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Biomedical subjects

E Langer

Publications and source records attributed to E Langer.

At least 37 records · Page 2Linked to original sources
PubMed1990

Do the elderly sue physicians?

We reviewed malpractice data from the state of Wisconsin for 1983 and 1984 to determine the frequency and the outcome of malpractice litigation by the elderly. Research data were obtained from court dockets filed with Wisconsin's Patients Compensation Panel and from 281 attorneys who provided the age for 431 claimants. The results showed that 10.0% of malpractice suits in Wisconsin were filed by the elderly during the study years. When we compared the frequency of litigation with the use of the health care system (number of hospitalizations and inpatient days), the elderly were significantly less likely than younger persons to initiate malpractice litigation despite greater exposure to potential negligence. However, once a malpractice suit was filed, there was no significant difference between older and younger litigants in the disposition of the case or in the likelihood of being the prevailing party when a finding or award was made. These findings suggest that the elderly are less likely to file malpractice claims against health care providers than would be expected given their use of the health care system. This finding may be related to social, economic, and legal barriers to malpractice litigation by older adults.

Adult↗
PubMed1989

Increased platelet volume--sign of impaired thrombopoiesis in diabetes mellitus.

Increased functional properties of diabetic platelets might be already conditioned during thrombopoiesis in the stem cell system. This hypothesis was studied by recording the distribution characteristics of the peripheral platelet pool in 218 diabetic patients versus 51 controls. Furthermore, platelet membrane coating with the stem cell marker glycoprotein IB was analyzed in 41 diabetic subjects and compared to 23 healthy volunteers. A consistent, significant shift of the volume distribution to larger platelets was found in diabetics: Mean platelet volume (MPV) - 7.9 +/- 0.9 versus 7.2 +/- 0.8 [fl]; Megathrombocyte index (MTI) - 20.4 +/- 2.8 versus 18.1 +/- 2.5 [fl]. These deviations were present in all patient subsets, however did not correlate to parameters of glucose metabolism. Whole blood platelet count was increased in the patient group; 195.0 +/- 59.5 versus 184.0 +/- 37.5 x 10(3) plts/ul. Coating with glycoprotein IB receptors correlated significantly to platelet size in platelets of both controls and diabetics (r normal = 0.52 +/- 0.07; r diabetic = 0.46 +/- 0.1). The quantitative expression of glycoprotein IB was significantly enhanced in the diabetic group: 54,500 x 1.28 +/- 1 versus 39,100 x 1.3 +/- 1 molecules per platelet. In conclusion, these findings strongly support the assumption of diabetic stem cell dysfunction of the megakaryocytic series and progenitor cells resulting in platelets with primarily increased potency to adhere and aggregate in diabetes mellitus.

Adult↗
PubMed1989

[Flow cytophotometric measurements before and during radiotherapy of head and neck tumors].

The DNA index and proliferation activities were determined by flow cytophotometry in 59 tumors of the head and neck area. 35 tumors (59%) were aneuploid, 24 (41%) were diploid. Aneuploid tumors showed a tendency to increased formation of lymph node metastases, an increased risk of relapse as well as a shorter relapse-free interval. No correlation was found between the primary tumor stage and the incidence of aneuploid tumors. Whereas aneuploid tumors developed frequently regional recurrences, only local recurrences were observed in diploid tumors. A number of biopsies was additionally performed during radiotherapy in twelve tumors. After 10 or 20 Gy, aneuploid tumors showed a considerably increased number of S and S2 + M phase cells. In diploid tumors, substantial modifications of the cell cycle phases were not found, because it is not possible in these cases to distinguish between normal cells and tumor cells.

Aneuploidy↗
PubMed1988

[Kaposi's sarcoma with pericardial tamponade in AIDS].

In two males with AIDS, aged 26 and 39 years, who had disseminated Kaposi's sarcoma, massive pericardial effusion with tamponade (confirmed by echocardiography) developed in the final stages. Multiple pericardial taps, of up to two litres, of serous fluid yielded no malignant cells or pathogens cytologically or microbiologically. At autopsy the finding was of cytomegalovirus and cryptococcus septicaemia, respectively, and generalized Kaposi's sarcoma with infiltration of the heart along the great vessels and subepicardially along the coronary vessels. The pericardial sac was distended balloon-like with 800 ml sanguinous fluid (in both cases). Histological examination did not demonstrate cytomegalic inclusion bodies or fungal granulomas in cardiac tissue. The pericardial effusion was probably due to tumour spread in the lymph channels and along the vasa vasorum.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Reduction in numbers of large ganglion cells in cat retina following intravitreous injection of antibodies.

Antibodies were prepared against large ganglion cells isolated from bovine retina and injected into the vitreous chamber of 1 eye in 6 adult cats. The other eye of each cat received either a control pre-immune gamma-globulin injection or was untreated. After a survival time of 9-86 days, ganglion cell density was assessed from Nissl-stained retinal whole-mounts. In each cat, there were fewer large ganglion cells (alpha-cells) in the immunoglobulin-injected retina than in the control retina. The reduction in large ganglion cells occurred in patches adjacent to areas of approximately normal large ganglion cell density. Counts of the number of large ganglion cells in both eyes of the 6 cats indicated that the immunoglobulin injected eyes had from 8% to 61% (mean 32%) fewer large ganglion cells than the paired control eyes. This was significantly greater than the difference in the number of large ganglion cells between pairs of normal or control-injected eyes. The magnitude of the effect was not related to the survival time following the immunoglobulin injection. Cell size measures of all ganglion cells in selected areas of retina indicated that the small ganglion cells were unaffected by the antibodies. However, there was a suggestion that the largest of the medium size ganglion cells were affected in addition to the large ganglion cells. Counts of total ganglion cells per unit area in affected regions of retina revealed a reduced overall density, suggesting that the ganglion cells were lost rather than decreased in size. These results indicate that antibodies to the large ganglion cells can be used to reduce the number of large ganglion cells (alpha-cells) in the cat retina. Since these cells correspond to the Y-cell functional class of ganglion cells in the cat retina, the antibodies may provide a useful tool for studying Y-cell function in the visual pathways.

Animals↗
PubMed1982

Induced disability in nursing home patients: a controlled trial.

Many performance deficits observed in institutionalized elderly patients may be the results of social and environmental factors rather than disease or the aging process. To test this hypothesis, 72 nursing home residents (mean age, 78 years) were randomly assigned to three groups for training in completion of a simple psychomotor task. In four training sessions, members of Group I ("helped") were given extensive assistance in completing the task; members of Group II ("encouraged only") were given verbal encouragement but minimal assistance; members of Group III ("no contact") received no training sessions and served as controls. All subjects were tested on proficiency in completion of the task (a simple jigsaw puzzle) before and after the intervention period. Completeness of performance by Group II improved during the study, but that of Group I deteriorated significantly (P = 0.04 between groups) to a level even below that of the control group (P = 0.03). Similar differences were found in speed of performance, with Group II performing best, Group I performing worst (P = 0.05), and the control group performing intermediately. Perception of task difficulty was greater (P = 0.02) and self-confidence was less (P = 0.06) for Group I than for Group II. The psychosocial environment of long-term facilities can have important effects on the competence of elderly patients. Excessive infantilization of residents and overly intrusive help in self-care beyond clinical requirements can lead to "learned helplessness," with further disability.

Activities of Daily Living↗
PubMed1979

Epithelioid cell granulomata in the mucosa of the small intestine in Whipple's disease.

This report is the first description of sarcoid-like epithelioid cell granulomata in the mucosa of the small intestine in a case of Whipple's disease. The epithelioid cells do not contain PAS-positive material or products of bacterial degradation. Their ultrastructural features characterize them as histiocytes which have become secretory rather than phagocytic. These sarcoid-like lesions are considered to be a morphological manifestation of an immunological process in Whipple's disease and not to represent evidence of sarcoidosis as a concomitant or associated disorder.

Granuloma↗