Long-term results of tacrolimus in cyclosporine- and prednisone-dependent myasthenia gravis.
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Biomedical subjects
Publications and source records attributed to L H Phillips.
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Emotion regulation has been argued to be an important factor in well-being. The current study investigated the effects of adult aging on emotional expression, emotional control and rumination about emotional events, focusing on an emotion which is particularly important in social interaction: anger. Measures of anger regulation and well-being were obtained in a sample of 286 adults aged between 18 and 88. Older adults expressed anger outwardly less often, and reported more inner control of anger using calming strategies compared to their younger counterparts. These age differences were not explained by variance in social desirability of responding. Age improvements in negative affect and anxiety were partly explained by age differences in anger regulation suggesting an important role for anger management in good mental health amongst older adults. Further, age improvements in quality of life were explained by variance in anger regulation indicating that improved management of emotions with age is an important factor in maintaining well-being in old age.
BACKGROUND: There is some evidence that patients with Parkinson's disease may impaired in prospective memory performance (planning and self initiated realisation of delayed intentions). Little is known about the effect of the disease on distinct phases of prospective memory and the potential mechanisms underlying these effects. OBJECTIVE: To investigate intention formation, intention retention, intention initiation, and intention execution of patients with Parkinson's disease and test for the mediating influence of working memory, inhibition, short term retrospective memory, and divided attention. METHODS: 16 patients with Parkinson's disease and 16 age and education matched normal controls were given a complex event based prospective memory task which differentiates four phases of prospective remembering. In addition, participants completed tasks assessing potential cognitive mediators. RESULTS: On the prospective remembering task, Parkinson patients were impaired in the intention formation phase and showed a trend towards impairment in the intention initiation. In contrast, there were no impairments of retrospective intention retention or the fidelity with which the patients executed their previously developed plan. The group effects were related to interindividual differences in working memory span. CONCLUSIONS: The results suggest that the planning phase of prospective remembering is specifically impaired in Parkinson's disease, and that the impairment is related to working memory deficit. In contrast, even when complex intentions have to be remembered, the retrospective storage of intentions to be performed is not impaired.
Stiff-person syndrome (SPS) is a sporadic autoimmune disorder characterized by muscle stiffness with painful spasms and usually a high level of GAD65 antibody. The authors report familial SPS associated with GAD65 antibody. The clinical presentations were disparate; the father had an appendicular form of SPS and the daughter's axial SPS presented with episodic opisthotonos.
OBJECTIVE: We provided the standardisation of a new Cognitive Estimation Task (CET). PARTICIPANTS: the test was administered to 175 healthy subjects. RESULTS: performance on the Cognitive Estimation Task (CET) is associated with gender (where women show poorer performance than men) and education (where more highly educated individuals show better performance compared to individuals with lower levels of education). However,CET performance is not associated with age. DISCUSSION: the lack of age effects on the CET may be explained by the task dependence on "crystallised intelligence", which is less affected by healthy adult ageing than "fluid intelligence".
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Three correlational studies investigated the relationship between the time costs associated with Stroop stimuli (Stroop-costs) with the time costs associated with task-switching (switch-costs) obtained from colour-word stimuli and digit stimuli. In all studies, large and significant positive correlations were found between different measures of switch-costs. However, only small (and sometimes non-significant) correlations were obtained between the different measures of Stroop-costs and between measures of Stroop-costs and measures of switch-costs. The results are taken as evidence for the existence of some common or shared specialized mechanisms involved in task-switching, which are different from those used to overcome Stroop interference.
The Tower of London (TOL) task has been used extensively as a test of planning ability in neuropsychological patients and normal populations. Participants are asked to preplan mentally a sequence of moves to match a start set of discs to a goal, and then to execute the moves one by one. The mental preplanning stage has been identified as critical to efficient performance. The current experiments examined whether manipulations of mental preplanning influence performance on the TOL. In Experiment 1, the effect of different planning instructions was examined. Those told to make full mental plans spent considerably longer in planning than participants given no specific planning instructions, yet there was no effect of instruction condition on the efficiency of executing plans. Experiment 2 investigated whether people were able to plan mentally, by looking at their ability to identify intermediate states of an optimum mental plan. Results indicated that most individuals could make accurate preplans up to two subgoals ahead, but not three. However, making an efficient preplan did not result in better subsequent execution of moves to solve the TOL trial. It is concluded that people can make effective mental plans for a limited number of moves. However, on the TOL task, mental preplanning does not offer benefits in terms of quicker performance, or more accurate solution. The nature of planning in the TOL task is therefore questioned.
The frontal lobes show early signs of structural and functional change in the course of adult aging. The 1st study of the current article examined whether midlife aging influences open-ended planning, a skill that is particularly sensitive to frontal lobe damage. There were no midlife declines in the ability to carry out variants of the T. Shallice and P. Burgess (1991) Six Elements and Multiple Errands Tests. Younger adults were more likely to break individual task rules. In a 2nd experiment, middle-aged adults performed worse than young adults did on laboratory executive tests sensitive to frontal lobe damage-Self-Ordered Pointing and the Wisconsin Card Sorting Test (N. M. Fristoe, T. A. Salthouse, & J. L. Woodard, 1997). In spite of changes in novel executive test performance, real-world executive skills appear to be spared in midlife aging.
We report an isolated musculocutaneous neuropathy caused by a proximal humeral osteochondroma that became symptomatic after the patient played recreational basketball. Lesion resection resulted in complete deficit resolution. Mass lesions involving the musculocutaneous nerve should be considered in patients with atraumatic, isolated musculocutaneous neuropathies that are recurrent or fail to recover, even in the setting of strenuous exercise.
This study was designed to test the hypothesis that ventral roots in humans contain afferent nerve fibers. We made direct electrophysiological recordings of compound nerve action potentials in dorsal and ventral roots in children undergoing selective dorsal rhizotomy for spastic cerebral palsy. We stimulated the saphenous or sural nerves, which are pure sensory nerves, with electrical stimuli while systematically recording from ventral and dorsal roots from L3 to S2. In addition to the dorsal root nerve action potentials which we expected, we found smaller compound nerve action potentials, which were clearly afferent, in the ventral roots. This confirms the limited amount of experimental evidence that ventral roots do contain some afferent nerve fibers. The functional significance of these observations is not yet clear.
DAP12 is an ITAM-bearing membrane adaptor molecule implicated in the activation of NK and myeloid cells. In mice rendered DAP12 deficient by targeted gene disruption, lymphoid and myeloid development was apparently normal, although the activating Ly49 receptors on NK cells were downregulated and nonfunctional. To analyze the consequences of DAP12 deficiency in vivo, we examined the susceptibility of DAP12-/- mice to experimental autoimmune encephalomyelitis (EAE). DAP12-/- mice were resistant to EAE induced by immunization with myelin oligodendrocyte glycoprotein (MOG) peptide. Resistance was associated with a strongly diminished production of IFNgamma by myelin-reactive CD4+ T cells due to inadequate T cell priming in vivo. These data suggest that DAP12 signaling may be required for optimal antigen-presenting cell (APC) function or inflammation.
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We report four cases of Lambert-Eaton myasthenic syndrome (LEMS) or myasthenia gravis (MG) associated with pulmonary neuroendocrine carcinoma having prolonged survival. The tumors were atypical carcinoid or large cell neuroendocrine carcinoma. LEMS is associated with several neuroendocrine carcinomas. Because some neuroendocrine carcinomas have a better prognosis, aggressive tissue diagnosis of lung cancer in LEMS is warranted. Whether the association between MG and atypical carcinoid is a significant co-occurrence is uncertain.
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The Tower of London (TOL) task is widely used as a neuropsychological test of planning. Relatively little is known of the cognitive components of the task, and in particular the role of memory in performance. The current studies on normal adults looked at the role of verbal and spatial working memory in the TOL. The effects of verbal and visuospatial dual-task manipulations on TOL performance were examined in an experiment with 36 participants. Both verbal and visuospatial executive secondary tasks caused poorer performance on the TOL; however, concurrent articulatory suppression enhanced performance. The results suggest that executive and spatial components are important in the task, and raise questions about the role of preplanning in the TOL.