Biomedical subjects
Publications and source records attributed to D Schuler.
The effect of naloxone on inhibition of leucocyte migration by alpha-gliadin was examined in 24 patients with coeliac disease. In all cases in which alpha-gliadin inhibited leucocyte migration, naloxone blocked this inhibitory effect, which suggests that the effect of gliadin on lymphocytes from patients with coeliac disease may be mediated through opioid-like receptors.
Between 1971 and 1981, 699 children were diagnosed to have acute lymphoblastic leukemia (ALL) in Hungary. 34 of these children had received prednisolone therapy prior to the establishment of the diagnosis. The most frequent presumptive diagnoses that prompted steroid treatment were aplastic conditions and arthritic disorders. Leukemia was diagnosed when the presenting symptoms reappeared usually several weeks after the initiation of steroid therapy and often following withdrawal of the drug. Initial leukemic burden, as judged by leukocyte count and hepatosplenomegaly, was smaller in these patients than in other children with leukemia at the time of diagnosis. Although they entered remission at the same rate as the other patients, the length of continuous complete remission was significantly shorter in the prednisolone pretreated group. It appears that prolonged prednisolone therapy given before remission induction imparts a distinct unfavorable prognosis.
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Eighty-one children with malignancies and their families were investigated for the psychosocial changes that take place during the course of the disease. Seventeen patients were in the initial phase of treatment, 24 were in first remission, 14 were long-term survivors already off therapy, 11 were in relapse, and 15 children died 1-5 years before this study. Detailed personal interviews with the parents showed profound changes in the families' life and severe problems in adapting to the new situation. Marital problems, neglecting the healthy siblings, and a loss of interest in work occurred in the majority of parents, especially in mothers. Younger siblings suffered more from the strains imposed on the family than did elder ones. Psychosocial care is felt to be helpful for all families in adjusting to the altered circumstances and emotional upheavals.
During the 12-year period between 1971 and 1982 leukemia was diagnosed in 759 children in Hungary. Of these, 123 (16%) had acute myeloid or myelomonocytic leukemia. This corresponds to an annual incidence rate of 6.15 cases per 10(6) children. Analysis of the presentation symptoms at diagnosis showed a higher incidence of septic signs but otherwise no difference to those in acute lymphoid leukemia. Treatment schedules were intensified successively in stepwise fashion. Remission rates rose from 34% to 66%, and remission lengths also improved. Of the prognostic factors analyzed, initial WBC count in excess of 50 G/1 was found to confer bad prognosis, while the other factors had no significant effect on disease-free survival.
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An analysis is offered of the factors contributing to the very high incidence of low birthweight infants in Hungary, based on data of the last three decades. The incidence increased by 30% from 1950 to 1974, and since 1974 there has been a reduction by 20%. The main factors of the high incidence are harmful habits (smoking, alcohol consumption, etc.) during pregnancy, the uneven level of antenatal care, the low level of education and health culture, and the frequency of induced abortion. Further improvement can only be expected from a planned influence on the above factors.
The lymphocyte subpopulations were investigated in peripheral blood of small-for-gestational age (SGA) and appropriate-for-gestational age (AGA) preterm newborns. In SGA newborns the number and percentage of T lymphocytes were reduced. Among the T lymphocytes, the number and percentage of T helper cells were significantly decreased. The cytotoxic/suppressor T cells were also reduced, but to a lesser extent.
Sister chromatid exchange studies were conducted in 53 children with malignant diseases. Children with acute lymphoid leukemia in long remission, already off chemotherapy or on maintenance therapy, had normal SCE values, whereas those receiving intensive cytostatic therapy showed elevated levels. SCE values were primarily related to the time and dose of preceding cytostatic drug therapy, and the subsequent relapse might influence the SCE frequencies, independently from the cytostatic therapy.