Association Between Serum Midkine Level and Gastric Precancerous Lesion in Patients with Gastritis.

Background: Gastric cancer is the fifth most common malignancy and the third highest cancer-related mortality worldwide after lung and colorectal cancers. The gastric carcinogenesis is started with precancerous lesion. Prompt diagnosis and management of gastric precancerous lesion may prevent disease progression. Midkine is a growth factor associated with various cancers and proposed as a marker for detecting gastric precancerous lesion. Objective: The aim of the study is to determine the association between serum midkine level and gastric precancerous lesion in patients with gastritis. Methods: A cross sectional study was conducted at Haji Adam Malik general hospital. Subjects were obtained by consecutive sampling. Inclusion criteria were patients aged 18 years or older, diagnosed with gastritis from gastroscopy and histopathology results, and willing to cooperate in the study. Each subjects underwent interview and endoscopic examination. Serum midkine level was determined using enzyme-linked immunosorbent assay (ELISA) method. Chi square, receiver operating characteristic (ROC) curve, and logistic regression tests were applied. Results: A total of 160 subjects were enrolled with 29.4% had gastric precancerous lesion. Serum midkine level was associated with gastric premalignant lesion. Cut off point for serum midkine level was 252 pg/mL with area under the curve of 0.816 (p<0.001). It's sensitivity, specificity, and accuracy in diagnosing gastric precancerous lesion were 74.5%, 71.7%, and 72.5%, respectively. Helicobacter pylori infection, high serum midkine level, heavy alcohol drinker, and family history of gastric cancer were risk factors for gastric precancerous lesion. Conclusion: Serum midkine level is associated with gastric premalignant lesion in patients with gastritis and has good diagnostic values.

Impact of the Neuregulin rs35753505 C/T Polymorphisms on Neuregulin 1 Levels in Preterm Infants.

BACKGROUND: Neuregulin (NRG) 1 plays an important role in the development of various organ systems in human. Single nucleotide polymorphisms rs35753505 C/Tof the gene encoding NRG1 evident as allele C and T with genotypes of CT, CC, and TT are believed to have an impact on NRG1 levels. AIM: To determine the impact of the NRGrs35753505 C/T polymorphisms on NRG1 levels in preterm infants. METHODS: A cross-sectional study was conducted from February to December 2018, whereas 48 eligible preterm infants with a gestational age of 32- < 37 weeks were enrolled. An umbilical cord blood specimen was collected for determination of NRG1 levels with enzyme-linked immunosorbent assay (ELISA) and NRG1 polymorphisms with polymerase chain reaction (PCR). Statistical analysis was performed with 95%CI and P value of < 0.05 was considered statistically significant. RESULTS: Median value of NRG1 levels (174.4 pg/ml) served as a cut off value. NRG 1 polymorphisms composed distribution of CC (31%), CT (42%), TT (27%) genotypes and distribution of C and T alleles were 52% and 48%. The median NRG1 levels in CC and CT genotypes were significantly lower compared to TT genotype (151.1 pg/ml vs 407.2 pg/ml, P = 0.005 and 159.1 pg/ml vs 407.2 pg/ml, P = 0.009). Subjects with C allele had significantly lower median NRG1 levels than T allele (151.1 pg/ml vs 407.2 pg/ml, P = 0.002). Subjects with CC and CT genotypes had higher risk to develop lower NRG1 levels compared to TT genotype (OR = 8.25, P = 0.016 and OR = 10.74, P = 0.005, respectively). CONCLUSION: Allele C is associated with lower NRG1 levels. Preterm infants with CC and CT genotypes pose a higher risk to have lower NRG1 levels.

The Levels of Vitamin D, Metalloproteinase-9 and Tissue Inhibitor Metalloproteinase-1 in COPD Patients, Healthy Smokers and Non-Smokers of Indonesian Citizens.

BACKGROUND: Exposure to cigarette smoke may stimulate the inflammatory response and activate polymorphonuclear leukocytes, thus resulting in secretion of cellular proteases. Vitamin D has the potential to modulate the inflammatory response to harmful particles in patients with Chronic Obstructive Pulmonary Disease (COPD). AIM: This study aimed to determine the levels of vitamin D, MMP-9, and TIMP-1 in COPD subjects, healthy smokers and nonsmokers of Indonesian citizens. METHODS: Seventy-eight male subjects took part in this study. They comprised three groups, i.e. COPD (n = 26), healthy smokers (n = 25) and healthy non-smokers (n = 27). Serum 25(OHD) levels, MMP-9, and TIMP-1 concentrations measured by electrochemiluminescence binding assay (ECLIA) and enzyme-linked immunosorbent assay (ELISA). RESULTS: The levels of vitamin D in COPD (21.96 ± 6.62ng/mL) and healthy smokers (27.87 ± 7.08 ng/mL) were significantly (p < 0.001) lower compared to that in healthy non-smokers (31.71 ± 9.24 ng/mL). On contrary, the levels of MMP-9 in COPD (11.98 ± 41.54 ng/mL) was significantly (p = 0.003) higher compared to that in healthy smokers (2.23 ± 3.39 ng/mL) and healthy non-smokers (0.89 ± 1.12 ng/mL). Whereas the levels of TIMP-1 in healthy smokers (24.64 ± 57.77 ng/mL) was significantly (p < 0.001) lower compared to that in COPD (58.40 ± 77.53 ng/mL) and healthy non-smokers (46,54 ± 71,48 ng/mL). CONCLUSION: The present study showed the lowest level of vitamin D, the highest level of MMP-9 and TIMP-1 in the COPD subjects.

The Alteration of Plasma Matrix Metalloproteinase-9 Level after the Addition of Bromelin 500 mg to Standard Therapy of Acute Ischemic Stroke and Its Correlation with Outcome.

BACKGROUND: Matrix metalloproteinase-9 (MMP9) expression due to ischemic cause spreading of brain damage. Previous studies have reported that Bromelin was beneficial as anti-inflammation and prevent brain tissue damage. AIM: This study aimed to determine the alteration of plasma MMP9 level after addition of Bromelin 500 mg to Standard therapy and its correlation with outcome in acute ischemic stroke. METHODS: This was a preliminary report of a prospective randomised, double-blind study with pre and post-test design, forty-six acute ischemic stroke patients were randomly allocated with Bromelin and Standard groups. Measurement of MMP9 and outcome were performed before and after 14-days treatment. RESULT: The Bromelin group showed a significant decrement of MMP9 level, from 6.02 ± 0.32 ng/ml before treatment to 5.50 ± 0.94 ng/ml after treatment (p = 0.028). There was a negative correlation between MMP9 level and mRS (r= -0.03; p = 0.905) and a positive correlation toward BI (r = 0.039; p = 0.859), while the Standard group showed increased MMP9 level from 5.82 ± 0.71 ng/ml to 5.91 ± 0.83 ng/ml (p = 0.616) which was correlated insignificantly to outcome. CONCLUSION: We concluded that the addition of 500 mg Bromelin to standard ischemic stroke therapy reduced MMP9 level significantly and correlated to outcome improvement. However, there is a tight statistical correlation.

A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method.

BACKGROUND: Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep. AIM: The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients. METHODS: This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test. RESULT: The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001). CONCLUSION: There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.