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Biomedical subjects

L Wolf

Publications and source records attributed to L Wolf.

At least 55 records · Page 3Linked to original sources

Testosterone and avian life histories: the effect of experimentally elevated testosterone on corticosterone and body mass in dark-eyed juncos.

To assess whether alterations in the normal pattern of testosterone (T) secretion might be beneficial or detrimental, we studied a breeding population of dark-eyed juncos in which we elevated T experimentally and measured its effect on potential correlates of fitness. We treated both free-living and captive males with implants that were either empty (C-males, controls) or packed with T (T-males, experimentals). Timing of implant varied and was designed to mimic natural peak breeding levels except that peaks were either prolonged or premature. We bled the birds at recapture and analyzed their plasma, and that of their female mates, for T and corticosterone (B). We also measured body mass and fat score in free-living T- and C-males. In the field, T-implants elevated T and kept it elevated for at least a month. Experimental males also had higher B than controls. In captives, the effect of the implants on plasma T was detectable within 24 hr. B in captive T-males was again higher than in captive C-males. In females, neither T nor B differed between mates of T- and C-males. T-males implanted in early spring lost more mass between implant and recapture in late spring than did controls and also had lower fat scores when recaptured. When implants were inserted in summer, treatment did not influence mass. Elevated T in early spring apparently hastened the transition from the winter to the breeding mode of fat storage. We suggest that prolonged elevation of testosterone might be selected against because of the association between T and B. Premature elevation of T might be costly because of the resultant loss of mass and fat reserves, which could lead to mortality when spring snowstorms prevent access to food.

Adipose Tissue↗

The handicapped child: psychological effects of parental, marital, and sibling relationships.

Although the nature and severity of a handicapping condition are not the sole determinants of family functioning, the presence of a child with a pervasive developmental disorder has a significant effect on family members. Maternal mental health suffers, and the resulting depression affects her role as mother and marriage partner. Unlike other handicapping conditions with obvious physical stigmata, the invisible handicap of the autistic child and the frequent delay in diagnosis contribute to the mother's self-doubt about her parental competence. While the impact on paternal psychological health is less, the fathers of autistic children are nevertheless highly stressed and appear to be particularly vulnerable to the stress generated by these difficult children. Living within this family climate, the risks for emotional and behavioral problems for siblings must be evaluated, along with their intrinsic strengths, to plan preventive interventions for these children. Effective work with these families requires an understanding of the evolution of family system problems and their dynamic and reciprocal interaction over time.

Adaptation, Psychological↗

[Operative aspects of prosthesis change in the hip joint after fracture of the prosthesis shaft].

Between 1983 and 1988 revision arthroplasty was performed in 45 patients with broken femoral stems, an average of 11 years after primary total hip replacement. There were 25 men and 20 women, with an average age of 70 years at revision. The primary endoprostheses were all cemented and of the following types: Buchholz A1 (41) Charnley-Müller (2), Weber-Huggler (1), Charnley (1). In 8 cases the femoral stem only was changed, while in 37 both components had to be replaced. The posterior approach with the patient in the lateral position gave excellent exposure of both the acetabulum and the femur. This approach gave ready access to a dorsal window, through which the broken femoral stem could be removed with a punch. To achieve stability of the femur permitting immediate full weight-bearing, the femoral defect was always made good by a revision stem with at least twice the femoral diameter. In order to stabilize large acetabular defects a combination of homologous bone graft and an acetabular support ring was used. The implanted prostheses were of the revision type, cemented and individually selected in each case. It was possible to implant an adequate revision prosthesis in all cases. The following complications were noted during surgery: fracture of the femur (1) defects of the femur (5), and haemorrhages that were difficult to manage (2). It was necessary to reoperate in 2 patients, in 1 because of a stitched-up drain and in 1 because of postoperative haematoma. Postoperatively, 21 patients had cardiopulmonary complications, which were successfully treated in the intensive care unit in all cases but 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty.

The purpose of the study was to examine the gastrointestinal hormone responses to meals in morbidly obese patients before and after Roux-en-Y gastric bypass (GBP; n = 9) or vertical banded gastroplasty (VBG; n = 7). On consecutive days before and after operation, we measured changes in peripheral blood levels of glucose, insulin, enteroglucagon, serotonin, vasoactive intestinal polypeptide (VIP), and cholecystokinin (CCK) in response to a standardized glucose or protein-fat meal. The percentage of excess weight lost at 6 months after operation was 66.3% +/- 4% and 41.8% +/- 5% for GBP and VBG, respectively (p less than 0.01). The 3-hour integrated glucose response to a glucose meal decreased from 145.3 +/- 33.7 to 75.8 +/- 15.7 g min/L (p less than 0.02) after GBP. This was associated with a decrease in 3-hour integrated insulin response from 22.8 +/- 8.2 to 10.5 +/- 4.9 mU min/L. Vertical banded gastroplasty patients had lesser reductions of hyperglycemia and hyperinsulinemia. Neither the CCK, serotonin, nor VIP responses to meals were altered by either operation. The 3-hour integrated enteroglucagon response to glucose increased markedly in GBP patients after operation from 11.8 +/- 6 to 133.4 +/- 38 nmol min/mL (p less than 0.02). This increase in enteroglucagon occurred at the same time as development of dumping symptoms, which occurred exclusively in GBP patients after glucose but not protein. We conclude that (1) GBP surgery for morbid obesity results in amelioration of glucose intolerance and hyperinsulinemia, (2) CCK does not mediate an endocrine satiety effect of surgery, (3) GBP is associated with an exaggerated enteroglucagon response to glucose, and (4) enteroglucagon appears to be a marker of the dumping syndrome in GBP patients.

Adult↗

Weight loss with vertical banded gastroplasty and Roux-Y gastric bypass for morbid obesity with selective versus random assignment.

In a previous study, Roux-Y gastric bypass was found to be significantly more effective than vertical banded gastroplasty for weight loss in morbid obesity, especially for patients addicted to sweets, probably as a result of dumping syndrome symptoms. This study evaluated the ability to selectively assign nonsweet eaters to vertical banded gastroplasty and sweet eaters to gastric bypass. Compared with random assignment, the percentage excess weight lost at 2 years improved significantly with both groups combined. In the vertical banded gastroplasty group, the percentage increased from 41 +/- 19 to 55 +/- 19 percent. With selective assignment, the percentage excess weight lost with gastric bypass was still better than that with vertical banded gastroplasty. Weight loss with gastric bypass was still superior to that of vertical banded gastroplasty but at the expense of more complications. Gastric bypass was ineffective in 19 percent of the super obese patients. A combined restrictive, malabsorptive procedure may be necessary in such persons.

Anastomosis, Roux-en-Y↗

Factors affecting the sensitivity and specificity of the three-phase technetium bone scan in the diagnosis of reflex sympathetic dystrophy syndrome in the upper extremity.

The three-phase technetium bone scan has been recommended for use in the diagnosis of the reflex sympathetic dystrophy syndrome with a sensitivity and specificity of greater than 90%. A retrospective chart review was conducted of 63 patients who had three-phase technetium bone scan as part of a work-up for unexplained upper extremity pain, to determine the predictive value of the three-phase technetium bone scan in reflex sympathetic dystrophy syndrome, and what factors might affect it. The prevalence of definite or probable reflex sympathetic dystrophy syndrome, as assessed by Kozin's criteria, was 26% in this sample. The 3-hour delayed image demonstrated a sensitivity = 50%; specificity = 92%; positive predictive value = 67%, and negative predictive value = 84%. This was not improved using the data from the blood flow or pool phase. The sensitivity of 50% is lower than previous reports. The predictive value of the three-phase technetium bone scan was affected by the duration of symptoms and the age of the patient. Duration of symptoms less than 6 months, or ages more than 50 years substantially increased the sensitivity and positive predictive value of the three-phase technetium bone scan.

Adult↗

Mentally retarded adolescent sex offenders. A survey and pilot study.

There is not a great deal of empirical research on adolescent sex offenders and even less on mentally retarded adolescent sex offenders. This study provides some preliminary data in this area. Results of a survey of the extent and types of sexual problems evident amongst groups of mentally retarded and intellectually normal adolescents (N = 196), seen at an assessment and treatment centre in southwestern Ontario during a 14 month period is presented. In addition three groups of ten adolescents each (mentally retarded and intellectually normal sex offenders and one group of mentally retarded non-offenders with behavioural problems) were investigated to gain a more indepth perspective of characteristics of these adolescents and their backgrounds. Considering the high recidivism rate for these groups, indications for treatment are discussed with special consideration for the mentally retarded offenders.

Adolescent↗

Predictive value of the three-phase technetium bone scan in diagnosis of reflex sympathetic dystrophy syndrome.

Reflex sympathetic dystrophy syndrome (RSDS) is a painful and disabling problem, the diagnosis of which can be difficult to confirm by objective measures. The three-phase technetium bone scan (TPBS), with a combined sensitivity and specificity of greater than 90%, has been recommended for use in the diagnosis of RSDS. The purpose of this study was to determine the predictive value and usefulness of the TPBS in the diagnosis of RSDS and to discover how the predictive value might be influenced by demographic and medical factors (eg, duration of symptoms). A retrospective chart review was conducted of 119 patients who underwent a TPBS as part of a workup for unexplained limb pain. Twenty-five patients met the Kozin criteria for definite or probable RSDS. All patients were injected with technetium-99m methylene diphosphonate and scanned using established criteria. The three-hour delayed image demonstrated a sensitivity of 44%, a specificity of 92%, a positive predictive value of 61%, and a negative predictive value of 86%. The blood-flow and pool-imaging phases added no further sensitivity or specificity to that achieved by the uptake scan in patients with upper-extremity involvement. Blood-flow and pool-imaging did improve the predictive value of the TPBS in patients with involvement of the lower extremities. We conclude that a more cost-effective approach to diagnosis of upper-extremity RSDS is to use the uptake scan alone.

Adult↗

Cataract extractions for senior surgeons.

Two groups of surgeons over the age of 70 were contacted to determine their personal experience with cataract surgery. One hundred fifty-three of 250 ophthalmologists and 107 of 250 members of the American College of Surgeons responded to a questionnaire. Sixteen (10.5%) ophthalmologists and nine (8.4%) FACS members had undergone cataract surgery in at least one eye. The mean age at the time of surgery was 72.7 years for the ophthalmologists and 66.4 years for the FACS members. Results were excellent, with 24 of the 25 eyes among the ophthalmologists having vision of 20/30 or better. Rates for surgery among spouses of both groups were lower than those for the surgeons.

Aged↗

Autistic children grow up: an eight to twenty-four year follow-up study.

Eighty questionnaires were sent to parents and/or caregivers of autistic persons diagnosed between 1960-73 at CPRI, a regional assessment and treatment centre. The objective was to determine their present place of residence, functioning ability, language development, program involvement, and seizure activity. The results of this study support evidence that more than 50 percent require long-term institutional care; almost one-third suffer epileptic seizures; there is a persistence of symptoms and difficulty in gaining useful speech; few live independently or are capable of employment.

Adolescent↗

Parents' attitudes toward sterilization of their mentally retarded children.

Parents' attitude toward sterilization and the sexuality of their retarded offspring were identified. Parent and child characteristics associated with these attitudes were investigated. A random sample of parents with mentally retarded offspring under age 40 was selected from three countries in southwestern Ontario. Of this sample 55 percent responded to a mailed questionnaire. Results indicated a high percentage of parental agreement with sterilization: involuntary sterilization, 71 percent; voluntary, 67 percent.

Adolescent↗