VIRTUAL MACHINE

VIRTUAL MACHINE

 A. Sejarah dan Definisi

 Mesin virtual pada mulanya didefinisikan oleh Gerard J. Popek dan Robert P. Goldberg pada tahun 1974 sebagai sebuah duplikat yang efisien dan terisolasi dari suatu mesin asli. Pada masa sekarang ini, mesin-mesin virtual dapat mensimulasikan perangkat keras walaupun tidak ada perangkat keras aslinya sama sekali.
Contoh, program yang ditulis dalam bahasa Java akan dilayani oleh Java Virtual Machine (JVM) dengan cara memberikan perintah-perintah yang dimengerti JVM yang selanjutnya akan memberikan hasil yang diharapkan. Dengan memberikan layanan seperti ini kepada program tersebut, perangkat lunak JVM ini berlaku sebagai sebuah "mesin virtual", sehingga program tidak lagi perlu untuk mengakses langsung melalui sistem operasi ataupun perangkat keras yang sangat bervariasi dan memerlukan pemrograman masing-masing secara spesifik.
Mesin virtual terdiri dari dua kategori besar, dipisahkan menurut cara penggunaan dan tingkat keterhubungannya dengan mesin-mesin aslinya. Sebuah mesin virtual sistem adalah perangkat yang berupa platform sistem yang lengkap dan dapat menjalankan sebuah sistem operasi yang lengkap pula. Sebaliknya, mesin virtual proses didesain untuk menjalankan sebuah program komputer tertentu (tunggal), yang berarti mesin virtual ini mendukung proses tertentu juga. Karakteristik mendasar dari sebuah mesin virtual adalah batasan-batasan bagi perangkat lunak yang berjalan di dalam mesin tersebut, sumber daya yang dibatasi, dan tidak dapat mengakses ke luar tembok batasan dunia maya itu.

B. Kegunaan

Teknologi virtual  machine memiliki  banyak kegunaan seperti  memungkinkan konsolidasi  perangkat keras,  memudahkan  recovery  sistem,  dan menjalankan perangkat lunak terdahulu.  Salah  satu penerapan penting dari teknologi  VM adalah   integrasi   lintas  platform. Beberapa   penerapan   lainnya   yang   penting adalah:
1.    Konsolidasi  server
Jika beberapa server menjalankan aplikasi yang hanya memakan sedikit sumber daya, VM dapat digunakan untuk menggabungkan aplikasi-aplikasi tersebut sehingga berjalan pada satu server saja, walaupun aplikasi tersebut memerlukan sistem operasi yang berbeda-beda.
2.    Otomasi dan konsolidasi lingkungan pengembangan dan testing
Setiap VM  dapat   berperan   sebagai   lingkungan   yang   berbeda,   ini  memudahkan pengembang sehingga tidak perlu menyediakan lingkungan tersebut secara fisik.
3.    Menjalankan perangkat  lunak terdahulu
Sistem operasi dan perangkat lunak terdahulu dapat dijalankan pada sistem yang lebih baru.
4.    Memudahkan  recovery  sistem
Solusi   virtualisasi   dapat   dipakai   untuk rencana recovery sistem yang memerlukan portabilitas dan fleksibilitas antar platform.
5.    Demonstrasi perangkat lunak
Dengan teknologi VM, sistem operasi yang bersih dan konfigurasinya dapat disediakan secara cepat.

C. Kelebihan dan kekurangan

  Kelebihan :
 1. Hal  keamanan.
     VM memiliki  perlindungan yang  lengkap pada berbagai sistem  sumber   daya,   yaitu   dengan  meniadakan   pembagian   sumber   daya secara  langsung,  sehingga  tidak ada masalah proteksi  dalam VM.  Sistem VM adalah kendaraan yang sempurna untuk penelitian dan pengembangan sistem operasi. Dengan VM, jika terdapat suatu perubahan pada satu bagian dari mesin, maka dijamin tidak akan mengubah komponen lainnya.
  2. Memungkinkan   untuk  mendefinisikan   suatu   jaringan   dari   Virtual Machine   (VM).
Tiap-tiap   bagian  mengirim  informasi  melalui   jaringan komunikasi  virtual.  Sekali   lagi,   jaringan  dimodelkan   setelah komunikasi fisik jaringan diimplementasikan pada perangkat lunak.

Kekurangan:
 Beberapa kesulitan utama dari konsep VM, diantaranya adalah:
1. Sistem penyimpanan.
Sebagai contoh kesulitan dalam sistem penyimpanan adalah   sebagai   berikut:   Andaikan   kita   mempunyai   suatu   mesin   yang memiliki  3  disk drive  namun  ingin mendukung 7 VM.  Keadaan  ini   jelas tidak memungkinkan bagi kita untuk dapat mengalokasikan setiap disk drive untuk  tiap VM,  karena perangkat   lunak untuk mesin virtual   sendiri  akan membutuhkan   ruang disk   secara   substansial  untuk menyediakan  memori virtual  dan  spooling.  Solusinya   adalah dengan menyediakan disk  virtual atau   yang   dikenal   pula   dengan  minidisk,   dimana   ukuran   daya penyimpanannya   identik   dengan   ukuran   sebenarnya.   Dengan   demikian, pendekatan VM juga menyediakan sebuah antarmuka yang identik dengan perangkat keras yang mendasari.
2. Pengimplementasian sulit.
Meski konsep VM cukup baik, namun VM sulit diimplementasikan.
Contoh virtual machine : Vmware, Xen VMM , Java VM

Jenis-jenis dari VM adalah:
1.    VM sistem di mana sebuah VM dapat menjalankan sebuah  sistem operasinya  sendiri.
2.    VM proses  di  mana VM hanya menjalankan sebuah proses saja.

Kemudian VM juga dibagi berdasarkan tingkat virtualisasinya:
1.    Virtualisasi   penuh   yang  mensimulasikan   seluruh   fitur  perangkat  keras   sehingga memungkinkan perangkat   lunak berjalan pada VM tanpa  modifikasi.
2.    Virtualisasi   paruh,   di  mana   tidak   semua   fitur perangkat keras disimulasikan.
3.    Virtualisasi asli, yang mana merupakan   virtualisasi   penuh   yang   digabungkan   dengan   bantuan   perangkat keras yang mendukung virtualisasi.

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Determination of Hematocrit Value

Hematocrit or erythrocyte volume of the compressed (packed cell volume, PCV) is the percentage volume of erythrocytes in the blood is compressed by playing at a certain speed and in a certain time. The purpose of this test is to determine the concentration of erythrocytes in the blood.

Based on the reproducible and simple, this examination is the most trustworthy among other checks, namely hemoglobin and erythrocyte count. Can be used as a simple filter test against anemia.

Hematocrit or PCV values ​​can be set using the automatic hematology analyzer or manually. Manually hematocrit measurement method known there are two, namely :

Methods makrohematokrit

At the macro method, as much as 1 ml blood samples (EDTA or heparin blood) were included in Wintrobe tubes measuring 110 mm long with a diameter of 2.5-3.0 mm and 0-10 mm scale. The tubes then were centrifuged for 30 minutes at 3,000 rpm. High erythrocyte column is the hematocrit value is expressed in%.

Methods mikrohematokrit

At the micro method, blood samples (capillary blood, blood EDTA, heparin blood or blood-potassium-ammonium oxalate) is inserted in a capillary tube having a length of 75 mm in diameter and 1 mm. Capillary tubes are used there are two kinds, namely containing heparin (marked red) for capillary blood samples (direct), and without anticoagulant (marked blue) blood to EDTA / heparin / ammonium-potassium-oxalate.

Examination procedures are: blood sample is inserted into the capillary tube until 2 / 3 the volume of the tube. One end of the tube is closed with putty (clay) and then centrifuged for 5 minutes at 15,000 rpm. High erythrocytecolumn were measured with a hematocrit reader, its value expressed in%.

Mikrohematokrit method is more widely used because in addition to quite a short time, blood samples required is also small and can be used for samples without anticoagulant that can be obtained directly.

Reference Values

Adult male : 40 - 52%

Adult women : 35-47%

Newborns : 44-72%

Children aged 1-3 years : 35-43%

Children aged 4-5 years : 31-43%

Children aged 6-10 years : 33-45%

Clinical Problems

Decreased levels: acute blood loss, anemia (aplastic, hemolytic, folic acid deficiency, pernicious, sideroblastik, sickle cell), leukemia (lymphocytic, myelogenous, monositik), Hodgkin's disease, limfosarkoma, organ malignancies, multiple myeloma, cirrhosis of the liver, protein malnutrition , deficiency of vitamins (thiamine, vitamin C), gastric or duodenal fistula, peptic ulcer, failure, chronic kidney, pregnancy, SLE. The influence of drugs: antineoplastic, antibiotics (chloramphenicol, penicillin), radioactive medicine.

Increased levels: dehydration / hypovolemia, severe diarrhea, polycythemia vera, eritrositosis, diabetic acidosis, pulmonary emphysema late stage, whereas cerebral ischemia, eclampsia, surgery, burns.

Factors that may affect the laboratory's findings :

If a blood sample taken at the arm that is attached intra-venous lines, tend to be low hematocrit values ​​due to hemodilution. Installation of rope tourniquet that is too long the potential to cause hemoconcentration, so that the hematocrit value can be increased. Capillary blood sampling: punctures lacking in so that the volume gained slightly and squeeze the blood must be squeezed-out, which pierced the skin is still damp with alcohol so that the diluted blood, clots occur in the blood drops because of slow work.

Hematology test, Osmotic fragility erythrocytes

When erythrocytes are in solution hipotonis, osmolalitasnya fluid levels lower than normal plasma or serum (less than 280 mOsm / kg)

Erythrocyte osmotic fragility test (also called erythrocyte osmotic resistance) is done to measure the ability to withstand the occurrence of erythrocyte hemolysis (destruction of red blood cells) in asolution that hipotonis. The trick is as follows: erythrocytes were dissolved in saline solution with various concentrations. If hemolysis occurs at a slightly saline solution hipotonis, this state is called an increase in erythrocyte fragility (= reduction in resistance / durability erythrocytes), and if hemolysis occurs at a very hipotonis salinesolution, this situation indicates decreased osmotic fragility (= increase in erythrocyte resistance).

Hemoglobin out of the cells in each tube containing a solution of NaCl of different levels. Hb then determined fotokolorimetrik. The results are reported in percentages (%) hemolysis. Collection of hemolysis results are plotted in a curve as compared with normal erythrocytes data. In the state of increased fragility, erythrocytes are usually spherical, and the curves seem to shift to the right. While the decrease in fragility, thin and flat-shaped erythrocytes, the curve appears shifted to the left.

Clinical Problems

DECREASE fragility: Thalassemia major and minor (Mediterranean anemia or Cooley's anemia), anemia (iron deficiency, folic acid deficiency, vitamin B6 deficiency, sickle cell) hemoglobin C disease, polycythemia vera, post splenectomy, acute liver necrosis and sub-acute, jaundice obstructive.

IMPROVEMENT fragility: hereditary spherocytosis, transfusions (ABO and Rhesus incompatibility), autoimmune hemolytic anemia (AIHA), hemoglobin C disease, drug toxicity or chemicals, chronic lymphocytic leukemia, burns (thermal).

Procedure

This test is usually performed on fresh blood samples of less than 3 hours and / atu 24-hour blood samples were incubated at 37 ° C. Blood samples used in the form of heparin blood or blood "defibrinated". There are no restrictions on food or beverage intake.

In this test made solution with different concentrations of NaCl. Assessment of results with fotokolorimetri method (using photometer or spectrophotometer).

Prior to testing, provide a first buffer stock solution of NaCl 10% made from 9 grams NaCl, 1.365 g Na2HPO4, and 0.215 grams NaH2PO4.H2O. The material is then diluted with distilled water to 100 ml. Before being used for inspection, make asolution of 1.0% NaCl principal by dissolving 5.0 ml of saline buffer stock of 10% with distilled water to 50.0 ml. Next do the testing as follows :

1. Provide 12 pieces and then make a dilution tube multilevel solution of NaCl concentration: 0.85%, 0.75%, 0.65%, 0.60%, 0.55%, 0.50%, 0.45%, 0, 40%, 0.35%, 0.30%, 0.20% and 0.10%, respectively of 5.0 ml. NaCl solutions were made from the basicsolution of NaCl 1.0%.
2. Add into the canisters each 50 mL blood sample. Mix (homogenization) by way of tossing and turning the tube several times.
3. Inkubasikan for 30 minutes at room temperature.
4. Mix (homogenization) again and then worry about (centrifuges) of each tube for 5 minutes at 3000 rpm.
5. Measure the absorbance (OD) of the supernatant at λ 540 nm with the blank tube to supernatant-1 (0.85% NaCl).
6. Calculate the% hemolysis by dividing the absorbance (OD) of samples with the absorbance (OD) tubing to 12 multiplied by 100%.
7. Create a curve with the concentration of NaCl as the axis (x) and% hemolysis as the ordinate (y). Compare with the curve of normal blood controls.

Normal Value

The beginning of hemolysis on the concentration of NaCl 0.40% - 0.45%

Complete hemolysis at a concentration of 0.30% NaCl - 0.35%

The percentage of hemolysis in normal circumstances are :

97-100% hemolysis in 0.30% NaCl

50-90% hemolysis in 0.40% NaCl

5-45% hemolysis in 0.45% NaCl

0% hemolysis in 0.55% NaCl

Factors Affecting Laboratory Findings

• plasma pH, temperature, glucose concentration, and oxygen saturation in the blood
• Long-lived erythrocytes tend to have high osmotic fragility
• Blood samples taken over 3 hours can show increased osmotic fragility.

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Taking Blood Veins With Vacuum Tubes, Vacutainer

bd.com

Vacuum tube was first marketed by U.S. company BD (Becton-Dickinson) under the trade name Vacutainer. This type of tube in the form of a vacuum tube, made of glass or plastic. When the tube is attached to the needle, the blood will flow into the tube and the flow stops when a certain volume has been reached.

Needles used consists of two needles connected by a threaded connection. The needle on the anterior side is used to puncture the vein and the needle on the posterior side of the tubes plugged. Posterior needle encased by the material of rubber so as to prevent the blood from the patient flows out. Threaded connection serves to attachthe needle in a holder and ease when pushing the needle tube mounted directly on the posterior.

The advantage of using this retrieval method is, no need to divide the sample into several tubes of blood. Just one stabbing, can be used for multiple tubes alternately according to the type of tests required. For the purposes of the bacteria culture test, thismethod is also better because the patient's blood can flow directly into the tube containing the bacteria culture media. Thus, the possibility of contamination duringsample transfer to the decision by way of the manual can be avoided.

The drawback difficult decision in the elderly, small children, infants, or if the vein is unreliable (small, fragile), or if the patient is obese. To overcome this may be used needle with wings (winged needle).

Winged needle or needles is often also called "butterfly" needle vakutainer nearly equal as mentioned above. The difference is, betweenthe needle anterior and posterior wings there are two pieces of plastic at the base of the anterior needle and the needle tube that connects the anterior and posterior. If the proper insertion of the vein, blood will look into the hose (flash).

Procedure :

1. Prepare the necessary tools: needles, cotton 70% alcohol, a hedge strap (tourniquet), plaster, vacuum tubes.
2. Attach the needle to the holder, make sure it is firmly.
3. Approach the patient in a calm and friendly; try to patients as comfortable as possible.
4. Identification of patients correctly according to the data at the request sheet.
5. Verification of the patient, such as fasting or consumption of drugs. Record if the patient is taking certain medications, etc. are not fasting.
6. Ask the patient to straighten his arm, select the arm that did a lot of activity.
7. Have the patient make a fist.
8. Attach a rope hedge (tourniquet) is approximately 10 cm above the elbow fold.
9. Select the median cubital or cephalic vein. Do palpability (palpation) to ensure the position of the vein; vein palpable as a small pipe, elastic and has a thick wall. If the veins are not palpable, do the sorting of the wrist to the elbow, or warm compresses for 5 minutes the arm.
10. Clean the skin on the parts to be taken with alcohol 70% cotton and let dry. Skin that has been cleaned do not hold anymore.
11. Puncture the vein with a needle hole position facing up. Insert the tube into the holder and push that needle stuck in the posterior part of the tube, then the blood will flow into the tube. Wait until the blood stops flowing. If you require multiple tubes, having first filled the tube, remove and replace with a second tube, and so on.
12. Remove the tourniquet and ask the patient to open his fist. The volume of blood taken approximately three times the amount of serum or plasma required for the examination.
13. Put the cotton on the injection site and then immediately release / pull the needle. Press the cotton and plasters couple sat for about 15 minutes. Do not pull the needle before the tourniquet was opened.

Accommodate Blood In Tube

Some types of blood sample tubes used in the clinical laboratory practices are as follows :

Tube red cap. This tube without the addition of additives, the blood will be frozen and the serum separated by centrifugation. Commonly used for examination of blood chemistry, immunology, serology and blood bank (crossmatching test)

Tube yellow cap. It contains a gel separator tubes (serum separator tube / SST) whose function is to separate serum and blood cells. After centrifugation, the serum will be at the top of the gel and the blood cells are under the gel. Commonly used forexamination of blood chemistry, immunology and serology

Tube light green lid. It contains a gel separator tube (plasma separator tube / PST) with lithium heparin anticoagulant. After centrifugation, the plasma will be at the top of the gel and the blood cells are under the gel. Commonly used forexamination of blood chemistry.

Purple or lavender tube cap. This tube contains EDTA. Commonly used for complete blood count and blood banks (crossmatch)

Tube blue cap. This tube contains sodium citrate. Commonly used for examination of coagulation (eg PPT, APTT)

Tube green cap. This tube contains sodium or lithium heparin, commonly used for the examination of erythrocyte osmotic fragility, blood chemistry.

Dark blue cap tube. This tube contains EDTA-free metals, generally used for examination of trace elements (zinc, copper, mercury) and toxicology.

Tube light gray cap. This tube contains sodium fluoride and potassium oxalate, were used for examination of glucose.

Black cap tube; containing sodium citrate buffer, used for checking the LED (ESR).

Pink cap tube; containing potassium EDTA, used for examination imunohematologi.

White cap tube; potassium EDTA, used for examination of molecular / PCR and bDNA.

Tube yellow with a black cap at the top; containing culture media, used for microbiological examination - aerobic, anaerobic and fungal

Accommodate some of the important things in the blood sample is :

Blood from syring or injections should be inserted into the tube by removing the needle and the blood flow slowly through the tube wall. Enter the blood by way of spraying, especially without removing the needle, potentially causing hemolysis. Blood entering into the vacuum tube by a needle on the cap tube, allow blood to flow until it stops itself when the volume has been met.

Homogenization of samples if using anticoagulants by twisting the tube 4-5 times or tossing and turning the tube 5-10 times by softly. Whisk thesample potentially cause hemolysis.

The order to enter the blood samples into vacuum tubes are: first - bottle culture (culture) of blood or yellow-black cap tube second - coagulation tests (tube blue cap), third - non-additive tube (red cap), the fourth - the red cap tubes or yellow with separator gel or clot activator, tube cap purple / lavendet (EDTA), green cap tube (heparin), gray cap tubes (NaF and Na oxalate).

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Protein C-reactif

Protein C-reactif (C-reactive protein, CRP) are made by the liver and secreted into the bloodstream. CRP circulates in the blood for 6-10 hours after the acute inflammatory process and tissue destruction. Levels peaked within 48-72 hours. As with any test erythrocyte sedimentation rate (erithrocyte sedimentation rate, ESR), CRP is a non-specific test but the existence precedes the CRP increase during inflammation and necrosis of the LED and then immediately return to normal levels.

CRP is one of several proteins that are often referred to as acute phase proteins and used to monitor changes in the acute inflammatory phase is associated with many infectious diseases and autoimmune diseases. Some circumstances in which CRP may increase was found arthritis (rheumatoid arthritis), rheumatic fever, breast cancer, colitis, inflammatory disease stage (pelvic inflammatory disease, PID), Hodgkin's disease, SLE, bacterial infections.

CRP is also elevated in the final trimester of pregnancy, the use of intrauterine contraceptive devices and oral contraceptive drug effect.

CRP test is often performed repeatedly to evaluate and determine whether the treatment is effective. CRP is also used to monitor wound healing and to monitor post-surgical patients, organ transplant, or burns as an early detection system for possible infections.

High-sensitive CRP (hs-CRP)
This test can detect the inflammation that occurs due to the formation of atherosclerotic plaque in coronary arteries. hsCRP is a highly sensitive laboratory test for the risk of cardiovascular disease. This test is often done in conjunction with the test lipid profile (cholesterol, triglycerides, HDL, LDL). Positive hsCRP value is much lower than the standard value of serum CRP so that it becomes more useful test in detecting the risk of coronary heart disease (coronary heart disease, CHD), stroke, and peripheral arterial disease.

American Heart Association and the U.S. Centers for Disease Control and Prevention have defined risk groups as follows :

• Low risk: less than 1.0 mg / L
• Average Risk: 1.0 to 3.0 mg / L
• High risk: above 3.0 mg / L

Those values ​​are only a part of the evaluation process for kardiovaskuler.Tambahan disease risk factors to consider are the elevated levels of cholesterol, LDL, triglycerides, and glucose. In addition, smoking, high blood pressure (hypertension), and diabetes also raise the level of risk.

Procedure
CRP test can be performed manually using agglutination methods or other more advanced methods, such as sandwiches imunometri. Agglutination tests carried out by adding the latex particles coated with anti-CRP antibodies in the serum or plasma agglutination patient so that it will happen. To determine the titer of CRP, serum or plasma diluted with buffer glycine patients with multilevel dilution (1 / 2, 1 / 4, 1 / 8, 1 / 16 and so on) and then reacted with latex. CRP titer is the highest dilution that still occur agglutination.

Imunometri sandwich tests performed by measuring the intensity of colors using Nycocard Reader. Consecutive samples (serum, plasma, whole blood) and conjugate dropped on the coated membrane antibody testsspecific mononklonal CRP. CRP in the sample captured by antibodies bound to colloidal gold particle conjugates. Free conjugate was washed with wash solution (washing solution). If there is at the level of CRP in pathological samples, it will form a red-brown color in the test area with color intensity proportional to the content. Color intensity was measured quantitatively using a reader NycoCard II.

Normal reference value of CRP with imunometri sandwich method is <5 mg / L. This reference value would be different depending on each laboratory reagents and methods used.