Disseminated Histoplasmosis in an Indonesian HIV-Positive Patient: A Case Diagnosed by Fine Needle Aspiration Cytology

A 30-year-old Javanese-Indonesian man was admitted with complaints of 3 months persistent fever, weight loss, and fatigue. He had never known his past history of unprotected HIV until the admission. His only risk factor is unsafe sex. The patient seemed well nourished. Physical examination revealed blood pressure 100/60 mmHg, pulse 100 beats per minute, respiratory rate 20 times per minute, and temperature 38.8°C. Multiple cervical and inguinal lymphadenopathies were also found. Electrocardiogram showed anterolateral ischemic finding, whereas chest X-ray were normal. Laboratory test results revealed pancytopenia with hemoglobin of 8.2 g/dL, leucocyte count 2000 cells/mm3, platelet 78000 cells/mm3, hematocrit 25.8%, AST 162 IU/L, ALT 81 IU/L, decreased albumin of 2.72 g/dL. The clinical differential diagnosis were lymphoma or tuberculosis lymphadenopathy

The Effects of Exercise on Spleen Fibrosis and Macrophage Number in D-Galactose-Induced Aging Rat Model

Background: Spleen plays a role in human immune system as well as in recycling and filtering blood. The aging spleen is associated with fibrosis and impaired immune system, increasing individual vulnerability to getting infections. Regular physical activity is essential to maintain and enhance body fitness, endurance, and immune system.Objective: This study aimed to investigate the effects of mild and moderate-intensity treadmill exercise on the aging spleen by examining fibrosis and the number of macrophages in d-Galactose-induced aging rat models.Methods: Twenty-four male Wistar rats were randomly divided into four groups: G1 (control group), G2 (d‐Galactose, no exercise), G3 (d‐Galactose, low-intensity exercise), and G4 (d‐Galactose, moderate-intensity exercise). d-Galactose was administered intraperitoneally on day 0 and treadmill exercise was given for four weeks following the modified Brown et al. (2007) protocol. Spleens were histologically processed and stained for picrosirius red and against CD68+ antibody. Percentage of fibrosis fraction area and macrophage cell count were obtained using ImageJ, and the data were analyzed statistically using SPSS software.Results: The aging spleen did not show any differences in weight, length, and width among groups (P > 0.05). The administration of d-Galactose in rats causes fibrosis and an increased number of macrophages. Low and moderate-intensity treadmill exercise could not lower the percentages of fibrosis fraction area. However, the moderate-intensity treadmill exercise was effective in lowering macrophage number.Conclusion: Moderate-intensity treadmill exercise was effective in lowering macrophage cell count in the aging rat spleen induced by d-Galactose

Antifibrotics and Antioxidants of Chlorogenic Acid Inhibits Toll- Like Receptors-4 as Liver Fibrotic Marker

Introduction: Chlorogenic Acid (CGA) is an antifibrotic and antioxidant for fibrotic tissues. These double  roles be able to inhibit or fibrotic tissues chains because of internal and external issues.  For example, virus, bacteria or other pathogens and also by drugs, alcohol, cigarettes, etc. as external factor that affect quality of body tissues. Toll-Like Receptor-4 (TLR-4) as a marker fibrotic tissues.  It is a key for researcher could be find out by expression performance. The aim of this study is to reveal the CGA as a candidate of antifibrotic & antioxidant in liver fibrosis that induced by CCL4.    Methods: This is a pure experimental research with a simple experimental design or post-test only control group design. The total 29 mices of 2.5-month-old male Swiss mices with weigh 35-40 gram divided into 6 group: 3 groups of controls (injected by natrium chloride, CGA, and CCL4) and 3 groups of treated (injected by CGA doses 42 mg/kg, 63 mg/kg or 84 mg/kg).  Liver organ was used to examine the expression of TLR-4 by rt-PCR. This research revealed that expression of TLR-4 lower than the CCL4 control group (respectively, p=0.042; p=0.005; p=0.006; and p=0.001). Higher dose of CGA showed greater ability as anti-fibrotic through inhibit the expression of  TLR-4. Some research found the expression of TLR-4 has been decreased by treatment of Clorogenic Acid (CGA). Conclusion: To sum up, CGA has double roles to repair liver fibrotic tissues. The greater doses of CGA, the stronger inhibition of TLR-4 expression

Perbedaan Kadar Interferon Gamma Cairan Asites Pada Subtipe Histopatologi Serosa dan Non-Serosa Kanker Ovarium Tipe Epitel

Latar Belakang: Karsinoma ovarium dapat dibedakan menjadi subtipe serosa dan non-serosa, dimana subtipe serosa memiliki prognosis yang lebih baik. IFN-γ dapat memiliki aktivitas pro-tumor maupun anti-tumor. Penelitian tentang kadar IFN-γ asites serta hubungannya dengan subtipe serosa dan non-serosa belum banyak dilakukan.Tujuan: Mengetahui perbedaan rata-rata kadar IFN-γ cairan asites pada subtipe serosa dan non-serosa karsinoma ovarium.Metode: Penelitian cross sectional selama periode September – Desember 2018. Pengambilan sampel asites dilakukan di kamar operasi RSUP Dr. Sardjito dan pengujian sitokin menggunakan Human IFN-γ ELISA Kit dilakukan di Laboratorium Biologi Molekuler FKKMK Universitas Gadjah Mada.Hasil dan Pembahasan: Pada 11 sampel subtipe serosa didapatkan rata-rata kadar IFN-γ sebesar 0,46 pg/ml, sedangkan pada 7 sampel non-serosa didapatkan rata-rata 0,97 pg/ml, namun perbedaan rata-rata tersebut tidak signifikan secara statistik (p=0,104).Simpulan: Tidak terdapat perbedaan rata-rata kadar IFN-γ dalam cairan asites pada subtipe serosa dan non-serosa karsinoma ovarium.Kata Kunci: interferon gamma (IFN-γ), karsinoma ovarium, asites, subtipe histopatolog

DIFFUSE LARGE B-CELL LYMPHOMA OF THE HEART

Diffuse large B-cell lymphoma (DLBCL) of the heart accounts for only 1% of primary cardiac tumors. Histopathologic examination becomes the primary key for diagnosis and immunohistochemical evaluation for non-Hodgkin lymphoma (NHL) subtype determination is able to predict disease progression and therapeutical modality. Case description: 70-year-old man complained of shortness of breath. Echocardiographic examination revealed mass occupied the left atrium measured 5.9 x 2.9 cm inherent with interatrial septum and mass with a stem in the right atrium measured 4.6 x 2.4 cm. Intraoperative, considerable amount of extracardiac mass was found, mass extension was unable to be determined. Thoracic surgeon decided to sample the extracardiac mass without performing cardiac surgery. The histopathologic features showed round blue cell tumor resembling a NHL. Immunohistochemical staining were consistent with diffuse NHL, large cell, high grade lymphoma, suitable for DLBCL. Round blue cell tumor of extracardiac mass with positive expression of LCA and CD 20 is suitable for B-cell non-Hodgkin lymphoma. Ki-67 immunohistochemical staining revealed a 70-80% proliferation index which indicates a high-grade lymphoma and defining diagnosis and treatment of DLBCL

Ethanolic Extract of Pluchea indica Less leaf Increases Serum Growth Hormone in Lactating Rats

The objectives of the study were to evaluate the effect of ethanolic extract of P. indica Less leaf (EPI) on serum growth hormone (GH), milk yield, body weight gain of dams, and dam’s organ weight in lactating rats. A total of 25 lactating rats with six pups were randomized and distributed to one of five treatments (control (RO water), standard (domperidone 2,5 mg/kg BW/day), EPI 250 (250 mg/kg BW of EPI), EPI 500 (500 mg/kg BW of EPI), and EPI 750 (750 mg/kg BW of EPI)). The treatment was administered daily starting from the 2nd until the 15th day of lactation. On the 16th day serum growth hormone level, body and organ weight of rats were measured. Serum GH levels in the EPI 750 group (1963.25 ± 360.91 pg/µL) increased significantly compared to the domperidone (409.46 ± 28.80 pg/µL) and the control group (723.40 ± 95.78 pg/µL, p0.05). There was significant body weight gain in the EPI 750 group compared with the domperidone group. There was no significant difference in organ weight gain in each group. The study revealed that ethanolic extract of P. indica Less leaf can increase serum growth hormone in lactating rats

Antifibrotics and Antioxidants of Chlorogenic Acid Inhibits Toll- Like Receptors-4 as Liver Fibrotic Marker

Introduction: Chlorogenic Acid (CGA) is an antifibrotic and antioxidant for fibrotic tissues. These double  roles be able to inhibit or fibrotic tissues chains because of internal and external issues.  For example, virus, bacteria or other pathogens and also by drugs, alcohol, cigarettes, etc. as external factor that affect quality of body tissues. Toll-Like Receptor-4 (TLR-4) as a marker fibrotic tissues.  It is a key for researcher could be find out by expression performance. The aim of this study is to reveal the CGA as a candidate of antifibrotic & antioxidant in liver fibrosis that induced by CCL4.    Methods: This is a pure experimental research with a simple experimental design or post-test only control group design. The total 29 mices of 2.5-month-old male Swiss mices with weigh 35-40 gram divided into 6 group: 3 groups of controls (injected by natrium chloride, CGA, and CCL4) and 3 groups of treated (injected by CGA doses 42 mg/kg, 63 mg/kg or 84 mg/kg).  Liver organ was used to examine the expression of TLR-4 by rt-PCR. This research revealed that expression of TLR-4 lower than the CCL4 control group (respectively, p=0.042; p=0.005; p=0.006; and p=0.001). Higher dose of CGA showed greater ability as anti-fibrotic through inhibit the expression of  TLR-4. Some research found the expression of TLR-4 has been decreased by treatment of Clorogenic Acid (CGA). Conclusion: To sum up, CGA has double roles to repair liver fibrotic tissues. The greater doses of CGA, the stronger inhibition of TLR-4 expression

Upregulation of Endothelin-1/Endothelin A Receptor Expression Correlates with Heparanase Expression in Ovarian Carcinoma

Background: Heparanase and endothelin-1/endothelin A receptor (ET-1/ETAR) expressions increase in cancer. This condition enhances tumor progression and correlates with poor survival. Limited data are documented regarding the role of heparanase and ET-1/ETAR in epithelial ovarian cancer (EOC). We sought to characterize the correlation between heparanase and ET-1/ETAR in EOC. Methods: Thirty patients with benign and malignant ovarian neoplasms were recruited in this study. Neoplasm subtypes were diagnosed by pathologists. RNA extraction was done in fresh frozen neoplasms while immunohistochemical (IHC) staining was done on ETAR, heparanase, and proliferation (Ki-67 antigen) in paraffin sections. Reverse transcriptase PCR was done to quantify the expression of preproET-1 (ppET-1), ETAR, and heparanase. ETAR and heparanase histoscores were done based on IHC staining. The Independent Samples t Test, ANOVA, and correlations were used for statistical analysis. Results: Heparanase and ETAR histoscores, ppET-1 and ETAR mRNA levels, and Ki-67 were significantly higher in the group with EOC than in the benign or borderline group, regardless of the histopathological types. The heparanase histoscore correlated with the ETAR histoscore (r=0.484, P=0.007) and the ETAR mRNA level (r=0.551, P=0.003). The level of ppET-1 mRNA correlated with both ETAR mRNA level and ETAR histoscore (r=0.603, P=0.001 and r=0.455, P=028, respectively). The ovarian neoplasms with high ppET-1 mRNA levels also tended to have high heparanase mRNA levels; however, the correlation was weak (r=0.354, P=0.07). Ki-67 correlated with the heparanase and ETAR histoscores (r=0.381, P=0.038 and r=0.477, P=0.008, respectively). Conclusion: Heparanase and ETAR were upregulated in EOC, and the correlation between heparanase and ETAR expressions was also elucidated in the current study

Lactogenic activity of ethanolic extract of Pluchea indica Less leaf in lactating rats

Introduction: The leaves of Pluchea indica (L.) Less is empirically used to enhance milk production. This study aimed to evaluate the lactogenic effect of ethanolic extract of P. indica leaves (EPI) on milk production, prolactin, cortisol, oxytocin levels, and histological changes of mammary tissue in lactating rats and weight gain of their pups. Methods: Twenty-five lactating rats with six pups were randomized into five groups. The groups were control (reverse osmosis water), standard (domperidone 2.5 mg/kg BW), and EPI (250, 500, and 750 mg/kg BW). The daily treatments were administered by oral gavage, starting from the second day until day 15 of parturition. Milk production and the weight of the pups were measured daily. Serum prolactin, cortisol, and oxytocin levels in the lactating rats were determined by enzyme immunoassay. Histomorphological alterations of mammary tissues were investigated by hematoxylin and eosin-stained slides. Data were analyzed by one-way ANOVA tests and P0.05). Conclusion: Pluchea indica leaves revealed lactogenic activity in lactating rats