The efficacy of halofantrine in the treatment of acute malaria in nonimmune travelers.

A multicenter prospective trial was performed to investigate the efficacy and the tolerability of halofantrine in nonimmune patients with malaria imported from areas with drug-resistant falciparum parasites (mainly Africa). Forty-five of the 74 subjects were treated with a one-day regimen (3 x 500 mg) of halofantrine, and the other 29 received the same regimen with an additional treatment on day 7. In the second group, a 100% efficacy rate was demonstrated, but in the group receiving the one-day regimen, four recrudescences were observed in patients with falciparum malaria. Only five mild adverse reactions were seen, which disappeared spontaneously after the end of the treatment. We conclude that halofantrine is highly effective in curing malaria in nonimmune subjects. The treatment scheme for such persons should include an additional treatment on day 7 for nonimmune individuals. This drug was well tolerated in our patients, indicating that halofantrine will be useful in the treatment of multidrug-resistant malaria in nonimmune persons.     

汉语失语症患者动词功能损伤的神经语言学分析

目的:分析汉语失语症患者动词功能的损伤和临床病灶部位。方法:于2000-02/04在江苏省徐州市第一、二、三、四医院、解放军第九十七医院等大型医院入住的神经内科患者中选择6位典型的汉语失语症患者作为测查对象。采用北京医科大学汉语失语症成套测验检查法,同时参考波士顿诊断性失语检查法、西方失语症成套测验,并结合头颅CT的检查结果判断失语类型。根据本实验的目的,设计听觉路径和视觉路径两种测试方法。听觉路径通过语音来测试患者的动词功能知识(配价知识);视觉路径则是通过画面来测试患者的动词功能知识。最后,根据被试对测试的正确结果进行统计分析。结果:患者6例均进入结果分析。6例失语症患者的单宾语动词(二价动词)听觉路径成绩为:①字词层级,患者1的正确率为10%,患者2为55%,患者3为75%,患者4为60%,患者5为80%,患者6为35%。②语句层级,患者1的正确率为5%,患者2为40%,患者3为60%,患者4为55%,患者5为65%,患者6为30%。③篇章层级,患者1的正确率为5%,患者2为30%,患者3为50%,患者4为50%,患者5为60%,患者6为25%。6例失语症患者的二价动词视觉路径成绩为:①字词层级,患者1的正确率为15%,患者2为55%,患者3为80%,患者4为65%,患者5为85%,患者6为75%。②语句层级,患者1的正确率为10%,患者2为45%,患者3为65%,患者4为60%,患者5为75%,患者6为65%。③篇章层级,患者1的正确率为5%,患者2为35%,患者3为55%,患者4为50%,患者5为65%,患者6为60%。结论:汉语失语症患者的动词功能中受损伤程度最小的是该动词的基本价位,大脑对任何动词的各种论元结构变换都有极强的适应能力;左额下回后部对动词配价加工起主要作用,还涉及左额下回后部的周围区域和其他较远的相关区域。     

Adaptation of the precision grip orientation to a visual-haptic mismatch

Using a sequential-exposure approach, we examined sensorimotor adaptation of precision grip orientation to a visuo-haptic mismatch. Subjects (n = 41) were asked to grasp with thumb and index finger mirror-viewed objects. They could not see their hand due to the mirror, but they could feel an object located behind the mirror in the same place as the viewed object. When a −15° orientation mismatch between viewed and felt object was introduced, subjects adapted to it by gradually modifying the orientation of their finger opposition axis. When the visuo-haptic mismatch further changed to −30° or to +15°, subjects continued to perform according to their pre-established adaptive state, and gradually modified it until it became adequate for the new mismatch. This outcome supports the existence of a continuously acting mechanism for grasping adaptation, similar to that previously described for pointing and tracking adaptation. Precision grip adaptation generalized to unpracticed object orientations, which suggests that adaptation was based on a sensorimotor recalibration rather than the learning of specific stimulus–response pairs. Transfer to pointing movements was found only when similarity to the grasp adaptation task was high.     

Surface model of the gastrointestinal tract constructed from the Visible Korean

Most currently available three‐dimensional surface models of human anatomic structures have been artistically created to reflect the anatomy being portrayed. We have recently undertaken, as part of our Visible Korean studies, to build objective surface models based on cross‐sectional images of actual human anatomy. Objective of the present study was to elaborate surface models of the GI tract and neighboring structures that are helpful to medical simulation. The GI tract from stomach to anal canal was outlined and reconstructed from sectioned images of the Visible Korean (acomputer database containing the digitized transverse sectional images of a 33‐year‐old Korean man). The outlining procedure was supported by computational filtering and interpolation using commercially available software. The GI tract was divided into several parts, and each of these parts was surface reconstructed and then united with neighboring parts to produce a surface model of the complete GI tract. Surface models of about 100 neighboring structures were also prepared. The surface models produced will hopefully facilitate the development of interactive simulations for a variety of virtual abdominal surgical procedures or other educational programs. In addition, it is hoped that the improved outlining and surface reconstruction techniques described will encourage other researchers to construct similar surface models based on images obtained from different subjects. Clin. Anat. 22:601–609, 2009. © 2009 Wiley‐Liss, Inc.     

As good as it gets? A meta-analysis and systematic review of methodological quality of heart rate variability studies in functional somatic disorders

Autonomic nervous system (ANS) dysfunction is a potential mechanism connecting psychosocial stress to functional somatic disorders (FSD), such as chronic fatigue syndrome, fibromyalgia and irritable bowel syndrome. We present the first meta-analysis and systematic review of methodological study quality on the association between cardiac ANS dysfunction, measured as parasympathetic nervous system (PNS) activity using heart rate variability (HRV), and FSD. Literature search revealed 23 available studies including data on 533 FSD patients. Meta-analysis on a subgroup of 14 studies with suitable outcome measures indicated lower PNS activity in FSD patients compared to controls (weighted standardized mean difference (SMD) = −0.32, 95% CI −0.63 to −0.01, p = 0.04). The reliability of this summary estimate was, however, significantly limited by unexplained heterogeneity in the effect sizes and potential publication bias (weighted SMD after correction for funnel plot asymmetry = 0.01, 95% CI −0.34 to 0.36, p = 0.95). The systematic review of overall methodological quality of HRV studies in FSD demonstrates that there is substantial room for improvement, especially in selection of healthy control subjects, blinding of researchers performing HRV measurements, report of adequate HRV outcomes, and assessment of and adjustment for potential confounders. Methodological study quality was, however, not a significant predictor of study findings. We conclude that current available evidence is not adequate to firmly reject or accept a role of ANS dysfunction in FSD. Quality criteria and recommendations to improve future research on HRV in FSD are provided.     

Manganese‐enhanced MRI visualizes V1 in the non‐human primate visual cortex

MRI at 7 Tesla has been used to investigate the accumulation of manganese in the occipital cortex of common marmoset monkeys (Callithrix jacchus) after administering four fractionated injections of 30 mg/kg MnCl₂ · 4H₂O in the tail vein. We found a statistically significant decrease in T₁ in the primary (V1) and secondary (V2) areas of the visual cortex caused by an accumulation of manganese. The larger T₁ shortening in V1 (ΔT₁ = 640 ms) relative to V2 (ΔT₁ = 490 ms) allowed us to robustly detect the V1/V2 border in vivo using heavily T₁‐weighted MRI. Furthermore, the dorso‐medial (DM) and middle‐temporal (MT) areas of the visual pathway could be identified by their T₁‐weighted enhancement. We showed by comparison to histological sections stained for cytochrome oxidase (CO) activity that the extent of V1 is accurately identified throughout the visual cortex by manganese‐enhanced MRI (MEMRI). This provides a means of visualizing functional cortical regions in vivo and could be used in longitudinal studies of phenomena such as cortical plasticity, and for non‐destructive localization of cortical regions to guide in the implementation of functional techniques. Published in 2009 by John Wiley & Sons, Ltd.