• Journal of Korean Neurosurgical Society
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• 제60권2호
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• pp.220-224
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• 2017

Objective : This study aimed to unravel the putative mechanism underlying the neurologic deficits contralateral to the side with lumbar disc herniation (LDH) and to elucidate the treatment for this condition. Methods : From January 2009 to June 2015, 8 patients with LDH with predominantly contralateral neurologic deficits underwent surgical treatment on the side with LDH with or without decompressing the symptomatic side. A retrospective review of charts and radiological records of these 8 patients was performed. The putative mechanisms underlying the associated contralateral neurological deficits, magnetic resonance imaging (MRI), electromyography (EMG), and the adequate surgical approach are discussed here. Results : MRI revealed a similar laterally skewed paramedian disc herniation, with the apex deviated from the symptomatic side rather than directly compressing the nerve root; this condition may generate a contralateral traction force. EMG revealed radiculopathies in both sides of 6 patients and in the herniated side of 2 patients. Based on EMG findings and the existence of suspicious lateral recess stenosis of the symptomatic side, 6 patients underwent bilateral decompression of nerve roots and 2 were subjected to a microscopic discectomy to treat the asymptomatic disc herniation. No specific conditions such as venous congestion, nerve root anomaly or epidural lipomatosis were observed, which may be considered the putative pathomechanism causing the contralateral neurological deficits. The symptoms resolved significantly after surgery. Conclusion : The traction force generated on the contralateral side and lateral recess stenosis, rather than direct compression, may cause the contralateral neurologic deficits observed in LDH.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1267-1272
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• 2012

Background and Objective: The optimal resection extent for clinically unilateral papillary thyroid microcarcinoma (PTMC) remains controversial. The objective was to investigate risk factors associated with occult contralateral carcinoma, and put emphasis on the predictive value of preoperative BRAF mutation. Materials and Methods: 100 clinically unilateral PTMC patients all newly diagnosed, previously untreated were analyzed in a prospective cohort study. We assessed the T1799A BRAF mutation status in FNAB specimens obtained from all PTMC patients before undergoing total thyroidectomy (TT) and central lymph node dissection (CLND) for PTMC. Univariate and multivariate analyses were used to reveal the incidence of contralateral occult cancer, difference of risk factors and predictive value, with respect to the following variables: preoperative BRAF mutation status, age, gender, tumor size, multifocality of primary tumor, capsular invasion, presence of Hashimoto thyroiditis and central lymph node metastasis. Results: 20 of 100 patients (20%) had occult contralateral lobe carcinoma. On multi-variate analysis, preoperative BRAF mutation (p = 0.030, OR = 3.439) and multifocality of the primary tumor (p = 0.004, OR = 9.570) were independent predictive factors for occult contralateral PTMC presence. However, there were no significant differences between the presence of occult contralateral carcinomas and age, gender, tumor size, capsular invasion, Hashimoto thyroiditis and central lymph node metastasis. Conclusions: Total thyroidectomy, including the contralateral lobe, should be considered for the treatment of unilateral PTMC if preoperative BRAF mutation is positive and/or if the observed lesion presents as a multifocal tumor in the unilateral lobe.

• Archives of Plastic Surgery
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• 제44권5호
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• pp.413-419
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• 2017

Background In breast reconstruction using implants after unilateral mastectomy, it is challenging to create a natural, ptotic contour, and asymmetry is a potential drawback. To achieve breast symmetry and an ideal shape for both breasts, we performed contralateral augmentation in patients undergoing breast reconstruction with implants. Methods Patients underwent unilateral mastectomy and 2-stage reconstruction. During the second stage of the procedure, contralateral augmentation mammoplasty was performed. Preoperatively, we obtained the patients' demographic information, and we then assessed breast volume, the volume and dimensions of the inserted implants, and complications. Breast symmetry was observed by the surgeon and was assessed by measuring the disparity between the final volume of each breast. Results Contralateral augmentation was performed in 52 cases. When compared to patients who did not undergo a contralateral balancing procedure, patients who received contralateral augmentation were younger, thinner, and had smaller breasts. During implant selection for contralateral augmentation, we chose implants that were approximately 1 cm shorter in width, 1 level lower in height, and 1 or 2 levels lower in projection than the implants used for reconstruction. The postoperative breast contours were symmetric and the final volume discrepancy between each breast, which was measured by 3-dimensional scanning, was acceptable. Conclusions We demonstrate that contralateral augmentation can be recommended for patients who perceive their breasts to be small and not beautiful in order to achieve an ideal and beautiful shape for both breasts. Furthermore, this study offers guidelines for selecting the implant that will lead to the optimal aesthetic outcome.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.227-230
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• 2005

Hearing loss in the contralateral functioning ear is a rare and distressing complication after vetibular schwannoma removal. Various possible mechanisms have been proposed, however, the etiology of hearing loss is not clear. Fortunately, this is an extremely rare occurrence, sporadic case reports have appeared in the literatures. We report two cases of acute contralateral hearing loss after vestibular schwannoma removal and discuss the possible mechanisms of the phenomenon. Although permanent deafness may result, in our cases, the hearing loss was temporary, returning to near preoperative level within one month. The etiology of hearing loss in one case is thought to be cerebrospinal fluid leakage. However, in the other case, the cause of hearing loss is not clear. A better understanding of these events may lead to preventive measures to avoid contralateral hearing loss after vestibular schwannoma removal.

• 대한한의학회지
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• 제24권2호
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• pp.193-203
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• 2003

Objectives : In this study, we investigated the effect and pathway of contralateral heterotropic electroacupuncture (EA) on pain induced by fonualin in rats. Methods : Acu-points in the right forepaws, HT 7 and PC 7 were stimulated with 3~4mA, 2ms, and 10Hz after 5% formalin (50ul) s.c. injection to the left hind paw. In addition, it was investigated whether the dorsolateral funiculus (DLF), known to be related the descending inhibition, mediates analgesic effects of the contralateral heterotropic EA or whether administration of naltrexone, an opioid antagonist, blocks the effect of EA. Results : The results showed that contralateral heterotropic electroacupuncture (EA) inhibited late phase (63.311.7%) of pain induced by fonualin in the behavioral test, but sham-EA had little effect on pain behavior (85.616.8%) and no analgesic effects after transection of the dorsolateral funiculus (95.718.7%). The pretreatment of naltrexone (10mg/kg, i.p.) could not inhibit the analgesic effects of EA on formalin-induced pain behavior (70.713.1%). Also,EA suppressed formalin injection induced expression of cFos like protein (cFL) in the dorsal homo but not sham-EA. Suppressed expressions of cFL in the spinal cord were eliminated after transection of the ipsilateral dorsolateral funiculus at T10-11 leve1s. However, pretreatment of naltrexone could not prevent the suppressive expressions of cFL at the spinal cord. Conclusions : These results suggest that the analgesic effect of contralateral heterotropic electroacupuncture may be modulated through the dorsolateral funiculus constituting the descending inhibition.

• PNF and Movement
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• 제16권1호
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• pp.151-159
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• 2018

Purpose: The aim of this study was to examine the activation of the contralateral upper and lower extremities and trunk muscle during ipsilateral upper extremity diagonal isokinetic exercise. Methods: Twenty-one healthy male subjects with no history of shoulder injury undertook ipsilateral diagonal isokinetic exercise at 60, 120, and $180^{\circ}/sec$, utilizing a standard Biodex protocol. Muscle activation amplitudes were measured in the upper trapezius, pectoralis major, biceps brachii, rectus abdominis, external oblique, rectus femoris, adductor longus, and biceps femoris muscles using electromyography. A one-way analysis of variance and paired t-tests were conducted, and the data were analyzed using SPSS, version 21.0. Results: The results revealed no statistically significant interaction between motion and angular velocity and no statistically significant contralateral muscle activation according to angular velocity (p>0.05). However, they revealed statistically significant contralateral muscle activation according to motion (p<0.05). Conclusion: These results suggest that the movements involved in contralateral upper extremity diagonal isokinetic exercise can enhance muscle strength in patients affected by stroke, fracture, burns, or arthritis.

• Journal of Magnetics
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• 제21권1호
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• pp.133-140
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• 2016

In this study the contralateral breast skin dose was decreased. It was to apply the results to the clinical study after analysis of different radiation dose amounts to contralateral breast with nonmagnetic bolus and without nonmagnetic bolus. A Rando phantom was computed tomography (CT) simulated, five treatment plans were generated: open tangents, open field in field, wedge 15, wedge 30, and intensity-modulated radiotherapy (IMRT) plan with 50.4 Gy to cover sufficient breast tissue. Contralateral breast skin dose was measured at 8 points using a glass dosimeter. The average contralateral breast dose using nonmagnetic bolus showed better excellence in decreasing the absorbed dose in the order of $168{\pm}11.1$ cGy, $131{\pm}10.2$ cGy (29%), $112{\pm}9.7$ cGy (49%), and $102{\pm}9.5$ cGy (64%) than changing the treatment plan. This study focused on decreasing the effect of scattered dose by use of a nonmagnetic bolus on the contralateral breast during radiotherapy in breast cancer patients and an intriguingly significant decrease was observed parallel to the opposed beam.

• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.325-328
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• 2020

Purpose: This study examined the effects of the directions of neck rotation position on the muscle activity and strength of the elbow flexor and extensor muscle. Methods: Forty-one healthy adults participated in this study. The subjects were asked to their elbow 90° flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the sitting position. The muscle activities of the biceps and triceps brachii muscle were measured using surface electromyography. And the muscle strength of the elbow flexor was measured using dynamometer. One way repeated measures ANOVA was used to compare the muscle activity and strength of the elbow flexor and extensor depending on the different neck turning directions. Results: There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. But, there was no significant difference in the triceps brachii muscle activity in comparison with the neck rotation. There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. Conclusion: To summarize this study, the elbow flexor and extensor muscle activity and strength was highest in the contralateral neck rotation position. In other words, it was possible to confirm the effect of Asymmetrical Tonic Neck Reflex in healthy adults whose primitive reflexes were inhibition, and head and neck positions should be considered during clinical evaluation and treatment.

• 대한두경부종양학회지
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• 제21권2호
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• pp.196-200
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• 2005

Objectives: The purpose of this study was to evaluate the incidence and predictive factors of contralateral occult lymph node metastasis in oral cavity squamous cell carcinomas to form a rational basis for elective contralateral neck management. Materials and Methods: We performed a retrospective analysis of 66 N0-2 oral cavity cancer patients undergoing elective neck dissection for contralateral clinically negative necks from 1991 to 2003. Results: Clinically negative but pathologically positive contralateral lymph nodes occurred in 11%(7 of 66) . Of the 11 cases with a clinically ipsilateral node positive neck, contralateral occult lymph node metastases developed in 36%(4 of 10, in contrast with 5%(3/55) in the cases with clinically ipsilateral node negative necks(p<0.05). Based on the clinical staging of the tumor, 8%(3 of 37) of the cases showed lymph node metastases in T2 tumors, 25%(2 of 8) in T3, and 18%(2 of 11) in T4. None of the T1 tumors(10 cases) had pathologically positive lymph nodes. The rate of contralateral occult neck metastasis was significantly higher in advanced stage cases and those crossing the midline, compared to early stage or unilateral lesions(p<0.05). Patients with no evidence of contralateral nodal cancer had significantly improved disease-specific survival over patients with any pathologically positive nodes(5-year disease-specific survival rate was 79% vs. 43%, p<0.05). Conclusion: The risk of contralateral occult neck involvement in the oral cavity squamous cell carcinomas above the T3 stage or those crossing the midline with unilateral metastases was high. Therefore, we advocate an elective contralateral neck treatment with surgery or radiotherapy in oral cavity squamous cell carcinoma patients with ipsilateral node metastases or tumors that are greater than stage T3 or crossing the midline.

• Advances in pediatric surgery
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• 제15권2호
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• pp.149-156
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• 2009

Contralateral groin exploration (CGE) in children with unilateral inguinal hernia remains controversial. Between January 2002 and December 2007, 1967 pediatric patients with inguinal hernia were treated by two surgeons with different criteria of CGE (group A; boys younger than 2 years, older boys prematurely delivered, and all girls, B; birth weight lower than 2 kg with inguinal hernia presentation within 6 months after birth, and suspicious physical findings) at Samsung medical center. Patient's age, sex, body weight, diagnosis, and metachronous contralateral inguinal hernia (MIH) incidence were analyzed retrospectively. Among 895 patients in group A, CGE was performed in 460 patients (66.4 %) and MIH incidence was 1.7 %. In group B, 31 patients (3.5 %) had CGE among 1072 patients, and MIH incidence was 4.2 %. The average hospital costs of group A and B were 763,956 won and 500,708 won, respectively. The CGE criteria of group B had advantage in total hospital cost. The primary site and the age at presentation had a signiticant effect on the incidence of MIH. But MIH incidence was low and the more contralateral explorations lead to increase of total costs. Therefore, routine contralateral groin exploration and surgery for a patent processus vaginalis could not be justified.