences that distinguish p53−/− cells from WT myeloid cells in the presence of Interleukin-3 (IL-3) to determine if such differences contribute to the increased clonogenicity and survival responses observed in p53−/− cells. We show that p53−/− cells have a deregulated intracellular signaling environment and display a more rapid and sustained response to IL-3. This was accompanied by an increase in active ERK1/2 and a dependence on an intact MAP kinase signaling pathway. Contrastingly, we find that p53−/− cells are independent on AKT for their survival. Thus, loss of p53 in myeloid cells results in an altered transcriptional and kinase signaling environment that favors enhanced cytokine signaling

THE N-HEXANE FRACTION OF MYRMECODIA PENDANS INHIBITS CELL SURVIVAL AND PROLIFERATION IN COLON CANCER CELL LINE

Objective: Despite advanced treatment options available for colorectal cancer, many reported resistance and unresponsiveness to conventional chemotherapeutic agents. Therefore, it is urgent to discover a novel drug for colon cancer. Sarang Semut (Myrmecodia pendans), an Indonesian native plant, has been studied extensively due to its anti-cancer profiles. This study aimed to evaluate the anti-tumour activity of Sarang Semut in colon cancer cells.Methods: We evaluated cytotoxic activity of methanol extract as well as n-hexane and ethyl acetate fraction towards colon cancer cell lines (Caco-2 and HCT-116 cells) utilizing 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. The most potent fraction was evaluated further in inhibiting cell survival using MTT assay and cell proliferation using trypan blue exclusion assay as well as a clonogenic assay.Results: Our data showed that the n-hexane fraction of Sarang Semut induces more cell death than the methanol extract and ethyl acetate fraction. Therefore, we analyzed the n-hexane fraction further and found that the inhibitory concentration 50% (IC50) of the n-hexane fraction was 24 and 30 parts per million (ppm) for Caco-2 and HCT-116 cells, respectively. Moreover, it inhibited cell growth as well as cell colony formation, in particular, shown by the plating efficiency (P&lt;0.05) and colony area per seed (P&lt;0.01) of the control group were different to the treatment group.Conclusion: The n-hexane fraction of Sarang Semut demonstrates a high potential antitumor activity in colon cancer cell line

Engineering Chemoselectivity in Hemoprotein-Catalyzed Indole Amidation

Here we report a cytochrome P450 variant that catalyzes C_2-amidation of 1-methylindoles with tosyl azide via nitrene transfer. Before evolutionary optimization, the enzyme exhibited two undesired side reactivities resulting in reduction of the putative iron-nitrenoid intermediate or cycloaddition between the two substrates to form triazole products. We speculated that triazole formation was a promiscuous cycloaddition activity of the P450 heme domain, while sulfonamide formation likely arose from surplus electron transfer from the reductase domain. Directed evolution involving mutagenesis of both the heme and reductase domains delivered an enzyme providing the desired indole amidation products with up to 8400 turnovers, 90% yield, and a shift in chemoselectivity from 2:19:1 to 110:12:1 in favor of nitrene transfer over reduction or triazole formation. This work expands the substrate scope of hemoprotein nitrene transferases to heterocycles and highlights the adaptability of the P450 scaffold to solve challenging chemoselectivity problems in non-natural enzymatic catalysis

Engineering Chemoselectivity in Hemoprotein-Catalyzed Indole Amidation

Here we report a cytochrome P450 variant that catalyzes C_2-amidation of 1-methylindoles with tosyl azide via nitrene transfer. Before evolutionary optimization, the enzyme exhibited two undesired side reactivities resulting in reduction of the putative iron-nitrenoid intermediate or cycloaddition between the two substrates to form triazole products. We speculated that triazole formation was a promiscuous cycloaddition activity of the P450 heme domain, while sulfonamide formation likely arose from surplus electron transfer from the reductase domain. Directed evolution involving mutagenesis of both the heme and reductase domains delivered an enzyme providing the desired indole amidation products with up to 8400 turnovers, 90% yield, and a shift in chemoselectivity from 2:19:1 to 110:12:1 in favor of nitrene transfer over reduction or triazole formation. This work expands the substrate scope of hemoprotein nitrene transferases to heterocycles and highlights the adaptability of the P450 scaffold to solve challenging chemoselectivity problems in non-natural enzymatic catalysis

Activation of the innate immune receptor Dectin-1 upon formation of a 'phagocytic synapse'.

Innate immune cells must be able to distinguish between direct binding to microbes and detection of components shed from the surface of microbes located at a distance. Dectin-1 (also known as CLEC7A) is a pattern-recognition receptor expressed by myeloid phagocytes (macrophages, dendritic cells and neutrophils) that detects β-glucans in fungal cell walls and triggers direct cellular antimicrobial activity, including phagocytosis and production of reactive oxygen species (ROS). In contrast to inflammatory responses stimulated upon detection of soluble ligands by other pattern-recognition receptors, such as Toll-like receptors (TLRs), these responses are only useful when a cell comes into direct contact with a microbe and must not be spuriously activated by soluble stimuli. In this study we show that, despite its ability to bind both soluble and particulate β-glucan polymers, Dectin-1 signalling is only activated by particulate β-glucans, which cluster the receptor in synapse-like structures from which regulatory tyrosine phosphatases CD45 and CD148 (also known as PTPRC and PTPRJ, respectively) are excluded (Supplementary Fig. 1). The 'phagocytic synapse' now provides a model mechanism by which innate immune receptors can distinguish direct microbial contact from detection of microbes at a distance, thereby initiating direct cellular antimicrobial responses only when they are required