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Biomedical subjects

W C Stolov

Publications and source records attributed to W C Stolov.

At least 37 records · Page 2Linked to original sources
PubMed1987

Prevalence of diabetes mellitus and impaired glucose tolerance among second-generation Japanese-American men.

We describe the initial findings from a multidisciplinary, epidemiologic study of diabetes mellitus conducted in a population of second-generation Japanese-American (Nisei) men born between 1910 and 1939 who reside in King County, Washington (n = 1746). From this study population, 487 volunteered, and 229 were enrolled to comprise the study sample. A random sample of Nisei men was also drawn from the population to develop a reference sample of 189 men. All subjects participated in a 75-g oral glucose tolerance test; the National Diabetes Data Group (NDDG) and World Health Organization (WHO) diagnostic criteria as well as a modification of the WHO criteria were used to classify individuals with normal glucose tolerance, impaired glucose tolerance (IGT), or diabetes. Within the study sample, 79 men were found to have normal glucose tolerance, 72 had IGT, and 78 had type II diabetes. The mean age of the study sample was 61.4 yr. Based on comparison of the study sample to the reference sample, the study sample was ascertained to be representative of Nisei men in King County. Extrapolating from our observations in the reference sample and in the study sample, we have estimated that approximately 56% of Nisei men in the study population have abnormal glucose tolerance. Much of this is undiagnosed because only approximately 13% of the reference sample of Nisei men reported a prior diagnosis of diabetes. Of the men who enrolled in the study as nondiabetic subjects, 11.1% had diabetes and 39.2% had IGT; i.e., 50.3% had previously unknown abnormalities in glucose tolerance. We estimate that approximately 20% of Nisei men have diabetes (both previously diagnosed and undiagnosed) and approximately 36% have IGT.

Adult↗
PubMed1987

Prevalence of complications among second-generation Japanese-American men with diabetes, impaired glucose tolerance, or normal glucose tolerance.

In a study sample of 229 second-generation Japanese-American (Nisei) men, 79 with normal glucose tolerance, 72 with impaired glucose tolerance (IGT), and 78 with non-insulin-dependent diabetes, we have determined prevalence rates for certain conditions (ischemic heart disease, peripheral vascular disease, hypertension, retinopathy, neuropathy, and nephropathy) associated with diabetes. All subjects participated in a 75-g oral glucose tolerance test. World Health Organization (WHO) diagnostic criteria and information from the subject's medical history and personal physician were used to classify the subjects. Retinopathy was observed only in diabetic men in the study sample (11.5% of diabetic men). Furthermore, it was observed only in men who were receiving drug treatment for diabetes--40.0% of insulin-treated and 17.2% of sulfonylurea-treated men. Electrophysiologic evidence of peripheral neuropathy was observed in 46.2% of diabetic men and in 4.0% of nondiabetic (normal and IGT) men. For diabetic men with fasting serum glucose greater than or equal to 140 mg/dl, 63.8% had peripheral neuropathy and 19.1% had retinopathy, whereas for diabetic men with fasting serum glucose less than 140 mg/dl, 19.4% had neuropathy and none had retinopathy. For diabetic men with a diabetes duration of greater than or equal to 10 yr, 72.7% had neuropathy and 31.8% had retinopathy; with a diabetes duration of 5-9 yr, 70.6% had neuropathy and 11.8% had retinopathy; and with a diabetes duration of less than 5 yr, 20.5% had neuropathy and none had retinopathy. Nephropathy was distinctly uncommon, and among the measurements of kidney function, only proteinuria was clearly abnormal with diabetes. Prevalence rates of hypertension, peripheral vascular disease, and ischemic heart disease were highest in Nisei men with diabetes, lowest in men with normal glucose tolerance, and intermediate in men with IGT.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1986

Somatosensory evoked potentials after removal of somatosensory cortex in man.

Somatosensory evoked potentials (SEPs) to median nerve, ulnar nerve, thumb, middle finger, and posterior tibial nerve stimulation were recorded in a patient with a discrete resection of part of the postcentral somatosensory cortex as a treatment for focal epilepsy. Comparison of the different stimulation sites confirmed electrophysiologically the restricted locus of the lesion. The results strongly suggest that the early negative component (N20) and subsequent components recorded postcentrally are of cortical origin and depend upon postcentral gyrus cytoarchitectonic areas 3, 2, and 1. Moreover, these postcentral SEPs are distinct from precentrally recorded activity.

Adult↗
PubMed1984

Rehabilitation research training.

The need for increased productivity in rehabilitation research by a larger number of physicians is discussed. The ingredients of appropriate research training are described, and include recruitment, education, skill attainment and an apprenticeship. An estimate is made that the desired increase in research productivity could be achieved if each year for the next five to ten years just 20 physiatrists could be trained in rehabilitation research. Suggestions are made as to how the training of that number of physiatrists annually can be brought about.

Education, Medical↗
PubMed1983

Rehabilitation research: habit analysis and recommendations.

Respondents to a survey by the Association of Academic Physiatrists (AAP) on the research grant application behavior of its members indicated that 41% (45) made no applications during the 6-year period ending December 1980. Of the remainder, 12% (13) were aggressive achievers (eg, earned 54% of the awards), 33% were mild achievers and 14% were unsuccessful applicants. The successful applicants submitted 1 1/2 times more applications than did the unsuccessful ones. Of the awards made, 42% were federally funded. Of articles published in the Archives of Physical Medicine and Rehabilitation by physicians in the years 1978-1980, 76% were federally funded. Study of these data suggest that upgrading of knowledge and skills in the grant application process plus an exposure to new funding sources could increase rehabilitation research productivity. This paper discusses factors influencing success, research initiation and methods of accessing funds available from corporations and foundations.

Efficiency↗
PubMed1981

Carpal tunnel syndrome in chronic renal dialysis patients.

Pain, dysesthesias, sensory changes, and weakness in hands of uremic patients receiving renal dialysis are usually attributed to peripheral neuropathy or vascular steal syndrome. Our experience suggested superimposed carpal tunnel syndrome (CTS) as an additional etiology. This premise was studied by using electromyography and standardized electrodiagnostic techniques to measure median and ulnar conduction velocities and distal motor and sensory latencies. Of 48 patients tested, 15 (31%) had symptomatic CTS, confirmed by electrodiagnosis. Seven of these patients had bilateral CTS. Twelve patients subsequently had surgical flexor retinaculum release, resulting in relief of symptoms. Thirty-seven of the 48 patients tested, including all 15 with CTS, had peripheral neuropathy. Of the patients with peripheral neuropathy, and who were on dialysis longer than 5 years, 57% also had CTS. Slowing of ulnar nerve conduction velocity across the elbow was found in 11 arms, including 3 with CTS. The high incidence of CTS in this renal dialysis population appears to be related to nerve compression secondary to a thickened transverse carpal ligament. Increasing time on dialysis was related to an increased incidence of CTS. However, the presence of forearm access (AV fistula or cannula) was not crucial to the development of CTS. CTS is treatable and should be considered in the differential diagnosis of hand and arm symptoms in chronic dialysis patients.

Arteriovenous Shunt, Surgical↗
PubMed1979

Action myoclonus following acute cerebral anoxia.

Action myoclonus secondary to posthypoxic encephalopathy is being seen increasingly with improved resuscitation techniques. A case report describes 5 specific physical and occupational therapeutic techniques for achieving independence in ambulation, transfers and self-care: (1) analysis and segmentation of complex motions into small steps; (2) controlled progression of training; (3) voluntary cessation of abnormal activity (pacing); (4) progressive densensitization to external stimuli; and (5) quantification of progress. Literature review suggests that posthypoxic action myoclonus is secondary to a loss of inhibitory synapses in the brainstem reticular formation due to low serotonin levels. The proposed therapeutic effect of clonazepam, the drug used in this patient, is decreased serotinin degredation. L-5-hydroxytryptamine, an investigative drug, is also therapeutic, for it stimulates increased serotonin production.

Acute Disease↗
PubMed1978

Paraplegia: succinylcholine-induced hyperkalemia and cardiac arrest.

The rapid development of hyperkalemia leading to cardiac arrest can occur in patients with spinal cord injuries and other conditions when succinylcholine is used during the induction of anesthesia. Three patients with thoracolumbar spinal cord injuries resulting in lower motor neuron lesions or lesions above the lower extremity motor units developed hyperkalemia followed by cardiac arrest after succinylcholine administration. The mechanism by which succinylcholine leads to hyperkalemia from denervated muscle is described and precautions to be taken are mentioned. Physicians caring for patients with denervated muscle due to spinal cord injuries should be aware of this danger and nondepolarizing muscle relaxants should be used instead of succinylcholine.

Adult↗
PubMed1978

Gastrocnemius muscle belly and tendon length in stroke patients and able-bodied persons.

Length changes of gastrocnemius muscle belly and tendon at different passive tensions and ranges of motion (ROM) were measured in 31 healthy persons and 15 hemiplegic patients with clinically demonstrated ankle joint plantar flexion (PF) contractures. Preliminary studies were done to obtain accurate determination of gastrocnemius muscle insertion and origin points on x-ray films, to calculate the magnification factor due to x-ray beam divergence and to measure the length changes in muscle belly by the use of a wire hook placed at the muscle-tendon junction. Our results revealed: (1) change in length at different passive tensions is in the muscle belly, not in the tendon, (2) in hemiplegic patients no statistical difference in elongational characteristics of affected gastrocnemius muscle bellies with clinically demonstrated ankle PF contractures and of the contralateral nonaffected muscle bellies, (3) spastic and flaccid gastrocnemius muscle bellies are not statistically different in respect to passive elongations, (4) gastrocnemius muscle bellies of both affected and nonaffected legs of hemiplegic patients were statistically different from the muscle bellies of healthy persons in regard to maximal ROM and maxinum muscle belly length changes, (5) there was approximately .5 mm change in the belly length for each degree of ankle ROM, (6) age is not a factor influencing passive elongation of muscle belly, (7) average muscle belly lengths were consistently shorter in hemiplegic muscles while their tendon lengths did not change. The enumerated findings suggest that the limitation of ankle ROM in spastic hemiplegic legs obtained by the standard clinical measurements technique represents a change in muscle belly rest length without a structural contracture of the muscle fibers.

Adult↗
PubMed1977

Muscle fiber number in immobilization atrophy.

Eight Sprague-Dawley rats 10 to 12 weeks of age had one limb immobilized by plaster in knee flexion and ankle plantar flexion for four weeks. The soleus muscles from the control and immobilized limbs were excised and frozen. The technique used insured that cross sections subsequently cut and stained would contain all the fibers extending from the origin to the insertion aponeuroses. The total number of muscle fibers per muscle was counted from 25 to 50 photomicrographs made for each muscle cross section. Paired comparisons of total muscle fibers in control and immobilized muscles revealed no significant differences. The total number of fibers in control and immobilized soleus muscles was 2812 +/- 521 and 2930 +/- 403, respectively. Therefore, muscle fiber loss does not occur in disuse atrophy produced by external immobilization as has been reported.

Animals↗
PubMed1976

Microscopic features and transient contraction of palpable bands in canine muscle.

Ten pairs of biopsies were excised from gracilis and semitendinosus muscles of 4 mongrel dogs. These were compared with the histological findings reported in painful spots and muscle hardenings of human muscles. Test biopsies sampled a palpable band. Paired control biopsies sampled a portion of the same muscle where it showed no palpable hardening. Processed sections were randomized and read blind. Sections stained with aqueous toluidine blue showed no convincing metachromasia. Sections stained with trichrome showed no proliferation of endomysial connective tissue. Test sections stained with hematoxylin and eosin showed no proliferation of nuclei and no increase in the number of central nuclei in muscle fibers compared to control sections. No convincing histological difference was found. During surgery under Nembutal anesthesia, rubbing palpation of the exposed muscle elicited a transient contraction of a bundle of muscle fibers several milli-meters in diameter. This corresponded in time and position to the palpable band in the dog muscle. The band-like hardness palpated in these canine muscles appears to be caused by a circumscribed transient muscular contraction rather than histologically demonstrable structural changes.

Animals↗
PubMed1976

Needle electromyography: its effect on serum creatine phosphokinase activity.

The effect of needle electromyography on serum creatine phosphokinase (CPK) levels has remained unclear despite the diagnostic implications. Serum CPK was serially assayed for changes before and after electromyography (EMG) in two healthy persons and ten persons having low back pain, while they remained at total bed rest. Mean curves showed a peak at 6 hours post-EMG and a return to baseline 48 hours post-EMG. The mean peak value was 1.5 times the baseline. Only one sample exceeded the normal range and it was from a patient with frank positive waves and fibrillation potentials. Correcting for dilution of CPK released, by body weight and for total trauma, by number of needle insertions did not modify the results. The time course and magnitude of elevation of CPK parallel those reported for post exercise changes but are much less than those reported to follow myocardial infarction. In the differential diagnosis of myopathies, care must be taken to ensure that the combination of needle electromyography, exercise, diurnal variation and active denervation does not lead to a "false-positive" elevation of CPK above the normal range. Needle electromyography by itself should not induce a false-positive CPK level in a normal person and no significant changes in CPK levels are likely to occur within two hours after the study.

Adolescent↗