Torso movement constraint in stability of bimanual coordination.

This study investigated the relation between postural movement and upper-limb coordination stability. Adults produced bimanual circles using in-phase and anti-phase coordination patterns in time to an increasing rate metronome (i.e., movement-time instruction) in the horizontal (e.g., tabletop) and vertical (e.g., "wall" perpendicular to body) planes. All participants produced the instructed in- and anti-phase patterns. Coordination stability (i.e., SD of relative phase) was larger for anti-phase than in-phase patterns in both planes; however, anti-phase coordination stability was lower in the vertical plane than in the horizontal plane. Torso movement was larger during anti-phase coordination patterns in the horizontal plane, whereas it was larger during in-phase coordination patterns in the vertical plane. These results indicate that different orientations of the same task can produce different results for stability of coordination. This information may be important for performing and learning complex motor-coordination movements (e.g., playing musical instruments).

Phase II trial of gefitinib in recurrent glioblastoma.

PURPOSE: To evaluate the efficacy and tolerability of gefitinib (ZD1839, Iressa; AstraZeneca, Wilmington, DE), a novel epidermal growth factor receptor tyrosine kinase inhibitor, in patients with recurrent glioblastoma. PATIENTS AND METHODS: This was an open-label, single-center phase II trial. Fifty-seven patients with first recurrence of a glioblastoma who were previously treated with surgical resection, radiation, and usually chemotherapy underwent an open biopsy or resection at evaluation for confirmation of tumor recurrence. Each patient initially received 500 mg of gefitinib orally once daily; dose escalation to 750 mg then 1,000 mg, if a patient received enzyme-inducing antiepileptic drugs or dexamethasone, was allowed within each patient. RESULTS: Although no objective tumor responses were seen among the 53 assessable patients, only 21% of patients (11 of 53 patients) had measurable disease at treatment initiation. Seventeen percent of patients (nine of 53 patients) underwent at least six 4-week cycles, and the 6-month event-free survival (EFS) was 13% (seven of 53 patients). The median EFS time was 8.1 weeks, and the median overall survival (OS) time from treatment initiation was 39.4 weeks. Adverse events were generally mild (grade 1 or 2) and consisted mainly of skin reactions and diarrhea. Drug-related toxicities were more frequent at higher doses. Withdrawal caused by drug-related adverse events occurred in 6% of patients (three of 53 patients). Although the presence of diarrhea positively predicted favorable OS from treatment initiation, epidermal growth factor receptor expression did not correlate with either EFS or OS. CONCLUSION: Gefitinib is well tolerated and has activity in patients with recurrent glioblastoma. Further study of this agent at higher doses is warranted.

Transscleral permeability of fluorescent-labeled antibiotics.

PURPOSE: To determine the in vitro transscleral permeability of antibiotics for posterior segment infection. METHODS: Scleral sections from moist chamber-stored human globes were mounted in a 2-compartment perfusion chamber. Fluorescent-labeled vancomycin, polymyxin B, or penicillin G was added to the episcleral surface, while the choroidal side was slowly perfused with balanced salt solution (Alcon Laboratories, Inc., Ft. Worth, TX). The perfusate was collected and fluorescence was measured using a fluorometer. From the measurements, permeability (Ktrans) was calculated. Photomicrographs were taken with a fluorescent microscope to evaluate tissue absorption. RESULTS: The Ktrans values (cm/s, mean +/- standard error) were 6.66 +/- 1.46 x 10(-7) for vancomycin, 3.90 +/- 0.59 x 10(-7) for polymyxin B, and 1.89 +/- 0.21 x 10(-6) for penicillin G. The percent of antibiotic that diffused across the sclera from the donor chamber in 24 hours was 20.6 +/- 4.2 for vancomycin, 12.6 +/- 2.0% for polymyxin B, and 50.8 +/- 4.8% for penicillin G. CONCLUSIONS: This study shows that human sclera is more permeable to lower molecular weight, water-soluble penicillin G than to vancomycin or polymyxin B. The data suggests that a local, noninvasive, transscleral drug-delivery method may be reasonable for treating intraocular infections.

Gait transitions are not dependent on changes in intralimb coordination variability.

The HKB model (H. Haken, J. A. S. Kelso, & H. Bunz, 1985) of coordination has been predominantly applied to upper extremity stationary movements. It predicts increased variability of relative phase before a transition and a decrease after a transition. The authors of the present study extended the intralimb lower extremity locomotive research of F. J. Diedrich and W. H. Warren (1995) by conducting continuous treadmill walk-to-run and run-to-walk trials with 10 participants. Standard deviation of knee-ankle and hip-ankle relative phase did not increase before walk-to-run and run-to-walk transitions, and there was no decrease in knee-ankle relative phase variability after either transition. The results of this study did not provide strong support for application of the variability predictions of the HKB model of coordination to lower extremity intralimb coordination during gait transitions.

Variability in head movement during gait transitions.

Predictions from a model of coupled oscillators, which was based on stationary interlimb coordination, were examined in locomotor intralimb coordination. The present study measured head linear and angular accelerations and coordination relationships of the head and torso, e.g., using relative phase measures, during walking and running on a treadmill. Head linear acceleration increased from walking to running and decreased from running to walking, and head pitch/torso pitch relative phase decreased from walking to running and increased from running to walking. No other measures were significantly different for either walking or running (head angular acceleration, mean head vertical displacement/head pitch relative phase, SD head vertical displacement/head pitch, and SD head pitch/torso pitch). This information will aid further understanding of the many aspects involved in locomotor coordination.

Bimanual coordination dynamics in adults with Down syndrome.

Previous experiments involving discrete unimanual tasks have shown that individuals with Down syndrome (DS) have auditory/verbal-motor deficits. The present study investigated unimanual and bimanual continuous perceptual-motor actions in adults with DS. Ten adults with DS, 10 typical adults, and 10 children drew continuous circles at increasing periods bimanually and unimanually with each hand. Movement was paced by either a visual or an auditory metronome. The results revealed that for circle shape and coordination measures, children and adults were more accurate with the visual metronome, whereas adults with DS were more accurate with the auditory metronome. In the unimanual tasks, adults with DS displayed hand asymmetries on spatial measures. In the bimanual task, however, adults with DS adopted an in-phase coordination pattern and stability more similar to adults than children. These results suggest that bimanual coordination in adults with DS is functioning effectively despite hand asymmetries evident in unimanual performance.