Medical Journal of Indonesia

Editor: Nafrialdi

ISSN: 0853-1773(Print)

Frequency: Quarterly

Language: English

Published by Faculty of Medicine Universitas Indonesia

Peer-reviewed open access journal indexed in Index Medicus

Web site: https://mji.ui.ac.id/v2/

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Now showing 1 - 20 of 567
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    Language barrier, funding, communication and time management problems found in the Medical Journal of Indonesia, 1995 - 2001.
    (2001-10) Suryono, Isnani A; Pawitan, Jeanne A; Saifuddin, Abdul B
    The objective of this study is to assess the problems encountered in the management of Medical Journal of Indonesia and whether any progress has been achieved during the past 7 years. A retrospective descriptive study was done in the MJI. Available data used as parameters were: number of articles submitted and author's home institution, number of articles submitted and rejected, cause/criteria of rejection, qualification of reviewers and editors, duration of manuscript processing, and whether pre-scheduled time is met in the Med J Indones. For this purpose, all manuscripts from January 1995- January 2001 were evaluated. In addition, recent problems encountered were noted. Problems encountered were limited supply of manuscript that might be due to language barrier, decrease in circulation due to limited budget, communication problems due to seniority, and increase in average processing time that might be due to restriction in the time allocated for MJI Number of articles submitted by authors originating from national versus foreign institutions in 1995-1997 was 101 versus 16, and in 1998 - 2000 were 124 versus 84. Articles rejected were ±26.4 % (1999-2001) and the most frequent causes of rejection were insignificancy of substance and improper data analysis. As for the qualification of editors there was an increase in the number of PhDs and professors. Average processing time is approximately 1.5 times the scheduled time. It seems that the 4 main problems encounteredwere (l.l Language barrier, (2) Funding, (3) Communication problems and (4) Time management; and though not impressive, there are definitely positive changes in the number of manuscipts submitted, qualification of editors and peer reviewers. Average processirtg time is about the same, and the prescheduled time of editing is yet to be met.
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    Menopause and hormone replacement therapy.
    (2001-10) Baziad, Ali
    The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT). Natural HRT is usually prefened. Synthetic estrogen in oral contraceptives (oc) are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death.
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    Primary malignant mesenchymoma of bone: A case report.
    (2001-10) Hutagalung, Errol U; Gumay, Saukani; Budiatmoko, Bambang; Anggawidjaja, Suga
    Primary malignant mesenchymoma of bone (PMMB) is an exceedingly rare neoplasm consisting of two or more unrelated malignant mesenchymal components other than fibrosarcoma or malignant fibrous histiocytoma. Review of the literature reports only 16 cases, most of which were composed of osteosarcoma and liposarcoma. We report a case af PMMB composed of liposarcoma, rhabdomyosarcoma and high grade chondrosarcoma arising within the left distal femur in a 52-year-old male, resulting in the patient's death 3 months after presentation.
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    Some medical and other risk factors for current cesarean section in a Jakarta hospital.
    (2001-10) Poedjiningsih, Endang; Basuki, Bastaman; Supardi, A W
    For the last year the prevalence of cesarean section (CS) increased in several countries as well as in Indonesia. In Indonesia there was no comprehensive study on risk factors related to CS. This case-control study was conducted at Fatmawati Hospital in Jakarta from 1 July 200 until 31 January 2001. Data was extracted from available medical records. Ceserean section was defined as a delivery through laparotomy. The control group consisted of subjects having vaginal deliveries. For each cases were selected randomly a control based on the date before or after 18 October 2000. Subject who had fetal distress had 544-folds increased risk to be CS relative to those who did not have fetal distress [adjusted odds ratio (OR) = 544.86; 95% confidence intervals (CI) = 71.85- 4131.78]. Furthermore, relative those who did not have dystocia, those who had dystocia had 143 times increased risk to be CS (adjusted OR = 52.86; 95% CI = 52.86 - 391.17). In term of previous CS, subjects who ever had previous CS had 30 times increased risk to be CS compared with the subjects who never had CS (adjusted OR = 30.23; 95% CI = 12.06 - 75.57). In contrast, compared with those who non cash payment, those who paid in cash had a lowered risk of 80% (adjusted OR = 0.20; 95% CI = 0.11-0.34). In conclusion, previous CS, dystocia, pre eclampsia, other medical indications, fetal distress, and non cash hospitalization expences increased risk of CS.
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    Past antihypertensive drugs, obesity, daily light working load and risk of hypertension: An Indonesian 2001 rural study.
    (2001-10) Basuki, Bastaman; Soemarko, Dewi Soemark; Amri, Zarni; Ibrahim, Ermita Isfandiary
    This study aims to identify some risk factors related to hypeertension in rural areas. The data for this study is a part af the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta, on June 27h , 2001, at Cijeruk subdistrict in Bogor regency. The subjects were seleccted randomly using neighborhood cluster which was diffirent from the previous study in 2000. Interviews and blood pressure were taken at the houses of the subjects from 1:00 PM to 4:00 PM. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 18-39 year old group, and the risk was most prominent among the 55-59 year group [adjusted odds ratio (OR)= 17.7; 95% confidence intervals (CI)=6.26-59.2). Compared to the subjects with normal body posture,those who were obese had more than two-fold increase in the risk to be hypertensive (adjusted OR= 0.87; 95% CI= 0.87-4.17; P= 0.109). In addition, those who discontinued antihypertensive drugs had almost 14-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR= 14.16; 95% CI= 7.14- 28.05). In general, the results of this study is similar with our last year study which used different subjects. This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs; andwhom had light daily working load to prevent hypertension.
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    The chronopharmacological effect of curcurnin on human gall-bladder.
    (2001-10) Rasyid, Abdul; Rahman, Abdul Rashid Abdul; Jaalam, Kamaruddin; Lelo, Aznan
    Human gallbladder physiologically contracts and relaxes periodically. It has been demonstrated that curcumin (C) an active compound of Curcuma xanthorrhiza and Curcuma domestica produces a positive cholekinetic effect. The objective of this study is to define the influence of physiologic contraction and refilling of human gallbladder on the cholekinetic effect of Curcumin, and to determine the rime to achieve the maximum gall-bladder contraction after administration of 40 mg curcumin. Twelve healthy volunteers ingested 40 mg C and placebo (P) in a randomized double blind cross over study design. The volumes of gallbladder before and after taking C and P were half hourly determined by utrasonography and calculated using the ellipsoid methad for 6.0 hours. After P administration there is no gallbladder contraction. While afier C administration there was a contraction phase for 2 hours followed by a refilling phase for another 2.5 hours and then followed by second gall-bladder contraction started for 4.5 up to 6.0 hours. The maximal volume of gallblndder after 6.A hours was less than the basal volume, The cholekinetic effect of C is not chronopharmacologically influenced by the gall-bladder physiologic periodic contraction and refilling. The maximum contraction effect of C was achieved at 2 hours after oral administraion.
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    Combination of interferon alfa-2b and ribavirin in relapsed or nonresponding chronic hepatitis C patients following interferon therapy.
    (2001-10) Lesmana, Laurentius A; Budihusodo, Unggul; Akbar, Nurul; Sulaiman, Ali; Noer, Sjaifoellah; Kristanti, Inge Ade; Setiabudy, Rianto
    Twenty six patients (pts) with chronic hepatitis C (CHC) who reLapsed or non-responded following.interferon (IFN) therapy were given lFN alfa-2b 3 MIU three times a week for 48 weeks in combination with Ribavirin 800-1000 mg daily 2I (80,8%) of the 26.pts completed the study consisted of 12 relapsers and 9 non-responders. Five pts dropped out due to drug adverse events in three pts and non-drug related reason in the other two. In the relapsed group complete response, relapse and sustained response rates were obtained in 9/12(75%), 2/2 (16,5%) and 7/12(58,3%) pts respectively. In the non- responding group, these figures were 3/9 (33,3%), 1/9(I1,1%), and 2/9(22,2%) pts, respectively. The most frequent adverse event was flu-like syndrome, which was found in 18 pts (85,7%). Combination therapy of IFN alfa-2b and ribavirin may induce sustained virological response in relapsed and non-responding CHC patients. This combination therapy is more effective for relapsers compared to for non-responders.
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    Identification of point mutations in Glucose-6-Phosphate Dehydrogenase gene in Timor Island people : A preliminary report.
    (2001-10) Hardjowasito, Widanto; Pardjianto, Bambang; Fitri, Loeki Enggar; Ys, Mardhani; Loekito, R M; Shirakawa, Taku; Nishiyama, Kaoru; Matsuo, Masafumi
    Glucose 6 phosphate dehydrogenase (G6PD) deficiency is common in malaria endemic region, however no molecular study has been performed on G6PD deficiency in Timor Island, Indonesia a malarial hyperendemic area which Proto Malay is the majority of the people in that island. To observe the frequency and molecular type of mutations in G6PD deficient Proto Malay people, 118 native people were screened using formazan ring test. Mutation in the G6PD gene were determined by MPTP (Multiple PCR using Multiple Tandem Forward Primers and a common Reserve Pimer) method and confirmed by automatic sequencer. This study shows that three males have lower G6PD activity. Using MPTP method, a point mutation could be indicated in the two cases. Sequencing of the amplified products in 2 G6PD patients disclosed mutations of T383C in exon 5 and C 592 T in exon 6 in respective case. Our result documents point mutations in exon 5 and exon 6 in the G6PD gene of two Proto Malay people in Timor. These mutations are common in Asia region.
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    The correlation between histologic placentitis and amnionitis and the amnioniotic fluid's inflammatory cytokines in case of spontaneous pre-term labor with intact membrane.
    (2001-10) Abadi, Agus
    Pre-term labor is presumed to result from spreading of lower genital infection to upper part, subsequently to decidual and choioamniotic tissues. Host response to this injury include the expression of protein which is responsible to the inflammatory reactions. The expression of the inflammatory cytokines such as IL-1β, IL-6, IL-8 and TNF-α increase in case of infection.These cytokines may play an essential role in the pathophysiology of spontaneous pretem labor with intact membrane.An observational analytic cohort study was caried out on cases of spontaneous pre-tefln labor with intact membrane. The objectives of this study are to examine the relationship between l) the histologic amnionitis and placentitis and the incidence of preterm delivery,2) the expression of amniotic fluid's IL-1β, IL-6, IL-8 and TNF-α and the incidence of preterm delivery, 3) the level of amniotic fluid's IL-1β, IL-6, IL-8 and TNF-α and the grade of histologic amnionitis and placentitis in case of pre-term labor with intact membrane. Cases of spontaneous Pre'teftn labor with intact membrane which underwent transabdominal amniocentesis at admission and managed as standard procedure for pre-term labor with intact membrane. Atl of the cases were observed until the delivery of the baby, eithir preterm or term. The membrane and the placentawere cut postnatally and then the histologic acute inflammation eyaluated based on the criteria of Salafia.The level of amniotic fluid IL-1β, IL-6, IL-8 and TNF-α were analyzed quantitatively by Elisa method. This study showed thet the degree of histologic amnionitis and placentitis, and the level of amniotic fluid's IL-1β, IL-6, IL-8 and TNF-α were significantly higher in pre-term compared to terrn deliveries (p<0.05) and lhere were a positive correlation between the grade of histoLogic inflammation and the level of amniotic fluid's cytokines (Spearmann Rank Conelation test; p<0,05) in cases of preterm labor with intact membrane. The higher the grade of histologic amnionitis and placentitis, the higher the level of arnniotic fluid's IL-1β, IL-6, IL-8 and TNF-α resulting in a higher rtsk of pre-tenn delivery in case of prererm labor with intact membrane. These correlation moy indicate a progression of inflarvnation from placenn and membrane into the amniotic cavity.
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    Neuropeptides in atopic dermatitis.
    (2001-07) Cholis, M
    The nervous system, the immune system, and the cutaneous system are not independent systems, but are closely associated and use the same language of cytokines and neurotransmitters. Atopic dermatitis (AD) is exacerbated by several factors, such as emotional stress, scratching and sweating. This review presents the role of neuropeptides (NP) in AD. In AD, abnormalities occur in distribution of some types of neural filaments and in the associated active NP. Nerve fibre increases. Nerve fibres for substance-P (SP) and calcitonin gene-related peptide (CGRP) are positive, The cutaneous concentration of SP decreases while vasoactive-intestinal polypeptide (VIP) increases. Immunohistochemical examination has revealed neuropeptide-Y (NPY)-positive dendritic epidermal cells in AD lesions but no somatostatin (SOM) fibres. Neuromediators modulate functions of all cutaneous cellular types, which are all part of the neuroimmunocutaneous system (NCIS): endothelial cells, glandular cells, fibroblasts, epidermal cells and immune cells. Conclusion: during the course of AD, the NICS is destabilized. Evidence show that NP can also be responsible for the induction and maintenance of the cutaneous inflammation process and confirm an involvement in the pathogenesis of AD. Release of the NP by cutaneous nerve potentially explains the role of emotional stress, scratching and sweating in exacerbation of AD.
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    Filariasis in the new millennium.
    (2001-07) Nelwan, R H H
    The lndonesian national filariasis eradication program in its pursuit in obtaining microfilarial rates below 1% in filariasis endemic locations was on its right track until the monetary crisis started 3 years ago. This crisis which is not over yet at present is complicated by unstable public safety causing population shifts where people from filaria endemic locations seek refuge in non-endemic areas. This updated review will hopefully serve as a timely reminder to our physicians and health workers especially on the mode of filarial transmission as well as on its clinical presentations and presently accepted ways of manaqement. This paper also will serve as an introduction into the present breakthroughs in this new millenium as noted in the field of diagnostics and simplified mass treatment schedules making it possible for the elimination of lymphatic filariasis as a public health problem. A global alliance under the guidance of the World Health Organization with support of the multinational pharmaceutical companies for providing free expensive medication as needed. The WHO also cooperates closely with the Tropical Diseases Research task forces of Filariasis Intervention Research and of Product Development, that in the end will provide the means to eradicate this disease for once and forever from the face of the earth.
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    Selective estrogen receptor modulators (SERM): A new choice for postmenopausal women and physicians who worry on cancer.
    (2001-07) Baziad, A
    The postmenopausal state is characterized by the cessation of menstruation, loss of ovarian function, and a dramatic decrease in the level of circulating estrogen. This state of estrogen deficiency contributes to the acceleration of several age-related health problems in women, including cardiovascular disease, osteoporosis, and dementia. Estrogen replacement is clearly effective in the short-term and long-term treatment and prevention of postmenopausal symptoms. However, until now, the amount of HRT user is still very low. Fear of breast cancer and endometrial cancer are the most common concern in using hormone replacement therapy (HRT), although the relationship between long-term HRT and breast cancer remains controversial. For physicians or patients, who worry on cancer, the ideal drug is now available i.e. the selective estrogen receptor modulators (SERM), with the generic name raloxifine.
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    Controversies in hormone replacement therapy.
    (2001-07) Baziad, A
    Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT) with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine.
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    Genetic risk factors for chronic obstructive pulmonary disease.
    (2001-07) Tandon, Monika; Tandon, Sanjeev; Gupta, Mahesh; Gupta, K B
    Chronic obstructive pulmonary disease (COPD) is a complex condition, influenced by environmental and/or genetic risk factors. It is important to identify these factors, and develop new therapies for the management of COPD. This review identifies these factors and highlights the role they will play in future treatment options of COPD.
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    The prevalence of Strongyloides stercoralis infection in rural population of Bali: A preliminary study.
    (2001-07) Widjana, Dewa P; Sutisna, Putu
    A cross-sectional study was carried out from March until September 1992 in 4 different geo-climatic rural villages in Bali to assess the prevalence of Strongyloides stercoralis infection related to age, gender and geo-climatic condition. The number of selected samples using multistage stratified random sampling based on age and gender was 2880. Strongyloides larvae in stool samples were identified by modified Harada Mori fecal culture technique. The results showed that the overall prevalence of Strongyloides infection was 1.6%; the prevalence in male was 1.2% and in female was 2.1%, however the gender difference was not statistically significant. In term of age, there was no statistically significant difference. The highest prevalence (2.4%) was found among 7-12 years children, followed by aged 7 years or less (1.6%), 18 years or over (1.6%), and 13-18 years (0.6%). The prevalence of Strongyloides infection related to geo-climatic conditions was significantly difference. The highest prevalence of Strongyloides infection was at wet highland (3.3%), followed by wet lowland (1.5%), dry highland (1.0%), and dry lowland (0.9%). In conclusion, the prevalence of Strongyloides stercoralis infection in Bali was very low. Prevalence of Strongyloides infection was highly related to geo-climatic type of area, but not to gender and age groups.
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    Traumatic hemipelvectomy (amputae): Report of one case.
    (2001-07) Hutagalung, Errol U; Qomarrudin, Qomarrudin
    Traumatic hemipelvectomy (amputae) is a catastrophic injury resulting front violent shearing forces which avulsed the lower limb at the level sacroiliac joint and symphisis pubis. Patients surviving traumatic hemipelvectomy are rare. One case of a 25 months old girl surviving traumatic hemipelvectomy), is presented. This is the first case reported from Indonesia.
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    Assessment of utility of Siriraj Stroke Score (SSS) in stroke patients of Pt. BD Sharma PGIMS hospital, Rohtak, India.
    (2001-07) Singh, H; Gupta, J B; Gupta, M S; Aggarwal, Rohit
    India has predominantly poor rural population where brain CT scan, most often advised investigation in patients of stroke, may not always be available, hence Indian physician in such setting base his diagnosis on bed side sign evaluation for which Siriraj Stroke Score (SSS) could be helpful. Objective of study: to assess the utility of SSS in patients of stroke. Methodology: sixty subjects of stroke were evaluated on SSS and 'probable' diagnosis so made was compared with CT scan's (brain) 'certain' diagnosis. Main findings: by using SSS, the probable bedside diagnosis was cerebral infarct (score < -1) in 32 subjects and cerebral haemorrhage (score > +1) in 24 subjects while 4 subjects had indeterminant score (-1 to +1). Fifty subjects had their probable diagnosis matched with brain CT scan certain diagnosis. The above findings showed that SSS had 93.7% sensitivity, 76.6% specificity, 81.2% positive predictive value, 92% negative predictive value with an overall accuracy as 93.7% for diagnosis of cerebral infarction. For patients of cerebral haemorrhage the sensitivity was 83.3%, specificity was 92.5%, positive predictive value was 86.9%, negative predictive values was 92.5% with overall accuracy as 83.3%. Principal conclusion: physicians in the rural settings may find SSS to be quite useful in the management of stroke especially where more sophisticated radiological investigations may not be available for confirmation of diagnosis due to high cost or attended due to transportation risk.
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    Study of genetic diversity of Salmonella typhi using pulsed-field gel electrophoresis.
    (2001-07) Moehario, Lucky Hartati; Soemanto, Retno Kadarsih
    DNA genomes of Salmonella typhi (S. typhi), which were isolated from sporadic typhoid fever cases who were hospitalized in Persahabatan Hospital, Jakarta, during the 1st semester of 1998, were examined for their genetic diversities. Pulsed-field gel electrophoresis (PFGE) of genomic DNA digested with Xbal was performed for 25 isolates. Electrophoresis patterns of most isolates varied and 18 PFGE types were identified. Cluster analysis showed that all isolates originated from two main groups; and at ≥ 84% level of similarity, 7 clusters were found. Thus, the results showed that genetic diversity of S. typhi was considerably high, and that S. typhi isolated from sporadic typhoid fever cases were derived from multiple clones.
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    Influence of protein kinase C inhibitor in phagocytosis activity toward Candida sp.
    (2001-07) Adiprayitno, Adiprayitno
    Protein kinase C isoenzyme family that expresses in all of cells plays a pivotal role in the signal transduction pathway of a variety of hormones, cytokines, neurotransmitter, and growth factors. The immunity against Candida sp is mainly mediated and performed by the T cells and macrophages. The objective of this experiment is to know the influence the protein kinase C inhibitor - bisindolylmaleimides in phagocytosis activity toward Candida sp. The culture of peritoneal macrophage derived from BALB/c mice are treated with bisindolylmaleimides as a protein kinase C inhibitor concentration varied from 5 ng/ml to 100 ng/ml for as long as 10 minute. Then the Candida sp added is observed after every 30 minute for as long as 120 minute. As the experimental design is used the method of factorial and orthogonal polynomial. The data consisting the length of pseudopodia and the number of Candida sp which are phagocytosed are analyzed applying the Anova. One Way Anova to show the differences of each manipulation, the Two Way Anova to show the interaction of manipulations and the Student's t Test to show the differences with control. Statistical test show significant differences on the length of pseudopodia, and phagocytosed Candida sp, at different bisindolylmaleimides concentration (p<0.001) and different observed time (p<0.001). The data show a significant interaction between the bisindolylmaleimides concentration and observed time (p<0.001). The higher the bisindolylmaleimides concentration, the earlier the observed time, the much number the protein kinase C are going inactive and the shorter the length of pseudopodia or the lower the macrophages phagocytic activity toward Candida sp. The result of this experiment indicates that bisindolylmaleimides can inhibit the macrophage mobility and phagocytic activity toward Candida sp. Further experiment in protein kinase C, especially in macrophage, is suggested.
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    Identification of C5+ extraband of butyrylcholinesterase and two protein bands cathodic to it.
    (2001-07) Suyatna, F D; Setiabudy, R; Tjandrat, O; Herwanal, E
    Electrophoresis of human plasma yields 4 butyrylcholinesterase (BChE) protein bands, i.e. C1, C2, C3, C4 and in some individuals also an extraband C5+. In addition to that other protein bands called "S" bands are also invariably detected. In order to know whether the C5+ and the "S" bands are related to the BChE protein, we have carried out immunological and peptide mapping studies on these proteins. The immunology approach was done by raising polyclonal antibodies against each protein bands (S1, S2, C4 and C5+) and reacted to the plasma protein bands transferred on nitrocellulose papers. Individual raised antibodies recognized all protein bands studied including the C4, an isozyme of BChE, indicating that the protein bands contain similar epitopes. Several protein bands cathodic to S1 also reacted with the antibodies, suggesting that they are probably fractions of the BChE protein, as well. When individual protein bands were digested with S. aureus V8 toxin and α-chymotrypsin, they revealed a striking similarity in peptide pattern among each other. These studies indicate that the S1, S2 and C5+ protein bands belong to the BChE protein.