Biomedical subjects
R Wolf
Publications and source records attributed to R Wolf.
Sexual function after radical prostatectomy.
Forty-five patients undergoing radical retropubic prostatectomy by a standard technique modified by the author (JEP) were interviewed regarding their sexual function prior to and after the operation. Thirty-five patients were sexually potent prior to the surgery. Post-operatively, 19 patients retained erectile potency (54%), although in 15 partial erections of varying degrees were noted. In 4 of these patients, erections were not satisfactory for sexual intercourse. It is evident that a significant number of patients retained sexual function after radical prostatectomy, even when no particular attention was made to preserve the neurovascular supply.
A new concept in the pathogenesis of drug-induced psoriasis.
Since drug-induced psoriasis is triggered by a known agent, studies of this type of psoriasis may provide clues to understanding the pathogenesis of the disease. Analysis of the reported cases of drug-induced psoriasis lead us to the postulation of a new concept of this disease. According to this concept drug-induced psoriasis is an auto-immune disease of the beta receptors of the skin. The initial and central event is the alteration of the immunological properties of the receptor due to an interaction with the drug. This leads further to the activation of an immunological cascade that results in a reduction in the functional activity of the receptors and through a known pathway to the development of the clinical manifestation of the disease.
Tinea capitis among children of Ethiopian immigrants.
The incidence, clinical appearance and causative agent of tinea capitis among children of Ethiopian immigrants, was studied. Out of 124 children examined, 36 had scalp lesions and 32 cases were confirmed as scalp-ringworm on direct microscopy. Culture showed the dermatophyte to be Trichophyton violaceum. The clinical presentation, resembling seborrheic dermatitis, without clinically apparent hair invasion, was atypical.
Intraovarian secretion of catecholamines, oxytocin, beta-endorphin, and gamma-amino-butyric-acid in freely moving rats: development of a push-pull tubing method.
We have developed and validated a push-pull technique that allows focal perfusion of the ovary in unanesthetized freely moving rats. We have used this method to investigate the intraovarian secretion of catecholamines (dopamine, norepinephrine, epinephrine), oxytocin, beta-endorphin and gamma-amino-butyric acid (GABA) during the estrous cycle. Cycling animals were implanted with ovarian push-pull catheters and jugular vein catheters under ether anaesthesia on proestrus, estrus and diestrous Day 2. This procedure did not disrupt normal preovulatory release of prolactin and luteinizing hormone (LH). Thus, perfusion of the ovary and simultaneous monitoring of hormone levels in systemic blood in freely moving rats allow correlation of the temporal relationship of ovarian events with cyclic gonadotropin secretion. The results clearly indicate that a rise in ovarian norepinephrine occurs concomitant with the preovulatory surge in prolactin and LH. Ovarian beta-endorphin concentrations exhibit cyclic changes, whereas GABA release rates remain stable throughout the cycle. Oxytocin is secreted by ovarian tissue, and the secretion rate appears to be inversely related to prolactin. In view of the proposed involvement of ovarian nerves and particularly catecholamines in the process of follicular maturation and ovulation, our findings suggest a preovulatory activation of ovarian noradrenergic sympathetic neurons.
Visually stimulated saccadic eye movements in patients treated with lithium.
Saccadic eye movements were stimulated with the aid of 11 light spot stimuli, 10 of which were arranged at 3 degrees, 6 degrees, 9 degrees, 12 degrees, and 15 degrees to the left and right of the central stimulus. The parameters average and maximal eye movement velocity and latency were precisely investigated. 19 patients averaging 6.6 years on lithium prophylaxis were compared with 23 healthy controls. Significant differences between the two groups could not be found at this level of function.
Sleep-inducing effect of L-tryptophane.
Night sleep recordings were performed in 10 patients with sleep disturbance in falling asleep as well as in maintaining sleep using a mobile 4-channel EEG registration system. Three consecutive nights, which were spent under different conditions, were evaluated automatically. The first night without treatment was used as a baseline night to objectify the disturbed sleep, the second night was measured following an infusion of a physiological saline solution and prior to the third recording 5 g l-tryptophane were applied to the patients. Besides a significant decrease of delayed latency times until the appearance of the light sleep stages, an influence was seen on the quantitative sleep parameters such as sleep period time and total sleep time. In parallel, an improvement of the subjective feeling measured by a self-rating scale resulted after l-tryptophane. On the other hand, no definite influence on the other sleep parameters such as an increase of slow wave sleep was observed, so that the use of this treatment might be recommended in disturbances in falling asleep particularly.
Sleep alterations in ischemic stroke.
In 19 patients with cerebral infarctions in the middle cerebral artery territory, investigations of sleep using a mobile EEG recording system were performed. Sleep was found to be markedly altered compared to a normal group. Although an increase of time in bed and sleep period time was observed, total sleep time did not rise in a parallel manner, so that a distinct reduction of the sleep efficiency index was found. This increase of quantitative parameters was particularly caused by a higher amount of NREM time, whereas REM sleep was found to be deeply suppressed. Regarding the different NREM sleep stages, stage 0 (time spent awake during the night) and stage 1 had increased, whereas stage 4 was reduced. Interhemispheric differences were noticed referring to the sleep period time, which was found to be increased particularly in right-sided infarctions (because of an increase of NREM time) and a reduction of REM sleep in lesions of the right hemisphere (worsening of the REM to NREM ratio). Slow-wave sleep (stage 4), on the contrary, was found to be decreased in infarctions of the left hemisphere. These results support the hypothesis of a REM-inducing and regulating function of the right hemisphere and will lead to a new understanding of sleep-controlling mechanisms.
Mobile long-term EEG monitoring in generalized seizure disorders of different etiology.
Eighteen EEG long-term recordings were carried out in patients with generalized fits of different etiologies using a mobile 4-channel monitoring system in order to observe individual patterns of epileptic activity. In patients with idiopathic tonic-clonic seizures (A) no connection of frequency of spike-wave bursts with the sleep-wakefulness cycle was observed. In patients suffering from fits of organic nature (B) a peak of paroxysms was obtained in the hours before sleep onset, whereas in patients with absence seizures (C) a maximum was found in the morning hours after awakening. In patients with idiopathic fits (tonic-clonic and absence seizures) the minimum of bursts was observed in REM sleep, whereas stage 0 (tonic-clonic) and stage 1 (absence) were most prone to discharges. Patients with secondary generalized epilepsy had most spike-wave bursts in deep sleep. In the absence seizure group the transitional periods within the light non-REM-sleep stages were more susceptible to paroxysms than the retained stages. In patients with idiopathic grand mal seizures, the highest frequency of paroxysmal discharges was found during time spent awake in the night when retained over a longer period of time. The group including cases with attacks of organic nature did not show any preference to shifting times or preservation episodes of sleep stages.
How to manage psoriasis of the eyelids. A glance at opinions of other dermatologists.
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Multiple-angle, variable-interval, nonorthogonal MRI.
Multiple-angle, variable-interval, nonorthogonal (MAVIN) MRI is a new, time-saving technique that allows for the independent choice of slice angle and position for each slice in a multiangle pulse sequence. By appropriate adjustment of the slice-select radiofrequency pulse and the slice-select and readout magnetic-field gradients, the interval and angle of each slice may be individually chosen. MAVIN can reduce examination time in studies of the lumbar spine, orbits, knees, and heart, where nonparallel oblique scanning may be necessary and would otherwise require the use of additional pulse sequences. Loss of signal in the region of intersection of multiple planes due to local changes in effective repetition time is a practical limitation. For this reason, scan planes are chosen so that the intersection does not overlie the region of interest.
Genetic dissection of optomotor behavior in Drosophila melanogaster. Studies on wild-type and the mutant optomotor-blindH31.
In stationary flight Drosophila melanogaster produces yaw torque in response to visual movement stimuli. The residual optomotor yaw torque response of the mutant optomotor-blindH31 (omb), which lacks the horizontal (HS) and vertical (VS) giant fibers in the lobula plate, differs from that of wild-type in several aspects: it is restricted to the frontal visual field, it is only elicited by front-to-back motion and appears to be mediated by a different set of elementary movement detectors (EMDs). Using a single black stripe as motion stimulus the torque response is, even in wild-type flies, dominated by the frontal visual field and by front-to-back motion. We thus propose that Drosophila's optomotor yaw control is organized as two partially parallel subunits. The component still displayed by omb is called "object response"; the component missing in the mutant (which is presumably mediated by the giant HS-cells in the wild-type) is called "large field response". Several properties of the object response are described.
[Future ways of hospital financing and their effects on hospital organization].
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Whole bladder photodynamic therapy for transitional cell carcinoma of bladder.
Our preliminary studies indicate that the bulb-tip technique for whole bladder photodynamic therapy (PDT) illuminates the entire bladder mucosa and is applicable to the management of superficial transitional cell carcinoma of the bladder. This treatment modality may be an option to patients who are failures to other standard treatments. A randomized clinical study is needed to decide on PDT as a primary treatment of choice for transitional cell carcinoma of the bladder.
Monitoring intravesical bacillus Calmette-Guerin treatment of bladder carcinoma with flow cytometry.
Flow cytometry of bladder irrigation specimens was studied in 22 patients with low stage bladder carcinoma who were treated by transurethral resection of visible tumor followed in 3 to 5 weeks by a course of intravesical bacillus Calmette-Guerin. The most informative examinations were just before the first bacillus Calmette-Guerin treatment, 6 weeks after completing a 6-week course of treatment (3 months) and at 9 months. Of the patients 10 had recurrent tumors after therapy; recurrence was anticipated correctly by flow cytometry at the 12-week followup examination in 6 of the 10 patients and suspected in another. Of 12 patients who remained clinically free of disease for a minimum of 15 months after bacillus Calmette-Guerin therapy flow cytometry identified correctly 7 at 12 weeks, while 1 had a partial response and the remaining 4 reverted to a negative status at 9 months. Of interest, only 4 of the 22 patients were free of disease by flow cytometry at the start of bacillus Calmette-Guerin treatment despite attempted ablation of the tumor by transurethral resection, suggesting that intravesical administration of bacillus Calmette-Guerin destroys existing carcinoma in situ in some cases.
Norwegian-type scabies mimicking contact dermatitis in an immunosuppressed patient.
Patients taking immunosuppressive drugs are susceptible to various forms of infection, including dermatologic disease. Recently, atypical manifestations of scabies have been reported in such patients. In the case reported here, a 26-year-old woman who had had a renal transplant and was taking immunosuppressive drugs had a pruritic rash on the back that closely resembled contact dermatitis. However, skin scrapings from the involved areas and punch biopsy specimen of the back showed live scabies mites. The pruritus was relieved and the skin lesions disappeared within ten days of treatment with scabicides. We believe that current widespread use of immunosuppressive agents may result in more cases of atypical forms of scabies. Therefore, physicians who deal with immunosuppressed patients should be aware of this possibility.
Polarization studies of H(2p) charge-exchange excitation: H+-Ar collisions.
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Extensive pityriasis alba and atopic dermatitis.
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