Organizing a business coalition for health care cost containment.
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Biomedical subjects
Publications and source records attributed to C Haller.
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Although pure motor hemiplegia has not been reported after cerebral cortical infarction, occasional exceptions may occur. We provide three such examples. Necropsy study confirmed the site of lesion in one patient, and laboratory results (EEG and computerized axial tomography) suggested cortical involvement in the other two patients.
A 77-year-old man suddenly developed left hemiplegia without sensory impairment, visual or speech difficulties, loss of consciousness, or ataxia. He died one month later of pulmonary embolism, and a cystic infarction in the right medullary pyramid was the only lesion in the corticospinal system.
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Precursor lymphocytes undergo expansion prior to immunoglobulin (Ig) or T cell receptor (TCR) rearrangements. Development of thymocytes, but not B cells, is entirely blocked in mice lacking both the receptor-tyrosine-kinase c-kit and the common cytokine receptor gamma chain (gamma c). In c-kit-gamma c-mice, TCR beta rearrangements are limited to mono- or oligoclonal DJ junctions. Here, effects of lack of c-kit or gamma c, or both, on the junctional diversity of TCR gamma and delta, and Ig VH(DH)JH loci were analyzed. All rearrangements were present in wildtype and mutant mice. However, sequencing of the junctions revealed monoclonal TCR gamma (V gamma 2 J gamma 1) and TCR delta (V delta 1(D delta)J delta 2) joints in c-kit-gamma c-, but not c-kit+ gamma c- or wildtype thymocytes. In contrast to TCR beta, gamma and delta loci, VHDHJH junctions were more diverse in c-kit-gamma c-mice. Thus, the two analyzed growth factor receptors mediate signaling pathways required for progenitor expansion and generation of junctional diversity at TCR loci, but have less influence on the diversity of IgH junctions.
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OBJECTIVE AND METHODS: A large number of studies from the field of "psychorheumatology" have investigated the relationship between critical life events and disease parameters with varying results. In the present study 48 patients with rheumatoid arthritis (RA) (mean age 57.8; range 32-78 years) were questioned about life events within the past two years using an "inventory for assessing life change events"-ILE (1). In contrast to previous studies, this inventory not only assesses the number of life events, but also captures the extent of subjectively experienced stress caused by these events. Since psychosocial factors such as social support and coping strategies influence subjectively experienced stress, these factors were taken into consideration for the definition of "life event". Furthermore, a series of objective medical parameters as well as the patient's and the physician's subjective impression of disease activity were assessed. RESULTS: The results show that patients with RA in the earlier stages of the disease cannot be differentiated from severely affected patients in later stages on the basis of life event parameters. In addition, no differences in the life event data could be observed between patients with and those without subjectively experienced episodes of illness in the two years immediately preceding the study. CONCLUSION: Our results suggest that the course of RA is influenced neither by the number of life events nor by the extent of stress caused by these life events. Therefore, the role of life events should not be overemphasized, at least as far as the disease parameters in RA is concerned.