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ABSTRACT: It has long been established that the left hemisphere is specialized for speech whereas the right for music. However, it remains elusive whether the labor division between the two hemispheres is determined by function or acoustic property of stimuli. The confusion in the literature raises a possibility that the two factors are involved at different levels of auditory perception, respectively. In the present study, we demonstrate the dependence of hemisphere specialization on acoustic properties of stimulus in early auditory processing. We frequently presented to Mandarin Chinese speakers a meaningful consonant-vowel syllable and infrequently varied either its lexical tone or initial consonant to result in changes in word meaning. The lexical tone contrasts evoked a stronger pre-attentive electric response, as revealed by whole-head recordings of the mismatch negativity, in the right hemisphere than in the left but the consonant contrasts produced an opposite pattern. This hemisphere dominance was acoustically dependent since lexical tones and consonants in Chinese have an equal function in defining word meaning but have distinct spectral and temporal features. Our finding suggests that dominant involvement of functional cues in hemisphere specialization is only possible at a higher level of auditory processing.
The Journal of the Acoustical Society of America 04/2012; 131(4):3387. · 1.55 Impact Factor
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ABSTRACT: Cushing's disease is associated with high morbidity and mortality. Pasireotide, a potential therapy, has a unique, broad somatostatin-receptor-binding profile, with high binding affinity for somatostatin-receptor subtype 5.
In this double-blind, phase 3 study, we randomly assigned 162 adults with Cushing's disease and a urinary free cortisol level of at least 1.5 times the upper limit of the normal range to receive subcutaneous pasireotide at a dose of 600 μg (82 patients) or 900 μg (80 patients) twice daily. Patients with urinary free cortisol not exceeding 2 times the upper limit of the normal range and not exceeding the baseline level at month 3 continued to receive their randomly assigned dose; all others received an additional 300 μg twice daily. The primary end point was a urinary free cortisol level at or below the upper limit of the normal range at month 6 without an increased dose. Open-label treatment continued through month 12.
Twelve of the 82 patients in the 600-μg group and 21 of the 80 patients in the 900-μg group met the primary end point. The median urinary free cortisol level decreased by approximately 50% by month 2 and remained stable in both groups. A normal urinary free cortisol level was achieved more frequently in patients with baseline levels not exceeding 5 times the upper limit of the normal range than in patients with higher baseline levels. Serum and salivary cortisol and plasma corticotropin levels decreased, and clinical signs and symptoms of Cushing's disease diminished. Pasireotide was associated with hyperglycemia-related adverse events in 118 of 162 patients; other adverse events were similar to those associated with other somatostatin analogues. Despite declines in cortisol levels, blood glucose and glycated hemoglobin levels increased soon after treatment initiation and then stabilized; treatment with a glucose-lowering medication was initiated in 74 of 162 patients.
The significant decrease in cortisol levels in patients with Cushing's disease who received pasireotide supports its potential use as a targeted treatment for corticotropin-secreting pituitary adenomas. (Funded by Novartis Pharma; ClinicalTrials.gov number, NCT00434148.).
New England Journal of Medicine 03/2012; 366(10):914-24. · 53.30 Impact Factor
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ABSTRACT: To evaluate the visual and anatomic outcomes of intravitreal bevacizumab in patients with subfoveal idiopathic choroidal neovascularization (CNV).
Prospective, nonrandomized, interventional case series.
Forty patients with subfoveal idiopathic CNV were included in this clinical trial. Their eyes were treated with a single intravitreal injection of 1.25 mg bevacizumab followed by as-needed dosing indicated by the presence and recurrence of intraretinal edema, subretinal fluid (SRF), or pigment epithelial detachment (PED), based on optical coherence tomography (OCT) performed monthly. Visual, clinical, angiographic, and anatomic changes were observed over a 12-month follow-up period.
After 12 months of follow-up, the mean logarithm of minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 0.53 (20/68 in Snellen equivalent) at baseline to 0.29 (20/39 in Snellen equivalent; P < .001). Mean central retinal thickness determined by OCT decreased from 321 μm to 237 μm (P < .001). All eyes (100%) had stable or improved vision, and 28 eyes (70%) showed an improvement of 2 lines or more. All lesions were in the cicatricial stage of CNV at 12 months of follow-up, with no leakage of fluorescein in the late phase of fluorescein angiography and no intraretinal edema, SRF, and/or PED detected by OCT. No drug-related systemic or ocular side effects were observed.
Intravitreal bevacizumab is generally well tolerated and improves BCVA in eyes with subfoveal idiopathic CNV over a period of 12 months. Large, randomized, controlled, long-term clinical trials are required to further evaluate the efficacy and optimal strategy of this treatment modality.
American journal of ophthalmology 02/2012; 153(2):300-306.e1. · 3.83 Impact Factor
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ABSTRACT: Extraction of linguistically relevant auditory features is critical for speech comprehension in complex auditory environments, in which the relationships between acoustic stimuli are often abstract and constant while the stimuli per se are varying. These relationships are referred to as the abstract auditory rule in speech and have been investigated for their underlying neural mechanisms at an attentive stage. However, the issue of whether or not there is a sensory intelligence that enables one to automatically encode abstract auditory rules in speech at a preattentive stage has not yet been thoroughly addressed.
We chose Chinese lexical tones for the current study because they help to define word meaning and hence facilitate the fabrication of an abstract auditory rule in a speech sound stream. We continuously presented native Chinese speakers with Chinese vowels differing in formant, intensity, and level of pitch to construct a complex and varying auditory stream. In this stream, most of the sounds shared flat lexical tones to form an embedded abstract auditory rule. Occasionally the rule was randomly violated by those with a rising or falling lexical tone. The results showed that the violation of the abstract auditory rule of lexical tones evoked a robust preattentive auditory response, as revealed by whole-head electrical recordings of the mismatch negativity (MMN), though none of the subjects acquired explicit knowledge of the rule or became aware of the violation.
Our results demonstrate that there is an auditory sensory intelligence in the perception of Chinese lexical tones. The existence of this intelligence suggests that the humans can automatically extract abstract auditory rules in speech at a preattentive stage to ensure speech communication in complex and noisy auditory environments without drawing on conscious resources.
PLoS ONE 01/2012; 7(1):e30027. · 4.09 Impact Factor
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Zhonghua zhong liu za zhi [Chinese journal of oncology] 10/2011; 33(10):794-6.
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ABSTRACT: The purpose of this article was to evaluate the efficacy and safety of intravitreal bevacizumab (Avastin) in eyes with macular edema secondary to central retinal vein occlusion (CRVO).
Forty-five consecutive eyes with macular edema secondary to CRVO were included in a prospective clinical trial. Eyes were treated with 3 initial intravitreal bevacizumab injections of 1.25 mg at monthly intervals. Retreatment was based on central retinal thickness (CRT) measured by optical coherence tomography (OCT). OCT was performed monthly; fluorescein angiography was performed every 3 months. Main outcome parameters were visual acuity (VA, using the Early Treatment of Diabetic Retinopathy Study protocol) and CRT in an 18-month follow-up period.
After 18 months of follow-up, mean VA increased from 40.9 letters at baseline to 61.9 letters (+21 letters; P<0.001) at month 18; CRT decreased from 572.3 μm at baseline to 273.2 μm at month 18 (-299.1 μm; P<0.001). Neither age, duration of CRVO, baseline VA, nor baseline CRT was correlated with the change in VA. No drug-related systemic or ocular side effects were observed following intravitreal bevacizumab treatment.
Intravitreal bevacizumab is generally well tolerated and may improve VA and decrease CRT in patients with macular edema secondary to CRVO over a period of 18 months.
Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics 08/2011; 27(6):615-21. · 1.46 Impact Factor
