BACKGROUND: Population aging is considered to be a global phenomenon today. Age-associated immune system dysfunction or “immunosenescence” is indicated by increased susceptibility to infections and chronic diseases, such as hypertension, diabetes mellitus, autoimmune diseases, heart disease, and atherosclerosis. One of the immunosenescence markers is a significant drop in CD28 and reduced proinflammatory cytokine interleukin-2 (IL-2). The mango mistletoes are deemed to have a better affinity for docking the CD28 and IL-2R receptors of α and β subunits than other plants. AIM: This study aims to determine the effect of ethanol extract of mango mistletoes on IL-2 levels, the percentage of CD4+CD28+, and the percentage of CD8+CD28+ in aged female mice. METHODS: The leaves of mango mistletoes were extracted using 96% ethanol solvent, and the extract was administered to aged female mice (18–20 months) orally with different doses for each group, namely 150, 300, and 600 mg/kg. Mango mistletoe leaves extract was administered once a day for 14 days. Then, the IL-2 levels of the mice were checked from their heart blood samples using Enzyme-Linked Immunosorbent Assay, while the percentages of CD4+CD28+ and CD8+CD28+ were examined from the spleen samples using flow cytometry. RESULTS: The ethanol extract of mango mistletoe leaves was able to increase the percentage of CD4+CD28+ significantly (p < 0.05) at doses of 300 and 600 mg/kg and increase the percentage of CD8+CD28+ significantly (p < 0.05) at a dose of 600 mg/kgBW, while other various doses had a strong enough correlation (r = 0.48) to increase IL-2 levels. CONCLUSION: The ethanol extract of mango mistletoe leaves has the good potential to inhibit the aging process in the immune system, as characterized by an increase in IL-2 levels and the percentage of CD4+CD28+ and CD8+CD28+.

Objective: To know whether the expression of Fas Ligand has correlation with incidene of metastasis of pelvic lymph node and lymph-vascular stromal invasion (LVSI). Methods: All patients diagnosed of cervical cancer stage IB or IIA who underwent radical hysterectomy in Dr. Cipto Mangunkusumo Central General Hospital from January 2008 until December 2009 were included in analytic cross sectional study. We tested expression of Fas Ligand in cervical cancer specimen by immunohystochemistry with monoclonal antibody. The expression of Fas Ligand was compared between the group of patients with a positive and negative pelvic lymph node and between LVSI positive and negative. The difference of expression in both group were statistically analized with Chi-square test and the correlation Spearman test. Result: Ninety one patients underwent radical hysterectomy for two years and 43 patients were included in these study. The expression of Fas Ligand in 7 patients (16.3%) were negative and the others were positive, with weak, moderate and strong expression were 4 (9.3%), 27 (62.8%), and 5 (11.6%) respectively. The expression of Fas Ligand was significantly higher in the group of patients with positive pelvic lymph node compared to the group of the patients with negative pelvic lymph node (p=0.007) but there was no significant difference between group of the patients with LVSI positive and negative. With Spearman test, we found that the expression of Fas Ligand had a strong correlation with pelvic lymph nodes metastasis (coeff. correlation=0.519 and p=0.00) and have no correlation with LVSI (coef. corellation=0.112 and p=0.474). Conclusion: These finding suggested that expression of Fas Ligand in cervical cancer patients has a strong correlation with the incidence of pelvic lymph node metastasis and none with LVSI. [Indones J Obstet Gynecol 2012; 36-4: 194-9] Keywords: cervical cancer, fas ligand, immunohystochemistry, LVSI, pelvic lymph node metastasis

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<em>Carica papaya</em> is one kind of herbal plant that can help the wound healing process. Scientifically, the leaves of papaya are proven to have anti-inflammatory effects. Flavonoid, alkaloid, tannin, and saponin compounds in papaya leaves have antimicrobial and antioxidant properties to accelerate the re-epithelization and cell migration needed for wound healing. This research aims to determine the effect of papaya leaf extract gel <em>(Carica </em><em>papaya)</em> on the healing of incision wounds in <em>Ra</em><em>ttus norvegicus</em> based on changes in wound morphology (signs of redness, edema, pus, granulation, moisture, and wound length). This research used female <em>Rattus norvegicus</em> aged 12-16 weeks weighing 180-200 grams, divided into five groups (NaCl 0,9%, povidone-iodine, papaya leaf extract gel with concentrations of 10%, 20%, and 30%). Incision wounds on the back of the rat with a length of 2 cm and depth of 1 cm. The normality test used the Shapiro-Wilk test, and the homogeneity test used the Levene test. The research data were not normally distributed nor homogeneous, so they were analyzed using the Kruskal Wallis and Mann-Whitney tests. The results showed that the extract of papaya leaves with concentrations of 10%, 20%, and 30% had significant differences in positive and negative control groups in the wound healing process with the differences in redness (p=0.038), granulation tissue (p=0.039), moistures (0,48), and wound length (p=0,049). It can be concluded that papaya leaf extract gel <em>(Carica papaya)</em> is effective in accelerating the healing process of incision wounds in <em>Rattus norwegicus</em> at concentrations of 10%, 20%, and 30%, so for further research, it is hoped that a histopathological examination can be carried out so that changes that occur in collagen, neutrophile cells, monocytes, and lymphocytes are seen.

Objective: Comparing scoring with RMI3 and RMI4 in establishing the diagnosis of adnexal tumour in RSUD Dr. Saiful Anwar Malang.Methods: Prospective cohort study with samples of all patients suspected of having an adnexal tumour diagnosed in gynecology policlinic using gynecological oncology policlinic medical records at RSUD Dr. Saiful Anwar in the form of age, demographics, menopause status, Ca125, ultrasound results.Results: Between the RMI3 results and the results of histopathology, a contingency coeffi cient of 0.596 was obtained with a p-value of 0.000015 (p <0.05), with a PPV of 83%, an NPV of 91%. Between the RMI4 results and the histopathology results, a contingency coeffi cient of 0.657 with a p-value of 0.0000004 (p <0.05) was obtained, with a PPV of 92%, NPV of 95%. On the ROC curve, the area of the predicted results using the RMI4 score is higher than the RMI3 score.Conclusions: Using the RMI4 score results in more accurate predictions than the RMI3 score in detecting adnexal tumour malignancies.Keywords: adnexal tumours, diagnostic tests, ovarian tumours, risk of malignancy index, ultrasound. Abstrak Tujuan: Membandingkan Skoring RMI3 dan RMI4 dalam menegakkan diagnosis tumor adneksa di RSUD dr. Saiful Anwar Malang.Metode: penelitian kohort prospective dengan sampel semua pasien yang dicurigai menderita tumor adneksa yang didiagnosis di poli Ginekologi menggunakan data rekam medis poli Ginekologi Onkologi RSUD dr. Saiful Anwar berupa usia, demografi , status menopause, Ca125, hasil USG.Hasil: Antara hasil RMI3 dengan hasil hispatologi, didapatkan koefi sien kontingensi sebesar 0,596 dengan p-value 0,000015 (p<0,05), dengan PPV 83%, NPV 91%. Antara hasil RMI4 dengan hasil histopatologi, didapatkan koefisien kontingensi sebesar 0,657 dengan p-value 0,0000004 (p<0,05), dengan PPV 92%, NPV 95%. Pada kurva ROC, luas area hasil prediksi dengan menggunakan skor RMI4 lebih tinggi daripada skor RMI3.Kesimpulan: Menggunakan skor RMI4 menghasilkan prediksi yang lebih tepat daripada skor RMI3 dalam mendeteksi keganasan tumor adneksa.Kata kunci: risk of malignancy index, tumor adneksa, tumor ovarium, uji diagnostik, USG.