Biomedical subjects
Publications and source records attributed to M Petrini.
The enzymes ADA and PNP were evaluated in lymphocytic subpopulations in peripheral blood obtained from healthy subjects, elderly subjects and patients with immunoproliferative diseases. Some similar assessments were performed on lymphoid cells from cord blood. Preliminary studies indicate that Thymostimulin can in some cases correct enzymic defects.
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In recent years an antimitotic effect has been observed in animal studies for bromocryptine, an ergot-alkaloid derivative. In this paper a case of severe leucopenia in a hyperprolactinaemic woman on chronic bromocryptine treatment is reported. Furthermore, results are reported of an experimental study carried out in vitro on blood lymphocytes from healthy human donors. The suggested cytostatic activity of bromocryptine was studied by evaluating the effects of progressively increasing doses (1, 5, 20 micrograms) of the drug on methyl-[3H]-thymidine incorporation by lymphocytes. A significant reduction of thymidine incorporation was observed corresponding to the increase of the bromocryptine dose which had been added to the cultures. With only 20 micrograms of bromocryptine the viability of cells was reduced by 50%. These results, which demonstrate that bromocryptine has an inhibitory action on DNA synthesis of cultured lymphocytes, suggest that it is justified to employ bromocryptine for medical therapy of large prolactinomas, in order to favour the subsequent surgical approach to these tumours.
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The circulating lymphocytes of 16 normal subjects and of 18 patients with paraproteinemia have been characterized by measuring the levels of ADA, AMPA, PNPase, CDA. The results obtained reveal a highly significant increase in PNPase of subjects affected by paraproteinemia as compared to that of normal subjects (p less than 0.005). The fact that the increased enzymatic levels are found mainly in patients not affected by Bence-Jones proteinuria seems to indicate that the evolution of the paraproteinemia disease is in some way related to the intralymphocyte levels of PNPase.
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The expression of the p170 multidrug resistance protein by bone marrow plasma cells (BMPC) was assessed at clinical presentation in 53 patients with multiple myeloma (MM) using the C219 monoclonal antibody. Twenty-two of the 53 (41 per cent) patients had variable aliquots (1-60 per cent, median = 6 per cent) of p170+ BMPC by immunocytochemistry. Five of 10 patients studied using bivariate flow cytometry had both diploid and hyperdiploid (DNA index ranged from 1.2 to 1.5) BMPC with hyperdiploid clones having significantly greater p170 expression than diploid ones. Of the 37 patients evaluated for a response, 20 (54 per cent) had responded to induction chemotherapy. The presence of p170+ BMPC was a negative indicator for achieving response. The response rate was 75 per cent for p170- and 25 per cent for p170+ cases (p < 0.01), with no difference on the basis of treatment schedule (melphalan and prednisone, 24 patients; peptichemio, vincristine and prednisone, 13 patients). No difference in response and survival duration was found between p170+ and p170- patients. In six of nine patients studied both at diagnosis and following induction chemotherapy the p170+ BMPC% increased irrespective of the type of treatment or outcome.
An intensive third generation regimen (P-VABEC) including adriamycin, etoposide, cyclophosphamide, vincristine, bleomycin and prednisolone was administered to 43 unselected elderly patients with intermediate or high-grade non-Hodgkin's lymphomas (NHL). The median age was 67, 40 per cent were Ann Arbor stage IV, 73 per cent had 'B' symptoms, 55 per cent had bulky disease, 48 per cent had serum lactate dehydrogenase greater than 450 U/l, 85 per cent had serum thymidine-kinase greater than 4 U/l. Thirty patients were previously untreated. The complete remission (CR) rate was 74 per cent, and the partial remission (PR) rate 23 per cent, with an overall response rate of 97 per cent. The regimen was carried out on an outpatient basis in all patients. No death occurred during therapy. The Kaplan-Meier actuarial survival of all patients at 3-years is 47 per cent, and 50 per cent (16/32) of all patients who attained CR remain alive and in remission at a median of 21+ months (range 6+ to 42+). These results confirm that high remission and failure-free survival rates can be achieved also in elderly unselected patients with aggressive NHL treated with curative intent.
The membrane immunoglobulin (MIg) of B lymphocytes is thought to have an important role in antigen recognition and cellular activation. In common with many membrane glycoproteins, MIg moves extensively in the lipid bilayer, and after binding of specific antisera displays lateral mobility with patch and cap formation. This phenomenon appears to involve the cytoskeleton, particularly the actin that is present in the cell membrane of B lymphocytes and aggregates beneath capped immunoglobulin. Recently, it has been reported that the isolation of MIg results in co-purification of actin and an unknown protein of molecular weight (MW) approximately 56,000 (refs 7, 8). We now demonstrate that this component displays physicochemical and immunological properties indistinguishable from those of Gc (group-specific component). In addition, evidence is presented which suggests that this vitamin D3-binding protein is involved in the linkage between MIg and actin, and may therefore be important in signal transduction.
A 23-year-old woman was receiving bromocriptine (CB-154, 7.5-10 mg/day, for a hyperprolactinemic galactorrhea-amenorrhea syndrome. She also had insulin-dependent diabetes. After three months the bromocriptine therapy was stopped because she developed severe leukopenia (leukocyte counts about 1,800/cu mm) and mild thrombocytopenia (platelet count about 130,000/cu mm). Five months after stopping the bromocriptine therapy, the leukocyte count returned to normal (4,400/cu mm), as did the platelet count (238,000/cu mm). Prior to bromocriptine therapy, the patient's leukocyte and platelet counts ranged between 5,500 and 6,000/cu mm and 250,000 and 300,000/cu mm, respectively. While taking bromocriptine she was on insulin maintenance therapy and took no other drugs. Regular menses had returned and spontaneous galactorrhea had disappeared during bromocriptine therapy, and serum prolactin levels became normal. After stopping bromocriptine therapy the patient again became basally hyperprolactinemic and amenorrheic, with spontaneous galactorrhea. The article discusses possible mechanisms of this hematologic reaction.
The Elderly Services of USL 3 "Genovese" together with the team for Continuing Education designed and implemented a survey on the elderly clients referred to the home care and nursing home services. The aim of the study was to describe the frequency, distribution and severity of pressure ulcers. The data were collected during a period of seven months: from 1st November 1997 to 31st May 1998. One thousand seven hundred and twenty nine clients were observed; 705 (41%) had single or multiple pressure ulcers. Patients with multiple pressure ulcers accounted for 42% of the total. The sacrum was the most affected site (43% of the patients with a single ulcer and 33% with multiple ulcers). Patients with severe pressure ulcers (stages 3 degrees and 4 degrees NPUAP classification) accounted for 42% of the total. Pressure sores were observed in 15% of "at no risk" patients and in 40% of those at low risk (Norton Scale score). The study highlighted a lack of documentation (90% patients) on treatments performed in the hospital and prescribed at discharge for the pressure sores. These findings reflects possibly the fact that this aspect of care is unduly disregarded by nursing personnel, and that a goal-oriented retraining, underlining also the need of appropriate documentation, is warranted.