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Biomedical subjects

H Lang

Publications and source records attributed to H Lang.

At least 127 records · Page 7Linked to original sources
PubMed1996

Cost effectiveness of treating primary care patients in accident and emergency: a comparison between general practitioners, senior house officers, and registrars.

OBJECTIVES: To compare outcome and costs of general practitioners, senior house officers, and registrars treating patients who attended accident and emergency department with problems assessed at triage as being of primary care type. DESIGN: Prospective intervention study which was later costed. SETTING: Inner city accident and emergency department in south east London. SUBJECTS: 4641 patients presenting with primary care problems: 1702 were seen by general practitioners, 2382 by senior house officers, and 557 by registrars. MAIN OUTCOME MEASURES: Satisfaction and outcome assessed in subsample of 565 patients 7-10 days after hospital attendance and aggregate costs of hospital care provided. RESULTS: Most patients expressed high levels of satisfaction with clinical assessment (430/562 (77%)), treatment (418/557 (75%)), and consulting doctor's manner (434/492 (88%)). Patients' reported outcome and use of general practice in 7-10 days after attendance were similar: 206/241 (85%), 224/263 (85%), and 52/59 (88%) of those seen by general practitioners, senior house officers, and registrars respectively were fully recovered or improving (chi2 = 0.35, P = 0.840), while 48/240 (20%), 48/268 (18%), and 12/57 (21%) respectively consulted a general practitioner or practice nurse (chi2 = 0.51, P = 0.774). Excluding costs of admissions, the average costs per case were 19.30 pounds, 17.97 pounds, and 11.70 pounds for senior house officers, registrars, and general practitioners respectively. With cost of admissions included, these costs were 58.25 pounds, 44.68 pounds, and 32.30 pounds respectively. CONCLUSION: Management of patients with primary care needs in accident and emergency department by general practitioners reduced costs with no apparent detrimental effect on outcome. These results support new role for general practitioners.

Consultants↗
PubMed1996

Intraoperative ultrasound during ex situ liver resection.

This report describes the application of intraoperative ultrasound at the explanted liver during ex situ liver surgery. A 55-year-old woman underwent extracorporeal liver resection for multilocular metastases of a duodenal leiomyosarcoma. At surgery, routine intraoperative ultrasound (5-MHz probe) was performed before hepatectomy at the completely mobilized but still normally perfused liver. After hepatectomy ultrasound of the liver was repeated at the back table. By use of the ultrasonographic examination at the back table all the metastases seen with usual intraoperative ultrasound could be confirmed. In addition, one metastasis with a diameter of 6 mm was detected which had neither been suggested by peroperative computer tomography and sonography nor by intraoperative ultrasound or surgical exploration. In cases of extracorporeal liver surgery the combination of in situ and ex situ sonography may improve the identification of hepatic metastases.

Duodenal Neoplasms↗
PubMed1996

Tissue oxygen saturation of human hepatic grafts after reperfusion: paradoxical elevation in poor graft function.

The present study investigated the pathophysiology of primary nonfunction (PNF) of grafted livers with regard to hepatic tissue oxygenation. Hemoglobin oxygen saturation in hepatic tissue (H-So2) after reperfusion was determined using near-infrared spectroscopy. Graft tissue oxygen consumption was also estimated according to Fick's principle. Six grafts with PNF were compared with 40 functioning grafts. One PNF graft with extremely low and heterogeneous H-So2 after reperfusion was found to contain multiple intrahepatic portal thrombi. However, five other PNF grafts showed no lower and, on the contrary, more homogeneous H-So2 at the end of the operation. As a whole, mean H-So2 was negatively correlated and the coefficient of variation (CV) of H-So2 was positively correlated with graft tissue oxygen consumption at the end of the operation; grafts whose H-So2 showed a secondary decrease had better initial function. In later relaparotomy, the H-So2 of the five PNF grafts was significantly higher and more homogeneous than that of the functioning grafts. These results suggest that H-So2 level reflects tissue oxygen consumption as well as oxygenation, and that the dissociation of both factors can occur in hepatic graft reperfusion. Not only low and heterogeneous H-So2 but also high and homogeneous H-So2, suggesting some shunt mechanism, can be signs of poor graft function.

Adolescent↗
PubMed1996

Inhibition of IKs in guinea pig cardiac myocytes and guinea pig IsK channels by the chromanol 293B.

The chromanol derivative 293B was previously shown to inhibit a cAMP regulated K+ conductance in rat colon crypts. Subsequent studies on cloned K+ channels from the rat demonstrated that 293B blocks specifically IsK channels expressed in Xenopus oocytes, but does not affect the delayed and inward rectifier Kv1.1 and Kir2.1, respectively. In the present study, the specificity of 293B for the cardiac K+ conductances IKs and IKr, and for the cloned guinea pig IsK channel and the human HERG channel, which underly IKs and IKr, respectively, was analyzed. 293B inhibited both the slowly activating K+ conductance IKs in cardiac myocytes and guinea pig IsK channels expressed in Xenopus oocytes with a similar IC50 (2-6 micromol/l). In contrast, high concentrations of 293B had only a negligible effect on the more rapid activating IKr. Similarly, 293B exerted no effect on HERG channels expressed in Xenopus oocytes. In summary, 293B appears to be a rather specific inhibitor of IKs and the underlying IsK channels.

Animals↗
PubMed1996

Motivational and attitudinal orientations in learning American Sign Language.

Integrative motivation was found to correlate significantly with sign language proficiency of adult learners at a post-secondary program for deaf students. Instrumental motives, however, were perceived as less important. Higher achievement in ASL was also associated with a positive cultural attitude toward deaf people. Learning of ASL as a second language may be enhanced if instructors design strategies that build upon these cultural and integrative motives and provide rewarding experiences to adult learners.

Journal Article↗
PubMed1996

Motivational factors in learning American sign lanquage.

This study focuses on factors that motivate and demotivate professionals to learn American Sign Language (ASL). Using a qualitative approach known as the Critical Incident Technique (CIT), faculty and staff were asked to reflect on their sign language learning expericences, and their responses were examined for motivational patterns. Principal motivating factors were intrinsic in nature, including a desire to perform well in one's position, personal goals, and an interest in sign language per se. Integrative factors were also important, especially an interest in social interactions with deaf people. Principal factors that demotivated the respondents were more extrinsic in nature, dealing with workload, scheduling issues associated with the sign language curriculum, instruction, and the attitudes of self and others. We draw implications from the findings for the enhancement of sign language instruction programs.

Journal Article↗
PubMed1996

[Causal "cancer personality" attribution--an expression of maladaptive coping with illness?].

In psycho-oncology, the concept of a "cancer-prone personality" has gained some attention. This notion means that persons who try to stay pseudo-normal in spite of severe life stress, suppress negative emotions, particularly anger, and sacrifice themselves for other people without uttering any personal demands, are at a high risk to develop cancer. However, it has been demonstrated by previous research that features of the cancer-prone personality could only be found if the ill person was convinced to suffer from cancer, irrespective of what the factual diagnosis was. Thus it can be concluded that at least some aspects of the so called cancer personality might be the results of coping with the belief of having cancer. The present study had the objective to describe causal attributions to psychosocial factors in cancer patients, and to find out if these were connected with emotional state and coping. N = 120 newly diagnosed lung cancer patients were included in the study. The instruments consisted of a semi-structured interview, a check-list of subjective causal factors, self-reports and interviewer ratings on emotional state and standardised questionnaires about depression and coping. Patients who made a psychosocial causal attribution proved to suffer from greater emotional distress, to be more depressed and less hopeful than other patients. This difference seemed to be mediated by a depressive way of coping with the illness (brooding, wrangling). Thus, an attribution of the illness to psychological factors seems indicative of a maladaptive way of coping with illness. This result is supported by similar findings of previous research. The question is put up to discussion if the psychosomatic concept of a cancer personality may reflect patients' subjective theories which in turn may be the expression of their depressive coping modes.

Adaptation, Psychological↗
PubMed1996

Experience with color-coded duplex sonography after combined kidney/pancreas transplantation--preliminary results.

The value of color-coded duplex sonography in the assessment of combined kidney and pancreatic transplantations (KTX/PTX) was studied in 9 patients. In normal graft function the median resistive index (RI) was 0.69 (range 0.60-0.80) for the kidney and 0.61 (range 0.55-0.70) for the pancreas. Ten episodes of graft dysfunction (kidney n = 4; pancreas n = 6) were observed. During renal rejection and hemolytic uremic syndrome the RI was above 0.80. In pancreatic rejection the RI exceeded 0.80 while all other causes of pancreatic dysfunction were not associated with changes in the RI. Color-coded duplex sonography may prove to be a reliable noninvasive diagnostic method in the evaluation of the posttransplant course after combined KTX/PTX, in particular in the diagnosis of pancreatic rejection.

Diabetes Mellitus, Type 1↗
PubMed1996

Dissimilar age influences on two ERP waveforms (LPC and N400) reflecting semantic context effect.

Age-related changes in semantic context effects were examined using late event-related brain potentials (ERPs). Auditory ERPs to semantically congruous and incongruous final words in spoken sentences were recorded in 16 children (aged 5-11 years) and 16 adults. Previous findings concerning age-related effects on N400 were replicated: the N400 effect was significantly larger in children than in adults. The main new finding was that a late positive component (LPC) following N400 and modulated by semantic context in adults was not found in children. Thus, the common generalization that semantic context effects decline with age holds only for ERP components occurring in the N400 time window or earlier. The cognitive function reflected by the semantic LPC we observed is not clear, but it seems to have a role different from that of the N400, although in adults the components often co-exist as an N400-LPC complex.

Aging↗
PubMed1996

[Is liver transplantation as surgical therapy concept in metastases of neuroendocrine tumors justified?].

Between 1982 and February 1996 11 patients underwent liver transplantation for irresectable neuroendocrine hepatic metastases. The operative mortality was one of 11, while two patients died due to sepsis respectively tumor recurrence 7 and 68 months after transplantation. Eight patients are alive with a median survival of 55 months (range from 10 days to 8.5 years). In three patients there is no evidence of tumor and the longest disease-free survival is 102 months after LTx. These results suggest that liver transplantation represents a justified treatment for irresectable hepatic metastases arising from neuroendocrine tumors.

Adolescent↗
PubMed1996

[A new way for inbred strain mice genetic monitoring and the discovery of sex-linkaging RAPD markers].

We used 21 10 bp random primers to amplify DNA for four colonies of BALB/ c mice, four individuals of C 57 BL mice, and four individuals of Kunming stock mice. The amplified band patterns were different between BALB/c and C 57 BL mice in the products of 13 primers, and 8 primer products showed difference between BALB/c and Kunming stock mice. These results indicated that we can easily distinguish different strains of mice by RAPD method. For the four colonies of BALB/c mice, the genetic background of Chengdu colony. Shanghai colony and Beijing colony were homogeneous at all RAPD markers, however, in Kunming colony, there were two BALB/c individuals were disclosed different amplified patterns by 4 primers, showing that these two Kunming BALB/c mice maybe suffer genetic contamination or mutation some time. An unexpected phenomenon discovered in this study is that sex specific amplification bands were amplified by primer OPG 2, OPE 4, OPE 9 in all male mice. Although an 1.2 kb band were disclosed by both OPG 2 and OPE 4 in male mice, cross RAPD and not hybridization showed that the two bands were not homologous.

Animals↗
PubMed1996

[Dynamic effects of sulphuric gentamicin on vestibular function in guinea pigs].

Sinusoidal rotation and rotational stimulation tests were used to examine vestibular function in guinea pigs. The results showed that there was no statistically significant difference in the mean number of nystagmus of semi-cycle sinusoidal rotation test and the duration of nystagmus of rotational stimulation test for both the control and test groups before treatment in albinos and pigmented guinea pigs. Meantime, daily subcutaneous injection of gentamicin 125 mg/kg body weight for 12 days in albinos and pigmented guinea pigs showed no significant change in vestibular function until the 7th day of treatment. Significant impairment of vestibular function was noticed on the 10th treatment day. At 5 days after treatment vestibular impairment reached its maximum and minimal recovery was seen at 14 days after treatment. No Further improvement of vestibular function was noticed three months after treatment. The methods are feasible and reliable.

Animals↗
PubMed1996

[Bromodeoxyuridine immunohistochemical observation of sensory epithelium repair after ototoxic destruction in the crista ampullaris of guinea pigs].

In this in vivo study we investigated the proliferation of crista ampullaris in guinea pigs after Gentamicin intoxication by BrdU immunohistochemical observation and semi-thin sections. The experimental animals were given a single intraperitonial injection of BrdU at a dose of 150 mg/kg body weight before subsequently killed at 1, 3, 7, 14 and 22 day post-treatment (PT). Supporting cell proliferation was evident by BrdU immunoreactivity in the chromatin material of dividing cells at 7 and 14 day PT. The results demonstrated that the crista ampullaris of guinea pigs had repaired by supporting cell mitosis.

Animals↗
PubMed1995

Cortical processing of vowels and tones as measured by event-related desynchronization.

Event-Related Desynchronization (ERD) and Synchronization (ERS) were studied in 20 normal subjects during a Sternberg-type auditory memory-scanning paradigm. Half of the subjects performed the experiment with vowels and the other half with tones as stimuli. The stimuli consisted of 100 msec long synthesized vowels and 100 msec long tones produced by eight different synthesized instruments. In this paradigm each trial started with the presentation of a visual warning signal, after which a four-stimulus set was presented for memorization whether after a probe stimulus was presented and identified by the subject as belonging or not belonging to the memorized set. The ERD/ERS of the lower (8-10 Hz) and upper (10-12 Hz) alpha frequency bands differed in their reactivity to stimulus type; the differences between the two frequency bands reached statistical significance only in the case of vowels. The presentation of the memory set elicited ERS which was more pronounced in the 10-12 Hz frequency band and greater for vowels than for tones. On the other hand, the presentation of the probe elicited ERD which was greater for vowels than for tones, especially in the upper alpha frequency band. The results of this exploratory study suggest that ERD is closely related to memory process and that the ERD/ERS-technique might provide a valuable tool for future research encompassing more complex auditory stimulation like speech and music.

Acoustic Stimulation↗
PubMed1995

Causal attribution and adaptation among lung cancer patients.

The aim of the present study was to describe lung cancer patients' causal attributions and examine their associations with adaptation. Methods were based on semi-structured interview, content analysis, self-reports, interviewer ratings and standardized questionnaires. 'Smoking cigarettes' and 'toxins in the work place' were the most commonly mentioned possible causes. Patients who made a psychosocial causal attribution suffered greater emotional distress, were more depressed, and less hopeful than other patients. They were also more likely to be rated as showing a maladaptive way of coping with illness. The implications of these findings for psychosocial care are discussed.

Adaptation, Psychological↗
PubMed1995

Monoclonal antibodies against inhibin represent key markers of adult granulosa cell tumors of the ovary even in their metastases. A report of three cases with late metastasis, being previously misinterpreted as hemangiopericytoma.

Antibodies against human inhibin, a peptide hormone produced by ovarian granulosa cells to inhibit FSH, are widely applied to determine serum inhibin levels. Recently, they were, however, proved also to stain follicle cells in ovarian tissue by immunoreactions in histological sections. The commercially available inhibin antibody produced by Serotec, applied to sections of paraffin blocks, stained follicle epithelia in 6/6 samples of ovarian tissue from females under the age of 40 recruited from the archives. Adult granulosa cell tumor tissue samples from primary tumors of the ovary showed positive reaction in 6/6 cases. No positive reaction was found in staining tissues from hemangiopericytomas from males (0/3), leiomyomas, leiomyosarcomas, and a malignant melanoma (0/5), serving as negative controls. No positive reactions could be observed in tumor cells of 10 ovarian carcinomas, whereas in two of these cases single cells of the specialized ovarian stroma stained positively with inhibin. Positive immunostainings were revealed in three late metastases (two within the liver) from granulosa cell tumors in females, primarily misinterpreted as hemangiopericytomas or leiomyosarcomas, because the previously resected primaries of the ovary were not known at the time of liver surgery. The recognition of granulosa cell tumors, especially the distinction of the sarcomatoid growth type from soft tissue tumors, may be difficult, even if immunostaining for intermediate filaments are applied. Immunostaining by antibodies against inhibin, which can be applied reliably in histopathology, may therefore provide a useful tool to distinguish between granulosa cell tumors and genuine soft tissue tumors. This is also of clinical importance, because treatment of the former by cisplatin-based polychemotherapy and antisex hormone therapy proved to be helpful. Furthermore, the inhibin antibody can be used as an early serum marker for detecting tumor recurrence months before clinical evidence.

Adult↗