Bone marrow percentage of plasma cells in the staging of monoclonal gammopathies.

In the present study, the relationships between percentage of bone marrow plasma cells (BMP%), tumor cell mass, stage, and survival are statistically analyzed in a large number (90) of monoclonal gammopathies (MG). Though BMP% has not been included among the criteria for the staging of multiple myeloma, our results indicate that the above mentioned parameters correlate at highly significant degrees. BMP% is therefore proposed as a new, useful parameter in the staging of MG.

Autorhythmometry in hypertension: some methodological aspects and clinical implications.

Autorhythmometry of blood pressure is a technique easy to be performed and well accepted by hypertensive patients. A simple inspection of data self-collected 5 times a day for many days constitute a sufficiently reliable automonitoring of blood pressure both in basal conditions and in relation to the efficacy of some dietary and/or pharmacological treatment. Several examples are reported to show that more sophisticated statistical manipulation of the data collected may give rise to a better understanding of some clinical and physiological aspects. Both analysis of variance, performed on individual subsets of data averaged at each sampling hour, and single cosinor, performed on longitudinal time series, may be used to detect and quantify a circadian rhythm as a systematic daily variation, averaging towards zero the noise superimposed to the actual time series. Serial section analysis of the data, along all the experimental span, is useful to detect a) the reproducibility of the rhythm b) the variation of its parameters induced by changes in the experimental conditions c) the long-term trend. In the first subject the influence on the circadian rhythm of the pulse rate, temperature and blood pressure, due to a 4 h advancing shift in the rest-activity synchronizer, is well documented. In the first hypertensive patient a circadian rhythm is demonstrated also in blood pressure during two non-consecutive months. No difference is detected in both mesor and amplitude of blood pressure and a full resynchronization of the acrophase is achieved when a 1 h delaying shift in the rest activity synchronizer is imposed. In the second patient a well reproducible rhythm of systolic blood pressure and a low noise/signal ratio is documented by the serial section display. In the third patient the 'lability' of hypertention seems mainly due to salt sensitivity, as documented by the significant lowering of the mesor in the second experimental span, when a lowering of only 30 mEq/day in salt intake is imposed. The serial section better documents the salt-sensitivity of this patient, during a span when loading and depressing of salt intake is imposed. In the last patient the prompt effect of therapy in lowering blood pressure within normal range is well documented by serial section with 3 day interval. A possible effect of masking the circadian rhythm of blood pressure, due to therapy, is inferred by the serial section display with an interval of the same length (33 days) as the subspan without therapy. The possibility of prevention in the hypertensive disease is discussed, with the aim of autorhythmometry and statistical methods employed in this paper.

Circadian study of immunoreactive prolactin in patients with cirrhosis of the liver.

The pattern of immunoreactive prolactin secretion over 24 hr in a group of patients suffering from cirrhosis of the liver has been studied and compared to that of healthy controls. The results were analyzed by use of chronograms and by mean cosinor. Although the daily mean average secretion of serum prolactin by the cirrhotics is not different from that of the control subjects utilizing the standard t-test, cosinor analysis of the data fails to demonstrate a circadian rhythm for prolactin secretion in the cirrhotics. These results are discussed in view of the apparent clinical hyperestrogenization and known changes in electrolyte balance which are commonly found in persons with advanced liver disease.

Circadian study on serum gastrin in patients with duodenal ulcers and in a control group.

Two groups of subjects (one consisting of fourteen apparently healthy subjects, the other of fourteen patients with peptic ulcers) were kept for a least 7 days on the same living schedule (nocturnal sleep for 22(00) to 05(00) and meals standardized at 08(00)-08(30), 12(00)-12(30), 17(30)-18(00)). During 24 hors, samples of venous blood were obtained from each subject every 4 hours for the serum gastrin radioimmunoassay. The results were analyzed by mean cosinor method. The control group has a statistically significant circadian rhythm, while we were not able to detect a circadian rhythm in the patients with duodenal ulcers. The daily mean of serum gastrin levels appears to be significantly reduced in the ulcer group.

[Circadian aspects of iron metabolism. Changes of total iron binding capacity in patients with liver cirrhosis and in apparently healthy persons]. / Aspetti circadiani del metabolismo del ferro

A group of 8 patients (M) with liver cirrhosis were studied. Each subject was standardized with rest time extending from 22,00 to 05,00 and meals scheduled at 08,00-08,30, 12,00-12,30, 17,30-18,00. Then was sampled at 04,00, 08,00 12,00, 16,00, 20,00, 24,00. In each sample of serum were determined iron, T.I.B.C. and L.I.B.C. All data were analyzed by macroscopic approach (chronograms) and by mean cosinor. A significant circadian rhythm was detected in all parameters, with a statistically valid difference between normal subjects and patients with liver cirrhosis in the mesor of T.I.B.C. and L.I.B.C.