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Biomedical subjects

M Luongo

Publications and source records attributed to M Luongo.

9 recordsLinked to original sources

HLA allele frequency and clinical outcome in Italian patients with cutaneous melanoma.

The current study focuses the analysis on the possible relationship between HLA allele frequency and clinical outcome of melanoma in a population of 382 Italian patients, as compared with 203 ethnically matched controls. In a 3-year follow-up study, results showed significant differences between groups of patients selected according to clinical stage, histology, and progression of the disease. A*01 seems to be correlated with a less aggressive variant of the disease, whereas DRB1*01-DQB1*0501 seems to be associated with metastatic progression of melanoma. Moreover, a negative association with B*13, B*44, as well as with DRB1*04-DQB1*0302 was found. A multivariate logistic regression model showed HLA-DRB1*04 to behave as an independent favorable prognostic marker of melanoma in our population (OR = 2.34, CI = 1.15-4.74).

Adolescent↗

Hypermethylation of GpG islands in the promoter region of p15(INK4b) in acute promyelocytic leukemia represses p15(INK4b) expression and correlates with poor prognosis.

We evaluated the methylation status of p15 gene in a series of 65 patients with newly diagnosed acute promyelocytic leukemia (APL) receiving homogeneous treatment. Moreover, in 32 of them, the methylation status of p15 gene was correlated to the p15 m-RNA expression. In total, 31 patients had no p15 methylation (U group). An abnormal methylation pattern was found in 34 patients: in seven of these patients only methylated DNA was detected (M group), while in the remaining 27 patients (M/U group), both methylated and unmethylated DNA were amplified. Patients from M group showed a higher incidence of relapses and a lower disease-free survival (DSF) with respect to patients from U and M/U groups (29, 64 and 79% at 5 years for M, U/M and U patients, respectively, P=0.03), while p15 methylation had no impact on overall survival. The p15 expression was detectable in all patients with unmethylated DNA, in none of patients with fully methylated DNA and in 60% of patients with partially methylated DNA. The DFS estimate at 5 years for p15-negative patients was significantly lower than that of p15-positive patients (P=0.03). These data confirm that the presence of p15 methylation negatively influences the prognosis of APL, mainly when it represses the p15 gene transcription.

Adult↗

Expression of p15(ink4b) gene during megakaryocytic differentiation of normal and myelodysplastic hematopoietic progenitors.

In myelodysplastic syndrome (MDS), the expression of the cyclin-dependent kinase inhibitor p15(ink4B) (p15) is frequently decreased because of the aberrant methylation of the gene promoter; p15 is normally up-regulated during megakaryocytic differentiation. It was hypothesized that p15 methylation and deregulation of gene expression contribute to defective megakaryocytopoiesis in patients with MDS. Here it is shown that the increasing autocrine production of TGF-beta1 stimulates megakaryocytic differentiation in normal CD34(+) cells and that p15 mediates, at least in part, this effect. This TGF-beta1-dependent pathway is altered in MDS CD34(+) progenitors because of p15 methylation. The demethylating agent 2-deoxyAZAcytidin can restore the normal demethylated state of the p15 gene and increase its expression. Nevertheless, MDS CD34(+) cells only poorly differentiate to the megakaryocytic lineage. These findings suggest that p15 methylation occurs in a neoplastic clone with a profound defect of cell proliferation, survival, and differentiation that cannot be overcome by using a demethylating drug.

Anemia, Refractory, with Excess of Blasts↗

[Gastric carcinoid. A clinical case and review of the literature].

INTRODUCTION: Endoscopic examination of the gastrointestinal tract is very useful, because it allows a rapid diagnosis and, in some cases, a therapeutical effect. CLINICAL CASE: The authors have seen a woman, 72 years old, with epigastric pain, dryness of the mouth, diarrhoea and meteorism. She had an old simple gastritis (of two years standing) and her therapy, since the time of the diagnosis, is omeprazole (20 mg/die). The patient was submitted to gastroscopic examination that revealed two spot lesions and a polypous lesion on which was made a biopsy. The patient was submitted also to the following examination: 1) urinary dosage of 5 HIAA; 2) urinary dosage of 5 OHT; 3) Computed tomography of the abdomen; 4) Heart echography; 5) Endoscopy of the colon; 6) Endoscopy of the bronchus. DISCUSSION: Carcinoid tumors are usually small and rare lesions and they are in the following sites: A) between mouth and the second part of duodenum; B) between the second part of the duodenum and the transverse segment of the colon; C) between the latter and the anus. CLINICAL PICTURE: Patients are usually 50-60 years old, with other neoplasm. The picture is marked by flushing, diarrhoea, abdominal cramp and disease of the right heart valve. DIAGNOSIS: Diagnosis is based on urinary dosage of 5-HIAA (n.v. > 10 mg/24 h.) that is higher than the normal value. Computed tomography and echography are useful. THERAPY: The small neoplasm are treated by local surgical resection, while the biggest tumors have been treated by pharmacological therapy with useless results.

5-Hydroxytryptophan↗

A complete computerized program for nutritional management in the neonatal intensive care nursery.

A computerized program in BASIC, which integrates the infant's fluid and nutritional requirements per gestational age and weight with the infant's postpartum age, was developed using the Apple II Plus microcomputer, dual floppy disks, and an Epson printer. Daily requirements of fluids, proteins, fat, CHO, vitamins, minerals, and trace elements are computed. For reference, the program displays the composition and indications for intravenous and hyperalimentation solutions, mature human milk, and 14 commercial formulas. Safety limits to prevent overload or deficient formulations are strategically displayed, warning the physician about possible complications and gradually orienting him toward achieving adequate nutritional balance in the patient. The nutritional intake, weight, and other important clinical variables are stored and retrieved for future evaluation. The flexibility of the program allows for modifications in intravenous and oral composition according to clinical requirements. The program improves the efficiency of the arduous daily formulation of nutritional needs, reduces the possibility of human error, facilitates the calculation process, diminishes time spent on the calculations, and increases the ease of nutritional data retrieval and the development of output programs.

Birth Weight↗

[Medically managed delivery under CT 1341 (althesin (Glaxo)) anesthesia].

The Authors, after illustrating the pharmacological and physiological characteristics of CT 1341 (Althesin Glaxo), have experimented this medicine in medico-piloted delivery under narcosis on two homogenous groups of 20 patients each. The Authors have evidenced the lack of any harmful effect on the proceeding of labour, the viability of the infant, the delivery of the placenta and on post-partum, provided that a time of induction not too premature with regard to the evolution of labour be respected.

Adolescent↗

How we teach and how they learn.

Residents need to learn how to assess and accommodate to a variety of behaviors and affective styles presented by patients and their families. This requires those skills which enable them to facilitate interactions with people in a positive, effective, and efficient manner. The teaching of these interpersonal and communication skills should incorporate a multi-disciplinary model. The development and implementation of a successful resident training program requires careful attention to the establishment of goals and objectives, learning activities and evaluation strategies that will meet the needs of the resident. The utilization of a multi-teaching, multi-media, and collaborative team approach intensifies the effectiveness of the overall training program. This article describes a training program that focuses on communication skills while being mindful of the various settings in which residency training occurs. These include the use of video-tape of physician/patient interaction in continuing care clinic, communication with children in non-medical settings and audio-tape reviews of physicians telephone management in a pediatric emergency care setting. The evaluation instruments developed to assess interpersonal and communications skills are reviewed and discussed as an integral component of this educational and training model.

Communication↗