• Title/Summary/Keyword: Contralateral effect

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Improved Long-term Survival with Contralateral Prophylactic Mastectomy among Young Women

  • Zeichner, Simon Blechman;Ruiz, Ana Lourdes;Markward, Nathan Joseph;Rodriguez, Estelamari
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1155-1162
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    • 2014
  • Background: Despite mixed survival data, the utilization of contralateral prophylactic mastectomy (CPM) for the prevention of a contralateral breast cancer (CBC) has increased significantly over the last 15 years, especially among women less than 40. We set out to look at our own experience with CPM, focusing on outcomes in women less than 40, the sub-population with the highest cumulative lifetime risk of developing CBC. With an extended follow-up, we hoped to demonstrate differences in the long-term disease free survival (DFS) and overall survival (OS) among groups who underwent the procedure (CPM) versus those that did not (NCPM). Materials and Methods: We performed a retrospective review of all breast cancer patients less than age 40 diagnosed at Mount Sinai Medical Center between January 1, 1980 and December 31, 2010 (n=481). Among these patients, 42 were identified as having undergone CPM, while 195 were confirmed as being CPM-free during the observation period. A univariate and multivariate analyses were performed. Results: The CPM group had a significantly higher percentage of patients who were diagnosed between 2000 and 2010 (95.2% vs 40%, p=0.0001). The CPM group had significantly smaller tumors (0-2cm.: 41.7% vs 24.8%, p=0.04). Among the entire group of patients, the overall five- and 10-year DFS were 81.3% and 73.3%, respectively. CPM was significantly associated [HR 2.35 (1.02, 5.41); p=0.046] with 10-year OS, although a similar effect was not observed for five-year OS. Conclusions: We found that CPM has increased dramatically over the last 15 years, especially among white women with locally advanced disease. In patients less than 40, who are thought to be at greatest cumulative risk of secondary breast cancer, CPM provided an OS advantage, regardless of genetics, tumor or patient characteristics, and which was only seen after 10 years of follow-up.

Effect of Acute Unilateral Ureteral Obstruction on Handling of $Li^+$ by Contralateral Kidney in Rabbits (급성 일측 수뇨관 폐쇄후 상대신의 $Li^+$처리에 관한 연구)

  • Sung, Ho-Kyung;Earm, Yung-E
    • The Korean Journal of Physiology
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    • v.16 no.2
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    • pp.165-175
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    • 1982
  • Changes in handling of $Li^+$ by contralateral kidney during acute $Li^+$ loading were investigated immediately after unilateral ureteral obstruction. Carotid artery, jugular vein, renal vein and ureter of experimental animal were catheterized and renal venous flow was shunted to .external jugular vein. In experimental group right ureter was ligated. One to two hours after operation a single shot of LiCl solution (2 mEq/kg) was intravenously injected and then .arterial, renal venous blood and urine samples were taken sequentially for 1 to $1{\frac{1}{2}}$ hours. Urine volume, plasma and urinary concentrations of $Li^+$, $Na^+$ and $K^+$ were measured and urinary excretion of them were calculated. Results obtained were as follows: 1) In experimental group urine volume, urinary excretion of $Na^+$, and $K^+$ by contralateral kidney after unilateral ureteral obstruction were slightly larger than mean value of both kidney in control group. 2) During acute $Li^+$ loading contralateral kidney in experimental group showed limited $K^+$ excretion, but urinary flow and $Na^+$ excretion were comparable to mean value of both kidney in control group. 3) Urinary osmolar concentration in experimental group was much lower than that in control group, and it was maintained at low level even after Li loading. 4) In experimental group plasma$Li^+$ concentration decreased more slowly than in control group after a single shot of LiCl solution. 5) Urinary excretion of $Li^+$ in experimental group was markedly decreased, even lesseer than mean of both kidney in control group. 6) From the above results it was concluded that immediately after unilateral ureteral obstruction contralateral kidney showed normal water and $Na^+$ diuretic response to Li load but urinay $Li^+$ excretion was decreased and reclaimed $Li^+$ to systemic circulation.

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Distribution of Calretinin in the Superficial Layers of the Mouse Superior Colliculus: Effect of Monocular Enuclection

  • Yang, Hye-Won;Jeon-Jeon, Chang-Jin
    • Animal cells and systems
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    • v.2 no.3
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    • pp.389-393
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    • 1998
  • We localized a calcium-binding protein, calretinin, in the superior colliculus of the mouse and studied the distribution and effect of eye enucleation on the distribution of this protein. Calretinin was localized with immunocyto-chemistry. A dense plexus of anti-calretinin-labeled fibers was found within the superficial layers. The highest density was found in the deep superficial gray layer. Monocular enucleation produced an almost complete reduction of calretinin-immunoreactive fibers in the superficial layers of the superior colliculus contralateral to the enucleation. Furthermore, many calretinin-labeled cells appeared in the contralateral superior colliculus. These newly appeared neurons had small oval or round cell bodies. The results demonstrate that calretinin identify unique neuronal sublaminar organizations in the superior colliculus of the mouse. They also suggest that the retinal projection may control in part the content of calretinin in some neurons in the superficial layers of the mouse superior colliculus.

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Influence of Isoproterenol on Intra-renal Blood Flow in the Dog (개의 신내혈류(腎內血流)에 미치는 Isoproterenol의 영향(影響))

  • Park, Ki-Dong
    • The Korean Journal of Pharmacology
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    • v.5 no.2
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    • pp.141-148
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    • 1969
  • The direct effect of isoproterenol on renal function, when given intravenously, is usually obscured by its potent hypotensive action. To obviate the latter action, isoproterenol was infused directly into one renal artery of the dog, the other kidney serving as a control for the general action. And following results were obtained. In the first series of experiments, the directic action of isoproterenol was ascertained. $1.0\;{\mu}g/kg/min$. reduced on both kidneys the urine flow, clearances of PAH and creatinine, as well as the amount of sodium excreted, but the effect was weaker on the experimental side than on contralateral side. With $0.1\;{\mu}g/kg/min$., two cases among 6 experiments showed marked diuresis, two cases no apparent effect, and another two marked antidiuresis on the experimental kidney, whereas the contralateral kidney exhibited antidiuresis in all cases. Further reducing the dose unmasked the diuretic action on the ,experimental kidney. In another series, the effects of isoproterenol on the blood flow distribution within the kidney and on sodium concentration gradient within the kidney tissue were observed. $0.05\;{\mu}g/kg/min$ isoproterenol markedly increased the medullary plasma flow and slightly increased total renal plasma flow and glomerular filtration rate, along with concomitant increase in the amount of sodium excreted and osmolar clearance, and decrease in reabsorption of free water. Sodium concentration gradient markedly decreased in the experimental kidney, reaching 2/3 of the value observed in the contralateral kidney at the papilla. It is thus concluded that isoproterenol exerts a diuretic action, when infused directly into a renal artery, and the mechanism of the action rests on its hemodynamic action, substantiated as the increase in glomerular filtration and in the medullary blood flow, resulting in washout of hyperosmolality produced by the coutercurrent multiplier system.

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Autonomic Neural Regulation of Sodium Transporters and Water Channels in Rat Submandibular Gland

  • Ryu, Sun-Yeol;Jung, Hyun;Kim, Ki-Yung;Kim, Mi-Won;Lee, Jong-Un
    • The Korean Journal of Physiology and Pharmacology
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    • v.10 no.2
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    • pp.65-69
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    • 2006
  • The present study was undertaken to explore the role of autonomic nerves in the regulation of sodium transporters and water channels in the salivary gland. Rats were denervated of their sympathetic or parasympathetic nerves to the submandibular gland. One week later, the expression of Na,K-ATPase, epithelial sodium channels (ENaC), and aquaporins (AQP) was examined in the denervated and contralateral glands. The sympathetic denervation slightly but significantly decreased the expression of ${\alpha}1$ subunit of Na,K-ATPase, whereas the parasympathetic denervation increased it. The expression of ${\alpha}$-subunit of ENaC was significantly increased in both the denervated and contralateral glands either by the sympathetic or parasympathetic denervation. The sympathetic denervation significantly increased the expression of AQP5 in both the denervated and contralateral glands, whereas the parasympathetic denervation decreased it. It is suggested that the autonomic nerves have a tonic effect on the regulation of sodium transporters and AQP water channels in the salivary gland.

Investigation of the effects of temporomandibular joint arthrocentesis on blood volume of the retinal structures

  • Keskinruzgar, Aydin;Cankal, Dilek Aynur;Koparal, Mahmut;Simsek, Ali;Karadag, Ayse Sevgi
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.1
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    • pp.37-44
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    • 2019
  • Objective: Arthrocentesis is a minimally invasive surgical procedure that is used to alleviate the symptoms of temporomandibular joint (TMJ) disorders. The aim of this study was to investigate the effect of arthrocentesis on the blood supply to the retinal structures. Materials and Methods: Arthrocentesis was performed on 20 patients with TMJ disorders, and choroidal thickness (CT) in patients was measured to evaluate retinal blood circulation. The blood volume of the retinal structures was evaluated ipsilaterally before and after arthrocentesis, and these measurements were then compared with measurements obtained from the contralateral side. Results: Before arthrocentesis, there were no differences in retinal blood volumes between the ipsilateral and contralateral sides (P = 0.96). When ipsilateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was found to have significantly decreased after arthrocentesis (P = 0.04). When contralateral CT measurements taken before and after arthrocentesis were compared, retinal blood supply was also found to have decreased after arthrocentesis, but not significantly (P = 0.19). Conclusion: The solution of local anesthesia with epinephrine applied before the arthrocentesis procedure was found to reduce the blood volume of the retinal structures. To the best of our knowledge, this is the first study that has investigated the blood volume of the retinal structures following arthrocentesis.

Functional Relationship between the Vestibular Canals and the Extraocular Oblique Muscles (미노반규관(迷路半規管)과 외안사근(外眼斜筋)의 기능적(機能的) 관계(關係)에 관(關)하여)

  • Kim, Jeh-Hyub
    • The Korean Journal of Physiology
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    • v.6 no.2
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    • pp.49-56
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    • 1972
  • This experiment was designed to explore specific functional relationship between the vestibular canals and the extraocular oblique muscles by observing the isometric tension responeses of the muscles to the selected vestibular canal excitation. The vestibular excitation was simulated by either stimulation of the individual canal nerve or endolymphatic fluid displacement in each canal. Each canal nerve was subjected to square wave pulses with a monopolar wire electrode placed closely to the ampullary nerve endings for electrical stimulation, and a fine stainless cannula was introduced into the each canal toward the ampulla and a minute amount $(0.5{\sim}3.5\;microliter)$ of fluid was injected in or ejected out by means of a microsyringe connected to the cannula to produce ampullopetal or ampullofugal displacement of endolymphatic fluid. The superior oblique muscle was contracted by the excitation of homolateral canals and was relaxed by contralateral canals. On the contrary, the inferior oblique was contracted by the contralateral canals and was relaxed by the homolateral canals. Summation of excitatory and inhibitory canal effects from the bilateral vestibular system was demonstrable on the tension changes of the oblique muscles. Excitation of either dual or triple canals of the unilateral vestibular system also caused summation effect on the tension response of the oblique pair; thus multiple signals from the different ampullary receptors seems to be converged into the relevant ocular motor muclei. Since the superior and inferior obliques are known to receive their motor fibers from the contralateral trochlear nuclei and intermediate nuclei of the homolateral oculomotor complex respectively, the above experimental evidences indicate that the ocular motor nuclei for oblique muscles receive excitatory signals from the contralateral vestibular canals and inhibitory signals from the homolateral canals.

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The Kernohan-Woltman Notch Phenomenon : A Systematic Review of Clinical and Radiologic Presentation, Surgical Management, and Functional Prognosis

  • Beucler, Nathan;Cungi, Pierre-Julien;Baucher, Guillaume;Coze, Stephanie;Dagain, Arnaud;Roche, Pierre-Hugues
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.652-664
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    • 2022
  • The Kernohan-Woltman notch phenomenon (KWNP) refers to an intracranial lesion causing massive side-to-side mass effect which leads to compression of the contralateral cerebral peduncle against the free edge of the cerebellar tentorium. Diagnosis is based on "paradoxical" motor deficit ipsilateral to the lesion associated with radiologic evidence of damage to the contralateral cerebral peduncle. To date, there is scarce evidence regarding KWNP associated neuroimaging patterns and motor function prognostic factors. A systematic review was conducted on Medline database from inception to July 2021 looking for English-language articles concerning KWNP, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research yielded 45 articles for a total of 51 patients. The mean age was 40.7 years-old and the male/female sex ratio was 2/1. 63% of the patients (32/51) suffered from head trauma with a majority of acute subdural hematomas (57%, 29/51). 57% (29/51) of the patients were in the coma upon admission and 47% (24/51) presented pupil anomalies. KWNP presented the neuroimaging features of compression ischemic stroke located in the contralateral cerebral peduncle, with edema in the surrounding structures and sometimes compression stroke of the cerebral arteries passing nearby. 45% of the patients (23/51) presented a good motor functional outcome; nevertheless, no predisposing factor was identified. A Glasgow coma scale (GCS) of more than 3 showed a trend (p=0.1065) toward a better motor functional outcome. The KWNP is a regional compression syndrome oftentimes caused by sudden and massive uncal herniation and leading to contralateral cerebral peduncle ischemia. Even though patients suffering from KWNP usually present a good overall recovery, patients with a GCS of 3 may present a worse motor functional outcome. In order to better understand this syndrome, future studies will have to focus on more personalized criteria such as individual variation of tentorial notch width.

Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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Effect of DHEA on Recovery of Muscle Atrophy Induced by Parkinson' s Disease

  • Choe, Myoung-Ae;An, Gyeong-Ju;Koo, Byung-Soo;Jeon, Song-Hee
    • Journal of Korean Academy of Nursing
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    • v.41 no.6
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    • pp.834-842
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    • 2011
  • Purpose: The purpose of this study was to determine the effect of dehydroepiandrosterone (DHEA) on recovery of muscle atrophy induced by Parkinson's disease. Methods: The rat model was established by direct injection of 6-hydroxydopamine (6-OHDA, 20 ${\mu}g$) into the left striatum using stereotaxic surgery. Rats were divided into two groups; the Parkinson's disease group with vehicle treatment (Vehicle; n=12) or DHEA treatment group (DHEA; n=22). DHEA or vehicle was administrated intraperitoneally daily at a dose of 0.34 mmol/kg for 21 days. At 22-days after DHEA treatment, soleus, plantaris, and striatum were dissected. Results: The DHEA group showed significant increase (p<.01) in the number of tyrosine hydroxylase (TH) positive neurons in the lesioned side substantia nigra compared to the vehicle group. Weights and Type I fiber cross-sectional areas of the contralateral soleus of the DHEA group were significantly greater than those of the vehicle group (p=.02, p=.00). Moreover, extracellular signal-regulated kinase (ERK) phosphorylation significantly decreased in the lesioned striatum, but was recovered with DHEA and also in the contralateral soleus muscle, Akt and ERK phosphorylation recovered significantly and the expression level of myosin heavy chain also recovered by DHEA treatment. Conclusion: Our results suggest that DHEA treatment recovers Parkinson's disease induced contralateral soleus muscle atrophy through Akt and ERK phosphorylation.