Slump Test: Effect of Contralateral Knee Extension on Response Sensations in Asymptomatic Subjects and Cadaver Study.

PubMed

Shacklock, Michael; Yee, Brian; Van Hoof, Tom; Foley, Russ; Boddie, Keith; Lacey, Erin; Poley, J Bryan; Rade, Marinko; Kankaanpää, Markku; Kröger, Heikki; Airaksinen, Olavi

2016-02-01

Part 1: A randomized, single-blind study on the effect of contralateral knee extension on sensations produced by the slump test (ST) in asymptomatic subjects. Part 2: A cadaver study simulating the nerve root behavior of part 1. Part 1: Test if contralateral knee extension consistently reduces normal stretch sensations with the ST.Part 2: Ascertain in cadavers an explanation for the results. In asymptomatic subjects, contralateral knee extension reduces stretch sensations with the ST. In sciatica patients, contralateral SLR also can temporarily reduce sciatica. We studied this methodically in asymptomatic subjects before considering a clinical population. Part 1: Sixty-one asymptomatic subjects were tested in control (ST), sham, or intervention (contralateral ST) groups and their sensation response intensity compared.Part 2: Caudal tension was applied to the L5 nerve root of 3 cadavers and tension behavior of the contralateral neural tissue recorded visually. Part 1: Reduction of stretch sensations occurred in the intervention group but not in control and sham groups (P ≤ 0.001).Part 2: Tension in the contralateral lumbar nerve roots and dura reduced in a manner consistent with the responses in the intervention (contralateral ST) group. Part 1: In asymptomatic subjects, normal thigh stretch sensations with the ST reduced consistently with the contralateral ST, showing that this is normal and may now be compared with patients with sciatica.Part 2: Contralateral reduction in lumbar neural tension with unilateral application of tension-producing movements also occurred in cadavers, supporting the proposed explanatory hypothesis.

Principles of ipsilateral and contralateral cortico-cortical connectivity in the mouse.

PubMed

Goulas, Alexandros; Uylings, Harry B M; Hilgetag, Claus C

2017-04-01

Structural connectivity among cortical areas provides the substrate for information exchange in the cerebral cortex and is characterized by systematic patterns of presence or absence of connections. What principles govern this cortical wiring diagram? Here, we investigate the relation of physical distance and cytoarchitecture with the connectional architecture of the mouse cortex. Moreover, we examine the relation between patterns of ipsilateral and contralateral connections. Our analysis reveals a mirrored and attenuated organization of contralateral connections when compared with ipsilateral connections. Both physical distance and cytoarchitectonic similarity of cortical areas are related to the presence or absence of connections. Notably, our analysis demonstrates that the combination of these factors relates better to cortico-cortical connectivity than each factor in isolation and that the two factors relate differently to ipsilateral and contralateral connectivity. Physical distance is more tightly related to the presence or absence of ipsilateral connections, but its relevance greatly diminishes for contralateral connections, while the contribution of cytoarchitectonic similarity remains relatively stable. Our results, together with similar findings in the cat and macaque cortex, suggest that a common set of principles underlies the macroscale wiring of the mammalian cerebral cortex.

Simple shielding reduces dose to the contralateral breast during prone breast cancer radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goyal, Uma, E-mail: uma.goyal@gmail.com; Locke, Angela; Smith-Raymond, Lexie

Our goal was to design a prone breast shield for the contralateral breast and study its efficacy in decreasing scatter radiation to the contralateral breast in a prone breast phantom setup receiving radiation therapy designed for breast cancer. We constructed a prone breast phantom setup consisting of (1) A thermoplastic mask with a left-sided depression created by a water balloon for a breast shape; (2) 2 plastic bags to hold water in the thermoplastic mask depression; (3) 2000 mL of water to fill the thermoplastic mask depression to create a water-based false breast; (4) 1-cm thick bolus placed in themore » contralateral breast holder; (5) 2 lead (Pb) sheets, each 0.1-cm thick for blocking scatter radiation in the contralateral bolus-based false breast; (6) a prone breast board to hold the thermoplastic mask, water, bolus, and lead; (7) 9 cm solid water on top of the breast board to simulate body; (8) a diode was used to verify dose for each treatment field of the treated water-based breast; (9) metal–oxide–semiconductor-field effect transistor (MOSFET) dosimeters to measure dose to the contralateral bolus-based breast. The phantom prone breast setup was CT simulated and treatment was designed with 95% isodose line covering the treated breast. The maximum dose was 107.1%. Megavoltage (MV) port images ensured accurate setup. Measurements were done using diodes on the treated water-based breast and MOSFET dosimeters at the medial and lateral sides of the contralateral bolus-based breast without and with the Pb shield. Five treatments were done for each of the 3 data sets and recorded individually for statistical purposes. All treatments were completed with 6 MV photons at 200 cGy per treatment. The dose contributions from each of the 3 data sets including 15 treatments total without and with the prone lead shield to the medial and lateral portions of contralateral bolus-based breast were averaged individually. Unshielded dose means were 37.11 and 2.94 c

Influence of contralateral acoustic hearing on adult bimodal outcomes after cochlear implantation.

PubMed

Plant, Kerrie; van Hoesel, Richard; McDermott, Hugh; Dawson, Pamela; Cowan, Robert

2016-08-01

To examine post-implantation benefit and time taken to acclimate to the cochlear implant for adult candidates with more hearing in the contralateral non-implanted ear than has been previously considered within local candidacy guidelines. Prospective, within-subject experimental design. Forty postlingual hearing-impaired adult subjects with a contralateral ear word score in quiet ranging from 27% to 100% (median 67%). Post-implantation improvement of 2.4 dB and 4.0 dB was observed on a sentence in coincident babble test at presentation levels of 65 and 55 dB SPL respectively, and a 2.1 dB benefit in spatial release from masking (SRM) advantage observed when the noise location favoured the implanted side. Significant post-operative group mean change of between 2.1 and 3.0 was observed on the sub-scales of the speech, spatial, and qualities (SSQ) questionnaire. Degree of post-implantation speech reception threshold (SRT) benefit on the coincident babble test and on perception of soft speech and sounds in the environment was greater for subjects with less contralateral hearing. The degree of contralateral acoustic hearing did not affect time taken to acclimate to the device. The findings from this study support cochlear implantation for candidates with substantial acoustic hearing in the contralateral ear, and provide guidance regarding post-implantation expectations.

Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report.

PubMed

Kim, Jin-Sung; Choi, Gun; Lee, Sang-Ho

2011-08-01

Technical case report. The authors report a new percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of lumbar disc herniation via a contralateral approach. When there are highly down-migrated lumbar disc herniation along just medial to pedicle and narrow ipsilateral intervertebral foramen, the conventional PELD is not easily accessible via ipsilateral transforaminal route. Five patients manifested gluteal and leg pain because of a soft disc herniation at the L4-L5 level. Transforaminal PELD via a contralateral approach was performed to remove the herniated fragment, achieving complete decompression of the nerve root. The symptom was relieved and the patient was discharged the next day. When a conventional transforaminal PELD is difficult because of some anatomical reasons, PELD via a contralateral route could be a good alternative option in selected cases.

Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

PubMed

Le, Trong Binh; Lee, Taeg Ki; Park, Keun-Myoung; Jeon, Yong Sun; Hong, Kee Chun; Cho, Soon Gu

2018-04-25

To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P < .001). The primary patency rate of the contralateral CIV stent was 70% at 20 months. Contralateral DVT after CIV stent implantation has a relatively high incidence and often occurs late during follow-up. Overextension of the CIV stent to the IVC is associated with development of contralateral DVT, and VIH should be considered a potential cause. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

Endodontic management of contralateral mandibular first molars with six root canals

PubMed Central

Bhargav, Kambhampati; Sirisha, Kantheti; Jyothi, Mandava; Boddeda, Mohan Rao

2017-01-01

The knowledge of variations in root canal morphology is essential for a successful endodontic outcome. Contralateral mandibular molar with six root canals is a rare entity. Root canal treatment of mandibular molars with aberrant canal configuration can be diagnostically and technically challenging. While dealing with variant mandibular molars, mishaps may happen. This case report describes variations in contralateral mandibular molars and also an endodontic mishap while managing them. PMID:29259369

Contralateral radiculopathy after transforaminal lumbar interbody fusion in the treatment of lumbar degenerative diseases: A Case Series.

PubMed

Hu, Hong-Tao; Ren, Liang; Sun, Xian-Ze; Liu, Feng-Yu; Yu, Jin-He; Gu, Zhen-Fang

2018-04-01

Transforaminal lumbar interbody fusion (TLIF) is an effective treatment for patients with degenerative lumbar disc disorder. Contralateral radiculopathy, as a complication of TLIF, has been recognized in this institution, but is rarely reported in the literature. In this article, we report 2 cases of contralateral radiculopathy after TLIF in our institution and its associated complications. In the 2 cases, the postoperative computed tomography (CT) and magnetic resonance image (MRI) showed obvious upward movement of the superior articular process, leading to contralateral foraminal stenosis. Revision surgery was done at once to partially resect the opposite superior facet and to relieve nerve root compression. After revision surgery, the contralateral radiculopathy disappeared. Contralateral radiculopathy is an avoidable potential complication. It is very important to create careful preoperative plans and to conscientiously plan the use of intraoperative techniques. In case of postoperative contralateral leg pain, the patients should be examined by CT and MRI. If CT and MRI show that the superior articular process significantly migrated upwards, which leads to contralateral foraminal stenosis, revision surgery should be done at once to partially resect the contralateral superior facet so as to relieve nerve root compression and avoid possible long-term impairment.

Choosing the appropriate side for subcutaneous port catheter placement in patients with mastectomy: ipsilateral or contralateral?

PubMed

Nas, Omer Fatih; Hacikurt, Kadir; Kaya, Ahmet; Dogan, Nurullah; Sanal, Bekir; Ozkaya, Guven; Dundar, Halit Ziya; Erdogan, Cuneyt

2017-06-01

To evaluate long-term clinical follow-up results of implanting subcutaneous port catheters (SPCs) on ipsilateral or contralateral with mastectomy side in patients with axillary lymph node dissection. A total of 73 patients composed of ipsilateral (34 catheters) and contralateral (39 catheters) groups, with SPCs were included. All patients had lumpectomy or modified radical mastectomy for breast cancer. Ipsilateral and contralateral groups had similar patient characteristics. Five late complications were seen in the ipsilateral group and 2 late complications in the contralateral group. No statistical significant difference was seen between two groups in regard to late complications. Four complications of the ipsilateral group were classified as major group C and 1 as major group D, while 1 complication of the contralateral group was classified as minor group B and 1 as major group C according to Society of Interventional Radiology (SIR) classification. No statistical significant difference was seen between complication rates of two groups in regard to SIR classification. SPC related complications do not differ in regard to ipsilateral or contralateral side selection on mastectomized patients with breast cancer and lymph node dissection. SPCs can be implanted on ipsilateral or contralateral sides of the operation in these patients.

Cavernous sinus thrombosis caused by contralateral sphenoid sinusitis: a case report

PubMed Central

2013-01-01

Objective To report a rare case of unilateral cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. Case report A 33-year-old female visited our hospital for severe, right-sided, temporal headache, chemosis, periorbital edema, and proptosis. These signs were associated with congested erythematous nasal mucosa with purulent discharge from the right superior nasal meatus. Contrast enhanced CT showed dilated left superior ophthalmic vein, suggestive of thrombosis, contrast enhancement of the left cavernous sinuses, and dilation of cavernous sinus, indicating cavernous sinus inflammation. The right maxillary, ethmoid and sphenoid sinuses showed mucosal thickening and retention of purulent material. She was diagnosed with cavernous sinus thrombosis caused by contralateral sphenoid sinusitis. All clinical symptoms and signs improved after endoscopic sphenoidotomy and appropriate medical treatment. Conclusions Sphenoiditis can cause contralateral cavernous sinus thrombosis. Early surgical sphenoidotomy and aggressive medical treatment are the cornerstones of successful management of this life-threatening complication. PMID:23497466

Postoperative recovery of hippocampal contralateral diffusivity in medial temporal lobe epilepsy.

PubMed

Thivard, Lionel; Tanguy, Marie-Laure; Adam, Claude; Clémenceau, Stéphane; Dezamis, Edouard; Lehéricy, Stéphane; Dormont, Didier; Chiras, Jacques; Baulac, Michel; Dupont, Sophie

2007-03-01

To search for a recovery after surgery of mean diffusivity (MD) values in the contralateral nonsclerotic hippocampus of patients with medial temporal lobe epilepsy (MTLE) and hippocampal sclerosis (HS). Twenty-four MTLE patients (12 right-sided and 12 left-sided MTLE) and 36 healthy volunteers were investigated using diffusion tensor imaging. A region-of-interest approach was used to measure pre- and postoperative interictal hippocampal MD values in patients. Diffusion abnormalities in contralateral nonsclerotic hippocampus recovered after surgery (p<0.0001). A subgroup of 14 patients exhibited a clear increase in MD values whereas the remaining 10 patients were stable. No significant difference was found between the two subgroups for each of the electroclinical data studied including early postoperative outcome, all patients being either seizure free or with rare persistent auras. This finding suggests that diffusion abnormalities in contralateral hippocampus may represent a functional mechanism linked to the active epileptic process.

Contralateral migration of oculomotor neurons is regulated by Slit/Robo signaling.

PubMed

Bjorke, Brielle; Shoja-Taheri, Farnaz; Kim, Minkyung; Robinson, G Eric; Fontelonga, Tatiana; Kim, Kyung-Tai; Song, Mi-Ryoung; Mastick, Grant S

2016-10-22

Oculomotor neurons develop initially like typical motor neurons, projecting axons out of the ventral midbrain to their ipsilateral targets, the extraocular muscles. However, in all vertebrates, after the oculomotor nerve (nIII) has reached the extraocular muscle primordia, the cell bodies that innervate the superior rectus migrate to join the contralateral nucleus. This motor neuron migration represents a unique strategy to form a contralateral motor projection. Whether migration is guided by diffusible cues remains unknown. We examined the role of Slit chemorepellent signals in contralateral oculomotor migration by analyzing mutant mouse embryos. We found that the ventral midbrain expresses high levels of both Slit1 and 2, and that oculomotor neurons express the repellent Slit receptors Robo1 and Robo2. Therefore, Slit signals are in a position to influence the migration of oculomotor neurons. In Slit 1/2 or Robo1/2 double mutant embryos, motor neuron cell bodies migrated into the ventral midbrain on E10.5, three days prior to normal migration. These early migrating neurons had leading projections into and across the floor plate. In contrast to the double mutants, embryos which were mutant for single Slit or Robo genes did not have premature migration or outgrowth on E10.5, demonstrating a cooperative requirement of Slit1 and 2, as well as Robo1 and 2. To test how Slit/Robo midline repulsion is modulated, we found that the normal migration did not require the receptors Robo3 and CXCR4, or the chemoattractant, Netrin 1. The signal to initiate contralateral migration is likely autonomous to the midbrain because oculomotor neurons migrate in embryos that lack either nerve outgrowth or extraocular muscles, or in cultured midbrains that lacked peripheral tissue. Overall, our results demonstrate that a migratory subset of motor neurons respond to floor plate-derived Slit repulsion to properly control the timing of contralateral migration.

Women's preferences for contralateral prophylactic mastectomy: An investigation using protection motivation theory.

PubMed

Tesson, Stephanie; Richards, Imogen; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Musiello, Toni; Marven, Michelle; Butow, Phyllis

2016-05-01

Most women diagnosed with unilateral breast cancer without BRCA1 or BRCA2 mutations are at low risk of contralateral breast cancer. Contralateral Prophylactic Mastectomy (CPM) decreases the relative risk of contralateral breast cancer, but may not increase life expectancy; yet international uptake is increasing. This study applied protection motivation theory (PMT) to determine factors associated with women's intentions to undergo CPM. Three hundred eighty-eight women previously diagnosed with unilateral breast cancer and of negative or unknown BRCA1 or BRCA2 status were recruited from an advocacy group's research database. Participants completed measures of PMT constructs based on a common hypothetical CPM decision-making scenario. PMT constructs explained 16% of variance in intentions to undergo CPM. Response efficacy (CPM's advantages) and response costs (CPM's disadvantages) were unique individual predictors of intentions. Decision-making appears driven by considerations of the psychological, cosmetic and emotional advantages and disadvantages of CPM. Overestimations of threat to life from contralateral breast cancer and survival benefit from CPM also appear influential factors. Patients require balanced and medically accurate information regarding the pros and cons of CPM, survival rates, and recurrence risks to ensure realistic and informed decision-making.

Lumbar disc herniation presenting with contralateral symptoms: a case report.

PubMed

Koh, Zhi Sheng Darren; Lin, Shuxun; Hey, Hwee Weng Dennis

2017-03-01

Lumbar disc herniation is common and may be symptomatic. The magnetic resonance imaging (MRI) scan is an appropriate tool to confirm the diagnosis and affected level of the spine. While a disc herniation is usually associated with ipsilateral symptoms, a few cases have been reported to present with contralateral symptoms. We report a unique case of left lumbar disc herniation at L5/S1 who presented with contralateral symptoms and was successfully treated with a right L5/S1 foraminal block. However, the patient developed concordant ipsilateral symptoms 6 weeks later and was treated with left L5/S1 microdiscectomy.

Trans-falcine and contralateral sub-frontal electrode placement in pediatric epilepsy surgery: technical note.

PubMed

Pindrik, Jonathan; Hoang, Nguyen; Tubbs, R Shane; Rocque, Brandon J; Rozzelle, Curtis J

2017-08-01

Phase II monitoring with intracranial electroencephalography (ICEEG) occasionally requires bilateral placement of subdural (SD) strips, grids, and/or depth electrodes. While phase I monitoring often demonstrates a preponderance of unilateral findings, individual studies (video EEG, single photon emission computed tomography [SPECT], and positron emission tomography [PET]) can suggest or fail to exclude a contralateral epileptogenic onset zone. This study describes previously unreported techniques of trans-falcine and sub-frontal insertion of contralateral SD grids and depth electrodes for phase II monitoring in pediatric epilepsy surgery patients when concern about bilateral abnormalities has been elicited during phase I monitoring. Pediatric patients with medically refractory epilepsy undergoing stage I surgery for phase II monitoring involving sub-frontal and/or trans-falcine insertion of SD grids and/or depth electrodes at the senior author's institution were retrospectively reviewed. Intra-operative technical details of sub-frontal and trans-falcine approaches were studied, while intra-operative complications or events were noted. Operative techniques included gentle subfrontal retraction and elevation of the olfactory tracts (while preserving the relationship between the olfactory bulb and cribriform plate) to insert SD grids across the midline for coverage of the contralateral orbito-frontal regions. Trans-falcine approaches involved accessing the inter-hemispheric space, bipolar cauterization of the anterior falx cerebri below the superior sagittal sinus, and sharp dissection using a blunt elevator and small blade scalpel. The falcine window allowed contralateral SD strip, grid, and depth electrodes to be inserted for coverage of the contralateral frontal regions. The study cohort included seven patients undergoing sub-frontal and/or trans-falcine insertion of contralateral SD strip, grid, and/or depth electrodes from February 2012 through June 2015. Five

Contralateral Autologous Corneal Transplantation Experience in Mexico City.

PubMed

Perez-Balbuena, Ana L; Ancona-Lezama, David; Delgado-Pelayo, Sarai; Martinez, Jaime D

2017-01-01

The aim of this study is to expand the limited knowledge regarding autologous contralateral penetrating keratoplasty. We report the retrospective outcomes of patients who received autokeratoplasty and contralateral opaque corneas in the donor eye at a tertiary care ophthalmology hospital in Mexico City. Eleven patients received autokeratoplasty and contralateral opaque corneas in the donor eye at our center from 2010 to 2015. The mean patient age at the time of surgery was 58 years (range, 35-85 yrs), with 4 female and 7 male patients. There were no surgical or immediate postsurgical complications in the autokeratoplasty eye. However, 1 patient had expulsive hemorrhage in the sightless eye. Follow-up duration ranged from 11 to 65 months (mean, 26 mo). During follow-up, 3 of the autokeratoplasty procedures failed because of endothelial attenuation. Identified known risk factors for failure of the eye with visual potential included the presence of an Ahmed glaucoma drainage device in 7/11 patients (63%), history of glaucoma in 8/11 (72%), past heterologous penetrating keratoplasty in 2/11 (18%), Vogt-Koyanagi-Harada syndrome in 1/11 (9%), and 4-quadrant corneal vascularization in 1/11 (9%). Autokeratoplasty is a good choice in cases having high risk factors and when fresh corneal tissue is not available. This is the largest study describing outcomes of patients who underwent autokeratoplasty. This technique offers no risk of immune rejection and no need for immunosuppression treatment. This study reports a good prognosis in cases having high risk factors for failure.

Lumbar disc herniation with contralateral radiculopathy: do we neglect the epidural fat?

PubMed

Yang, Jun-Song; Zhang, Dong-Jie; Hao, Ding-Jun

2015-01-01

Lumbar disc herniation (LDH) is the most common cause of radiculopathy, whose pathological entity underlying nerve root compression is usually on the same side as the symptoms. However, LDH causing contralateral radiculopathy are sometimes encountered by pain physicians. There have been tremendous developments in the treatment options for LDH; the situation of LDH causing contralateral radiculopathy is indeed a dilemma for some pain physicians. We will report a case of a patient with a L4-5 disc herniation whose left herniated disc caused radiculopathy on the right side. After a percutaneous lumbar endoscopic discectomy via the side ipsilateral to the symptomatic side, this case obtained a significant symptom remission. The migrated epidural fat is discussed as a cause of associated contralateral neurological deficit. Only via a surgical approach ipsilateral to the herniated side, could there be a clinical improvement postoperatively.

Lumbar disc herniation presenting with contralateral symptoms: a case report

PubMed Central

Koh, Zhi Sheng Darren; Lin, Shuxun

2017-01-01

Lumbar disc herniation is common and may be symptomatic. The magnetic resonance imaging (MRI) scan is an appropriate tool to confirm the diagnosis and affected level of the spine. While a disc herniation is usually associated with ipsilateral symptoms, a few cases have been reported to present with contralateral symptoms. We report a unique case of left lumbar disc herniation at L5/S1 who presented with contralateral symptoms and was successfully treated with a right L5/S1 foraminal block. However, the patient developed concordant ipsilateral symptoms 6 weeks later and was treated with left L5/S1 microdiscectomy. PMID:28435926

Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

PubMed

Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

2014-08-01

While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

SOD1 overexpression prevents acute hyperglycemia-induced cerebral myogenic dysfunction: relevance to contralateral hemisphere and stroke outcomes

PubMed Central

Coucha, Maha; Li, Weiguo; Hafez, Sherif; Abdelsaid, Mohammed; Johnson, Maribeth H.; Fagan, Susan C.

2014-01-01

Admission hyperglycemia (HG) amplifies vascular injury and neurological deficits in acute ischemic stroke, but the mechanisms remain controversial. We recently reported that ischemia-reperfusion (I/R) injury impairs the myogenic response in both hemispheres via increased nitration. However, whether HG amplifies contralateral myogenic dysfunction and whether loss of tone in the contralateral hemisphere contributes to stroke outcomes remain to be determined. Our hypothesis was that contralateral myogenic dysfunction worsens stroke outcomes after acute hyperglycemic stroke in an oxidative stress-dependent manner. Male wild-type or SOD1 transgenic rats were injected with saline or 40% glucose solution 10 min before surgery and then subjected to 30 min of ischemia/45 min or 24 h of reperfusion. In another set of animals (n = 5), SOD1 was overexpressed only in the contralateral hemisphere by stereotaxic adenovirus injection 2–3 wk before I/R. Myogenic tone and neurovascular outcomes were determined. HG exacerbated myogenic dysfunction in contralateral side only, which was associated with infarct size expansion, increased edema, and more pronounced neurological deficit. Global and selective SOD1 overexpression restored myogenic reactivity in ipsilateral and contralateral sides, respectively, and enhanced neurovascular outcomes. In conclusion, our results show that SOD1 overexpression nullified the detrimental effects of HG on myogenic tone and stroke outcomes and that the contralateral hemisphere may be a novel target for the management of acute hyperglycemic stroke. PMID:25552308

Contralateral Noise Stimulation Delays P300 Latency in School-Aged Children.

PubMed

Ubiali, Thalita; Sanfins, Milaine Dominici; Borges, Leticia Reis; Colella-Santos, Maria Francisca

2016-01-01

The auditory cortex modulates auditory afferents through the olivocochlear system, which innervates the outer hair cells and the afferent neurons under the inner hair cells in the cochlea. Most of the studies that investigated the efferent activity in humans focused on evaluating the suppression of the otoacoustic emissions by stimulating the contralateral ear with noise, which assesses the activation of the medial olivocochlear bundle. The neurophysiology and the mechanisms involving efferent activity on higher regions of the auditory pathway, however, are still unknown. Also, the lack of studies investigating the effects of noise on human auditory cortex, especially in peadiatric population, points to the need for recording the late auditory potentials in noise conditions. Assessing the auditory efferents in schoolaged children is highly important due to some of its attributed functions such as selective attention and signal detection in noise, which are important abilities related to the development of language and academic skills. For this reason, the aim of the present study was to evaluate the effects of noise on P300 responses of children with normal hearing. P300 was recorded in 27 children aged from 8 to 14 years with normal hearing in two conditions: with and whitout contralateral white noise stimulation. P300 latencies were significantly longer at the presence of contralateral noise. No significant changes were observed for the amplitude values. Contralateral white noise stimulation delayed P300 latency in a group of school-aged children with normal hearing. These results suggest a possible influence of the medial olivocochlear activation on P300 responses under noise condition.

Quantification of Contralateral Breast Dose and Risk Estimate of Radiation-Induced Contralateral Breast Cancer Among Young Women Using Tangential Fields and Different Modes of Breathing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zurl, Brigitte, E-mail: brigitte.zurl@klinikum-graz.at; Stranzl, Heidi; Winkler, Peter

2013-02-01

Purpose: Whole breast irradiation with deep-inspiration breath-hold (DIBH) technique among left-sided breast cancer patients significantly reduces cardiac irradiation; however, a potential disadvantage is increased incidental irradiation of the contralateral breast. Methods and Materials: Contralateral breast dose (CBD) was calculated by comparing 400 treatment plans of 200 left-sided breast cancer patients whose tangential fields had been planned on gated and nongated CT data sets. Various anatomic and field parameters were analyzed for their impact on CBD. For a subgroup of patients (aged {<=}45 years) second cancer risk in the contralateral breast (CB) was modeled by applying the linear quadratic model, compoundmore » models, and compound models considering dose-volume information (DVH). Results: The mean CBD was significantly higher in DIBH with 0.69 Gy compared with 0.65 Gy in normal breathing (P=.01). The greatest impact on CBD was due to a shift of the inner field margin toward the CB in DIBH (mean 0.4 cm; range, 0-2), followed by field size in magnitude. Calculation with different risk models for CBC revealed values of excess relative risk/Gy ranging from 0.48-0.65 vs 0.46-0.61 for DIBH vs normal breathing, respectively. Conclusion: Contralateral breast dose, although within a low dose range, was mildly but significantly increased in 200 treatment plans generated under gated conditions, predominately due to a shift in the medial field margin. Risk modeling for CBC among women aged {<=}45 years also pointed to a higher risk when comparing DIBH with normal breathing. This risk, however, was substantially lower in the model considering DVH information. We think that clinical decisions should not be affected by this small increase in CBD with DIBH because DIBH is effective in reducing the dose to the heart in all patients.« less

Pattern of spread and prognosis in lower limb-onset ALS

PubMed Central

TURNER, MARTIN R.; BROCKINGTON, ALICE; SCABER, JAKUB; HOLLINGER, HANNAH; MARSDEN, RACHAEL; SHAW, PAMELA J.; TALBOT, KEVIN

2011-01-01

Our objective was to establish the pattern of spread in lower limb-onset ALS (contra- versus ipsi-lateral) and its contribution to prognosis within a multivariate model. Pattern of spread was established in 109 sporadic ALS patients with lower limb-onset, prospectively recorded in Oxford and Sheffield tertiary clinics from 2001 to 2008. Survival analysis was by univariate Kaplan-Meier log-rank and multivariate Cox proportional hazards. Variables studied were time to next limb progression, site of next progression, age at symptom onset, gender, diagnostic latency and use of riluzole. Initial progression was either to the contralateral leg (76%) or ipsilateral arm (24%). Factors independently affecting survival were time to next limb progression, age at symptom onset, and diagnostic latency. Time to progression as a prognostic factor was independent of initial direction of spread. In a regression analysis of the deceased, overall survival from symptom onset approximated to two years plus the time interval for initial spread. In conclusion, rate of progression in lower limb-onset ALS is not influenced by whether initial spread is to the contralateral limb or ipsilateral arm. The time interval to this initial spread is a powerful factor in predicting overall survival, and could be used to facilitate decision-making and effective care planning. PMID:20001488

Frontal Eye Fields Control Attentional Modulation of Alpha and Gamma Oscillations in Contralateral Occipitoparietal Cortex

PubMed Central

O'Shea, Jacinta; Jensen, Ole; Bergmann, Til O.

2015-01-01

Covertly directing visuospatial attention produces a frequency-specific modulation of neuronal oscillations in occipital and parietal cortices: anticipatory alpha (8–12 Hz) power decreases contralateral and increases ipsilateral to attention, whereas stimulus-induced gamma (>40 Hz) power is boosted contralaterally and attenuated ipsilaterally. These modulations must be under top-down control; however, the control mechanisms are not yet fully understood. Here we investigated the causal contribution of the human frontal eye field (FEF) by combining repetitive transcranial magnetic stimulation (TMS) with subsequent magnetoencephalography. Following inhibitory theta burst stimulation to the left FEF, right FEF, or vertex, participants performed a visual discrimination task requiring covert attention to either visual hemifield. Both left and right FEF TMS caused marked attenuation of alpha modulation in the occipitoparietal cortex. Notably, alpha modulation was consistently reduced in the hemisphere contralateral to stimulation, leaving the ipsilateral hemisphere relatively unaffected. Additionally, right FEF TMS enhanced gamma modulation in left visual cortex. Behaviorally, TMS caused a relative slowing of response times to targets contralateral to stimulation during the early task period. Our results suggest that left and right FEF are causally involved in the attentional top-down control of anticipatory alpha power in the contralateral visual system, whereas a right-hemispheric dominance seems to exist for control of stimulus-induced gamma power. These findings contrast the assumption of primarily intrahemispheric connectivity between FEF and parietal cortex, emphasizing the relevance of interhemispheric interactions. The contralaterality of effects may result from a transient functional reorganization of the dorsal attention network after inhibition of either FEF. PMID:25632139

Mobile-bearing medial unicompartmental knee arthroplasty restores limb alignment comparable to that of the unaffected contralateral limb

PubMed Central

Mullaji, Arun B; Shah, Siddharth; Shetty, Gautam M

2017-01-01

Background and purpose — Medial unicompartmental knee arthroplasty (UKA) is undertaken in patients with a passively correctable varus deformity. We investigated whether restoration of natural soft tissue tension would result in a lower limb alignment similar to that of the contralateral unaffected lower limb after mobile-bearing medial UKA. Patients and methods — In this retrospective study, hip-knee-ankle (HKA) angle, position of the weight-bearing axis (WBA), and knee joint line obliquity (KJLO) after mobile-bearing medial UKA was compared with that of the unaffected (clinically and radiologically) contralateral lower limb in 123 patients. Results — Postoperatively, HKA angle was restored to within ±3° of the contralateral lower limb in 87% of the patients and the WBA passed within ±1 Kennedy and White’s tibial zone of the unaffected contralateral lower limb in 95% of the patients. The mean KJLO in the operated limbs was not significantly different from that in the unaffected lower limbs (p = 0.07) and the KJLO in the operated limb was restored to within ±3° of that in the contralateral lower limb in 96% of the patients. Interpretation — Lower limb alignment and knee joint line obliquity after mobile-bearing medial UKA were comparable to that of the unaffected contralateral limb in most patients. Comparison with the contralateral unaffected lower limb is a reliable method for evaluation and validation of limb mechanical alignment after mobile-bearing medial UKA. PMID:27794622

Contralateral prophylactic mastectomy: current perspectives

PubMed Central

Yao, Katharine; Sisco, Mark; Bedrosian, Isabelle

2016-01-01

There has been an increasing trend in the use of contralateral prophylactic mastectomy (CPM) in the United States among women diagnosed with unilateral breast cancer, particularly young women. Approximately one-third of women <40 years old are undergoing CPM in the US. Most studies have shown that the CPM trend is mainly patient-driven, which reflects a changing environment for newly diagnosed breast cancer patients. The most common reason that women choose CPM is based on misperceptions about CPM’s effect on survival and overestimation of their contralateral breast cancer (CBC) risk. No prospective studies have shown survival benefit to CPM, and the CBC rate for most women is low at 10 years. Fear of recurrence is also a big driver of CPM decisions. Nonetheless, studies have shown that women are mostly satisfied with undergoing CPM, but complications and subsequent surgeries with reconstruction have been associated with dissatisfaction with CPM. Studies on surgeon’s perspectives on CPM are sparse but show that the most common reasons surgeons discuss CPM with patients is because of a suspicious family history or for a patient who is a confirmed BRCA mutation carrier. Studies on the cost–effectiveness of CPM have been conflicting and are highly dependent on patient’s quality of life after CPM. Most recent guidelines for CPM are contradictory. Future areas of research include the development of interventions to better inform patients about CPM, modification of the guidelines to form a more consistent statement, longer term studies on CBC risk and CPM’s effect on survival, and prospective studies that track the psychosocial effects of CPM on body image and sexuality. PMID:27382334

Miniopen Transforaminal Lumbar Interbody Fusion with Unilateral Fixation: A Comparison between Ipsilateral and Contralateral Reherniation

PubMed Central

Liu, Fubing; Jiang, Chun

2016-01-01

The aim of this study was to evaluate the risk factors between ipsilateral and contralateral reherniation and to compare the effectiveness of miniopen transforaminal lumbar interbody fusion (TLIF) with unilateral fixation for each group. From November 2007 to December 2014, clinical and radiographic data of each group (ipsilateral or contralateral reherniation) were collected and compared. Functional assessment (Visual Analog Scale (VAS) score and Japanese Orthopaedic Association (JOA)) and radiographic evaluation (fusion status, disc height, lumbar lordosis (LL), and functional spine unit (FSU) angle) were applied to compare surgical effect for each group preoperatively and at final followup. MacNab questionnaire was applied to further evaluate the satisfactory rate after the discectomy and fusion. No difference except pain-free interval was found between ipsilateral and contralateral groups. There was a significant difference in operative time between two groups. No differences were found in clinical and radiographic data for assessment of surgical effect between two groups. The satisfactory rate was decreasing in both groups with time passing after discectomy. Difference in pain-free interval may be a distinction for ipsilateral and contralateral reherniation. Miniopen TLIF with unilateral pedicle screw fixation can be a recommendable way for single level reherniation regardless of ipsilateral or contralateral reherniation. PMID:27885358

Masking overshoot: Effects of ipsilateral, bilateral and contralateral priming

NASA Astrophysics Data System (ADS)

Connington, Maureen Catherine

This study was concerned with masking overshoot, the elevation of the threshold of a brief signal when it is presented at the onset of a masking noise rather than at its temporal center. More specifically, it was concerned with the release from overshoot (i.e., threshold improvement) produced by priming stimuli, presented ipsilaterally, bilaterally and contralaterally at primer- masker gaps of 20, 40 and 80 msec. The more general purpose of the study was to assess the contributions of peripheral and central factors to the overshoot and overshoot-release phenomena. The primers and masking stimuli consisted of white noise bursts of 200 and 400 msec duration, respectively. The probe signal was a 20 msec 4kHz tone. The tone and masker were always presented in one ear. There were, however, 3 modes of primer presentation: ipsilateral, bilateral (identical waveforms to both ears) and contralateral. Three primer-masker gaps of 20, 40 and 80 msec were used. Five normally hearing adults were tested at primer and masker levels of 80 dB HL. Four of the five subjects exhibited significant masking overshoot, when tested without priming. Ipsilateral priming with 20 and 40 msec gaps produced significant masking release from overshoot. Threshold became poorer, however with increasing gap duration and with increasing distance of the perceived primer from the test ear (i.e. ipsilateral priming produced better thresholds than did bilateral priming and bilateral priming produced better thresholds than contralateral priming). There was significant masking enhancement (i.e. threshold was significantly poorer than in the unprimed probe at onset condition) with the contralateral 80 msec primer. The fact that ipsilateral and bilateral primers performed differently does not support the theory that masking overshoot and its release are solely the results of peripheral adaptation. In fact, the group results support the conclusion that masking overshoot is influenced by central factors. However

A case of loss of consciousness with contralateral acute subdural haematoma during awake craniotomy

PubMed Central

Kamata, Kotoe; Maruyama, Takashi; Nitta, Masayuki; Ozaki, Makoto; Muragaki, Yoshihiro; Okada, Yoshikazu

2014-01-01

We are reporting the case of a 56-year-old woman who developed loss of consciousness during awake craniotomy. A thin subdural haematoma in the contralateral side of the craniotomy was identified with intraoperative magnetic resonance imaging and subsequently removed. Our case indicates that contralateral acute subdural haematoma could be a cause of deterioration of the conscious level during awake craniotomy. PMID:25301378

Frontal eye fields control attentional modulation of alpha and gamma oscillations in contralateral occipitoparietal cortex.

PubMed

Marshall, Tom R; O'Shea, Jacinta; Jensen, Ole; Bergmann, Til O

2015-01-28

Covertly directing visuospatial attention produces a frequency-specific modulation of neuronal oscillations in occipital and parietal cortices: anticipatory alpha (8-12 Hz) power decreases contralateral and increases ipsilateral to attention, whereas stimulus-induced gamma (>40 Hz) power is boosted contralaterally and attenuated ipsilaterally. These modulations must be under top-down control; however, the control mechanisms are not yet fully understood. Here we investigated the causal contribution of the human frontal eye field (FEF) by combining repetitive transcranial magnetic stimulation (TMS) with subsequent magnetoencephalography. Following inhibitory theta burst stimulation to the left FEF, right FEF, or vertex, participants performed a visual discrimination task requiring covert attention to either visual hemifield. Both left and right FEF TMS caused marked attenuation of alpha modulation in the occipitoparietal cortex. Notably, alpha modulation was consistently reduced in the hemisphere contralateral to stimulation, leaving the ipsilateral hemisphere relatively unaffected. Additionally, right FEF TMS enhanced gamma modulation in left visual cortex. Behaviorally, TMS caused a relative slowing of response times to targets contralateral to stimulation during the early task period. Our results suggest that left and right FEF are causally involved in the attentional top-down control of anticipatory alpha power in the contralateral visual system, whereas a right-hemispheric dominance seems to exist for control of stimulus-induced gamma power. These findings contrast the assumption of primarily intrahemispheric connectivity between FEF and parietal cortex, emphasizing the relevance of interhemispheric interactions. The contralaterality of effects may result from a transient functional reorganization of the dorsal attention network after inhibition of either FEF. Copyright © 2015 the authors 0270-6474/15/351638-10$15.00/0.

Unilateral hypoplasia with contralateral hypertrophy of anterior belly of digastric muscle: a case report.

PubMed

Ochoa-Escudero, Martin; Juliano, Amy F

2016-10-01

Anomalies of the anterior belly of the digastric muscle (DM) are uncommon. We present a case of hypoplasia of the anterior belly of the left DM with hypertrophy of the anterior belly of the contralateral DM. The importance of recognizing this finding is to differentiate hypoplasia of the anterior belly of the DM from denervation atrophy, and not to confuse contralateral hypertrophy with a submental mass or lymphadenopathy. In denervation atrophy of the anterior belly of the DM, associated atrophy of the ipsilateral mylohyoid muscle is present. Hypertrophy of the anterior belly of the contralateral DM can be differentiated from a submental mass or lymphadenopathy by recognizing its isodensity on computed tomography and isointensity on magnetic resonance imaging to other muscles, without abnormal contrast enhancement.

Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.

PubMed

Nava, Maurizio B; Rocco, Nicola; Catanuto, Giuseppe; Falco, Giuseppe; Capalbo, Emanuela; Marano, Luigi; Bordoni, Daniele; Spano, Andrea; Scaperrotta, Gianfranco

2015-08-01

The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction. We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups. Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90). This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms. Copyright © 2015 Elsevier Ltd. All rights reserved.

Simultaneous cranioplasty and subdural-peritoneal shunting for contralateral symptomatic subdural hygroma following decompressive craniectomy.

PubMed

Lin, Muh-Shi; Chen, Tzu-Hsuan; Kung, Woon-Man; Chen, Shuo-Tsung

2015-01-01

Contralateral subdural hygroma caused by decompressive craniectomy tends to combine with external cerebral herniation, causing neurological deficits. Nine patients who underwent one-stage, simultaneous cranioplasty and contralateral subdural-peritoneal shunting were included in this study. Clinical outcome was assessed by Glasgow Outcome Scale as well as Glasgow Coma Scale, muscle power scoring system, and complications. Postoperative computed tomography scans demonstrated completely resolved subdural hygroma and reversed midline shifts, indicating excellent outcome. Among these 9 patients, 4 patients (44%) had improved GOS following the proposed surgery. Four out of 4 patients with lethargy became alert and orientated following surgical intervention. Muscle strength improved significantly 5 months after surgery in 7 out of 7 patients with weakness. Two out of 9 patients presented with drowsiness due to hydrocephalus at an average time of 65 days after surgery. Double gradient shunting is useful to eliminate the respective hydrocephalus and contralateral subdural hygroma. The described surgical technique is effective in treating symptomatic contralateral subdural hygroma following decompressive craniectomy and is associated with an excellent structural and functional outcome. However, subdural-peritoneal shunting plus cranioplasty thoroughly resolves the subdural hygroma collection, which might deteriorate the cerebrospinal fluid circulation, leading to hydrocephalus.

Assessment of rock musician's efferent system functioning using contralateral suppression of otoacoustic emissions.

PubMed

Kumar, Prawin; Grover, Vibhu; Publius A, Sam; Sanju, Himanshu Kumar; Sinha, Sachchidanand

2016-12-01

Contralateral suppression of oto acoustic emission (OAE) is referred as activation of efferent system. Previous literature mentioned about the importance of contralateral suppression of OAEs as a tool to assess efferent system in different groups of population. There is dearth of literature to explore the efferent system function in experienced musicians exposed to rock music using TEOAEs and DPOAEs. Two groups of participant (14 rock musicians and 14 non-musicians) in the age range of 18-25 years were involved in the study. Contralateral suppression of TEOAEs and DPOAEs were measured using ILO (Version 6) in both groups. Descriptive statistics showed higher suppression of TEOAEs and DPOAEs in rock-musicians at most of the frequencies in comparison to non-musicians. For DPOAE measures, Mann Whitney U test results revealed significantly greater DPOAE suppression only at 1 kHz and 3 kHz in rock-musicians compared to non-musicians. For within group comparison, Kruskal Wallis test results revealed there were significant difference observed across most of the frequencies i.e. at 1 kHz, 3 kHz and 6 kHz. For TEOAE measures, Mann Whitney U test results revealed that only at 2 kHz, TEOAE suppression in rock-musician was significantly greater compared to non-musicians. Similarly, Kuskal Wallis test results revealed that within group there were no significant differences observed for most of the frequencies except 2 kHz. Based on the above finding, present study concludes that rock musicians are having better efferent system compared to non-musicians. No suppression effect at few frequencies probably indicates more vulnerability at those frequencies. Contralateral suppression of DPOAE shows more significant finding in comparison to contralateral suppression of TEOAEs in present study.

Ruptured ectopic pregnancy with contralateral adnexal torsion after spontaneous conception.

PubMed

DiLuigi, Andrea J; Maier, Donald B; Benadiva, Claudio A

2008-11-01

To describe a case of ruptured ectopic pregnancy and contralateral adnexal torsion after spontaneous conception. Case report. Tertiary university medical center. A 23-year-old multiparous female with severe bilateral pelvic pain and a positive pregnancy test. Operative laparoscopy with detorsion of left adnexa, drainage of left ovarian hemorrhagic corpus luteum cyst, right salpingectomy, and dilation and curettage. Laparoscopy revealed a 5 cm hemorrhagic corpus luteum cyst of the left ovary, torsion of the left ovary and fallopian tube, and a ruptured right ampullary ectopic pregnancy. Normal perfusion of left ovary and fallopian tube after detorsion, resolution of left ovarian hemorrhagic corpus luteum cyst, patent left fallopian tube with chromopertubation, and successful removal of ectopic pregnancy. This is a unique case of adnexal torsion and contralateral ectopic pregnancy occurring after spontaneous conception.

The evolution of contralateral control of the body by the brain: is it a protective mechanism?

PubMed

Whitehead, Lorne; Banihani, Saleh

2014-01-01

Contralateral control, the arrangement whereby most of the human motor and sensory fibres cross the midline in order to provide control for contralateral portions of the body, presents a puzzle from an evolutionary perspective. What caused such a counterintuitive and complex arrangement to become dominant? In this paper we offer a new perspective on this question by showing that in a complex interactive control system there could be a significant net survival advantage with contralateral control, associated with the effect of injuries of intermediate severity. In such cases an advantage could arise from a combination of non-linear system response combined with correlations between injuries on the same side of the head and body. We show that a simple mathematical model of these ideas emulates such an advantage. Based on this model, we conclude that effects of this kind are a plausible driving force for the evolution of contralateral control.

Endothelinergic Contractile Hyperreactivity in Rat Contralateral Carotid to Balloon Injury: Integrated Role for ETB Receptors and Superoxide Anion

PubMed Central

Gimenes, Lilian R.; Gomes, Mayara S.; do Vale, Bruno N.; Cardoso, Cristina R. B.; de Oliveira, Ana M.; Moreira, Josimar D.

2017-01-01

Temporal consequences of neurocompensation to balloon injury on endothelinergic functionality in rat contralateral carotid were evaluated. Rats underwent balloon injury in left carotid and were treated with CP-96345 (NK1 antagonist). Concentration-response curves for endothelin-1 were obtained in contralateral (right) carotid at 2, 8, 16, 30, or 45 days after surgery in the absence or presence of BQ-123 (ETA antagonist), BQ-788 (ETB antagonist), or Tempol (superoxide-dismutase mimic). Endothelin-1-induced calcium mobilization was evaluated in functional assays carried out with BQ-123, BQ-788, or Tempol. Endothelin-1-induced NADPH oxidase-driven superoxide generation was measured by lucigenin chemiluminescence assays performed with BQ-123 or BQ-788. Endothelin-1-induced contraction was increased in contralateral carotid from the sixteenth day after surgery. This response was restored in CP-96345-treated rats. Endothelium removal or BQ-123 did not change endothelin-1-induced contraction in contralateral carotid. This response was restored by BQ-788 or Tempol. Contralateral carotid exhibited an increased endothelin-1-induced calcium mobilization, which was restored by BQ-788 or Tempol. Contralateral carotid exhibited an increased endothelin-1-induced lucigenin chemiluminescence, which was restored by BQ-788. We conclude that the NK1-mediated neurocompensatory response to balloon injury elicits a contractile hyperreactivity to endothelin-1 in rat contralateral carotid by enhancing the muscular ETB-mediated NADPH oxidase-driven generation of superoxide, which activates calcium channels. PMID:29062837

Can sparing of the superficial contralateral parotid lobe reduce xerostomia following radiotherapy for head and neck cancer?

PubMed

Nevens, Daan; Nuyts, Sandra

2017-12-01

The purpose of this study is to see whether sparing the superficial contralateral parotid lobe can help limiting xerostomia following radiotherapy for head and neck cancer. 88 patients that were included in two prospective randomized studies were analysed in the current study. Using the dosimetry of both the parotid glands, we divided our patients in four groups. Group 1 includes patients where we were able to reduce the radiation dose below the threshold in order to spare both the ipsilateral and contralateral parotid glands, Group 2 consists of patients where only the contralateral parotid gland could be spared. Group 3 consists of patients where only the contralateral superficial parotid lobe could be spared, while in Group 4 not even the contralateral superficial lobe could be spared. When we compared Group 1 and Group 2, we did not observe a significant difference between both groups in terms of xerostomia scores at 6 or 12 months. When we compared these groups with Group 3, we observed significant differences with more xerostomia in Group 3 where only the contralateral superficial lobe was spared. A significant difference was also observed between Group 3 and Group 4 with more xerostomia in Group 4. Sparing of just one superficial parotid lobe results in less xerostomia when compared to not sparing any lobe of both parotid glands. Advances in knowledge: When sparing of the whole contralateral parotid gland is not possible, delineating both the superficial parotid glands and trying to spare at least one of them can mean a way forward in limiting xerostomia in head and neck cancer patients treated with radiotherapy.

Younger patients are at increased risk for graft rupture and contralateral injury after anterior cruciate ligament reconstruction.

PubMed

Webster, Kate E; Feller, Julian A; Leigh, Warren B; Richmond, Anneka K

2014-03-01

Graft rupture of the same knee or injury to the anterior cruciate ligament (ACL) in the contralateral knee is a devastating outcome after ACL reconstruction surgery. While a number of factors have been identified as potentially increasing the risk of subsequent ACL injury, the literature is far from definitive. To determine the rates of graft rupture and contralateral ACL injury in a large cohort and to investigate patient characteristics that may be associated with these. Case-control study; Level of evidence, 3. A consecutive cohort of 750 patients who had undergone primary ACL reconstruction surgery with a minimum 3-year follow-up were questioned about the incidence of ACL graft rupture, contralateral ACL injury, family history of ACL injury, and current activity level. Patient databases provided details for age, sex, original injury mechanism, meniscus or articular surface injury, and graft diameter. Responses were received from 561 patients (75%) at a mean ± SD follow-up time of 4.8 ± 1.1 years. Anterior cruciate ligament graft ruptures occurred in 25 patients (4.5%), and contralateral ACL injuries occurred in 42 patients (7.5%). The highest incidence of further ACL injury occurred in patients younger than 20 years at the time of surgery. In this group, 29% sustained a subsequent ACL injury to either knee. The odds for sustaining an ACL graft rupture or contralateral injury increased 6- and 3-fold, respectively, for patients younger than 20 years. Returning to cutting/pivoting sports increased the odds of graft rupture by a factor of 3.9 and contralateral rupture by a factor of 5. A positive family history doubled the odds for both graft rupture and contralateral ACL injury. Patients younger than 20 years who undergo ACL reconstruction are at significantly increased risk for both graft rupture and contralateral ACL injury. Whether age per se is a risk factor or age represents a proxy for other factors remains to be determined.

Contralaterally Controlled Functional Electrical Stimulation for Stroke Rehabilitation

PubMed Central

Knutson, Jayme S.; Harley, Mary Y.; Hisel, Terri Z.; Makowski, Nathaniel S.; Fu, Michael J.; Chae, John

2012-01-01

Contralaterally controlled functional electrical stimulation (CCFES) is an innovative method of delivering neuromuscular electrical stimulation for rehabilitation of paretic limbs after stroke. It is being studied to evaluate its efficacy in improving recovery of arm and hand function and ankle dorsiflexion in chronic and subacute stroke patients. The initial studies provide preliminary evidence supporting the efficacy of CCFES. PMID:23365893

Effect of excessive contralateral trunk tilt on pitching biomechanics and performance in high school baseball pitchers.

PubMed

Oyama, Sakiko; Yu, Bing; Blackburn, J Troy; Padua, Darin A; Li, Li; Myers, Joseph B

2013-10-01

There is a growing number of pitching-related upper extremity injuries among young baseball pitchers; however, there is a lack of data on the identification of injury prevention strategies, particularly the prevention of injuries through the instruction/modification of technique. The identification of technical parameters that are associated with increased joint loading is needed. To investigate the effects of excessive contralateral trunk tilt, a common technique identifiable by video observation, on pitching biomechanics and performance in high school baseball pitchers. The hypothesis was that this strategy is associated with greater joint loading and poor pitching performance. Descriptive laboratory study; Level of evidence, 3. The 3-dimensional pitching biomechanics, ball speed, and frontal view of the pitching technique from 72 high school baseball pitchers were captured on video and analyzed. The videos were reviewed to determine if the pitcher's trunk was excessively contralaterally tilted at the instant of maximal shoulder external rotation by examining whether the side of the pitcher's head ipsilateral to the throwing limb deviated by more than a head width from a vertical line passing through the pitcher's stride foot ankle. Upper extremity kinetics and upper extremity/trunk kinematics between pitchers with and without excessive contralateral trunk tilt were compared using independent t tests. Compared with pitchers who did not demonstrate excessive contralateral trunk tilt, those with excessive contralateral trunk tilt pitched at a higher ball speed (mean, 32.6 ± 2.2 vs 31.1 ± 2.9 m/s, respectively; P = .019) and experienced a greater elbow proximal force (mean, 103.9 ± 12.7 vs 93.2 ± 13.9 %weight, respectively; P = .001), shoulder proximal force (mean, 104.8 ± 14.1 vs 94.3 ± 15.5 %weight, respectively; P = .004), elbow varus moment (mean, 4.29 ± 0.73 vs 3.84 ± 0.8 %height*weight, respectively; P = .017), and shoulder internal rotation moment

Contralateral Bias of High Spatial Frequency Tuning and Cardinal Direction Selectivity in Mouse Visual Cortex

PubMed Central

Zeitoun, Jack H.; Kim, Hyungtae

2017-01-01

Binocular mechanisms for visual processing are thought to enhance spatial acuity by combining matched input from the two eyes. Studies in the primary visual cortex of carnivores and primates have confirmed that eye-specific neuronal response properties are largely matched. In recent years, the mouse has emerged as a prominent model for binocular visual processing, yet little is known about the spatial frequency tuning of binocular responses in mouse visual cortex. Using calcium imaging in awake mice of both sexes, we show that the spatial frequency preference of cortical responses to the contralateral eye is ∼35% higher than responses to the ipsilateral eye. Furthermore, we find that neurons in binocular visual cortex that respond only to the contralateral eye are tuned to higher spatial frequencies. Binocular neurons that are well matched in spatial frequency preference are also matched in orientation preference. In contrast, we observe that binocularly mismatched cells are more mismatched in orientation tuning. Furthermore, we find that contralateral responses are more direction-selective than ipsilateral responses and are strongly biased to the cardinal directions. The contralateral bias of high spatial frequency tuning was found in both awake and anesthetized recordings. The distinct properties of contralateral cortical responses may reflect the functional segregation of direction-selective, high spatial frequency-preferring neurons in earlier stages of the central visual pathway. Moreover, these results suggest that the development of binocularity and visual acuity may engage distinct circuits in the mouse visual system. SIGNIFICANCE STATEMENT Seeing through two eyes is thought to improve visual acuity by enhancing sensitivity to fine edges. Using calcium imaging of cellular responses in awake mice, we find surprising asymmetries in the spatial processing of eye-specific visual input in binocular primary visual cortex. The contralateral visual pathway is

Computer-Aided Diagnostic (CAD) Scheme by Use of Contralateral Subtraction Technique

NASA Astrophysics Data System (ADS)

Nagashima, Hiroyuki; Harakawa, Tetsumi

We developed a computer-aided diagnostic (CAD) scheme for detection of subtle image findings of acute cerebral infarction in brain computed tomography (CT) by using a contralateral subtraction technique. In our computerized scheme, the lateral inclination of image was first corrected automatically by rotating and shifting. The contralateral subtraction image was then derived by subtraction of reversed image from original image. Initial candidates for acute cerebral infarctions were identified using the multiple-thresholding and image filtering techniques. As the 1st step for removing false positive candidates, fourteen image features were extracted in each of the initial candidates. Halfway candidates were detected by applying the rule-based test with these image features. At the 2nd step, five image features were extracted using the overlapping scale with halfway candidates in interest slice and upper/lower slice image. Finally, acute cerebral infarction candidates were detected by applying the rule-based test with five image features. The sensitivity in the detection for 74 training cases was 97.4% with 3.7 false positives per image. The performance of CAD scheme for 44 testing cases had an approximate result to training cases. Our CAD scheme using the contralateral subtraction technique can reveal suspected image findings of acute cerebral infarctions in CT images.

Incidence Rate and Risk Factors for Contralateral Eye Involvement among Patients with AIDS and Cytomegalovirus Retinitis Treated with Local Therapy.

PubMed

Sittivarakul, Wantanee; Benjhawaleemas, Thanyapat; Aui-Aree, Nipat; Jirarattanasopa, Pichai; Liabsuetrakul, Tippawan

2016-10-01

To calculate the incidence of, and to identify the risk factors for developing contralateral eye involvement among patients with AIDS and unilateral cytomegalovirus retinitis (CMV retinitis), who were treated, in the era of highly-active antiretroviral therapy (HAART), with repetitive intravitreal ganciclovir injections. The clinical records of 119 patients were included. The main outcome measurement was the occurrence of contralateral eye involvement. Over a mean follow-up period of 1.6 years, the overall incidence rate of contralateral involvement was 0.17/person-year. The cumulative incidence of contralateral involvement at 6 months and 1 year was 23.8% and 28.4%, respectively. Receiving HAART at the visit before the event was associated with a decreased risk of developing contralateral retinitis (hazard ratio [HR] = 0.26, P = 0.002). The use of HAART, associated with subsequent immune recovery, significantly reduced the incidence of contralateral eye involvement by approximately 75% among patients in our setting.

[Lower limb salvage with a free fillet fibula flap harvested from the contralateral amputated leg].

PubMed

Bouyer, M; Corcella, D; Forli, A; Mesquida, V; Semere, A; Moutet, F

2015-06-01

We report a unusual case of "fillet flap" to reconstruct the lower limb with the amputated contralateral leg. This kind of procedure was first described by Foucher et al. in 1980 for traumatic hand surgery as the "bank finger". A 34-year-old man suffered a microlight accident with bilateral open legs fractures. A large skin defect of the left leg exposed the ankle, the calcaneus and a non-vascularized part of the tibial nerve (10 cm). The patient came to the OR for surgical debridement and had massive bone resection of the left calcaneus. The right leg showed limited skin defect at the lower part, exposing the medial side of the ankle and a tibial bone defect, measuring 10 cm. Salvage the left leg was impossible due to complex nerve, bones and skin associated injuries, so this leg was sacrificed and used as a donor limb, to harvest a free fibula flap for contralateral tibial reconstruction. At 18 months of follow-up, the patient was very satisfied, the clinical result was very good on both lower limbs and X-rays showed excellent integration of the free fibula flap. The patient had normal dailies occupations, can run and have bicycle sport practice with a functional left leg fit prosthesis. This case showed an original application of the "fillet flap concept" to resolve complex and rare traumatic situations interesting the both lower limbs. In our opinion, this strategy must be a part of the plastic surgeon skills in uncommon situations. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Evaluation of the Contralateral Inguinal Ring in Clinically Unilateral Inguinal Hernia: A Systematic Review and Meta-analysis

PubMed Central

Kokorowski, Paul J; Wang, Hsin-Hsiao Scott; Routh, Jonathan C; Hubert, Katherine C; Nelson, Caleb P

2013-01-01

Purpose The management of the contralateral inguinal canal in children with clinical unilateral inguinal hernia is controversial. Our objective was to systematically review the literature regarding management of the contralateral inguinal canal. Methods We searched MEDLINE, EMBASE, and Cochrane databases (1940–2011) using ‘hernia’ and ‘inguinal’ and either ‘pediatric,’ ‘infant,’ or ‘child,’ to identify studies of pediatric (age≤21 yrs) patients with inguinal hernia. Among clinical unilateral hernia patients, we assessed the number of cases with contralateral patent processus (CPP) and incidence of subsequent clinical metachronous contralateral hernia (MCH). We evaluated three strategies for contralateral management: expectant management, laparoscopic evaluation or pre-operative ultrasound. Pooled estimates of MCH or CPP were generated with random effects by study when heterogeneity was found (I2>50%, or Cochrane’s Q p≥0.10). Results We identified 2,477 non-duplicated studies, 129 of which met our inclusion criteria and had sufficient information for quantitative analysis. The pooled incidence of MCH after open unilateral repair was 7.3% (95% CI 6.5%–8.1%). Laparoscopic examination identified CPP in 30% (95% CI 26%–34%). Lower age was associated with higher incidence of CPP (p<0.01). The incidence of MCH after a negative laparoscopic evaluation was 0.9% (95% CI 0.5%–1.3%). Significant heterogeneity was found in studies and pooled estimates should be interpreted with caution. Conclusions The literature suggests that laparoscopically identified CPP is a poor indicator of future contralateral hernia. Almost a third of patients will have a CPP, while less than one in 10 will develop MCH when managed expectantly. Performing contralateral hernia repair in patients with CPP results in overtreatment in roughly 2 out of 3 patients. PMID:23963735

Stronger efferent suppression of cochlear neural potentials by contralateral acoustic stimulation in awake than in anesthetized chinchilla.

PubMed

Aedo, Cristian; Tapia, Eduardo; Pavez, Elizabeth; Elgueda, Diego; Delano, Paul H; Robles, Luis

2015-01-01

There are two types of sensory cells in the mammalian cochlea, inner hair cells, which make synaptic contact with auditory-nerve afferent fibers, and outer hair cells that are innervated by crossed and uncrossed medial olivocochlear (MOC) efferent fibers. Contralateral acoustic stimulation activates the uncrossed efferent MOC fibers reducing cochlear neural responses, thus modifying the input to the central auditory system. The chinchilla, among all studied mammals, displays the lowest percentage of uncrossed MOC fibers raising questions about the strength and frequency distribution of the contralateral-sound effect in this species. On the other hand, MOC effects on cochlear sensitivity have been mainly studied in anesthetized animals and since the MOC-neuron activity depends on the level of anesthesia, it is important to assess the influence of anesthesia in the strength of efferent effects. Seven adult chinchillas (Chinchilla laniger) were chronically implanted with round-window electrodes in both cochleae. We compared the effect of contralateral sound in awake and anesthetized condition. Compound action potentials (CAP) and cochlear microphonics (CM) were measured in the ipsilateral cochlea in response to tones in absence and presence of contralateral sound. Control measurements performed after middle-ear muscles section in one animal discarded any possible middle-ear reflex activation. Contralateral sound produced CAP amplitude reductions in all chinchillas, with suppression effects greater by about 1-3 dB in awake than in anesthetized animals. In contrast, CM amplitude increases of up to 1.9 dB were found in only three awake chinchillas. In both conditions the strongest efferent effects were produced by contralateral tones at frequencies equal or close to those of ipsilateral tones. Contralateral CAP suppressions for 1-6 kHz ipsilateral tones corresponded to a span of uncrossed MOC fiber innervation reaching at least the central third of the chinchilla cochlea.

[Prediction of occult carcinoma in contralateral nodules based on the ultrasonic features of unilateral papillary thyroid carcinoma].

PubMed

Yang, L M; Li, Q; Zhao, B W; Lyu, J G; Xu, H S; Xu, L L; Li, S Y; Gao, L; Zhu, J

2017-04-07

Objective: To investigate the occurrence of occult carcinoma in contralateral lobes based on the ultrasonic features of unilateral papillary thyroid carcinoma. Methods: The study included 202 consecutives cases of unilateral papillary thyroid carcinoma with benign nodules in the contralateral lobe identified by preoperative ultrasound or fine-needle aspiration from June 2014 to December 2015. All patients received total thyroidectomies, and with postoperative pathological examination they were divided into two groups, one including 60 cases with positive occult cancer and another one consisting of 142 cases with negative occult cancer. Univariate and multivariate analyses were performed to analyze the sonographic features of unilateral papillary thyroid carcinoma relevant to the occurrence of occult carcinoma in the contralateral nodules. Results: Univariate analysis indicated occult carcinoma in the contralateral lobes was associated with Hashimoto's thyroiditis(χ(2)=3.955, P =0.047), unclear border (χ(2)=4.375, P =0.036)and multifocality in the ipsilateral(χ(2)=7.375, P =0.007), but not with tumors maximum size, location, A/T, shape, internal structure, internal echo, acoustic halo, calcification, capsular invasion and blood flow signal in the lobe with carcinoma on another side. Multivariate analysis showed unclear border ( OR =2.727, P =0.010) and multifocality in the ipsilateral( OR =2.807, P =0.005)of carcinoma were independent predictive factor for contralateral occult PTC. Conclusions: Unclear border and multifocality of PTC in the ipsilateral were closely relevant to the occurrence of occult carcinoma in the contralateral nodules.

Contralateral suppression of transient-evoked otoacoustic emissions in children with sickle cell disease.

PubMed

Stuart, Andrew; Preast, June L

2012-01-01

In previous studies, otoacoustic emissions (OAEs) have been found to be larger in normal-hearing children with sickle cell disease (SCD). It was hypothesized that some dysfunction or reduction in the medial olivocochlear efferent suppression of outer hair cell activity was responsible for this phenomenon. To test this hypothesis, contralateral suppression of transient-evoked otoacoustic emissions (TEOAEs) was examined in children with and without SCD. Thirteen African American school-aged normal-hearing children with homozygous SCD and 13 age- and gender-matched control children participated. TEOAEs were obtained bilaterally with 80 dB peSPL nonlinear click stimuli. To examine contralateral suppression, TEOAEs were obtained with 60 dB peSPL linear click stimuli with and without a contralateral 65 dB SPL white noise suppressor. Overall and half-octave band TEOAE levels were found to be larger in children with SCD relative to the normal control children (p < 0.05), consistent with previous reports of increased OAE levels. There was no significant difference (p > 0.05) in the absolute or proportional amount of TEOAE suppression as a function of group and ear. There were also no significant correlations or linear predictive relationships between TEOAE suppression and TEOAE level for either ear or group (p > 0.05). These findings do not support the notion that increased OAE levels in children with SCD are a consequence of abnormal medial olivocochlear system function as assessed with contralateral suppression of TEOAEs.

Progressive contralateral hippocampal atrophy following surgery for medically refractory temporal lobe epilepsy.

PubMed

Elliott, Cameron A; Gross, Donald W; Wheatley, B Matt; Beaulieu, Christian; Sankar, Tejas

2016-09-01

Determine the extent and time course of volumetric changes in the contralateral hippocampus following surgery for medically refractory temporal lobe epilepsy (TLE). Serial T1-weighted MRI brain scans were obtained in 26 TLE patients pre- and post-temporal lobe epilepsy surgery as well as in 12 control subjects of similar age. Patients underwent either anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SAH). Blinded, manual hippocampal volumetry (head, body, and tail) was performed in two groups: 1) two scan group [ATL (n=6); SAH (n=10)], imaged pre-surgery and on average at 5.4 years post-surgery; and 2) longitudinal group [ATL (n=8); SAH (n=2)] imaged pre-surgery and on post-operative day 1, 2, 3, 6, 60, 120 and a delayed time point (average 2.4 years). In the two scan group, there was atrophy by 12% of the unresected contralateral hippocampus (p<0.001), with atrophy being most pronounced (27%) in the hippocampal body (p<0.001) with no significant differences seen for the hippocampal head or tail. In the longitudinal group, significant atrophy was also observed for the whole hippocampus and the body with atrophy seen as early as post-operative day #1 which progressed significantly over the first post-operative week (1.3%/day and 3.0%./day, respectively) before stabilizing over the long-term to a 13% reduction in total volume. There was no significant difference in atrophy compared by surgical approach (ATL vs. SAH; p=0.94) or side (p=0.31); however, atrophy was significantly more pronounced in patients with ongoing post-operative seizures (hippocampal body, p=0.019; whole hippocampus, p=0.048). There were no detectable post-operative neuropsychological deficits attributable to contralateral hippocampal atrophy. Significant contralateral hippocampal atrophy occurs following TLE surgery, which begins immediately and progresses over the first post-operative week. The observation that seizure free patients had significantly less atrophy of the

Transient osteoporosis of the hip with a contralateral delayed involvement: a case report

PubMed Central

Iannò, Bruno; De Gori, Marco; Familiari, Filippo; Pugliese, Teresa; Gasparini, Giorgio

2017-01-01

Summary We describe a case of non-simultaneous bilateral hip pain with bone marrow edema occurring in an adult male, with the contralateral hip being involved 12 years later after the onset of symptoms. On the basis of clinical and imaging findings, together with a complete resolution after conservative management, a post-hoc diagnosis of metachronous bilateral transient osteoporosis of the hip (TOH) was made. Non-simultaneous bilateral presentation of TOH is exceptional, and contralateral involvement with a 12-year delay has never been previously described. PMID:28740530

Does the type of somatosensory information from the contralateral finger touch affect grip force control while lifting an object?

PubMed

Chen, Bing; Aruin, Alexander S

2013-11-27

The magnitude of grip force used to lift and transport a hand-held object is decreased if a light finger touch from the contralateral arm is provided to the wrist of the target arm. We investigated whether the type of contralateral arm sensory input that became available with the finger touch to the target arm affects the way grip force is reduced. Nine healthy subjects performed the same task of lifting and transporting an instrumented object with no involvement of the contralateral arm and when an index finger touch of the contralateral arm was provided to the wrist, elbow, and shoulder. Touching the wrist and elbow involved movements of the contralateral arm; no movements were produced while touching the shoulder. Grip force was reduced by approximately the same amount in all conditions with the finger touch compared to the no touch condition. This suggests that information from the muscle and joint receptors of the contralateral arm is used in control of grip force when a finger touch is provided to the wrist and elbow, and cutaneous information is utilized when lifting an object while touching the shoulder. The results of the study provide additional evidence to support the use of a second arm in the performance of activities of daily living and stress the importance of future studies investigating contralateral arm sensory input in grip force control. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Computed tomography demonstrates abnormalities of contralateral ear in subjects with unilateral sensorineural hearing loss.

PubMed

Marcus, Sonya; Whitlow, Christopher T; Koonce, James; Zapadka, Michael E; Chen, Michael Y; Williams, Daniel W; Lewis, Meagan; Evans, Adele K

2014-02-01

Prior studies have associated gross inner ear abnormalities with pediatric sensorineural hearing loss (SNHL) using computed tomography (CT). No studies to date have specifically investigated morphologic inner ear abnormalities involving the contralateral unaffected ear in patients with unilateral SNHL. The purpose of this study is to evaluate contralateral inner ear structures of subjects with unilateral SNHL but no grossly abnormal findings on CT. IRB-approved retrospective analysis of pediatric temporal bone CT scans. 97 temporal bone CT scans, previously interpreted as "normal" based upon previously accepted guidelines by board certified neuroradiologists, were assessed using 12 measurements of the semicircular canals, cochlea and vestibule. The control-group consisted of 72 "normal" temporal bone CTs with underlying SNHL in the subject excluded. The study-group consisted of 25 normal-hearing contralateral temporal bones in subjects with unilateral SNHL. Multivariate analysis of covariance (MANCOVA) was then conducted to evaluate for differences between the study and control group. Cochlea basal turn lumen width was significantly greater in magnitude and central lucency of the lateral semicircular canal bony island was significantly lower in density for audiometrically normal ears of subjects with unilateral SNHL compared to controls. Abnormalities of the inner ear were present in the contralateral audiometrically normal ears of subjects with unilateral SNHL. These data suggest that patients with unilateral SNHL may have a more pervasive disease process that results in abnormalities of both ears. The findings of a cochlea basal turn lumen width disparity >5% from "normal" and/or a lateral semicircular canal bony island central lucency disparity of >5% from "normal" may indicate inherent risk to the contralateral unaffected ear in pediatric patients with unilateral sensorineural hearing loss. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Is prophylactic fixation a cost-effective method to prevent a future contralateral fragility hip fracture?

PubMed

Faucett, Scott C; Genuario, James W; Tosteson, Anna N A; Koval, Kenneth J

2010-02-01

: A previous hip fracture more than doubles the risk of a contralateral hip fracture. Pharmacologic and environmental interventions to prevent hip fracture have documented poor compliance. The purpose of this study was to examine the cost-effectiveness of prophylactic fixation of the uninjured hip to prevent contralateral hip fracture. : A Markov state-transition model was used to evaluate the cost and quality-adjusted life-years (QALYs) for unilateral fixation of hip fracture alone (including internal fixation or arthroplasty) compared with unilateral fixation and contralateral prophylactic hip fixation performed at the time of hip fracture or unilateral fixation and bilateral hip pad protection. Prophylactic fixation involved placement of a cephalomedullary nail in the uninjured hip and was initially assumed to have a relative risk of a contralateral fracture of 1%. Health states included good health, surgery-related complications requiring a second operation (infection, osteonecrosis, nonunion, and malunion), fracture of the uninjured hip, and death. The primary outcome measure was the incremental cost-effectiveness ratio estimated as cost per QALY gained in 2006 US dollars with incremental cost-effectiveness ratios below $50,000 per QALY gained considered cost-effective. Sensitivity analyses evaluated the impact of patient age, annual mortality and complication rates, intervention effectiveness, utilities, and costs on the value of prophylactic fixation. : In the baseline analysis, in a 79-year-old woman, prophylactic fixation was not found to be cost-effective (incremental cost-effectiveness ratio = $142,795/QALY). However, prophylactic fixation was found to be a cost-effective method to prevent contralateral hip fracture in: 1) women 71 to 75 years old who had 30% greater relative risk for a contralateral fracture; and 2) women younger than age 70 years. Cost-effectiveness was greater when the additional costs of prophylaxis were less than $6000. However, for

SU-E-T-373: Evaluation and Reduction of Contralateral Skin /subcutaneous Dose for Tangential Breast Irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Butson, M; Carroll, S; Whitaker, M

2015-06-15

Purpose: Tangential breast irradiation is a standard treatment technique for breast cancer therapy. One aspect of dose delivery includes dose delivered to the skin caused by electron contamination. This effect is especially important for highly oblique beams used on the medical tangent where the electron contamination deposits dose on the contralateral breast side. This work aims to investigate and predict as well as define a method to reduce this dose during tangential breast radiotherapy. Methods: Analysis and calculation of breast skin and subcutaneous dose is performed using a Varian Eclipse planning system, AAA algorithm for 6MV x-ray treatments. Measurements weremore » made using EBT3 Gafchromic film to verify the accuracy of planning data. Various materials were tested to assess their ability to remove electron contamination on the contralateral breast. Results: Results showed that the Varian Eclipse AAA algorithm could accurately estimate contralateral breast dose in the build-up region at depths of 2mm or deeper. Surface dose was underestimated by the AAA algorithm. Doses up to 12% of applied dose were seen on the contralateral breast surface and up to 9 % at 2mm depth. Due to the nature of this radiation, being mainly low energy electron contamination, a bolus material could be used to reduce this dose to less than 3%. This is accomplished by 10 mm of superflab bolus or by 1 mm of lead. Conclusion: Contralateral breast skin and subcutaneous dose is present for tangential breast treatment and has been measured to be up to 12% of applied dose from the medial tangent beam. This dose is deposited at shallow depths and is accurately calculated by the Eclipse AAA algorithm at depths of 2mm or greater. Bolus material placed over the contralateral can be used to effectively reduce this skin dose.« less

Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

PubMed

Cho, Bum-Joo; Kim, Ji-Soo; Hwang, Jeong-Min

2013-12-01

A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

Contralateral Superior Cerebellar Artery Syndrome: A Consequence of Brain Herniation

PubMed Central

Mohseni, Meysam; Habibi, Zohreh; Nejat, Farideh

2017-01-01

Vascular compromise is a well-known consequence of brain herniation syndromes. Transtentorial brain herniation most often involves posterior cerebral arteries. However, isolated involvement of contralateral superior cerebellar artery (SCA) during unilateral impending brain herniation is reported only once and we present another case of this exceedingly rare entity. A 24-year-old man was referred to us with impending herniation due to a multiloculated hydrocephalus, and during the course of illness, he developed an isolated SCA ischemia in the opposite side of the most dilated entrapped horn. In the current article we discuss the probable pathophysiologic mechanisms of this phenomenon, as well as recommending more inclusive brain studies in cases suspected of Kernohan-Woltman notch phenomenon in unilateral brain herniation. The rationale for this commentary is that contralateral SCA transient ischemia or infarct might be the underdiagnosed underlying pathomechanism of ipsilateral hemiparesis occurring in many cases of this somehow vague phenomenon. PMID:28490164

Prior contralateral amputation predicts worse outcomes for lower extremity bypasses performed in the intact limb.

PubMed

Baril, Donald T; Goodney, Philip P; Robinson, William P; Nolan, Brian W; Stone, David H; Li, YouFu; Cronenwett, Jack L; Schanzer, Andres

2012-08-01

To date, history of a contralateral amputation as a potential predictor of outcomes after lower extremity bypass (LEB) for critical limb ischemia (CLI) has not been studied. We sought to determine if a prior contralateral lower extremity amputation predicts worse outcomes in patients undergoing LEB in the remaining intact limb. A retrospective analysis of all patients undergoing infrainguinal LEB for CLI between 2003 and 2010 within hospitals comprising the Vascular Study Group of New England was performed. Patients were stratified according to whether or not they had previously undergone a contralateral major or minor amputation before LEB. Primary end points included major amputation and graft occlusion at 1 year postoperatively. Secondary end points included in-hospital major adverse events, discharge status, and mortality at 1 year. Of 2636 LEB procedures, 228 (8.6%) were performed in the setting of a prior contralateral amputation. Patients with a prior amputation compared to those without were younger (66.5 vs 68.7; P = .034), more like to have congestive heart failure (CHF; 25% vs 16%; P = .002), hypertension (94% vs 85%; P = .015), renal insufficiency (26% vs 14%; P = .0002), and hemodialysis-dependent renal failure (14% vs 6%; P = .0002). They were also more likely to be nursing home residents (8.0% vs 3.6%; P = .036), less likely to ambulate without assistance (41% vs 80%; P < .0002), and more likely to have had a prior ipsilateral bypass (20% vs 12%; P = .0005). These patients experience increased in-hospital major adverse events, including myocardial infarction (MI; 8.9% vs 4.2%; P = .002), CHF (6.1% vs 3.4%; P = .044), deterioration in renal function (9.0% vs 4.7%; P = .006), and respiratory complications (4.2% vs 2.3%; P = .034). They were less likely to be discharged home (52% vs 72%; P < .0001) and less likely to be ambulatory on discharge (25% vs 55%; P < .0001). Although patients with a prior contralateral amputation experienced increased rates of

Prior contralateral amputation predicts worse outcomes for lower extremity bypasses performed in the intact limb

PubMed Central

Baril, Donald T.; Goodney, Philip P.; Robinson, William P.; Nolan, Brian W.; Stone, David H.; Li, YouFu; Cronenwett, Jack L.; Schanzer, Andres

2013-01-01

Introduction To date, history of a contralateral amputation as a potential predictor of outcomes after lower extremity bypass (LEB) for critical limb ischemia (CLI) has not been studied. We sought to determine if a prior contralateral lower extremity amputation predicts worse outcomes in patients undergoing LEB in the remaining intact limb. Methods A retrospective analysis of all patients undergoing infrainguinal LEB for CLI between 2003 and 2010 within hospitals comprising the Vascular Study Group of New England was performed. Patients were stratified according to whether or not they had previously undergone a contralateral major or minor amputation before LEB. Primary end points included major amputation and graft occlusion at 1 year postoperatively. Secondary end points included in-hospital major adverse events, discharge status, and mortality at 1 year. Results Of 2636 LEB procedures, 228 (8.6%) were performed in the setting of a prior contralateral amputation. Patients with a prior amputation compared to those without were younger (66.5 vs 68.7; P = .034), more like to have congestive heart failure (CHF; 25% vs 16%; P = .002), hypertension (94% vs 85%; P = .015), renal insufficiency (26% vs 14%; P = .0002), and hemodialysis-dependent renal failure (14% vs 6%; P = .0002). They were also more likely to be nursing home residents (8.0% vs 3.6%; P = .036), less likely to ambulate without assistance (41% vs 80%; P < .0002), and more likely to have had a prior ipsilateral bypass (20% vs 12%; P = .0005). These patients experience increased in-hospital major adverse events, including myocardial infarction (MI; 8.9% vs 4.2%; P = .002), CHF (6.1% vs 3.4%; P = .044), deterioration in renal function (9.0% vs 4.7%; P = .006), and respiratory complications (4.2% vs 2.3%; P = .034). They were less likely to be discharged home (52% vs 72%; P < .0001) and less likely to be ambulatory on discharge (25% vs 55%; P < .0001). Although patients with a prior contralateral amputation

Contralateral suppression of transient otoacoustic emissions and sentence recognition in noise in young adults.

PubMed

Stuart, Andrew; Butler, Alyson K

2012-10-01

One purported role of the medial olivocochlear (MOC) efferent system is to reduce the effects of masking noise. MOC system functioning can be evaluated noninvasively in humans through contralateral suppression of otoacoustic emissions. It has been suggested that the strength of the MOC efferent activity should be positively associated with listening performance in noise. The objective of the study was to further explore this notion by examining contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) and sentence recognition in two noises with normal hearing young adults. A repeated measures multivariate quasi-experimental design was employed. Thirty-two normal hearing young adult females participated. Reception thresholds for sentences (RTSs) were determined monaurally and binaurally in quiet and in competing continuous and interrupted noises. Both noises had an identical power spectrum and differed only in their temporal continuity. "Release from masking" was computed by subtracting RTS signal-to-noise ratios in interrupted from continuous noise. TEOAEs were evoked with 80 dB peSPL click stimuli. To examine contralateral suppression, TEOAEs were evaluated with 60 dB peSPL click stimuli with and without a contralateral 65 dB SPL white noise suppressor. A binaural advantage was observed for RTSs in quiet and noise (p < .0001) while there was no difference between ears (p >.05). In noise, performance was superior in the interrupted noise (i.e., RTSs were lower vs. continuous noise; p < .0001). There were no statistically significant differences in TEOAE levels between ears (p >.05). There was also no significant difference in the amount of suppression between ears (p = .41). There were no significant correlations or predictive linear relations between the amount of TEOAE suppression and any indices of sentence recognition in noise (i.e., RTS signal-to-noise ratios and release from masking; p > .05). The findings are not consistent with the notion

TMS activation of interhemispheric pathways between the posterior parietal cortex and the contralateral motor cortex

PubMed Central

Koch, Giacomo; Ruge, Diane; Cheeran, Binith; Fernandez Del Olmo, Miguel; Pecchioli, Cristiano; Marconi, Barbara; Versace, Viviana; Lo Gerfo, Emanuele; Torriero, Sara; Oliveri, Massimiliano; Caltagirone, Carlo; Rothwell, John C

2009-01-01

Using a twin coil transcranial magnetic stimulation (tc-TMS) approach we have previously demonstrated that facilitation may be detected in the primary motor cortex (M1) following stimulation over the ipsilateral caudal intraparietal sulcus (cIPS). Here we tested the interhemispheric interactions between the IPS and the contralateral motor cortex (M1). We found that conditioning the right cIPS facilitated contralateral M1 when the conditioning stimulus had an intensity of 90% resting motor threshold (RMT) but not at 70% or 110% RMT. Facilitation was maximal when the interstimulus interval (ISI) between cIPS and M1 was 6 or 12 ms. These facilitatory effects were mediated by interactions with specific groups of interneurons in the contralateral M1. In fact, short intracortical inhibition (SICI) was reduced following cIPS stimulation. Moreover, additional comparison of facilitation of responses evoked by anterior–posterior versus posterior–anterior stimulation of M1 suggested that facilitation was more effective on early I1/I2 circuits than on I3 circuits. In contrast to these effects, stimulation of anterior IPS (aIPS) at 90% RMT induced inhibition, instead of facilitation, of contralateral M1 at ISIs of 10–12 ms. Finally, we found similar facilitation between left cIPS and right M1 although the conditioning stimuli had to have a higher intensity compared with stimulation of right cIPS (110% instead of 90% RMT). These findings demonstrate that different subregions of the posterior parietal cortex (PPC) in humans exert both facilitatory and inhibitory effects towards the contralateral primary motor cortex. These corticocortical projections could contribute to a variety of motor tasks such as bilateral manual coordination, movement planning in space and grasping. PMID:19622612

Contralateral suppression of aldosterone at adrenal venous sampling predicts hyperkalemia following adrenalectomy for primary aldosteronism.

PubMed

Shariq, Omair A; Bancos, Irina; Cronin, Patricia A; Farley, David R; Richards, Melanie L; Thompson, Geoffrey B; Young, William F; McKenzie, Travis J

2018-01-01

We aimed to determine whether a greater degree of contralateral suppression of aldosterone secretion at adrenal venous sampling predicted the development of postoperative hyperkalemia after unilateral adrenalectomy for primary aldosteronism. A retrospective analysis of patients undergoing unilateral adrenalectomy for primary aldosteronism between 2004-2015 was performed. Clinical and biochemical parameters of patients who developed hyperkalemia (≥5.2 mmol/L) after unilateral adreanlectomy were compared with those who remained normokalemic. The contralateral suppression index was defined as the aldosterone-to-cortisol ratio from the nondominant adrenal vein divided by the aldosterone-to-cortisol ratio from the external iliac vein. Of 192 patients who met criteria for inclusion, 12 (6.3%) developed hyperkalemia (median serum potassium 5.5 mmol/L, range 5.2-6.2 mmol/L), with a median time to onset of 13.5 days (range 7-55 days). Five patients had transiently increased serum potassium concentrations that normalized spontaneously. Four patients received mineralocorticoid replacement therapy with fludrocortisone. On univariate analysis, hyperkalemic patients had slightly greater preoperative serum creatinine levels (1.2 vs 1.0 mg/dL, P = .01), higher postoperative creatinine (1.3 vs 1.0 mg/dL, P = .02), lesser median contralateral suppression index (0.14 vs 0.27, P = .03), and larger adenomas (1.9 vs 1.4 cm, P = .02). On multivariable logistic regression, the contralateral suppression index remained the only significant predictor of postoperative hyperkalemia (P = .04) with an optimal cut-off of <0.47. Hyperkalemia after unilateral adrenalectomy for primary aldosteronism is uncommon and usually transient, but may require mineralocorticoid supplementation. Patients with a contralateral suppression index of <0.47 require meticulous follow-up and monitoring of serum potassium concentrations after unilateral adrenalectomy. Copyright © 2017

Effect of muscle relaxation in the foot on simultaneous muscle contraction in the contralateral hand.

PubMed

Kato, Kouki; Kanosue, Kazuyuki

2016-10-28

We investigated the effects of foot muscle relaxation and contraction on muscle activities in the hand on both ipsilateral and contralateral sides. The subjects sat in an armchair with hands in the pronated position. They were able to freely move their right/left hand and foot. They performed three tasks for both ipsilateral (right hand and right foot) and contralateral limb coordination (left hand and right foot for a total of six tasks). These tasks involved: (1) wrist extension from a flexed (resting) position, (2) wrist extension with simultaneous ankle dorsiflexion from a plantarflexed (resting) position, and (3) wrist extension with simultaneous ankle relaxation from a dorsiflexed position. The subjects performed each task as fast as possible after hearing the start signal. Reaction time for the wrist extensor contraction (i.e. the degree to which it preceded the motor reaction time), as observed in electromyography (EMG), became longer when it was concurrently done with relaxation of the ankle dorsiflexor. Also, the magnitude of EMG activity became smaller, as compared with activity when wrist extensor contraction was done alone or with contraction of the ankle dorsiflexor. These effects were observed not only for the ipsilateral hand, but also for the contralateral hand. Our findings suggest that muscle relaxation in one limb interferes with muscle contraction in both the ipsilateral and contralateral limbs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The BRAFT1799A mutation is not associated with occult contralateral carcinoma in patients with unilateral papillary thyroid microcarcinoma.

PubMed

Wan, Han-Feng; Zhang, Bin; Yan, Dan-Gui; Xu, Zhen-Gang

2015-01-01

The phenomenon of occult carcinoma maybe observed in patients with clinically unilateral papillary thyroid microcarcinoma (PTMC). Although many studies have reported that the BRAFT1799A mutation is associated with aggressive PTMC, the relationship between BRAFT1799A mutation and occult carcinoma is unclear. The aim of this study was to investigate the risk factors, including BRAFT1799A mutation, for occult contralateral carcinoma in clinically unilateral PTMC accompanied by benign nodules in the contralateral lobe. From January 2011 to December 2013,we prospectively enrolled 89 consecutive PTMC patients with clinically unilateral carcinoma accompanied by benign nodules in the contralateral lobe who received a total thyroidectomy and cervical lymph node dissection. BRAFT1799A mutation was tested by pyrosequencing on postoperative paraffin specimens. The frequency and predictive factors for occult contralateral carcinoma were analyzed with respect to the following variables: age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or BRAFT1799A mutation. A total of 36 patients (40.4%) had occult PTMC in the contralateral lobe. The median diameter of the occult tumors was 0.33±0.21 cm. The BRAFT1799A mutation was found in 38 cases (42.7%). According to the univariate analysis, there were no significant differences between the presence of occult contralateral carcinoma and age, gender, family history, tumor size, presence of Hashimoto thyroiditis, extrathyroidal extension, central lymph node metastasis, multifocality of primary tumor, or BRAFT1799A mutation. Using current methods, it is difficult to preoperatively identify patients with PTMC, and further research is needed to determine predictive factors for the presence of occult contralateral carcinoma in patients with unilateral PTMC.

Contralateral approach to iliac artery recanalization with kissing nitinol stents present in the aortic bifurcation☆

PubMed Central

Joseph, George; Hooda, Amit; Thomson, Viji Samuel

2015-01-01

A 69-year-old man, who had earlier undergone reconstruction of the aortic bifurcation with kissing nitinol stents, presented with occlusion of the left external iliac artery. The occlusion was successfully and safely recanalized using contralateral femoral approach with passage of interventional hardware through the struts of the stents in the aortic bifurcation. Presence of contemporary flexible nitinol stents with open-cell design in the aortic bifurcation is not a contraindication to the use of the contralateral femoral approach. PMID:26702686

Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion.

PubMed

Yíldíz, Hamit; Durmus, Ali Said; Simşek, Halil; Yaman, Mine

2011-01-01

This study was designed to investigate prevention of contralateral testicular injury with sildenafil citrate after unilateral testicular torsion/detorsion. Thirty-seven adult male rats were divided into four groups: sham operated (group 1, n = 7), torsion/detorsion + saline (group 2, n = 10), torsion/detorsion + 0.7 mg of sildenafil citrate (group 3, n = 10) and torsion/detorsion + 1.4 mg of sildenafil citrate (group 4, n = 10). Unilateral testicular torsion was created by rotating the right testis 720º in a clockwise direction for 2 h in other groups, except for group 1, which was served as sham group. After torsion (2 h) and detorsion (2 h) periods, rats were killed. The level of reduced glutathion (GSH) (p < 0.05) and the activities of catalase (p < 0.01) and glutathione peroxidase (p < 0.05) in the contralateral testis from group 2 were significantly lower and nitric oxide (NO) (p < 0.05) level in the contralateral testis were significantly higher than those of group 1. Administration of low-dose sildenafil citrate (group 3) prevented the increases in malondialdehyde and NO levels and decreases in glutathione peroxidase activities and GSH values induced by testicular torsion. However, administration of high-dose sildenafil citrate (group 4) had no effect on these testicular parameters (p > 0.05). Histopathological changes were detected in groups 2, 3 and 4. These results suggest that biochemically and histologically torsion/detorsion injury occurs in the contralateral testis following 2-h torsion and 2-h detorsion and that administration of low-dose sildenafil citrate before detorsion prevents ischemia/reperfusion cellular damage in testicular tissue.

Dose-dependent effect of mammographic breast density on the risk of contralateral breast cancer.

PubMed

Chowdhury, Marzana; Euhus, David; O'Donnell, Maureen; Onega, Tracy; Choudhary, Pankaj K; Biswas, Swati

2018-07-01

Increased mammographic breast density is a significant risk factor for breast cancer. It is not clear if it is also a risk factor for the development of contralateral breast cancer. The data were obtained from Breast Cancer Surveillance Consortium and included women diagnosed with invasive breast cancer or ductal carcinoma in situ between ages 18 and 88 and years 1995 and 2009. Each case of contralateral breast cancer was matched with three controls based on year of first breast cancer diagnosis, race, and length of follow-up. A total of 847 cases and 2541 controls were included. The risk factors included in the study were mammographic breast density, age of first breast cancer diagnosis, family history of breast cancer, anti-estrogen treatment, hormone replacement therapy, menopausal status, and estrogen receptor status, all from the time of first breast cancer diagnosis. Both univariate analysis and multivariate conditional logistic regression analysis were performed. In the final multivariate model, breast density, family history of breast cancer, and anti-estrogen treatment remained significant with p values less than 0.01. Increasing breast density had a dose-dependent effect on the risk of contralateral breast cancer. Relative to 'almost entirely fat' category of breast density, the adjusted odds ratios (and p values) in the multivariate analysis for 'scattered density,' 'heterogeneously dense,' and 'extremely dense' categories were 1.65 (0.036), 2.10 (0.002), and 2.32 (0.001), respectively. Breast density is an independent and significant risk factor for development of contralateral breast cancer. This risk factor should contribute to clinical decision making.

Unilateral lesion of dorsal hippocampus in adult rats impairs contralateral long-term potentiation in vivo and spatial memory in the early postoperative phase.

PubMed

Li, Hongjie; Wu, Xiaoyan; Bai, Yanrui; Huang, Yan; He, Wenting; Dong, Zhifang

2012-05-01

It is well documented that bilateral hippocampal lesions or unilateral hippocampal lesion at birth causes impairment of contralateral LTP and long-term memory. However, effects of unilateral hippocampal lesion in adults on contralateral in vivo LTP and memory are not clear. We here examined the influence of unilateral electrolytic dorsal hippocampal lesion in adult rats on contralateral LTP in vivo and spatial memory during different postoperative phases. We found that acute unilateral hippocampal lesion had no effect on contralateral LTP. However, contralateral LTP was impaired at 1 week after lesion, and was restored to the control level at postoperative week 4. Similarly, spatial memory was also impaired at postoperative week 1, and was restored at postoperative week 4. In addition, the rats at postoperative week 1 showed stronger spatial exploratory behavior in a novel open-field environment. The sham operation had no effects on contralateral LTP, spatial memory and exploration at either postoperative week 1 or week 4. These results suggest that unilateral dorsal hippocampal lesion in adult rats causes transient contralateral LTP impairment and spatial memory deficit. Copyright © 2012 Elsevier B.V. All rights reserved.

Evaluating the dose to the contralateral breast when using a dynamic wedge versus a regular wedge.

PubMed

Weides, C D; Mok, E C; Chang, W C; Findley, D O; Shostak, C A

1995-01-01

The incidence of secondary cancers in the contralateral breast after primary breast irradiation is several times higher than the incidence of first time breast cancer. Studies have shown that the scatter radiation to the contralateral breast may play a large part in the induction of secondary breast cancers. Factors that may contribute to the contralateral breast dose may include the use of blocks, the orientation of the field, and wedges. Reports have shown that the use of regular wedges, particularly for the medial tangential field, gives a significantly higher dose to the contralateral breast compared to an open field. This paper compares the peripheral dose outside the field using a regular wedge, a dynamic wedge, and an open field technique. The data collected consisted of measurements taken with patients, solid water and a Rando phantom using a Varian 2300CD linear accelerator. Ion chambers, thermoluminescent dosimeters (TLD), diodes, and films were the primary means for collecting the data. The measurements show that the peripheral dose outside the field using a dynamic wedge is close to that of open fields, and significantly lower than that of regular wedges. This information indicates that when using a medial wedge, a dynamic wedge should be used.

The Influence of the Contralateral Knee Prior to Knee Arthroplasty on Post-Arthroplasty Function: The Multicenter Osteoarthritis Study

PubMed Central

Maxwell, Jessica; Niu, Jingbo; Singh, Jasvinder A.; Nevitt, Michael C.; Law, Laura Frey; Felson, David

2013-01-01

Background: Some of the poor functional outcomes of knee arthroplasty may be due to pain in the contralateral, unreplaced knee. We investigated the relationship between the preoperative pain status of the contralateral knee and the risk of a poor postoperative functional outcome in patients who underwent knee arthroplasty. Methods: We analyzed data on 271 patients in the Multicenter Osteoarthritis Study who had undergone knee arthroplasty since the time of enrollment. Eighty-six percent of these patients were white, 72% were female, and the mean age was sixty-seven years. The severity of pain in the knee contralateral to the one that was replaced was measured before the knee arthroplasty with use of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, with the scores being grouped into four categories (0, 1 to 4, 5 to 9, and 10 to 20). Poor post-arthroplasty function six months or more after surgery was determined with use of the Patient Acceptable Symptom State (PASS) outcome tool and a clinical performance measure of walking speed. We evaluated the relationship between contralateral pain severity and the functional outcomes with use of Poisson regression. Results: Seventy-two (27%) of 264 patients demonstrated poor post-arthroplasty function by failing to attain the threshold PASS score, and seventy-six (30%) of 250 subjects had a slow walking speed. As the pre-arthroplasty pain in the contralateral knee increased, there was a steady increase in the proportion with poor post-arthroplasty function (p < 0.0001 for PASS and p = 0.04 for slow walking speed). Compared with patients who had no pre-arthroplasty pain in the contralateral knee, those in the highest category of contralateral pain severity had 4.1 times the risk (95% confidence interval, 1.5 to 11.5) of having poor self-reported post-arthroplasty function. Patients in whom both knees had been replaced at the time of outcome collection were less likely to have poor self

Contralateral acute interdural haematoma occurring after burr hole drainage of chronic subdural haematoma.

PubMed

Eom, Ki Seong; Kim, Tae Young; Park, Jong Tae

2009-04-01

We report the case of a 78-year-old man with chronic subdural haematoma (CSDH) who presented with impairment in recent memory and gait disturbance. He underwent burr-hole craniostomy with a closed-drainage system. A computed tomography scan conducted on postoperative day 3 demonstrated an acute epidural haematoma over the contralateral frontoparietal convexity. Craniotomy and haematoma evacuation were immediately performed. The haematoma was located between the outer and inner dura mater that each comprise a single layer. To our knowledge, this is the first reported case of an acute haematoma located between the separated dura mater that occurred following drainage of a contralateral CSDH, and it is the second reported case of interdural haematoma over the cerebral convexity.

Reducing contralateral SI activity reveals hindlimb receptive fields in the SI forelimb-stump representation of neonatally amputated rats.

PubMed

Pluto, Charles P; Chiaia, Nicolas L; Rhoades, Robert W; Lane, Richard D

2005-09-01

In adult rats that sustained forelimb amputation on the day of birth, >30% of multiunit recording sites in the forelimb-stump representation of primary somatosensory cortex (SI) also respond to cutaneous hindlimb stimulation when cortical GABA(A+B) receptors are blocked (GRB). This study examined whether hindlimb receptive fields could also be revealed in forelimb-stump sites by reducing one known source of excitatory input to SI GABAergic neurons, the contralateral SI cortex. Corpus callosum projection neurons connect homotopic SI regions, making excitatory contacts onto pyramidal cells and interneurons. Thus in addition to providing monosynaptic excitation in SI, callosal fibers can produce disynaptic inhibition through excitatory synapses with inhibitory interneurons. Based on the latter of these connections, we hypothesized that inactivating the contralateral (intact) SI forelimb region would "unmask" normally suppressed hindlimb responses by reducing the activity of SI GABAergic neurons. The SI forelimb-stump representation was first mapped under normal conditions and then during GRB to identify stump/hindlimb responsive sites. After GRB had dissipated, the contralateral (intact) SI forelimb region was mapped and reversibly inactivated with injections of 4% lidocaine, and selected forelimb-stump sites were retested. Contralateral SI inactivation revealed hindlimb responses in approximately 60% of sites that were stump/hindlimb responsive during GRB. These findings indicate that activity in the contralateral SI contributes to the suppression of reorganized hindlimb receptive fields in neonatally amputated rats.

Studies of the mechanism of contralateral polyuria after renal artery stenosis.

PubMed Central

Galvez, O G; Roberts, B W; Mishkind, M H; Bay, W H; Ferris, T F

1977-01-01

Acute renal artery stenosis in hydropenic dogs caused a contralateral increase in urine volume and free water clearance without change in glomerular filtration, renal blood flow, or osmolar clearance. The increase in urine volume was not dependent on the development of hypertension since it occurred in animals pretreated with trimethaphan but was dependent upon angiotensin since it was presented with angiotensin blockade with Saralasin. The effect was not caused by angiotensin inhibiting antidiuretic hormone release since the polyuria occurred in hypophysectomized animals receiving a constant infusion of 10 muU/kg per min of aqueous Pitressin. Since the rise in urine volume was associated with an increase in renal vein prostaglandin E concentration and was prevented by pretreatment with indomethacin (5 mg/kg) the results suggest that the rise in plasma angiotensin after renal artery stenosis causes an increase in contralateral prostaglandin E synthesis with resultant antagonism to antidiuretic hormone at the collecting tubule. PMID:845253

Contralateral versus ipsilateral rTMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: comparative study.

PubMed

Khedr, E M; Abo-Elfetoh, N; Rothwell, J C; El-Atar, A; Sayed, E; Khalifa, H

2010-07-01

Repetitive transcranial magnetic stimulation (rTMS) applied over left temporoparietal cortex has been reported to have a long-term therapeutic effect on tinnitus. We compare the impact of 1 and 25 Hz rTMS delivered either contralateral or ipsilateral to symptoms in 62 patients with unilateral chronic tinnitus. Patients were randomly assigned to one of four treatment groups: with stimulation at 1 or 25 Hz applied either ipsilateral or contralateral to symptoms. Two thousand pulses per session were given daily for 2 weeks. Changes in tinnitus handicap inventory (THI), self-rating scores of loudness, awareness, and annoyance were measured monthly for 10 months. Duration of residual inhibition (RI) and psychiatric morbidity were evaluated monthly for 3 months. There was a significant main effect of time (P < 0.0001) and a significant time x side interaction (P = 0.032) between groups. This was because of the fact that contralateral stimulation had a greater effect on THI than ipsilateral stimulation; it was also superior to left side stimulation (P = 0.027). Ratings of loudness improved more after contralateral rTMS (P = 0.037). Twenty patients had no remaining tinnitus after 3 months; the remainder had a significant increase in RI. Patients with the shortest history of tinnitus tended to respond better to rTMS. There was a significant correlation between changes in THI score and changes in Hamilton anxiety and depression scores. Ten daily treatments of 1 and 25 Hz rTMS contralateral to the side of tinnitus have a greater beneficial effect on symptoms than either ipsilateral or left side stimulation.

Evaluation of contralateral kidney, liver and lung after extracorporeal shock wave lithotripsy in rabbits.

PubMed

Senyucel, M F; Boybeyi, O; Ayva, S; Aslan, M K; Soyer, T; Demet, A I; Kısa, U; Basar, M; Cakmak, M A

2013-10-01

An experimental study was carried out to evaluate the effects of extracorporeal shock wave lithotripsy (ESWL) on contralateral kidney, liver and lung by histopathological and biochemical methods. Twelve New Zealand rabbits were allocated to two groups (n = 6). Tissues of control group (CG, n = 6) were harvested without any intervention. In ESWL group (EG), right kidneys were exposed to 3,000 shock waves at 14 kV energy using electro-hydraulic type ESWL device three times every other day. Both kidneys, liver, and right lobe of lung tissues in EG were harvested on seventh day. Kidneys were examined histopathologically for presence of glomerular and tubular injury, interstitial edema, congestion, inflammation and fibrosis. Livers were examined for hepatocyte vacuolization, congestion, portal inflammation and fibrosis. Lung tissues were examined for loss of normal structure, emphysema, interstitial congestion-edema, prominent alveolar septal vessels, interstitial inflammation, intra-alveolar hemorrhage, intraluminal hemorrhage, peribronchial edema, congestion, inflammation in bronchial wall and epithelial desquamation. Biochemical analysis of tissue samples was performed for oxidative injury markers. Histopathological evaluations revealed that tubular injury was found in both shocked and contralateral kidneys (p < 0.05). EG showed higher grades of portal fibrosis in liver and higher grades of peribronchial congestion in lung when compared to CG (p < 0.05). Biochemical evaluations of both kidneys showed that malondialdehyde levels were higher in EG than in CG (p < 0.05). ESWL causes histopathologic alterations both in shocked and contralateral kidneys. Extrarenal tissues such as liver and lung can be affected by shock waves histopathologically and oxidative injury of contralateral kidney may occur acutely after ESWL.

The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

PubMed

Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

2008-06-01

Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

Proprioception in patients with posterior cruciate ligament tears: A meta-analysis comparison of reconstructed and contralateral normal knees

PubMed Central

Ko, Seung-Nam

2017-01-01

Posterior cruciate ligament (PCL) reconstruction for patients with PCL insufficiency has been associated with postoperative improvements in proprioceptive function due to mechanoreceptor regeneration. However, it is unclear whether reconstructed PCL or contralateral normal knees have better proprioceptive function outcomes. This meta-analysis was designed to compare the proprioceptive function of reconstructed PCL or contralateral normal knees in patients with PCL insufficiency. All studies that compared proprioceptive function, as assessed with threshold to detect passive movement (TTDPM) or joint position sense (JPS) in PCL reconstructed or contralateral normal knees were included. JPS was calculated by reproducing passive positioning (RPP). Five studies met the inclusion/exclusion criteria for the meta-analysis. The proprioceptive function, defined as TTDPM (95% CI: 0.25 to 0.51°; P<0.00001) and RPP (95% CI: 0.19 to 0.45°; P<0.00001), was significantly different between the reconstructed PCL and contralateral normal knees. The mean difference in angle of error between the reconstructed PCL and contralateral normal knees was 0.06° greater in TTDPM than by RPP. In addition, results from subgroup analyses, based on the starting angles and the moving directions of the knee, that evaluated TTDPM at 15° flexion to 45° extension, TTDPM at 45° flexion to 110° flexion, RPP in flexion, and RPP in extension demonstrated that mean angles of error were significantly greater, by 0.38° (P = 0.0001), 0.36° (P = 0.02), 0.36° (P<0.00001), and 0.23° (P = 0.04), respectively, in reconstructed PCL than in contralateral normal knees. The proprioceptive function of PCL reconstructed knees was decreased, compared with contralateral normal knees, as determined by both TTDPM and RPP. In addition, the amount of loss of proprioception was greater in TTDPM than in RPP, even with minute differences. Results from subgroup analysis, that evaluated the mean angles of error in moving

Malalignment and subchondral bone turnover in contralateral knees of overweight/obese women with unilateral osteoarthritis: implications for bilateral disease.

PubMed

Mazzuca, Steven A; Brandt, Kenneth D; Lane, Kathleen A; Chakr, Rafael

2011-11-01

To explore whether the risk of incident tibiofemoral (TF) osteoarthritis (OA) in the radiographically normal contralateral knee of overweight/obese women with unilateral knee OA is mediated by malalignment and/or preceded by increased turnover of subchondral bone. We used data of post hoc analyses from a randomized controlled trial. Cross-sectional analyses evaluated the baseline association between frontal plane alignment and bone turnover in the medial TF compartment in 78 radiographically normal contralateral knees. Longitudinal analyses ascertained whether incident radiographic OA (TF osteophyte formation within 30 months) was associated with malalignment and/or increased bone turnover at baseline. Alignment subcategories (varus/neutral/valgus) were based on the anatomic axis angle. (99m)Tc-methylene diphosphonate uptake in a late-phase bone scan was quantified in regions of interest in the medial tibia (MT) and medial femur (MF) and adjusted for uptake in a reference segment of the ipsilateral tibial shaft (TS). MF and MT uptake in varus contralateral knees was 50-55% greater than in the TS. Adjusted MT uptake in varus contralateral knees was significantly greater than that in neutral and valgus contralateral knees (mean 1.55 versus 1.38 and 1.43, respectively; P < 0.05). Among 69 contralateral knees followed longitudinally, 22 (32%) developed TF OA. Varus angulation was associated with a marginally significant increase in the odds of incident OA (adjusted odds ratio 3.98, P = 0.067). While the small sample size limited our ability to detect statistically significant risk factors, these data suggest that the risk of developing bilateral TF OA in overweight/obese women may be mediated by varus malalignment. Copyright © 2011 by the American College of Rheumatology.

Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?

PubMed

Gao, Kai-Ming; Lao, Jie; Guan, Wen-Jie; Hu, Jing-Jing

2018-01-01

If a partial contralateral C 7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C 7 nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C 7 nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C 7 root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C 7 root was transected and transferred to the median nerve. In the entire root + posterior division group, the entire contralateral C 7 root was transected but only the posterior division was transferred to the median nerve. After neurectomy, the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root + posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root + posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root + posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C 7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a

Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?

PubMed Central

Gao, Kai-ming; Lao, Jie; Guan, Wen-jie; Hu, Jing-jing

2018-01-01

If a partial contralateral C7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C7 nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C7 nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C7 root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C7 root was transected and transferred to the median nerve. In the entire root + posterior division group, the entire contralateral C7 root was transected but only the posterior division was transferred to the median nerve. After neurectomy, the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root + posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root + posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root + posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a donor

The Effect of Contralateral Acoustic Stimulation on Spontaneous Otoacoustic Emissions

PubMed Central

Dhar, Sumitrajit

2009-01-01

Evoked otoacoustic emissions are often used to study the medial olivocochlear (MOC) efferents in humans. There has been concern that the emission-evoking stimulus may itself elicit efferent activity and alter the evoked otoacoustic emission. Spontaneous otoacoustic emissions (SOAEs) are hence advantageous as no external stimulation is necessary to record the response in the test ear. Contralateral acoustic stimulation (CAS) has been shown to suppress SOAE level and elevate SOAE frequency, but the time course of these effects is largely unknown. By utilizing the Choi–Williams distribution, here we report a gradual adaptation during the presence of CAS and an overshoot following CAS offset in both SOAE magnitude and frequency from six normal-hearing female human subjects. Furthermore, we have quantified the time constants of both magnitude and frequency shifts at the onset, presence, and offset of four levels of CAS. Most studies using contralateral elicitors do not stringently control the middle-ear muscle (MEM) reflex, leaving the results difficult to interpret. In addition to clinically available measures of the MEM reflex, we have incorporated a sensitive laboratory technique to monitor the MEM reflex in our subjects, allowing us to interpret the results with greater confidence. PMID:19798532

Backward masked fearful faces enhance contralateral occipital cortical activity for visual targets within the spotlight of attention

PubMed Central

Reinke, Karen S.; LaMontagne, Pamela J.; Habib, Reza

2011-01-01

Spatial attention has been argued to be adaptive by enhancing the processing of visual stimuli within the ‘spotlight of attention’. We previously reported that crude threat cues (backward masked fearful faces) facilitate spatial attention through a network of brain regions consisting of the amygdala, anterior cingulate and contralateral visual cortex. However, results from previous functional magnetic resonance imaging (fMRI) dot-probe studies have been inconclusive regarding a fearful face-elicited contralateral modulation of visual targets. Here, we tested the hypothesis that the capture of spatial attention by crude threat cues would facilitate processing of subsequently presented visual stimuli within the masked fearful face-elicited ‘spotlight of attention’ in the contralateral visual cortex. Participants performed a backward masked fearful face dot-probe task while brain activity was measured with fMRI. Masked fearful face left visual field trials enhanced activity for spatially congruent targets in the right superior occipital gyrus, fusiform gyrus and lateral occipital complex, while masked fearful face right visual field trials enhanced activity in the left middle occipital gyrus. These data indicate that crude threat elicited spatial attention enhances the processing of subsequent visual stimuli in contralateral occipital cortex, which may occur by lowering neural activation thresholds in this retinotopic location. PMID:20702500

Effect of ligamenta flava hypertrophy on lumbar disc herniation with contralateral symptoms and signs: a clinical and morphometric study

PubMed Central

Yildizhan, Ahmet; Atar, Elmas K.; Yaycioglu, Soner; Gocmen-Mas, Nuket; Yazici, Canan

2010-01-01

Introduction The purpose of this study was to determine whether ligamentum flavum hypertrophy among disc herniated patients causes contralateral pain symptoms. For this reason we measured the thickness of the ligament in disc herniated patients with ipsilateral or contralateral symptoms. Material and methods Two hundred disc herniated patients with ipsilateral symptoms as group I were compared with five disc herniated patients with only contralateral symptoms as group II. Ligamenta flava thicknesses and spinal canal diameters of both groups were measured on magnetic resonance imaging (MRI) with a micro-caliper. Results Both groups underwent surgery only on the disc herniated side. The total thicknesses of the ligamenta flava in group II was thicker than in group I. There was no spinal stenosis in either group and no significance difference between the groups. Statistically significant differences were found for both ipsilateral and contralateral thickness of the ligament flava in both groups. We also compared thickness of the ligamenta flava for each level of disc herniation in group I; ligamenta flava hypertrophy was more common at L3-L4 and L4-L5 levels of vertebrae in females. Conclusions Aetiology of contralateral sciatica among disc herniated patients may be related to hypertrophy of the ligamenta flava, especially on the opposite side. Surgical approaches of the disc herniated side alone may be sufficient for a good outcome. PMID:22371809

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma

PubMed Central

Fan, Song; Tang, Qiong-lan; Lin, Ying-jin; Chen, Wei-liang; Li, Jin-song; Huang, Zhi-quan; Yang, Zhao-hui; Wang, You-yuan; Zhang, Da-ming; Wang, Hui-jing; Dias-Ribeiro, Eduardo; Cai, Qiang; Wang, Lei

2011-01-01

Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently. PMID:22010576

The Aortic Bifurcation Angle as a Factor in Application of the Outback for Femoropopliteal Lesions in Ipsilateral Versus Contralateral Approaches.

PubMed

Raskin, Daniel; Khaitovich, Boris; Balan, Shmuel; Silverberg, Daniel; Halak, Moshe; Rimon, Uri

2018-01-01

To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site. Technical success was assessed. During the study period, a total of 1300 endovascular procedures were performed on 489 patients for CLI. The Outback was applied on 50 femoropopliteal chronic total occlusions. Thirty-nine contralateral and 11 ipsilateral antegrade femoral were accessed. The device was used successfully in 41 patients (82%). There were nine failures, all in the contralateral approach group. Six due to inability to deliver the device due to acute aortic bifurcation angle and three due to failure to achieve luminal reentry. Procedural success was significantly affected by the aortic bifurcation angle (p = 0.013). The Outback has high technical success rates in treatment of femoropopliteal occlusion, when applied from either an ipsi- or contralateral approach. When applied in contralateral access, acute aortic bifurcation angle predicts procedural failure.

Effects of contralateral white noise stimulation on distortion product otoacoustic emissions in myasthenic patients.

PubMed

Di Girolamo, S; d'Ecclesia, A; Quaranta, N; Garozzo, A; Evoli, A; Paludetti, G

2001-12-01

Myasthenia gravis (MG) induces a reduction of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) that reverses partially after administration of an acetylcholinesterase (AChE) inhibitor. In normal subjects a contralateral acoustic stimulation (CAS) produces an amplitude reduction of TEOAEs and DPOAEs. This effect, called contralateral suppression (CS), is mediated by the efferent auditory system. Twenty subjects affected by MG underwent DPOAE recording with and without contralateral white noise in a drug-free baseline period ('basal') and 1 h ('post') after administration of a reversible AChE inhibitor. In 'basal' condition CAS did not induce significant DPOAE amplitude changes but a paradoxical slight increase was observed. After drug administration, CAS produced a significant decrease of DPOAE amplitudes for middle frequencies (f(2) between 1306 and 2600 Hz). In normal controls CAS caused a significant decrease (P<0.001) for all frequencies. The amount of CS in controls and in the MG 'post' condition was not significantly different. The increased acetylcholine (ACh) availability following drug consumption seems to partially restore outer hair cell function and enhances their electromotility; a further influx of ACh due to CAS yields to restoration of the CS. These findings also suggest that DPOAEs may be useful in the diagnosis of MG and for monitoring the effectiveness of treatment.

Robotic simulation of identical athletic-task kinematics on cadaveric limbs exhibits a lack of differences in knee mechanics between contralateral pairs

PubMed Central

Bates, Nathaniel A.; McPherson, April L.; Nesbitt, Rebecca J.; Shearn, Jason T.; Myer, Gregory D.; Hewett, Timothy E.

2017-01-01

Limb asymmetry is a known factor for increased ACL injury risk. These asymmetries are normally observed during in vivo testing. Prior studies have developed in vitro testing methodologies driven by in vivo kinematics to investigate knee mechanics relative to ACL injury. The objective of this study was to determine if mechanical side-to-side asymmetries persist in contralateral pairs during in vitro simulation testing. In vivo kinematics were recorded for male and female drop vertical jump and sidestep cutting tasks. The recorded kinematics were used to robotically simulate the motions on 7 contralateral pairs of cadaveric lower extremities specimens. ACL and MCL force, torque, and strains were recorded and analyzed for differences between contralateral pairs. There was a general lack of mechanical differences between limb sides. Adduction peak torque for the male sidestep cut movement was significantly different between limb sides (p = 0.04). However, this is consistent with ACL injury mechanics in that movement in the frontal plane (abduction/adduction) increases injury risk and it is possible loading differences in this plane may have resulted from tolerances within the setup process. The findings of this study indicate that contralateral knee joints were representative of each other during biomechanical in vitro tests. In future cadaveric robotic simulations, contralateral limbs can be used interchangeably. In addition, direct comparisons of the structural behaviors of isolated conditions for contralateral knee joints can be performed. PMID:28062120

Role of Active Listening and Listening Effort on Contralateral Suppression of Transient Evoked Otoacousic Emissions.

PubMed

Kalaiah, Mohan Kumar; Theruvan, Nikhitha B; Kumar, Kaushlendra; Bhat, Jayashree S

2017-04-01

The present study aimed to investigate the effect of active listening and listening effort on the contralateral suppression of transient evoked otoacoustic emissions (CSTEOAEs). Twenty eight young adults participated in the study. Transient evoked otoacoustic emissions (TEOAEs) were recorded using 'linear' clicks at 60 dB peSPL, in three contralateral noise conditions. In condition 1, TEOAEs were obtained in the presence of white noise in the contralateral ear. While, in condition 2, speech was embedded into white noise at +3, -3, and -9 dB signal-to-noise ratio (SNR) and delivered to the contralateral ear. The SNR was varied to investigate the effect of listening effort on the CSTEOAE. In condition 3, speech was played backwards and embedded into white noise at -3 dB SNR. The conditions 1 and 3 served as passive listening condition and the condition 2 served as active listening condition. In active listening condition, the participants categorized the words in to two groups (e.g., animal and vehicle). CSTEOAE was found to be largest in the presence of white noise, and the amount of CSTEOAE was not significantly different between active and passive listening conditions (condition 2 and 3). Listening effort had an effect on the CSTEOAE, the amount of suppression increased with listening effort, when SNR was decreased from +3 dB to -3 dB. However, when the SNR was further reduced to -9 dB, there was no further increase in the amount of CSTEOAE, instead there was a reduction in the amount of suppression. The findings of the present study show that listening effort might affect CSTEOAE.

The value of preoperative 18F-FDG PET/CT for the assessing contralateral neck in head and neck cancer patients with unilateral node metastasis (N1-3).

PubMed

Joo, Y-H; Yoo, I-R; Cho, K-J; Park, J-O; Nam, I-C; Kim, C-S; Kim, S-Y; Kim, M-S

2014-12-01

The purpose of this study was to determine whether preoperative (18) F-FDG PET/CT is useful in assessing contralateral lymph node metastasis in the neck. A retrospective review of medical records was performed. Patients treated at a single institute. One hundred and fifty-seven patients whose pathology results were positive for unilateral node metastasis (N1-3) involvement and underwent preoperative (18) F-FDG PET/CT for head and neck squamous cell carcinoma (HNSCC) were reviewed. Prognostic factors and nodal SUVmax were studied to identify the risk of contralateral disease. Thirty-six (22.9%) patients had contralateral cervical lymph node metastases. The (18) F-FDG PET/CT had a sensitivity of 80% and a specificity of 96% in identifying the contralateral cervical lymph node metastases on a level-by-level basis. The median SUVmax values of the ipsilateral and contralateral lymph nodes were 3.99 ± 3.36 (range, 0-20.4) and 2.94 ± 2.04 (range, 0-8.7), respectively (P = 0.001). There was a significant difference in the median SUVmax of contralateral nodes between the benign and malignant cervical lymph nodes (2.31 ± 0.62 versus 3.28 ± 2.43, P = 0.014). The cut-off value of contralateral median SUVmax in the context of contralateral cervical metastasis was 2.5 with the sensitivity of 75% and the specificity of 94%. A median contralateral lymph node SUVmax  ≥ 2.5 was associated with 5-year disease-specific survival (P = 0.038). (18) F-FDG PET/CT median SUVmax cut-off values of contralateral lymph nodes ≥2.5 were associated with contralateral cervical lymph node metastases and 5-year disease-specific survival in HNSCC patients with unilateral metastases. © 2014 John Wiley & Sons Ltd.

Improvement in Cerebral and Ocular Hemodynamics Early after Carotid Endarterectomy in Patients of Severe Carotid Artery Stenosis with or without Contralateral Carotid Occlusion.

PubMed

Wang, Jian; Wang, Weici; Jin, Bi; Zhang, Yanrong; Xu, Ping; Xiang, Feixiang; Zheng, Yi; Chen, Juan; Sheng, Shi; Ouyang, Chenxi; Li, Yiqing

2016-01-01

Purpose. To investigate the alternation in cerebral and ocular blood flow velocity (BFV) in patients of carotid stenosis (CS) with or without contralateral carotid occlusion (CO) early after carotid endarterectomy (CEA). Patients and Methods. Nineteen patients underwent CEA for ≥50% CS. Fourteen patients had the unilateral CS, and five patients had the ipsilateral CS and the contralateral CO. Transcranial Doppler (TCD) and Color Doppler Imaging (CDI) were performed before and early after CEA. Results. In patients with unilateral CS, significant improvements in BFV were observed in anterior cerebral artery (ACA) and middle cerebral artery (MCA) on the ipsilateral side after CEA. In patients of ipsilateral CS and contralateral CO, significant improvements in BFV were observed in the ACA and MCA not only on the ipsilateral side but also on the contralateral side postoperatively. The ipsilateral ophthalmic artery (OA) retrograde flows in two patients were recovered to anterograde direction following CEA. The BFV in short posterior ciliary artery (SPCA) of the ipsilateral side significantly increased postoperatively irrespective of the presence of contralateral CO. Conclusions. CEA improved cerebral anterior circulation hemodynamics especially in patients of unilateral CS and contralateral CO, normalized the OA reverse flow, and increased the blood perfusion of SPCA.

[Contralateral hepatic hypertrophy following unilateral yttrium-90 radioembolization : Implications for liver surgery].

PubMed

Garlipp, B; Seidensticker, M; Jechorek, D; Ptok, H; Bruns, C J; Ricke, J

2016-05-01

Preservation of an adequate future liver remnant (FLR) is the principal limitation to liver surgery in patients with primary or secondary liver malignancies. Hence, methods to increase the volume of the FLR in preparation for liver resection are gaining in importance. In addition to the traditional methods for induction of FLR hypertrophy, such as portal vein embolization (PVE) or portal vein ligation (PVL) with or without parenchymal dissection (ALPPS, in situ split), radioembolization (RE) using yttrium-90 microspheres also leads to a volume increase of non-embolized liver parenchyma. This review outlines its potential role as an alternative procedure for induction of liver hypertrophy. Synopsis and critical discussion of the available literature on the mechanisms of induction of liver hypertrophy, the advantages and drawbacks of the traditional methods, and current research on volume changes associated with RE as well as their implications for possible clinical use in preparation for liver surgery. Both PVE and PVL can achieve a substantial contralateral volume gain of up to 70 %. The development of contralateral hypertrophy can be accelerated by dissecting the liver parenchyma along the intended plane of resection in addition to PVL (in situ split). Compared to these methods, RE achieves less contralateral liver hypertrophy; however, this effect should not be disregarded as RE provides effective treatment of ipsilateral liver tumors along with induction of hypertrophy and may be associated with a reduced risk of tumor progression compared to PVE and PVL. The available data suggest that RE can complement the armamentarium of methods for induction of FLR hypertrophy in specific situations. Further studies are needed to establish its definitive role for this indication and are in preparation.

Contralateral Breast Dose After Whole-Breast Irradiation: An Analysis by Treatment Technique

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, Terence M.; Moran, Jean M., E-mail: jmmoran@med.umich.edu; Hsu, Shu-Hui

2012-04-01

Purpose: To investigate the contralateral breast dose (CBD) across a continuum of breast-conservation therapy techniques. Methods and Materials: An anthropomorphic phantom was CT-simulated, and six treatment plans were generated: open tangents, tangents with an external wedge on the lateral beam, tangents with lateral and medial external wedges, a simple segment plan (three segments per tangent), a complex segmental intensity-modulated radiotherapy (IMRT) plan (five segments per tangent), and a beamlet IMRT plan (>100 segments). For all techniques, the breast on the phantom was irradiated to 5000 cGy. Contralateral breast dose was measured at a uniform depth at the center and eachmore » quadrant using thermoluminescent detectors. Results: Contralateral breast dose varied with position and was 50 {+-} 7.3 cGy in the inner half, 24 {+-} 4.1 cGy at the center, and 16 {+-} 2.2 cGy in the outer half for the open tangential plan. Compared with an average dose of 31 cGy across all points for the open field, the average doses were simple segment 32 cGy (range, 99-105% compared with open technique), complex segment 34 cGy (range, 103-117% compared with open technique), beamlet IMRT 34 cGy (range, 103-124% compared with open technique), lateral wedge only 46 cGy (range, 133-175% compared with open technique), and medial and lateral wedge 96 cGy (range, 282-370% compared with open technique). Conclusions: Single or dual wedge techniques resulted in the highest CBD increases compared with open tangents. To obtain the desired homogeneity to the treated breast while minimizing CBD, segmental and IMRT techniques should be encouraged over external physical compensators.« less

Role of Active Listening and Listening Effort on Contralateral Suppression of Transient Evoked Otoacousic Emissions

PubMed Central

Theruvan, Nikhitha B; Kumar, Kaushlendra; Bhat, Jayashree S

2017-01-01

Background and Objectives The present study aimed to investigate the effect of active listening and listening effort on the contralateral suppression of transient evoked otoacoustic emissions (CSTEOAEs). Subjects and Methods Twenty eight young adults participated in the study. Transient evoked otoacoustic emissions (TEOAEs) were recorded using ‘linear’ clicks at 60 dB peSPL, in three contralateral noise conditions. In condition 1, TEOAEs were obtained in the presence of white noise in the contralateral ear. While, in condition 2, speech was embedded into white noise at +3, −3, and −9 dB signal-to-noise ratio (SNR) and delivered to the contralateral ear. The SNR was varied to investigate the effect of listening effort on the CSTEOAE. In condition 3, speech was played backwards and embedded into white noise at −3 dB SNR. The conditions 1 and 3 served as passive listening condition and the condition 2 served as active listening condition. In active listening condition, the participants categorized the words in to two groups (e.g., animal and vehicle). Results CSTEOAE was found to be largest in the presence of white noise, and the amount of CSTEOAE was not significantly different between active and passive listening conditions (condition 2 and 3). Listening effort had an effect on the CSTEOAE, the amount of suppression increased with listening effort, when SNR was decreased from +3 dB to −3 dB. However, when the SNR was further reduced to −9 dB, there was no further increase in the amount of CSTEOAE, instead there was a reduction in the amount of suppression. Conclusions The findings of the present study show that listening effort might affect CSTEOAE. PMID:28417101

Dose to the contralateral breast: a comparison of two techniques using the enhanced dynamic wedge versus a standard wedge.

PubMed

Warlick, W B; O'Rear, J H; Earley, L; Moeller, J H; Gaffney, D K; Leavitt, D D

1997-01-01

The dose to the contralateral breast has been associated with an increased risk of developing a second breast malignancy. Varying techniques have been devised and described in the literature to minimize this dose. Metal beam modifiers such as standard wedges are used to improve the dose distribution in the treated breast, but unfortunately introduce an increased scatter dose outside the treatment field, in particular to the contralateral breast. The enhanced dynamic wedge is a means of remote wedging created by independently moving one collimator jaw through the treatment field during dose delivery. This study is an analysis of differing doses to the contralateral breast using two common clinical set-up techniques with the enhanced dynamic wedge versus the standard metal wedge. A tissue equivalent block (solid water), modeled to represent a typical breast outline, was designed as an insert in a Rando phantom to simulate a standard patient being treated for breast conservation. Tissue equivalent material was then used to complete the natural contour of the breast and to reproduce appropriate build-up and internal scatter. Thermoluminescent dosimeter (TLD) rods were placed at predetermined distances from the geometric beam's edge to measure the dose to the contralateral breast. A total of 35 locations were used with five TLDs in each location to verify the accuracy of the measured dose. The radiation techniques used were an isocentric set-up with co-planar, non divergent posterior borders and an isocentric set-up with a half beam block technique utilizing the asymmetric collimator jaw. Each technique used compensating wedges to optimize the dose distribution. A comparison of the dose to the contralateral breast was then made with the enhanced dynamic wedge vs. the standard metal wedge. The measurements revealed a significant reduction in the contralateral breast dose with the enhanced dynamic wedge compared to the standard metal wedge in both set-up techniques. The

Screening for carcinoma in situ in the contralateral testicle in patients with testicular cancer: a population-based study.

PubMed

Kier, M G G; Lauritsen, J; Almstrup, K; Mortensen, M S; Toft, B G; Rajpert-De Meyts, E; Skakkebaek, N E; Rørth, M; von der Maase, H; Agerbaek, M; Holm, N V; Andersen, K K; Dalton, S O; Johansen, C; Daugaard, G

2015-04-01

Screening programmes for contralateral carcinoma in situ (CIS) testis in patients with unilateral germ-cell cancer (GCC) have never been evaluated. We investigated the effect of screening for contralateral CIS in a large nation-wide, population-based study. A contralateral single-site biopsy was offered to 4130 patients in whom GCC had been diagnosed in 1984-2007 (screened cohort); 462 patients in whom GCC was diagnosed in 1984-1988 comprised the unscreened cohort. Cases with CIS were offered radiotherapy. Initially CIS-negative biopsies in patients with metachronous GCC were revised according to today's standards. Risk for metachronous GCC was estimated using cumulative incidence and the Cox proportional hazards model. In the screened cohort, contralateral CIS was found in 181 (4.4%) patients. The cumulative incidence of metachronous GCC after 20 years was 1.9% in the screened cohort and 3.1% in the unscreened cohort (P = 0.097), hazard ratio (HR) for the unscreened cohort: 1.59 (P = 0.144). Expert revision with contemporary methodology of CIS-negative biopsy samples from patients with metachronous cancer revealed CIS in 17 out of 45 (38%) cases. Decreased risks for metachronous GCC were related to older age at diagnosis (HR 0.52 per 10 years, P < 0.001) and chemotherapy (HR 0.35, P = 0.002). Limitations include the small number of patients in the unscreened cohort and the retrospective study design. Our evaluation of a national population-based screening programme for contralateral CIS in patients with testicular cancer showed no significant difference in the risk for metachronous GCC between a screened and an unscreened cohort. Single-site biopsy including modern immunohistochemistry does not identify all cases of CIS. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Contralateral cerebello-thalamo-cortical pathways with prominent involvement of associative areas in humans in vivo.

PubMed

Palesi, Fulvia; Tournier, Jacques-Donald; Calamante, Fernando; Muhlert, Nils; Castellazzi, Gloria; Chard, Declan; D'Angelo, Egidio; Wheeler-Kingshott, Claudia A M

2015-11-01

In addition to motor functions, it has become clear that in humans the cerebellum plays a significant role in cognition too, through connections with associative areas in the cerebral cortex. Classical anatomy indicates that neo-cerebellar regions are connected with the contralateral cerebral cortex through the dentate nucleus, superior cerebellar peduncle, red nucleus and ventrolateral anterior nucleus of the thalamus. The anatomical existence of these connections has been demonstrated using virus retrograde transport techniques in monkeys and rats ex vivo. In this study, using advanced diffusion MRI tractography we show that it is possible to calculate streamlines to reconstruct the pathway connecting the cerebellar cortex with contralateral cerebral cortex in humans in vivo. Corresponding areas of the cerebellar and cerebral cortex encompassed similar proportion (about 80%) of the tract, suggesting that the majority of streamlines passing through the superior cerebellar peduncle connect the cerebellar hemispheres through the ventrolateral thalamus with contralateral associative areas. This result demonstrates that this kind of tractography is a useful tool to map connections between the cerebellum and the cerebral cortex and moreover could be used to support specific theories about the abnormal communication along these pathways in cognitive dysfunctions in pathologies ranging from dyslexia to autism.

Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds.

PubMed

Reis, Luis Roque; Fernandes, Paulo; Escada, Pedro

Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Bilateral totally extraperitoneal (TEP) repair of the ultrasound-diagnosed asymptomatic contralateral inguinal hernia.

PubMed

Malouf, Phillip A; Descallar, Joseph; Berney, Christophe R

2018-02-01

The aim of this series is to determine the clinical utility of routine ultrasound (US) of the contralateral, clinically normal groin when a unilateral inguinal hernia is referred for hernia repair-specifically assessing the morbidity and short-term change in quality-of-life (QoL) due to repair of this occult contralateral hernia when also repairing the symptomatic side. TEP inguinal hernia repair affords the opportunity to repair any groin hernia through the same small incisions. US detects 96.6% of groin hernias with 84.4% specificity. 234 consecutive male patients with clinically unilateral and clinically bilateral hernia were enrolled; those with a clinically unilateral hernia were sent for groin US and if positive, a bilateral TEP groin hernia repair was performed (USBH). If negative, a unilateral TEP groin hernia repair was performed (UNIH). Carolina's comfort scales (CCS) and visual analogue scores (VAS) were recorded at 2 and 6 weeks postoperatively, while a modified CCS (MCCS) was recorded for all patients preoperatively. Bilateral TEP repair resulted in higher VAS scores than unilateral repair at 2 weeks but not 6 weeks. CCS were worse in the USBH group than UNIH group at 2 weeks but were similar by 6 weeks. Complications' rates were similar amongst all 3 groups. Factors contributing to worse scores were: smaller hernia, complications, worse preoperative MCCS results, recurrent hernia and bilateral rather than unilateral repair. Bilateral TEP for the clinically unilateral groin hernia with an occult contralateral groin hernia can be performed without increased morbidity, accepting a minor and very temporary impairment of QoL.

Relationship of unilateral total hip arthroplasty (THA) to contralateral and ipsilateral knee joint degeneration - a longitudinal 3T MRI study from the Osteoarthritis Initiative (OAI).

PubMed

Jungmann, P M; Nevitt, M C; Baum, T; Liebl, H; Nardo, L; Liu, F; Lane, N E; McCulloch, C E; Link, T M

2015-07-01

To evaluate the association of prevalent unilateral total hip arthroplasty (THA) with worsening of degenerative knee abnormalities and clinical outcomes in the ipsilateral and contralateral knee. Both knees of 30 individuals in the Osteoarthritis Initiative (OAI) with unilateral THA (n = 14 left, n = 16 right) at baseline were assessed at baseline and at 4-year follow-up for Whole-organ MR Imaging Scores (WORMS), cartilage T2 relaxation times (only available for right knees), Western Ontario and McMasters Universities Arthritis Index (WOMAC) scores and upper leg isometric strength. Right knees of 30 individuals without THA were analyzed as controls. Contralateral knees were compared to ipsilateral knees with paired t-tests and to control knees with multivariate regression analysis adjusting for covariates. In paired analyses, compared to ipsilateral knees, contralateral knees had higher WORMS total (P = 0.008) and cartilage scores (P = 0.007) at baseline. Over 4 years contralateral knees worsened more on WORMS total score (P = 0.008). Cartilage T2 values were higher in knees contralateral to the THA (baseline, P = 0.02; follow-up, P < 0.001). Contralateral knees had greater declines in knee extension strength (P = 0.04) and had a trend for greater worsening in WOMAC pain, stiffness, function and total scores (P = 0.04-0.09). Similar results were found comparing contralateral knees with control knees in multivariate regression models. Prevalent unilateral THA is associated with an greater progression of degenerative findings for the knee contralateral to THA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The prevalence of rotator cuff tears: is the contralateral shoulder at risk?

PubMed

Liem, Dennis; Buschmann, Vera Elisa; Schmidt, Carolin; Gosheger, Georg; Vogler, Tim; Schulte, Tobias L; Balke, Maurice

2014-04-01

Rotator cuff tears are a common cause of pain and disability of the shoulder. Information on the prevalence and identification of potential risk factors could help in early detection of rotator cuff tears and improve treatment outcome. Patients treated for a symptomatic rotator cuff tear on one side have a higher prevalence of rotator cuff tears and decreased shoulder function on the contralateral side compared with an age- and sex-matched group of healthy individuals. Case control study; Level of evidence, 3. One group consisted of 55 patients who had been arthroscopically treated on one shoulder for rotator cuff tear (tear group). In this group, the nonoperated contralateral shoulder was examined. For comparison, the matching shoulder in a control group consisting of 55 subjectively healthy individuals matched by age (±1 year) and sex to the tear group was included. Diagnosis of a rotator cuff tear was made by ultrasound. Outcomes were measured using the Constant score. The prevalence of supraspinatus tears was significantly higher (P < .0001) in the tear group (67.3%) compared with the control group (11.0%). The Constant score for the activities of daily living subscale, however, was significantly lower (18.4) in the tear group compared with the control group (19.9; P = .012). No other subcategory score nor the overall score showed a significant difference. There was a significantly higher tear prevalence in the tear group of patients aged between 50 and 59 years (P < .001) and 60 and 69 years (P = .004). No tear was diagnosed in the control group in individuals younger than 60 years. Patients treated for partial and full-thickness rotator cuff tears have a significantly higher risk of having a tear on the contralateral side and have noticeable deficits in their shoulder function regarding activities of daily living even if the tear is otherwise asymptomatic.

Is NAA reduction in normal contralateral cerebral tissue in stroke patients dependent on underlying risk factors?

PubMed

Walker, P M; Ben Salem, D; Giroud, M; Brunotte, F

2006-05-01

This retrospective study investigated the dependence of N-acetyl aspartate (NAA) ratios on risk factors for cerebral vasculopathy such as sex, age, hypertension, diabetes mellitus, carotid stenosis, and dyslipidaemia, which may have affected brain vessels and induced metabolic brain abnormalities prior to stroke. We hypothesise that in stroke patients metabolic alterations in the apparently normal contralateral brain are dependent on the presence or not of such risk factors. Fifty nine patients (31 male, 28 female: 58.8+/-16.1 years old) with cortical middle cerebral artery (MCA) territory infarction were included. Long echo time chemical shift imaging spectroscopy was carried out on a Siemens 1.5 T Magnetom Vision scanner using a multi-voxel PRESS technique. Metabolite ratios (NAA/choline, NAA/creatine, lactate/choline, etc) were studied using uni- and multivariate analyses with respect to common risk factors. The influence of age, stroke lesion size, and time since stroke was studied using a linear regression approach. Age, sex, and hypertension all appeared to individually influence metabolite ratios, although only hypertension was significant after multivariate analysis. In both basal ganglia and periventricular white matter regions in apparently normal contralateral brain, the NAA/choline ratio was significantly lower in hypertensive (1.37+/-0.16 and 1.50+/-0.19, respectively) than in normotensive patients (1.72+/-0.19 and 1.85+/-0.15, respectively). Regarding MCA infarction, contralateral tissue remote from the lesion behaves abnormally in the presence of hypertension, the NAA ratios in hypertensive patients being significantly lower. These data suggest that hypertension may compromise the use of contralateral tissue data as a reference for comparison with ischaemic tissue.

Contralateral peripheral neurotization for a hemiplegic hindlimb after central neurological injury.

PubMed

Zheng, Mou-Xiong; Hua, Xu-Yun; Jiang, Su; Qiu, Yan-Qun; Shen, Yun-Dong; Xu, Wen-Dong

2018-01-01

OBJECTIVE Contralateral peripheral neurotization surgery has been successfully applied to rescue motor function of the hemiplegic upper extremity in patients with central neurological injury (CNI). It may contribute to strengthened neural pathways between the contralesional cortex and paretic limbs. However, the effect of this surgery in the lower extremities remains unknown. In the present study the authors explored the effectiveness and safety of contralateral peripheral neurotization in treating a hemiplegic lower extremity following CNI in adult rats. METHODS Controlled cortical impact (CCI) was performed on the hindlimb motor cortex of 36 adult Sprague-Dawley rats to create severe unilateral traumatic brain injury models. These CCI rats were randomly divided into 3 groups. At 1 month post-CCI, the experimental group (Group 1, 12 rats) underwent contralateral L-6 to L-6 transfer, 1 control group (Group 2, 12 rats) underwent bilateral L-6 nerve transection, and another control group (Group 3, 12 rats) underwent an L-6 laminectomy without injuring the L-6 nerves. Bilateral L-6 nerve transection rats without CCI (Group 4, 12 rats) and naïve rats (Group 5, 12 rats) were used as 2 additional control groups. Beam and ladder rung walking tests and CatWalk gait analysis were performed in each rat at baseline and at 0.5, 1, 2, 4, 6, 8, and 10 months to detect the skilled walking functions and gait parameters of both hindlimbs. Histological and electromyography studies were used at the final followup to verify establishment of the traumatic brain injury model and regeneration of the L6-L6 neural pathway. RESULTS In behavioral tests, comparable motor injury in the paretic hindlimbs was observed after CCI in Groups 1-3. Group 1 started to show significantly lower slip and error rates in the beam and ladder rung walking tests than Groups 2 and 3 at 6 months post-CCI (p < 0.05). In the CatWalk analysis, Group 1 also showed a higher mean intensity and swing speed after 8

Contralateral functional reorganization of the speech supplementary motor area following neurosurgical tumor resection.

PubMed

Chivukula, Srinivas; Pikul, Brian K; Black, Keith L; Pouratian, Nader; Bookheimer, Susan Y

2018-05-18

We evaluated plasticity in speech supplemental motor area (SMA) tissue in two patients using functional magnetic resonance imaging (fMRI), following resection of tumors in or associated with the dominant hemisphere speech SMA. Patient A underwent resection of a anaplastic astrocytoma NOS associated with the left speech SMA, experienced SMA syndrome related mutism postoperatively, but experienced full recovery 14 months later. FMRI performed 32 months after surgery demonstrated a migration of speech SMA to homologous contralateral hemispheric regional tissue. Patient B underwent resection of a oligodendroglioma NOS in the left speech SMA, and postoperatively experienced speech hesitancy, latency and poor fluency, which gradually resolved over 18 months. FMRI performed at 64 months after surgery showed a reorganization of speech SMA to the contralateral hemisphere. These data support the hypothesis of dynamic, time based plasticity in speech SMA tissue, and may represent a noninvasive neural marker for SMA syndrome recovery. Copyright © 2018 Elsevier Inc. All rights reserved.

Predictors for contralateral prophylactic mastectomy in breast cancer patients

PubMed Central

Fu, Yun; Zhuang, Zhigang; Dewing, Michelle; Apple, Sophia; Chang, Helena

2015-01-01

Background: In recent years, radical breast cancer surgery has been largely replaced by breast conservation treatment, due to early diagnosis and more effective adjuvant treatment. While breast conservation is mostly preferred, the trend of bilateral mastectomy has risen in the United States. The aim of this study is to determine factors influencing patients’ choice for having contralateral prophylactic mastectomy (CPM). Methods: This is a retrospective study of 373 patients diagnosed with primary invasive breast cancer who were treated by bilateral or unilateral mastectomy (BM or UM) at the Revlon/UCLA Breast Center between Jan. 2002 and Dec. 2010. In the BM group, only those with unilateral breast cancer who chose CPM were included in the analysis. Results: When compared with the UM group, the following factors were found to be associated with BM: younger age, pre-menopausal, a family history of breast/ovarian cancer, BRCA mutation, more breast biopsies, history of breast augmentation, having MRI study within 6 months before the surgery, more likely to have reconstruction and sentinel lymph node biopsy (SLNB) and fewer had neoadjuvant/adjuvant chemotherapy/radiation. When patients with bilateral breast cancer were excluded, multivariate logistic regression analysis indicated younger patients with negative nodes, SLNB as the only nodal surgery and positive family history were significant factors predicting CPM and immediate reconstruction using tissue expanders or implants. Conclusion: Younger age, lower TN stage, requiring only SLNB and high risk family history predict contralateral prophylactic mastectomy. Tissue expander/implant-based reconstructions were more frequently chosen by patients with BM. PMID:26097557

Endoscopic contralateral transmaxillary approach for pterygoid process osteotomy in total maxillectomy: A technical case report.

PubMed

Hanazawa, Toyoyuki; Yamasaki, Kazuki; Chazono, Hideaki; Okamoto, Yoshitaka

2018-06-01

An approach for total maxillectomy with endoscopic transection of the pterygoid process via the contralateral maxillary sinus is described. In total maxillectomy, the resection of the pterygoid process of the sphenoid is a key step for successful resection. However, a conventional craniofacial approach requires extensive incision in the face, elevation of the lateral cheek flap. Even after elevation of the lateral cheek flap, visualization of this region is not good. An endoscopic approach through the contralateral maxillary sinus improved visualization of the pterygoid process, and osteotomy using a diamond-drilling bar was successfully performed. This technique has the potential to widen the indication for total maxillectomy in malignant neoplasms of the maxillary sinus. Copyright © 2017 Elsevier B.V. All rights reserved.

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy

PubMed Central

Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

2014-01-01

Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia. PMID:25405168

Benefits of awake uniportal pulmonary resection in a patient with a previous contralateral lobectomy.

PubMed

Galvez, Carlos; Navarro-Martinez, Jose; Bolufer, Sergio; Lirio, Francisco; Mafe, Juan Jose; Rivera, Maria Jesus; Roca, Joaquin; Baschwitz, Benno

2014-09-01

Surgical resection of a contralateral recurrence of non-small cell lung cancer (NSCLC) is indicated in patients without evidence of disseminated disease and considered functionally operable. General anesthesia and double-lumen intubation involves one lobe ventilation in a patient treated with a previous lobectomy, thus increasing the risks of ventilator-induced injuries and the morbidity. Awake procedures facilitate the surgery decreasing the anesthetic and surgical times, keeping the diaphragm motion and diminishing the ventilator-induced injuries into the remaining contralateral lobe. We present a 43-year-old woman with a previous left-lower lobectomy for a 3.1-cm mucinous adenocarcinoma 15 months before without nodal involvement, who presents a right-lower lobe 8-mm cavitated nodule, with evident radiological growth and fine-needle aspiration concordant with mucinous adenocarcinoma. We suggest an awake procedure with locoregional epidural anesthesia.

A systematic review of contralateral liver lobe hypertrophy after unilobar selective internal radiation therapy with Y90.

PubMed

Teo, Jin-Yao; Allen, John C; Ng, David C; Choo, Su-Pin; Tai, David W M; Chang, Jason P E; Cheah, Foong-Khoon; Chow, Pierce K H; Goh, Brian K P

2016-01-01

Curative liver resection is the treatment of choice for both primary and secondary liver malignancies. However, an inadequate future liver remnant (FLR) frequently precludes successful surgery. Portal vein embolization is the gold-standard modality for inducing hypertrophy of the FLR. In recent times, unilobar Yttrium-90 selective internal radiation therapy (SIRT) has been reported to induce hypertrophy of the contralateral, untreated liver lobe. The aim of this study is to review the current literature reporting on contralateral liver hypertrophy induced by unilobar SIRT. A systematic review of the English-language literature between 2000 and 2014 was performed using the search terms "Yttrium 90" OR "selective internal radiation therapy" OR "radioembolization" AND "hypertrophy". Seven studies, reporting on 312 patients, were included. Two hundred and eighty four patients (91.0%) received treatment to the right lobe. Two hundred and fifteen patients had hepatocellular carcinoma (HCC), 12 had intrahepatic cholangiocarcinoma, and 85 had liver metastases from mixed primaries. Y90 SIRT resulted in contralateral liver hypertrophy which ranged from 26 to 47% at 44 days-9 months. All studies were retrospective in nature, and heterogeneous, with substantial variations relative to pathology treated, underlying liver disease, dosage and delivery of Y90, number of treatment sessions and time to measurement of hypertrophy. Unilobar Y90 SIRT results in significant hypertrophy of the contralateral liver lobe. The rate of hypertrophy seems to be slower than that achieved by other methods. Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Contralateral occlusion is not a clinically important reason for choosing carotid artery stenting for patients with significant carotid artery stenosis.

PubMed

Brewster, Luke P; Beaulieu, Robert; Kasirajan, Karthik; Corriere, Matthew A; Ricotta, Joseph J; Patel, Siddharth; Dodson, Thomas F

2012-11-01

Contralateral carotid artery occlusion by itself carries an increased risk of stroke. Carotid endarterectomy (CEA) in the presence of contralateral carotid artery occlusion has high reported rates of perioperative morbidity and mortality. Our objective was to determine if there is a clinical benefit to patients who receive carotid artery stenting (CAS) compared to CEA in the presence of contralateral carotid artery occlusion. We conducted a retrospective medical chart review over a 4.5-year institutional experience of persons with contralateral carotid artery occlusion and ipsilateral carotid artery stenosis who underwent CAS or CEA. The main outcome measures were 30-day cardiac, stroke, and mortality rate, and midterm mortality. Of a total of 713 patients treated for carotid artery stenosis during this time period, 57 had contralateral occlusion (~8%). Thirty-nine of these patients were treated with CAS, and 18 with CEA. The most common indications for CAS were prior neck surgery (18), contralateral internal carotid occlusion (nine), and prior neck radiation (seven). The average age was 70 ± 8.5 for CEA and 66.7 ± 9.3 for CAS (P = .20). Both groups were predominantly men (CEA 12 of 18; CAS 28 of 39; P = .76), with similar prevalence of symptomatic lesions (CEA 8 of 18, CAS 20 of 39; P = .77). Two patients died within 30 days in the CAS group (5%). No deaths occurred within 30 days in the CEA group (P = .50); the mortality rate for CAS and CEA combined was 3.5%. No perioperative strokes or myocardial infarction occurred in either group. Two transient ischemic attacks occurred after CAS. At mean follow-up of 29.4 ± 16 months (CEA) and 28 ± 14.4 months (CAS; range, 1.5-48.5 months), seven deaths occurred in the CAS group and one in the CEA group (17.9% vs 5.5%; P = .40). There were two reinterventions in the CAS group for in-stent restenosis and there were no reoperations in the CEA group. Although CEA and CAS can both be performed with good perioperative results

Survival and contralateral breast cancer in CHEK2 1100delC breast cancer patients: impact of adjuvant chemotherapy.

PubMed

Kriege, M; Hollestelle, A; Jager, A; Huijts, P E A; Berns, E M; Sieuwerts, A M; Meijer-van Gelder, M E; Collée, J M; Devilee, P; Hooning, M J; Martens, J W M; Seynaeve, C

2014-08-26

We assessed the sensitivity to adjuvant chemotherapy in cell cycle checkpoint kinase 2 (CHEK2) vs non-CHEK2 breast cancer patients by comparing the contralateral breast cancer incidence and distant disease-free and breast cancer-specific survival between both groups, stratified for adjuvant chemotherapy. One Dutch hereditary non-BRCA1/2 breast cancer patient cohort (n=1220) and two Dutch cohorts unselected for family history (n=1014 and n=2488, respectively) were genotyped for CHEK2 1100delC. Hazard ratios for contralateral breast cancer, distant disease-free and breast cancer-specific death for mutation carriers vs noncarriers were calculated using the Cox proportional hazard method, stratified for adjuvant chemotherapy. The CHEK2 mutation carriers (n=193) had an increased incidence of contralateral breast cancer (multivariate hazard ratio 3.97, 95% confidence interval 2.59-6.07). Distant disease-free and breast cancer-specific survival were similar in the first 6 years in mutation carriers compared with noncarriers, but diverted as of 6 years after breast cancer diagnosis (multivariate hazard ratios and 95% confidence intervals 2.65 (1.79-3.93) and 2.05 (1.41-2.99), respectively). No significant interaction between CHEK2 and adjuvant chemotherapy was observed. The CHEK2 1100delC-associated breast cancer is associated with a higher contralateral breast cancer rate as well as worse survival measures beyond 6 years after diagnosis. No differential sensitivity to adjuvant chemotherapy was observed in CHEK2 patients.

Musicianship enhances ipsilateral and contralateral efferent gain control to the cochlea.

PubMed

Bidelman, Gavin M; Schneider, Amy D; Heitzmann, Victoria R; Bhagat, Shaum P

2017-02-01

Human hearing sensitivity is easily compromised with overexposure to excessively loud sounds, leading to permanent hearing damage. Consequently, finding activities and/or experiential factors that distinguish "tender" from "tough" ears (i.e., acoustic vulnerability) would be important for identifying people at higher risk for hearing damage. To regulate sound transmission and protect the inner ear against acoustic trauma, the auditory system modulates gain control to the cochlea via biological feedback of the medial olivocochlear (MOC) efferents, a neuronal pathway linking the lower brainstem and cochlear outer hair cells. We hypothesized that a salient form of auditory experience shown to have pervasive neuroplastic benefits, namely musical training, might act to fortify hearing through tonic engagement of these reflexive pathways. By measuring MOC efferent feedback via otoacoustic emissions (cochlear emitted sounds), we show that dynamic ipsilateral and contralateral cochlear gain control is enhanced in musically-trained individuals. Across all participants, MOC strength was correlated with the years of listeners' training suggested that efferent gain control is experience dependent. Our data provide new evidence that intensive listening experience(s) (e.g., musicianship) can strengthen the ipsi/contralateral MOC efferent system and sound regulation to the inner ear. Implications for reducing acoustic vulnerability to damaging sounds are discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

Nonpalpable testes: Ultrasound and contralateral testicular hypertrophy predict the surgical access, avoiding unnecessary laparoscopy.

PubMed

Berger, Christoph; Haid, Bernhard; Becker, Tanja; Koen, Mark; Roesch, Judith; Oswald, Josef

2018-04-01

In up to 20% of patients presenting with undescended testes, one or both are non-palpable. Whereas the most reliable means to exclude an abdominal testis is laparoscopy, there has been a lot of debate about the role of inguinal ultrasound (US) in detecting non-palpable inguinal testis. While we do not aim to add another paper claiming the benefits of US, we wanted to determine the excess capability of US to determine the correct surgical approach - inguinal or laparoscopy. In the light of avoiding unnecessary diagnostic laparoscopies, even the cost-effectiveness raised in many current papers might be called into question. Of a total of 684 boys who underwent surgery for undescended testes at our department between 2011 and 2014, in 58 (8.5%), one or both testes were neither palpable preoperatively nor under general anesthesia. These boys were examined by two experienced pediatric urologists clinically as well as by US. Besides the size of the contralateral testis, the presence of a testis in the inguinal channel was investigated. The additional impact of US over clinical exam and consideration of the size of the contralateral testis was assessed by means of intra-individual comparisons using Cochran-Q as well as McNemar tests. Clinical exam without considering the size of the contralateral testis had a sensitivity of 9% (95% CI 2-24%) and a specificity of 100% (95% CI 86-100%) to accurately predict the surgical approach deemed appropriate postoperatively. The consideration of the size of the contralateral testis - taken as an isolated factor - accurately predicted the surgical approach with a sensitivity of 21% (95% CI 9-38%) and a specificity of 88% (95% CI 68-97%). Ultrasound accounted for a sensitivity of 53% (95% CI 35-70%) and a specificity of 100% (95% CI 86-100%). The addition of US increased the sensitivity to correctly predict an inguinal incision from 29% to 71% and specificity slightly increased from 88% to 92%. This difference is significant (p = 0

Combined Electric and Contralateral Acoustic Hearing: Word and Sentence Recognition with Bimodal Hearing

ERIC Educational Resources Information Center

Gifford, Rene H.; Dorman, Michael F.; McKarns, Sharon A.; Spahr, Anthony J.

2007-01-01

Purpose: The authors assessed whether (a) a full-insertion cochlear implant would provide a higher level of speech understanding than bilateral low-frequency acoustic hearing, (b) contralateral acoustic hearing would add to the speech understanding provided by the implant, and (c) the level of performance achieved with electric stimulation plus…

[Glomerular changes in the contralateral kidney in the rat with experimental hydronephrosis].

PubMed

Castillo Bernabéu, R; Gázquez Ortiz, A; Bonillo Morales, A; Sierra Planas, M A; Ocaña Losa, J M; Romanos Lezcano, A

1985-10-31

We have studied under optic and electronmicroscopes the alterations of glomeruli in contralateral kidneys of rats with experimental hydronephrosis. Forty-eight Wistar rats, divided into two groups (control and experimental) were used. They were sacrificed 3, 6, 9 and 12 days after ureteral obstruction. There was a slight hypertrophy of glomeruli and hiperplasia of other components accompanied by a increased development of podocytes.

Adolescents and female patients are at increased risk for contralateral anterior cruciate ligament reconstruction: a cohort study from the Swedish National Knee Ligament Register based on 17,682 patients.

PubMed

Snaebjörnsson, Thorkell; Hamrin Senorski, Eric; Sundemo, David; Svantesson, Eleonor; Westin, Olof; Musahl, Volker; Alentorn-Geli, Eduard; Samuelsson, Kristian

2017-12-01

The impact of different surgical techniques in index ACL reconstruction for patients undergoing contralateral ACL reconstruction was investigated. The study was based on data from the Swedish National Knee Ligament Register. Patients undergoing index ACL reconstruction and subsequent contralateral ACL reconstruction using hamstring graft under the study period were included. The following variables were evaluated: age at index surgery, gender, concomitant meniscal or cartilage injury registered at index injury, transportal femoral bone tunnel drilling and transtibial femoral bone tunnel drilling. The end-point of primary contralateral ACL surgery was analysed as well as the time-to-event outcomes using survivorship methods including Kaplan-Meier estimation and Cox proportional hazards regression models. A total of 17,682 patients [n = 10,013 males (56.6%) and 7669 females (43.4%)] undergoing primary ACL reconstruction from 1 January 2005 through 31 December 2014 were included in the study. A total of 526 (3.0%) patients [n = 260 males (49.4%) and 266 females (50.6%)] underwent primary contralateral ACL reconstruction after index ACL reconstruction during the study period. Females had a 33.7% greater risk of contralateral ACL surgery [HR 1.337 (95% CI 1.127-1.586); (P = 0 0.001)]. The youngest age group (13-15 years) showed an increased risk of contralateral ACL surgery compared with the reference (36-49) age group [HR 2.771 (95% CI 1.456-5.272); (P = 0.002)]. Decreased risk of contralateral ACL surgery was seen amongst patients with concomitant cartilage injury at index surgery [HR 0.765 (95% CI 0.623-0.939); (P = 0.010)]. No differences in terms of the risk of contralateral ACL surgery were found between anatomic and non-anatomic techniques of primary single-bundle ACL reconstruction, comparing transportal anatomic technique to transtibial non-anatomic, anatomic and partial-anatomic. Age and gender were identified as risk factors for

Social and Clinical Determinants of Contralateral Prophylactic Mastectomy.

PubMed

Hawley, Sarah T; Jagsi, Reshma; Morrow, Monica; Janz, Nancy K; Hamilton, Ann; Graff, John J; Katz, Steven J

2014-06-01

The growing rate of contralateral prophylactic mastectomy (CPM) among women diagnosed as having breast cancer has raised concerns about potential for overtreatment. Yet, there are few large survey studies of factors that affect women's decisions for this surgical treatment option. To determine factors associated with the use of CPM in a population-based sample of patients with breast cancer. A longitudinal survey of 2290 women newly diagnosed as having breast cancer who reported to the Detroit and Los Angeles Surveillance, Epidemiology, and End Results registries from June 1, 2005, to February 1, 2007, and again 4 years later (June 2009 to February 2010) merged with Surveillance, Epidemiology, and End Results registry data (n = 1536). Multinomial logistic regression was used to evaluate factors associated with type of surgery. Primary independent variables included clinical indications for CPM (genetic mutation and/or strong family history), diagnostic magnetic resonance imaging, and patient extent of worry about recurrence at the time of treatment decision making. Type of surgery received from patient self-report, categorized as CPM, unilateral mastectomy, or breast conservation surgery. Of the 1447 women in the analytic sample, 18.9% strongly considered CPM and 7.6% received it. Of those who strongly considered CPM, 32.2% received CPM, while 45.8% received unilateral mastectomy and 22.8% received breast conservation surgery (BCS). The majority of patients (68.9%) who received CPM had no major genetic or familial risk factors for contralateral disease. Multivariate regression showed that receipt of CPM (vs either unilateral mastectomy or breast conservation surgery) was significantly associated with genetic testing (positive or negative) (vs UM, relative risk ratio [RRR]: 10.48; 95% CI, 3.61-3.48 and vs BCS, RRR: 19.10; 95% CI, 5.67-56.41; P < .001), a strong family history of breast or ovarian cancer (vs UM, RRR: 5.19; 95% CI, 2.34-11.56 and vs BCS, RRR

Cervical sympathetic block prolongs the latency and reduces the amplitude of trigeminal somatosensory evoked potentials on the contralateral side.

PubMed

Kawaguchi, Jun; Matsuura, Nobuyuki; Kasahara, Masataka; Ichinohe, Tatsuya

2015-02-01

The purpose of this study was to investigate the latency and amplitude of trigeminal somatosensory evoked potentials to clarify how nerve function on the contralateral side is affected after cervical sympathetic block (CSB). Subjects comprised 16 volunteers. For CSB, the tip of a needle was contacted with the transverse process of the sixth cervical vertebra on the right side, and lidocaine was injected. Trigeminal somatosensory evoked potentials were recorded bilaterally from C5/C6 scalp positions. Pupil diameters were also measured. Electrical stimulations were applied to the left-side lower lip, and trigeminal somatosensory evoked potentials waveforms derived from both sides of the scalp were recorded. Then, electrical stimulations were applied to the right-side of the lower lip, and recording was again performed. Recordings were performed at 5, 15, and 30 minutes after CSB. On the CSB side, pupil diameter decreased at 5 and 15 minutes after CSB. Trigeminal somatosensory evoked potentials at contralateral stimulation showed a prolongation of the latency in both P20 and N25 components on bilateral recording sites 5 and 15 minutes after CSB. Trigeminal somatosensory evoked potentials' amplitude at contralateral stimulation was smaller than at ipsilateral stimulation 5 minutes after CSB. Cervical sympathetic block prolongs the latency and reduces the amplitude of trigeminal somatosensory evoked potentials on the contralateral side.

Contralateral Supracerebellar-Infratentorial Approach for Resection of Thalamic Cavernous Malformations.

PubMed

Mascitelli, Justin; Burkhardt, Jan-Karl; Gandhi, Sirin; Lawton, Michael T

2018-02-26

Surgical resection of cavernous malformations (CM) in the posterior thalamus, pineal region, and midbrain tectum is technically challenging owing to the presence of adjacent eloquent cortex and critical neurovascular structures. Various supracerebellar infratentorial (SCIT) approaches have been used in the surgical armamentarium targeting lesions in this region, including the median, paramedian, and extreme lateral variants. Surgical view of a posterior thalamic CM from the traditional ipsilateral vantage point may be obscured by occipital lobe and tentorium. To describe a novel surgical approach via a contralateral SCIT (cSCIT) trajectory for resecting posterior thalamic CMs. From 1997 to 2017, 75 patients underwent the SCIT approach for cerebrovascular/oncologic pathology by the senior author. Of these, 30 patients underwent the SCIT approach for CM resection, and 3 patients underwent the cSCIT approach. Historical patient data, radiographic features, surgical technique, and postoperative neurological outcomes were evaluated in each patient. All 3 patients presented with symptomatic CMs within the right posterior thalamus with radiographic evidence of hemorrhage. All surgeries were performed in the sitting position. There were no intraoperative complications. Neuroimaging demonstrated complete CM resection in all cases. There were no new or worsening neurological deficits or evidence of rebleeding/recurrence noted postoperatively. This study establishes the surgical feasibility of a contralateral SCIT approach in resection of symptomatic thalamic CMs It demonstrates the application for this procedure in extending the surgical trajectory superiorly and laterally and maximizing safe resectability of these deep CMs with gravity-assisted brain retraction.

Proteomic analysis of trans-hemispheric motor cortex reorganization following contralateral C7 nerve transfer

PubMed Central

Yuan, Yin; Xu, Xiu-yue; Lao, Jie; Zhao, Xin

2018-01-01

Nerve transfer is the most common treatment for total brachial plexus avulsion injury. After nerve transfer, the movement of the injured limb may be activated by certain movements of the healthy limb at the early stage of recovery, i.e., trans-hemispheric reorganization. Previous studies have focused on functional magnetic resonance imaging and changes in brain-derived neurotrophic factor and growth associated protein 43, but there have been no proteomics studies. In this study, we designed a rat model of total brachial plexus avulsion injury involving contralateral C7 nerve transfer. Isobaric tags for relative and absolute quantitation and western blot assay were then used to screen differentially expressed proteins in bilateral motor cortices. We found that most differentially expressed proteins in both cortices of upper limb were associated with nervous system development and function (including neuron differentiation and development, axonogenesis, and guidance), microtubule and cytoskeleton organization, synapse plasticity, and transmission of nerve impulses. Two key differentially expressed proteins, neurofilament light (NFL) and Thy-1, were identified. In contralateral cortex, the NFL level was upregulated 2 weeks after transfer and downregulated at 1 and 5 months. The Thy-1 level was upregulated from 1 to 5 months. In the affected cortex, the NFL level increased gradually from 1 to 5 months. Western blot results of key differentially expressed proteins were consistent with the proteomic findings. These results indicate that NFL and Thy-1 play an important role in trans-hemispheric organization following total brachial plexus root avulsion and contralateral C7 nerve transfer. PMID:29557385

Contralateral prophylactic mastectomy in an Asian population: a single institution review.

PubMed

Sim, Yirong; Tan, Veronique Kiak Mien; Ho, Gay Hui; Wong, Chow Yin; Madhukumar, Preetha; Tan, Benita Kiat Tee; Yong, Wei Sean; Ng, Yvonne Ying Ru; Ong, Kong Wee

2014-02-01

Contralateral prophylactic mastectomy (CPM) removes the non-diseased breast in women who have unilateral breast cancer. This reduces the incidence of contralateral breast cancer, and potentially improves survival in high risk patients. Such surgical risk-reduction strategy is increasingly being adopted in the United States, despite a decreasing incidence of contralateral breast cancer. The use of CPM in an Asian population is yet unknown. We present the first Asian report on CPM rates and trends in Singapore, the country with the highest incidence of breast cancer in Asia. A retrospective review of all patients who had breast cancer surgery from 2001 to 2010 at the largest healthcare system in Singapore was performed. Patient demographics and tumour characteristics were analysed with regards to type of surgery performed. Factors associated with CPM were identified. From 2001 to 2010, a total of 5130 patients underwent oncological breast surgery. A decreasing trend of mastectomies (82.7%-70.8%), an upward trend of breast conserving surgery (BCS) (17.3%-29.2%) and an increasing trend in CPM (0.46%-1.25%) is observed. Patients who opted for CPM are likely to be younger (48.4 ± 9.4 years), married (60%), parous (56.7%), with no family history of breast/ovarian cancer (66.7%), and diagnosed at an earlier stage. The rate of synchronous occult breast malignancy was found to be 10% (n = 30), and these were in patients who were of a low cancer-risk profile. This retrospective study reflects an increasing incidence of breast cancer in Singapore, with a decrease in mastectomies, and an increase in BCS and CPM rates, similar to Western data. Similar to Western populations, the Asian woman who opts for CPM is likely to be young and have an earlier stage of breast cancer. In contrast, the Asian woman is likely to have no family history of breast or ovarian cancers. Commonly cited reasons for increased CPM rates such as the increased availability of genetic counselling and

SU-F-T-536: Contra-Lateral Breast Study for Prone Versus Supine Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marrero, M; Joseph, K; Klein, E

Purpose: There are several advantages to utilizing the prone technique for intact breast cancer patients. However, as the topography changes, accompanied by the influence of a supporting breast board and patient treatment couch, the question that arises is to whether there is a concern for contralateral breast dose for intact breast cancer patients being treated with this technique. Methods: An anthropomorphic phantom with breast mounds to duplicate intact breast cancer treatment was planned in prone and supine position. Two tangential beams were executed in the similar manner for as the radiotherapy planning system. For the prone setup, a breast densemore » foam board was used to support the phantom. A grid of 24 OSL nanodots was placed at 6cm, 4cm, and 2cm apart from the medial border for both prone and supine setups. The phantom was set up using megavoltage imaging and treated as per plan. Additional, a similar study was performed on a patient treated in prone position. Results: Overall, the contralateral breast dose was generally higher for prone setups at all locations especially when close to the medial border. The average mean dose was found to be 1.8%, 2.5% of the prescribed dose for supine respectively prone position. The average of the standard deviation is 1.04%, 1.38% for supine respectively prone position. As for patient treated in prone position average mean dose was found to be 1.165% of the prescribed dose and average of the standard deviation is 9.456%. Conclusion: There is minimal influence of scatter from the breast board. It appears that the volatility of the setup could lead to higher doses than expected from the planning system to the contralateral breast when the patient is in the prone position.« less

Restoration of the Patient-Specific Anatomy of the Proximal and Distal Parts of the Humerus: Statistical Shape Modeling Versus Contralateral Registration Method.

PubMed

Vlachopoulos, Lazaros; Lüthi, Marcel; Carrillo, Fabio; Gerber, Christian; Székely, Gábor; Fürnstahl, Philipp

2018-04-18

In computer-assisted reconstructive surgeries, the contralateral anatomy is established as the best available reconstruction template. However, existing intra-individual bilateral differences or a pathological, contralateral humerus may limit the applicability of the method. The aim of the study was to evaluate whether a statistical shape model (SSM) has the potential to predict accurately the pretraumatic anatomy of the humerus from the posttraumatic condition. Three-dimensional (3D) triangular surface models were extracted from the computed tomographic data of 100 paired cadaveric humeri without a pathological condition. An SSM was constructed, encoding the characteristic shape variations among the individuals. To predict the patient-specific anatomy of the proximal (or distal) part of the humerus with the SSM, we generated segments of the humerus of predefined length excluding the part to predict. The proximal and distal humeral prediction (p-HP and d-HP) errors, defined as the deviation of the predicted (bone) model from the original (bone) model, were evaluated. For comparison with the state-of-the-art technique, i.e., the contralateral registration method, we used the same segments of the humerus to evaluate whether the SSM or the contralateral anatomy yields a more accurate reconstruction template. The p-HP error (mean and standard deviation, 3.8° ± 1.9°) using 85% of the distal end of the humerus to predict the proximal humeral anatomy was significantly smaller (p = 0.001) compared with the contralateral registration method. The difference between the d-HP error (mean, 5.5° ± 2.9°), using 85% of the proximal part of the humerus to predict the distal humeral anatomy, and the contralateral registration method was not significant (p = 0.61). The restoration of the humeral length was not significantly different between the SSM and the contralateral registration method. SSMs accurately predict the patient-specific anatomy of the proximal and distal aspects

Two-year analysis for predicting renal function and contralateral hypertrophy after robot-assisted partial nephrectomy: A three-dimensional segmentation technology study.

PubMed

Kim, Dae Keun; Jang, Yujin; Lee, Jaeseon; Hong, Helen; Kim, Ki Hong; Shin, Tae Young; Jung, Dae Chul; Choi, Young Deuk; Rha, Koon Ho

2015-12-01

To analyze long-term changes in both kidneys, and to predict renal function and contralateral hypertrophy after robot-assisted partial nephrectomy. A total of 62 patients underwent robot-assisted partial nephrectomy, and renal parenchymal volume was calculated using three-dimensional semi-automatic segmentation technology. Patients were evaluated within 1 month preoperatively, and postoperatively at 6 months, 1 year and continued up to 2-year follow up. Linear regression models were used to identify the factors predicting variables that correlated with estimated glomerular filtration rate changes and contralateral hypertrophy 2 years after robot-assisted partial nephrectomy. The median global estimated glomerular filtration rate changes were -10.4%, -11.9%, and -2.4% at 6 months, 1 and 2 years post-robot-assisted partial nephrectomy, respectively. The ipsilateral kidney median parenchymal volume changes were -24%, -24.4%, and -21% at 6 months, 1 and 2 years post-robot-assisted partial nephrectomy, respectively. The contralateral renal volume changes were 2.3%, 9.6% and 12.9%, respectively. On multivariable linear analysis, preoperative estimated glomerular filtration rate was the best predictive factor for global estimated glomerular filtration rate change on 2 years post-robot-assisted partial nephrectomy (B -0.452; 95% confidence interval -0.84 to -0.14; P = 0.021), whereas the parenchymal volume loss rate (B -0.43; 95% confidence interval -0.89 to -0.15; P = 0.017) and tumor size (B 5.154; 95% confidence interval -0.11 to 9.98; P = 0.041) were the significant predictive factors for the degree of contralateral renal hypertrophy on 2 years post-robot-assisted partial nephrectomy. Preoperative estimated glomerular filtration rate significantly affects post-robot-assisted partial nephrectomy renal function. Renal mass size and renal parenchyma volume loss correlates with compensatory hypertrophy of the contralateral kidney. Contralateral hypertrophy

Survival and contralateral breast cancer in CHEK2 1100delC breast cancer patients: impact of adjuvant chemotherapy

PubMed Central

Kriege, M; Hollestelle, A; Jager, A; Huijts, P E A; Berns, E M; Sieuwerts, A M; Meijer-van Gelder, M E; Collée, J M; Devilee, P; Hooning, M J; Martens, J W M; Seynaeve, C

2014-01-01

Background: We assessed the sensitivity to adjuvant chemotherapy in cell cycle checkpoint kinase 2 (CHEK2) vs non-CHEK2 breast cancer patients by comparing the contralateral breast cancer incidence and distant disease-free and breast cancer-specific survival between both groups, stratified for adjuvant chemotherapy. Methods: One Dutch hereditary non-BRCA1/2 breast cancer patient cohort (n=1220) and two Dutch cohorts unselected for family history (n=1014 and n=2488, respectively) were genotyped for CHEK2 1100delC. Hazard ratios for contralateral breast cancer, distant disease-free and breast cancer-specific death for mutation carriers vs noncarriers were calculated using the Cox proportional hazard method, stratified for adjuvant chemotherapy. Results: The CHEK2 mutation carriers (n=193) had an increased incidence of contralateral breast cancer (multivariate hazard ratio 3.97, 95% confidence interval 2.59–6.07). Distant disease-free and breast cancer-specific survival were similar in the first 6 years in mutation carriers compared with noncarriers, but diverted as of 6 years after breast cancer diagnosis (multivariate hazard ratios and 95% confidence intervals 2.65 (1.79–3.93) and 2.05 (1.41–2.99), respectively). No significant interaction between CHEK2 and adjuvant chemotherapy was observed. Conclusions: The CHEK2 1100delC-associated breast cancer is associated with a higher contralateral breast cancer rate as well as worse survival measures beyond 6 years after diagnosis. No differential sensitivity to adjuvant chemotherapy was observed in CHEK2 patients. PMID:24918820

Increased growth rate of vestibular schwannoma after resection of contralateral tumor in neurofibromatosis type 2

PubMed Central

Peyre, Matthieu; Goutagny, Stephane; Imbeaud, Sandrine; Bozorg-Grayeli, Alexis; Felce, Michele; Sterkers, Olivier; Kalamarides, Michel

2011-01-01

Surgical management of bilateral vestibular schwannomas (VS) in neurofibromatosis type 2 (NF2) is often difficult, especially when both tumors threaten the brainstem. When the largest tumor has been removed, the management of the contralateral VS may become puzzling. To give new insights into the growth pattern of these tumors and to determine the best time point for treatment (surgery or medical treatment), we studied radiological growth in 11 VS (11 patients with NF2) over a long period (mean duration, 7.6 years), before and after removal of the contralateral tumor while both were threatening the brainstem. We used a quantitative approach of the radiological velocity of diametric expansion (VDE) on consecutive magnetic resonance images. Before first surgery, growth patterns of both tumors were similar in 9 of 11 cases. After the first surgery, VDE of the remaining VS was significantly elevated, compared with the preoperative period (2.5 ± 2.2 vs 4.4 ± 3.4 mm/year; P = .01, by Wilcoxon test). Decrease in hearing function was associated with increased postoperative growth in 3 cases. Growth pattern of coexisting intracranial meningiomas was not modified by VS surgery on the first side. In conclusion, removal of a large VS in a patient with NF2 might induce an increase in the growth rate of the contralateral medium or large VS. This possibility should be integrated in NF2 patient management to adequately treat the second VS. PMID:21798887

Decreased contralateral breast volume after mastectomy, adjuvant chemotherapy, and anti-estrogen therapy, in particular in breasts with high density.

PubMed

Ishii, Naohiro; Ando, Jiro; Harao, Michiko; Takemae, Masaru; Kishi, Kazuo

2017-10-01

Adjuvant chemotherapy and anti-estrogenic therapy can result in decreased volume of the contralateral breast, following mastectomy for the treatment of breast cancer. However, no data on the effect of adjuvant therapy on contralateral breast volume have previously been reported. We aimed to evaluate the extent to which adjuvant therapy and differences in breast density contribute to decreased breast volume. We conducted a prospective cohort study, selecting 40 nonconsecutive patients who underwent immediate breast reconstruction with mastectomy and expander insertion followed by expander replacement. We measured the contralateral breast volume before each procedure. The extent of the change was analyzed with respect to adjuvant therapy and breast density measured by preoperative mammography. The greatest decrease in breast volume was 135.1 cm 3 . The decrease in breast volume was significantly larger in the adjuvant therapy (+) group, particularly in patients with high breast density, than in the adjuvant therapy (-) group. Significant differences between the chemotherapy (+), tamoxifen (+) group and the chemotherapy (-), tamoxifen (+) group were not found. Breast density scores had a range of 2.0-3.3 (mean: 2.8). In breast reconstruction, particularly when performed in one stage, preoperative mammography findings are valuable to plastic surgeons, and possible decreases in the contralateral breast volume due to adjuvant therapy, particularly in patients with high breast density, should be considered carefully. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Tactile perceptual learning: learning curves and transfer to the contralateral finger.

PubMed

Kaas, Amanda L; van de Ven, Vincent; Reithler, Joel; Goebel, Rainer

2013-02-01

Tactile perceptual learning has been shown to improve performance on tactile tasks, but there is no agreement about the extent of transfer to untrained skin locations. The lack of such transfer is often seen as a behavioral index of the contribution of early somatosensory brain regions. Moreover, the time course of improvements has never been described explicitly. Sixteen subjects were trained on the Ludvigh task (a tactile vernier task) on four subsequent days. On the fifth day, transfer of learning to the non-trained contralateral hand was tested. In five subjects, we explored to what extent training effects were retained approximately 1.5 years after the final training session, expecting to find long-term retention of learning effects after training. Results showed that tactile perceptual learning mainly occurred offline, between sessions. Training effects did not transfer initially, but became fully available to the untrained contralateral hand after a few additional training runs. After 1.5 years, training effects were not fully washed out and could be recuperated within a single training session. Interpreted in the light of theories of visual perceptual learning, these results suggest that tactile perceptual learning is not fundamentally different from visual perceptual learning, but might proceed at a slower pace due to procedural and task differences, thus explaining the apparent divergence in the amount of transfer and long-term retention.

Foveational Complexity in Single Word Identification: Contralateral Visual Pathways Are Advantaged over Ipsilateral Pathways

ERIC Educational Resources Information Center

Obregon, Mateo; Shillcock, Richard

2012-01-01

Recognition of a single word is an elemental task in innumerable cognitive psychology experiments, but involves unexpected complexity. We test a controversial claim that the human fovea is vertically divided, with each half projecting to either the contralateral or ipsilateral hemisphere, thereby influencing foveal word recognition. We report a…

Limiting Radiotherapy to the Contralateral Retropharyngeal and High Level II Lymph Nodes in Head and Neck Squamous Cell Carcinoma is Safe and Improves Quality of Life

PubMed Central

Spencer, Christopher R.; Gay, Hiram A.; Haughey, Bruce H.; Nussenbaum, Brian; Adkins, Douglas R.; Wildes, Tanya M.; DeWees, Todd A.; Lewis, James S.; Thorstad, Wade L.

2014-01-01

Background Radiation treatment volumes in head and neck squamous cell carcinoma (HNSCC) are controversial. Here we report the outcomes, failures, and quality of life (QOL) of patients treated using intensity modulated radiation therapy (IMRT) that eliminated treatment of contralateral retropharyngeal lymph nodes (RPLN) in the clinically uninvolved neck. Methods A prospective institutional database identified patients with primary oral cavity, oropharynx, hypopharynx, larynx and unknown primary HNSCC treated using IMRT. There were three temporal groups (G1-3). G1 received comprehensive neck IMRT with parotid sparing, G2 eliminated the contralateral high level II (HLII) lymph nodes, and G3 further eliminated the contralateral RPLN in the clinically uninvolved neck. Patterns of failure and survival analyses were completed and QOL data measured by the MD Anderson Dysphagia Inventory (MDADI) was compared in a subset of patients from G1 and G3. Results There were 748 patients identified. Of the 488 patients treated in G2 or G3, 406 had a clinically uninvolved contralateral neck. There were no failures in the spared RPLNs (95% CI; 0-1.3%) or high contralateral neck (95% CI; 0-0.7%). QOL data was compared between 44 patients in G1 and 51 patients in G3. QOL improved both globally and in all domains assessed for G3 in which reduced radiotherapy volumes were used (p < 0.007). Conclusions For patients with locally advanced HNSCC, eliminating coverage to the contralateral HLII and contralateral RPLN in the clinically uninvolved side of the neck is associated with minimal risk of failure in these regions and significantly improved patient-reported QOL. PMID:25143048

Perceptions of Contralateral Breast Cancer Risk: A Prospective, Longitudinal Study.

PubMed

Portschy, Pamela R; Abbott, Andrea M; Burke, Erin E; Nzara, Rumbidzayi; Marmor, Schelomo; Kuntz, Karen M; Tuttle, Todd M

2015-11-01

An increasing proportion of breast cancer patients undergo contralateral prophylactic mastectomy (CPM) to reduce their risk of contralateral breast cancer (CBC). Our goal was to evaluate CBC risk perception changes over time among breast cancer patients. We conducted a prospective, longitudinal study of women with newly diagnosed unilateral breast cancer. Patients completed a survey before and approximately 2 years after treatment. Survey questions used open-ended responses or 5-point Likert scale scoring (e.g., 5 = very likely, 1 = not at all likely). A total of 74 women completed the presurgical treatment survey, and 43 completed the postsurgical treatment survey. Baseline characteristics were not significantly different between responders and nonresponders of the follow-up survey. The mean estimated 10-year risk of CBC was 35.7 % on the presurgical treatment survey and 13.8 % on the postsurgical treatment survey (p < 0.001). The perceived risks of developing cancer in the same breast and elsewhere in the body significantly decreased between surveys. Both CPM and non-CPM (breast-conserving surgery or unilateral mastectomy) patients' perceived risk of CBC significantly decreased from pre- to postsurgical treatment surveys. Compared with non-CPM patients, CPM patients had a significantly lower perceived 10-year risk of CBC (5.8 vs. 17.3 %, p = 0.046) on postsurgical treatment surveys. The perceived risk of CBC significantly attenuated over time for both CPM and non-CPM patients. These data emphasize the importance of early physician counseling and improvement in patient education to provide women with accurate risk information before they make surgical treatment decisions.

Hindlimb spasticity after unilateral motor cortex lesion in rats is reduced by contralateral nerve root transfer.

PubMed

Zong, Haiyang; Ma, Fenfen; Zhang, Laiyin; Lu, Huiping; Gong, Jingru; Cai, Min; Lin, Haodong; Zhu, Yizhun; Hou, Chunlin

2016-12-01

Lower extremity spasticity is a common sequela among patients with acquired brain injury. The optimum treatment remains controversial. The aim of our study was to test the feasibility and effectiveness of contralateral nerve root transfer in reducing post stroke spasticity of the affected hindlimb muscles in rats. In our study, we for the first time created a novel animal hindlimb spastic hemiplegia model in rats with photothrombotic lesion of unilateral motor cortex and we established a novel surgical procedure in reducing motor cortex lesion-induced hindlimb spastic hemiplegia in rats. Thirty six rats were randomized into three groups. In group A, rats received sham operation. In group B, rats underwent unilateral hindlimb motor cortex lesion. In group C, rats underwent unilateral hindlimb cortex lesion followed by contralateral L4 ventral root transfer to L5 ventral root of the affected side. Footprint analysis, Hoffmann reflex (H-reflex), cholera toxin subunit B (CTB) retrograde tracing of gastrocnemius muscle (GM) motoneurons and immunofluorescent staining of vesicle glutamate transporter 1 (VGLUT1) on CTB-labelled motoneurons were used to assess spasticity of the affected hindlimb. Sixteen weeks postoperatively, toe spread and stride length recovered significantly in group C compared with group B (P<0.001). H max (H-wave maximum amplitude)/M max (M-wave maximum amplitude) ratio of gastrocnemius and plantaris muscles (PMs) significantly reduced in group C (P<0.01). Average VGLUT1 positive boutons per CTB-labelled motoneurons significantly reduced in group C (P<0.001). We demonstrated for the first time that contralateral L4 ventral root transfer to L5 ventral root of the affected side was effective in relieving unilateral motor cortex lesion-induced hindlimb spasticity in rats. Our data indicated that this could be an alternative treatment for unilateral lower extremity spasticity after brain injury. Therefore, contralateral neurotization may exert a potential

Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases.

PubMed

Sukkarieh, Hamdi G; Hitchon, Patrick W; Awe, Olatilewa; Noeller, Jennifer

2015-10-01

The authors sought to determine patient-related outcomes after minimally invasive surgical (MIS) lumbar intraspinal synovial cyst excision via a tubular working channel and a contralateral facet-sparing approach. All the patients with a symptomatic lumbar intraspinal synovial cyst who underwent surgery at the University of Iowa Hospitals and Clinics with an MIS excision via a contralateral approach were treated between July 2010 and August 2014. There was a total of 13 cases. Each patient was evaluated with preoperative neurological examinations, lumbar spine radiography, MRI, and visual analog scale (VAS) scores. The patients were evaluated postoperatively with neurological examinations and VAS and Macnab scores. The primary outcomes were improvement in VAS and Macnab scores. Secondary outcomes were average blood loss, hospital stay duration, and operative times. There were 5 males and 8 females. The mean age was 66 years, and the mean body mass index was 28.5 kg/m(2). Sixty-nine percent (9 of 13) of the cysts were at L4-5. Most patients had low-back pain and radicular pain, and one-third of them had Grade 1 spondylolisthesis. The mean (± SD) follow-up duration was 20.8 ± 16.9 months. The mean Macnab score was 3.4 ± 1.0, and the VAS score decreased from 7.8 preoperatively to 2.9 postoperatively. The mean operative time was 123 ± 30 minutes, with a mean estimated blood loss of 44 ± 29 ml. Hospital stay averaged 1.5 ± 0.7 days. There were no complications noted in this series. The MIS excision of lumbar intraspinal synovial cysts via a contralateral approach offers excellent exposure to the cyst and spares the facet joint at the involved level, thus minimizing risk of instability, blood loss, operative time, and hospital stay. Prospective randomized trials with longer follow-up times and larger cohorts are needed to conclusively determine the superiority of the contralateral MIS approach over others, including open or ipsilateral minimally invasive surgery.

Contribution of a contralateral hearing aid to perception of consonant voicing, intonation, and emotional state in adult cochlear implantees.

PubMed

Most, Tova; Gaon-Sivan, Gal; Shpak, Talma; Luntz, Michal

2012-01-01

Binaural hearing in cochlear implant (CI) users can be achieved either by bilateral implantation or bimodally with a contralateral hearing aid (HA). Binaural-bimodal hearing has the advantage of complementing the high-frequency electric information from the CI by low-frequency acoustic information from the HA. We examined the contribution of a contralateral HA in 25 adult implantees to their perception of fundamental frequency-cued speech characteristics (initial consonant voicing, intonation, and emotions). Testing with CI alone, HA alone, and bimodal hearing showed that all three characteristics were best perceived under the bimodal condition. Significant differences were recorded between bimodal and HA conditions in the initial voicing test, between bimodal and CI conditions in the intonation test, and between both bimodal and CI conditions and between bimodal and HA conditions in the emotion-in-speech test. These findings confirmed that such binaural-bimodal hearing enhances perception of these speech characteristics and suggest that implantees with residual hearing in the contralateral ear may benefit from a HA in that ear.

Anterior transarticular C1-C2 fixation with contralateral screw insertion: a report of two cases and technical note.

PubMed

Lvov, Ivan; Grin, Andrey; Kaykov, Aleksandr; Smirnov, Vladimir; Krylov, Vladimir

2017-08-08

Anterior transarticular fixation of the C1-C2 vertebrae is a well-known technique that involves screw insertion through the body of the C2 vertebra into the lateral masses of the atlas through an anterior transcervical approach. Meanwhile, contralateral screw insertion has been previously described only in anatomical studies. We describe two case reports of the clinical application of this new technique. In Case 1, the patient was diagnosed with an unstable C1 fracture. The clinical features of the case did not allow for any type of posterior atlantoaxial fusion, Halo immobilization, or routine anterior fixation using the Reindl and Koller techniques. The possible manner of screw insertion into the anterior third of the right lateral mass was via a contralateral trajectory, which was performed in this case. Case 2 involved a patient with neglected posteriorly dislocated dens fracture who could not lie in the prone position due to concomitant cardiac pathology. Reduction of atlantoaxial dislocation was insufficient, even after scar tissue resection at the fracture, while transdental fusion was not possible. Considering the success of the previous case, atlantoaxial fixation was performed through the small approach, using the Reindl technique and contralateral screw insertion. These two cases demonstrate the potential of anterior transarticular fixation of C1-C2 vertebrae in cases where posterior atlantoaxial fusion is not achievable. This type of fixation can be performed through a single approach if one screw is inserted using the Reindl technique and another is inserted via a contralateral trajectory.

Does Roller Massage With a Foam Roll Change Pressure Pain Threshold of the Ipsilateral Lower Extremity Antagonist and Contralateral Muscle Groups? An Exploratory Study.

PubMed

Cheatham, Scott W; Kolber, Morey J

2018-03-01

Foam rolling is a popular intervention used by allied health professionals and the general population. Current research suggests that foam rolling may have an effect on the ipsilateral antagonist muscle group and produce a cross-over effect in the muscles of the contralateral limb. The purpose of this study was to examine the acute effects of foam rolling to the left quadriceps on ipsilateral antagonist hamstrings and contralateral quadriceps muscle group pressure pain threshold (PPT). Through this research, we sought to gather data to further develop the methodology for future studies of this intervention. A pretest-posttest exploratory study. University kinesiology laboratory. 21 healthy adults (age = 27.52 ± 8.9 y). Video-guided foam roll intervention on the left quadriceps musculature. Ipsilateral hamstring (antagonist) and contralateral quadriceps muscle PPT. A significant difference was found between pretest to posttest measures for the ipsilateral hamstrings (t[20] = -6.2, P < 0.001) and contralateral quadriceps (t[20] = -9.1, P < 0.001) suggesting an increase in PPT. These findings suggest that foam rolling of the quadriceps musculature may have an acute effect on the PPT of the ipsilateral hamstrings and contralateral quadriceps muscles. Clinicians should consider these results to be exploratory and future investigations examining this intervention on PPT is warranted.

Imaging dose in breast radiotherapy: does breast size affect the dose to the organs at risk and the risk of secondary cancer to the contralateral breast?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Batumalai, Vikneswary, E-mail: vikneswary.batumalai@sswahs.nsw.gov.au; South Western Clinical School, University of New South Wales, Sydney, New South Wales; Quinn, Alexandra

Correct target positioning is crucial for accurate dose delivery in breast radiotherapy resulting in utilisation of daily imaging. However, the radiation dose from daily imaging is associated with increased probability of secondary induced cancer. The aim of this study was to quantify doses associated with three imaging modalities and investigate the correlation of dose and varying breast size in breast radiotherapy. Planning computed tomography (CT) data sets of 30 breast cancer patients were utilised to simulate the dose received by various organs from a megavoltage computed tomography (MV-CT), megavoltage electronic portal image (MV-EPI) and megavoltage cone-beam computed tomography (MV-CBCT). Themore » mean dose to organs adjacent to the target volume (contralateral breast, lungs, spinal cord and heart) were analysed. Pearson correlation analysis was performed to determine the relationship between imaging dose and primary breast volume and the lifetime attributable risk (LAR) of induced secondary cancer was calculated for the contralateral breast. The highest contralateral breast mean dose was from the MV-CBCT (1.79 Gy), followed by MV-EPI (0.22 Gy) and MV-CT (0.11 Gy). A similar trend was found for all organs at risk (OAR) analysed. The primary breast volume inversely correlated with the contralateral breast dose for all three imaging modalities. As the primary breast volume increases, the likelihood of a patient developing a radiation-induced secondary cancer to the contralateral breast decreases. MV-CBCT showed a stronger relationship between breast size and LAR of developing a radiation-induced contralateral breast cancer in comparison with the MV-CT and MV-EPI. For breast patients, imaging dose to OAR depends on imaging modality and treated breast size. When considering the use of imaging during breast radiotherapy, the patient's breast size and contralateral breast dose should be taken into account.« less

Contralateral posterior interhemispheric approach to deep medial parietooccipital vascular malformations: surgical technique and results.

PubMed

Burkhardt, Jan-Karl; Winkler, Ethan A; Lawton, Michael T

2017-07-21

OBJECTIVE Deep medial parietooccipital arteriovenous malformations (AVMs) and cerebral cavernous malformations (CCMs) are traditionally resected through an ipsilateral posterior interhemispheric approach (IPIA), which creates a deep, perpendicular perspective with limited access to the lateral margins of the lesion. The contralateral posterior interhemispheric approach (CPIA) flips the positioning, with the midline positioned horizontally for retraction due to gravity, but with the AVM on the upper side and the approach from the contralateral, lower side. The aim of this paper was to analyze whether the perpendicular angle of attack that is used in IPIA would convert to a parallel angle of attack with the CPIA, with less retraction, improved working angles, and no significant increase in risk. METHODS A retrospective review of pre- and postoperative clinical and radiographic data was performed in 8 patients who underwent a CPIA. RESULTS Three AVMs and 5 CCMs were resected using the CPIA, with an average nidus size of 2.3 cm and CCM diameter of 1.7 cm. All lesions were resected completely, as confirmed on postoperative catheter angiography or MRI. All patients had good neurological outcomes, with either stable or improved modified Rankin Scale scores at last follow-up. CONCLUSIONS The CPIA is a safe alternative approach to the IPIA for deep medial parietooccipital vascular malformations that extend 2 cm or more off the midline. Contralaterality and retraction due to gravity optimize the interhemispheric corridor, the surgical trajectory to the lesion, and the visualization of the lateral margin, without resection or retraction of adjacent normal cortex. Although the falx is a physical barrier to accessing the lesion, it stabilizes the ipsilateral hemisphere while gravity delivers the dissected lesion through the transfalcine window. Patient positioning, CSF drainage, venous preservation, and meticulous dissection of the deep margins are critical to the safety of

Outcomes of an anatomic total shoulder arthroplasty with a contralateral reverse total shoulder arthroplasty.

PubMed

Cox, Ryan M; Padegimas, Eric M; Abboud, Joseph A; Getz, Charles L; Lazarus, Mark D; Ramsey, Matthew L; Williams, Gerald R; Horneff, John G

2018-06-01

It is common for patients to require staged bilateral shoulder arthroplasties. There is a unique cohort of patients who require an anatomic total shoulder arthroplasty (TSA) and a contralateral reverse shoulder arthroplasty (RSA). This study compared the outcomes of patients with a TSA in 1 shoulder and an RSA in the contralateral shoulder. Our institutional database was queried to identify all patients with a TSA and a contralateral RSA. Data collection included patient demographics, preoperative and latest follow-up shoulder range of motion, radiographic analysis, and postoperative complications. Identified patients were assessed at follow-up visits or contacted by phone for functional outcome scores. Nineteen patients met our inclusion/exclusion criteria. There was statistically significant greater internal rotation in the TSA shoulder (P= .044) but no significant difference in forward elevation (P = .573) or external rotation (P= .368). There was no radiographic evidence of humeral or glenoid component loosening of any arthroplasty implants. There were no significant differences between TSA and RSA shoulders for the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (P= .381), Simple Shoulder Test (P = .352), Single Assessment Numerical Evaluation (P = .709), and visual analog scale satisfaction (P= .448) or pain scores (P= .305). Thirteen patients (68.4%) preferred the RSA side, 1 patient (5.3%; z = 4.04, P < .001) patient preferred the TSA side, and 5 patients expressed no preference. Despite known limitations and differences between TSA and RSA designs, patients who have received both implants are highly satisfied with both. The only parameter in which the TSA had superior outcomes was internal rotation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

[Reconstrucción ósea de defectos craneales secundarios a traumatismo con implantes personalizados].

PubMed

Cienfuegos, Ricardo; Fernández, Gerardo; Cruz, Aída; Sierra, Eduardo

2018-01-01

Los defectos craneales secundarios a traumatismos son frecuentes. Por lo común se reparan de forma secundaria por sintomatología como el síndrome del paciente trepanado, por protección cerebral y por el aspecto cosmético. Históricamente se han utilizado diversos materiales para la reconstrucción. Se presentan cinco casos de pacientes reconstruidos con implantes personalizados de polieteretercetona (PEEK) o polimetilmetacrilato poroso (PMMA). Las localizaciones afectaron el frontal, el borde orbitario superior y el techo orbitario en cuatro casos, y la porción lateral del frontal, la zona temporoparietal y el borde del occipital en un caso. La reconstrucción en cuatro pacientes fue entre 6 y 12 meses después de la lesión, y en un caso después de 25 años. En dos casos se requirió expansión tisular antes de colocar el implante. Cuatro pacientes evolucionaron favorablemente, con mejoría de los síntomas neurológicos, forma y contorno adecuados, así como un proceso de cicatrización adecuada de los colgajos de piel cabelluda. Un paciente presentó infección por Staphylococcus aureus, atribuida a la presencia de un mucocele y una fístula de la vía aérea a la cavidad craneal, lo que hizo necesario retirar el implante. Los implantes personalizados son un recurso útil para defectos óseos craneales. Brindan resultados satisfactorios desde el punto de vista funcional y cosmético. Deben tomarse precauciones respecto al tratamiento de las lesiones que afecten el seno frontal, para evitar la comunicación entre la vía aérea y la cavidad craneal. Cranial defects due to trauma are frequent. They are usually repaired in a secondary fashion due to features such as syndrome of the trephined, for brain protection and for cosmetic purposes. Historically, various materials have been used for reconstruction. Five cases of patients reconstructed with customized polyetheretherketone (PEEK) o polymethyl methacrylate (PMMA) implants are presented. Defects involved

On the Relationship Between Musicianship and Contralateral Suppression of Transient-Evoked Otoacoustic Emissions.

PubMed

Stuart, Andrew; Daughtrey, Emma R

2016-04-01

The medial olivocochlear (MOC) efferent reflex that modulates outer hair cell function has been shown to be more robust in musicians versus nonmusicians as evidenced in greater contralateral suppression of transient-evoked otoacoustic emissions (TEOAEs). All previous research comparing musical ability and MOC efferent strength has defined musicianship dichotomously (i.e., high-level music students or professional classical musicians versus nonmusicians). The objective of the study was to further explore contralateral suppression of TEOAEs among adults with a full spectrum of musicianship ranging from no history of musicianship to professional musicians. Musicianship was defined by both self-report and with an objective test to quantify individual differences in perceptual music skills. A single-factor between-subjects and correlational research designs were employed. Forty-five normal-hearing young adults participated. Participants completed a questionnaire concerning their music experience and completed the Brief Profile of Music Perception Skills (PROMS) to quantify perceptual musical skills across multiple musical domains (i.e., accent, melody, tempo, and tuning). TEOAEs were evaluated with 60 dB peak equivalent sound pressure level click stimuli with and without a contralateral 65 dB sound pressure level white noise suppressor. TEOAE suppression was expressed in two ways, absolute TEOAE suppression in dB and a normalized index of TEOAE suppression (i.e., percentage of suppression). Participants who considered themselves musicians scored significantly higher on all subscales and total Brief PROMS score (p < 0.05). There was no statistically significant difference between musicians and nonmusicians in absolute TEOAE suppression or percentage of TEOAE suppression (p > 0.05). There were no statistically significant correlations or linear predictive relationships between subscale or total Brief PROMS scores with absolute and percentage of TEOAE suppression (p > 0

Contralateral Vocal Fold Reactive Lesions: Nomenclature, Treatment Choice, and Outcome.

PubMed

Koss, Shira L; Kidwai, Sarah M; Pitman, Michael J

2016-06-01

Contralateral reactive lesions (RLs) represent a distinct entity among benign bilateral vocal fold (VF) lesions. Lack of uniform nomenclature and a myriad of surgical options have hampered attempts to develop treatment guidelines. The objective of this study is to better define RLs and their prognosis, through the development of a standard nomenclature, with an aim to guide treatment and delineate the role of phonosurgery. Case series with chart review. Tertiary care center. Analysis was performed on patients with Current Procedural Terminology code 31545. Operative reports with a primary lesion and contralateral RL were included. Outcomes included the Voice Handicap Index-10 (VHI-10) and GRBAS (grade, roughness, breathiness, asthenia, and strain) scale, lesion persistence/recurrence, mucosal wave, and edge character based on blinded videostroboscopy review. A nomenclature was developed based on intraoperative RLs (n = 30), defined by lesion consistency (fibrous or polypoid) and relationship to normal VF edge (gradual or steep). Reactive lesion treatment included no intervention, excision, potassium titanyl phosphate laser, steroid injection, or a combination thereof. Observations included the following: inconsistent treatment modalities were employed, excision of RLs did not yield better outcomes, fibrous RLs were more likely to persist and polypoid lesions more likely to recur, gradual lesions were more likely to remain disease free, and most treatments showed improved mucosal wave, VHI-10, and GRBAS. Reactive lesions have not been well classified, and treatments are based on subjective intraoperative decision making with unpredictable outcomes. The nomenclature proposed will allow for a better definition of the RL and provide a framework for future research to identify optimal treatment. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

The effects of ipsilateral, contralateral, and bilateral broadband noise on the mid-level hump in intensity discriminationa)

PubMed Central

Roverud, Elin; Strickland, Elizabeth A.

2015-01-01

Previous psychoacoustical and physiological studies indicate that the medial olivocochlear reflex (MOCR), a bilateral, sound-evoked reflex, may lead to improved sound intensity discrimination in background noise. The MOCR can decrease the range of basilar-membrane compression and can counteract effects of neural adaptation from background noise. However, the contribution of these processes to intensity discrimination is not well understood. This study examined the effect of ipsilateral, contralateral, and bilateral noise on the “mid-level hump.” The mid-level hump refers to intensity discrimination Weber fractions (WFs) measured for short-duration, high-frequency tones which are poorer at mid levels than at lower or higher levels. The mid-level hump WFs may reflect a limitation due to basilar-membrane compression, and thus may be decreased by the MOCR. The noise was either short (50 ms) or long (150 ms), with the long noise intended to elicit the sluggish MOCR. For a tone in quiet, mid-level hump WFs improved with ipsilateral noise for most listeners, but not with contralateral noise. For a tone in ipsilateral noise, WFs improved with contralateral noise for most listeners, but only when both noises were long. These results are consistent with MOCR-induced WF improvements, possibly via decreases in effects of compression and neural adaptation. PMID:26627798

Can the contralateral limb be used as a control during the growing period in a rodent model?

PubMed

Mustafy, Tanvir; Londono, Irène; Villemure, Isabelle

2018-05-12

The contralateral limb is often used as a control in various clinical, forensic and anthropological studies. However, no studies have been performed to determine if the contra-lateral limb is a suitable control during the bone development period. The aim of this study was to determine the bilateral symmetry of growing rat tibiae in terms of geometric shape, mechanical strength and bone morphological parameters with developmental stages. Left and right tibias of 18 male Sprague-Dawley rats at 4, 8 and 12 weeks of age were scanned with micro-CT for bone-morphometric evaluation and for 3D deviation analysis to quantify the geometric shape variations between left and right tibiae. Overall tibial lengths and curvatures were also measured, and bone mechanical strength was investigated using three-point bending tests. Deviation distributions between bilateral tibiae remained below 0.5 mm for more than 80% of the geometry for all groups. Tibial lengths, longitudinal tibial curvatures, bone-morphometric parameters and mechanical strengths changed significantly during the growing period but kept a strong degree of symmetry between bilateral tibiae. These results suggest that bilateral tibiae can be considered symmetrical in nature and that contralateral limb can be used as a control during the growing period in different experimental scenarios. Copyright © 2018 Elsevier Ltd. All rights reserved.

Differential involvement of ipsilateral and contralateral spinal cord astrocyte D-serine in carrageenan-induced mirror-image pain: role of σ1 receptors and astrocyte gap junctions.

PubMed

Choi, Hoon-Seong; Roh, Dae-Hyun; Yoon, Seo-Yeon; Choi, Sheu-Ran; Kwon, Soon-Gu; Kang, Suk-Yun; Moon, Ji-Young; Han, Ho-Jae; Beitz, Alvin J; Lee, Jang-Hern

2018-02-01

Although we have recently demonstrated that spinal astrocyte gap junctions mediate the development of mirror-image pain (MIP), it is still unclear which astrocyte-derived factor is responsible for the development of MIP and how its production is controlled. In the present study, we focused on the role of ipsilateral versus contralateral D-serine in the development of MIP and investigated the possible involvement of σ1 receptors and gap junctions in astrocyte D-serine production. Following carrageenan injection, mechanical allodynia was tested at various time points to examine the effect of individual drugs. Immunohistochemistry and Western blot analyses were performed to clarify the expression levels of spinal D-serine, serine racemase, σ1 receptors and connexin 43. The expression of ipsilateral D-serine was up-regulated during the early phase of inflammation, while contralateral D-serine increased during the later phase of inflammation. The pharmacological inhibition of D-serine during the early phase blocked the development of both ipsilateral and contralateral mechanical allodynia. However, the inhibition of D-serine during the later phase of inflammation blocked contralateral, but not ipsilateral mechanical allodynia. Furthermore, the inhibition of σ1 receptors during the earlier phase of inflammation inhibited the increase in ipsilateral D-serine. Conversely, the blockade of astrocyte gap junctions suppressed the up-regulation of contralateral D-serine during the later phase of inflammation. Spinal astrocyte D-serine plays an important role in the development of mirror-image pain. Furthermore, σ1 receptors and astrocyte gap junction signalling mediate ipsilateral and contralateral D-serine production respectively. © 2017 The British Pharmacological Society.

Early Outcomes of Endoscopic Contralateral Foraminal and Lateral Recess Decompression via an Interlaminar Approach in Patients with Unilateral Radiculopathy from Unilateral Foraminal Stenosis.

PubMed

Kim, Hyeun Sung; Patel, Ravish; Paudel, Byapak; Jang, Jee-Soo; Jang, Il-Tae; Oh, Seong-Hoon; Park, Jae Eun; Lee, Sol

2017-12-01

Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is an established procedure. Better preservation of contralateral facet joint compared with that of the approach side has been shown with uniportal bilateral decompression. The aim of this retrospective case series was to analyze the early clinical and radiologic outcomes of stand-alone contralateral foraminotomy and lateral recess decompression using PECILF. Twenty-six consecutive patients with unilateral lower limb radiculopathy underwent contralateral foraminotomy and lateral recess decompression using PECILF. Their clinical outcomes were evaluated with visual analog scale leg pain score, Oswestry Disability Index, and the MacNab criteria. Completeness of decompression was documented with a postoperative magnetic resonance imaging. Mean age for the study group was 62.9 ± 9.2 years and the male/female ratio was 4:9. A total of 30 levels were decompressed, with 18 patients (60%) undergoing decompression at L4-L5, 9 at L5-S1 (30%), 2 at L3-L4 (6.7%), and 1 at L2-L3 (3.3%). Mean estimated blood loss was 27 ± 15 mL per level. Mean operative duration was 48 ± 12 minutes/level. Visual analog scale leg score improved from 7.7 ± 1 to 1.8 ± 0.8 (P < 0.0001). Oswestry Disability Index improved from 64.4 ± 5.8 to 21 ± 4.5 (P < 0.0001). Mean follow-up of the study was 13.7 ± 2.7 months. According to the MacNab criteria, 10 patients (38.5%) had good results, 14 patients (53.8%) had excellent results, and 2 patients (7.7%) had fair results. One patient required revision surgery. Facet-preserving contralateral foraminotomy and lateral recess decompression with PECILF is effective for treatment of lateral recess and foraminal stenosis. Thorough decompression with acceptable early clinical outcomes and minimal perioperative morbidity can be obtained with the contralateral endoscopic approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Calcaneal Scoring as an Adjunct to Modified Oxford Hip Scores: Prediction of Contralateral Slipped Capital Femoral Epiphysis.

PubMed

Nicholson, Allen D; Huez, Coridon M; Sanders, James O; Liu, Raymond W; Cooperman, Daniel R

2016-03-01

In 2 recent studies, modified Oxford hip scores of 16 through 18 have been shown to predict an extremely high risk of contralateral slipping in unilateral slipped capital femoral epiphysis (SCFE). However, the modified Oxford system is not widely used. This may be due, in part, to the complexity of the scoring system, difficulty in viewing all 5 radiographic features on a single x-ray and phenotypic variation in the features. Ossification of the calcaneal apophysis provides an osteologic marker of skeletal maturation in relation to peak height velocity and has been described previously. We examine the value of the calcaneal apophyseal ossification sequence for predicting modified Oxford hip scores. We examined 279 pelvis and matching foot x-rays that were taken at the same session from 94 healthy children aged 3 to 18 years. A fellowship-trained pediatric orthopaedist determined the modified Oxford hip score for each hip radiograph. The calcaneal x-rays had been previously graded. Modified Oxford hip scores were compared with calcaneal scores for each set of matched hip and calcaneal x-rays. Stage 0 to 2 calcanei had 94% of corresponding hip radiographs rated as modified Oxford scores of 16 to 18. Stage 3 calcanei had 54% rated as 16 to 18 and 31% rated as scores 19 to 21. Stage 4 calcanei had 31% rated as scores 19 to 21, and 68% rated as scores 22 to 26. Stage 5 calcanei had 100% rated as 22 to 26. Using data from Popejoy and colleagues' study, the weighted risk of contralateral SCFE was 94% for calcaneal stage 0, 86.5% for calcaneal stage 1, 90.3% for calcaneal stage 2, 55.8% for calcaneal stage 3, 6.1% for calcaneal stage 4, and 0 for calcaneal stage 5. Calcaneal stages 0 to 3 correspond entirely to modified Oxford scores indicating elevated risk of contralateral SCFE. The calcaneal scoring system has potential for adjunctive use with the modified Oxford score for prediction of contralateral SCFE.

Generalized seizures and transient contralateral hemiparesis following retrobulbar anesthesia: a case report.

PubMed

Dettoraki, Maria; Dimitropoulou, Chrisafoula; Nomikarios, Nikolaos; Moschos, Marilita M; Brοuzas, Dimitrios

2015-07-28

Retrobulbar block is a local anesthetic technique widely used for intraocular surgery. Although retrobulbar anesthesia is considered to be relatively safe, a number of serious adverse events have been reported. To our knowledge, immediate onset of generalized seizures with contralateral hemiparesis after retrobulbar anesthesia has not been reported. A 62-year-old Caucasian healthy male with a right eye retinal detachment was admitted for pars plana vitrectomy. During retrobulbar anesthesia with ropivacaine and before needle withdrawal, the patient developed twitching of the face which rapidly progressed to generalized tonic-clonic seizures. Arterial oxygen saturation decreased to 75 %. Chin lift was performed and 100 % oxygen was administrated via face mask, which increased saturation to 99 %. Midazolam 2 mg was administrated intravenously to control seizures. After cessation of seizures, left-sided hemiparesis was evident. Brain computed tomography and electroencephalogram were normal 3 h later. The patient underwent pars plana vitrectomy under general anesthesia 4 days later. Serious complications of local anesthesia for ophthalmic surgery are uncommon. We present a case in which generalized tonic-clonic seizures developed during retrobulbar anesthesia, followed by transient contralateral hemiparesis. The early onset of seizures indicated intra-arterial injection of the anesthetic. Our case suggested the need for close monitoring during the performance of retrobulbar anesthesia and the presence of well-trained personnel for early recognition and immediate management of the complications.

Reliability of measures of transient evoked otoacoustic emissions with contralateral suppression.

PubMed

Stuart, Andrew; Cobb, Kensi M

2015-01-01

The reliability of measures of transient evoked otoacoustic emissions (TEOAEs) with contralateral suppression was examined. The effect of test session (i.e., initial test; retest without probe removal; retest with probe removal; and retest 1-2 days post initial test), gender, and ear was examined in 14 young adult females and 14 young adult males. TEOAEs were obtained bilaterally with 60 dB peSPL linear click stimuli with and without a contralateral 65 dB SPL broadband noise suppressor. Absolute TEOAE suppression and a normalized index of TEOAE suppression (i.e., percentage of suppression) were examined. Reliability of these measures was assessed with repeated measures linear mixed model analysis of variance, a coefficient of reliability, and Bland-Altman analyses. There were no statistically significant (p>0.05) main effects of test, gender, and ear or interactions for both absolute dB and % TEOAE suppression values. Cronbach's α were greater than 0.90 across the four tests for both TEOAE measures. Mean test differences or bias (i.e., between the initial and subsequent tests) for absolute and % TEOAE suppression ranged from -0.05 to 0.11 dB and -1.5% to 1.1%, respectively. There was no proportional/systematic bias with the mean differences of the first and subsequent measurements. Data herein were consistent with the view that bilateral TEOAE suppression measures are reliable across test sessions of 1-2 days among females and males and may provide a method to monitor medial olivocochlear efferent reflex status over time. Copyright © 2015 Elsevier Inc. All rights reserved.

Temporal Effects on Monaural Amplitude-Modulation Sensitivity in Ipsilateral, Contralateral and Bilateral Noise.

PubMed

Marrufo-Pérez, Miriam I; Eustaquio-Martín, Almudena; López-Bascuas, Luis E; Lopez-Poveda, Enrique A

2018-04-01

The amplitude modulations (AMs) in speech signals are useful cues for speech recognition. Several adaptation mechanisms may make the detection of AM in noisy backgrounds easier when the AM carrier is presented later rather than earlier in the noise. The aim of the present study was to characterize temporal adaptation to noise in AM detection. AM detection thresholds were measured for monaural (50 ms, 1.5 kHz) pure-tone carriers presented at the onset ('early' condition) and 300 ms after the onset ('late' condition) of ipsilateral, contralateral, and bilateral (diotic) broadband noise, as well as in quiet. Thresholds were 2-4 dB better in the late than in the early condition for the three noise lateralities. The temporal effect held for carriers at equal sensation levels, confirming that it was not due to overshoot on carrier audibility. The temporal effect was larger for broadband than for low-band contralateral noises. Many aspects in the results were consistent with the noise activating the medial olivocochlear reflex (MOCR) and enhancing AM depth in the peripheral auditory response. Other aspects, however, indicate that central masking and adaptation unrelated to the MOCR also affect both carrier-tone and AM detection and are involved in the temporal effects.

Sensory Feedback in Interlimb Coordination: Contralateral Afferent Contribution to the Short-Latency Crossed Response during Human Walking.

PubMed

Gervasio, Sabata; Voigt, Michael; Kersting, Uwe G; Farina, Dario; Sinkjær, Thomas; Mrachacz-Kersting, Natalie

2017-01-01

A constant coordination between the left and right leg is required to maintain stability during human locomotion, especially in a variable environment. The neural mechanisms underlying this interlimb coordination are not yet known. In animals, interneurons located within the spinal cord allow direct communication between the two sides without the need for the involvement of higher centers. These may also exist in humans since sensory feedback elicited by tibial nerve stimulation on one side (ipsilateral) can affect the muscles activation in the opposite side (contralateral), provoking short-latency crossed responses (SLCRs). The current study investigated whether contralateral afferent feedback contributes to the mechanism controlling the SLCR in human gastrocnemius muscle. Surface electromyogram, kinematic and kinetic data were recorded from subjects during normal walking and hybrid walking (with the legs moving in opposite directions). An inverse dynamics model was applied to estimate the gastrocnemius muscle proprioceptors' firing rate. During normal walking, a significant correlation was observed between the magnitude of SLCRs and the estimated muscle spindle secondary afferent activity (P = 0.04). Moreover, estimated spindle secondary afferent and Golgi tendon organ activity were significantly different (P ≤ 0.01) when opposite responses have been observed, that is during normal (facilitation) and hybrid walking (inhibition) conditions. Contralateral sensory feedback, specifically spindle secondary afferents, likely plays a significant role in generating the SLCR. This observation has important implications for our understanding of what future research should be focusing on to optimize locomotor recovery in patient populations.

Altered contralateral sensorimotor system organization after experimental hemispherectomy: a structural and functional connectivity study.

PubMed

Otte, Willem M; van der Marel, Kajo; van Meer, Maurits P A; van Rijen, Peter C; Gosselaar, Peter H; Braun, Kees P J; Dijkhuizen, Rick M

2015-08-01

Hemispherectomy is often followed by remarkable recovery of cognitive and motor functions. This reflects plastic capacities of the remaining hemisphere, involving large-scale structural and functional adaptations. Better understanding of these adaptations may (1) provide new insights in the neuronal configuration and rewiring that underlies sensorimotor outcome restoration, and (2) guide development of rehabilitation strategies to enhance recovery after hemispheric lesioning. We assessed brain structure and function in a hemispherectomy model. With MRI we mapped changes in white matter structural integrity and gray matter functional connectivity in eight hemispherectomized rats, compared with 12 controls. Behavioral testing involved sensorimotor performance scoring. Diffusion tensor imaging and resting-state functional magnetic resonance imaging were acquired 7 and 49 days post surgery. Hemispherectomy caused significant sensorimotor deficits that largely recovered within 2 weeks. During the recovery period, fractional anisotropy was maintained and white matter volume and axial diffusivity increased in the contralateral cerebral peduncle, suggestive of preserved or improved white matter integrity despite overall reduced white matter volume. This was accompanied by functional adaptations in the contralateral sensorimotor network. The observed white matter modifications and reorganization of functional network regions may provide handles for rehabilitation strategies improving functional recovery following large lesions.

Vibrissa motor cortex activity suppresses contralateral whisking behavior.

PubMed

Ebbesen, Christian Laut; Doron, Guy; Lenschow, Constanze; Brecht, Michael

2017-01-01

Anatomical, stimulation and lesion data implicate vibrissa motor cortex in whisker motor control. Work on motor cortex has focused on movement generation, but correlations between vibrissa motor cortex activity and whisking are weak. The exact role of vibrissa motor cortex remains unknown. We recorded vibrissa motor cortex neurons during various forms of vibrissal touch, which were invariably associated with whisker protraction and movement. Free whisking, object palpation and social touch all resulted in decreased cortical activity. To understand this activity decrease, we performed juxtacellular recordings, nanostimulation and in vivo whole-cell recordings. Social touch resulted in decreased spiking activity, decreased cell excitability and membrane hyperpolarization. Activation of vibrissa motor cortex by intracortical microstimulation elicited whisker retraction, as if to abort vibrissal touch. Various vibrissa motor cortex inactivation protocols resulted in contralateral protraction and increased whisker movements. These data collectively point to movement suppression as a prime function of vibrissa motor cortex activity.

Impact of Node Negative Target Volume Delineation on Contralateral Parotid Gland Dose Sparing Using IMRT in Head and Neck Cancer.

PubMed

Magnuson, William J; Urban, Erich; Bayliss, R Adam; Harari, Paul M

2015-06-01

There is considerable practice variation in treatment of the node negative (N0) contralateral neck in patients with head and neck cancer. In this study, we examined the impact of N0 neck target delineation volume on radiation dose to the contralateral parotid gland. Following institutional review board approval, 12 patients with head and neck cancer were studied. All had indications for treatment of the N0 neck, such as midline base of tongue or soft palate extension or advanced ipsilateral nodal disease. The N0 neck volumes were created using the Radiation Therapy Oncology Group head and neck contouring atlas. The physician-drawn N0 neck clinical target volume (CTV) was expanded by 25% to 200% to generate volume variation, followed by a 3-mm planning target volume (PTV) expansion. Surrounding organs at risk were contoured and complete intensity-modulated radiation therapy plans were generated for each N0 volume expansion. The median N0 target volume drawn by the radiation oncologist measured 93 cm(3) (range 71-145). Volumetric expansion of the N0 CTV by 25% to 200% increased the resultant mean dose to the contralateral parotid gland by 1.4 to 8.5 Gray (Gy). For example, a 4.1-mm increase in the N0 neck CTV translated to a 2.0-Gy dose increase to the parotid, 7.4 mm to a 4.5 Gy dose increase, and 12.5 mm to an 8.5 Gy dose increase, respectively. The treatment volume designated for the N0 neck has profound impact on resultant dose to the contralateral parotid gland. Variations of up to 15 mm are routine across physicians in target contouring, reflecting individual preference and training expertise. Depending on the availability of immobilization and image guidance techniques, experts commonly recommend 3 to 10 mm margin expansions to generate the PTV. Careful attention to the original volume of the N0 neck CTV, as well as expansion margins, is important in achieving effective contralateral gland sparing to reduce the resultant xerostomia and dysguesia that may ensue

[The application of contralateral acupuncture for rehabilitation after acute closed achilles tendon rupture].

PubMed

Zhang, Dawei; Ye, Xiangming; Zhang, Xiaofeng; Zhang, Wenjie

2017-03-12

To observe the differences of affected-side ankle plantar flexors function and clinical efficacy between contralateral acupuncture combined with rehabilitation training and rehabilitation training alone for patients with acute closed achilles tendon rupture. Seventy-four patients with acute closed achilles tendon rupture were randomly assigned to an observation group and a control group, 37 cases in each group. Patients in the both groups were treated with routine rehabilitation training after the operation for 12 weeks; besides, patients in the observation group were treated with contralateral acupuncture at Zusanli (ST 36), Yanglingquan (GB 34), Chengshan (BL 57), Taixi (KI 3) before rehabilitation training in the first 6 weeks. The treatment were given once a day, 5 times as 1 course with 2 d at the interval. The Biodex System 4 multi-joint dynamometers system was applied to test and compare affected-side plantar flexion peak torque (PFPT), peak torque/body weight (PT/BW) and total work (TW) after 6 weeks, 8 weeks and 12 weeks. The efficacy evaluation was conducted after 6 weeks and 12 weeks, and the follow-up visit was conducted 12 weeks after end of treatment. The PFPT, PT/BW, TW in the observation group were significantly superior to those in the control group after 8 weeks and 12 weeks of treatment (all P <0.05); compared with those after 6 weeks, the PFPT, PT/BW, TW were significantly increased after 8 weeks of treatment (all P <0.05); compared with those after 6 weeks and 8 weeks, the PFPT, PT/BW, TW were significantly increased after 12 weeks of treatment (all P <0.05). After 12 weeks of treatment and at follow-up visit, the clinical excellent and effective rates in the observation group were higher than those in the control group[89.2% (33/37) vs 70.3% (26/37), 94.6% (35/37) vs 75.7% (28/37), both P <0.05]. During the postoperative rehabilitation of acute closed achilles tendon rupture, the contralateral acupuncture combined with rehabilitation training

Intraoperative Recurrent Laryngeal Nerve Monitoring in a Patient with Contralateral Vocal Fold Palsy.

PubMed

Na, Bub-Se; Choi, Jin-Ho; Park, In Kyu; Kim, Young Tae; Kang, Chang Hyun

2017-10-01

Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.

Perilesional and contralateral white matter evolution and integrity in patients with periventricular nodular heterotopia and epilepsy: a longitudinal diffusion tensor imaging study.

PubMed

Liu, W; Yan, B; An, D; Niu, R; Tang, Y; Tong, X; Gong, Q; Zhou, D

2017-12-01

This study aimed to assess the evolution of perinodular and contralateral white matter abnormalities in patients with periventricular nodular heterotopia (PNH) and epilepsy. Diffusion tensor imaging (DTI) (64 directions) and 3 T structural magnetic resonance imaging were performed in 29 PNH patients (mean age 27.3 years), and 16 patients underwent a second scan (average time between the two scans 1.1 years). Fractional anisotropy and mean diffusivity were measured within the perilesional and contralateral white matter. Longitudinal analysis showed that white matter located 10 mm from the focal nodule displayed characteristics intermediate to tissue 5 mm away, and normal-appearing white matter (NAWM) also established evolution profiles of perinodular white matter in different cortical lobes. Compared to 29 age- and sex-matched healthy controls, significant decreased fractional anisotropy and elevated mean diffusivity values were observed in regions 5 and 10 mm from nodules (P < 0.01), whilst DTI metrics of the remaining NAWM did not differ significantly from controls. Additionally, normal DTI metrics were shown in the contralateral region in patients with unilateral PNH. Periventricular nodular heterotopia is associated with microstructural abnormalities within the perilesional white matter and the extent decreases with increasing distance from the nodule. In the homologous contralateral region, white matter diffusion metrics were unchanged in unilateral PNH. These findings have clinical implications with respect to the medical and surgical interventions of PNH-related epilepsy. © 2017 EAN.

The Efficacy of Simultaneous Breast Reconstruction and Contralateral Balancing Procedures in Reducing the Need for Second Stage Operations

PubMed Central

Clarke-Pearson, Emily M; Vornovitsky, Michael; Dayan, Joseph H; Samson, William; Sultan, Mark R

2014-01-01

Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry. PMID:25276646

Cost of Contralateral Prophylactic Mastectomy

PubMed Central

Deshmukh, Ashish A.; Cantor, Scott B.; Crosby, Melissa A.; Dong, Wenli; Shen, Yu; Bedrosian, Isabelle; Peterson, Susan K.; Parker, Patricia A.; Brewster, Abenaa M.

2014-01-01

Purpose To compare the health care costs of women with unilateral breast cancer who underwent contralateral prophylactic mastectomy (CPM) with those of women who did not. Methods We conducted a retrospective study of 904 women treated for stage I–III breast cancer with or without CPM. Women were matched according to age, year at diagnosis, stage, and receipt of chemotherapy. We included healthcare costs starting from the date of surgery to 24 months. We identified whether care was immediate or delayed (CPM within 6 months or 6–24 months after initial surgery, respectively). Costs were converted to approximate Medicare reimbursement values and adjusted for inflation. Multivariable regression analysis was performed to evaluate the effect of CPM on total breast cancer care costs adjusting for patient characteristics and accounting for matched pairs. Results The mean difference between the CPM and no-CPM matched groups was $3,573 (standard error [SE]=$455) for professional costs, $4,176 (SE=$1,724) for technical costs, and $7,749 (SE=$2,069) for total costs. For immediate and delayed CPM, the mean difference for total costs was $6,528 (SE =$2,243) and $16,744 (SE=$5,017), respectively. In multivariable analysis, the CPM group had a statistically significant increase of 16.9% in mean total costs compared to the no-CPM group (P<0.0001). HER-2/neu-positive status, receipt of radiation, and reconstruction were associated with increases in total costs. Conclusions CPM significantly increases short-term healthcare costs for women with unilateral breast cancer. These patient-level cost results can be used for future studies that evaluate the influence of costs of CPM on decision making. PMID:24809301

Contralateral regional recurrence after elective unilateral neck irradiation in oropharyngeal carcinoma: A literature-based critical review.

PubMed

Al-Mamgani, Abrahim; van Werkhoven, Erik; Navran, Arash; Karakullukcu, Baris; Hamming-Vrieze, Olga; Machiels, Melanie; van der Velden, Lilly-Ann; Vogel, Wouter V; Klop, W Martin

2017-09-01

The head and neck region has rich regional lymphatic network, with a theoretical risk on contralateral metastasis from oropharyngeal cancer (OPC). There is a long-standing convention to irradiate the great majority of these tumors electively to both sides of the neck to reduce the risk of contralateral regional failure (cRF), but this can induce significant toxicity. We aimed to identify patient groups where elective contralateral irradiation may safely be omitted. PubMed and EMBASE were searched for original full-text articles in English with a combination of search terms related to the end points: cRF in OPC primarily treated by radiotherapy only to the ipsilateral neck and identifying predictive factors for increased incidence of cRF. The data from the identified studies were pooled, the incidence of cRF was calculated and the correlation with different predictive factors was investigated. Eleven full-text articles met the inclusion criteria. In these studies, 1116 patients were treated to the ipsilateral neck alone. The mean incidence of cRF was 2.42% (range 0-5.9%, 95% CI 1.6-3.5%). The incidence of cRF correlated only with T-stage (p=0.008), and involvement of midline (p=0.001). However, the significant correlation with T-stage can be explained by the very low incidence of cRF among T1 (0.77%), and disappeared when the incidence of cRF was compared between T2, T3,and T4 (p=0.344). The incidence of cRF in patients with OPC is very low, with involvement of midline providing the most significant prognosticator. These results call for trials on unilateral elective irradiation in selected groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

Esophagus and Contralateral Lung-Sparing IMRT for Locally Advanced Lung Cancer in the Community Hospital Setting.

PubMed

Kao, Johnny; Pettit, Jeffrey; Zahid, Soombal; Gold, Kenneth D; Palatt, Terry

2015-01-01

The optimal technique for performing lung IMRT remains poorly defined. We hypothesize that improved dose distributions associated with normal tissue-sparing IMRT can allow safe dose escalation resulting in decreased acute and late toxicity. We performed a retrospective analysis of 82 consecutive lung cancer patients treated with curative intent from 1/10 to 9/14. From 1/10 to 4/12, 44 patients were treated with the community standard of three-dimensional conformal radiotherapy or IMRT without specific esophagus or contralateral lung constraints (standard RT). From 5/12 to 9/14, 38 patients were treated with normal tissue-sparing IMRT with selective sparing of contralateral lung and esophagus. The study endpoints were dosimetry, toxicity, and overall survival. Despite higher mean prescribed radiation doses in the normal tissue-sparing IMRT cohort (64.5 vs. 60.8 Gy, p = 0.04), patients treated with normal tissue-sparing IMRT had significantly lower lung V20, V10, V5, mean lung, esophageal V60, and mean esophagus doses compared to patients treated with standard RT (p ≤ 0.001). Patients in the normal tissue-sparing IMRT group had reduced acute grade ≥3 esophagitis (0 vs. 11%, p < 0.001), acute grade ≥2 weight loss (2 vs. 16%, p = 0.04), and late grade ≥2 pneumonitis (7 vs. 21%, p = 0.02). The 2-year overall survival was 52% with normal tissue-sparing IMRT arm compared to 28% for standard RT (p = 0.015). These data provide proof of principle that suboptimal radiation dose distributions are associated with significant acute and late lung and esophageal toxicity that may result in hospitalization or even premature mortality. Strict attention to contralateral lung and esophageal dose-volume constraints are feasible in the community hospital setting without sacrificing disease control.

Contralateral disconnection of the rat prelimbic cortex and dorsomedial striatum impairs cue-guided behavioral switching

PubMed Central

Baker, Phillip M.

2014-01-01

Switches in reward outcomes or reward-predictive cues are two fundamental ways in which information is used to flexibly shift response patterns. The rat prelimbic cortex and dorsomedial striatum support behavioral flexibility based on a change in outcomes. The present experiments investigated whether these two brain regions are necessary for conditional discrimination performance in which a switch in reward-predictive cues occurs every three to six trials. The GABA agonists baclofen and muscimol infused into the prelimbic cortex significantly impaired performance leading rats to adopt an inappropriate turn strategy. The NMDA receptor antagonist D-AP5 infused into the dorsomedial striatum or prelimbic cortex and dorsomedial striatum contralateral disconnection impaired performance due to a rat failing to switch a response choice for an entire trial block in about two out of 13 test blocks. In an additional study, contralateral disconnection did not affect nonswitch discrimination performance. The results suggest that the prelimbic cortex and dorsomedial striatum are necessary to support cue-guided behavioral switching. The prelimbic cortex may be critical for generating alternative response patterns while the dorsomedial striatum supports the selection of an appropriate response when cue information must be used to flexibly switch response patterns. PMID:25028395

Bilateral implantation of +2.5 D multifocal intraocular lens and contralateral implantation of +2.5 D and +3.0 D multifocal intraocular lenses: Clinical outcomes.

PubMed

Nuijts, Rudy M M A; Jonker, Soraya M R; Kaufer, Robert A; Lapid-Gortzak, Ruth; Mendicute, Javier; Martinez, Cristina Peris; Schmickler, Stefanie; Kohnen, Thomas

2016-02-01

To assess the clinical visual outcomes of bilateral implantation of Restor +2.5 diopter (D) multifocal intraocular lenses (IOLs) and contralateral implantation of a Restor +2.5 D multifocal IOL in the dominant eye and Restor +3.0 D multifocal IOL in the fellow eye. Multicenter study at 8 investigative sites. Prospective randomized parallel-group patient-masked 2-arm study. This study comprised adults requiring bilateral cataract extraction followed by multifocal IOL implantation. The primary endpoint was corrected intermediate visual acuity (CIVA) at 60 cm, and the secondary endpoint was corrected near visual acuity (CNVA) at 40 cm. Both endpoints were measured 3 months after implantation with a noninferiority margin of Δ = 0.1 logMAR. In total, 103 patients completed the study (53 bilateral, 50 contralateral). At 3 months, the mean CIVA at 60 cm was 0.13 logMAR and 0.10 logMAR in the bilateral group and contralateral group, respectively (difference 0.04 logMAR), achieving noninferiority. Noninferiority was not attained for CNVA at 40 cm; mean values at 3 months for bilateral and contralateral implantation were 0.26 logMAR and 0.11 logMAR, respectively (difference 0.15 logMAR). Binocular defocus curves suggested similar performance in distance vision between the 2 groups. Treatment-emergent ocular adverse events rates were similar between the groups. Bilateral implantation of the +2.5 D multifocal IOL resulted in similar distance as contralateral implantation of the +2.5 D multifocal IOL and +3.0 D multifocal IOL for intermediate vision (60 cm), while noninferiority was not achieved for near distances (40 cm). Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

A useful method for assessing differences of compensatory hypertrophy in the contralateral kidney before and after radical nephrectomy in patients with renal cell carcinoma: ellipsoid formula on computed tomography.

PubMed

Park, Bong Hee; Cho, Kang Jun; Kim, Jung Im; Bae, Sang Rak; Lee, Yong Seok; Kang, Sung Hak; Kim, Joon Chul; Han, Chang Hee

2018-02-01

To investigate the usefulness of the ellipsoid formula for assessing compensatory hypertrophy of the contralateral kidney on pre-operative and post-operative CT in renal cell carcinoma (RCC) patients. We retrospectively identified 389 patients who had radical nephrectomy for RCC between 2011  and 2015. Contrast-enhanced CT was performed within 3 months pre-operative and at 1 year post-operative. The kidney volumes were calculated from CT using the ellipsoid formula. We subdivided patients into three groups based on tumour size (I: ≤4 cm, II: 4-7 cm, III: >7 cm). Volumetric renal parameters were compared and multivariate analyses were performed to determine predictors associated with pre-operative  and post-operative compensatory hypertrophy. Kidney volume calculation using the ellipsoid  method took a median of 51 s. Group III had a significantly larger median pre-operative contralateral renal volume than Groups I and II (I:  140.4, II: 141.6, III: 166.7 ml, p < 0.05). However, the median ratio of post-operative contralateral renal volume change was significantly higher in Groups I and II than Group III (I: 0.36, II: 0.23, III: 0.12, p < 0.001). On multivariate analysis, tumour size revealed the strongest positive association with pre-operative contralateral kidney volume (partial regression coefficient: β = 30.8, >7 cm) and ratio of post-operative contralateral kidney volume change (β  = 0.214, I vs III; β = 0.168, II vs III). Kidney volume calculation for assessing pre- and post-operative compensatory hypertrophy of the contralateral kidney in RCC patients can be easily and rapidly performed from CT images using the ellipsoid formula. Advances in knowledge: The ellipsoid formula allows reliable method for assessing pre-operative and post-operative compensatory hypertrophy of the contralateral kidney in RCC.

Resilience to the contralateral visual field bias as a window into object representations

PubMed Central

Garcea, Frank E.; Kristensen, Stephanie; Almeida, Jorge; Mahon, Bradford Z.

2016-01-01

Viewing images of manipulable objects elicits differential blood oxygen level-dependent (BOLD) contrast across parietal and dorsal occipital areas of the human brain that support object-directed reaching, grasping, and complex object manipulation. However, it is unknown which object-selective regions of parietal cortex receive their principal inputs from the ventral object-processing pathway and which receive their inputs from the dorsal object-processing pathway. Parietal areas that receive their inputs from the ventral visual pathway, rather than from the dorsal stream, will have inputs that are already filtered through object categorization and identification processes. This predicts that parietal regions that receive inputs from the ventral visual pathway should exhibit object-selective responses that are resilient to contralateral visual field biases. To test this hypothesis, adult participants viewed images of tools and animals that were presented to the left or right visual fields during functional magnetic resonance imaging (fMRI). We found that the left inferior parietal lobule showed robust tool preferences independently of the visual field in which tool stimuli were presented. In contrast, a region in posterior parietal/dorsal occipital cortex in the right hemisphere exhibited an interaction between visual field and category: tool-preferences were strongest contralateral to the stimulus. These findings suggest that action knowledge accessed in the left inferior parietal lobule operates over inputs that are abstracted from the visual input and contingent on analysis by the ventral visual pathway, consistent with its putative role in supporting object manipulation knowledge. PMID:27160998

Microglia in mouse retina contralateral to experimental glaucoma exhibit multiple signs of activation in all retinal layers

PubMed Central

2014-01-01

Background Glaucomatous optic neuropathy, a leading cause of blindness, can progress despite control of intraocular pressure - currently the main risk factor and target for treatment. Glaucoma progression shares mechanisms with neurodegenerative disease, including microglia activation. In the present model of ocular hypertension (OHT), we have recently described morphological signs of retinal microglia activation and MHC-II upregulation in both the untreated contralateral eyes and OHT eyes. By using immunostaining, we sought to analyze and quantify additional signs of microglia activation and differences depending on the retinal layer. Methods Two groups of adult Swiss mice were used: age-matched control (naïve, n = 12), and lasered (n = 12). In the lasered animals, both OHT eyes and contralateral eyes were analyzed. Retinal whole-mounts were immunostained with antibodies against Iba-1, MHC-II, CD68, CD86, and Ym1. The Iba-1+ cell number in the plexiform layers (PL) and the photoreceptor outer segment (OS), Iba-1+ arbor area in the PL, and area of the retina occupied by Iba-1+ cells in the nerve fiber layer-ganglion cell layer (NFL-GCL) were quantified. Results The main findings in contralateral eyes and OHT eyes were: i) ameboid microglia in the NFL-GCL and OS; ii) the retraction of processes in all retinal layers; iii) a higher level of branching in PL and in the OS; iv) soma displacement to the nearest cell layers in the PL and OS; v) the reorientation of processes in the OS; vi) MHC-II upregulation in all retinal layers; vii) increased CD68 immunostaining; and viii) CD86 immunolabeling in ameboid cells. In comparison with the control group, a significant increase in the microglial number in the PL, OS, and in the area occupied by Iba-1+ cells in the NFL-GCL, and significant reduction of the arbor area in the PL. In addition, rounded Iba-1+ CD86+ cells in the NFL-GCL, OS and Ym1+ cells, and rod-like microglia in the NFL-GCL were restricted to OHT eyes

Molecular and Culture-Based Assessment of the Microbial Diversity of Diabetic Chronic Foot Wounds and Contralateral Skin Sites

PubMed Central

Oates, Angela; Bowling, Frank L.; Boulton, Andrew J. M.

2012-01-01

Wound debridement samples and contralateral (healthy) skin swabs acquired from 26 patients attending a specialist foot clinic were analyzed by differential isolation and eubacterium-specific PCR-denaturing gradient gel electrophoresis (DGGE) in conjunction with DNA sequencing. Thirteen of 26 wounds harbored pathogens according to culture analyses, with Staphylococcus aureus being the most common (13/13). Candida (1/13), pseudomonas (1/13), and streptococcus (7/13) were less prevalent. Contralateral skin was associated with comparatively low densities of bacteria, and overt pathogens were not detected. According to DGGE analyses, all wounds contained significantly greater eubacterial diversity than contralateral skin (P < 0.05), although no significant difference in total eubacterial diversity was detected between wounds from which known pathogens had been isolated and those that were putatively uninfected. DGGE amplicons with homology to Staphylococcus sp. (8/13) and S. aureus (2/13) were detected in putatively infected wound samples, while Staphylococcus sp. amplicons were detected in 11/13 noninfected wounds; S. aureus was not detected in these samples. While a majority of skin-derived DGGE consortial fingerprints could be differentiated from wound profiles through principal component analysis (PCA), a large minority could not. Furthermore, wounds from which pathogens had been isolated could not be distinguished from putatively uninfected wounds on this basis. In conclusion, while chronic wounds generally harbored greater eubacterial diversity than healthy skin, the isolation of known pathogens was not associated with qualitatively distinct consortial profiles or otherwise altered diversity. The data generated support the utility of both culture and DGGE for the microbial characterization of chronic wounds. PMID:22553231

Ipsilateral Breast Tumor Reappearance and Contralateral Breast Cancer after Primary Breast Cancer Treatment: A Comprehensive Retrospective Study of 15,168 Patients.

PubMed

Corso, Giovanni; Maisonneuve, Patrick; Santomauro, Giorgia Irene; De Scalzi, Alessandra Margherita; Toesca, Antonio; Bassi, Fabio Domenico; Farante, Gabriel; Caldarella, Pietro; Intra, Mattia; Galimberti, Viviana; Veronesi, Paolo

2018-05-30

The aim of this retrospective study was to assess the risk factors for developing ipsilateral breast tumor reappearance (IBTR) and de novo contralateral breast cancer (BC) after primary BC treatment. Retrospectively, 15,168 consecutive patients with primary monolateral BC were enrolled in this monocentric study (from June 1994 to December 2006). Clinicopathological features, follow-up, and survival at 15 years were considered for statistical analysis. Significant associations of increased risk for IBTR were verified with metastatic axillary lymph nodes (HR 1.37 [1.15-1.62], p = 0.0004), high tumor grade G2 (HR 1.35 [1.05-1.74], p = 0.02) and G3 (HR 1.35 [1.01-1.79], p = 0.04), luminal B (HR 1.51 [1.25-1.82], p < 0.0001), and HER2-positive (HR1.66 [1.14-2.41], p = 0.008) and triple-negative subtype (HR 1.54 [1.07-2.21], p = 0.02). Older age (HR 1.44 [1.08-1.91], p = 0.01) and positive family history (HR 1.85 [1.47-2.32], p < 0.0001) were risk factors for contralateral BC. Significant protective factors for IBTR were hormonotherapy (HR 0.71 [0.59-0.85], p = 0.0003), chemotherapy (HR 0.72 [0.60-0.87], p = 0.001), and radiotherapy (HR 0.73 [0.61-0.87], p = 0.0005). Hormonotherapy was also confirmed as a protective factor for contralateral second BC (HR 0.43 [0.30-0.60], p < 0.0001). We classified factors for IBTR and contralateral BC in high- and low-risk groups. In the high-risk group, breast surgery still remains more important than in the low-risk group, which seems to benefit more from adjuvant treatments. © 2018 S. Karger AG, Basel.

External root resorption during orthodontic treatment in root-filled teeth and contralateral teeth with vital pulp: A clinical study of contributing factors.

PubMed

Lee, Yun Ju; Lee, Tae Yeon

2016-01-01

There is a lack of research to support the belief that root canal treatment can be considered for stopping or decreasing external apical root resorption (EARR). There is conflicting evidence as to whether root-filled teeth are more or less likely to experience EARR after orthodontic treatment. The purpose of this study was to compare the degree of EARR of root-filled teeth with that of contralateral teeth with vital pulp after fixed orthodontic treatment. The study sample consisted of 35 patients aged 25.23 ± 4.92 years who had at least 1 root-filled tooth before orthodontic treatment. Digital panoramic radiographs of each patient taken before and after orthodontic treatment were used to measure the EARR. The Student t test for matched pairs and the Pearson correlation analysis were applied. The mean EARR values were 0.22 (0.14, 0.35) for root-filled teeth and 0.87 (0.59, 1.31) for contralateral teeth with vital pulp, indicating significantly less EARR for root-filled teeth compared with the contralateral teeth with vital pulp after orthodontic treatment. EARR was influenced by the patient's age, treatment duration, treatment type, and periapical pathosis, but not by tooth type and sex. Root-filled teeth appear to be associated with significantly less EARR than are contralateral teeth with vital pulp. This study suggests that the possible complication of EARR in root-filled teeth may not be an important consideration in orthodontic treatment planning, and root canal treatment can be considered for stopping or decreasing EARR when severe EARR occurs during orthodontic treatment. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers.

PubMed

Kuchenbaecker, Karoline B; Hopper, John L; Barnes, Daniel R; Phillips, Kelly-Anne; Mooij, Thea M; Roos-Blom, Marie-José; Jervis, Sarah; van Leeuwen, Flora E; Milne, Roger L; Andrieu, Nadine; Goldgar, David E; Terry, Mary Beth; Rookus, Matti A; Easton, Douglas F; Antoniou, Antonis C; McGuffog, Lesley; Evans, D Gareth; Barrowdale, Daniel; Frost, Debra; Adlard, Julian; Ong, Kai-Ren; Izatt, Louise; Tischkowitz, Marc; Eeles, Ros; Davidson, Rosemarie; Hodgson, Shirley; Ellis, Steve; Nogues, Catherine; Lasset, Christine; Stoppa-Lyonnet, Dominique; Fricker, Jean-Pierre; Faivre, Laurence; Berthet, Pascaline; Hooning, Maartje J; van der Kolk, Lizet E; Kets, Carolien M; Adank, Muriel A; John, Esther M; Chung, Wendy K; Andrulis, Irene L; Southey, Melissa; Daly, Mary B; Buys, Saundra S; Osorio, Ana; Engel, Christoph; Kast, Karin; Schmutzler, Rita K; Caldes, Trinidad; Jakubowska, Anna; Simard, Jacques; Friedlander, Michael L; McLachlan, Sue-Anne; Machackova, Eva; Foretova, Lenka; Tan, Yen Y; Singer, Christian F; Olah, Edith; Gerdes, Anne-Marie; Arver, Brita; Olsson, Håkan

2017-06-20

The clinical management of BRCA1 and BRCA2 mutation carriers requires accurate, prospective cancer risk estimates. To estimate age-specific risks of breast, ovarian, and contralateral breast cancer for mutation carriers and to evaluate risk modification by family cancer history and mutation location. Prospective cohort study of 6036 BRCA1 and 3820 BRCA2 female carriers (5046 unaffected and 4810 with breast or ovarian cancer or both at baseline) recruited in 1997-2011 through the International BRCA1/2 Carrier Cohort Study, the Breast Cancer Family Registry and the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, with ascertainment through family clinics (94%) and population-based studies (6%). The majority were from large national studies in the United Kingdom (EMBRACE), the Netherlands (HEBON), and France (GENEPSO). Follow-up ended December 2013; median follow-up was 5 years. BRCA1/2 mutations, family cancer history, and mutation location. Annual incidences, standardized incidence ratios, and cumulative risks of breast, ovarian, and contralateral breast cancer. Among 3886 women (median age, 38 years; interquartile range [IQR], 30-46 years) eligible for the breast cancer analysis, 5066 women (median age, 38 years; IQR, 31-47 years) eligible for the ovarian cancer analysis, and 2213 women (median age, 47 years; IQR, 40-55 years) eligible for the contralateral breast cancer analysis, 426 were diagnosed with breast cancer, 109 with ovarian cancer, and 245 with contralateral breast cancer during follow-up. The cumulative breast cancer risk to age 80 years was 72% (95% CI, 65%-79%) for BRCA1 and 69% (95% CI, 61%-77%) for BRCA2 carriers. Breast cancer incidences increased rapidly in early adulthood until ages 30 to 40 years for BRCA1 and until ages 40 to 50 years for BRCA2 carriers, then remained at a similar, constant incidence (20-30 per 1000 person-years) until age 80 years. The cumulative ovarian cancer risk to age 80 years was 44

Multichannel fiber-based diffuse reflectance spectroscopy for the rat brain exposed to a laser-induced shock wave: comparison between ipsi- and contralateral hemispheres

NASA Astrophysics Data System (ADS)

Miyaki, Mai; Kawauchi, Satoko; Okuda, Wataru; Nawashiro, Hiroshi; Takemura, Toshiya; Sato, Shunichi; Nishidate, Izumi

2015-03-01

Due to considerable increase in the terrorism using explosive devices, blast-induced traumatic brain injury (bTBI) receives much attention worldwide. However, little is known about the pathology and mechanism of bTBI. In our previous study, we found that cortical spreading depolarization (CSD) occurred in the hemisphere exposed to a laser- induced shock wave (LISW), which was followed by long-lasting hypoxemia-oligemia. However, there is no information on the events occurred in the contralateral hemisphere. In this study, we performed multichannel fiber-based diffuse reflectance spectroscopy for the rat brain exposed to an LISW and compared the results for the ipsilateral and contralateral hemispheres. A pair of optical fibers was put on the both exposed right and left parietal bone; white light was delivered to the brain through source fibers and diffuse reflectance signals were collected with detection fibers for both hemispheres. An LISW was applied to the left (ipsilateral) hemisphere. By analyzing reflectance signals, we evaluated occurrence of CSD, blood volume and oxygen saturation for both hemispheres. In the ipsilateral hemispheres, we observed the occurrence of CSD and long-lasting hypoxemia-oligemia in all rats examined (n=8), as observed in our previous study. In the contralateral hemisphere, on the other hand, no occurrence of CSD was observed, but we observed oligemia in 7 of 8 rats and hypoxemia in 1 of 8 rats, suggesting a mechanism to cause hypoxemia or oligemia or both that is (are) not directly associated with CSD in the contralateral hemisphere.

Cortical inhibition effect in musicians and non-musicians using P300 with and without contralateral stimulation.

PubMed

Rabelo, Camila Maia; Neves-Lobo, Ivone Ferreira; Rocha-Muniz, Caroline Nunes; Ubiali, Thalita; Schochat, Eliane

2015-01-01

Musicians have more robust and efficient neural responses in the cortical and sub-cortical regions, demonstrating that musical experience benefits the processing of both non-linguistic and linguistic stimuli. This study aimed to verify P300's latency and amplitude behavioral using contralateral stimulation in musicians and non-musicians. This was a case-control study. Subjects were divided in two groups: musicians, comprising 30 professional musicians, and non-musicians, comprising 25 subjects without musical experience. The present study showed that the musicians had lower latencies and higher amplitudes than the non-musicians in the P300 without contralateral noise. For the P300 amplitude values, the difference between groups persisted, and the musicians presented significantly higher amplitude values compared with the non-musicians; additionally, the analysis of the noise effect on the P300 response showed that the latency values were significantly increased in the musicians. The central auditory nervous system of musicians presents peculiar characteristics of electrophysiological responses probably due to the plasticity imposed by musical practice. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Evidence for a bipolar change in distortion product otoacoustic emissions during contralateral acoustic stimulation in humans

NASA Astrophysics Data System (ADS)

Müller, Jörg; Janssen, Thomas; Heppelmann, Guido; Wagner, Wolfgang

2005-12-01

The aim of this study was to investigate the activity of the medial olivocochlear (MOC) efferents during contralateral (CAS) and ipsilateral acoustic stimulation (IAS) by recording distortion product otoacoustic emission (DPOAE) suppression and DPOAE adaptation in humans. The main question was: do large bipolar changes in DPOAE level (transition from enhancement to suppression) also occur in humans when changing the primary tone level within a small range as described by Maison and Liberman for guinea pigs [J. Neurosci. 20, 4701-4707 (2000)]? In the present study, large bipolar changes in DPOAE level (14 dB on average across subjects) were found during CAS predominantly at frequencies where dips in the DPOAE fine structure occurred. Thus, effects of the second DPOAE source might be responsible for the observed bipolar effect. In contrast, comparable effects were not found during IAS as was reported in guinea pigs. Reproducibility of CAS DPOAEs was better than that for IAS DPOAEs. Thus, contralateral DPOAE suppression is suggested to be superior to ipsilateral DPOAE adaptation with regard to measuring the MOC reflex strength and for evaluating the vulnerability of the cochlea to acoustic overexposure in a clinical context.

Surgeons' Perspectives of Contralateral Prophylactic Mastectomy.

PubMed

Bellavance, Emily; Peppercorn, Jeffrey; Kronsberg, Shari; Greenup, Rachel; Keune, Jason; Lynch, Julie; Collyar, Deborah; Magder, Laurence; Tilburt, Jon; Hlubocky, Fay; Yao, Katharine

2016-09-01

Contralateral prophylactic mastectomy (CPM) is commonly performed for the treatment of breast cancer, despite its limited oncologic benefit. Little is known about surgeons' perceptions of performing CPM. We hypothesized that a proportion of surgeons would report discomfort with performing CPM, particularly when there is discordance between patients' perceived benefit from CPM and the expected oncologic benefit. A survey was sent to members of the American Society of Breast Surgeons seeking self-reports of surgeons' practice patterns, perceptions, and comfort levels with CPM. Of the 2436 members surveyed, 601 responded (response rate = 24.7 %). The median age of respondents was 52 years, and 59 % of responders were women. The majority (58 %) reported that 80 % of their practice was devoted to the treatment of breast disease. Fifty-seven percent (n = 326) of respondents reported discomfort with performing CPM at some point in their practice. While most surgeons (95 %) were comfortable with CPM on a patient with a deleterious BRCA mutation, only 34 % were comfortable performing CPM on an average-risk patient. The most common reasons reported for surgeon discomfort with CPM were a concern for overtreatment, an unfavorable risk/benefit ratio, and inadequate patient understanding of the anticipated risks and benefits of CPM. Despite the increasing use of CPM for the treatment of breast cancer, many surgeons report discomfort with CPM. Concerns with performing CPM predominantly focus on ambiguities surrounding the oncologic benefit and relative risk of this procedure. Further research is needed to define optimal shared decision-making practices in this area.

Granulosa cell tumor of the contralateral testis in a man with a history of cryptorchism.

PubMed

Guzzo, Thomas; Gerstein, Matthew; Mydlo, Jack H

2004-01-01

We report a case of adult-type testicular granulosa cell tumor in a 33-year-old man with a history of cryptorchism of the contralateral testis as well as Crohn's disease. The tumor was identified as a 1 x 1 x 1 cm mass on baseline ultrasound evaluation. CT evaluation of the patient revealed extensive mesenteric adenopathy, most likely secondary to his history of Crohn's disease. Copyright 2004 S. Karger AG, Basel

Ipsi- and Contralateral Motor Response Using Ultrasound-induced Neurostimulation in Deeply Anesthetized Mice

NASA Astrophysics Data System (ADS)

Kamimura, Hermes; Wang, Shutao; Chen, Hong; Wang, Qi; Aurup, Christian; Fan, Kathtleen; Carneiro, Antonio; Konofagou, Elisa

Ultrasound neurostimulation has been proven capable of eliciting motor responses. However, the studies in sedated rodents presented problems with target specificity due to the use of low ultrasound frequencies (<700 kHz). Here, we show that focused ultrasound (FUS) in mega-Hz range was able to evoke motor responses in mice under deep anesthesia. Contralateral movements of the hind limbs were observed when sonications were carried out at +2 mm of Lambda and ±2 mm lateral of midline in three mice. Moreover, stimulating other regions of the somatosensory and cerebellum induced trunk and ipsilateral limb movements in all six mice.

Contralateral Prophylactic Mastectomy for Women with T4 Locally Advanced Breast Cancer.

PubMed

Murphy, Brittany L; Hoskin, Tanya L; Boughey, Judy C; Degnim, Amy C; Glazebrook, Katrina N; Hieken, Tina J

2016-10-01

The use of contralateral prophylactic mastectomy (CPM) for women with unilateral breast cancer is increasing. The authors were interested in assessing whether this trend extended to patients with T4 disease. We identified 92 patients from our prospective breast surgery registry with unilateral clinical T4 M0 disease who underwent mastectomy at our institution from October 2008 to July 2015. Patient, tumor, and treatment variables were compared between patients who did and those who did not undergo CPM, and the reasons patients elected CPM were ascertained. Of the 92 patients, 33 (36 %) underwent a CPM, including 25 of 55 patients (45 %) with inflammatory breast cancer. Immediate breast reconstruction was performed for 11 of the 92 patients (12 %), including 4 CPM patients. Pathology showed benign findings in all 33 CPM cases, including 3 patients with atypical hyperplasia. The primary reason for CPM reported by the patients included fear of occult current or future breast cancer in 12 cases (36 %), symmetry in 11 cases (33 %), avoidance of future chemotherapy in 5 cases (15 %), deleterious BRCA mutation in 2 cases (6 %), contralateral benign breast disease in 2 cases (6 %), and medical oncologist recommendation in 1 cases (3 %). Patients selecting CPM were younger and more likely to have undergone BRCA testing. A substantial rate of CPM was observed among women undergoing mastectomy for unilateral T4 breast cancer despite the considerable risk of mortality from their index cancer. The reasons for selection of CPM paralleled those reported for patients with early-stage disease. The most common motivation was fear of occult current or future breast cancer and included the desire to avoid further chemotherapy.

Study of external root resorption during orthodontic treatment in root filled teeth compared with their contralateral teeth with vital pulps.

PubMed

Llamas-Carreras, J M; Amarilla, A; Solano, E; Velasco-Ortega, E; Rodríguez-Varo, L; Segura-Egea, J J

2010-08-01

To determine whether root filled teeth and those with vital pulps exhibit a similar degree of external root resorption (ERR) as a consequence of orthodontic treatment. The study sample consisted of 77 patients, with a mean age of 32.7 +/- 10.7 years, who had one root filled tooth before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the root filled tooth and that in its contralateral tooth with a vital pulp. The student's t-test, anova and logistic regression analysis were used to determine statistical significance. The mean PRR was 1.00 +/- 0.13, indicating that, in the total sample, there were no significant differences in root resorption in the root filled teeth and their contralateral teeth with vital pulps. Multivariate logistic regression analysis suggested that PRR was significantly greater in incisors (P = 0.0014; odds ratio = 6.2885, C.I. 95% = 2.0-19.4), compared to other teeth, and in women (P = 0.0255; odds ratio = 4.2, C.I. 95% = 1.2-14.6), compared to men. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root filled teeth and their contralateral teeth with vital pulps.

High femoral artery bifurcation predicts contralateral high bifurcation: implications for complex percutaneous cardiovascular procedures requiring large caliber and/or dual access.

PubMed

Gupta, Vipul; Feng, Kent; Cheruvu, Pavan; Boyer, Nathan; Yeghiazarians, Yerem; Ports, Thomas A; Zimmet, Jeffrey; Shunk, Kendrick; Boyle, Andrew J

2014-09-01

Recent advances in technology have led to an increase in the use of bilateral femoral artery access and the requirement for large-bore access. Optimal access is in the common femoral artery (CFA), rather than higher (in the external iliac artery) or lower (in one of the branches of the CFA). However, there is a paucity of data in the literature about the relationship between bifurcation level of one CFA and the contralateral CFA. To define the prevalence of high bifurcation of the CFA and the relationship between bifurcation level on both sides, we performed a retrospective analysis of all patients with bilateral femoral angiography. From 4880 femoral angiograms performed at UCSF cardiac catheterization laboratory between 2005-2013, a total of 273 patients had bilateral femoral angiograms. The prevalence of low/normal, high, and very-high femoral bifurcations was 70%, 26%, and 4%, respectively, with no difference between sides. A high or very-high bifurcation significantly increased the likelihood of a high bifurcation on the contralateral side (odds ratio >3.0). Multivariable logistic regression analysis revealed age, gender, self-reported race, height, weight, and body mass index were not predictive of high or very-high bifurcations on either side. In conclusion, high femoral artery bifurcations are common and increase the likelihood of a high bifurcation of the contralateral femoral artery.

Probing the Effects and Mechanisms of Electroacupuncture at Ipsilateral or Contralateral ST36-ST37 Acupoints on CFA-induced Inflammatory Pain.

PubMed

Lu, Kung-Wen; Hsu, Chao-Kuei; Hsieh, Ching-Liang; Yang, Jun; Lin, Yi-Wen

2016-02-24

Transient receptor potential vanilloid 1 (TRPV1) and associated signaling pathways have been reported to be increased in inflammatory pain signaling. There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). EA can reliably attenuate the increase of TRPV1 in mouse inflammatory pain models with unclear signaling mechanisms. Moreover, the difference in the clinical therapeutic effects between using the contralateral and ipsilateral acupoints has been rarely studied. We found that inflammatory pain, which was induced by injecting the complete Freund's adjuvant (CFA), (2.14 ± 0.1, p < 0.05, n = 8) can be alleviated after EA treatment at either ipsilateral (3.91 ± 0.21, p < 0.05, n = 8) or contralateral acupoints (3.79 ± 0.25, p < 0.05, n = 8). EA may also reduce nociceptive Nav sodium currents in dorsal root ganglion (DRG) neurons. The expression of TRPV1 and associated signaling pathways notably increased after the CFA injection; this expression can be further attenuated significantly in EA treatment. TRPV1 and associated signaling pathways can be prevented in TRPV1 knockout mice, suggesting that TRPV1 knockout mice are resistant to inflammatory pain. Through this study, we have increased the understanding of the mechanism that both ipsilateral and contralateral EA might alter TRPV1 and associated signaling pathways to reduce inflammatory pain.

Mammographic findings after reshaping with autoprosthesis in women undergoing contralateral breast reconstruction and mastectomy.

PubMed

Scaperrotta, Gianfranco; Capalbo, Emanuela; Ferranti, Claudio; Falco, Giuseppe; Nava, Maurizio B; Di Leo, Gianni; Marchesini, Monica; Suman, Laura; Panizza, Pietro

2016-01-01

Breast reduction and mastopexy combined with inferior dermo-lipo-glandular flap (autoprosthesis) gives good breast shape, long-term projection, and upper pole fullness. We assess the impact on breast oncologic surveillance compared to other techniques. A total of 105 patients who underwent mastectomy and reconstruction were divided into 3 groups of 35 patients each: groups 1 and 2 include patients with contralateral breast symmetrization performed with and without autoprosthesis technique, respectively. Group 3 is a control group without contralateral breast reshaping. On mammography, edema, skin thickening, architectural distortion, and calcifications were recorded, as well as further diagnostic examinations, biopsies, and surgical treatments required. Statistically significant differences (p<0.001) in the first follow-up mammography between groups 1 and 2 were stromal edema (6% vs 51%) and architectural distortion (74% vs 63%). The latest findings meant architectural distortion also have significant difference (p<0.001) in the last mammography (79% vs 66%). Microcalcification has statistically significant difference (p<0.001) in the latest postsurgical mammography, increased in group 1. Skin thickening had a similar course in either group. Mammography follow-up was not impaired in most cases notwithstanding the parenchyma distortion as compared with mammography after breast-conserving surgery. Four core biopsies were performed in both groups: 3 new breast cancers and 1 benign epithelial hyperplasia were found. No difficulties were found impairing mammographic evaluation in patients treated with autoprosthesis as compared to other techniques.

Ipsilateral hemiparesis and contralateral lower limb paresis caused by anterior cerebral artery territory infarct

PubMed Central

Xu, Yongfeng; Liu, Lan

2016-01-01

Ipsilateral hemiparesis is rare after a supratentorial stroke, and the role of reorganization in the motor areas of unaffected hemisphere is important for the rehabilitation of the stroke patients. In this study, we present a patient who had a subclinical remote infarct in the right pons developed ipsilateral hemiparesis and contralateral lower limb paresis caused by a new infarct in the left anterior cerebral artery territory. Our case suggests that the motor areas of the unaffected hemisphere might be reorganized after stroke, which is important for the rehabilitation of stroke patients. PMID:27356659

Ipsilateral hemiparesis and contralateral lower limb paresis caused by anterior cerebral artery territory infarct.

PubMed

Xu, Yongfeng; Liu, Lan

2016-07-01

Ipsilateral hemiparesis is rare after a supratentorial stroke, and the role of reorganization in the motor areas of unaffected hemisphere is important for the rehabilitation of the stroke patients. In this study, we present a patient who had a subclinical remote infarct in the right pons developed ipsilateral hemiparesis and contralateral lower limb paresis caused by a new infarct in the left anterior cerebral artery territory. Our case suggests that the motor areas of the unaffected hemisphere might be reorganized after stroke, which is important for the rehabilitation of stroke patients.

Metoclopramide unmasks potentially misleading contralateral suppression in patients undergoing adrenal vein sampling for primary aldosteronism.

PubMed

Rossitto, Giacomo; Miotto, Diego; Battistel, Michele; Barbiero, Giulio; Maiolino, Giuseppe; Bisogni, Valeria; Sanga, Viola; Rossi, Gian Paolo

2016-11-01

As metoclopramide stimulates aldosterone secretion, we tested its usefulness in the assessment of lateralization of primary aldosteronism by adrenal vein sampling (AVS). Prospective within-patient study in consecutive patients undergoing AVS for primary aldosteronism subtyping. We compared the diagnostic accuracy of baseline and postmetoclopramide lateralization index and relative (to cortisol) aldosterone secretion indices (RASI) for each adrenal gland with aldosterone-producing adenoma (APA) determined by the four corners criteria as the reference diagnosis. We recruited 93 consecutive patients (mean age: 52 years; women 31%). Metoclopramide increased plasma aldosterone in the inferior vena cava and in both adrenal veins. The postmetoclopramide lateralization index was accurate in identifying APA, but did not increase diagnostic accuracy over baseline lateralization index, because the RASI increased similarly in both sides. Conversely, metoclopramide raised RASI to values more than 0.90 bilaterally in non-APA patients allowing accurate identification of factitious aldosterone suppression. In contrast, RASI was 0.90 or less in 48% contralateral to the tumor in APA patients. Regression analysis showed the APA patients with persistent suppression of RASI contralaterally showed a more florid primary aldosteronism phenotype. Metoclopramide does not enhance lateralization of aldosterone excess in APA, but consistently increased the value of RASI in non-APA cases, thus unmasking potentially misleading suppression of aldosterone. Postmetoclopramide RASI may therefore allow a more precise diagnosis when AVS can be achieved only unilaterally.

Real-time monitoring of ischemic and contralateral brain pO2 during stroke by variable length multisite resonators

PubMed Central

Hou, Huagang; Li, Hongbin; Dong, Ruhong; Khan, Nadeem; Swartz, Harold

2014-01-01

Purpose Electron paramagnetic resonance (EPR) oximetry using variable length multi-probe implantable resonator (IR), was used to investigate the temporal changes in the ischemic and contralateral brain pO2 during stroke in rats. Material and Methods The EPR signal to noise ratio (S/N) of the IR with four sensor loops at a depth of up to11 mm were compared with direct implantation of lithium phthalocyanine (LiPc, oximetry probe) deposits in vitro. These IRs were used to follow the temporal changes in pO2 at two sites in each hemisphere during ischemia induced by left middle cerebral artery occlusion (MCAO) in rats breathing 30% O2 or 100% O2. Results The S/N ratios of the IRs were significantly greater than the LiPc deposits. A similar pO2 at two sites in each hemisphere prior to the onset of ischemia was observed in rats breathing 30% O2. However, a significant decline in the pO2 of the left cortex and striatum occurred during ischemia but no change in the pO2 of the contralateral brain was observed. A significant increase in the pO2 of only the contralateral non-ischemic brain was observed in the rats breathing 100% O2. No significant difference in the infarct volume was evident between the animals breathing 30% O2 or 100% O2 during ischemia. Conclusions EPR oximetry with IRs can repeatedly assess temporal changes in the brain pO2 at four sites simultaneously during stroke. This oximetry approach can be used to test and develop interventions to rescue ischemic tissue by modulating cerebral pO2 during stroke. PMID:24629514

Effect of Contralateral Strength Training on Muscle Weakness in People With Multiple Sclerosis: Proof-of-Concept Case Series.

PubMed

Manca, Andrea; Cabboi, Maria Paola; Ortu, Enzo; Ginatempo, Francesca; Dragone, Daniele; Zarbo, Ignazio Roberto; de Natale, Edoardo Rosario; Mureddu, Giovanni; Bua, Guido; Deriu, Franca

2016-06-01

The contralateral strength training (CST) effect is a transfer of muscle performance to the untrained limb following training of the contralateral side. The aim of this study was to explore, in individuals with multiple sclerosis (MS) presenting marked lower limb strength asymmetry, the effectiveness of CST on management of muscle weakness of the more-affected limb following training of the less-affected limb. A single-subject research design was used. Eight individuals with MS underwent 16 to 18 high-intensity training sessions of the less-affected ankle dorsiflexor muscles. The primary outcome measure of this single-system case series was maximal strength expressed as peak moment and maximal work. Secondary outcome measures were: Six-Minute-Walk Test, Timed "Up & Go" Test, 10-Meter Timed Walk Test, and Multiple Sclerosis Quality of Life-54 questionnaire. After the 6-week intervention, the contralateral more affected (untrained) limb showed a 22% to 24% increase in maximal strength. From pretest-posttest measurements, participants also performed significantly better on the clinical and functional secondary outcome measures. At the 12-week follow-up, the strength levels of the weaker untrained limb remained significantly superior to baseline levels in the majority (5 out of 8) of the outcome parameters. Considering the design used, the absence of a control group, and the sample size, these findings should be cautiously generalized and will need confirmation in a properly planned randomized controlled trial. The present proof-of-concept study shows, for the first time, the occurrence of the CST effect on muscle performance of ankle dorsiflexor muscles in people with MS. These preliminary findings reveal new potential implications for CST as a promising rehabilitation approach to those conditions where unilateral muscle weakness does not allow or makes difficult performing conventional strength training of the weaker limb. © 2016 American Physical Therapy

Retropharyngeal Contralateral C7 Nerve Transfer to the Lower Trunk for Brachial Plexus Birth Injury: Technique and Results.

PubMed

Vu, Anthony T; Sparkman, Darlene M; van Belle, Christopher J; Yakuboff, Kevin P; Schwentker, Ann R

2018-05-01

Brachial plexus birth injuries with multiple nerve root avulsions present a particularly difficult reconstructive challenge because of the limited availability of donor nerves. The contralateral C7 has been described for brachial plexus reconstruction in adults but has not been well-studied in the pediatric population. We present our technique and results for retropharyngeal contralateral C7 nerve transfer to the lower trunk for brachial plexus birth injury. We performed a retrospective review. Any child aged less than 2 years was included. Charts were analyzed for patient demographic data, operative variables, functional outcomes, complications, and length of follow-up. We had a total of 5 patients. Average nerve graft length was 3 cm. All patients had return of hand sensation to the ulnar nerve distribution as evidenced by a pinch test, unprompted use of the recipient limb without mirror movement, and an Active Movement Scale (AMS) of at least 2/7 for finger and thumb flexion; one patient had an AMS of 7/7 for finger and thumb flexion. Only one patient had return of ulnar intrinsic hand function with an AMS of 3/7. Two patients had temporary triceps weakness in the donor limb and one had clinically insignificant temporary phrenic nerve paresis. No complications were related to the retropharyngeal nerve dissection in any patient. Average follow-up was 3.3 years. The retropharyngeal contralateral C7 nerve transfer is a safe way to supply extra axons to the severely injured arm in brachial plexus birth injuries with no permanent donor limb deficits. Early functional recovery in these patients, with regard to hand function and sensation, is promising. Therapeutic V. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Some glial progenitors in the neonatal subventricular zone migrate through the corpus callosum to the contralateral cerebral hemisphere.

PubMed

Kakita, Akiyoshi; Zerlin, Marielba; Takahashi, Hitoshi; Goldman, James E

2003-04-14

The great majority of glial cells of the mammalian forebrain are generated in the perinatal period from progenitors in the subventricular zone (SVZ). We investigated the migration of progenitors from the neonatal (postnatal day 0, P0) rat forebrain SVZ by labeling them in vivo with a green fluorescence protein (GFP) retrovirus and monitoring their movements by time-lapse video microscopy in P3 slices. We identified a small number of progenitors that migrated tangentially within the corpus callosum (CC) and crossed the midline. These cells retained a relatively uniform morphology: the leading process was extended toward the contralateral side but showed no process branching or turning away from the migratory direction. Net migration requires the elongation of the leading process and nuclear translocation, and the migrating cells in the CC showed both modes. We confirmed the presence of unmyelinated axon bundles within the P3 CC, but failed to detect any radially directed glial processes (vimentin- or GLAST-immunolabeled fibers) spanning through the CC. Confocal images showed a close proximity between neurofilament-immunolabeled axons and the leading process of the GFP-expressing progenitors in the CC. The destination of the callosal fibers was examined by applying DiI to the right cingulum; the labeled fibers ran throughout the CC and reached the left cingulate and motor areas. The distribution and final fates of the retrovirus-labeled cells were examined in P28 brains. A small proportion of the labeled cells were found in the contralateral hemisphere, where, as oligodendrocytes and astrocytes, they colonized predominantly the cortex and the underlying white matter of the cingulate and secondary motor areas. The distribution pattern appears to coincide well with the projection direction of the callosal fibers. Thus, glial progenitors migrate across the CC, presumably in conjunction with unmyelinated axons, to colonize the contralateral hemisphere. Copyright 2003

Comparison of the inflammatory burden of truly asymptomatic carotid atheroma with atherosclerotic plaques contralateral to symptomatic carotid stenosis: an ultra small superparamagnetic iron oxide enhanced magnetic resonance study

PubMed Central

Tang, Tjun Y; Howarth, Simon P S; Miller, Sam R; Graves, Martin J; U‐King‐Im, Jean‐Marie; Trivedi, Rikin A; Li, Zhi Yong; Walsh, Stewart R; Brown, Andrew P; Kirkpatrick, Peter J; Gaunt, Michael E; Gillard, Jonathan H

2007-01-01

Background Inflammation is a recognised risk factor for the vulnerable atherosclerotic plaque. The aim of this study was to explore whether there is a difference in the degree of magnetic resonance (MR) defined inflammation using ultra small superparamagnetic iron oxide (USPIO) particles within carotid atheroma in completely asymptomatic individuals and the asymptomatic carotid stenosis contralateral to the symptomatic side. Methods 20 symptomatic patients with contralateral disease and 20 completely asymptomatic patients underwent multi‐sequence MR imaging before and 36 h after USPIO infusion. Images were manually segmented into quadrants and signal change in each quadrant was calculated following USPIO administration. Mean signal change was compared across all quadrants in the two groups. Results The mean percentage of quadrants showing signal loss was 53% in the contralateral group compared with 31% in completely asymptomatic individuals (p = 0.025). The mean percentages showing enhancement were 44% and 65%, respectively (p = 0.024). The mean signal difference between the two groups was 8.6% (95% CI 1.6% to 15.6%; p = 0.017). Conclusions Truly asymptomatic plaques seem to demonstrate inflammation but not to the extent of the contralateral asymptomatic stenosis to the symptomatic side. Inflammatory activity may be a significant risk factor in asymptomatic disease. PMID:17578854

Reconstruction of an anterior chest wall radionecrosis defect by a contralateral latissimus dorsi flap: A case report.

PubMed

Vairinho, A; Al Hindi, A; Revol, M; Legras, A; Rem, K; Guenane, Y; Cristofari, S; Sorin, T

2018-04-01

Soft tissue and bone radionecrosis are rare but serious complications may occur late after radiotherapy. We report the case of an 86-year-old woman with a history an infiltrating ductal carcinoma of the left breast, treated by total mastectomy, left axillary dissection and adjuvant radiotherapy. Eighteen years later, the first radionecrosis lesions appeared and grew progressively in a 6-month period. These lesions are deep, involving the anterior aspect of the 4th to the 6th ribs and infiltrating the chest wall to the left cardio-thoracic space communicating largely with the pericardium. During axillary dissection, the neurovascular pedicle of the left latissimus dorsi muscle had been severed. The first part of the operation consisted of performing a left side parietectomy of the thoracic wall with a large resection of pericardial tissue and a small myocardial patch. The second step consisted of repairing the thoracic wall defect with a contralateral musculocutaneous latissimus dorsi flap. Due to its significant axis of rotation, the latissimus dorsi muscle flap must be considered in the therapeutic algorithm for covering of contralateral anterior chest wall defects. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Does Contralateral Delay Activity Reflect Working Memory Storage or the Current Focus of Spatial Attention within Visual Working Memory?

PubMed

Berggren, Nick; Eimer, Martin

2016-12-01

During the retention of visual information in working memory, event-related brain potentials show a sustained negativity over posterior visual regions contralateral to the side where memorized stimuli were presented. This contralateral delay activity (CDA) is generally believed to be a neural marker of working memory storage. In two experiments, we contrasted this storage account of the CDA with the alternative hypothesis that the CDA reflects the current focus of spatial attention on a subset of memorized items set up during the most recent encoding episode. We employed a sequential loading procedure where participants memorized four task-relevant items that were presented in two successive memory displays (M1 and M2). In both experiments, CDA components were initially elicited contralateral to task-relevant items in M1. Critically, the CDA switched polarity when M2 displays appeared on the opposite side. In line with the attentional activation account, these reversed CDA components exclusively reflected the number of items that were encoded from M2 displays, irrespective of how many M1 items were already held in working memory. On trials where M1 and M2 displays were presented on the same side and on trials where M2 displays appeared nonlaterally, CDA components elicited in the interval after M2 remained sensitive to a residual trace of M1 items, indicating that some activation of previously stored items was maintained across encoding episodes. These results challenge the hypothesis that CDA amplitudes directly reflect the total number of stored objects and suggest that the CDA is primarily sensitive to the activation of a subset of working memory representations within the current focus of spatial attention.

Risk of second primary cancers after testicular cancer in East and West Germany: A focus on contralateral testicular cancers

PubMed Central

Rusner, Carsten; Streller, Brigitte; Stegmaier, Christa; Trocchi, Pietro; Kuss, Oliver; McGlynn, Katherine A; Trabert, Britton; Stang, Andreas

2014-01-01

Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type (seminoma and non-seminoma) among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany (1961–1989 and 1996–2008) and Saarland (a federal state in West Germany; 1970–2008), respectively. We estimated the risk of a second primary cancer using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 (SIR: 1.9; 95% CI: 1.7–2.1), and 159 cancers (any location) were observed between 1996 and 2008 (SIR: 1.7; 95% CI: 1.4–2.0). The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups. PMID:24407180

IS PAIN IN ONE KNEE ASSOCIATED WITH ISOMETRIC MUSCLE STRENGTH IN THE CONTRALATERAL LIMB? - DATA FROM THE OSTEOARTHRITIS INITIATIVE (OAI)

PubMed Central

Steidle, E.; Wirth, W.; Glass, N.; Ruhdorfer, A.; Cotofana, S.; Eckstein, F.; Segal, N. A.

2014-01-01

Objective Knee pain and muscle weakness confer risk for knee osteoarthritis incidence and progression. The purpose of this study was to determine whether unilateral knee pain influences contralateral thigh muscle strength. Design Of 4796 Osteoarthritis Initiative participants, 224 (mean±SD age 63.9±8.9 years) cases could be matched to a control. Cases were defined as having unilateral knee pain (numerical rating scale (NRS)≥4/10; ≥infrequent pain) and one pain-free knee (NRS 0–1; ≤infrequent pain; WOMAC≤1). Controls were defined as having bilaterally pain-free knees (NRS 0–1; ≤infrequent pain; WOMAC≤1). Maximal isometric muscle strength [N] was compared between limbs in participants with unilateral pain (cases), and between pain-free limbs of cases and controls. Results Knee extensor/flexor strength in pain-free limbs of cases was lower than in bilaterally pain-free controls (−5.5%/–8.4%; p=0.043/p=0.022). Within cases, maximum extensor/flexor strength was significantly lower in the painful than in the pain-free limb (−6.4%/4.1%; p<0.0001/p=0.015). Conclusions These results suggest that strength in limbs without knee pain is associated with the pain status of the contralateral knee. The strength difference between unilateral pain-free cases and matched bilateral pain-free controls was similar to that between limbs in persons with unilateral knee pain. Lower strength due to contralateral knee pain might be centrally mediated. PMID:25768069

Kinetic analysis of contralateral liver hypertrophy after radioembolization of primary and metastatic liver tumors.

PubMed

Orcutt, Sonia T; Abuodeh, Yazan; Naghavi, Arash; Frakes, Jessica; Hoffe, Sarah; Kis, Bela; Anaya, Daniel A

2018-05-01

Radioembolization induces liver hypertrophy, although the extent and rate of hypertrophy are unknown. Our goal was to examine the kinetics of contralateral liver hypertrophy after transarterial radioembolization. A retrospective study (2010-2014) of treatment-naïve patients with primary/secondary liver malignancies undergoing right lobe radioembolization was performed. Computed tomography volumetry was performed before and 1, 3, and 6 months after radioembolization. Outcomes of interest were left lobe (standardized future liver remnant) degree of hypertrophy, kinetic growth rate, and ability to reach goal standardized future liver remnant ≥40%. Medians were compared with the Kruskall-Wallis test. Time to event analysis was used to estimate time to reach goal standardized future liver remnant. In the study, 25 patients were included. At 1, 3, and 6 months, median degree of hypertrophy was 4%, 8%, and 12% (P < .001), degree of hypertrophy relative to baseline future liver remnants was 11%, 17%, and 31% (P = .015), and kinetic growth rate was 0.8%, 0.5%, and 0.4%/week (P = .002). In patients with baseline standardized future liver remnant <40% (N= 16), median time to reach standardized future liver remnant ≥40% was 7.3 months, with 75% accomplishing standardized future liver remnant ≥40% at 8.2 months. Radioembolization induces hypertrophy of the contralateral lobe to a similar extent as existing methods, although at a lower rate. The role of radioembolization as a dual therapy (neoadjuvant and hypetrophy-inducing) for selected patients needs to be studied. (Surgery 2017;160:XXX-XXX.). Copyright © 2017 Elsevier Inc. All rights reserved.

Contribution of a Contralateral Hearing Aid to Perception of Consonant Voicing, Intonation, and Emotional State in Adult Cochlear Implantees

ERIC Educational Resources Information Center

Most, Tova; Gaon-Sivan, Gal; Shpak, Talma; Luntz, Michal

2012-01-01

Binaural hearing in cochlear implant (CI) users can be achieved either by bilateral implantation or bimodally with a contralateral hearing aid (HA). Binaural-bimodal hearing has the advantage of complementing the high-frequency electric information from the CI by low-frequency acoustic information from the HA. We examined the contribution of a…

Shrinkage of ipsilateral taste buds and hyperplasia of contralateral taste buds following chorda tympani nerve transection.

PubMed

Li, Yi-Ke; Yang, Juan-Mei; Huang, Yi-Bo; Ren, Dong-Dong; Chi, Fang-Lu

2015-06-01

The morphological changes that occur in the taste buds after denervation are not well understood in rats, especially in the contralateral tongue epithelium. In this study, we investigated the time course of morphological changes in the taste buds following unilateral nerve transection. The role of the trigeminal component of the lingual nerve in maintaining the structural integrity of the taste buds was also examined. Twenty-four Sprague-Dawley rats were randomly divided into three groups: control, unilateral chorda tympani nerve transection and unilateral chorda tympani nerve transection + lingual nerve transection. Rats were allowed up to 42 days of recovery before being euthanized. The taste buds were visualized using a cytokeratin 8 antibody. Taste bud counts, volumes and taste receptor cell numbers were quantified and compared among groups. No significant difference was detected between the chorda tympani nerve transection and chorda tympani nerve transection + lingual nerve transection groups. Taste bud counts, volumes and taste receptor cell numbers on the ipsilateral side all decreased significantly compared with control. On the contralateral side, the number of taste buds remained unchanged over time, but they were larger, and taste receptor cells were more numerous postoperatively. There was no evidence for a role of the trigeminal branch of the lingual nerve in maintaining the structural integrity of the anterior taste buds.

Short-duration stimulation of the supplementary eye fields perturbs anti-saccade performance while potentiating contralateral head orienting.

PubMed

Chapman, Brendan B; Corneil, Brian D

2014-01-01

Many forms of brain stimulation utilize the notion of state dependency, whereby greater influences are observed when a given area is more engaged at the time of stimulation. Here, by delivering intracortical microstimulation (ICMS) to the supplementary eye fields (SEF) of monkeys performing interleaved pro- and anti-saccades, we show a surprising diversity of state-dependent effects of ICMS-SEF. Short-duration ICMS-SEF passed around cue presentation selectively disrupted anti-saccades by increasing reaction times and error rates bilaterally, and also recruited neck muscles, favoring contralateral head turning to a greater degree on anti-saccade trials. These results are consistent with the functional relevance of the SEF for anti-saccades. The multiplicity of stimulation-evoked effects, with ICMS-SEF simultaneously disrupting anti-saccade performance and facilitating contralateral head orienting, probably reflects both the diversity of cortical and subcortical targets of SEF projections, and the response of this oculomotor network to stimulation. We speculate that the bilateral disruption of anti-saccades arises via feedback loops that may include the thalamus, whereas neck muscle recruitment arises via feedforward polysynaptic pathways to the motor periphery. Consideration of both sets of results reveals a more complete picture of the highly complex and multiphasic response to ICMS-SEF that can play out differently in different effector systems.

The correlation of background parenchymal enhancement in the contralateral breast with patient and tumor characteristics of MRI-screen detected breast cancers.

PubMed

Vreemann, Suzan; Gubern-Mérida, Albert; Borelli, Cristina; Bult, Peter; Karssemeijer, Nico; Mann, Ritse M

2018-01-01

Higher background parenchymal enhancement (BPE) could be used for stratification of MRI screening programs since it might be related to a higher breast cancer risk. Therefore, the purpose of this study is to correlate BPE to patient and tumor characteristics in women with unilateral MRI-screen detected breast cancer who participated in an intermediate and high risk screening program. As BPE in the affected breast may be difficult to discern from enhancing cancer, we assumed that BPE in the contralateral breast is a representative measure for BPE in women with unilateral breast cancer. This retrospective study was approved by our local institutional board and a waiver for consent was granted. MR-examinations of women with unilateral breast cancers screen-detected on breast MRI were evaluated by two readers. BPE in the contralateral breast was rated according to BI-RADS. Univariate analyses were performed to study associations. Observer variability was computed. Analysis included 77 breast cancers in 76 patients (age: 48±9.8 years), including 62 invasive and 15 pure ductal carcinoma in-situ cases. A negative association between BPE and tumor grade (p≤0.016) and a positive association with progesterone status (p≤0.021) was found. The correlation was stronger when only considering invasive disease. Inter-reader agreement was substantial. Lower BPE in the contralateral breast in women with unilateral breast cancer might be associated to higher tumor grade and progesterone receptor negativity. Great care should be taken using BPE for stratification of patients to tailored screening programs.

Probing the Effects and Mechanisms of Electroacupuncture at Ipsilateral or Contralateral ST36–ST37 Acupoints on CFA-induced Inflammatory Pain

PubMed Central

Lu, Kung-Wen; Hsu, Chao-Kuei; Hsieh, Ching-Liang; Yang, Jun; Lin, Yi-Wen

2016-01-01

Transient receptor potential vanilloid 1 (TRPV1) and associated signaling pathways have been reported to be increased in inflammatory pain signaling. There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). EA can reliably attenuate the increase of TRPV1 in mouse inflammatory pain models with unclear signaling mechanisms. Moreover, the difference in the clinical therapeutic effects between using the contralateral and ipsilateral acupoints has been rarely studied. We found that inflammatory pain, which was induced by injecting the complete Freund’s adjuvant (CFA), (2.14 ± 0.1, p < 0.05, n = 8) can be alleviated after EA treatment at either ipsilateral (3.91 ± 0.21, p < 0.05, n = 8) or contralateral acupoints (3.79 ± 0.25, p < 0.05, n = 8). EA may also reduce nociceptive Nav sodium currents in dorsal root ganglion (DRG) neurons. The expression of TRPV1 and associated signaling pathways notably increased after the CFA injection; this expression can be further attenuated significantly in EA treatment. TRPV1 and associated signaling pathways can be prevented in TRPV1 knockout mice, suggesting that TRPV1 knockout mice are resistant to inflammatory pain. Through this study, we have increased the understanding of the mechanism that both ipsilateral and contralateral EA might alter TRPV1 and associated signaling pathways to reduce inflammatory pain. PMID:26906464

Correlation of Respiratory Activity of Contralateral Diaphragm Muscles for Evaluation of Recovery Following Hemiparesis

PubMed Central

Dow, Douglas E.; Zhan, Wen-Zhi; Sieck, Gary C.; Mantilla, Carlos B.

2014-01-01

Respiration is impaired by disruption of the central drive for inspiration to the diaphragm muscle (DIAm). Some function may recover involving nerve regeneration, reinnervation or neuroplasticity. A research animal model involves inducing hemiparesis of the DIAm and monitoring any recovery under different conditions. Methods to accurately track the level of functional recovery are needed. In this study, an algorithm was developed and tested to quantify the relative amount of electromyogram (EMG) activity that temporally correlated for an experimental (EXP) hemi-DIAm with its intact contralateral hemi-DIAm. An average rectified value (ARV) trace was calculated. A template was formed of the ARV trace of the intact hemi-DIAm, with higher positive values corresponding with periods of inspirations and lower negative values corresponding with quiet periods. This template was multiplied by the EXP ARV trace to reward (more positive) periods of correlating activity, and punish (more negative) periods of high activity on the EXP side that corresponded with quiet periods on the intact side. The average integrated value was the index of correlating contralateral activity (ICCA). A negative ICCA value indicated no net correlation of activity, and a positive value indicated a net correlation of activity. The algorithm was tested on rats having the conditions of control or hemi-paresis induced by denervatation (DNV), tetrodotoxin administration (TTX) or cervical spinal hemi-section (SH). Control had high positive ICCA values, and DNV had negative values. TTX maintained negative ICCA values at 3, 7 and 14 days, indicating a lack of functional recovery. SH maintained negative values at 3 and 7 days, but a subset had positive values at 14 days indicating some functional recovery. PMID:19965125

Unilateral localized conjunctival amyloidosis in a patient with a history of contralateral orbit/eyelid lymphoma.

PubMed

Byers, Joshua T; Qing, Xin; Lo, Christopher; French, Samuel W; Ji, Ping

2018-04-01

Amyloidosis is a disorder characterized by the deposition of insoluble abnormal proteins in the extracellular space. It may occur as a localized lesion or as a systemic disease involving multiple organs and systems. Localized conjunctival amyloidosis is rare and is less frequently associated with systemic involvement. Although amyloidosis itself is a benign lesion involvement of multiple organs and systems is associated with poor prognosis. Diagnosis of amyloidosis is made on biopsy specimens with Congo red staining for the appearance of apple-green birefringence under polarized light microscopy. Liquid chromatography tandem-mass spectrometry (LC-MS/MS) is much more sensitive in diagnosing amyloidosis and can determine the type of amyloid deposit. Here we reported a case of conjunctival amyloidosis in a 52 year-old male patient who was presented with left lower eyelid swelling to our medical center. He has a complicated past medical history of anti-phospholipid antibody syndrome, Buerger's disease (thromboangitis obliterans), and small cell lymphoma (SLL) of the right orbit/eyelid. The patient received radiation to the right orbit to treat SLL with therapy completed one and a half years prior to presentation. Physical examination revealed a firm, raised yellowish colored lesion in the left lower conjunctiva. The conjunctival lesion was biopsied, and tissue sections were examined with Congo red stains and LC-MS/MS analysis. The biopsy showed amyloid deposits without evidence of malignancy, and the type of proteins in the deposit was immunoglobulin light chain (AL) of kappa type. A complete work up was taken for possible systemic involvement of amyloidosis and results were all negative. To our knowledge, this is the first case of localized conjunctival amyloidosis with a history of contralateral orbit/eyelid SLL. Copyright © 2018 Elsevier Inc. All rights reserved.

Cytokine mRNA expression in synovial fluid of affected and contralateral stifle joints and the left shoulder joint in dogs with unilateral disease of the stifle joint.

PubMed

de Bruin, Tanya; de Rooster, Hilde; van Bree, Henri; Duchateau, Luc; Cox, Eric

2007-09-01

To examine mRNA expression of cytokines in synovial fluid (SF) cells from dogs with cranial cruciate ligament (CrCL) rupture and medial patellar luxation (MPL) and determine mRNA expression for 3 joints (affected stifle, unaffected contralateral stifle, and left shoulder joints) in dogs with unilateral CrCL rupture. 29 stifle joints with CrCL rupture (29 dogs), 8 stifle joints with MPL (7 dogs), and 24 normal stifle joints (16 clinically normal dogs). Immediately before reconstructive surgery, SF was aspirated from the cruciate-deficient stifle joint or stifle joint with MPL. Fourteen of 29 dogs had unilateral CrCL rupture; SF was also aspirated from the unaffected contralateral stifle joint and left shoulder joint. Those 14 dogs were examined 6 and 12 months after reconstructive surgery. Total RNA was extracted from SF cells and reverse transcription-PCR assay was performed to obtain cDNA. Canine-specific cytokine mRNA expression was determined by use of a real-time PCR assay. Interleukin (IL)-8 and -10 and interferon-gamma expression differed significantly between dogs with arthropathies and dogs with normal stifle joints. For the 14 dogs with unilateral CrCL rupture, a significant difference was found for IL-8 expression. Before reconstructive surgery, IL-8 expression differed significantly between the affected stifle joint and left shoulder joint or contralateral stifle joint. Six months after surgery, IL-8 expression was significantly increased in the unaffected contralateral stifle joint, compared with the shoulder joint. No conclusions can be made regarding the role of the examined cytokines in initiation of CrCL disease.

Different functional reorganization of motor cortex after transfer of the contralateral C7 to different recipient nerves in young rats with total brachial plexus root avulsion.

PubMed

Pan, Feng; Wei, Hai-feng; Chen, Liang; Gu, Yu-dong

2012-12-07

Clinically, contralateral C7 transfer is used for nerve reconstruction in brachial plexus injuries. Postoperatively, synchronous motions at the donor limb are noteworthy. This study studied if different recipient nerves influenced transhemispheric functional reorganization of motor cortex after this procedure. 90 young rats with total root avulsion of the brachial plexus were divided into groups 1-3 of contralateral C7 transfer to anterior division of the upper trunk, to both the musculocutaneous and median nerves, and to the median nerve, respectively. After reinnervation of target muscles, number of sites for forelimb representations in bilateral motor cortices was determined by intracortical microstimulation at 1.5, 3, 6, 9, and 12 months postoperatively. At nine months, transhemispheric reorganization of nerves neurotized by contralateral C7 was fulfilled in four of six rats in group 1, one of six in group 2 and none in group 3, respectively; at 12 months, that was fulfilled in five of six in group 1, four of six in groups 2 and 3, respectively. Logistic regression analysis showed that rate of fulfilled transhemispheric reorganization in group 1 was 12.19 times that in group 3 (95% CI 0.006-0.651, p=0.032). At 12 months, number of sites for hindlimb representations which had encroached upon original forelimb representations on the uninjured side was statistically more in group 3 than in group 2 (t=9.5, p<0.0001). It is concluded that contralateral C7 transfer to upper trunk or to both the musculocutaneous and median nerves induces faster transhemispheric functional reorganization of motor cortex than that to median nerve alone in rats. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Trunk Muscle Function Deficit in Youth Baseball Pitchers With Excessive Contralateral Trunk Tilt During Pitching.

PubMed

Oyama, Sakiko; Waldhelm, Andrew G; Sosa, Araceli R; Patel, Ravina R; Kalinowski, Derick L

2017-09-01

Pitching technique is one of many factors that affect injury risk. Exhibiting excessive contralateral trunk tilt (CLT) during pitching has been linked to higher ball speed but also to increased joint loading. Deficit in trunk muscle strength has been suggested as an underlying cause of this movement pattern. The purpose of the study was to compare trunk muscle strength between youth baseball pitchers with varying degree of CLT during pitching. Cross-sectional study. Baseball practice fields. Twenty-eight youth baseball pitchers. Pitching technique was captured using a video camera. Based on the 2-dimensional trunk contralateral flexion angle, pitchers were categorized into low (<15 degrees), moderate (15-30 degrees), or high (>30 degrees) CLT groups. Maximum isometric strength tests for trunk flexion, extension, and bilateral rotation, measured using a dynamometer. The pitchers with high CLT (n = 10) had longer pitching experience (P = 0.014), produced higher ball speed (P = 0.003) compared with the pitchers with moderate (n = 10) and low (n = 8) CLT, but demonstrated greater asymmetry in trunk rotation strength (relative weakness in rotation strength toward dominant side) compared with the pitchers with low CLT (P = 0.015). Excessive CLT may be a strategy that young pitchers learn to achieve higher ball velocity but also may be associated with imbalance between the oblique muscles on dominant and nondominant side, which may be acquired from repetitive pitching. Strengthening and emphasizing the use of dominant side oblique muscles may keep pitchers from leaning excessively during pitching and thus decrease joint loading.

[Contralateral Recession of the Inferior Oblique Muscle in Grave's Disease Patients with Mild M. rectus inferior fibrosis].

PubMed

Eckstein, A; Raczynski, S; Dekowski, D; Esser, J

2015-10-01

The aim of this study was to evaluate the dose effect and the resulting binocular single vision for inferior oblique muscle recession in patients with Grave's orbitopathy. The evaluation covered all patients (n = 13) between 2010-2013 treated with recession of the inferior oblique muscle for vertical deviation caused by inferior fibrosis of the contralateral eye. The inclusion criterion was a small vertical squint angle with excyclotorsion. The corrected vertical squint angle was 3.75° [7 pdpt] (median, min 1.5° [3 pdpt], max 8° [16 pdpt]) in primary position and 5.5° in adduction [11pdpt] (median, min 3°[6 pdpt], max 9°[18pdpt]). Excyclotorsion was 4° [8 pdpt] (median, min 1° [2 pdpt], max 9° [18 pdpt]). Elevation was only slightly impaired and the side difference was 5° (median). The recession distance was preoperatively determined: 0.5° squint angle reduction per mm recession distance (calculation from patients who received surgery before 2010). Inferior oblique recession generated a good field of binocular single vision (BSV) for all patients. All patients reached BSV in the central area (20°) and within 30° of downgaze. Sixty nine percent of the patients were completely diplopia free in downgaze. Diplopia persisted in more than half of the patients in up gaze outside 15°. Squint reduction was 0.5° [1 pdpt] [0.45-0.67]/per mm recession distance in primary position and 0.65° [1.3 pdpt] [0.55-0.76]/per mm for the vertical deviation in adduction. Excyclotorsion was reduced to ≤ 2° in 77 % of the patients. Inferior oblique muscle recession can be very successfully performed on the contralateral eye in patients with mild inferior rectus muscle fibrosis. Surgery at the contralateral yoke muscle prevents the risk of overeffect with resulting diplopia in downgaze, which could occur if small distance recession had been performed at the inferior rectus muscle. An overeffect in relation to inferior oblique recession will only

Non-recurrent laryngeal nerve with a coexisting contralateral nerve demonstrating extralaryngeal branching.

PubMed

Constable, James D; Bathala, Srinivasalu; Ahmed, Jacob J; McGlashan, Julian A

2017-03-17

Non-recurrence and extralaryngeal branching are 2 of the more frequently encountered anomalies of the recurrent laryngeal nerve. If not anticipated intraoperatively, these abnormalities can put the nerve at risk, with subsequent vocal cord palsy. It is therefore important to report on and understand these abnormalities. We present a unique case of a non-recurrent laryngeal nerve with a coexisting contralateral nerve demonstrating extralaryngeal branching. This case allows us to demonstrate the importance of arteria lusoria in head and neck surgery, and to conclude that non-recurrence and extralaryngeal branching can occur separately within individual nerves in the same patient. The case also highlights the importance of a systematic intraoperative approach to the identification of every recurrent laryngeal nerve, especially in bilateral procedures having already exposed an anomalous nerve on one side. 2017 BMJ Publishing Group Ltd.

Psychosocial factors associated with the uptake of contralateral prophylactic mastectomy among BRCA1/2 mutation noncarriers with newly-diagnosed breast cancer

PubMed Central

Hamilton, Jada G.; Genoff, Margaux C.; Salerno, Melissa; Amoroso, Kimberly; Boyar, Sherry R.; Sheehan, Margaret; Fleischut, Megan Harlan; Siegel, Beth; Arnold, Angela G.; Salo-Mullen, Erin E.; Hay, Jennifer L.; Offit, Kenneth; Robson, Mark E.

2017-01-01

Purpose Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM. Methods We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n=92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing. Data obtained from self-report questionnaires and patient medical records were used to examine associations between theoretically-relevant background and psychosocial factors and BRCA1/2 mutation noncarriers’ decisions to undergo CPM. Results Among BRCA1/2 mutation noncarriers, 25% (n=23) elected to undergo CPM. Psychosocial factors including a self-reported physician recommendation for CPM, greater perceived contralateral breast cancer risk, and greater perceived benefits of CPM were all significantly associated with the uptake of CPM. Conclusions A sizeable minority of BRCA1/2 mutation noncarriers choose to undergo CPM after learning their mutation status through pre-surgical genetic testing. BRCA1/2 mutation noncarriers’ cognitive perceptions and social influences appear to be important in shaping their decisions regarding CPM. This work highlights the importance of several psychosocial factors in influencing patients’ surgical decisions. Future research is needed that examines the formation of BRCA1/2 mutation noncarriers’ beliefs regarding their disease and available treatment options, and that characterizes the physician-patient communication that occurs in this complex decision-making context. PMID:28150129

Psychosocial factors associated with the uptake of contralateral prophylactic mastectomy among BRCA1/2 mutation noncarriers with newly diagnosed breast cancer.

PubMed

Hamilton, Jada G; Genoff, Margaux C; Salerno, Melissa; Amoroso, Kimberly; Boyar, Sherry R; Sheehan, Margaret; Fleischut, Megan Harlan; Siegel, Beth; Arnold, Angela G; Salo-Mullen, Erin E; Hay, Jennifer L; Offit, Kenneth; Robson, Mark E

2017-04-01

Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM. We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n = 92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing. Data obtained from self-report questionnaires and patient medical records were used to examine associations between theoretically relevant background and psychosocial factors and BRCA1/2 mutation noncarriers' decisions to undergo CPM. Among BRCA1/2 mutation noncarriers, 25% (n = 23) elected to undergo CPM. Psychosocial factors including a self-reported physician recommendation for CPM, greater perceived contralateral breast cancer risk, and greater perceived benefits of CPM were all significantly associated with the uptake of CPM. A sizeable minority of BRCA1/2 mutation noncarriers choose to undergo CPM after learning their mutation status through pre-surgical genetic testing. BRCA1/2 mutation noncarriers' cognitive perceptions and social influences appear to be important in shaping their decisions regarding CPM. This work highlights the importance of several psychosocial factors in influencing patients' surgical decisions. Future research is needed that examines the formation of BRCA1/2 mutation noncarriers' beliefs regarding their disease and available treatment options, and that characterizes the physician-patient communication that occurs in this complex decision-making context.

Portal Vein Embolization Utilizing N-Butyl Cyanoacrylate for Contralateral Lobe Hypertrophy Prior to Liver Resection: A Systematic Review and Meta-Analysis.

PubMed

Wajswol, Ethan; Jazmati, Tarek; Contractor, Sohail; Kumar, Abhishek

2018-04-23

To evaluate the safety and effectiveness of n-butyl cyanoacrylate (NBCA) for portal vein embolization (PVE) when used to induce contralateral future liver remnant (FLR) hypertrophy in patients undergoing planned hepatic resection for hepatic malignancy. The PubMed database (including articles indexed by MEDLINE) was searched for articles published from 1970 to 2018 describing patients treated with PVE utilizing NBCA to induce hypertrophy of the FLR prior to contralateral hepatic lobe resection. Demographic data, embolization technique, complications of embolization, resultant FLR hypertrophy, and surgical outcomes were obtained when available. A meta-analysis was performed to determine the cumulative relative hypertrophy rate of the FLR following PVE with NBCA. The literature search yielded 18 relevant articles. Six hundred and seven patients (383 men, 220 women; mean age 60.7 years) with procedures describing PVE utilizing NBCA were reviewed. The most common underlying hepatic malignancies were colorectal metastases (n = 348), followed by cholangiocarcinomas (n = 92), and hepatocellular carcinomas (n = 89). Technical success was reportedly achieved in 603/607 patients, for a success rate of 99.3%. Fixed effects meta-analysis of the relative hypertrophy rate of the FLR among studies resulted in an aggregate rate of 49.4 ± 1.3%. Of the patients who underwent attempted PVE, 461/607 (75.9%) eventually underwent surgical resection. Major complications following PVE occurred in 19 patients (3.13%), while minor complications following PVE occurred in 38 patients (6.26%). PVE utilizing NBCA to induce hypertrophy of the FLR prior to contralateral lobe resection in the setting of hepatic malignancy is safe and effective. Level IIa-Systematic review of cohort studies.

Intelligibility in speech maskers with a binaural cochlear implant sound coding strategy inspired by the contralateral medial olivocochlear reflex.

PubMed

Lopez-Poveda, Enrique A; Eustaquio-Martín, Almudena; Stohl, Joshua S; Wolford, Robert D; Schatzer, Reinhold; Gorospe, José M; Ruiz, Santiago Santa Cruz; Benito, Fernando; Wilson, Blake S

2017-05-01

We have recently proposed a binaural cochlear implant (CI) sound processing strategy inspired by the contralateral medial olivocochlear reflex (the MOC strategy) and shown that it improves intelligibility in steady-state noise (Lopez-Poveda et al., 2016, Ear Hear 37:e138-e148). The aim here was to evaluate possible speech-reception benefits of the MOC strategy for speech maskers, a more natural type of interferer. Speech reception thresholds (SRTs) were measured in six bilateral and two single-sided deaf CI users with the MOC strategy and with a standard (STD) strategy. SRTs were measured in unilateral and bilateral listening conditions, and for target and masker stimuli located at azimuthal angles of (0°, 0°), (-15°, +15°), and (-90°, +90°). Mean SRTs were 2-5 dB better with the MOC than with the STD strategy for spatially separated target and masker sources. For bilateral CI users, the MOC strategy (1) facilitated the intelligibility of speech in competition with spatially separated speech maskers in both unilateral and bilateral listening conditions; and (2) led to an overall improvement in spatial release from masking in the two listening conditions. Insofar as speech is a more natural type of interferer than steady-state noise, the present results suggest that the MOC strategy holds potential for promising outcomes for CI users. Copyright © 2017. Published by Elsevier B.V.

Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

PubMed

Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

2017-09-01

To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

Transverse vs torsional ultrasound: prospective randomized contralaterally controlled study comparing two phacoemulsification-system handpieces

PubMed Central

Assil, Kerry K; Harris, Lindsay; Cecka, Jeannie

2015-01-01

Purpose To compare surgical efficiency and multiple early clinical outcome variables in eyes undergoing phacoemulsification using either transversal or torsional ultrasound systems. Setting Assil Eye Institute, Beverly Hills, CA, USA. Design Prospective, randomized, clinician-masked, contralaterally controlled single-center evaluation. Patients and methods Patients seeking cataract removal in both eyes with implantation of multifocal intraocular lenses were randomly assigned to one of two treatment rooms for phacoemulsification with either a transverse ultrasound system or torsional handpiece system. The contralateral eye was treated at a later date with the alternate device. A total of 54 eyes of 27 patients having similar degrees of cataract, astigmatism, and visual potential were included. All operative data were collected for analysis, and patients were followed for 3 months after surgery. Results Similar visual acuity was reported at all postoperative visits between the two groups. Mean phacoemulsification time and total power required were both significantly lower with the transverse system than with the torsional technique (P<0.05 for both). Similarly, mean total balanced salt solution used was significantly less with the transverse system vs torsional (P<0.05). Postoperative safety demonstrated significantly lower endothelial cell loss at 1 day and 1 month (P<0.05) with transverse vs torsional. Macular swelling was less at 1 week, 1 month, and 3 months with transverse vs torsional, although the difference did not achieve significance (P=0.1) at any single time point. Clinically detectable corneal edema was reported less frequently at all postoperative time points with the transverse system. Conclusion The transverse ultrasound system was found to be possibly associated with less balanced salt-solution use, less phacoemulsification time, and less power required than the torsional phaco system. Postoperative data suggested that improved phaco efficiency may

Transverse vs torsional ultrasound: prospective randomized contralaterally controlled study comparing two phacoemulsification-system handpieces.

PubMed

Assil, Kerry K; Harris, Lindsay; Cecka, Jeannie

2015-01-01

To compare surgical efficiency and multiple early clinical outcome variables in eyes undergoing phacoemulsification using either transversal or torsional ultrasound systems. Assil Eye Institute, Beverly Hills, CA, USA. Prospective, randomized, clinician-masked, contralaterally controlled single-center evaluation. Patients seeking cataract removal in both eyes with implantation of multifocal intraocular lenses were randomly assigned to one of two treatment rooms for phacoemulsification with either a transverse ultrasound system or torsional handpiece system. The contralateral eye was treated at a later date with the alternate device. A total of 54 eyes of 27 patients having similar degrees of cataract, astigmatism, and visual potential were included. All operative data were collected for analysis, and patients were followed for 3 months after surgery. Similar visual acuity was reported at all postoperative visits between the two groups. Mean phacoemulsification time and total power required were both significantly lower with the transverse system than with the torsional technique (P<0.05 for both). Similarly, mean total balanced salt solution used was significantly less with the transverse system vs torsional (P<0.05). Postoperative safety demonstrated significantly lower endothelial cell loss at 1 day and 1 month (P<0.05) with transverse vs torsional. Macular swelling was less at 1 week, 1 month, and 3 months with transverse vs torsional, although the difference did not achieve significance (P=0.1) at any single time point. Clinically detectable corneal edema was reported less frequently at all postoperative time points with the transverse system. The transverse ultrasound system was found to be possibly associated with less balanced salt-solution use, less phacoemulsification time, and less power required than the torsional phaco system. Postoperative data suggested that improved phaco efficiency may translate to a better overall safety profile for the patient.

The timing of female genital mutilation and the role of contralateral palpal insertions in the spider Cyclosa argenteoalba.

PubMed

Nakata, Kensuke

2017-11-01

Some male spiders exhibit female genital mutilation behaviour (FGM) by removing the female genital appendage (scape) to control the mating frequency of females. Female spiders have two, i.e. right and left, genital openings connected with separate spermathecae into which males transfer sperm successively using one pedipalp (secondary genitalia) at a time. Thus, males must complete at least two palpal insertions to fill both spermathecae, before FGM. The present study examined whether (i) scape removal is only associated with the second palpal insertion (one-action hypothesis) or (ii) two contralateral palpal insertions facilitate FGM, with each insertion cutting the basal part of the scape halfway (two-actions hypothesis). Experiments in which females were replaced after a male had made the first insertion did not support the one-action hypothesis, because scapes remained intact after the newly introduced virgin females received their first palpal insertion, which was the second insertion by the males. In comparison, mating experiments using two half-eunuchs (i.e. one of the palps of each male had been manually removed, forcing them to fill female spermatheca on one side only) supported the two-actions hypothesis. FGM was more frequent in females that received two contralateral palpal insertions than in females that received ipsilateral insertions.

The timing of female genital mutilation and the role of contralateral palpal insertions in the spider Cyclosa argenteoalba

PubMed Central

2017-01-01

Some male spiders exhibit female genital mutilation behaviour (FGM) by removing the female genital appendage (scape) to control the mating frequency of females. Female spiders have two, i.e. right and left, genital openings connected with separate spermathecae into which males transfer sperm successively using one pedipalp (secondary genitalia) at a time. Thus, males must complete at least two palpal insertions to fill both spermathecae, before FGM. The present study examined whether (i) scape removal is only associated with the second palpal insertion (one-action hypothesis) or (ii) two contralateral palpal insertions facilitate FGM, with each insertion cutting the basal part of the scape halfway (two-actions hypothesis). Experiments in which females were replaced after a male had made the first insertion did not support the one-action hypothesis, because scapes remained intact after the newly introduced virgin females received their first palpal insertion, which was the second insertion by the males. In comparison, mating experiments using two half-eunuchs (i.e. one of the palps of each male had been manually removed, forcing them to fill female spermatheca on one side only) supported the two-actions hypothesis. FGM was more frequent in females that received two contralateral palpal insertions than in females that received ipsilateral insertions. PMID:29291078

Single-session tDCS over the dominant hemisphere affects contralateral spectral EEG power, but does not enhance neurofeedback-guided event-related desynchronization of the non-dominant hemisphere's sensorimotor rhythm.

PubMed

Mondini, Valeria; Mangia, Anna Lisa; Cappello, Angelo

2018-01-01

Transcranial direct current stimulation (tDCS) and neurofeedback-guided motor imagery (MI) have attracted considerable interest in neurorehabilitation, given their ability to influence neuroplasticity. As tDCS has been shown to modulate event-related desynchronization (ERD), the neural signature of motor imagery detected for neurofeedback, a combination of the techniques was recently proposed. One limitation of this approach is that the area targeted for stimulation is the same from which the signal for neurofeedback is acquired. As tDCS may interfere with proximal electroencephalographic (EEG) electrodes, in this study our aim was to test whether contralateral tDCS could have interhemispheric effects on the spectral power of the unstimulated hemisphere, possibly mediated by transcallosal connection, and whether such effects could be used to enhance ERD magnitudes. A contralateral stimulation approach would indeed facilitate co-registration, as the stimulation electrode would be far from the recording sites. Twenty right-handed healthy volunteers (aged 21 to 32) participated in the study: ten assigned to cathodal, ten to anodal versus sham stimulation. We applied stimulation over the dominant (left) hemisphere, and assessed ERD and spectral power over the non-dominant (right) hemisphere. The effect of tDCS was evaluated over time. Spectral power was assessed in theta, alpha and beta bands, under both rest and MI conditions, while ERD was evaluated in alpha and beta bands. Two main findings emerged: (1) contralateral alpha-ERD was reduced after anodal (p = 0.0147), but not enhanced after cathodal tDCS; (2) both stimulations had remote effects on the spectral power of the contralateral hemisphere, particularly in theta and alpha (significant differences in the topographical t-value maps). The absence of contralateral cathodal ERD enhancement suggests that the protocol is not applicable in the context of MI training. Nevertheless, ERD results of anodal and spectral

Single-session tDCS over the dominant hemisphere affects contralateral spectral EEG power, but does not enhance neurofeedback-guided event-related desynchronization of the non-dominant hemisphere's sensorimotor rhythm

PubMed Central

Mangia, Anna Lisa; Cappello, Angelo

2018-01-01

Background and objective Transcranial direct current stimulation (tDCS) and neurofeedback-guided motor imagery (MI) have attracted considerable interest in neurorehabilitation, given their ability to influence neuroplasticity. As tDCS has been shown to modulate event-related desynchronization (ERD), the neural signature of motor imagery detected for neurofeedback, a combination of the techniques was recently proposed. One limitation of this approach is that the area targeted for stimulation is the same from which the signal for neurofeedback is acquired. As tDCS may interfere with proximal electroencephalographic (EEG) electrodes, in this study our aim was to test whether contralateral tDCS could have interhemispheric effects on the spectral power of the unstimulated hemisphere, possibly mediated by transcallosal connection, and whether such effects could be used to enhance ERD magnitudes. A contralateral stimulation approach would indeed facilitate co-registration, as the stimulation electrode would be far from the recording sites. Methods Twenty right-handed healthy volunteers (aged 21 to 32) participated in the study: ten assigned to cathodal, ten to anodal versus sham stimulation. We applied stimulation over the dominant (left) hemisphere, and assessed ERD and spectral power over the non-dominant (right) hemisphere. The effect of tDCS was evaluated over time. Spectral power was assessed in theta, alpha and beta bands, under both rest and MI conditions, while ERD was evaluated in alpha and beta bands. Results Two main findings emerged: (1) contralateral alpha-ERD was reduced after anodal (p = 0.0147), but not enhanced after cathodal tDCS; (2) both stimulations had remote effects on the spectral power of the contralateral hemisphere, particularly in theta and alpha (significant differences in the topographical t-value maps). Conclusion The absence of contralateral cathodal ERD enhancement suggests that the protocol is not applicable in the context of MI training

Unilateral Plantar Flexors Static-Stretching Effects on Ipsilateral and Contralateral Jump Measures

PubMed Central

da Silva, Josinaldo Jarbas; Behm, David George; Gomes, Willy Andrade; Silva, Fernando Henrique Domingues de Oliveira; Soares, Enrico Gori; Serpa, Érica Paes; Vilela Junior, Guanis de Barros; Lopes, Charles Ricardo; Marchetti, Paulo Henrique

2015-01-01

The aim of this study was to evaluate the acute effects of unilateral ankle plantar flexors static-stretching (SS) on the passive range of movement (ROM) of the stretched limb, surface electromyography (sEMG) and single-leg bounce drop jump (SBDJ) performance measures of the ipsilateral stretched and contralateral non-stretched lower limbs. Seventeen young men (24 ± 5 years) performed SBDJ before and after (stretched limb: immediately post-stretch, 10 and 20 minutes and non-stretched limb: immediately post-stretch) unilateral ankle plantar flexor SS (6 sets of 45s/15s, 70-90% point of discomfort). SBDJ performance measures included jump height, impulse, time to reach peak force, contact time as well as the sEMG integral (IEMG) and pre-activation (IEMGpre-activation) of the gastrocnemius lateralis. Ankle dorsiflexion passive ROM increased in the stretched limb after the SS (pre-test: 21 ± 4° and post-test: 26.5 ± 5°, p < 0.001). Post-stretching decreases were observed with peak force (p = 0.029), IEMG (P<0.001), and IEMGpre-activation (p = 0.015) in the stretched limb; as well as impulse (p = 0.03), and jump height (p = 0.032) in the non-stretched limb. In conclusion, SS effectively increased passive ankle ROM of the stretched limb, and transiently (less than 10 minutes) decreased muscle peak force and pre-activation. The decrease of jump height and impulse for the non-stretched limb suggests a SS-induced central nervous system inhibitory effect. Key points When considering whether or not to SS prior to athletic activities, one must consider the potential positive effects of increased ankle dorsiflexion motion with the potential deleterious effects of power and muscle activity during a simple jumping task or as part of the rehabilitation process. Since decreased jump performance measures can persist for 10 minutes in the stretched leg, the timing of SS prior to performance must be taken into consideration. Athletes, fitness enthusiasts and therapists should

Unilateral donor lung dysfunction does not preclude successful contralateral single lung transplantation.

PubMed

Puskas, J D; Winton, T L; Miller, J D; Scavuzzo, M; Patterson, G A

1992-05-01

Single lung transplantation remains limited by a severe shortage of suitable donor lungs. Potential lung donors are often deemed unsuitable because accepted criteria (both lungs clear on the chest roentgenogram, arterial oxygen tension greater than 300 mm Hg with an inspired oxygen fraction of 1.0, a positive end-expiratory pressure of 5 cm H2O, and no purulent secretions) do not distinguish between unilateral and bilateral pulmonary disease. Many adequate single lung grafts may be discarded as a result of contralateral aspiration or pulmonary trauma. We have recently used intraoperative unilateral ventilation and perfusion to assess single lung function in potential donors with contralateral lung disease. In the 11-month period ending October 1, 1990, we performed 18 single lung transplants. In four of these cases (22%), the donor chest roentgenogram or bronchoscopic examination demonstrated significant unilateral lung injury. Donor arterial oxygen tension, (inspired oxygen fraction 1.0; positive end-expiratory pressure 5 cm H2O) was below the accepted level in each case (246 +/- 47 mm Hg, mean +/- standard deviation). Through the sternotomy used for multiple organ harvest, the pulmonary artery to the injured lung was clamped. A double-lumen endotracheal tube or endobronchial balloon occlusion catheter was used to permit ventilation of the uninjured lung alone. A second measurement of arterial oxygen tension (inspired oxygen fraction 1.0; positive end-expiratory pressure 5 cm H2O) revealed excellent unilateral lung function in all four cases (499.5 +/- 43 mm Hg; p less than 0.0004). These single lung grafts (three right, one left) were transplanted uneventfully into four recipients (three with pulmonary fibrosis and one with primary pulmonary hypertension). Lung function early after transplantation was adequate in all patients. Two patients were extubated within 24 hours. There were two late deaths, one caused by rejection and Aspergillus infection and the other

Contralaterally Controlled Neuromuscular Electrical Stimulation for Recovery of Ankle Dorsiflexion

PubMed Central

Knutson, Jayme S.; Hansen, Kristine; Nagy, Jennifer; Bailey, Stephanie N.; Gunzler, Douglas D.; Sheffler, Lynne R.; Chae, John

2013-01-01

Objective Compare the effects of contralaterally controlled neuromuscular electrical stimulation (CCNMES) versus cyclic neuromuscular electrical stimulation (NMES) on lower extremity impairment, functional ambulation, and gait characteristics. Design Twenty-six stroke survivors with chronic (≥6mo) footdrop during ambulation were randomly assigned to six weeks of CCNMES or cyclic NMES. Both groups had ten sessions per week of self-administered home application of either CCNMES or cyclic NMES plus two sessions per week of gait training with a physical therapist. Primary outcomes included lower extremity Fugl-Meyer score, modified Emory Functional Ambulation Profile, and gait velocity. Assessments were made at pretreatment, posttreatment, and at 1 and 3 months posttreatment. Results There were no significant differences between groups in the outcome trajectories for any of the measures. With data from both groups pooled, there were significant but modest and sustained improvements in the Fugl-Meyer score and the modified Emory Functional Ambulation Profile, but not in gait velocity. Conclusions The results support the hypothesis that gait training combined with either CCNMES or cyclic NMES reduces lower extremity impairment and functional ambulation, but do not support the hypothesis that CCNMES is more effective than cyclic NMES in chronic patients. PMID:23867888

Inventario mundial de la calidad del carbon mineral (WoCQI) [The world coal quality inventory (WoCQI)

USGS Publications Warehouse

Finkelman, R.B.; Lovern, V.S.

2001-01-01

Los oficiales encargados de la politica comercial de cada pais requieren informacion clara y precisa sobre el recurso del carbon mineral, particularmente sobre sus propiedades y caracteristicas, para tomar decisiones bien fundamentadas con respecto al mejor uso de los recursos naturales, necesidades de importacion y oportunidades de exportacion, objetivos de politica interna y externa, oportunidades de transferencia tecnologica, posibilidades de inversion externa, estudios ambientales y de salud, y asuntos relacionados con el uso de productos secundarios y su disposicion.

Contralateral interictal and ictal EEG epileptiform activity accentuate memory impairment in unilateral mesial temporal sclerosis patients.

PubMed

Pinto, Lecio F; Adda, Carla C; Silva, Liliane C A; Banaskiwitz, Natalie H C; Passarelli, Valmir; Jorge, Carmen L; Valerio, Rosa M; Castro, Luiz H

2017-03-01

Memory impairment is a recognized complication of mesial temporal sclerosis (MTS). Epileptiform activity may negatively impact on cognition. We evaluated the impact of contralateral EEG involvement on memory in unilateral MTS (uMTS) patients. Retrospective review of 121 right-handed uMTS patients (69 left) evaluated with prolonged video-EEG and verbal and nonverbal memory tests (Rey Auditory Verbal Learning Test and Rey-Osterrieth Complex figure), with additional very delayed trials. Patients were classified according to ictal/interictal EEG findings and MTS side as left or right concordant or discordant. Thirty-nine normal individuals who underwent the same neuropsychological battery served as controls. Demographic, disease, and treatment features did not differ among groups. On the 7-day verbal memory free recall, left discordant performed significantly worse than controls and right concordant, recognized fewer words, and had more recognition errors than all other groups, including left concordant. For nonverbal memory, right discordant performed significantly worse than controls on delayed recall, and attained lower scores than other groups on immediate and 7-day recall, but this difference did not reach statistical significance. Left discordant had higher scores of memory complaints than controls and disclosed a trend toward accentuated memory impairment compared with the other groups over time. Our results suggest that contralateral electrographic involvement in uMTS was associated with more pronounced memory impairment for verbal material in left discordant patients, and to a lesser extent, for nonverbal material in right discordant patients. Left discordant group also had increased memory complaints. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The evidence base for the application of contralateral bone anchored hearing aids in acquired unilateral sensorineural hearing loss in adults.

PubMed

Baguley, D M; Bird, J; Humphriss, R L; Prevost, A T

2006-02-01

. Acquired unilateral sensorineural hearing loss reduces the ability to localize sounds and to discriminate in background noise. . Four controlled trials attempt to determine the benefit of contralateral bone anchored hearing aids over contralateral routing of signal (CROS) hearing aids and over the unaided condition. All found no significant improvement in auditory localization with either aid. Speech discrimination in noise and subjective questionnaire measures of auditory abilities showed an advantage for bone anchored hearing aid (BAHA) > CROS > unaided conditions. . All four studies have material shortfalls: (i) the BAHA was always trialled after the CROS aid; (ii) CROS aids were only trialled for 4 weeks; (iii) none used any measure of hearing handicap when selecting subjects; (iv) two studies have a bias in terms of patient selection; (v) all studies were underpowered (vi) double reporting of patients occurred. . There is a paucity of evidence to support the efficacy of BAHA in the treatment of acquired unilateral sensorineural hearing loss. Clinicians should proceed with caution and perhaps await a larger randomized trial. . It is perhaps only appropriate to insert a BAHA peg at the time of vestibular schwanoma tumour excision in patients with good preoperative hearing, as their hearing handicap increases most.

The contralateral delay activity as a neural measure of visual working memory

PubMed Central

Luria, Roy; Balaban, Halely; Awh, Edward; Vogel, Edward K.

2016-01-01

The contralateral delay activity (CDA) is a negative slow wave sensitive to the number of objects maintained in visual working memory (VWM). In recent years, a growing number of labs started to use the CDA in order to investigate VWM, leading to many fascinating discoveries. Here, we discuss the recent developments and contribution of the CDA in various research fields. Importantly, we report two meta-analyses that unequivocally validate the relationship between the set-size increase in the CDA amplitude and the individual VWM capacity, and between the CDA and filtering efficiency. We further discuss how the CDA was used to study the role of VWM in visual search, multiple object tracking, grouping, binding, and whether VWM capacity allocation is determined by the items’ resolution or instead by the number of objects regardless of their complexity. In addition, we report how the CDA has been used to characterize specific VWM deficits in special populations. PMID:26802451

Contralateral prophylactic mastectomy: A qualitative approach to exploring the decision making process.

PubMed

Greener, Judith R; Bass, Sarah Bauerle; Lepore, Stephen J

2018-01-01

The proportion of women with unilateral breast cancer and no familial or genetic risk factors who elect contralateral prophylactic mastectomy (CPM) has grown dramatically, even in the absence of clear data demonstrating improved outcomes. To further extend the literature that addresses treatment decision-making, qualitative interviews were conducted with eleven women who considered CPM. A social ecological model of breast cancer treatment decision-making provided the conceptual framework, and grounded theory was used to identify the cognitive, psychosocial, and emotional influences motivating treatment choice. This research identified five themes that give context to women's decision-making experience: (1) variability in physician communication, (2) immediacy of the decision, (3) meaning of being proactive about treatment, (4) meaning of risk, and (5) women's relationship with their breasts. The results suggest that greater emphasis should be placed on a more nuanced understanding of patients' emotional reaction to breast cancer and managing the decision-making environment.

Contralateral Associated Movements Correlate with Poorer Inhibitory Control, Attention and Visual Perception in Preschool Children.

PubMed

Kakebeeke, Tanja H; Messerli-Bürgy, Nadine; Meyer, Andrea H; Zysset, Annina E; Stülb, Kerstin; Leeger-Aschmann, Claudia S; Schmutz, Einat A; Arhab, Amar; Puder, Jardena J; Kriemler, Susi; Munsch, Simone; Jenni, Oskar G

2017-10-01

Contralateral associated movements (CAMs) frequently occur in complex motor tasks. We investigated whether and to what extent CAMs are associated with inhibitory control among preschool children in the Swiss Preschoolers' Health Study. Participants were 476 healthy, typically developing children (mean age = 3.88 years; 251 boys) evaluated on two consecutive afternoons. The children performed the Zurich Neuromotor Assessment, the statue subtest of the Neuropsychological Assessment for Children (NEPSY), and cognitive tests of the Intelligence and Development Scales-Preschool (IDS-P). CAMs were associated with poor inhibitory control on the statue test and poor selective attention and visual perception on the IDS-P. We attributed these findings to preschoolers' general immaturity of the central nervous system.

Klotho and activin A in kidney injury: plasma Klotho is maintained in unilateral obstruction despite no upregulation of Klotho biosynthesis in the contralateral kidney.

PubMed

Nordholm, Anders; Mace, Maria L; Gravesen, Eva; Hofman-Bang, Jacob; Morevati, Marya; Olgaard, Klaus; Lewin, Ewa

2018-05-01

In a new paradigm of etiology related to chronic kidney disease-mineral and bone disorder (CKD-MBD), kidney injury may cause induction of factors in the injured kidney that are released into the circulation and thereby initiate and maintain renal fibrosis and CKD-MBD. Klotho is believed to ameliorate renal fibrosis and CKD-MBD, while activin A might have detrimental effects. The unilateral ureter obstruction (UUO) model is used here to examine this concept by investigating early changes related to renal fibrosis in the obstructed kidney, untouched contralateral kidney, and vasculature which might be affected by secreted factors from the obstructed kidney, and comparing with unilateral nephrectomized controls (UNX). Obstructed kidneys showed early Klotho gene and protein depletion, whereas plasma Klotho increased in both UUO and UNX rats, indicating an altered metabolism of Klotho. Contralateral kidneys had no compensatory upregulation of Klotho and maintained normal expression of the examined fibrosis-related genes, as did remnant UNX kidneys. UUO caused upregulation of transforming growth factor-β and induction of periostin and activin A in obstructed kidneys without changes in the contralateral kidneys. Plasma activin A doubled in UUO rats after 10 days while no changes were seen in UNX rats, suggesting secretion of activin A from the obstructed kidney with potentially systemic effects on CKD-MBD. As such, increased aortic sclerostin was observed in UUO rats compared with UNX and normal controls. The present results are in line with the new paradigm and show very early vascular effects of unilateral kidney fibrosis, supporting the existence of a new kidney-vasculature axis.

Predicting women's intentions for contralateral prophylactic mastectomy: An application of an extended theory of planned behaviour.

PubMed

Richards, Imogen; Tesson, Stephanie; Porter, David; Phillips, Kelly-Anne; Rankin, Nicole; Musiello, Toni; Marven, Michelle; Butow, Phyllis

2016-04-01

Most women with unilateral breast cancer (BC) without BRCA1/2 gene mutations are at low risk of contralateral breast cancer (CBC). One CBC risk-management option is contralateral prophylactic mastectomy (CPM). While there is no evidence that CPM increases life-expectancy, its uptake is increasing. This study aimed to assess the validity of an extended social-cognition model, the Theory of Planned Behaviour (TPB), in predicting women's intentions to undergo CPM. Four hundred women previously treated for BC completed an online survey exploring demographic and disease factors, attitude, subjective norm, perceived behavioural control, anticipated regret, uncertainty avoidance, self-efficacy to not have CPM and intentions to undergo CPM in a common hypothetical decision-making scenario. The TPB uniquely explained 25.7% of intention variance. Greater anticipated regret, uncertainty avoidance and lower self-efficacy to cope with not having CPM were associated with stronger CPM intentions, explaining an additional 7.7%, 10.6% and 2.9% respectively, of variance over and above the TPB. Women who had undergone CPM, had not attended university, and had children reported stronger CPM intentions. A holistic understanding of CPM decision-making appears to require consideration beyond CBC risk, demographics and disease characteristics, exploring women's expectations about CPM outcomes, others' opinions, and avoidance of emotionality and difficulties associated with not undergoing surgery. This study provides a theoretical basis from which the complexity of CPM decision-making may be understood, and from which resources for patients and treating staff may be developed to support women's informed decision-making aligning with their personal values. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Binaural Cochlear Implant Sound Coding Strategy Inspired by the Contralateral Medial Olivocochlear Reflex

PubMed Central

Eustaquio-Martín, Almudena; Stohl, Joshua S.; Wolford, Robert D.; Schatzer, Reinhold; Wilson, Blake S.

2016-01-01

Objectives: In natural hearing, cochlear mechanical compression is dynamically adjusted via the efferent medial olivocochlear reflex (MOCR). These adjustments probably help understanding speech in noisy environments and are not available to the users of current cochlear implants (CIs). The aims of the present study are to: (1) present a binaural CI sound processing strategy inspired by the control of cochlear compression provided by the contralateral MOCR in natural hearing; and (2) assess the benefits of the new strategy for understanding speech presented in competition with steady noise with a speech-like spectrum in various spatial configurations of the speech and noise sources. Design: Pairs of CI sound processors (one per ear) were constructed to mimic or not mimic the effects of the contralateral MOCR on compression. For the nonmimicking condition (standard strategy or STD), the two processors in a pair functioned similarly to standard clinical processors (i.e., with fixed back-end compression and independently of each other). When configured to mimic the effects of the MOCR (MOC strategy), the two processors communicated with each other and the amount of back-end compression in a given frequency channel of each processor in the pair decreased/increased dynamically (so that output levels dropped/increased) with increases/decreases in the output energy from the corresponding frequency channel in the contralateral processor. Speech reception thresholds in speech-shaped noise were measured for 3 bilateral CI users and 2 single-sided deaf unilateral CI users. Thresholds were compared for the STD and MOC strategies in unilateral and bilateral listening conditions and for three spatial configurations of the speech and noise sources in simulated free-field conditions: speech and noise sources colocated in front of the listener, speech on the left ear with noise in front of the listener, and speech on the left ear with noise on the right ear. In both bilateral and

A Binaural Cochlear Implant Sound Coding Strategy Inspired by the Contralateral Medial Olivocochlear Reflex.

PubMed

Lopez-Poveda, Enrique A; Eustaquio-Martín, Almudena; Stohl, Joshua S; Wolford, Robert D; Schatzer, Reinhold; Wilson, Blake S

2016-01-01

In natural hearing, cochlear mechanical compression is dynamically adjusted via the efferent medial olivocochlear reflex (MOCR). These adjustments probably help understanding speech in noisy environments and are not available to the users of current cochlear implants (CIs). The aims of the present study are to: (1) present a binaural CI sound processing strategy inspired by the control of cochlear compression provided by the contralateral MOCR in natural hearing; and (2) assess the benefits of the new strategy for understanding speech presented in competition with steady noise with a speech-like spectrum in various spatial configurations of the speech and noise sources. Pairs of CI sound processors (one per ear) were constructed to mimic or not mimic the effects of the contralateral MOCR on compression. For the nonmimicking condition (standard strategy or STD), the two processors in a pair functioned similarly to standard clinical processors (i.e., with fixed back-end compression and independently of each other). When configured to mimic the effects of the MOCR (MOC strategy), the two processors communicated with each other and the amount of back-end compression in a given frequency channel of each processor in the pair decreased/increased dynamically (so that output levels dropped/increased) with increases/decreases in the output energy from the corresponding frequency channel in the contralateral processor. Speech reception thresholds in speech-shaped noise were measured for 3 bilateral CI users and 2 single-sided deaf unilateral CI users. Thresholds were compared for the STD and MOC strategies in unilateral and bilateral listening conditions and for three spatial configurations of the speech and noise sources in simulated free-field conditions: speech and noise sources colocated in front of the listener, speech on the left ear with noise in front of the listener, and speech on the left ear with noise on the right ear. In both bilateral and unilateral listening

Contralateral-noise effects on cochlear responses in anesthetized mice are dominated by feedback from an unknown pathway

PubMed Central

Usubuchi, Hajime; Vetter, Douglas E.; Elgoyhen, A. Bélen; Thomas, Steven A.; Liberman, M. Charles

2012-01-01

Suppression of ipsilateral distortion product otoacoustic emissions (DPOAEs) by contralateral noise is used in humans and animals to assay the strength of sound-evoked negative feedback from the medial olivocochlear (MOC) efferent pathway. However, depending on species and anesthesia, contributions of other feedback systems to the middle or inner ear can cloud the interpretation. Here, contributions of MOC and middle-ear muscle reflexes, as well as autonomic feedback, to contra-noise suppression in anesthetized mice are dissected by selectively eliminating each pathway by surgical transection, pharmacological blockade, or targeted gene deletion. When ipsilateral DPOAEs were evoked by low-level primaries, contra-noise suppression was typically ∼1 dB with contra-noise levels around 95 dB SPL, and it always disappeared upon contralateral cochlear destruction. Lack of middle-ear muscle contribution was suggested by persistence of contra-noise suppression after paralysis with curare, tensor tympani cauterization, or section of the facial nerve. Contribution of cochlear sympathetics was ruled out by studying mutant mice lacking adrenergic signaling (dopamine β-hydroxylase knockouts). Surprisingly, contra-noise effects on low-level DPOAEs were also not diminished by eliminating the MOC system pharmacologically (strychnine), surgically, or by deletion of relevant cholinergic receptors (α9/α10). In contrast, when ipsilateral DPOAEs were evoked by high-level primaries, the contra-noise suppression, although comparable in magnitude, was largely eliminated by MOC blockade or section. Possible alternate pathways are discussed for the source of contra-noise-evoked effects at low ipsilateral levels. PMID:22514298

Carotid artery stiffness in patients with symptomatic carotid artery disease with contralateral asymptomatic carotid artery disease and in patients with bilateral asymptomatic carotid artery disease: a cine phase-contrast carotid MR study.

PubMed

Sadat, Umar; Usman, Ammara; Howarth, Simon P S; Tang, Tjun Y; Alam, Fahreyar; Graves, Martin J; Gillard, Jonathan H

2014-04-01

Atherosclerosis is a systemic inflammatory disease that may affect multiple arterial beds simultaneously. Vascular distensibility is increasingly used in the clinical assessment of patients with atherosclerotic disease. In this study, we assess distensibility of symptomatic atherosclerotic carotid artery and of contralateral asymptomatic side. We also investigate the distensibility of bilaterally asymptomatic atherosclerotic carotid arteries using cine phase-contrast carotid magnetic resonance (MR) imaging. Nineteen patients with bilateral carotid artery disease underwent cine phase-contrast carotid imaging on a 1.5 T MR system. Ten patients had ipsilateral symptomatic carotid artery disease and contralateral asymptomatic stenosis. Nine additional patients with bilateral asymptomatic carotid artery disease constituted historical control group. Cine phase-contrast MR imaging acquired at the common carotid artery, maximum luminal stenosis, and internal carotid artery was used to determine carotid distensibility bilaterally for carotid arteries in both patient groups. Symptomatic carotid arteries were found to be significantly less distensible (mean distensibility coefficient [DC] 35.4 ± 6.12 × 10(-3)/kPa) than the contralateral asymptomatic vessels (mean DC 54.4 ± 7.88 × 10(-3)/kPa, P = .03) at the level of the common carotid artery. A similar trend of high distensibility for asymptomatic side in the area of maximum stenosis and the internal carotid artery was seen, but it was not found to be statistically significant. Plaque burden was comparable between the 2 groups at all locations. DC was comparable for patients with bilateral asymptomatic carotid artery stenoses. Distensibility of bilaterally asymptomatic carotid arteries was greater than that of asymptomatic carotid artery contralateral to the symptomatic side. Symptomatic carotid artery is stiffer than the contralateral asymptomatic side, despite comparable plaque burden. Patients with bilateral

Objective speech transmission improvements with a binaural cochlear implant sound-coding strategy inspired by the contralateral medial olivocochlear reflex.

PubMed

Lopez-Poveda, Enrique A; Eustaquio-Martín, Almudena

2018-04-01

It has been recently shown that cochlear implant users could enjoy better speech reception in noise and enhanced spatial unmasking with binaural audio processing inspired by the inhibitory effects of the contralateral medial olivocochlear (MOC) reflex on compression [Lopez-Poveda, Eustaquio-Martin, Stohl, Wolford, Schatzer, and Wilson (2016). Ear Hear. 37, e138-e148]. The perceptual evidence supporting those benefits, however, is limited to a few target-interferer spatial configurations and to a particular implementation of contralateral MOC inhibition. Here, the short-term objective intelligibility index is used to (1) objectively demonstrate potential benefits over many more spatial configurations, and (2) investigate if the predicted benefits may be enhanced by using more realistic MOC implementations. Results corroborate the advantages and drawbacks of MOC processing indicated by the previously published perceptual tests. The results also suggest that the benefits may be enhanced and the drawbacks overcome by using longer time constants for the activation and deactivation of inhibition and, to a lesser extent, by using a comparatively greater inhibition in the lower than in the higher frequency channels. Compared to using two functionally independent processors, the better MOC processor improved the signal-to-noise ratio in the two ears between 1 and 6 decibels by enhancing head-shadow effects, and was advantageous for all tested target-interferer spatial configurations.

Contralateral breast dose from chest wall and breast irradiation: local experience.

PubMed

Alzoubi, A S; Kandaiya, S; Shukri, A; Elsherbieny, E

2010-06-01

Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47+/-0.22 cGy and 5.44 cGy, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1% of the prescribed dose which is comparable to the values reported by other authors.

A contralateral repeated bout effect attenuates induction of NF-κB DNA binding following eccentric exercise.

PubMed

Xin, Ling; Hyldahl, Robert D; Chipkin, Stuart R; Clarkson, Priscilla M

2014-06-01

We investigated the existence of contralateral repeated bout effect and tested if the attenuation of nuclear factor-kappa B (NF-κB; an important regulator of muscle inflammation) induction following eccentric exercise is a potential mechanism. Thirty-one healthy men performed two bouts of knee extension eccentric exercise, initially with one leg and then with the opposite leg 4 wk later. Vastus lateralis muscle biopsies of both exercised and control legs were taken 3 h postexercise. Knee extension isometric and isokinetic strength (60°/sec and 180°/sec) were measured at baseline, pre-exercise, immediately postexercise, and 1/day for 5 days postexercise. Serum creatine kinase (CK) activity and muscle soreness were assessed at baseline and 1/day for 5 days postexercise. NF-κB (p65) DNA-binding activity was measured in the muscle biopsies. Isometric strength loss was lower in bout 2 than in bout 1 at 24, 72, and 96 h postexercise (P < 0.05). Isokinetic strength (60°/s and 180°/s) was reduced less in bout 2 than in bout 1 at 72 h postexercise (P < 0.01). There were no significant differences between bouts for postexercise CK activity or muscle soreness. p65 DNA-binding activity was increased following eccentric exercise (compared with the control leg) in bout 1 (122.9% ± 2.6%; P < 0.001) and bout 2 (109.1% ± 3.0%; P < 0.05). Compared with bout 1, the increase in NF-κB DNA-binding activity postexercise was attenuated after bout 2 (P = 0.0008). Repeated eccentric exercise results in a contralateral repeated bout effect, which could be due to the attenuated increase in NF-κB activity postexercise. Copyright © 2014 the American Physiological Society.

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial.

PubMed

Kitterick, Pádraig T; O'Donoghue, Gerard M; Edmondson-Jones, Mark; Marshall, Andrew; Jeffs, Ellen; Craddock, Louise; Riley, Alison; Green, Kevin; O'Driscoll, Martin; Jiang, Dan; Nunn, Terry; Saeed, Shakeel; Aleksy, Wanda; Seeber, Bernhard U

2014-01-01

Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of the interventions on

Contralateral Delay Activity Tracks Fluctuations in Working Memory Performance.

PubMed

Adam, Kirsten C S; Robison, Matthew K; Vogel, Edward K

2018-01-08

Neural measures of working memory storage, such as the contralateral delay activity (CDA), are powerful tools in working memory research. CDA amplitude is sensitive to working memory load, reaches an asymptote at known behavioral limits, and predicts individual differences in capacity. An open question, however, is whether neural measures of load also track trial-by-trial fluctuations in performance. Here, we used a whole-report working memory task to test the relationship between CDA amplitude and working memory performance. If working memory failures are due to decision-based errors and retrieval failures, CDA amplitude would not differentiate good and poor performance trials when load is held constant. If failures arise during storage, then CDA amplitude should track both working memory load and trial-by-trial performance. As expected, CDA amplitude tracked load (Experiment 1), reaching an asymptote at three items. In Experiment 2, we tracked fluctuations in trial-by-trial performance. CDA amplitude was larger (more negative) for high-performance trials compared with low-performance trials, suggesting that fluctuations in performance were related to the successful storage of items. During working memory failures, participants oriented their attention to the correct side of the screen (lateralized P1) and maintained covert attention to the correct side during the delay period (lateralized alpha power suppression). Despite the preservation of attentional orienting, we found impairments consistent with an executive attention theory of individual differences in working memory capacity; fluctuations in executive control (indexed by pretrial frontal theta power) may be to blame for storage failures.

Combined SCI and TBI: Recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement

PubMed Central

Inoue, Tomoo; Lin, Amity; Ma, Xiaokui; McKenna, Stephen L.; Creasey, Graham H.; Manley, Geoffrey T.; Ferguson, Adam R.; Bresnahan, Jacqueline C.; Beattie, Michael S.

2015-01-01

A significant proportion (estimates range from 16–74%) of patients with spinal cord injury (SCI) have concomitant traumatic brain injury (TBI), and the combination often produces difficulties in planning and implementing rehabilitation strategies and drug therapies. For example, many of the drugs used to treat SCI may interfere with cognitive rehabilitation, and conversely drugs that are used to control seizures in TBI patients may undermine locomotor recovery after SCI. The current paper presents an experimental animal model for combined SCI and TBI to help drive mechanistic studies of dual diagnosis. Rats received a unilateral SCI (75 kdyn) at C5 vertebral level, a unilateral TBI (2.0 mm depth, 4.0 m/s velocity impact on the forelimb sensori-motor cortex), or both SCI + TBI. TBI was placed either contralateral or ipsilateral to the SCI. Behavioral recovery was examined using paw placement in a cylinder, grooming, open field locomotion, and the IBB cereal eating test. Over 6 weeks, in the paw placement test, SCI + contralateral TBI produced a profound deficit that failed to recover, but SCI + ipsilateral TBI increased the relative use of the paw on the SCI side. In the grooming test, SCI + contralateral TBI produced worse recovery than either lesion alone even though contralateral TBI alone produced no observable deficit. In the IBB forelimb test, SCI + contralateral TBI revealed a severe deficit that recovered in 3 weeks. For open field locomotion, SCI alone or in combination with TBI resulted in an initial deficit that recovered in 2 weeks. Thus, TBI and SCI affected forelimb function differently depending upon the test, reflecting different neural substrates underlying, for example, exploratory paw placement and stereotyped grooming. Concurrent SCI and TBI had significantly different effects on outcomes and recovery, depending upon laterality of the two lesions. Recovery of function after cervical SCI was retarded by the addition of a moderate TBI in the

Combined SCI and TBI: recovery of forelimb function after unilateral cervical spinal cord injury (SCI) is retarded by contralateral traumatic brain injury (TBI), and ipsilateral TBI balances the effects of SCI on paw placement.

PubMed

Inoue, Tomoo; Lin, Amity; Ma, Xiaokui; McKenna, Stephen L; Creasey, Graham H; Manley, Geoffrey T; Ferguson, Adam R; Bresnahan, Jacqueline C; Beattie, Michael S

2013-10-01

A significant proportion (estimates range from 16 to 74%) of patients with spinal cord injury (SCI) have concomitant traumatic brain injury (TBI), and the combination often produces difficulties in planning and implementing rehabilitation strategies and drug therapies. For example, many of the drugs used to treat SCI may interfere with cognitive rehabilitation, and conversely drugs that are used to control seizures in TBI patients may undermine locomotor recovery after SCI. The current paper presents an experimental animal model for combined SCI and TBI to help drive mechanistic studies of dual diagnosis. Rats received a unilateral SCI (75 kdyn) at C5 vertebral level, a unilateral TBI (2.0 mm depth, 4.0 m/s velocity impact on the forelimb sensori-motor cortex), or both SCI+TBI. TBI was placed either contralateral or ipsilateral to the SCI. Behavioral recovery was examined using paw placement in a cylinder, grooming, open field locomotion, and the IBB cereal eating test. Over 6weeks, in the paw placement test, SCI+contralateral TBI produced a profound deficit that failed to recover, but SCI+ipsilateral TBI increased the relative use of the paw on the SCI side. In the grooming test, SCI+contralateral TBI produced worse recovery than either lesion alone even though contralateral TBI alone produced no observable deficit. In the IBB forelimb test, SCI+contralateral TBI revealed a severe deficit that recovered in 3 weeks. For open field locomotion, SCI alone or in combination with TBI resulted in an initial deficit that recovered in 2 weeks. Thus, TBI and SCI affected forelimb function differently depending upon the test, reflecting different neural substrates underlying, for example, exploratory paw placement and stereotyped grooming. Concurrent SCI and TBI had significantly different effects on outcomes and recovery, depending upon laterality of the two lesions. Recovery of function after cervical SCI was retarded by the addition of a moderate TBI in the contralateral

Tamoxifen and Risk of Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers

PubMed Central

Phillips, Kelly-Anne; Milne, Roger L.; Rookus, Matti A.; Daly, Mary B.; Antoniou, Antonis C.; Peock, Susan; Frost, Debra; Easton, Douglas F.; Ellis, Steve; Friedlander, Michael L.; Buys, Saundra S.; Andrieu, Nadine; Noguès, Catherine; Stoppa-Lyonnet, Dominique; Bonadona, Valérie; Pujol, Pascal; McLachlan, Sue Anne; John, Esther M.; Hooning, Maartje J.; Seynaeve, Caroline; Tollenaar, Rob A.E.M.; Goldgar, David E.; Beth Terry, Mary; Caldes, Trinidad; Weideman, Prue C.; Andrulis, Irene L.; Singer, Christian F.; Birch, Kate; Simard, Jacques; Southey, Melissa C.; Olsson, Håkan L.; Jakubowska, Anna; Olah, Edith; Gerdes, Anne-Marie; Foretova, Lenka; Hopper, John L.

2013-01-01

Purpose To determine whether adjuvant tamoxifen treatment for breast cancer (BC) is associated with reduced contralateral breast cancer (CBC) risk for BRCA1 and/or BRCA2 mutation carriers. Methods Analysis of pooled observational cohort data, self-reported at enrollment and at follow-up from the International BRCA1, and BRCA2 Carrier Cohort Study, Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, and Breast Cancer Family Registry. Eligible women were BRCA1 and BRCA2 mutation carriers diagnosed with unilateral BC since 1970 and no other invasive cancer or tamoxifen use before first BC. Hazard ratios (HRs) for CBC associated with tamoxifen use were estimated using Cox regression, adjusting for year and age of diagnosis, country, and bilateral oophorectomy and censoring at contralateral mastectomy, death, or loss to follow-up. Results Of 1,583 BRCA1 and 881 BRCA2 mutation carriers, 383 (24%) and 454 (52%), respectively, took tamoxifen after first BC diagnosis. There were 520 CBCs over 20,104 person-years of observation. The adjusted HR estimates were 0.38 (95% CI, 0.27 to 0.55) and 0.33 (95% CI, 0.22 to 0.50) for BRCA1 and BRCA2 mutation carriers, respectively. After left truncating at recruitment to the cohort, adjusted HR estimates were 0.58 (95% CI, 0.29 to 1.13) and 0.48 (95% CI, 0.22 to 1.05) based on 657 BRCA1 and 426 BRCA2 mutation carriers with 100 CBCs over 4,392 person-years of prospective follow-up. HRs did not differ by estrogen receptor status of the first BC (missing for 56% of cases). Conclusion This study provides evidence that tamoxifen use is associated with a reduction in CBC risk for BRCA1 and BRCA2 mutation carriers. Further follow-up of these cohorts will provide increased statistical power for future prospective analyses. PMID:23918944

Sensorimotor state of the contralateral leg affects ipsilateral muscle coordination of pedaling.

PubMed

Ting, L H; Raasch, C C; Brown, D A; Kautz, S A; Zajac, F E

1998-09-01

The objective of this study was to determine if independent central pattern generating elements controlling the legs in bipedal and unipedal locomotion is a viable theory for locomotor propulsion in humans. Coordinative coupling of the limbs could then be accomplished through mechanical interactions and ipsilateral feedback control rather than through central interlimb neural pathways. Pedaling was chosen as the locomotor task to study because interlimb mechanics can be significantly altered, as pedaling can be executed with the use of either one leg or two legs (cf. walking) and because the load on the limb can be well-controlled. Subjects pedaled a modified bicycle ergometer in a two-legged (bilateral) and a one-legged (unilateral) pedaling condition. The loading on the leg during unilateral pedaling was designed to be identical to the loading experienced by the leg during bilateral pedaling. This loading was achieved by having a trained human "motor" pedal along with the subject and exert on the opposite crank the torque that the subject's contralateral leg generated in bilateral pedaling. The human "motor" was successful at reproducing each subject's one-leg crank torque. The shape of the motor's torque trajectory was similar to that of subjects, and the amount of work done during extension and flexion was not significantly different. Thus the same muscle coordination pattern would allow subjects to pedal successfully in both the bilateral and unilateral conditions, and the afferent signals from the pedaling leg could be the same for both conditions. Although the overall work done by each leg did not change, an 86% decrease in retarding (negative) crank torque during limb flexion was measured in all 11 subjects during the unilateral condition. This corresponded to an increase in integrated electromyography of tibialis anterior (70%), rectus femoris (43%), and biceps femoris (59%) during flexion. Even given visual torque feedback in the unilateral condition

Assessing joint line positions by means of the contralateral knee: a new approach for planning knee revision surgery?

PubMed

Maderbacher, Günther; Keshmiri, Armin; Zeman, Florian; Grifka, Joachim; Baier, Clemens

2015-11-01

Reconstructing the natural joint line in knee revision surgery improves clinical and functional outcome but may be challenging when both cartilage and bone were removed during previous operations. Assessing joint lines (JLs) by means of bony landmarks is inadvisable because of large variations in human anatomy. Because of the inherent symmetry of the human body, we hypothesised that JLs may be directly assessed by measuring the distances from the bony landmarks to the JL of the contralateral knee by means of radiographic images. Using scaled weight-bearing radiographs in anteroposterior view of both knees, two independent observers measured the distances from the fibular head, the medial and lateral epicondyle, and the adductor tubercle to the JL. A two-sided p value of ≤0.05 was considered statistically significant. Two hundred knees of 100 patients (50 men and 50 women) were examined. For the fibular head, the mean difference between the treated and the control knee was 0.0 mm with narrow confidence limits ranging from -1.1 to 1.1. As a new assessment method, we have suggested to assess the JL by means of radiographs of the contralateral knee. The most precise parameter was found to be the distance between the fibular head and the JL. The level of arthritis, age, gender, visibility of the landmarks, and misalignment did not influence measurement accuracy. This parameter is the first tibia-related landmark for assessing the JL, which advantageously corresponds to the tibia-first technique in revision surgery. Diagnostic Study, Level II.

Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model.

PubMed

Ortega-Porcayo, Luis Alberto; Leal-López, Andres; Soriano-López, Miroslava Elizabeth; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Soriano-Solis, Sergio; Rodríguez-García, Manuel; Soriano-Solis, Hector Antonio; Soriano-Sánchez, José Antonio

2018-04-01

Retrospective comparative clinical study. This study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model. The increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined. We performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient. The mean FCSA at the surgical site was 20.97±5.07 cm 2 at the superior level and 8.89±2.87 cm 2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm 2 at the superior level and 9.20±2.66 cm 2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites ( p =0.5, p =0.922, respectively). Using a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent levels.

Assessment of Paraspinal Muscle Atrophy Percentage after Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Instrumentation Using a Novel Contralateral Intact Muscle-Controlled Model

PubMed Central

Ortega-Porcayo, Luis Alberto; Leal-López, Andres; Soriano-López, Miroslava Elizabeth; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Soriano-Solis, Sergio; Rodríguez-García, Manuel; Soriano-Solis, Hector Antonio

2018-01-01

Study Design Retrospective comparative clinical study. Purpose This study aimed to assess paraspinal muscle atrophy in patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and unilateral pedicle screw fixation using a novel contralateral intact muscle-controlled model. Overview of Literature The increased incidence of paravertebral lumbar muscle injuries after open techniques has raised the importance of implementing minimally invasive spine surgical techniques using tubular retractors and minimally invasive screw placement. The functional cross-sectional area (FCSA) represents the lean muscle mass; furthermore, FCSA is a useful marker of the contractile ability of a muscle following a spine surgery. However, the benefits of unilateral fixation and MI-TLIF on paraspinal muscles have not been defined. Methods We performed a retrospective imagenological review on eleven patients who underwent unilateral MI-TLIF and unilateral transpedicular screw lumbar placement. FCSAs of the multifidus and erector spinae were measured 1 year after surgery at adjacent levels and were compared to the contralateral intact muscles. Measurement differences between the surgical and nonsurgical sites were compared. The interobserver reliability was calculated using an intraclass correlation coefficient. Results The mean FCSA at the surgical site was 20.97±5.07 cm2 at the superior level and 8.89±2.87 cm2 at the inferior level. The mean FCSA at the contralateral nonsurgical site was 20.15±5.95 cm2 at the superior level and 9.20±2.66 cm2 at the inferior level was. The superior and inferior FCSA measurements showed no significant difference between the surgical and nonsurgical sites (p=0.5, p=0.922, respectively). Conclusions Using a mini-open tubular approach through the sulcus between the longissimus and iliocostalis, MI-TLIF and unilateral pedicle screw instrumentation produced minimal paraspinal muscle damage at the superior and inferior adjacent

Motivations for contralateral prophylactic mastectomy as a function of socioeconomic status.

PubMed

Baptiste, Dadrie F; MacGeorge, Erina L; Venetis, Maria K; Mouton, Ashton; Friley, L Brooke; Pastor, Rebekah; Hatten, Kristen; Lagoo, Janaka; Clare, Susan E; Bowling, Monet W

2017-02-01

Despite no demonstrated survival advantage for women at average risk of breast cancer, rates of contralateral prophylactic mastectomy (CPM) continue to increase. Research reveals women with higher socioeconomic status (SES) are more likely to select CPM. This study examines how indicators of SES, age, and disease severity affect CPM motivations. Patients (N = 113) who underwent CPM at four Indiana University affiliated hospitals completed telephone interviews in 2013. Participants answered questions about 11 CPM motivations and provided demographic information. Responses to motivation items were factor analyzed, resulting in 4 motivational factors: reducing long-term risk, symmetry, avoiding future medical visits, and avoiding treatments. Across demographic differences, reducing long-term risk was the strongest CPM motivation. Lower income predicted stronger motivation to reduce long-term risk and avoid treatment. Older participants were more motivated to avoid treatment; younger and more-educated patients were more concerned about symmetry. Greater severity of diagnosis predicted avoiding treatments. Reducing long-term risk is the primary motivation across groups, but there are also notable differences as a function of age, education, income, and disease severity. To stop the trend of increasing CPM, physicians must tailor patient counseling to address motivations that are consistent across patient populations and those that vary between populations.

Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

PubMed

Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

2015-02-15

During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. Copyright © 2015 the American Physiological Society.

Comparison of the benefits of cochlear implantation versus contra-lateral routing of signal hearing aids in adult patients with single-sided deafness: study protocol for a prospective within-subject longitudinal trial

PubMed Central

2014-01-01

Background Individuals with a unilateral severe-to-profound hearing loss, or single-sided deafness, report difficulty with listening in many everyday situations despite having access to well-preserved acoustic hearing in one ear. The standard of care for single-sided deafness available on the UK National Health Service is a contra-lateral routing of signals hearing aid which transfers sounds from the impaired ear to the non-impaired ear. This hearing aid has been found to improve speech understanding in noise when the signal-to-noise ratio is more favourable at the impaired ear than the non-impaired ear. However, the indiscriminate routing of signals to a single ear can have detrimental effects when interfering sounds are located on the side of the impaired ear. Recent published evidence has suggested that cochlear implantation in individuals with a single-sided deafness can restore access to the binaural cues which underpin the ability to localise sounds and segregate speech from other interfering sounds. Methods/Design The current trial was designed to assess the efficacy of cochlear implantation compared to a contra-lateral routing of signals hearing aid in restoring binaural hearing in adults with acquired single-sided deafness. Patients are assessed at baseline and after receiving a contra-lateral routing of signals hearing aid. A cochlear implant is then provided to those patients who do not receive sufficient benefit from the hearing aid. This within-subject longitudinal design reflects the expected care pathway should cochlear implantation be provided for single-sided deafness on the UK National Health Service. The primary endpoints are measures of binaural hearing at baseline, after provision of a contra-lateral routing of signals hearing aid, and after cochlear implantation. Binaural hearing is assessed in terms of the accuracy with which sounds are localised and speech is perceived in background noise. The trial is also designed to measure the impact of

Increased contralateral suppression of otoacoustic emissions indicates a hyperresponsive medial olivocochlear system in humans with tinnitus and hyperacusis

PubMed Central

Shera, Christopher A.; Melcher, Jennifer R.

2014-01-01

Atypical medial olivocochlear (MOC) feedback from brain stem to cochlea has been proposed to play a role in tinnitus, but even well-constructed tests of this idea have yielded inconsistent results. In the present study, it was hypothesized that low sound tolerance (mild to moderate hyperacusis), which can accompany tinnitus or occur on its own, might contribute to the inconsistency. Sound-level tolerance (SLT) was assessed in subjects (all men) with clinically normal or near-normal thresholds to form threshold-, age-, and sex-matched groups: 1) no tinnitus/high SLT, 2) no tinnitus/low SLT, 3) tinnitus/high SLT, and 4) tinnitus/low SLT. MOC function was measured from the ear canal as the change in magnitude of distortion-product otoacoustic emissions (DPOAE) elicited by broadband noise presented to the contralateral ear. The noise reduced DPOAE magnitude in all groups (“contralateral suppression”), but significantly more reduction occurred in groups with tinnitus and/or low SLT, indicating hyperresponsiveness of the MOC system compared with the group with no tinnitus/high SLT. The results suggest hyperresponsiveness of the interneurons of the MOC system residing in the cochlear nucleus and/or MOC neurons themselves. The present data, combined with previous human and animal data, indicate that neural pathways involving every major division of the cochlear nucleus manifest hyperactivity and/or hyperresponsiveness in tinnitus and/or low SLT. The overactivation may develop in each pathway separately. However, a more parsimonious hypothesis is that top-down neuromodulation is the driving force behind ubiquitous overactivation of the auditory brain stem and may correspond to attentional spotlighting on the auditory domain in tinnitus and hyperacusis. PMID:25231612

3D ocular ultrasound using gaze tracking on the contralateral eye: a feasibility study.

PubMed

Afsham, Narges; Najafi, Mohammad; Abolmaesumi, Purang; Rohling, Robert

2011-01-01

A gaze-deviated examination of the eye with a 2D ultrasound transducer is a common and informative ophthalmic test; however, the complex task of the pose estimation of the ultrasound images relative to the eye affects 3D interpretation. To tackle this challenge, a novel system for 3D image reconstruction based on gaze tracking of the contralateral eye has been proposed. The gaze fixates on several target points and, for each fixation, the pose of the examined eye is inferred from the gaze tracking. A single camera system has been developed for pose estimation combined with subject-specific parameter identification. The ultrasound images are then transformed to the coordinate system of the examined eye to create a 3D volume. Accuracy of the proposed gaze tracking system and the pose estimation of the eye have been validated in a set of experiments. Overall system error, including pose estimation and calibration, are 3.12 mm and 4.68 degrees.

Orthodontic space closure without contralateral extraction through mesial movement of lower molars in patients with aplastic lower second premolars.

PubMed

Zimmer, B; Guitard, Y

2001-09-01

A method is presented that allows unilateral space closure in patients with aplastic lower second premolars. Based on a straight-wire appliance, space closure was achieved with a combination of "push mechanics" using the second molar as an anchorage unit and Class II "pull mechanics", thus avoiding the application of any distalizing force on the lower incisors. The results from 13 consecutively treated subjects (five boys, eight girls, mean age 12 years and 6 months) were analyzed. Complete bodily space closure was achieved in all 13 cases within a mean treatment time of 2 years and 7 months. The desired Angle Class III molar relationship of one premolar width (+/- 1/4 premolar width) on the aplastic side was successful in eleven patients, an additional 4.7 mm of space being created for the third molar on the aplastic side compared with the contralateral side (p < or = 0.01). However, adverse effects could be kept to a minimum, with no method-dependent side effects being recorded with regard to canine and molar relationships on the contralateral side, or to overbite, overjet, or upper and lower incisor inclination. The mean lower midline shift of 0.8 mm was in accordance with the mean distal canine relationship of 1/3 premolar width on the aplastic side. These results confirm that orthodontic space closure in cases of unilateral aplastic lower second premolars can be performed successfully with the presented treatment method without the need for additional premolar extractions, prosthodontic treatment or implants. Furthermore, the prognosis for the lower wisdom tooth on the aplastic side is improved.

Contralateral decubitus positioning enhances computed tomographic angiographic evaluation of pulmonary vasculature in a patient with a pulmonary arteriovenous malformation.

PubMed

Tafti, Bashir Akhavan; Berenji, Gholam R; Santiago, Silverio; Barack, Bruce M

2012-11-01

Computed tomographic pulmonary angiography has become the diagnostic procedure of choice in patients suspected of having a pulmonary embolus. However, intrapulmonary shunting of blood in a variety of pathologic conditions can cause suboptimal opacification of the pulmonary arterial circulation and result in a suboptimal or even nondiagnostic study. Radiologists should be aware of these conditions and be familiar with positioning techniques to minimize such shunting. We report a patient suspected of having pulmonary embolism, in whom a preexisting unilateral arteriovenous malformation prevented adequate evaluation of the pulmonary circulation. Positioning the patient in the contralateral decubitus position significantly enhanced image quality.

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy.

PubMed

Anderson, Chelsea; Islam, Jessica Y; Elizabeth Hodgson, M; Sabatino, Susan A; Rodriguez, Juan L; Lee, Clara N; Sandler, Dale P; Nichols, Hazel B

2017-06-01

Contralateral prophylactic mastectomy (CPM) rates have been increasing in the US, and although high levels of satisfaction with CPM have been reported, few studies have evaluated the long-term effects on body image, comparing CPM with breast-conserving surgery (BCS) and unilateral mastectomy (UM). We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n = 1176). Among women who underwent mastectomy, we examined satisfaction with the mastectomy decision, as well as variation in the use of reconstruction and experience of complications. Five survey items, evaluated individually and as a summed total score, were used to compare body image across surgery types (BCS, UM without reconstruction, CPM without reconstruction, UM with reconstruction, and CPM with reconstruction). Participants were, on average, 3.6 years post-diagnosis at the time of survey (standard deviation 1.7). The majority of women (97% of CPM, 89% of UM) were satisfied with their mastectomy decision. Reconstruction was more common after CPM than after UM (70 vs. 47%), as were complications (28 vs. 19%). Body image scores were significantly worse among women who underwent CPM than among women who underwent BCS, with the lowest scores among women who underwent CPM without reconstruction. In our sample, most women were highly satisfied with their mastectomy decision, including those who elected to undergo CPM. However, body image was lower among those who underwent CPM than among those who underwent BCS. Our findings may inform decisions among women considering various courses of surgical treatment.

A clinical rule (sex, contralateral occlusion, age, and restenosis) to select patients for stenting versus carotid endarterectomy: systematic review of observational studies with validation in randomized trials.

PubMed

Touzé, Emmanuel; Trinquart, Ludovic; Felgueiras, Rui; Rerkasem, Kittipan; Bonati, Leo H; Meliksetyan, Gayané; Ringleb, Peter A; Mas, Jean-Louis; Brown, Martin M; Rothwell, Peter M

2013-12-01

Compared with carotid endarterectomy (CEA), carotid angioplasty and stenting (CAS) is associated with a higher risk of procedural stroke or death especially in patients with symptomatic stenosis. However, after the perioperative period, risk is similar with both treatments, suggesting that CAS could be an acceptable option in selected patients. We performed systematic reviews of observational studies of procedural risks of CEA or CAS and extracted data on 9 predefined risk factors (age, contralateral carotid occlusion, coronary artery disease, diabetes mellitus, sex, hypertension, peripheral artery disease, and type and side of stenosis). We calculated pooled relative risks of procedural stroke or death. Factors with differential effects on risk of CAS versus CEA were identified by interaction tests and used to derive a rule. The rule was tested using individual patient data from randomized trials of CAS versus CEA from the Carotid Stenting Trialists' Collaboration (CSTC). We identified 170 studies. The effects of sex, contralateral occlusion, age, and restenosis (SCAR) on the procedural risk of stroke or death differed. Patients with contralateral occlusion or restenosis and women<75 years were at relatively low risk for CAS (SCAR negative), with all others being high risk (SCAR positive). Among the 3049 patients in the CSTC validation, 694 (23%) patients were SCAR negative. The pooled RR of procedural stroke and death with CAS versus CEA was 0.93 (0.49-1.77; P=0.83) in SCAR-negative and 2.41 (1.68-3.45; P<0.0001) in SCAR-positive patients (P [interaction]=0.05). The SCAR rule is potentially useful to identify patients in whom CAS has a similar risk of perioperative stroke or death to CEA.

SU-F-T-195: Systematic Constraining of Contralateral Parotid Gland Led to Improved Dosimetric Outcomes for Multi-Field Optimization with Scanning Beam Proton Therapy: Promising Results From a Pilot Study in Patients with Base of Tongue Carcinoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, R; Liu, A; Poenisch, F

Purpose: Treatment planning for Intensity Modulated Proton Therapy (IMPT) for head and neck cancer is time-consuming due to the large number of organs-at-risk (OAR) to be considered. As there are many competing objectives and also wide range of acceptable OAR constraints, the final approved plan may not be most optimal for the given structures. We evaluated the dose reduction to the contralateral parotid by implementing standardized constraints during optimization for scanning beam proton therapy planning. Methods: Twenty-four (24) consecutive patients previously treated for base of tongue carcinoma were retrospectively selected. The doses were 70Gy, 63Gy and 57Gy (SIB in 33more » fractions) for high-, intermediate-, and standard-risk clinical target volumes (CTV), respectively; the treatment included bilateral neck. Scanning beams using MFO with standardized bilateral anterior oblique and PA fields were applied. New plans where then developed and optimized by employing additional contralateral parotid constraints at multiple defined dose levels. Using a step-wise iterative process, the volume-based constraints at each level were then further reduced until known target coverages were compromised. The newly developed plans were then compared to the original clinically approved plans using paired student t-testing. Results: All 24 newly optimized treatment plans maintained initial plan quality as compared to the approved plans, and the 98% prescription dose coverage to the CTV’s were not compromised. Representative DVH comparison is shown in FIGURE 1. The contralateral parotid doses were reduced at all levels of interest when systematic constraints were applied to V10, V20, V30 and V40Gy (All P<0.0001; TABLE 1). Overall, the mean contralateral parotid doses were reduced by 2.26 Gy on average, a ∼13% relative improvement. Conclusion: Applying systematic and volume-based contralateral parotid constraints for IMPT planning significantly reduced the dose at all

Informational masking of speech in children: Effects of ipsilateral and contralateral distracters

NASA Astrophysics Data System (ADS)

Wightman, Frederic L.; Kistler, Doris J.

2005-11-01

Using a closed-set speech recognition paradigm thought to be heavily influenced by informational masking, auditory selective attention was measured in 38 children (ages 4-16 years) and 8 adults (ages 20-30 years). The task required attention to a monaural target speech message that was presented with a time-synchronized distracter message in the same ear. In some conditions a second distracter message or a speech-shaped noise was presented to the other ear. Compared to adults, children required higher target/distracter ratios to reach comparable performance levels, reflecting more informational masking in these listeners. Informational masking in most conditions was confirmed by the fact that a large proportion of the errors made by the listeners were contained in the distracter message(s). There was a monotonic age effect, such that even the children in the oldest age group (13.6-16 years) demonstrated poorer performance than adults. For both children and adults, presentation of an additional distracter in the contralateral ear significantly reduced performance, even when the distracter messages were produced by a talker of different sex than the target talker. The results are consistent with earlier reports from pure-tone masking studies that informational masking effects are much larger in children than in adults.

Development and pilot testing of a Decision Aid (DA) for women with early-stage breast cancer considering contralateral prophylactic mastectomy.

PubMed

Ager, B; Jansen, J; Porter, D; Phillips, K A; Glassey, R; Butow, P

2018-05-22

Describe the development, acceptability and feasibility of a Decision Aid (DA) for women with early-stage breast cancer (BC) at average contralateral breast cancer (CBC) risk considering contralateral prophylactic mastectomy (CPM). The DA was developed using the International Patient Decision Aid Standards (IPDAS) and the Ottawa Decision Support Framework. It provides evidence-based information about CPM in a booklet format combining text, graphs and images of surgical options. Twenty-three women with a history of early-stage breast cancer were interviewed in person or over the phone using a 'think aloud approach'. Framework analysis was used to code and analyse data. Twenty-three women participated in the study. Mean age of participants was 58.6 years and time since diagnosis ranged from 14 months to 21 years. Five women had CPM and eighteen had not. Women strongly endorsed the DA. Many felt validated by a section on appearance and found information on average risk of recurrence and metastases helpful, however, noted the importance of discussing personal risk with their surgeon. Many requested more information on surgery details (time taken, recovery) and costs of the different options. The DA was acceptable to women, including the format, content and proposed implementation strategies. Practical and financial issues are important to women in considering treatment options. Women appreciate information about CPM at diagnosis and emphasised the importance of discussing potential downsides of the procedure in addition to benefits. The DA was considered acceptable to facilitate such discussions. Copyright © 2018 Elsevier Ltd. All rights reserved.

A New Anatomic Variation: Coexistence of Both Dandy-Walker Variant and Ophthalmic Artery Originating From Contralateral Internal Carotid Artery.

PubMed

Ogul, Hayri; Havan, Nuri; Gedikli, Yusuf; Pirimoglu, Berhan; Kantarci, Mecit

2016-06-01

The authors report on 1 patient of variant origin of right ophthalmic artery (OA) from ophthalmic segment of the left internal carotid artery. A 41-year-old man was performed magnetic resonance (MR) imaging and MR angiography. Cerebral MR imaging revealed a Dandy-Walker variant. In MR angiography the authors observed this unusual variant of origin of OA and a complete occlusion of right internal carotid artery. To the authors' knowledge, this is the first patient who has coincidence of both Dandy-Walker variant and origin of OA from contralateral internal carotid artery. Careful observation of MR angiography images with maximum intensity projection is very important for detecting rare vascular variations.

Neural correlates of visuospatial consciousness in 3D default space: insights from contralateral neglect syndrome.

PubMed

Jerath, Ravinder; Crawford, Molly W

2014-08-01

One of the most compelling questions still unanswered in neuroscience is how consciousness arises. In this article, we examine visual processing, the parietal lobe, and contralateral neglect syndrome as a window into consciousness and how the brain functions as the mind and we introduce a mechanism for the processing of visual information and its role in consciousness. We propose that consciousness arises from integration of information from throughout the body and brain by the thalamus and that the thalamus reimages visual and other sensory information from throughout the cortex in a default three-dimensional space in the mind. We further suggest that the thalamus generates a dynamic default three-dimensional space by integrating processed information from corticothalamic feedback loops, creating an infrastructure that may form the basis of our consciousness. Further experimental evidence is needed to examine and support this hypothesis, the role of the thalamus, and to further elucidate the mechanism of consciousness. Copyright © 2014 Elsevier Inc. All rights reserved.

Increasing rates of contralateral prophylactic mastectomy - a trend made in USA?

PubMed

Güth, U; Myrick, M E; Viehl, C T; Weber, W P; Lardi, A M; Schmid, S M

2012-04-01

Numerous recent studies conducted in the USA reported a considerable rise in the rates of contralateral prophylactic mastectomy (CPM) in early-stage breast cancer (BC). However, this aggressive surgical approach only showed an evidence-based improvement in prognosis for a small subgroup of high-risk BC patients. We present the first European study reporting CPM rates in an unselected cohort of patients with BC. The data of 881 patients (≤ 80 years) who underwent surgery for stage I-III BC from 1995 to 2009 at the University of Basel Breast Center was analyzed. CPM was performed in 23 of 881 patients (2.6%). Of the entire patient population, 37.5% underwent ipsilateral mastectomy and of those, only 7.0% chose to undergo CPM. Importantly, there was no trend over time in the rate of CPM. Women who chose CPM were significantly younger (54 vs. 60 years, p < 0.001), had more often a positive family history (39.1% vs. 24.4%, p = 0.032) and tumors of lobular histology (30.5% vs. 13.9%, p = 0.035). Our analysis of CPM rates in BC patients, conducted at a European University breast center, does not show the considerably rising CPM rates observed in the USA. We hypothesize that different medico-social and cultural factors, which are highlighted by a different public perception of BC and a different attitude toward plastic surgery, determine the varying CPM rates between the USA and Europe. © 2011 Elsevier Ltd. All rights reserved.

Avascular Necrosis in the Contralateral Hip in Patients With Congenital Femoral Deficiency: A Report of 3 Cases.

PubMed

Brown, Timothy S; Wimberly, Robert L; Birch, John G

2017-01-01

Congenital femoral deficiency is an uncommon clinical entity. We report 3 patients who developed avascular necrosis of the hip in the long (normal) leg during longitudinal observation and/or treatment of congenital femoral deficiency. Patients were identified in limb length discrepancy clinic and their charts were retrospectively reviewed for clinical and radiographic data collection. We describe the occurrence of idiopathic avascular necrosis in the normal limb in patients being followed for limb length discrepancy. Although no conclusion could be drawn about the etiology of the avascular necrosis, we describe a previously undocumented relationship between congenital femoral deficiency and avascular necrosis in the contralateral hip. This occurred in our congenital femoral deficiency population at a rate higher than expected compared with published incidences of avascular necrosis of the hip in children. Level IV-case series.

Aesthetic outcome of single-tooth implant restorations following early implant placement and guided bone regeneration: crown and soft tissue dimensions compared with contralateral teeth.

PubMed

Cosyn, Jan; De Rouck, Tim

2009-10-01

The aim of this study was to compare crown and soft tissue dimensions of single-tooth implant restorations following early implant placement and guided bone regeneration (GBR) with contralateral non-restored teeth. Twenty-seven patients treated by one and the same surgeon and prosthodontist to restore a single-tooth gap with a class I bone defect in the premaxilla by means of an implant-supported restoration were reviewed. Patients were examined at least 6 months following placement of the crown. All implants had been inserted 6-8 weeks following tooth extraction in conjunction with GBR. At evaluation, crown dimensions, soft tissue dimensions, clinical conditions and patients' aesthetic satisfaction were assessed by one clinician who had not been involved in the treatment. Implant-supported crowns were not significantly longer than contralateral teeth and midfacial soft tissues showed comparable levels after on average 21 months of function. Our data also indicated significant papilla loss especially at the distal aspect of the implants. As the patient's aesthetic appreciation was favourable in 88% of the cases, this appeared to be of trivial importance. Favourable aesthetics may be achieved for single-tooth implant restorations following early implant placement and GBR. The impact of the latter on papilla levels, however, remains to be determined in longitudinal studies.

Synthesizing (ZrAl3 + AlN)/Mg-Al composites by a 'matrix exchange' method

NASA Astrophysics Data System (ADS)

Gao, Tong; Li, Zengqiang; Hu, Kaiqi; Han, Mengxia; Liu, Xiangfa

2018-06-01

A method named 'matrix exchange' to synthesize ZrAl3 and AlN reinforced Mg-Al composite was developed in this paper. By inserting Al-10ZrN master alloy into Mg matrix and reheating the cooled ingot to 550 °C, Al and Mg atoms diffuse to the opposite side. As a result, liquid melt occurs once the interface areas reach to proper compositions. Then dissolved Al atoms react with ZrN, leading to the in-situ formation of ZrAl3 and AlN particles, while the Al matrix is finally replaced by Mg. This study provides a new insight for preparing Mg composites.

Assessment of DNA methylation profiling and copy number variation as indications of clonal relationship in ipsilateral and contralateral breast cancers to distinguish recurrent breast cancer from a second primary tumour.

PubMed

Huang, Katie T; Mikeska, Thomas; Li, Jason; Takano, Elena A; Millar, Ewan K A; Graham, Peter H; Boyle, Samantha E; Campbell, Ian G; Speed, Terence P; Dobrovic, Alexander; Fox, Stephen B

2015-10-09

Patients with breast cancer have an increased risk of developing subsequent breast cancers. It is important to distinguish whether these tumours are de novo or recurrences of the primary tumour in order to guide the appropriate therapy. Our aim was to investigate the use of DNA methylation profiling and array comparative genomic hybridization (aCGH) to determine whether the second tumour is clonally related to the first tumour. Methylation-sensitive high-resolution melting was used to screen promoter methylation in a panel of 13 genes reported as methylated in breast cancer (RASSF1A, TWIST1, APC, WIF1, MGMT, MAL, CDH13, RARβ, BRCA1, CDH1, CDKN2A, TP73, and GSTP1) in 29 tumour pairs (16 ipsilateral and 13 contralateral). Using the methylation profile of these genes, we employed a Bayesian and an empirical statistical approach to estimate clonal relationship. Copy number alterations were analysed using aCGH on the same set of tumour pairs. There is a higher probability of the second tumour being recurrent in ipsilateral tumours compared with contralateral tumours (38 % versus 8 %; p <0.05) based on the methylation profile. Using previously reported recurrence rates as Bayesian prior probabilities, we classified 69 % of ipsilateral and 15 % of contralateral tumours as recurrent. The inferred clonal relationship results of the tumour pairs were generally concordant between methylation profiling and aCGH. Our results show that DNA methylation profiling as well as aCGH have potential as diagnostic tools in improving the clinical decisions to differentiate recurrences from a second de novo tumour.

A Comparison of Bacterial Composition in Diabetic Ulcers and Contralateral Intact Skin

PubMed Central

Gontcharova, Viktoria; Youn, Eunseog; Sun, Yan; Wolcott, Randall D; Dowd, Scot E

2010-01-01

An extensive portion of the healthcare budget is allocated to chronic human infection. Chronic wounds in particular are a major contributor to this financial burden. Little is known about the types of bacteria which may contribute to the chronicity, biofilm and overall bioburden of the wound itself. In this study we compare the bacteriology of wounds and associated intact skin. Wound and paired intact skin swabs (from a contralateral location) were collected. The bacterial diversity was determined using bacterial Tag-encoded FLX amplicon pyrosequencing (bTEFAP). Diversity analysis showed intact skin to be significantly more diverse than wounds on both the species and genus levels (3% and 5% divergence). Furthermore, wounds show heightened levels of anaerobic bacteria, like Peptoniphilus, Finegoldia, and Anaerococcus, and other detrimental genera such as Corynebacterium and Staphylococcus. Although some of these and other bacterial genera were found to be common between intact skin and wounds, notable opportunistic wound pathogens were found at lower levels in intact skin. Principal Component Analysis demonstrated a clear separability of the two groups. The findings of the study not only greatly support the hypothesis of differing bacterial composition of intact skin and wounds, but also contribute additional insight into the ecology of skin and wound microflora. The increased diversity and lowered levels of opportunistic pathogens found in skin make the system highly distinguishable from wounds. PMID:20461221

Contralateral Prophylactic Mastectomy: Factors Predictive of Occult Malignancy or High-Risk Lesion and the Impact of MRI and Genetic Testing.

PubMed

Erdahl, Lillian M; Boughey, Judy C; Hoskin, Tanya L; Degnim, Amy C; Hieken, Tina J

2016-01-01

Despite decreasing rates of subsequent contralateral breast cancer after diagnosis of unilateral primary breast cancer, the proportion of patients electing contralateral prophylactic mastectomy (CPM) is increasing. Our aim was to identify risk factors associated with the identification of occult malignancy (OM) or high-risk lesion (HRL) in CPM to facilitate patient counseling and operative planning. We identified patients undergoing CPM in addition to mastectomy for index breast cancer between October 2008 and June 2013. Patient and tumor factors were analyzed to identify associations with OM or HRL in CPM. Among 740 CPM patients, an OM was identified in 4.1 % and an HRL was identified in 10.5 %. On multivariable analysis, factors associated with either occult finding included older age [odds ratio (OR) 1.37, per 10-year increase], invasive lobular index tumor histology (OR 2.60), progesterone receptor (PR)-positive index tumor (OR 1.79), and neoadjuvant therapy (OR 0.55). Overall, 244 patients (33 %) underwent BRCA testing, and 38 (16 %) had a deleterious mutation; 494 patients (67 %) had a preoperative breast MRI. Neither absence of a deleterious BRCA mutation nor a negative preoperative MRI decreased the likelihood of an occult finding in CPM. Although invasive cancer was identified infrequently in CPM specimens, the rate of HRL or OM in our study was 14.6 %. Older age and infiltrating lobular and PR-positive index breast cancers were associated with a higher risk of OM in CPM, while neoadjuvant therapy diminished the risk. BRCA testing and preoperative MRI were not associated with HRL or OM. This information is valuable for patient counseling and surgical planning.

Automated detection of abnormalities in paranasal sinus on dental panoramic radiographs by using contralateral subtraction technique based on mandible contour

NASA Astrophysics Data System (ADS)

Mori, Shintaro; Hara, Takeshi; Tagami, Motoki; Muramatsu, Chicako; Kaneda, Takashi; Katsumata, Akitoshi; Fujita, Hiroshi

2013-02-01

Inflammation in paranasal sinus sometimes becomes chronic to take long terms for the treatment. The finding is important for the early treatment, but general dentists may not recognize the findings because they focus on teeth treatments. The purpose of this study was to develop a computer-aided detection (CAD) system for the inflammation in paranasal sinus on dental panoramic radiographs (DPRs) by using the mandible contour and to demonstrate the potential usefulness of the CAD system by means of receiver operating characteristic analysis. The detection scheme consists of 3 steps: 1) Contour extraction of mandible, 2) Contralateral subtraction, and 3) Automated detection. The Canny operator and active contour model were applied to extract the edge at the first step. At the subtraction step, the right region of the extracted contour image was flipped to compare with the left region. Mutual information between two selected regions was obtained to estimate the shift parameters of image registration. The subtraction images were generated based on the shift parameter. Rectangle regions of left and right paranasal sinus on the subtraction image were determined based on the size of mandible. The abnormal side of the regions was determined by taking the difference between the averages of each region. Thirteen readers were responded to all cases without and with the automated results. The averaged AUC of all readers was increased from 0.69 to 0.73 with statistical significance (p=0.032) when the automated detection results were provided. In conclusion, the automated detection method based on contralateral subtraction technique improves readers' interpretation performance of inflammation in paranasal sinus on DPRs.

SU-F-T-204: A Preliminary Approach of Reducing Contralateral Breast and Heart Dose in Left Sided Whole Breast Cancer Patients Utilizing Proton Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Islam, M; Algan, O; Jin, H

Purpose: To investigate the plan quality and feasibility of a hybrid plan utilizing proton and photon fields for superior coverage in the internal mammary (IM) and supraclavicular (S/C) regions while minimizing heart and contralateral breast dose for the left-sided whole breast cancer patient treatment. Methods: This preliminary study carried out on single left-sided intact breast patient involved IM and S/C nodes. The IM and S/C node fields of the 5-Field 3DCRT photon-electron base plan were replaced by two proton fields. These two along with two Field-in-Field tangential photon fields were optimized for comparable dose coverage. The treatment plans were donemore » using Eclipse TPS for the total dose of 46Gy in 23 fractions with 95% of the prescription dose covering 95% of the RTOG PTV. The 3DCRT photon-electron and 4-Field photon-proton hybrid plans were compared for the PTV dose coverage as well as dose to OARs. Results: The overall RTOG PTV coverage for proton-hybrid and 3DCRT plan was comparable (95% of prescription dose covers 95% PTV volume). In proton-hybrid plan, 99% of IM volume received 100% dose whereas in 3DCRT only 77% received 100% dose. For S/C regions, 97% and 77% volume received 100% prescription dose in proton-hybrid and 3DCRT plans, respectively. The heart mean dose, V3Gy(%), and V5Gy(%) was 2.2Gy, 14.4%, 9.8% for proton-hybrid vs. 4.20 Gy, 21.5%, and 39% for 3DCRT plan, respectively. The maximum dose to the contralateral breast was 39.75Gy for proton-hybrid while 56.87Gy for 3DCRT plan. The mean total lung dose, V20Gy(%), and V30Gy(%) was 5.68Gy, 11.3%, 10.5% for proton-hybrid vs. 5.90Gy, 9.8%, 7.2% for 3DCRT, respectively. Conclusion: The protonhybrid plan can offer better dose coverage to the involved lymphatic tissues while lower doses to the heart and contralateral breast. More treatment plans are currently in progress before being implemented clinically.« less

Contralateral structural femoral autograft use in treatment of an open periarticular knee fracture to perform knee arthrodesis.

PubMed

Mack, Andrew W; Helgeson, Melvin D; Tis, John E

2008-09-01

Combat-related blast injuries often cause devastating extremity trauma. We report a case of a 21-year-old male service member who sustained massive bilateral lower extremity trauma secondary to a blast injury. His orthopaedic injuries included a near traumatic disarticulation of the right knee and a left open type IIIB periarticular knee fracture with traumatic patellectomy, loss of the extensor mechanism, and segmental loss of the distal 11 cm of his femur. Definitive treatment of his injuries included a contralateral structural cortical femoral autograft which was implanted into the left knee segmental defect to facilitate knee fusion with an intramedullary knee fusion nail and a right transfemoral amputation. Radiographic evidence of solid fusion was obtained 8 months postoperatively. Currently, the patient is a community ambulator with the aid of his right lower extremity prosthetic limb and cane.

Long-Term Satisfaction and Body Image After Contralateral Prophylactic Mastectomy

PubMed Central

Anderson, Chelsea; Islam, Jessica Y.; Hodgson, M. Elizabeth; Sabatino, Susan A.; Rodriguez, Juan L.; Lee, Clara N.; Sandler, Dale P.; Nichols, Hazel B.

2017-01-01

Background Contralateral prophylactic mastectomy (CPM) rates have been increasing in the U.S. Though some studies have reported high overall satisfaction among women who undergo CPM, it is unclear how long-term satisfaction differs from that of women who undergo unilateral mastectomy (UM). Furthermore, few studies have assessed whether the effects of CPM on body image differ from those of breast conserving surgery (BCS) or UM. Methods We analyzed responses from a survey of women with both a personal and family history of breast cancer who were enrolled in the Sister Study (n=1176). Among women who underwent mastectomy, satisfaction with mastectomy decision and reconstruction was compared between women who underwent CPM and UM. We also evaluated responses on 5 items related to body image according to surgery type (BCS, UM without reconstruction, CPM without reconstruction, UM with reconstruction, and CPM with reconstruction). Results Participants were, on average, 60.8 years old at diagnosis (SD=8.7) and 3.6 years post-diagnosis at the time of survey (SD=1.7). BCS was the most common surgical treatment reported (63%), followed by CPM (22%) and UM (15%). Satisfaction with mastectomy decision was reported by 97% of women who underwent CPM and 89% of those who underwent UM. Compared to other surgery types, women who underwent CPM without reconstruction reported feeling more self-conscious, less feminine, less whole, and less satisfied with the appearance of their breasts. Body image was consistently highest among women who underwent BCS. Conclusions In our sample of women with both a personal and family history of breast cancer, most were highly satisfied with their mastectomy decision, including those who elected to undergo CPM. However, body image was lowest among women who underwent CPM without reconstruction. Our findings may inform decisions among women considering various courses of surgical treatment. PMID:28058563

Contralateral acoustic stimulation alters the magnitude and phase of distortion product otoacoustic emissions.

PubMed

Deeter, Ryan; Abel, Rebekah; Calandruccio, Lauren; Dhar, Sumitrajit

2009-11-01

Activation of medial olivocochlear efferents through contralateral acoustic stimulation (CAS) has been shown to modulate distortion product otoacoustic emission (DPOAE) level in various ways (enhancement, reduction, or no change). The goal of this study was to investigate the effect of a range of CAS levels on DPOAE fine structure. The 2f(1)-f(2) DPOAE was recorded (f(2)/f(1)=1.22, L(1)=55 dB, and L(2)=40 dB) from eight normal-hearing subjects, using both a frequency-sweep paradigm and a fixed frequency paradigm. Contamination due to the middle ear muscle reflex was avoided by monitoring the magnitude and phase of a probe in the test ear and by monitoring DPOAE stimulus levels throughout testing. Results show modulations in both level and frequency of DPOAE fine structure patterns. Frequency shifts observed at DPOAE level minima could explain reports of enhancement in DPOAE level due to efferent activation. CAS affected the magnitude and phase of the DPOAE component from the characteristic frequency region to a greater extent than the component from the overlap region between the stimulus tones. This differential effect explains the occasional enhancement observed in DPOAE level as well as the frequency shift in fine structure patterns.

Ipsilateral versus Contralateral Placement of the Pancreas Allograft in Pancreas after Kidney Transplant Recipients.

PubMed

Yin, Hang; Arpali, Emre; Leverson, Glen E; Sollinger, Hans W; Kaufman, Dixon B; Odorico, Jon S

2018-06-28

In a diabetic, uremic kidney transplant recipient that may receive a future pancreas after kidney (PAK) transplant, the kidney is typically implanted on the left side in anticipation of the subsequent pancreas transplant on the right side. In this study, we sought to determine if ipsilateral PAK (iPAK) is as safe as contralateral PAK (cPAK). 115 PAK transplants (iPAK n=57, cPAK n=58) were performed from 1997-2010 and results were compared between the groups. Kidney graft survival and pancreas graft survival was similar between the two groups. Kidney graft function according to serum creatinine and eGFR was not different between the cPAK and iPAK groups and there were no episodes of kidney graft thrombosis in either group. Subgroup analyses focusing on donor source, also did not show worse outcomes for graft survivals in iPAK group when compared to cPAK group. Pancreas and kidney graft survival in PAK transplants is unaffected by the surgical procedure and iPAK is safe. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A pilot study of contralateral homonymous muscle activity simulated electrical stimulation in chronic hemiplegia.

PubMed

Osu, Rieko; Otaka, Yohei; Ushiba, Junichi; Sakata, Sachiko; Yamaguchi, Tomofumi; Fujiwara, Toshiyuki; Kondo, Kunitsugu; Liu, Meigen

2012-01-01

For the recovery of hemiparetic hand function, a therapy was developed called contralateral homonymous muscle activity stimulated electrical stimulation (CHASE), which combines electrical stimulation and bilateral movements, and its feasibility was studied in three chronic stroke patients with severe hand hemiparesis. Patients with a subcortical lesion were asked to extend their wrist and fingers bilaterally while an electromyogram (EMG) was recorded from the extensor carpi radialis (ECR) muscle in the unaffected hand. Electric stimulation was applied to the homonymous wrist and finger extensors of the affected side. The intensity of the electrical stimulation was computed based on the EMG and scaled so that the movements of the paretic hand looked similar to those of the unaffected side. The patients received 30-minutes of therapy per day for 2 weeks. Improvement in the active range of motion of wrist extension was observed for all patients. There was a decrease in the scores of modified Ashworth scale in the flexors. Fugl-Meyer assessment scores of motor function of the upper extremities improved in two of the patients. The results suggest a positive outcome can be obtained using the CHASE system for upper extremity rehabilitation of patients with severe hemiplegia.

Magnetism of Al-substituted magnetite reduced from Al-hematite

NASA Astrophysics Data System (ADS)

Jiang, Zhaoxia; Liu, Qingsong; Zhao, Xiang; Roberts, Andrew P.; Heslop, David; Barrón, Vidal; Torrent, José

2016-06-01

Aluminum-substituted magnetite (Al-magnetite) reduced from Al-substituted hematite or goethite (Al-hematite or Al-goethite) is an environmentally important constituent of magnetically enhanced soils. In order to characterize the magnetic properties of Al-magnetite, two series of Al-magnetite samples were synthesized through reduction of Al-hematite by a mixed gas (80% CO2 and 20% CO) at 395°C for 72 h in a quartz tube furnace. Al-magnetite samples inherited the morphology of their parent Al-hematite samples, but only those transformed from Al-hematite synthesized at low temperature possessed surficial micropores, which originated from the release of structural water during heating. Surface micropores could thus serve as a practical fingerprint of fire or other high-temperature mineralogical alteration processes in natural environments, e.g., shear friction in seismic zones. In addition, Al substitution greatly affects the magnetic properties of Al-magnetite. For example, coercivity (Bc) increases with increasing Al content and then decreases slightly, while the saturation magnetization (Ms), Curie temperature (Tc), and Verwey transition temperature (Tv) all decrease with increasing Al content due to crystal defect formation and dilution of magnetic ions caused by Al incorporation. Moreover, different trends in the correlation between Tc and Bc can be used to discriminate titanomagnetite from Al-magnetite, which is likely to be important in environmental and paleomagnetic studies, particularly in soil.

Familial ALS

PubMed Central

Boylan, Kevin

2015-01-01

Synopsis Genes linked to ALS susceptibility are being identified at an increasing rate owing to advances in molecular genetic technology. Genetic mechanisms in ALS pathogenesis appear to exert major effects in ~10% of patients, but genetic factors at some level may be important components of disease risk in most ALS patients. Identification of gene variants associated with ALS has informed concepts of the pathogenesis of ALS, aided the identification of therapeutic targets, facilitated research to develop new ALS biomarkers, and supported the establishment of clinical diagnostic tests for ALS-linked genes. Translation of this knowledge to ALS therapy development is ongoing. PMID:26515623

Efficacy of laparoscopically assisted high ligation of patent processus vaginalis in children.

PubMed

Ahmed, H; Youssef, M K; Salem, E A; Fawzi, A M; Desoky, E A E; Eliwa, A M; Sakr, A M N; Shahin, A M S

2016-02-01

Laparoscopic hernia repairs have been proven to be efficient and safe for children, despite the slightly higher recurrence rate compared with the classic surgical repair. They have the advantage of easy and precise identification of the type of defect and its correction, both in ipsilateral and contralateral sides. The objectives of this study were to evaluate the efficacy, safety and outcome of the laparoscopically assisted piecemeal high ligation of a patent processus vaginalis (PPV) in children. A total of 40 children were enrolled into this prospective study; they were aged ≥ 6 months and had an inguinal hernia. The peritoneal cavity, including the contralateral side, was inspected for the possibility of bilateral hernias using a 3-mm 30° telescope. Another 3-mm port was introduced through the same infra-umbilical incision. The hernia was manually reduced or with the aid of a working infra-umbilical grasper. A prolene or vicryl 2/0 or 3/0 suture on a curved semicircle round-bodied taper-ended 25-30 mm needle was introduced through a very small inguinal skin-crease incision. It was passed through the abdominal wall layers to the peritoneum and was manipulated by the laparoscopic grasper to pick up the peritoneum in piecemeal all around the internal ring. The needle was then pushed to the outside near to the entrance site, thus forming a semicircle around the internal ring. The suture was then tied and the knot was subcutaneously buried. The primary outcome of the procedure was the incidence of intraoperative diagnosis and surgical repair of contralateral hernias in pre-operatively diagnosed unilateral cases. The secondary outcomes were defined as the incidence of complications and hernia recurrence. The exploratory laparoscopy found contralateral patent processus vaginalis (CPPV) with a detection rate of 28.1%. Chan et al., Esposito et al., Toufique et al. and Niyogi et al. reported similar figures for laparoscopic contralateral hernia detection rates of 28

The financial impact and drivers of hospital charges in contralateral prophylactic mastectomy and reconstruction: a Nationwide Inpatient Sample hospital analysis.

PubMed

Bucknor, Alexandra; Chattha, Anmol; Ultee, Klaas; Wu, Winona; Kamali, Parisa; Bletsis, Patrick; Chen, Austin; Lee, Bernard T; Cronin, Claire; Lin, Samuel J

2017-09-01

Rates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction. Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009-2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group). Generalized linear modeling with gamma regression and a log-link function provided mean marginal hospital charge (MMHC) estimates associated with the presence or absence of patient, hospital and operative characteristics, postoperative complications, and length of stay (LOS). Overall, 70,695 women underwent mastectomy and reconstruction for unilateral breast cancer; 36,691 (51.9%) in the CPM group, incurring additional MMHCs of $20,775 compared to those in the UM group (p < 0.001). In the CPM group, MMHCs were reduced in those aged >60 years (p < 0.001), while African American or Hispanic origin increased MMHCs (p < 0.001). Diabetes, depression, and obesity increased MMHCs (p < 0.001). MMHCs increased with larger (p < 0.001) hospitals, Western location (p < 0.001), greater household income (p < 0.001), complications (p < 0.001), and increasing LOS (p < 0.001). MMHCs decreased in urban teaching hospitals and Midwest or Southern regions (p < 0.001). There are many patient and hospital factors affecting charges; this study provides surgeons and hospital systems with transparent, quantitative charge data in patients undergoing contralateral prophylactic mastectomy and immediate breast reconstruction.

Interfacial characterization of Al-Al thermocompression bonds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Malik, N., E-mail: nishantmalik1987@gmail.com; SINTEF ICT, Department of Microsystems and Nanotechnology, P.O. Box 124 Blindern, N-0314 Oslo; Carvalho, P. A.

2016-05-28

Interfaces formed by Al-Al thermocompression bonding were studied by the transmission electron microscopy. Si wafer pairs having patterned bonding frames were bonded using Al films deposited on Si or SiO{sub 2} as intermediate bonding media. A bond force of 36 or 60 kN at bonding temperatures ranging from 400–550 °C was applied for a duration of 60 min. Differences in the bonded interfaces of 200 μm wide sealing frames were investigated. It was observed that the interface had voids for bonding with 36 kN at 400 °C for Al deposited both on Si and on SiO{sub 2}. However, the dicing yield was 33% for Al onmore » Si and 98% for Al on SiO{sub 2}, attesting for the higher quality of the latter bonds. Both a bond force of 60 kN applied at 400 °C and a bond force of 36 kN applied at 550 °C resulted in completely bonded frames with dicing yields of, respectively, 100% and 96%. A high density of long dislocations in the Al grains was observed for the 60 kN case, while the higher temperature resulted in grain boundary rotation away from the original Al-Al interface towards more stable configurations. Possible bonding mechanisms and reasons for the large difference in bonding quality of the Al films deposited on Si or SiO{sub 2} are discussed.« less

Ab initio modeling of zincblende AlN layer in Al-AlN-TiN multilayers

DOE PAGES

Yadav, S. K.; Wang, J.; Liu, X. -Y.

2016-06-13

An unusual growth mechanism of metastable zincblende AlN thin film by diffusion of nitrogen atoms into Al lattice is established. Using first-principles density functional theory, we studied the possibility of thermodynamic stability of AlN as a zincblende phase due to epitaxial strains and interface effect, which fails to explain the formation of zincblende AlN. We then compared the formation energetics of rocksalt and zincblende AlN in fcc Al through direct diffusion of nitrogen atoms to Al octahedral and tetrahedral interstitials. Furthermore, the formation of a zincblende AlN thin film is determined to be a kinetically driven process, not a thermodynamicallymore » driven process.« less

Visuotopic organization of the cebus pulvinar: a double representation the contralateral hemifield.

PubMed

Gattass, R; Oswaldo-Cruz, E; Sousa, A P

1978-08-18

The projection of the visual field in the pulvinar nucleus was studied in 17 Cebus monkeys using electrophysiological techniques. Visual space is represented in two regions of the pulvinar; (1) the ventrolateral group, Pvlg, comprising nuclei P delta, P delta, P gamma, P eta and P mu 1; and (2) P mu. In the first group, which corresponds to the pulvinar inferior and ventral part of the pulvinar lateralis, we observed a greater respresentation of the central part of the visual field. Approximately 58% of the volume of the ventrolateral group is concerned with the visual space within 10 degrees of the fovea. This portion of the visual field is represented at its lateral aspects, mainly close to the level of the caudal pole of the lateral geniculate nucleus (LGN). Projection of the vertical meridian runs along its lateral border while that of the horizontal one is found running from the dorsal third of the LGN's hilus to the medial border of the ventro-lateral group. The lower quadrant is represented at its dorsal portion while the upper quadrant is represented at the ventral one. In Pmu the representation is rotated 90 degrees clockwise around the rostrocaudal axis: the vertical meridian is found at the ventromedial border of this nucleus. Thus, the lower quadrant is represented at the later portion of Pmu and the upper at its medial portion. Both projections are restricted to the contralateral hemifield.

Does unilateral basal ganglia activity functionally influence the contralateral side? What we can learn from STN stimulation in patients with Parkinson's disease.

PubMed

Brun, Yohann; Karachi, Carine; Fernandez-Vidal, Sara; Jodoin, Nicolas; Grabli, David; Bardinet, Eric; Mallet, Luc; Agid, Yves; Yelnik, Jerome; Welter, Marie-Laure

2012-09-01

In humans, the control of voluntary movement, in which the corticobasal ganglia (BG) circuitry participates, is mainly lateralized. However, several studies have suggested that both the contralateral and ipsilateral BG systems are implicated during unilateral movement. Bilateral improvement of motor signs in patients with Parkinson's disease (PD) has been reported with unilateral lesion or high-frequency stimulation (HFS) of the internal part of the globus pallidus or the subthalamic nucleus (STN-HFS). To decipher the mechanisms of production of ipsilateral movements induced by the modulation of unilateral BG circuitry activity, we recorded left STN neuronal activity during right STN-HFS in PD patients operated for bilateral deep brain stimulation. Left STN single cells were recorded in the operating room during right STN-HFS while patients experienced, or did not experience, right stimulation-induced dyskinesias. Most of the left-side STN neurons (64%) associated with the presence of right dyskinesias were inhibited, with a significant decrease in burst and intraburst frequencies. In contrast, left STN neurons not associated with right dyskinesias were mainly activated (48%), with a predominant increase 4-5 ms after the stimulation pulse and a decrease in oscillatory activity. This suggests that unilateral neuronal STN modulation is associated with changes in the activity of the contralateral STN. The fact that one side of the BG system can influence the functioning of the other could explain the occurrence of bilateral dyskinesias and motor improvement observed in PD patients during unilateral STN-HFS, as a result of a bilateral disruption of the pathological activity in the corticosubcortical circuitry.

The feasibility of contralateral lower neck sparing intensity modulation radiated therapy for nasopharyngeal carcinoma patients with unilateral cervical lymph node involvement.

PubMed

Tang, Ling-Long; Tang, Xin-Ran; Li, Wen-Fei; Chen, Lei; Tian, Li; Lin, Ai-Hua; Sun, Ying; Ma, Jun

2017-06-01

To investigate the feasibility of contralateral lower neck sparing intensity modulation radiated therapy (IMRT) for nasopharyngeal carcinoma patients (NPC) with unilateral cervical lymph node metastasis. Retrospective review of 546 patients with unilateral cervical lymph node metastasis treated between November 2009 and February 2012 at one institution. All patients were staged using magnetic resonance imaging and received radical IMRT. Patients were classified into two groups: the inferior border of the negative neck irradiation field only covered Levels III to Va in Group 1; the inferior border covered entire neck down to Levels IV to Vb in Group 2. Median follow-up was 49.9months (range, 1.3-69.2months). Four-year overall survival (OS:89.3% vs. 88.9%, P=0.91), disease-free survival (DFS:81.7% vs. 81.0%, P=0.91), distant metastasis-free survival (DMFS:88.2% vs. 87.9%, P=0.95), local relapse-free survival (LRFS:96.7% vs. 94.7%, P=0.70) and nodal relapse-free survival (NRFS: 96.1% vs. 95.9%, P=0.94) were not significantly different between Group 1 and Group 2. Twenty-two patients developed cervical lymph node relapse; of whom 20/22 (91.0%) developed unilateral relapse within pretreatment positive neck. Only one patient developed out-of-field relapse, though this patient also relapsed within the neck irradiation field (Level II). No clinicopathological feature tested had significant prognostic value for NRFS in multivariate analysis. In the IMRT and MRI era, contralateral lower neck sparing IMRT seems to be feasible for NPC patients with unilateral cervical lymph node metastasis. Copyright © 2017. Published by Elsevier Ltd.

Percutaneous unilateral biliary metallic stent placement in patients with malignant obstruction of the biliary hila and contralateral portal vein steno-occlusion.

PubMed

Son, Rak Chae; Gwon, Dong Il; Ko, Heung Kyu; Kim, Jong Woo; Ko, Gi-Young

2015-01-01

To investigate the outcomes of percutaneous unilateral metallic stent placement in patients with a malignant obstruction of the biliary hila and a contralateral portal vein steno-occlusion. Sixty patients with a malignant hilar obstruction and unilobar portal vein steno-occlusion caused by tumor invasion or preoperative portal vein embolization were enrolled in this retrospective study from October 2010 to October 2013. All patients were treated with percutaneous placement of a biliary metallic stent, including expanded polytetrafluoroethylene (ePTFE)-covered stents in 27 patients and uncovered stents in 33 patients. A total of 70 stents were successfully placed in 60 patients. Procedural-related minor complications, including self-limiting hemobilia (n = 2) and cholangitis (n = 4) occurred in six (10%) patients. Acute cholecystitis occurred in two patients. Successful internal drainage was achieved in 54 (90%) of the 60 patients. According to a Kaplan-Meier analysis, median survival time was 210 days (95% confidence interval [CI], 135-284 days), and median stent patency time was 133 days (95% CI, 94-171 days). No significant difference in stent patency was observed between covered and uncovered stents (p = 0.646). Stent dysfunction occurred in 16 (29.6%) of 54 patients after a mean of 159 days (range, 65-321 days). Unilateral placement of ePTFE-covered and uncovered stents in the hepatic lobe with a patent portal vein is a safe and effective method for palliative treatment of patients with a contralateral portal vein steno-occlusion caused by an advanced hilar malignancy or portal vein embolization. No significant difference in stent patency was detected between covered and uncovered metallic stents.

Percutaneous Unilateral Biliary Metallic Stent Placement in Patients with Malignant Obstruction of the Biliary Hila and Contralateral Portal Vein Steno-Occlusion

PubMed Central

Son, Rak Chae; Ko, Heung Kyu; Kim, Jong Woo; Ko, Gi-Young

2015-01-01

Objective To investigate the outcomes of percutaneous unilateral metallic stent placement in patients with a malignant obstruction of the biliary hila and a contralateral portal vein steno-occlusion. Materials and Methods Sixty patients with a malignant hilar obstruction and unilobar portal vein steno-occlusion caused by tumor invasion or preoperative portal vein embolization were enrolled in this retrospective study from October 2010 to October 2013. All patients were treated with percutaneous placement of a biliary metallic stent, including expanded polytetrafluoroethylene (ePTFE)-covered stents in 27 patients and uncovered stents in 33 patients. Results A total of 70 stents were successfully placed in 60 patients. Procedural-related minor complications, including self-limiting hemobilia (n = 2) and cholangitis (n = 4) occurred in six (10%) patients. Acute cholecystitis occurred in two patients. Successful internal drainage was achieved in 54 (90%) of the 60 patients. According to a Kaplan-Meier analysis, median survival time was 210 days (95% confidence interval [CI], 135-284 days), and median stent patency time was 133 days (95% CI, 94-171 days). No significant difference in stent patency was observed between covered and uncovered stents (p = 0.646). Stent dysfunction occurred in 16 (29.6%) of 54 patients after a mean of 159 days (range, 65-321 days). Conclusion Unilateral placement of ePTFE-covered and uncovered stents in the hepatic lobe with a patent portal vein is a safe and effective method for palliative treatment of patients with a contralateral portal vein steno-occlusion caused by an advanced hilar malignancy or portal vein embolization. No significant difference in stent patency was detected between covered and uncovered metallic stents. PMID:25995688

Anti-VEGF and its impact on the outer retina: retinal pigment epithelium tear after an injection of aflibercept in contralateral eye.

PubMed

Campos Polo, R; Rubio Sánchez, C

2016-05-01

A 62-year-old woman with a history of bilateral retinal pigment epithelium detachment (PED), secondary of age-related macular degeneration (AMD), who presented with a retinal pigment epithelium (RPE) tear on her left eye after an aflibercept injection in the contralateral eye one month earlier. A RPE tear is the main complication when the anti-VEGF therapy is used for the management of the PED. Furthermore, it should be noted that systemic absorption of the drug can induce an effect on the untreated eye. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

Contralateral Inhibition of Click- and Chirp-Evoked Human Compound Action Potentials

PubMed Central

Smith, Spencer B.; Lichtenhan, Jeffery T.; Cone, Barbara K.

2017-01-01

Cochlear outer hair cells (OHC) receive direct efferent feedback from the caudal auditory brainstem via the medial olivocochlear (MOC) bundle. This circuit provides the neural substrate for the MOC reflex, which inhibits cochlear amplifier gain and is believed to play a role in listening in noise and protection from acoustic overexposure. The human MOC reflex has been studied extensively using otoacoustic emissions (OAE) paradigms; however, these measurements are insensitive to subsequent “downstream” efferent effects on the neural ensembles that mediate hearing. In this experiment, click- and chirp-evoked auditory nerve compound action potential (CAP) amplitudes were measured electrocochleographically from the human eardrum without and with MOC reflex activation elicited by contralateral broadband noise. We hypothesized that the chirp would be a more optimal stimulus for measuring neural MOC effects because it synchronizes excitation along the entire length of the basilar membrane and thus evokes a more robust CAP than a click at low to moderate stimulus levels. Chirps produced larger CAPs than clicks at all stimulus intensities (50–80 dB ppeSPL). MOC reflex inhibition of CAPs was larger for chirps than clicks at low stimulus levels when quantified both in terms of amplitude reduction and effective attenuation. Effective attenuation was larger for chirp- and click-evoked CAPs than for click-evoked OAEs measured from the same subjects. Our results suggest that the chirp is an optimal stimulus for evoking CAPs at low stimulus intensities and for assessing MOC reflex effects on the auditory nerve. Further, our work supports previous findings that MOC reflex effects at the level of the auditory nerve are underestimated by measures of OAE inhibition. PMID:28420960

Contralateral transmaxillary corridor: an augmented endoscopic approach to the petrous apex.

PubMed

Patel, Chirag R; Wang, Eric W; Fernandez-Miranda, Juan C; Gardner, Paul A; Snyderman, Carl H

2017-10-20

OBJECTIVE The endoscopic endonasal approach (EEA) has been shown to be an effective means of accessing lesions of the petrous apex. Lesions that are lateral to the paraclival segment of the internal carotid artery (ICA) require lateralization of the paraclival segment of the ICA or a transpterygoid infrapetrous approach. In this study the authors studied the feasibility of adding a contralateral transmaxillary (CTM) corridor to provide greater access to the petrous apex with decreased need for manipulation of the ICA. METHODS Using image guidance, EEA and CTM extension were performed bilaterally on 5 cadavers. The anterior wall of the sphenoid sinus and rostrum were removed. The angle of the surgical approach from the axis of the petrous segment of the ICA was measured. Five illustrative clinical cases are presented. RESULTS The CTM corridor required a partial medial maxillectomy. When measured from the axis of the petrous ICA, the CTM corridor decreased the angle from 44.8° ± 2.78° to 20.1° ± 4.31°, a decrease of 24.7° ± 2.58°. Drilling through the CTM corridor allowed the drill to reach lateral aspects of the petrous apex that would have required lateralization of the ICA or would not have been accessible via EEA. The CTM corridor allowed us to achieve gross-total resection of the petrous apex region in 5 clinical cases with significant paraclival extension. CONCLUSIONS The CTM corridor is a feasible extension to the standard EEA to the petrous apex that offers a more lateral trajectory with improved access. This approach may reduce the risk and morbidity associated with manipulation of the paraclival ICA.

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center.

PubMed

Roberts, Amanda; Sandhu, Lakhbir; Cil, Tulin D; Hofer, Stefan O P; Zhong, Toni

2016-06-10

To examine trends of contralateral prophylactic mastectomy (CPM) rates at a Canadian academic breast cancer center. A single-institution retrospective cohort study was completed. Women of any age who underwent at least a unilateral mastectomy (UM) for primary unilateral breast carcinoma between January 1, 2004 and December 31, 2010 were included. Patients who underwent CPM on the same day as UM were isolated to create two distinct cohorts. Patient and procedure characteristics were compared across groups using R software (version 3.1.0). The percentage of CPMs per year was determined. The Cochrane-Armitage test was used to assess the trend of CPMs over time. A P value of < 0.05 was considered significant. A total of 811 women met the inclusions/exclusion criteria; 759 (93.6%) underwent UM alone and 52 (6.4%) underwent UM with immediate CPM. The absolute number of procedures (UM and UM + CPM) increased over time, from 83 in 2004 to 147 in 2010 reflecting an increase in mastectomy volume. Annual CPM rates did not increase over time (P = 0.7) and varied between 2.6% to 10.7%. Family history of breast cancer [OR 3.6 (1.8-7.3)] and immediate reconstruction [10.0 (5.2-19.3)] were both significantly associated with CPM. Women who underwent CPM were younger (median age CPM 49 years vs UM 52 years, P < 0.0001) but age less than 50 years was not statistically associated with increased rates of CPM. CPM rates from 2004 to 2010 at a high-volume Canadian breast cancer center did not increase over time, in contrast to trends observed in the United States.

Thermal Modeling of Al-Al and Al-Steel Friction Stir Spot Welding

NASA Astrophysics Data System (ADS)

Jedrasiak, P.; Shercliff, H. R.; Reilly, A.; McShane, G. J.; Chen, Y. C.; Wang, L.; Robson, J.; Prangnell, P.

2016-09-01

This paper presents a finite element thermal model for similar and dissimilar alloy friction stir spot welding (FSSW). The model is calibrated and validated using instrumented lap joints in Al-Al and Al-Fe automotive sheet alloys. The model successfully predicts the thermal histories for a range of process conditions. The resulting temperature histories are used to predict the growth of intermetallic phases at the interface in Al-Fe welds. Temperature predictions were used to study the evolution of hardness of a precipitation-hardened aluminum alloy during post-weld aging after FSSW.

Proton irradiation studies on Al and Al5083 alloy

NASA Astrophysics Data System (ADS)

Bhattacharyya, P.; Gayathri, N.; Bhattacharya, M.; Gupta, A. Dutta; Sarkar, Apu; Dhar, S.; Mitra, M. K.; Mukherjee, P.

2017-10-01

The change in the microstructural parameters and microhardness values in 6.5 MeV proton irradiated pure Al and Al5083 alloy samples have been evaluated using different model based techniques of X-ray diffraction Line Profile Analysis (XRD) and microindendation techniques. The detailed line profile analysis of the XRD data showed that the domain size increases and saturates with irradiation dose both in the case of Al and Al5083 alloy. The corresponding microstrain values did not show any change with irradiation dose in the case of the pure Al but showed an increase at higher irradiation doses in the case of Al5083 alloy. The microindendation results showed that unirradiated Al5083 alloy has higher hardness value compared to that of unirradiated pure Al. The hardness increased marginally with irradiation dose in the case of Al5083, whereas for pure Al, there was no significant change with dose.

Combustion synthesis of AlB2-Al2O3 composite powders with AlB2 nanowire structures

NASA Astrophysics Data System (ADS)

Yang, Pan; Xiao, Guoqing; Ding, Donghai; Ren, Yun; Yang, Shoulei; Lv, Lihua; Hou, Xing

2018-05-01

Using of Al and B2O3 powders as starting materials, and Mg-Al alloy as additives, AlB2-Al2O3 composite powders with AlB2 nanowire structures were successfully fabricated via combustion synthesis method in Ar atmosphere at a pressure of 1.5 MPa. The effect of different amount of Mg-Al alloy on the phase compositions and morphology of the combustion products was investigated. The results revealed that AlB2 and Al2O3 increased, whereas Al decreased with the content of Mg-Al alloy increasing. The impurities MgAl2O4 and AlB12 would exist in the sample with adding of 18 wt% Mg-Al alloy. Interestingly, FESEM/TEM/EDS results showed that AlB2 nanowires were observed in the products when the content of Mg-Al alloy is 6 wt% and 12 wt%. The more AlB2 nanowires can be found as the content of Mg-Al alloy increased. And the yield of AlB2 nanowires with the diameter of about 200 nanometers (nm) and the length up to several tens of micrometers (μm) in the combustion product is highest when the content of Mg-Al alloy is 12 wt%. The vapor, such as Mg-Al (g), B2O2 (g), AlO (g) and Al2O (g), produced during the process of combustion synthesis, reacted with each other to yield AlB2 nanowires by vapor-solid (VS) mechanism and the corresponding model was also proposed.

Cortical Effects on Ipsilateral Hindlimb Muscles Revealed with Stimulus-Triggered Averaging of EMG Activity

PubMed Central

Messamore, William G.; Van Acker, Gustaf M.; Hudson, Heather M.; Zhang, Hongyu Y.; Kovac, Anthony; Nazzaro, Jules; Cheney, Paul D.

2016-01-01

While a large body of evidence supports the view that ipsilateral motor cortex may make an important contribution to normal movements and to recovery of function following cortical injury (Chollet et al. 1991; Fisher 1992; Caramia et al. 2000; Feydy et al. 2002), relatively little is known about the properties of output from motor cortex to ipsilateral muscles. Our aim in this study was to characterize the organization of output effects on hindlimb muscles from ipsilateral motor cortex using stimulus-triggered averaging of EMG activity. Stimulus-triggered averages of EMG activity were computed from microstimuli applied at 60–120 μA to sites in both contralateral and ipsilateral M1 of macaque monkeys during the performance of a hindlimb push–pull task. Although the poststimulus effects (PStEs) from ipsilateral M1 were fewer in number and substantially weaker, clear and consistent effects were obtained at an intensity of 120 μA. The mean onset latency of ipsilateral poststimulus facilitation was longer than contralateral effects by an average of 0.7 ms. However, the shortest latency effects in ipsilateral muscles were as short as the shortest latency effects in the corresponding contralateral muscles suggesting a minimal synaptic linkage that is equally direct in both cases. PMID:26088970

Interfacial Phenomena in Al/Al, Al/Cu, and Cu/Cu Joints Soldered Using an Al-Zn Alloy with Ag or Cu Additions

NASA Astrophysics Data System (ADS)

Pstruś, Janusz; Gancarz, Tomasz

2014-05-01

The studies of soldered joints were carried out in systems: Al/solder/Al, Al/solder/Cu, Cu/solder/Cu, where the solder was (Al-Zn)EUT, (Al-Zn)EUT with 0.5, 1.0, and 1.5 at.% of Ag and (Al-Zn)EUT with 0.5, 1.0, and 1.5 at.% of Cu addition. Brazing was performed at 500 °C for 3 min. The EDS analysis indicated that the composition of the layers starting from the Cu pad was CuZn, Cu5Zn8, and CuZn4, respectively. Wetting tests were performed at 500 °C for 3, 8, 15, and 30 min, respectively. Thickness of the layers and their kinetics of growth were measured based on the SEM micrographs. The formation of interlayers was not observed from the side of Al pads. On the contrary, dissolution of the Al substrate and migration of Al-rich particles into the bulk of the solder were observed.

Orientation relationship of eutectoid FeAl and FeAl2.

PubMed

Scherf, A; Kauffmann, A; Kauffmann-Weiss, S; Scherer, T; Li, X; Stein, F; Heilmaier, M

2016-04-01

Fe-Al alloys in the aluminium range of 55-65 at.% exhibit a lamellar microstructure of B2-ordered FeAl and triclinic FeAl 2 , which is caused by a eutectoid decomposition of the high-temperature Fe 5 Al 8 phase, the so-called ∊ phase. The orientation relationship of FeAl and FeAl 2 has previously been studied by Bastin et al. [ J. Cryst. Growth (1978 ▸), 43 , 745] and Hirata et al. [ Philos. Mag. Lett. (2008 ▸), 88 , 491]. Since both results are based on different crystallographic data regarding FeAl 2 , the data are re-evaluated with respect to a recent re-determination of the FeAl 2 phase provided by Chumak et al. [ Acta Cryst. (2010 ▸), C 66 , i87]. It is found that both orientation relationships match subsequent to a rotation operation of 180° about a 〈112〉 crystallographic axis of FeAl or by applying the inversion symmetry of the FeAl 2 crystal structure as suggested by the Chumak data set. Experimental evidence for the validity of the previously determined orientation relationships was found in as-cast fully lamellar material (random texture) as well as directionally solidified material (∼〈110〉 FeAl || solidification direction) by means of orientation imaging microscopy and global texture measurements. In addition, a preferential interface between FeAl and FeAl 2 was identified by means of trace analyses using cross sectioning with a focused ion beam. On the basis of these habit planes the orientation relationship between the two phases can be described by ([Formula: see text]01) FeAl || (114)[Formula: see text] and [111] FeAl || [1[Formula: see text]0][Formula: see text]. There is no evidence for twinning within FeAl lamellae or alternating orientations of FeAl lamellae. Based on the determined orientation and interface data, an atomistic model of the structure relationship of Fe 5 Al 8 , FeAl and FeAl 2 in the vicinity of the eutectoid decomposition is derived. This model is analysed with respect to the strain which has to be

(99m)Tc-pyrophosphate scintigraphy for differentiating light-chain cardiac amyloidosis from the transthyretin-related familial and senile cardiac amyloidoses.

PubMed

Bokhari, Sabahat; Castaño, Adam; Pozniakoff, Ted; Deslisle, Susan; Latif, Farhana; Maurer, Mathew S

2013-03-01

Differentiating immunoglobulin light-chain (AL) from transthyretin-related cardiac amyloidoses (ATTR) is imperative given implications for prognosis, therapy, and genetic counseling. We validated the discriminatory ability of (99m)Tc-pyrophosphate ((99m)Tc-PYP) scintigraphy in AL versus ATTR. Forty-five subjects (12 AL, 16 ATTR wild type, and 17 ATTR mutants) underwent (99m)Tc-PYP planar and single-photon positive emission computed tomography cardiac imaging. Scans were performed by experienced nuclear cardiologists blinded to the subjects' cohort assignment. Cardiac retention was assessed with both a semiquantitative visual score (range, 0; no uptake to 3, diffuse uptake) and by quantitative analysis by drawing a region of interest over the heart corrected for contralateral counts and calculating a heart-to-contralateral ratio. Subjects with ATTR cardiac amyloid had a significantly higher semiquantitative cardiac visual score than the AL cohort (2.9±0.06 versus 0.8±0.27; P<0.0001) as well as a higher quantitative score (1.80±0.04 versus 1.21±0.04; P<0.0001). Using a heart-to-contralateral ratio >1.5 consistent with intensely diffuse myocardial tracer retention had a 97% sensitivity and 100% specificity with area under the curve 0.992, P<0.0001 for identifying ATTR cardiac amyloidosis. (99m)Tc-PYP cardiac imaging distinguishes AL from ATTR cardiac amyloidosis and may be a simple, widely available method for identifying subjects with ATTR cardiac amyloidosis, which should be studied in a larger prospective manner.

A common neural element receiving rhythmic arm and leg activity as assessed by reflex modulation in arm muscles

PubMed Central

Tazoe, Toshiki; Nakajima, Tsuyoshi; Futatsubashi, Genki; Ohtsuka, Hiroyuki; Suzuki, Shinya; Zehr, E. Paul; Komiyama, Tomoyoshi

2016-01-01

Neural interactions between regulatory systems for rhythmic arm and leg movements are an intriguing issue in locomotor neuroscience. Amplitudes of early latency cutaneous reflexes (ELCRs) in stationary arm muscles are modulated during rhythmic leg or arm cycling but not during limb positioning or voluntary contraction. This suggests that interneurons mediating ELCRs to arm muscles integrate outputs from neural systems controlling rhythmic limb movements. Alternatively, outputs could be integrated at the motoneuron and/or supraspinal levels. We examined whether a separate effect on the ELCR pathways and cortico-motoneuronal excitability during arm and leg cycling is integrated by neural elements common to the lumbo-sacral and cervical spinal cord. The subjects performed bilateral leg cycling (LEG), contralateral arm cycling (ARM), and simultaneous contralateral arm and bilateral leg cycling (A&L), while ELCRs in the wrist flexor and shoulder flexor muscles were evoked by superficial radial (SR) nerve stimulation. ELCR amplitudes were facilitated by cycling tasks and were larger during A&L than during ARM and LEG. A low stimulus intensity during ARM or LEG generated a larger ELCR during A&L than the sum of ELCRs during ARM and LEG. We confirmed this nonlinear increase in single motor unit firing probability following SR nerve stimulation during A&L. Furthermore, motor-evoked potentials following transcranial magnetic and electrical stimulation did not show nonlinear potentiation during A&L. These findings suggest the existence of a common neural element of the ELCR reflex pathway that is active only during rhythmic arm and leg movement and receives convergent input from contralateral arms and legs. PMID:26961103

Ohmic contacts to Al-rich AlGaN heterostructures

DOE PAGES

Douglas, E. A.; Reza, S.; Sanchez, C.; ...

2017-06-06

Due to the ultra-wide bandgap of Al-rich AlGaN, up to 5.8 eV for the structures in this study, obtaining low resistance ohmic contacts is inherently difficult to achieve. A comparative study of three different fabrication schemes is presented for obtaining ohmic contacts to an Al-rich AlGaN channel. Schottky-like behavior was observed for several different planar metallization stacks (and anneal temperatures), in addition to a dry-etch recess metallization contact scheme on Al 0.85Ga 0.15N/Al 0.66Ga 0.34N. However, a dry etch recess followed by n +-GaN regrowth fabrication process is reported as a means to obtain lower contact resistivity ohmic contacts onmore » a Al 0.85Ga 0.15N/Al 0.66Ga 0.34N heterostructure. In conclusion, specific contact resistivity of 5×10 -3 Ω cm 2 was achieved after annealing Ti/Al/Ni/Au metallization.« less

Growth and stress-induced transformation of zinc blende AlN layers in Al-AlN-TiN multilayers

DOE PAGES

Li, Nan; Yadav, Satyesh K.; Wang, Jian; ...

2015-12-18

We report that AlN nanolayers in sputter deposited {111}Al/AlN/TiN multilayers exhibit the metastable zinc-blende-structure (z-AlN). Based on density function theory calculations, the growth of the z-AlN is ascribed to the kinetically and energetically favored nitridation of the deposited aluminium layer. In situ nanoindentation of the as-deposited {111}Al/AlN/TiN multilayers in a high-resolution transmission electron microscope revealed the z-AlN to wurzite AlN phase transformation through collective glide of Shockley partial dislocations on every two {111} planes of the z-AlN.

Contralateral cerebral hemoglobin oxygen saturation changes in patients undergoing thoracotomy with general anesthesia with or without paravertebral block: a randomized controlled trial.

PubMed

Mukaihara, Keika; Hasegawa-Moriyama, Maiko; Kanmura, Yuichi

2017-12-01

Perioperative analgesia during thoracotomy is often achieved by combining paravertebral block (PVB) with general anesthesia (GA). Functional near-infrared spectroscopy (NIRS) can detect changes in cerebral oxygenation resulting from nociceptive stimuli in the awake state or under sedation. We used NIRS to measure changes in cerebral blood flow provoked by thoracotomy incision made under GA and determine how these changes were influenced by supplementation of GA with PVB. Thirty-four patients undergoing elective thoracotomy were enrolled. Patients were randomly assigned to a group receiving only GA, or GA combined with PVB (GA + PVB). Changes in cerebral oxygenated hemoglobin (ΔO 2 Hb), deoxygenated-Hb (ΔHHb), and total-Hb (ΔtotalHb) were evaluated by NIRS as surgery began. In the GA group, ΔO 2 Hb was significantly higher in the hemisphere contralateral to the side of surgery when the incision was made and 2 min after incision compared with the ipsilateral side (start of surgery, P < 0.01; 2 min, P < 0.05). In contrast, there were no significant changes in the ΔO 2 Hb at any of the time points in the GA + PVB group. Comparable with ΔO 2 Hb, the concentration of ΔtotalHb was significantly higher in the contralateral hemisphere in the GA group at the start of surgery (P < 0.05). Changes in the cerebral O 2 Hb concentration were detected by NIRS immediately after surgical incision under GA, but not in the presence of a PNB. NIRS could be used to monitor surgical pain. PVB inhibited changes in oxygenation induced by incision-provoked pain.

Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison's disease.

PubMed

Ozturk, Hakan; Karaaslan, Serap

2014-09-01

Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison's disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histo-pathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison's disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

Comparing the Thermodynamic Behaviour of Al(1)+ZrO2(s) to Al(1)+Al2O3(s)

NASA Technical Reports Server (NTRS)

Copland, Evan

2004-01-01

In an effort to better determine the thermodynamic properties of Al(g) and Al2O(g). the vapor in equilibrium with Al(l)+ZrO2(s) was compared to the vapor in equilibrium with Al(l)+Al2O3(s) over temperature range 1197-to-1509K. The comparison was made directly by Knudsen effusion-cell mass spectrometry with an instrument configured for a multiple effusion-cell vapor source (multi-cell KEMS). Second law enthalpies of vaporization of Al(g) and Al2O(g) together with activity measurements show that Al(l)+ZrO2(s) is thermodynamically equivalent to Al(l)+Al2O3(s), indicating Al(l) remained pure and Al2O3(s) was present in the ZrO2-cell. Subsequent observation of the Al(l)/ZrO2 and vapor/ZrO2 interfaces revealed a thin Al2O3-layer had formed, separating the ZrO2-cell from Al(l) and Al(g)+Al2O(g), effectively transforming it into an Al2O3 effusion-cell. This behavior agrees with recent observations made for Beta-NiAl(Pt) alloys measured in ZrO2 effusion-cell.

Nanoporous Al sandwich foils using size effect of Al layer thickness during Cu/Al/Cu laminate rolling

NASA Astrophysics Data System (ADS)

Yu, Hailiang; Lu, Cheng; Tieu, A. Kiet; Li, Huijun; Godbole, Ajit; Kong, Charlie

2018-06-01

The roll bonding technique is one of the most widely used methods to produce metal laminate sheets. Such sheets offer interesting research opportunities for both scientists and engineers. In this paper, we report on an experimental investigation of the 'thickness effect' during laminate rolling for the first time. Using a four-high multifunction rolling mill, Cu/Al/Cu laminate sheets were fabricated with a range of thicknesses (16, 40, 70 and 130 μm) of the Al layer. The thickness of the Cu sheets was a constant 300 μm. After rolling, TEM images show good bonding quality between the Cu and Al layers. However, there are many nanoscale pores in the Al layer. The fraction of nanoscale pores in the Al layer increases with a reduction in the Al layer thickness. The finite element method was used to simulate the Cu/Al/Cu rolling process. The simulation results reveal the effect of the Al layer thickness on the deformation characteristics of the Cu/Al/Cu laminate. Finally, we propose that the size effect of the Al layer thickness during Cu/Al/Cu laminate rolling may offer a method to fabricate 'nanoporous' Al sandwich laminate foils. Such foils can be used in electromagnetic shielding of electrical devices and noisy shielding of building.

Ti{sub 2}AlN thin films synthesized by annealing of (Ti+Al)/AlN multilayers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cabioch, Thierry, E-mail: Thierry.cabioch@univ-poitiers.fr; Alkazaz, Malaz; Beaufort, Marie-France

2016-08-15

Highlights: • Epitaxial thin films of the MAX phase Ti{sub 2}AlN are obtained by thermal annealing. • A new metastable (Ti,Al,N) solid solution with the structure of α-T is evidenced. • The formation of the MAX phase occurs at low temperature (600 °C). - Abstract: Single-phase Ti{sub 2}AlN thin films were obtained by annealing in vacuum of (Ti + Al)/AlN multilayers deposited at room temperature by magnetron sputtering onto single-crystalline (0001) 4H-SiC and (0001) Al{sub 2}O{sub 3} substrates. In-situ X-ray diffraction experiments combined with ex-situ cross-sectional transmission electron microscopy observations reveal that interdiffusion processes occur in the multilayer at amore » temperature of ∼400 °C leading to the formation of a (Ti, Al, N) solid solution, having the hexagonal structure of α-Ti, whereas the formation of Ti{sub 2}AlN occurs at 550–600 °C. Highly oriented (0002) Ti{sub 2}AlN thin films can be obtained after an annealing at 750 °C.« less

Peak pressure data and pressure-time integral in the contralateral limb in patients with diabetes and a trans-tibial prosthesis.

PubMed

Borg, Jael; Mizzi, Stephen; Formosa, Cynthia

2018-05-19

Clinicians currently rely on observational clinical data pertaining to the biomechanics of the diabetic foot. However, advances in technology can objectively describe this. A thorough understanding of the functional and mechanical consequences following trans-tibial amputations is lacking. Does a trans-tibial prostheses significantly increase peak plantar pressures and pressure time integrals in the intact foot of patients with type-2 diabetes and neuropathy? A prospective quantitative matched-subject design was employed. Twenty participants living with diabetes and peripheral sensory neuropathy were recruited. Ten participants presented with a trans-tibial amputation and 10 had intact feet. Participants were matched for gender, age, foot type and BMI. Peak plantar pressure and pressure time integral data were recorded using the Tekscan HR™ pressure mat system, using the two-step gait protocol. The Shapiro-Wilk test was used to determine normality of data. The Independent Samples t-test and the Mann Whitney U test were carried out to reject the null hypothesis. Although no significant differences (p < 0.05) in mean peak plantar pressures were observed in all the foot masks analysed between the amputee and the control group, a significant difference (p = 0.002) in mean pressure time integrals was recorded with highest pressure time integral (PTI) values under the 2nd-4th metatarsophalangeal joint (MTP joint) for the trans-tibial amputee group. Cumulative exposure of both pressure and time can lead to tissue damage. PTI could be considered as an important contributory factor in determining ulcer formation. Elevated PTI under the 2nd-4th MTP joints sustained in the intact contralateral limb in patients using below knee prosthesis could possibly be due to gait alterations in this population. The preservation of the contralateral limb is of great concern and importance as this might impact patient's mobility and quality of life. Copyright © 2018 Elsevier B

Accidentes laborales asociados al desánimo de médicos SERUMS para laborar en el primer nivel de atención de Lima, Perú

PubMed Central

Mejia, Christian R.; Valladares-Garrido, Mario J.; Romero, Brian M.; Valladares-Garrido, Danai; Linares-Reyes, Edgardo

2018-01-01

Introducción la retención laboral es un tema de suma importancia, porque se requiere de profesionales en el primer nivel de atención (PNA). El objetivo fue determinar si los accidentes laborales se asociaron al desánimo de los médicos para trabajar en el PNA de Lima, Perú. Métodos estudio transversal analítico de datos secundarios de una base de datos generada de una encuesta a médicos que realizaron su Servicio Rural y Urbano-Marginal en Salud (SERUMS). Se incluyó solo a los médicos que manifestaron al inicio del SERUMS que podían trabajar en el PNA de Lima. Se definió como cambio de intención de trabajo en el PNA a los que finalizando el SERUMS refirieron que ya no deseaban laborar en Lima. Esto se asoció según si tuvieron un accidente laboral y se ajustó por otras variables. Resultados de los 124 médicos el 63% fueron hombres (78). La mediana de edad fue de 26 años (rango intercuartílico: 25-27 años). Después de su SERUMS, el 12% (15) manifestó que cambió su interés y que deseaba trabajar en la capital. En el análisis multivariado, haber tenido un accidente laboral disminuyó la frecuencia del cambio de intención de trabajo en el PNA (RPa: 0.28, IC 95%: 0.14-0.54, p < 0,001), ajustado por ocho variables. Conclusiones en un estudio previo los accidentes laborales disminuyeron la frecuencia de trabajar en provincias, pero nuestro estudio dice lo contrario, posiblemente por la percepción de que un trabajo en la capital del país permite estar más cerca de los servicios para ser atendido en caso de cualquier emergencia. PMID:29190859

ALS Association

MedlinePlus

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Contralateral delay activity tracks object identity information in visual short term memory.

PubMed

Gao, Zaifeng; Xu, Xiaotian; Chen, Zhibo; Yin, Jun; Shen, Mowei; Shui, Rende

2011-08-11

Previous studies suggested that ERP component contralateral delay activity (CDA) tracks the number of objects containing identity information stored in visual short term memory (VSTM). Later MEG and fMRI studies implied that its neural source lays in superior IPS. However, since the memorized stimuli in previous studies were displayed in distinct spatial locations, hence possibly CDA tracks the object-location information instead. Moreover, a recent study implied the activation in superior IPS reflected the location load. The current research thus explored whether CDA tracks the object-location load or the object-identity load, and its neural sources. Participants were asked to remember one color, four identical colors or four distinct colors. The four-identical-color condition was the critical one because it contains the same amount of identity information as that of one color while the same amount of location information as that of four distinct colors. To ensure the participants indeed selected four colors in the four-identical-color condition, we also split the participants into two groups (low- vs. high-capacity), analyzed late positive component (LPC) in the prefrontal area, and collected participant's subjective-report. Our results revealed that most of the participants selected four identical colors. Moreover, regardless of capacity-group, there was no difference on CDA between one color and four identical colors yet both were lower than 4 distinct colors. Besides, the source of CDA was located in the superior parietal lobule, which is very close to the superior IPS. These results support the statement that CDA tracks the object identity information in VSTM. Copyright © 2011 Elsevier B.V. All rights reserved.

A common neural element receiving rhythmic arm and leg activity as assessed by reflex modulation in arm muscles.

PubMed

Sasada, Syusaku; Tazoe, Toshiki; Nakajima, Tsuyoshi; Futatsubashi, Genki; Ohtsuka, Hiroyuki; Suzuki, Shinya; Zehr, E Paul; Komiyama, Tomoyoshi

2016-04-01

Neural interactions between regulatory systems for rhythmic arm and leg movements are an intriguing issue in locomotor neuroscience. Amplitudes of early latency cutaneous reflexes (ELCRs) in stationary arm muscles are modulated during rhythmic leg or arm cycling but not during limb positioning or voluntary contraction. This suggests that interneurons mediating ELCRs to arm muscles integrate outputs from neural systems controlling rhythmic limb movements. Alternatively, outputs could be integrated at the motoneuron and/or supraspinal levels. We examined whether a separate effect on the ELCR pathways and cortico-motoneuronal excitability during arm and leg cycling is integrated by neural elements common to the lumbo-sacral and cervical spinal cord. The subjects performed bilateral leg cycling (LEG), contralateral arm cycling (ARM), and simultaneous contralateral arm and bilateral leg cycling (A&L), while ELCRs in the wrist flexor and shoulder flexor muscles were evoked by superficial radial (SR) nerve stimulation. ELCR amplitudes were facilitated by cycling tasks and were larger during A&L than during ARM and LEG. A low stimulus intensity during ARM or LEG generated a larger ELCR during A&L than the sum of ELCRs during ARM and LEG. We confirmed this nonlinear increase in single motor unit firing probability following SR nerve stimulation during A&L. Furthermore, motor-evoked potentials following transcranial magnetic and electrical stimulation did not show nonlinear potentiation during A&L. These findings suggest the existence of a common neural element of the ELCR reflex pathway that is active only during rhythmic arm and leg movement and receives convergent input from contralateral arms and legs. Copyright © 2016 the American Physiological Society.

Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy.

PubMed

Venetis, Maria K; MacGeorge, Erina L; Baptiste, Dadrie F; Mouton, Ashton; Friley, Lorin B; Pastor, Rebekah; Hatten, Kristen; Lagoo, Janaka; Bowling, Monet W; Clare, Susan E

2018-06-01

The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.

Which surgery should be offered for carpal tunnel syndrome in a patient who was previously treated for recurrence on the contralateral side? Preliminary study of 13 patients with the Canaletto® implant.

PubMed

Illuminati, I; Seigle-Murandi, F; Gouzou, S; Fabacher, T; Facca, S; Hidalgo Diaz, J J; Liverneaux, P

2017-12-01

There are no published studies on the management of carpal tunnel syndrome (CTS) patients who have already been operated for recurrent CTS on the contralateral side. The aim of this study was to evaluate 13 patients with CTS who underwent primary release using a Canaletto ® implant. The 13 patients had all been operated for recurrent CTS previously. On the contralateral side, they all had subjective signs, and two of them already had complications. All were operated with the Canaletto ® implant according to Duché's technique, in a mean of 20minutes. After a mean 19.3-month follow-up, paresthesia, pain, and QuickDASH scores were significantly improved, even in one patient who underwent revision at another facility. This preliminary study suggests that use of a Canaletto ® implant as first-line treatment for CTS in patients who already underwent revision surgery on the other side is a simple and safe technique, without worsening of symptoms. These findings should be assessed with a prospective randomized controlled trial. Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Reduced Performance of Prey Targeting in Pit Vipers with Contralaterally Occluded Infrared and Visual Senses

PubMed Central

Chen, Qin; Deng, Huanhuan; Brauth, Steven E.; Ding, Li; Tang, Yezhong

2012-01-01

Both visual and infrared (IR) senses are utilized in prey targeting by pit vipers. Visual and IR inputs project to the contralateral optic tectum where they activate both multimodal and bimodal neurons. A series of ocular and pit organ occlusion experiments using the short-tailed pit viper (Gloydius brevicaudus) were conducted to investigate the role of visual and IR information during prey targeting. Compared with unoccluded controls, snakes with either both eyes or pit organs occluded performed more poorly in hunting prey although such subjects still captured prey on 75% of trials. Subjects with one eye and one pit occluded on the same side of the face performed as well as those with bilateral occlusion although these subjects showed a significant targeting angle bias toward the unoccluded side. Performance was significantly poorer when only a single eye or pit was available. Interestingly, when one eye and one pit organ were occluded on opposite sides of the face, performance was poorest, the snakes striking prey on no more than half the trials. These results indicate that, visual and infrared information are both effective in prey targeting in this species, although interference between the two modalities occurs if visual and IR information is restricted to opposite sides of the brain. PMID:22606229

Dynamics of the contralateral white noise-induced enhancement in the guinea pig's middle latency response.

PubMed

Goksoy, Cuneyt; Demirtas, Serdar; Ungan, Pekcan

2004-08-13

The peak-to-peak amplitude of temporal middle latency response (MLR) of the guinea pig, evoked by a click in the contralateral ear, according to the recording side, is increased with the presence of continuous white noise (CWN) in the ipsilateral ear and this specialty is defined as the white noise enhancement (WNE). This phenomenon is evaluated as an interesting electrophysiological finding from the viewpoint of binaural interaction and in this study, its dynamic specifications were investigated. After the beginning of ipsilateral CWN, significant WNE was observed at 275th ms and it reached to a maximum, with an increase more than 40%, at 350th ms. After a habituation occurred, WNE reached to 20% on the 4th second by gradually decreasing and came to a steady state. In the time window between 2 and 5 ms after CWN started, a surprising amplitude decrease is observed. Therefore, CWN causes an effect, like a click, in the short-term and this on-response type effect originates from low level binaural centers, which decreases the MLR amplitude. However, the same CWN increases the MLR amplitude (WNE) by the effects over the high level binaural centers in the succeeding period, by its continuous characteristic.

Piezo-tunnel effect in Al/Al2O3/Al junctions elaborated by atomic layer deposition

NASA Astrophysics Data System (ADS)

Rafael, R.; Puyoo, E.; Malhaire, C.

2017-11-01

In this work, the electrical transport in Al/Al2O3/Al junctions under mechanical stress is investigated in the perspective to use them as strain sensors. The metal/insulator/metal junctions are elaborated with a low temperature process (≤200 °C) fully compatible with CMOS back-end-of-line. The conduction mechanism in the structure is found to be Fowler-Nordheim tunneling, and efforts are made to extract the relevant physical parameters. Gauge factors up to -32.5 were found in the fabricated devices under tensile stress. Finally, theoretical mechanical considerations give strong evidence that strain sensitivity in Al/Al2O3/Al structures originates not only from geometrical deformations but also from the variation of interface barrier height and/or effective electronic mass in the tunneling oxide layer.

Influence of AlN(0001) Surface Reconstructions on the Wettability of an Al/AlN System: A First-Principle Study.

PubMed

Cao, Junhua; Liu, Yang; Ning, Xiao-Shan

2018-05-11

A successful application of a hot dip coating process that coats aluminum (Al) on aluminum nitride (AlN) ceramics, revealed that Al had a perfect wettability to the ceramics under specific circumstances, which was different from previous reports. In order to elucidate the mechanism that controlled the supernormal wetting phenomenon during the dip coating, a first-principle calculation of an Al(111)/AlN(0001) interface, based on the density functional theory (DFT), was employed. The wettability of the Al melt on the AlN(0001) surface, as well as the effect that the surface reconstruction of AlN and the oxygen adsorption had on Al for the adhesion and the wettability of the Al/AlN system, were studied. The results revealed that a LCM (laterally contracted monolayer) reconstruction could improve the adhesion and wettability of the system. Oxygen adsorption on the free surface of Al decreased the contact angle, because the adsorption reduced of the surface tension of Al. A prefect wetting was obtained only after some of the oxygen atoms adsorbed on the free surface of Al. The supernormal wetting phenomenon came from the surface reconstruction of the AlN and the adsorption of oxygen atoms on the Al melt surface.

Japanese version of the ALS-FTD-Questionnaire (ALS-FTD-Q-J).

PubMed

Watanabe, Yasuhiro; Beeldman, Emma; Raaphorst, Joost; Izumi, Yuishin; Yoshino, Hiide; Masuda, Michihito; Atsuta, Naoki; Ito, Satoru; Adachi, Tadashi; Adachi, Yoshiki; Yokota, Osamu; Oda, Masaya; Hanashima, Ritsuko; Ogino, Mieko; Ichikawa, Hiroo; Hasegawa, Kazuko; Kimura, Hideki; Shimizu, Toshio; Aiba, Ikuko; Yabe, Hayato; Kanba, Makoto; Kusumi, Kimiyoshi; Aoki, Tetsuya; Hiroe, Yu; Watanabe, Hirohisa; Nishiyama, Kazutoshi; Nomoto, Masahiro; Sobue, Gen; Nakashima, Kenji

2016-08-15

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) share common clinical, genetic and neuropathological features. Some ALS patients have behavioral/personality changes, which could result in significant obstacles in the care provided by family members and caregivers. An easy screening tool would contribute greatly to the evaluation of these symptoms. We translated the ALS-FTD-Questionnaire, developed in the Netherlands, into Japanese (ALS-FTD-Q-J) and examined the clinimetric properties (internal consistency, construct and clinical validity). Patients with ALS and/or behavioral variant FTD (bvFTD) were evaluated alongside healthy controls in this multicenter study. All ALS patients, regardless of bvFTD status, were further evaluated by the frontal behavioral inventory (FBI) and for frontal/executive function, cognition, anxiety/depression, and motor functions. Data from 146 subjects were analyzed: ALS (92), ALS-bvFTD (6), bvFTD (16), and healthy controls (32). The internal consistency of the ALS-FTD-Q-J was good (Cronbach α=0.92). The ALS-FTD-Q-J showed construct validity as it exhibited a high correlation with the FBI (r=0.79). However, correlations were moderate with anxiety/depression and low with cognitive scales, in contrast to the original report, i.e. a moderate correlation with cognition and a low correlation with anxiety/depression. The ALS-FTD-Q-J discriminated ALS patients from (ALS-)bvFTD patients and controls. Thus, the ALS-FTD-Q-J is useful for evaluating Japanese ALS/FTD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Abu al-Layth al-Libi

DTIC Science & Technology

2015-02-01

in the region and apparently “showed brilliance in this regard through his perfect memorization , clever understanding, persistence, and patience...Taliban’s officials quietly left the capital without informing 73 Vernie Liebl, “Al-Qaida on the US Invasion of Afghanistan in Their Own Words ,” Small Wars... memorization . A talented and charismatic orator, he also used to deliver eulogies and `Id sermons. As to `Abdallah Sa`id al-Libi, his profile is similar

3-Dimensional Microstructure of Al-Al3Ti Alloy Severely Deformed by ECAP

NASA Astrophysics Data System (ADS)

Sato, Hisashi; Hishikawa, Takahisa; Makino, Yuuki; Kunimine, Takahiro; Watanabe, Yoshimi

Microstructure of Al-Al3Ti alloy deformed by Equal-Channel-Angular Pressing (ECAP) is 3-dimensionally investigated. Especially, distribution of Al3Ti particles is focused in this study. The Al-Al3Ti alloy has coarse Al3Ti platelet particles in α-Al matrix. When the Al-Al3Ti alloy is deformed by ECAP under route A, fine Al3Ti platelet particles are observed. These Al3Ti platelet particles are aligned along to deformation axis, and its plane normal is perpendicular to the deformation axis. On the other hand, Al-Al3Ti alloy ECAPed under route Bc forms several groups consisted of fine Al3Ti platelet particles. Moreover, longitudinal size of the Al3Ti particle groups is close to that of initial Al3Ti particles with 4-pass ECAP specimen. These distribution behaviors of the Al3Ti particle can be explained by plastic flow of α-Al matrix. Finally, it is concluded that distribution of Al3Ti particle in Al-Al3Ti alloy by ECAP is controlled by plastic deformation of α-Al matrix.

A Rechargeable Al/S Battery with an Ionic-Liquid Electrolyte.

PubMed

Gao, Tao; Li, Xiaogang; Wang, Xiwen; Hu, Junkai; Han, Fudong; Fan, Xiulin; Suo, Liumin; Pearse, Alex J; Lee, Sang Bok; Rubloff, Gary W; Gaskell, Karen J; Noked, Malachi; Wang, Chunsheng

2016-08-16

Aluminum metal is a promising anode material for next generation rechargeable batteries owing to its abundance, potentially dendrite-free deposition, and high capacity. The rechargeable aluminum/sulfur (Al/S) battery is of great interest owing to its high energy density (1340 Wh kg(-1) ) and low cost. However, Al/S chemistry suffers poor reversibility owing to the difficulty of oxidizing AlSx . Herein, we demonstrate the first reversible Al/S battery in ionic-liquid electrolyte with an activated carbon cloth/sulfur composite cathode. Electrochemical, spectroscopic, and microscopic results suggest that sulfur undergoes a solid-state conversion reaction in the electrolyte. Kinetics analysis identifies that the slow solid-state sulfur conversion reaction causes large voltage hysteresis and limits the energy efficiency of the system. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Defect structures in ordered intermetallics; grain boundaries and surfaces in FeAl, NiAl, CoAl and TiAl

NASA Astrophysics Data System (ADS)

Mutasa, Batsirai Manyara

Ordered intermetallics based on transition metal aluminides have been proposed as structural materials for advanced aerospace applications. The development of these materials, which have the advantages of low density and high operating temperatures, have been focused on the aluminides of titanium, nickel and iron. Though these materials exhibit attractive properties at elevated temperatures, their utilization is limited due to their propensity for low temperature fracture and susceptibility to decreased ductility due to environmental effects. A major embrittlement mechanism at ambient temperatures in these aluminides has been by the loss of cohesive strength at the interfaces (intergranular failure). This study focuses on this mechanism of failure, by undertaking a systematic study of the energies and structures of specific grain boundaries in some of these compounds. The relaxed atomistic grain boundary structures in B2 aluminides, FeAl, NiAl and CoAl and L10 gamma-TiAl were investigated using molecular statics and embedded atom potentials in order to explore general trends for a series of B2 compounds as well as TiAl. The potentials used correctly predict the proper mechanism of compositional disorder of these compounds. Using these potentials, point defects, free surface energies and various grain boundary structures of similar energies in three B2 compounds, FeAl, NiAl and CoAl were studied. These B2 alloys exhibited increasing anti-phase boundary energies respectively. The misorientations chosen for detailed study correspond to the Sigma5(310) and Sigma5(210) boundaries. These boundaries were investigated with consideration given to possible variations in the local chemical composition. The effects of both boundary stoichiometry and bulk stoichiometry on grain boundary energetics were also considered. Defect energies were calculated for boundaries contained in both stoichiometric and off-stoichiometric bulk. The surface energies for these aluminides were also

Multidisciplinary ALS care improves quality of life in patients with ALS.

PubMed

Van den Berg, J P; Kalmijn, S; Lindeman, E; Veldink, J H; de Visser, M; Van der Graaff, M M; Wokke, J H J; Van den Berg, L H

2005-10-25

To examine the effect of multidisciplinary ALS care on the quality-of-life (QoL) in patients with ALS and their caregivers. In a cross-sectional study, 208 patients with ALS and their caregivers were interviewed. QoL was assessed using the 36-item Short Form Health Survey (SF-36) and two visual analogue scales (VAS). Criteria for multidisciplinary ALS care were: an ALS team headed by a consultant in rehabilitation medicine and consisting of at least a physical therapist, occupational therapist, speech pathologist, dietician and a social worker; use of the Dutch ALS consensus guidelines for ALS care; and at least six incident ALS patients per year. Clinical characteristics and functional loss of the 133 patients receiving multidisciplinary ALS care and the 75 patients receiving general ALS care were similar. The percentage of patients with adequate aids and appliances was higher in those with multidisciplinary ALS care (93.1 vs 81.3%, p = 0.008), whereas the number of visits to professional caregivers was similar in both groups. Patients in the multidisciplinary ALS care group had a better mental QoL on the SF-36 Mental Summary Score than those in the general care group (p = 0.01). The difference in QoL was most pronounced in the domains of Social Functioning and Mental Health, and was independent of the presence of aids and appliances. No significant differences were found in the SF-36 Physical Summary Score, VAS, or in QoL of caregivers of patients with ALS. High standard of care improves mental quality-of-life in patients with ALS.

Growth of Ni-Al alloys on Ni(1 1 1), from Al deposits of various thicknesses: (II) Formation of NiAl over a Ni 3Al interfacial layer

NASA Astrophysics Data System (ADS)

Le Pévédic, S.; Schmaus, D.; Cohen, C.

2007-01-01

This paper describes the second part of a study devoted to the growth of thin Ni-Al alloys after deposition of Al on Ni(1 1 1). In the previous paper [S. Le Pévédic, D. Schmaus, C. Cohen, Surf. Sci. 600 (2006) 565] we have described the results obtained for ultra-thin Al deposits, leading, after annealing at 750 K, to an epitaxial layer of Ni 3Al(1 1 1). In the present paper we show that this regime is only observed for Al deposits smaller than 8 × 10 15 Al/cm 2 and we describe the results obtained for Al deposits exceeding this critical thickness, up to 200 × 10 15 Al/cm 2. Al deposition was performed at low temperature (around 130 K) and the alloying process was followed in situ during subsequent annealing, by Auger electron spectroscopy, low energy electron diffraction and ion beam analysis-channeling measurements, in an ultra-high vacuum chamber connected to a Van de Graaff accelerator. We evidence the formation, after annealing at 750 K, of a crystallographically and chemically well-ordered NiAl(1 1 0) layer (whose thickness depends on the deposited Al amount), over a Ni 3Al "interfacial" layer (whose thickness—about 18 (1 1 1) planes—is independent of the deposited Al amount). The NiAl overlayer is composed of three variants, at 120° from each other in the surface plane, in relation with the respective symmetries of NiAl(1 1 0) and Ni 3Al(1 1 1). The NiAl layer is relaxed (the lattice parameters of cc-B2 NiAl and fcc-L1 2 Ni 3Al differ markedly), and we have determined its epitaxial relationship. In the case of the thickest alloyed layer formed the results concerning the structure of the NiAl layer have been confirmed and refined by ex situ X-ray diffraction and information on its grain size has been obtained by ex situ Atomic Force Microscopy. The kinetics of the alloying process is complex. It corresponds to an heterogeneous growth leading, above the thin Ni 3Al interfacial layer, to a mixture of Al and NiAl over the whole Al film, up to the

AlGaN-based ultraviolet light-emitting diodes on sputter-deposited AlN templates with epitaxial AlN/AlGaN superlattices

NASA Astrophysics Data System (ADS)

Zhao, Lu; Zhang, Shuo; Zhang, Yun; Yan, Jianchang; Zhang, Lian; Ai, Yujie; Guo, Yanan; Ni, Ruxue; Wang, Junxi; Li, Jinmin

2018-01-01

We demonstrate AlGaN-based ultraviolet light-emitting diodes (UV-LEDs) grown by metalorganic chemical vapor deposition (MOCVD) on sputter-deposited AlN templates upon sapphire substrates. An AlN/AlGaN superlattices structure is inserted as a dislocation filter between the LED structure and the AlN template. The full width at half maximum values for (0002) and (10 1 bar 2) X-ray rocking curves of the n-type Al0.56Ga0.44N layer are 513 and 1205 arcsec, respectively, with the surface roughness of 0.52 nm. The electron concentration and mobility measured by Hall measurement are 9.3 × 1017cm-3 and 54 cm2/V·s at room temperature, respectively. The light output power of a 282-nm LED reaches 0.28 mW at 20 mA with an external quantum efficiency of 0.32%. And the values of leakage current and forward voltage of the LEDs are ∼3 nA at -10 V and 6.9 V at 20 mA, respectively, showing good electrical performance. It is expected that the cost of the UV-LED can be reduced by using sputter-deposited AlN template.

Cyclic oxidation resistance of a reaction milled NiAl-AlN composite

NASA Technical Reports Server (NTRS)

Lowell, Carl E.; Barrett, Charles A.; Whittenberger, J. D.

1990-01-01

Based upon recent mechanical property tests a NiAl-AlN composite produced by cryomilling has very attractive high temperature strength. This paper focuses on the oxidation resistance of the NiAl-AlN composite at 1473 and 1573 K as compared to that of Ni-47Al-0.15Zr, one of the most oxidation resistant intermetallics. The results of cyclic oxidation tests show that the NiAl-AlN composite has excellent properties although not quite as good as those of Ni-47Al-0.15Zr. The onset of failure of the NiAl-AlN was unique in that it was not accompanied by a change in scale composition from alumina to less protective oxides. Failure in the composite appears to be related to the entrapment of AlN particles within the alumina scale.

ALS-Plus Syndrome: Non-Pyramidal Features in a Large ALS Cohort

PubMed Central

McCluskey, Leo; Vandriel, Shannon; Elman, Lauren; Van Deerlin, Vivianna M.; Powers, John; Boller, Ashley; Wood, Elisabeth McCarty; Woo, John; McMillan, Corey T.; Rascovsky, Katya; Grossman, Murray

2014-01-01

Objective Autopsy studies show widespread pathology in amyotrophic lateral sclerosis (ALS), but clinical surveys of multisystem disease in ALS are rare. We investigated ALS-Plus syndrome, an understudied group of patients with clinical features extending beyond pyramidal and neuromuscular systems with or without cognitive/behavioral deficits. Methods In a large, consecutively-ascertained cohort of 550 patients with ALS, we documented atypical clinical manifestations. Genetic screening for C9orf72 hexanucleotide expansions was performed in 343 patients, and SOD1, TARDBP, and VCP were tested in the subgroup of patients with a family history of ALS. Gray matter and white matter imaging was available in a subgroup of 30 patients. Results Seventy-five (13.6%) patients were identified with ALS-Plus syndrome. We found disorders of ocular motility, cerebellar, extrapyramidal and autonomic functioning. Relative to those without ALS-Plus, cognitive impairment (8.0% vs 2.9%, p=0.029), bulbar-onset (49.3% vs 23.2%, p<0.001), and pathogenic mutations (20.0% vs 8.4%, p=0.015) were more than twice as common in ALS-Plus. Survival was significantly shorter in ALS-Plus (29.66 months vs 42.50 months, p=0.02), regardless of bulbar-onset or mutation status. Imaging revealed significantly greater cerebellar and cerebral disease in ALS-Plus compared to those without ALS-Plus. Conclusions ALS-Plus syndrome is not uncommon, and the presence of these atypical features is consistent with neuropathological observations that ALS is a multisystem disorder. ALS-Plus syndrome is associated with increased risk for poor survival and the presence of a pathogenic mutation. PMID:25086858

Is the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex important for motor recovery in rats with photochemically induced cortical lesions?

PubMed

Takata, Kotaro; Yamauchi, Hideki; Tatsuno, Hisashi; Hashimoto, Keiji; Abo, Masahiro

2006-01-01

To determine whether the ipsilateral cortex surrounding the lesion or the non-injured contralateral cortex is important for motor recovery after brain damage in the photochemically initiated thrombosis (PIT) model. We induced PIT in the sensorimotor cortex in rats and examined the recovery of motor function using the beam-walking test. In 24 rats, the right sensorimotor cortex was lesioned after 2 days of training for the beam-walking test (group 1). After 10 days, PIT was induced in the left sensorimotor cortex. Eight additional rats (group 2) received 2 days training in beam walking, then underwent the beam-walking test to evaluate function. After 10 days of testing, the left sensorimotor cortex was lesioned and recovery was monitored by the beam-walking test for 8 days. In group 1 animals, left hindlimb function caused by a right sensorimotor cortex lesion recovered within 10 days after the operation. Right hindlimb function caused by the left-side lesion recovered within 6 days. In group 2, right hindlimb function caused by induction of the left-side lesion after a total of 12 days of beam-walking training and testing recovered within 6 days as with the double PIT model. The training effect may be relevant to reorganization and neuromodulation. Motor recovery patterns did not indicate whether motor recovery was dependent on the ipsilateral cortex surrounding the lesion or the cortex of the contralateral side. The results emphasize the need for selection of appropriate programs tailored to the area of cortical damage in order to enhance motor functional recovery in this model. Copyright 2006 S. Karger AG, Basel.

Effect of AlB2 on the P-threshold in Al-Si alloy

NASA Astrophysics Data System (ADS)

Wu, Yuying; Liu, Xiangfa

2018-06-01

The nucleation of primary Si in Al-Si alloys has been investigated in this work. It was found that there was a threshold concentration of P, below which AlP can not heterogeneous nucleate primary Si in Al-12 wt%Si alloy. AlB2 can not nucleate primary Si directly, but the presence of AlB2 may assist the nucleation of AlP leading to the nucleation of primary Si particles. In addition, with addition of AlB2, the nucleation efficiency of AlP can be improved in Al-18 wt%Si alloy. The orientation relationship between AlB2 and AlP has been calculated, and the adsorption model for AlB2 and AlP was proposed in this work.

Valence subband coupling effect on polarization of spontaneous emissions from Al-rich AlGaN/AlN quantum wells.

PubMed

Lu, Huimin; Yu, Tongjun; Yuan, Gangcheng; Jia, Chuanyu; Chen, Genxiang; Zhang, Guoyi

2012-12-03

The optical polarization properties of Al-rich AlGaN/AlN quantum wells (QWs) were investigated using the theoretical model based on the k·p method. Numerical results show that there is valence subband coupling which can influence the peak emission wavelength and emission intensity for TE and TM polarization components from Al-rich AlGaN/AlN QWs. Especially the valence subband coupling could be strong enough when CH1 is close to HH1 and LH1 subbands to modulate the critical Al content switching dominant emissions from TE to TM polarization. It is believed that the valence subband coupling may give important influence on polarization properties of spontaneous emissions and should be considered in designing high efficiency AlGaN-based ultraviolet (UV) LEDs.

Modulating optical polarization properties of Al-rich AlGaN/AlN quantum well by controlling wavefunction overlap

NASA Astrophysics Data System (ADS)

Chen, X. J.; Yu, T. J.; Lu, H. M.; Yuan, G. C.; Shen, B.; Zhang, G. Y.

2013-10-01

Using modified k.p perturbation method, the optical polarization properties of Al-rich AlGaN/AlN quantum wells (QWs) are studied. It is found that change of wavefunction overlaps between conduction band and valance subbands of heavy hole, light hole, and crystal-field split off hole is different. Such difference leads to the overturn of polarization degree and modulates optical polarization properties as well width and strain vary. This prompts that changing wavefunction overlaps of electron and hole can lead to a way to modulate optical polarization properties of Al-rich AlGaN/AlN QWs, on no condition that valence band order changes.

Contralateral eye comparison on changes in visual field following laser in situ keratomileusis vs photorefractive keratectomy for myopia: a randomized clinical trial.

PubMed

Mostafaei, A; Sedgipour, M R; Sadeghi-Bazargani, H

2009-12-01

Study purpose was to compare the changes of Visual Field (VF) during laser in situ Keratomileusis (LASIK) VS photorefractive keratectomy (PRK). This randomized, double blind, study involved 54 eyes of 27 Myopia patients who underwent LASIK or PRK procedures for contralateral eyes in each patient. Using Humphrey 30-2 SITA standard, the Mean Defect (MD) and Pattern Standard Deviation (PSD) were evaluated preoperatively and three months after surgery. At the same examination optical zone size, papillary and corneal diameters were also evaluated. There was no clinically significant difference in PSD and MD measurements between treated eyes with LASIK or PRK in any zone pre and postoperatively. VF may not be affected by corneal changes induced by LASIK or PRK three months after surgery.

High temperature deformation of NiAl and CoAl

NASA Technical Reports Server (NTRS)

Nix, W. D.

1982-01-01

The high temperature mechanical properties of the aluminides are reviewed with respect to their potential as high temperature structural materials. It is shown that NiAl and CoAl are substantially stronger than the pure metals Ni and Co at high temperatures and approach the strength of some superalloys, particularly when those superalloys are tested in "weak" directions. The factors that limit and control the high temperature strengths of NiAl and CoAl are examined to provide a basis for the development of intermetallic alloys of this type.

Custom vs conventional PRK: a prospective, randomized, contralateral eye comparison of postoperative visual function.

PubMed

Mifflin, Mark D; Hatch, Bryndon B; Sikder, Shameema; Bell, James; Kurz, Christopher J; Moshirfar, Majid

2012-02-01

To determine whether VISX S4 (VISX Inc) custom photorefractive keratectomy (PRK) results in better visual outcomes than VISX S4 conventional PRK. Photorefractive keratectomy was performed on 80 eyes from 40 patients in this randomized, prospective, contralateral eye study. Dominant eyes were randomized to one group with the fellow eye receiving the alternate treatment. Primary outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and root-mean-square (RMS) higher order aberrations. Mean UDVA was -0.023±0.099 (20/19) in the custom group and -0.044±0.080 (20/18) in the conventional group 6 months after surgery (P=.293). Mean CDVA was -0.073±0.067 (20/17) in the custom group and -0.079±0.071 (20/17) in the conventional group 6 months after surgery (P=.659). Total higher order aberration RMS and spherical aberration increased in both groups compared to preoperative values (P<.05). Coma increased in the conventional group (P<.05) whereas it was similar to preoperative values in the custom group. No significant differences were noted in induction of trefoil. Custom and conventional PRK were shown to be safe and effective with excellent visual acuity and contrast sensitivity performance at 6 and 12 months. Conventional PRK induced more coma than custom PRK; however, this did not seem to correlate with clinical outcomes. Copyright 2012, SLACK Incorporated.

Atomistic Modeling of RuAl and (RuNi) Al Alloys

NASA Technical Reports Server (NTRS)

Gargano, Pablo; Mosca, Hugo; Bozzolo, Guillermo; Noebe, Ronald D.; Gray, Hugh R. (Technical Monitor)

2002-01-01

Atomistic modeling of RuAl and RuAlNi alloys, using the BFS (Bozzolo-Ferrante-Smith) method for alloys is performed. The lattice parameter and energy of formation of B2 RuAl as a function of stoichiometry and the lattice parameter of (Ru(sub 50-x)Ni(sub x)Al(sub 50)) alloys as a function of Ni concentration are computed. BFS based Monte Carlo simulations indicate that compositions close to Ru25Ni25Al50 are single phase with no obvious evidence of a miscibility gap and separation of the individual B2 phases.

Hemifacial hyperhidrosis associated with ipsilateral/contralateral cervical disc herniation myelopathy. Functional considerations on how compression pattern determines the laterality

PubMed Central

Iwase, Satoshi; Inukai, Yoko; Nishimura, Naoki; Sato, Maki; Sugenoya, Junichi

2014-01-01

Summary Sweating is an important mechanism for ensuring constant thermoregulation, but hyperhidrosis may be disturbing. We present five cases of hemifacial hyperhidrosis as a compensatory response to an/hypohidrosis caused by cervical disc herniation. All the patients complained of hemifacial hyperhidrosis, without anisocoria or blepharoptosis. Sweat function testing and thermography confirmed hyperhidrosis of hemifacial and adjacent areas. Neck MRI showed cervical disc herniation. Three of the patients had lateral compression with well-demarcated hypohidrosis below the hyperhidrosis on the same side as the cervical lesion. The rest had paramedian compression with poorly demarcated hyperhidrosis and hypohidrosis on the contralateral side. Although MRI showed no intraspinal pathological signal intensity, lateral dural compression might influence the circulation to the sudomotor pathway, and paramedian compression might influence the ipsilateral sulcal artery, which perfuses the sympathetic descending pathway and the intermediolateral nucleus. Sweat function testing and thermography should be performed to determine the focus of the hemifacial hyperhidrosis, and the myelopathy should be investigated on both sides. PMID:25014051

Al6H18: A baby crystal of γ-AlH3

NASA Astrophysics Data System (ADS)

Kiran, B.; Kandalam, Anil K.; Xu, Jing; Ding, Y. H.; Sierka, M.; Bowen, K. H.; Schnöckel, H.

2012-10-01

Using global-minima search methods based on the density functional theory calculations of (AlH3)n (n = 1-8) clusters, we show that the growth pattern of alanes for n ≥ 4 is dominated by structures containing hexa-coordinated Al atoms. This is in contrast to the earlier studies where either linear or ring structures of AlH3 were predicted to be the preferred structures in which the Al atoms can have a maximum of five-fold coordination. Our calculations also reveal that the Al6H18 cluster, with its hexa-coordination of the Al atoms, resembles the unit-cell of γ-AlH3, thus Al6H18 is designated as the "baby crystal." The fragmentation energies of the (AlH3)n (n = 2-8) along with the dimerization energies for even n clusters indicate an enhanced stability of the Al6H18 cluster. Both covalent (hybridization) and ionic (charge) contribution to the bonding are the driving factors in stabilizing the isomers containing hexa-coordinated Al atoms.

Contralateral Bimodal Stimulation: A Way to Enhance Speech Performance in Arabic-Speaking Cochlear Implant Patients.

PubMed

Abdeltawwab, Mohamed M; Khater, Ahmed; El-Anwar, Mohammad W

2016-01-01

The combination of acoustic and electric stimulation as a way to enhance speech recognition performance in cochlear implant (CI) users has generated considerable interest in the recent years. The purpose of this study was to evaluate the bimodal advantage of the FS4 speech processing strategy in combination with hearing aids (HA) as a means to improve low-frequency resolution in CI patients. Nineteen postlingual CI adults were selected to participate in this study. All patients wore implants on one side and HA on the contralateral side with residual hearing. Monosyllabic word recognition, speech in noise, and emotion and talker identification were assessed using CI with fine structure processing/FS4 and high-definition continuous interleaved sampling strategies, HA alone, and a combination of CI and HA. The bimodal stimulation showed improvement in speech performance and emotion identification for the question/statement/order tasks, which was statistically significant compared to patients with CI alone, but there were no significant statistical differences in intragender talker discrimination and emotion identification for the happy/angry/neutral tasks. The poorest performance was obtained with HA only, and it was statistically significant compared to the other modalities. The bimodal stimulation showed enhanced speech performance in CI patients, and it improves the limitations provided by electric or acoustic stimulation alone. © 2016 S. Karger AG, Basel.

Longitudinal measurements of luminance and chromatic contrast sensitivity: comparison between wavefront-guided LASIK and contralateral PRK for myopia.

PubMed

Barboni, Mirella Telles Salgueiro; Feitosa-Santana, Claudia; Barreto Junior, Jackson; Lago, Marcos; Bechara, Samir Jacob; Alves, Milton Ruiz; Ventura, Dora Fix

2013-10-01

The present study aimed to compare the postoperative contrast sensitivity functions between wavefront-guided LASIK eyes and their contralateral wavefront-guided PRK eyes. The participants were 11 healthy subjects (mean age=32.4 ± 6.2 years) who had myopic astigmatism. The spatial contrast sensitivity functions were measured before and three times after the surgery. Psycho and a Cambridge graphic board (VSG 2/4) were used to measure luminance, red-green, and blue-yellow spatial contrast sensitivity functions (from 0.85 to 13.1 cycles/degree). Longitudinal analysis and comparison between surgeries were performed. There was no significant contrast sensitivity change during the one-year follow-up measurements neither for LASIK nor for PRK eyes. The comparison between procedures showed no differences at 12 months postoperative. The present data showed similar contrast sensitivities during one-year follow-up of wave-front guided refractive surgeries. Moreover, one year postoperative data showed no differences in the effects of either wavefront-guided LASIK or wavefront-guided PRK on the luminance and chromatic spatial contrast sensitivity functions.

27Al MQMAS of the δ-Al 13-Keggin

DOE PAGES

Pilgrim, C. D.; Callahan, J. R.; Colla, C. A.; ...

2017-01-20

Here, one-dimensional 27Al, 23Na Magic-Angle-Spinning (MAS) NMR and 27Al Multiple-Quantum Magic-Angle-Spinning NMR (MQMAS) measurements are reported for the δ-isomer of the Al 13 Keggin structure at high spinning speed and 14.1 T field. Values for the CQ and η parameters are on the same scale as those seen in other isomers of the Al 13 structure. Density functional theory (DFT) calculations are performed for comparison to the experimental fits using the B3PW91/6-31+G* and PBE0/6-31+G* levels of theory, with the Polarizable Continuum Model (PCM).

Antiresorptive treatment, when initiated after a first hip fracture, may not protect of a second contralateral episode in elderly population: A study with 685 patients.

PubMed

Besalduch, M; Carrera, I; Gómez-Masdeu, M; De Caso, J

2016-04-01

Osteoporosis predisposes for a higher risk of hip fracture and its treatment is frequently underprescribed. Our purpose was to assess the relation between having a second hip fracture and receiving osteoporosis treatment. Also to assess the relation between this second fracture and using central nervous system drugs or being institutionalised. We reviewed all the patients that were admitted to our hospital with an osteoporotic proximal femoral fracture between September 2009 and February 2011. We identified 685 patients, 74 of which presented a contralateral fracture. We evaluated if they were receiving osteoporosis treatment or taking any medication that could affect the central nervous system and if they were institutionalised. A 10.8% of patients had a second fracture and the mean time between the two of them was 20 months (1-122). There was a clear female predominance (76.35%). The mean age at occurrence of the primary fracture was 83.02 years and 85 for the second. A 90.8% did not follow any type of osteoporosis medication before the first fracture. A 50.9% did not receive central nervous system drugs and 79.1% lived at home at the time of the first fracture. 12.8% of the patients that did not follow the osteoporosis treatment, had a contralateral fracture, 3% more than those that did follow some kind of treatment, but this difference was not significant (p=0.2). We identified a similar number of patients undergoing osteoporotic treatment as registered in literature. There was no significant difference between suffering a second hip fracture and following osteoporosis treatment, using psychotropic drugs or being institutionalised. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessing behavioural changes in ALS: cross-validation of ALS-specific measures.

PubMed

Pinto-Grau, Marta; Costello, Emmet; O'Connor, Sarah; Elamin, Marwa; Burke, Tom; Heverin, Mark; Pender, Niall; Hardiman, Orla

2017-07-01

The Beaumont Behavioural Inventory (BBI) is a behavioural proxy report for the assessment of behavioural changes in ALS. This tool has been validated against the FrSBe, a non-ALS-specific behavioural assessment, and further comparison of the BBI against a disease-specific tool was considered. This study cross-validates the BBI against the ALS-FTD-Q. Sixty ALS patients, 8% also meeting criteria for FTD, were recruited. All patients were evaluated using the BBI and the ALS-FTD-Q, completed by a carer. Correlational analysis was performed to assess construct validity. Precision, sensitivity, specificity, and overall accuracy of the BBI when compared to the ALS-FTD-Q, were obtained. The mean score of the whole sample on the BBI was 11.45 ± 13.06. ALS-FTD patients scored significantly higher than non-demented ALS patients (31.6 ± 14.64, 9.62 ± 11.38; p < 0.0001). A significant large positive correlation between the BBI and the ALS-FTD-Q was observed (r = 0.807, p < 0.0001), and no significant correlations between the BBI and other clinical/demographic characteristics indicate good convergent and discriminant validity, respectively. 72% of overall concordance was observed. Precision, sensitivity, and specificity for the classification of severely impaired patients were adequate. However, lower concordance in the classification of mild behavioural changes was observed, with higher sensitivity using the BBI, most likely secondary to BBI items which endorsed behavioural aspects not measured by the ALS-FTD-Q. Good construct validity has been further confirmed when the BBI is compared to an ALS-specific tool. Furthermore, the BBI is a more comprehensive behavioural assessment for ALS, as it measures the whole behavioural spectrum in this condition.

Lou Gehrig's Disease (ALS)

MedlinePlus

... for Educators Search English Español Lou Gehrig's Disease (ALS) KidsHealth / For Kids / Lou Gehrig's Disease (ALS) What's ... with ALS in the 1930s. What Happens in ALS? ALS damages motor neurons in the brain and ...

Pressure induced coordination change of Al in silicate melts from Al K edge XANES of high pressure NaAlSi2O6-NaAlSi3O8 glasses

NASA Astrophysics Data System (ADS)

Li, Dien; Secco, R. A.; Bancroft, G. M.; Fleet, M. E.

Aluminum K-edge XANES spectra of high pressure and high temperature (4.4 GPa and 1575°C) glasses along the NaAlSi2O6 (Jd)-NaAlSi3O8 (Ab) join are reported using synchrotron radiation, and shown to provide direct experimental evidence for the pressure-induced coordination change of Al. Five- and six-fold coordinated Al (5Al and 6Al), characterized by Al K-edge positions at 1567.8 and 1568.7 eV, respectively, first appear in glass of composition Jd60Ab40 and increase in proportion progressively with increasing Jd content. The end-member jadeite glass contains about 6% of each of 5Al and 6Al. The present direct measurements confirm literature suggestions for the important role of Al in controlling viscosity and diffusion in mantle melts.

A Contralateral Esophagus-Sparing Technique to Limit Severe Esophagitis Associated With Concurrent High-Dose Radiation and Chemotherapy in Patients With Thoracic Malignancies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Halabi, Hani; Paetzold, Peter; Sharp, Gregory C.

2015-07-15

Purpose: Severe (Radiation Therapy Oncology Group [RTOG] grade 3 or greater) esophagitis generally occurs in 15% to 25% of non–small cell lung cancer (NSCLC) patients undergoing concurrent chemotherapy and radiation therapy (CCRT), which may result in treatment breaks that compromise local tumor control and pose a barrier to dose escalation. Here, we report a novel contralateral esophagus-sparing technique (CEST) that uses intensity modulated radiation therapy (IMRT) to reduce the incidence of severe esophagitis. Methods and Materials: We reviewed consecutive patients with thoracic malignancies undergoing curative CCRT in whom CEST was used. The esophageal wall contralateral (CE) to the tumor wasmore » contoured as an avoidance structure, and IMRT was used to guide a rapid dose falloff gradient beyond the target volume in close proximity to the esophagus. Esophagitis was recorded based on the RTOG acute toxicity grading system. Results: We identified 20 consecutive patients treated with CCRT of at least 63 Gy in whom there was gross tumor within 1 cm of the esophagus. The median radiation dose was 70.2 Gy (range, 63-72.15 Gy). In all patients, ≥99% of the planning and internal target volumes was covered by ≥90% and 100% of prescription dose, respectively. Strikingly, no patient experienced grade ≥3 esophagitis (95% confidence limits, 0%-16%) despite the high total doses delivered. The median maximum dose, V45, and V55 of the CE were 60.7 Gy, 2.1 cc, and 0.4 cc, respectively, indicating effective esophagus cross-section sparing by CEST. Conclusion: We report a simple yet effective method to avoid exposing the entire esophagus cross-section to high doses. By using proposed CE dose constraints of V45 <2.5 cc and V55 <0.5 cc, CEST may improve the esophagus toxicity profile in thoracic cancer patients receiving CCRT even at doses above the standard 60- to 63-Gy levels. Prospective testing of CEST is warranted.« less

Doping and compensation in Al-rich AlGaN grown on single crystal AlN and sapphire by MOCVD

NASA Astrophysics Data System (ADS)

Bryan, Isaac; Bryan, Zachary; Washiyama, Shun; Reddy, Pramod; Gaddy, Benjamin; Sarkar, Biplab; Breckenridge, M. Hayden; Guo, Qiang; Bobea, Milena; Tweedie, James; Mita, Seiji; Irving, Douglas; Collazo, Ramon; Sitar, Zlatko

2018-02-01

In order to understand the influence of dislocations on doping and compensation in Al-rich AlGaN, thin films were grown by metal organic chemical vapor deposition (MOCVD) on different templates on sapphire and low dislocation density single crystalline AlN. AlGaN grown on AlN exhibited the highest conductivity, carrier concentration, and mobility for any doping concentration due to low threading dislocation related compensation and reduced self-compensation. The onset of self-compensation, i.e., the "knee behavior" in conductivity, was found to depend only on the chemical potential of silicon, strongly indicating the cation vacancy complex with Si as the source of self-compensation. However, the magnitude of self-compensation was found to increase with an increase in dislocation density, and consequently, AlGaN grown on AlN substrates demonstrated higher conductivity over the entire doping range.

The Existence of a Designer Al=Al Double Bond in the LiAl2 H4- Cluster Formed by Electronic Transmutation.

PubMed

Lundell, Katie A; Zhang, Xinxing; Boldyrev, Alexander I; Bowen, Kit H

2017-12-22

The Al=Al double bond is elusive in chemistry. Herein we report the results obtained via combined photoelectron spectroscopy and ab initio studies of the LiAl 2 H 4 - cluster that confirm the formation of a conventional Al=Al double bond. Comprehensive searches for the most stable structures of the LiAl 2 H 4 - cluster have shown that the global minimum isomer I possesses a geometric structure which resembles that of Si 2 H 4 , demonstrating a successful example of the transmutation of Al atoms into Si atoms by electron donation. Theoretical simulations of the photoelectron spectrum discovered the coexistence of two isomers in the ion beam, including the one with the Al=Al double bond. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Brain activity during bilateral rapid alternate finger tapping measured with magnetoencephalography

NASA Astrophysics Data System (ADS)

Fukuda, Hiroshi; Odagaki, Masato; Hiwaki, Osamu; Kodabashi, Atsushi; Fujimoto, Toshiro

2009-04-01

Using magnetoencephalography (MEG), brain regions involved in an alternate bimanual tapping task by index fingers triggered with spontaneous timing were investigated. The tapping mode in which both index fingers moved simultaneously was interlaced during the task. The groups of the alternate tapping (AL mode) and the simultaneous tapping (SI mode) were extracted from the successive alternating taps with a histogram of intervals between the right and left index fingers. MEG signals in each mode were averaged separately before and after the tapping initiation of the dominant index finger. The activities of the contralateral sensorimotor cortex before and after the tapping initiation in the AL mode were larger than that in the SI mode. The result indicates that the activity of the contralateral sensorimotor cortex depends on the degree of achievement in the difficult motor task such as the voluntary alternate tapping movements.

ALS - resources

MedlinePlus

Resources - ALS ... The following organizations are good resources for information on amyotrophic lateral sclerosis : Muscular Dystrophy Association -- www.mda.org/disease/amyotrophic-lateral-sclerosis National Amyotrophic Lateral Sclerosis (ALS) ...

Interdiffusion in U 3Si-Al, U 3Si 2-Al, and USi-Al dispersion fuels during irradiation

NASA Astrophysics Data System (ADS)

Kim, Yeon Soo; Hofman, Gerard L.

2011-03-01

Uranium-silicide compound fuel dispersion in an Al matrix is used in research and test reactors worldwide. Interaction layer (IL) growth between fuel particles and the matrix is one of performance issues. The interaction layer growth data for U 3Si, U 3Si 2 and USi dispersions in Al were obtained from both out-of-pile and in-pile tests. The IL is dominantly U(AlSi) 3 from out-of-pile tests, but its (Al + Si)/U ratio from in-pile tests is higher than the out-of-pile data, because of amorphous behavior of the ILs. IL growth correlations were developed for U 3Si-Al and U 3Si 2-Al. The IL growth rates were dependent on the U/Si ratio of the fuel compounds. During irradiation, however, the IL growth rates did not decrease with the decreasing U/Si ratio by fission. It is reasoned that transition metal fission products in the IL compensate the loss of U atoms by providing chemical potential for Al diffusion and volume expansion by solid swelling and gas bubble swelling. The addition of Mo in U 3Si 2 reduces the IL growth rate, which is similar to that of UMo alloy dispersion in a silicon-added Al matrix.

Characterization of N-polar AlN in GaN/AlN/(Al,Ga)N heterostructures grown by metal-organic chemical vapor deposition

NASA Astrophysics Data System (ADS)

Li, Haoran; Mazumder, Baishakhi; Bonef, Bastien; Keller, Stacia; Wienecke, Steven; Speck, James S.; Denbaars, Steven P.; Mishra, Umesh K.

2017-11-01

In GaN/(Al,Ga)N high-electron-mobility transistors (HEMT), AlN interlayer between GaN channel and AlGaN barrier suppresses alloy scattering and significantly improves the electron mobility of the two-dimensional electron gas. While high concentrations of gallium were previously observed in Al-polar AlN interlayers grown by metal-organic chemical vapor deposition, the N-polar AlN (Al x Ga1-x N) films examined by atom probe tomography in this study exhibited aluminum compositions (x) equal to or higher than 95% over a wide range of growth conditions. The also investigated AlN interlayer in a N-polar GaN/AlN/AlGaN/ S.I. GaN HEMT structure possessed a similarly high x content.

Pure AlN layers in metal-polar AlGaN/AlN/GaN and AlN/GaN heterostructures grown by low-temperature ammonia-based molecular beam epitaxy

NASA Astrophysics Data System (ADS)

Kaun, Stephen W.; Mazumder, Baishakhi; Fireman, Micha N.; Kyle, Erin C. H.; Mishra, Umesh K.; Speck, James S.

2015-05-01

When grown at a high temperature (820 °C) by ammonia-based molecular beam epitaxy (NH3-MBE), the AlN layers of metal-polar AlGaN/AlN/GaN heterostructures had a high GaN mole fraction (∼0.15), as identified by atom probe tomography in a previous study (Mazumder et al 2013 Appl. Phys. Lett. 102 111603). In the study presented here, growth at low temperature (<740 °C) by NH3-MBE yielded metal-polar AlN layers that were essentially pure at the alloy level. The improved purity of the AlN layers grown at low temperature was correlated to a dramatic increase in the sheet density of the two-dimensional electron gas (2DEG) at the AlN/GaN heterointerface. Through application of an In surfactant, metal-polar AlN(3.5 nm)/GaN and AlGaN/AlN(2.5 nm)/GaN heterostructures grown at low temperature yielded low 2DEG sheet resistances of 177 and 285 Ω/□, respectively.

Study of the Al m 26 ( d , p ) Al 27 Reaction and the Influence of the Al 26 0 + Isomer on the Destruction of Al 26 in the Galaxy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Almaraz-Calderon, S.; Rehm, K. E.; Gerken, N.

The existence of 26Al (t 1/2 = 7.17 × 10 5 yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0 + isomer ( 26Al m), however, severely complicates the astrophysical calculations. Here we present for the first time a study of the 26Al m (d, p) 27 Al reaction using an isomeric 26Al beam. The selectivity of this reaction allowed the study of ℓ = 0 transfers to T = 1/2, and T = 3/2 states in 27Al . Mirror symmetry arguments were then used to constrain themore » 26Al m (p,γ) 27Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric 26Al via radiative proton capture reactions, which is expected to dominate the destruction path of 26Al m in asymptotic giant branch stars, classical novae, and core collapse supernovae.« less

Study of the Al m 26 ( d , p ) Al 27 Reaction and the Influence of the Al 26 0 + Isomer on the Destruction of Al 26 in the Galaxy

DOE PAGES

Almaraz-Calderon, S.; Rehm, K. E.; Gerken, N.; ...

2017-08-17

The existence of 26Al (t 1/2 = 7.17 × 10 5 yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0 + isomer ( 26Al m), however, severely complicates the astrophysical calculations. Here we present for the first time a study of the 26Al m (d, p) 27 Al reaction using an isomeric 26Al beam. The selectivity of this reaction allowed the study of ℓ = 0 transfers to T = 1/2, and T = 3/2 states in 27Al . Mirror symmetry arguments were then used to constrain themore » 26Al m (p,γ) 27Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric 26Al via radiative proton capture reactions, which is expected to dominate the destruction path of 26Al m in asymptotic giant branch stars, classical novae, and core collapse supernovae.« less

Study of the ^{26}Al^{m}(d,p)^{27}Al Reaction and the Influence of the ^{26}Al 0^{+} Isomer on the Destruction of ^{26}Al in the Galaxy.

PubMed

Almaraz-Calderon, S; Rehm, K E; Gerken, N; Avila, M L; Kay, B P; Talwar, R; Ayangeakaa, A D; Bottoni, S; Chen, A A; Deibel, C M; Dickerson, C; Hanselman, K; Hoffman, C R; Jiang, C L; Kuvin, S A; Nusair, O; Pardo, R C; Santiago-Gonzalez, D; Sethi, J; Ugalde, C

2017-08-18

The existence of ^{26}Al (t_{1/2}=7.17×10^{5}  yr) in the interstellar medium provides a direct confirmation of ongoing nucleosynthesis in the Galaxy. The presence of a low-lying 0^{+} isomer (^{26}Al^{m}), however, severely complicates the astrophysical calculations. We present for the first time a study of the ^{26}Al^{m}(d,p)^{27}Al reaction using an isomeric ^{26}Al beam. The selectivity of this reaction allowed the study of ℓ=0 transfers to T=1/2, and T=3/2 states in ^{27}Al. Mirror symmetry arguments were then used to constrain the ^{26}Al^{m}(p,γ)^{27}Si reaction rate and provide an experimentally determined upper limit of the rate for the destruction of isomeric ^{26}Al via radiative proton capture reactions, which is expected to dominate the destruction path of ^{26}Al^{m} in asymptotic giant branch stars, classical novae, and core collapse supernovae.

Reduced electron back-injection in Al2O3/AlOx/Al2O3/graphene charge-trap memory devices

NASA Astrophysics Data System (ADS)

Lee, Sejoon; Song, Emil B.; Min Kim, Sung; Lee, Youngmin; Seo, David H.; Seo, Sunae; Wang, Kang L.

2012-12-01

A graphene charge-trap memory is devised using a single-layer graphene channel with an Al2O3/AlOx/Al2O3 oxide stack, where the ion-bombarded AlOx layer is intentionally added to create an abundance of charge-trap sites. The low dielectric constant of AlOx compared to Al2O3 reduces the potential drop in the control oxide Al2O3 and suppresses the electron back-injection from the gate to the charge-storage layer, allowing the memory window of the device to be further extended. This shows that the usage of a lower dielectric constant in the charge-storage layer compared to that of the control oxide layer improves the memory performance for graphene charge-trap memories.

Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients With Early-Stage Breast Cancer.

PubMed

Jagsi, Reshma; Hawley, Sarah T; Griffith, Kent A; Janz, Nancy K; Kurian, Allison W; Ward, Kevin C; Hamilton, Ann S; Morrow, Monica; Katz, Steven J

2017-03-01

Contralateral prophylactic mastectomy (CPM) use is increasing among women with unilateral breast cancer, but little is known about treatment decision making or physician interactions in diverse patient populations. To evaluate patient motivations, knowledge, and decisions, as well as the impact of surgeon recommendations, in a large, diverse sample of patients who underwent recent treatment for breast cancer. A survey was sent to 3631 women with newly diagnosed, unilateral stage 0, I, or II breast cancer between July 2013 and September 2014. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. Logistic and multinomial logistic regression of the data were conducted to identify factors associated with (1) CPM vs all other treatments combined, (2) CPM vs unilateral mastectomy (UM), and (3) CPM vs breast-conserving surgery (BCS). Associations between CPM receipt and surgeon recommendations were also evaluated. All statistical models and summary estimates were weighted to be representative of the target population. Receipt of CPM was the primary dependent variable for analysis and was measured by a woman's self-report of her treatment. Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. The mean (SD) age was 61.8 (12) years at the time of the survey. Overall, 1301 (43.9%) patients considered CPM (601 [24.8%] considered it very strongly or strongly); only 395 (38.1%) of them knew that CPM does not improve survival for all women with breast cancer. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received CPM. On multivariable analysis, factors associated with CPM included younger age

Phenotypic and genotypic studies of ALS cases in ALS-SMA families.

PubMed

Corcia, Philippe; Vourc'h, Patrick; Blasco, Helene; Couratier, Philippe; Dangoumau, Audrey; Bellance, Remi; Desnuelle, Claude; Viader, Fausto; Pautot, Vivien; Millecamps, Stephanie; Bakkouche, Salah; Salachas, FranÇois; Andres, Christian R; Meininger, Vincent; Camu, William

2018-08-01

Amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA) are the most frequent motor neuron disorders in adulthood and infancy, respectively. There is a growing literature supporting common pathophysiological patterns between those disorders. One important clinical issue for that is the co-occurrence of both diseases within a family. To collect families in which ALS and SMA patients co-exist and describe the phenotype and the genotype of ALS patients. Nine families with co-occurrence of SMA and ALS have been gathered over the last 15 years. Epidemiological, phenotype and genetic status were collected. Out of the nine families, six corresponded to the criteria of familial ALS (FALS). Clinical data were available for 11 patients out of the 15 ALS cases. Mean age of onset was 58.5 years, site of onset was lower limbs in nine cases (81.8%), median duration was 22 months. Four ALS patients carried a mutation: three mutations in SOD1 gene (G147N in two cases and one with E121G) and one repeat expansion in the C9ORF72 gene. Three patients had abnormal SMN1 copy numbers. While the high proportion of familial history of ALS cases in these ALS-SMA pedigrees could have suggested that these familial clusters of the two most frequent MND rely on a genetic background, we failed to exclude that this occurred by chance.

77 FR 73732 - In the Matter of Amendment of the Designation of al-Qa'ida in Iraq, aka Jam'at al Tawhid wa'al...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-11

...'ida in Iraq, aka Jam'at al Tawhid wa'al-Jihad, aka The Monotheism and Jihad Group, aka The al-Zarqawi Network, aka al-Tawhid, aka Tanzim Qa`idat al-Jihad fi Bilad al-Rafidayn, aka The Organization of al-Jihad... Rivers, aka al-Qaida of Jihad Organization in the Land of the Two Rivers, aka al- Qaida Group of Jihad in...

Familiarity Speeds Up Visual Short-term Memory Consolidation: Electrophysiological Evidence from Contralateral Delay Activities.

PubMed

Xie, Weizhen; Zhang, Weiwei

2018-01-01

To test how preexisting long-term memory influences visual STM, this study takes advantage of individual differences in participants' prior familiarity with Pokémon characters and uses an ERP component, the contralateral delay activity (CDA), to assess whether observers' prior stimulus familiarity affects STM consolidation and storage capacity. In two change detection experiments, consolidation speed, as indexed by CDA fractional area latency and/or early-window (500-800 msec) amplitude, was significantly associated with individual differences in Pokémon familiarity. In contrast, the number of remembered Pokémon stimuli, as indexed by Cowan's K and late-window (1500-2000 msec) CDA amplitude, was significantly associated with individual differences in Pokémon familiarity when STM consolidation was incomplete because of a short presentation of Pokémon stimuli (500 msec, Experiment 2), but not when STM consolidation was allowed to complete given sufficient encoding time (1000 msec, Experiment 1). Similar findings were obtained in between-group analyses when participants were separated into high-familiarity and low-familiarity groups based on their Pokémon familiarity ratings. Together, these results suggest that stimulus familiarity, as a proxy for the strength of preexisting long-term memory, primarily speeds up STM consolidation, which may subsequently lead to an increase in the number of remembered stimuli if consolidation is incomplete. These findings thus highlight the importance of research assessing how effects on representations (e.g., STM capacity) are in general related to (or even caused by) effects on processes (e.g., STM consolidation) in cognition.

Distribution and size of lava shields on the Al Haruj al Aswad and the Al Haruj al Abyad Volcanic Systems, Central Libya

NASA Astrophysics Data System (ADS)

Elshaafi, Abdelsalam; Gudmundsson, Agust

2017-05-01

The Al Haruj Volcanic Province (AHVP) consists of two distinct volcanic systems. In the north is the system of Al Haruj al Aswad, covering an area of 34,200 km2, while in the south the system of Al Haruj al Abyad, covering an area of 7,850 km2. The systems have produced some 432 monogenetic volcanoes, primarily scoria (cinder) cones, lava shields, and maars. The density distribution of the volcanoes in each system, plotted as eruption points or sites, has a roughly elliptical surface expression, suggesting similar plan-view geometry of the magma sources, here suggested as deep-seated reservoirs. More specifically, the Al Haruj al Aswad magma reservoir has major and minor axes of 210 km and 119 km, respectively, and an area of 19,176 km2, the corresponding figures for the Haruj al Abyad reservoir being 108 km and 74 km, for the axes, and 6209 km2 for the area. We measured 55 lava shields on the AHVP. They are mostly restricted to the northern and southern parts of AHVP and date from late Miocene to (at least) the end of Pleistocene, while some may have been active into Holocene. In fact, although primarily monogenetic, some of the lava shields show evidence of (possibly Holocene) fissure eruptions in the summit parts. The early lava shields tend to be located at the edges of volcanic systems and with greater volumes than later (more central) shields. The average lava shield basal diameter is 4.5 km and height 63 m. There is strong linear correlation between lava shield volume and basal area, the coefficient of determination (R2) being about 0.75. When 22 Holocene Icelandic lava shields are added to the dataset, for comparison, the correlation between volume and basal area becomes R2 = 0.95. Numerical models suggest that the local stress fields favoured rupture and dyke injection at the margins of the source reservoirs during late Miocene - early Pliocene, in agreement with the distribution of the early, large-volume shields.

Case of pregnancy in two cows with unicorn horn of the uterus either by artificial insemination at ipsilateral or embryo transfer at contralateral corpus luteum in the ovary.

PubMed

Moriyama, C; Kobayashi, I; Tani, M; Oishi, T; Kajisa, M; Horii, Y; Kamimura, S

2008-06-01

Two Holstein heifers and a cow were diagnosed with White Heifer Disease by ultrasonography. Case 1 was a 14 month-old heifer with aplasia of both sides of the uterine horn. In case 2, a primiparous cow and case 3, an 18 month-old heifer, both showed aplasia of the right uterine horn. Case 2 became pregnant by artificial insemination at ipsilateral ovulatory follicle and corpus luteum in the left ovary, while case 3 became pregnant by embryo transfer at 7 days after oestrus with contralateral corpus luteum in the right ovary.

Formation of gamma'-Ni3Al via the Peritectoid Reaction: gamma plus beta (+Al2O3) equals gamma'(+Al2O3)

NASA Technical Reports Server (NTRS)

Copland, Evan

2008-01-01

The activities of Al and Ni were measured using multi-cell Knudsen effusion-cell mass spectrometry (multi-cell KEMS), over the composition range 8 - 32 at.%Al and temperature range T = 1400 - 1750 K in the Ni-Al-O system. These measurements establish that equilibrium solidification of gamma'-Ni3Al-containing alloys occurs by the eutectic reaction, L (+ Al2O3) = gamma + beta (+ Al2O3), at 1640 plus or minus 1 K and a liquid composition of 24.8 plus or minus 0.2 at.%Al (at an unknown oxygen content). The {gamma + beta + Al2O3} phase field is stable over the temperature range 1633 - 1640 K, and gamma'-Ni3Al forms via the peritectiod, gamma + beta (+ Al2O3) = gamma'(+ Al2O3), at 1633 plus or minus 1 K. This behavior is inconsistent with the current Ni-Al phase diagram and a new diagram is proposed. This new Ni-Al phase diagram explains a number of unusual steady state solidification structures reported previously and provides a much simpler reaction scheme in the vicinity of the gamma'-Ni3Al phase field.

Directional Solidification and Mechanical Properties of NiAl-NiAlTa Alloys

NASA Technical Reports Server (NTRS)

Johnson, D. R.; Chen, X. F.; Oliver, B. F.; Noebe, R. D.; Whittenberger, J. D.

1995-01-01

Directional solidification of eutectic alloys is a promising technique for producing in-situ composite materials exhibiting a balance of properties. Consequently, the microstructure, creep strength and fracture toughness of directionally solidified NiAl-NiAlTa alloys were investigated. Directional solidification was performed by containerless processing techniques to minimize alloy contamination. The eutectic composition was found to be NiAl-15.5 at% Ta and well-aligned microstructures were produced at this composition. A near-eutectic alloy of NiAl-14.5Ta was also investigated. Directional solidification of the near-eutectic composition resulted in microstructures consisting of NiAl dendrites surrounded by aligned eutectic regions. The off-eutectic alloy exhibited promising compressive creep strengths compared to other NiAl-based intermetallics, while preliminary testing indicated that the eutectic alloy was competitive with Ni-base single crystal superalloys. The room temperature toughness of these two-phase alloys was similar to that of polycrystalline NiAl even with the presence of the brittle Laves phase NiAlTa.

Development of Al2O3 fiber-reinforced Al2O3-based ceramics.

PubMed

Tanimoto, Yasuhiro; Nemoto, Kimiya

2004-09-01

The purpose of this study was to use a tape casting technique to develop an Al2O3 fiber-reinforced Al2O3-based ceramic material (Al2O3-fiber/Al2O3 composite) into a new type of dental ceramic. The Al2O3-based ceramic used a matrix consisting of 60 wt% Al2O3 powder and 40 wt% SiO2-B2O3 powder. The prepreg sheets of Al2O3-fiber/Al2O3 composite (in which uniaxially aligned Al2O3 fibers were infiltrated with the Al2O3-based matrix) were fabricated continuously using tape casting technique with a doctor blade system. Multilayer preforms of Al2O3-fiber/Al2O3 composite sheets were then sintered at a maximum temperature of 1000 degrees C under an atmospheric pressure in a furnace. The results showed that the shrinkage and bending properties of Al2O3-fiber/Al2O3 composite exceeded those of unreinforced Al2O3--hence demonstrating the positive effects of fiber reinforcement. In conclusion, the tape casting technique has been utilized to successfully develop a new type of dental ceramic material.

Horizontal sound localization in cochlear implant users with a contralateral hearing aid.

PubMed

Veugen, Lidwien C E; Hendrikse, Maartje M E; van Wanrooij, Marc M; Agterberg, Martijn J H; Chalupper, Josef; Mens, Lucas H M; Snik, Ad F M; John van Opstal, A

2016-06-01

Interaural differences in sound arrival time (ITD) and in level (ILD) enable us to localize sounds in the horizontal plane, and can support source segregation and speech understanding in noisy environments. It is uncertain whether these cues are also available to hearing-impaired listeners who are bimodally fitted, i.e. with a cochlear implant (CI) and a contralateral hearing aid (HA). Here, we assessed sound localization behavior of fourteen bimodal listeners, all using the same Phonak HA and an Advanced Bionics CI processor, matched with respect to loudness growth. We aimed to determine the availability and contribution of binaural (ILDs, temporal fine structure and envelope ITDs) and monaural (loudness, spectral) cues to horizontal sound localization in bimodal listeners, by systematically varying the frequency band, level and envelope of the stimuli. The sound bandwidth had a strong effect on the localization bias of bimodal listeners, although localization performance was typically poor for all conditions. Responses could be systematically changed by adjusting the frequency range of the stimulus, or by simply switching the HA and CI on and off. Localization responses were largely biased to one side, typically the CI side for broadband and high-pass filtered sounds, and occasionally to the HA side for low-pass filtered sounds. HA-aided thresholds better than 45 dB HL in the frequency range of the stimulus appeared to be a prerequisite, but not a guarantee, for the ability to indicate sound source direction. We argue that bimodal sound localization is likely based on ILD cues, even at frequencies below 1500 Hz for which the natural ILDs are small. These cues are typically perturbed in bimodal listeners, leading to a biased localization percept of sounds. The high accuracy of some listeners could result from a combination of sufficient spectral overlap and loudness balance in bimodal hearing. Copyright © 2016 Elsevier B.V. All rights reserved.

Theory and X-ray Absorption Spectroscopy for Aluminum Coordination Complexes – Al K-Edge Studies of Charge and Bonding in (BDI)Al, (BDI)AlR2, and (BDI)AlX2 Complexes.

PubMed

Altman, Alison B; Pemmaraju, C D; Camp, Clément; Arnold, John; Minasian, Stefan G; Prendergast, David; Shuh, David K; Tyliszczak, Tolek

2015-08-19

Polarized aluminum K-edge X-ray absorption near edge structure (XANES) spectroscopy and first-principles calculations were used to probe electronic structure in a series of (BDI)Al, (BDI)AlX2, and (BDI)AlR2 coordination compounds (X = F, Cl, I; R = H, Me; BDI = 2,6-diisopropylphenyl-β-diketiminate). Spectral interpretations were guided by examination of the calculated transition energies and polarization-dependent oscillator strengths, which agreed well with the XANES spectroscopy measurements. Pre-edge features were assigned to transitions associated with the Al 3p orbitals involved in metal-ligand bonding. Qualitative trends in Al 1s core energy and valence orbital occupation were established through a systematic comparison of excited states derived from Al 3p orbitals with similar symmetries in a molecular orbital framework. These trends suggested that the higher transition energies observed for (BDI)AlX2 systems with more electronegative X(1-) ligands could be ascribed to a decrease in electron density around the aluminum atom, which causes an increase in the attractive potential of the Al nucleus and concomitant increase in the binding energy of the Al 1s core orbitals. For (BDI)Al and (BDI)AlH2 the experimental Al K-edge XANES spectra and spectra calculated using the eXcited electron and Core-Hole (XCH) approach had nearly identical energies for transitions to final state orbitals of similar composition and symmetry. These results implied that the charge distributions about the aluminum atoms in (BDI)Al and (BDI)AlH2 are similar relative to the (BDI)AlX2 and (BDI)AlMe2 compounds, despite having different formal oxidation states of +1 and +3, respectively. However, (BDI)Al was unique in that it exhibited a low-energy feature that was attributed to transitions into a low-lying p-orbital of b1 symmetry that is localized on Al and orthogonal to the (BDI)Al plane. The presence of this low-energy unoccupied molecular orbital on electron-rich (BDI)Al distinguishes

NiAl-base composite containing high volume fraction of AlN for advanced engines

NASA Technical Reports Server (NTRS)

Hebsur, Mohan (Inventor); Whittenbeger, John D. (Inventor); Lowell, Carl F. (Inventor)

1994-01-01

A particulate reinforced NiAl-AlN composite alloy has a NiAl matrix and greater than about 13 volume percent fine particles of AlN within the matrix. The particles preferably have a diameter from about 15 nanometers to about 50 nanometers. The particulate reinforced NiAl-AlN composite alloy may be prepared by cryomilling prealloyed NiAl in liquid nitrogen using grinding media having a diameter of from about 2 to 6 mm at an impeller speed of from about 450 RPM to about 800 RPM. The cryomilling may be done for a duration of from about 4 hours to about 20 hours to obtain a cryomilled powder. The cryomilled powder may be consolidated to form the particulate reinforced NiAl-AlN composite alloy. The particulate reinforced alloy can further include a toughening alloy. The toughening alloy may include NiCrAlY, FeCrAlY, and FeAl.

Molecular dynamics study of Al and Ni 3Al sputtering by Al clusters bombardment

NASA Astrophysics Data System (ADS)

Zhurkin, Eugeni E.; Kolesnikov, Anton S.

2002-06-01

The sputtering of Al and Ni 3Al (1 0 0) surfaces induced by impact of Al ions and Al N clusters ( N=2,4,6,9,13,55) with energies of 100 and 500 eV/atom is studied at atomic scale by means of classical molecular dynamics (MD). The MD code we used implements many-body tight binding potential splined to ZBL at short distances. Special attention has been paid to model dense cascades: we used quite big computation cells with lateral periodic and damped boundary conditions. In addition, long simulation times (10-25 ps) and representative statistics (up to 1000 runs per each case) were considered. The total sputtering yields, energy and time spectrums of sputtered particles, as well as preferential sputtering of compound target were analyzed, both in the linear and non-linear regimes. The significant "cluster enhancement" of sputtering yield was found for cluster sizes N⩾13. In parallel, we estimated collision cascade features depending on cluster size in order to interpret the nature of observed non-linear effects.

Decreased background parenchymal enhancement of the contralateral breast after two cycles of neoadjuvant chemotherapy is associated with tumor response in HER2-positive breast cancer.

PubMed

You, Chao; Gu, Yajia; Peng, Wen; Li, Jianwei; Shen, Xuxia; Liu, Guangyu; Peng, Weijun

2018-07-01

Background Several recent studies have focused on the association between background parenchymal enhancement (BPE) and tumor response to neoadjuvant chemotherapy (NAC), but early prediction of tumor response based on BPE has yet not been investigated. Purpose To retrospectively investigate whether changes in the BPE of the contralateral breast following NAC could help predict tumor response in early stage HER2-positive breast cancer. Material and Methods Data from 71 patients who were diagnosed with unilateral HER2 positive breast cancer and then underwent NAC with trastuzumab before surgery were analyzed retrospectively. Two experienced radiologists independently categorized the patients' levels of BPE of the contralateral breast into four categories (1 = minimal, 2 = mild, 3 = moderate, 4 = marked) at baseline and after the second cycle of NAC. After undergoing surgery, 34 patients achieved pathologic complete response (pCR) and 37 patients had residual disease (non-pCR). The association between BPE and histopathologic tumor response was analyzed. Result The level of BPE was higher in premenopausal than post-menopausal women both at baseline and after the second cycle of NAC ( P < 0.005). A significant reduction in BPE ( P < 0.001) was observed after the second NAC cycle; however, a more obvious decrease in BPE was identified in premenopausal relative to post-menopausal women ( P = 0.041). No significant association was identified between pCR and baseline BPE ( P = 0.287). However, after the second NAC cycle, decreased BPE was significantly associated with pCR ( P = 0.003). Conclusion For HER2-positive patients, changes in BPE may serve as an additional imaging biomarker of treatment response at an early stage.

Nb/Al-AlOx/Nb Edge Junctions for Distributed Mixers

NASA Astrophysics Data System (ADS)

Amos, R. S.; Lichtenberger, A. W.; Tong, C. E.; Blundell, R.; Pan, S.-K.; Kerr, A. R.

We have fabricated high quality Nb/Al-oxide/Al/Nb edge junctions using a Nb/SiO/sub 2/ bi-layer film as the base electrode, suitable for use as traveling wave mixers. An edge is cut in the bi-layer with an ion gun at a 45 degree angle using a photoresist mask. The wafer is then cleaned in-situ with a physical ion gun clean followed by the deposition of a thin Al (a1) film, which is then thermally oxidized, an optional second Al (a2) layer, and a Nb counter electrode. It was found that devices with an a2 layer resulted in superior electrical characteristics, though proximity effects increased strongly with a2 thickness. The counter electrode is defined with an SF/sub 6/+N/sub 2/ reactive ion etch, using the Al barrier layer as an etch stop. The Al barrier layer is then either removed with an Al wet etch to isolate the individual devices, or the devices are separated with an anodization process. Various ion gun cleaning conditions have been examined; in addition, both wet and plasma etch bi-layer edge surface pre-treatments were investigated. It was found that edge junctions with large widths (i.e., those more suitable for traveling wave mixers) typically benefited more from such treatments. Initial receiver results at 260 GHz have yielded a DSB noise temperature of 60 K.

Statistical methods for analysis of radiation effects with tumor and dose location-specific information with application to the WECARE study of asynchronous contralateral breast cancer

PubMed Central

Langholz, Bryan; Thomas, Duncan C.; Stovall, Marilyn; Smith, Susan A.; Boice, John D.; Shore, Roy E.; Bernstein, Leslie; Lynch, Charles F.; Zhang, Xinbo; Bernstein, Jonine L.

2009-01-01

Summary Methods for the analysis of individually matched case-control studies with location-specific radiation dose and tumor location information are described. These include likelihood methods for analyses that just use cases with precise location of tumor information and methods that also include cases with imprecise tumor location information. The theory establishes that each of these likelihood based methods estimates the same radiation rate ratio parameters, within the context of the appropriate model for location and subject level covariate effects. The underlying assumptions are characterized and the potential strengths and limitations of each method are described. The methods are illustrated and compared using the WECARE study of radiation and asynchronous contralateral breast cancer. PMID:18647297

Photoelectrical, photophysical and photocatalytic properties of Al based MOFs: MIL-53(Al) and MIL-53-NH{sub 2}(Al)

DOE Office of Scientific and Technical Information (OSTI.GOV)

An, Yang; Li, Huiliang; Liu, Yuanyuan, E-mail: yyliu@sdu.edu.cn

Two Al based MOFs (MIL-53(Al) and MIL-53-NH{sub 2} (Al)) were synthesized, and their photoelectrical, photophysical and photocatalytic properties towards oxygen evolution from water were investigated. Different from the ligand to metal charge transfer process previously reported, we proposes a new photocatalytic mechanism based on electron tunneling according to the results of theoretical calculation, steady state and time resolved fluorescence spectra. The organic linkers absorb photons, giving rise to electrons and holes. Then, the photogenerated electrons tunnel through the AlO{sub 6}-octahedra, which not only inhibit the recombination of photogenerated charge carriers, but also is a key factor to the photocatalytic activitymore » of Al based MOFs. - Graphical abstract: The photoelectrical, photophysical and photocatalytic properties towards oxygen evolution from water of two Al based MOFs were investigated. A new photocatalytic mechanism was proposed based on electron tunneling according to the results of both theoretical calculation and steady state, time resolved fluorescence spectra. The electron tunneling process not only inhibit the recombination of photogenerated charge carriers, but also is a key factor to the photocatalytic activity of Al based MOFs.« less

Hormone receptor status of contralateral breast cancers: analysis of data from the US SEER population-based registries.

PubMed

Mezencev, Roman; Švajdler, Marián

2017-05-01

Women diagnosed with breast cancer display higher propensity to develop second primary cancer in the contralateral breast (CBC). Identification of patients with increased risk of CBC and understanding relationships between hormone receptor (HR) statuses of the first and second breast cancers is desirable for endocrine-based prevention strategies. Using 1992-2012 data from 13 SEER registries, the risk of developing CBC was determined as ratio of observed and expected second breast cancers (SIR). Association between HR statuses was examined by exploratory data analysis and multivariable logistic regression. Women with ER-positive and ER-negative breast cancers have increased risk of developing CBC with SIR values 2.09 (CI 95 = 1.97-2.21) and 2.40 (CI 95 = 2.18-2.63), respectively. ER statuses of the CBC are moderately positively associated. In metachronous CBC, most cases with ER-positive first cancers had ER-positive second breast cancers (81.6 %; CI 95 = 80.2-82.9 %); however, considerable proportion of cases with ER-negative first cancers had ER-positive second cancers (48.8 %; CI 95 = 46.2-51.4 %). Some women with ER-negative breast cancers may benefit from endocrine-based prevention of ER-positive CBC.

Oxidation of Al2O3 continuous fiber-reinforced/NiAl composites

NASA Technical Reports Server (NTRS)

Doychak, J.; Nesbitt, J. A.; Noebe, R. D.; Bowman, R. R.

1992-01-01

The 1200 C and 1300 C isothermal and cyclic oxidation behavior of Al2O3 continuous fiber-reinforced/NiAl composites were studied. Oxidation resulted in formation of Al2O3 external scales in a similar manner as scales formed on monolithic NiAl. The isothermal oxidation of an Al2O3/NiAl composite resulted in oxidation of the matrix along the fiber/matrix interface near the fiber ends. This oxide acted as a wedge between the fiber and the matrix, and, under cyclic oxidation conditions, led to further oxidation along the fiber lengths and eventual cracking of the composite. The oxidation behavior of composites in which the Al2O3 fibers were sputter coated with nickel prior to processing was much more severe. This was attributed to open channels around the fibers which formed during processing, most likely as a result of the diffusion of the nickel coating into the matrix.

Structure of oxides prepared by decomposition of layered double Mg–Al and Ni–Al hydroxides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cherepanova, Svetlana V.; Novosibirsk State University, Novosibirsk; Leont’eva, Natalya N., E-mail: n_n_leonteva@list.ru

2015-05-15

Abstracts: Thermal decomposition of Mg–Al and Ni–Al layered double hydroxides LDH at temperatures lower than 800 °C leads to the formation of oxides with different structures. Mg–Al oxide has a very defective structure and consists of octahedral layers as in periclase MgO and mixed octahedral–tetrahedral layers as in spinel MgAl{sub 2}O{sub 4}. Mixed Ni–Al oxide has a sandwich-like structure, consisting of a core with Al-doped NiO-like structure and some surface layers with spinel NiAl{sub 2}O{sub 4} structure epitaxial connected with the core. Suggested models were verified by simulation of X-ray diffraction patterns using DIFFaX code, as well as HRTEM, IR-,more » UV-spectroscopies, and XPS. - Graphical abstract: In the Mg–Al layered double hydroxide Al{sup 3+} ions migrate into interlayers during decomposition. The Mg–Al oxide represents sequence of octahedral and octahedral–tetrahedral spinel layers with vacancies. The Ni–Al oxide has a sandwich-like structure with NiO-like core and surface spinel layers as a result of migration of Al{sup 3+} ions on the surface. The models explain the presence and absence of “memory effect” for the Mg–Al and Ni–Al oxides, respectively. - Highlights: • We study products of Mg(Ni)–Al LDH decomposition by calcination at 500(400)–800 °C. • In Mg–Al/Ni–Al LDH Al ions migrate into interlayers/on the surface during decomposition. • Mg–Al oxide represents sequence of periclase- and spinel-like layers with vacancies. • Ni–Al oxide has a sandwich-like structure with NiO-like core and surface spinel layers. • The models explain the presence/absence of “memory effect” for Mg–Al/Ni–Al oxides.« less

Molecular structure of Mg-Al, Mn-Al and Zn-Al halotrichites-type double sulfates--an infrared spectroscopic study.

PubMed

Palmer, Sara J; Frost, Ray L

2011-05-01

Near infrared (NIR), X-ray diffraction (XRD) and infrared (IR) spectroscopy have been applied to halotrichites of the formula MgAl(2)(SO(4))(4)·22H(2)O, MnAl(2)(SO(4))(4)·22H(2)O and ZnAl(2)(SO(4))(4)·22H(2)O. Comparison of the halotrichites in different spectral regions has shown that the incorporation of a divalent transition metal into the halotrichite structure causes a shift in OH stretching band positions to lower wavenumbers. Therefore, an increase of the hydrogen bond strength of the bonded water is observed for divalent cations with a larger molecular mass. XRD has confirmed the formation of halotrichite for all three samples and characteristic peaks of halotrichite have been identified for each halotrichite-type compound. It has been observed that Mg-Al and Mn-Al halotrichite are very similar in structure, while Zn-Al showed several differences particularly in the NIR spectra. This work has shown that compounds with halotrichite structures can be synthesised and characterised by infrared and NIR spectroscopy. Copyright © 2011 Elsevier B.V. All rights reserved.

Mechanisms of elevated-temperature deformation in the B2 aluminides NiAl and CoAl

NASA Technical Reports Server (NTRS)

Yaney, D. L.; Nix, W. D.

1988-01-01

A strain rate change technique, developed previously for distinguishing between pure-metal and alloy-type creep behavior, was used to study the elevated-temperature deformation behavior of the intermetallic compounds NiAl and CoAl. Tests on NiAl were conducted at temperatures between 1100 and 1300 K while tests on CoAl were performed at temperatures ranging from 1200 to 1400 K. NiAl exhibits pure-metal type behavior over the entire temperature range studied. CoAl, however, undergoes a transition from pure-metal to alloy-type deformation behavior as the temperature is decreased from 1400 to 1200 K. Slip appears to be inherently more difficult in CoAl than in NiAl, with lattice friction effects limiting the mobility of dislocations at a much higher tmeperature in CoAl than in NiAl. The superior strength of CoAl at elevated temperatures may, therefore, be related to a greater lattice friction strengthening effect in CoAl than in NiAl.

CVD Fiber Coatings for Al2O3/NiAl Composites

NASA Technical Reports Server (NTRS)

Boss, Daniel E.

1995-01-01

While sapphire-fiber-reinforced nickel aluminide (Al2O3/NiAl) composites are an attractive candidate for high-temperature structures, the significant difference in the coefficient of thermal expansion between the NiAl matrix and the sapphire fiber creates substantial residual stresses in the composite. This study seeks to produce two fiber-coating systems with the potential to reduce the residual stresses in the sapphire/NiAl composite system. Chemical vapor deposition (CVD) was used to produce both the compensating and compliant-fiber coatings for use in sapphire/NiAl composites. A special reactor was designed and built to produce the FGM and to handle the toxic nickel precursors. This process was successfully used to produce 500-foot lengths of fiber with coating thicknesses of approximately 3 microns, 5 microns, and 10 microns.

Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients with Early-Stage Breast Cancer

PubMed Central

Jagsi, Reshma; Hawley, Sarah T.; Griffith, Kent A.; Janz, Nancy K.; Kurian, Allison W.; Ward, Kevin C.; Hamilton, Ann S.; Morrow, Monica; Katz, Steven J.

2017-01-01

Importance Contralateral prophylactic mastectomy (CPM) use is increasing among women with unilateral breast cancer, but little is known about treatment decision making or physician interactions in diverse patient populations. Objective To evaluate patient motivations, knowledge, and decisions, as well as the impact of surgeon recommendations, in a large, diverse sample of patients who underwent recent treatment for breast cancer. Design/Setting/Participants A survey was sent to 3631 women with newly diagnosed, unilateral stage 0, I, or II breast cancer between July 2013 and September 2014. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. Logistic and multinomial logistic regression of the data were conducted to identify factors associated with (1) CPM vs all other treatments combined, 2) CPM vs unilateral mastectomy (UM), and (3) CPM vs breast-conserving surgery (BCS). Associations between CPM receipt and surgeon recommendations were also evaluated. All statistical models and summary estimates were weighted to be representative of the target population. Main Outcome and Measures Receipt of CPM was the primary dependent variable for analysis and was measured by a woman’s self-report of her treatment. Results Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. The mean (SD) age was 61.8 (12) years at the time of the survey. Overall, 1301 (43.9%) patients considered CPM (601[24.8%] considered it very strongly or strongly; only 395 (38.1%) of them knew that CPM does not improve survival for all women with breast cancer. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received

Study on Mg/Al Weld Seam Based on Zn–Mg–Al Ternary Alloy

PubMed Central

Liu, Liming; Liu, Fei; Zhu, Meili

2014-01-01

Based on the idea of alloying welding seams, a series of Zn–xAl filler metals was calculated and designed for joining Mg/Al dissimilar metals by gas tungsten arc (GTA) welding. An infrared thermography system was used to measure the temperature of the welding pool during the welding process to investigate the solidification process. It was found that the mechanical properties of the welded joints were improved with the increasing of the Al content in the Zn–xAl filler metals, and when Zn–30Al was used as the filler metal, the ultimate tensile strength could reach a maximum of 120 MPa. The reason for the average tensile strength of the joint increasing was that the weak zone of the joint using Zn–30Al filler metal was generated primarily by α-Al instead of MgZn2. When Zn–40Al was used as the filler metal, a new transition zone, about 20 μm-wide, appeared in the edge of the fusion zone near the Mg base metal. Due to the transition zones consisting of MgZn2- and Al-based solid solution, the mechanical property of the joints was deteriorated. PMID:28788508

Chemical failure modes of AlQ3-based OLEDs: AlQ3 hydrolysis.

PubMed

Knox, John E; Halls, Mathew D; Hratchian, Hrant P; Schlegel, H Bernhard

2006-03-28

Tris(8-hydroxyquinoline)aluminum(III), AlQ3, is used in organic light-emitting diodes (OLEDs) as an electron-transport material and emitting layer. The reaction of AlQ3 with trace H2O has been implicated as a major failure pathway for AlQ3-based OLEDs. Hybrid density functional calculations have been carried out to characterize the hydrolysis of AlQ3. The thermochemical and atomistic details for this important reaction are reported for both the neutral and oxidized AlQ3/AlQ3+ systems. In support of experimental conclusions, the neutral hydrolysis reaction pathway is found to be a thermally activated process, having a classical barrier height of 24.2 kcal mol(-1). First-principles infrared and electronic absorption spectra are compared to further characterize AlQ3 and the hydrolysis pathway product, AlQ2OH. The activation energy for the cationic AlQ3 hydrolysis pathway is found to be 8.5 kcal mol(-1) lower than for the neutral reaction, which is significant since it suggests a role for charge imbalance in promoting chemical failure modes in OLED devices.

Optical, structural, and nuclear scientific studies of AlGaN with high Al composition

NASA Astrophysics Data System (ADS)

Lin, Tse Yang; Chung, Yee Ling; Li, Lin; Yao, Shude; Lee, Y. C.; Feng, Zhe Chuan; Ferguson, Ian T.; Lu, Weijie

2010-08-01

AlGaN epilayers with higher Al-compositions were grown by Metalorganic Chemical Vapor Deposition (MOCVD) on (0001) sapphire. Trimethylgallium (TMGa), trimethylaluminium (TMAl) and NH3 were used as the source precursors for Ga, Al, and N, respectively. A 25 nm AlN nucleation layer was first grown at low-temperature of 590 °C at 300 Torr. Followed, AlxGa1-xN layers were grown at 1080 °C on low-temperature AlN nucleation layers. The heterostructures were characterized by a series of techniques, including x-ray diffraction (XRD), Rutherford backscattering (RBS), photoluminescence (PL), scanning electron microscopy (SEM) and Raman scattering. Precise Al compositions were determined through XRD, RBS, and SEM combined measurements. Room Temperature Raman Scattering spectra shows three major bands from AlGaN alloys, which are AlN-like, A1 longitudinal optical (LO) phonon modes, and E2 transverse optical (TO) band, respectively, plus several peak comes from the substrate. Raman spectral line shape analysis lead to an optical determination of the electrical property free carrier concentration of AlGaN. The optical properties of AlGaN with high Al composition were presented here.

Epitaxial growth of Al9Ir2 intermetallic compound on Al(100): Mechanism and interface structure

NASA Astrophysics Data System (ADS)

Kadok, J.; Pussi, K.; Šturm, S.; Ambrožič, B.; Gaudry, É.; de Weerd, M.-C.; Fournée, V.; Ledieu, J.

2018-04-01

The adsorption of Ir adatoms on Al(100) has been investigated under various exposures and temperature conditions. The experimental and theoretical results reveal a diffusion of Ir adatoms within the Al(100) surface selvedge already at 300 K. Above 593 K, two domains of a (√{5 }×√{5 }) R 26 .6∘ phase are identified by low energy electron diffraction (LEED) and scanning tunneling microscopy measurements. This phase corresponds to the initial growth of an Al9Ir2 compound at the Al(100) surface. The Al9Ir2 intermetallic domains are terminated by bulklike pure Al layers. The structural stability of Al9Ir2 (001) grown on Al(100) has been analyzed by density functional theory based calculations. Dynamical LEED analysis is consistent with an Ir adsorption leading to the growth of an Al9Ir2 intermetallic compound. We propose that the epitaxial relationship Al9Ir2(001 ) ∥Al (100) and Al9Ir2[100 ] ∥Al [031 ]/[013 ] originates from a matching of Al atomic arrangements present both on Al(100) and on pure Al(001) layers present in the Al9Ir2 compound. Finally, the interface between Al9Ir2 precipitates and the Al matrix has been characterized by transmission electron microscopy measurements. The cross-sectional observations are consistent with the formation of Al9Ir2 (001) compounds. These measurements indicate an important Ir diffusion within Al(100) near the surface region. The coherent interface between Al9Ir2 and the Al matrix is sharp.

Formation of gamma(sup prime)-Ni3Al via the Peritectoid Reaction: gamma + beta (+ Al2O3)=gamma(sup prime)(+ Al2O3)

NASA Technical Reports Server (NTRS)

Copeland, Evan

2008-01-01

The activities of Al and Ni were measured using multi-cell Knudsen effusion-cell mass spectrometry (multi-cell KEMS), over the composition range 8-32 at.%Al and temperature range T=1400-1750 K in the Ni-Al-O system. These measurements establish that equilibrium solidification of gamma(sup prime)-Ni3Al-containing alloys occurs by the eutectic reaction, L (+ Al2O3)=gamma + Beta(+ Al2O3), at 1640 +/- 1 K and a liquid composition of 24.8 +/- 0.2 at.%al (at an unknown oxygen content). The {gamma + Beta (+Al2O3} phase field is stable over the temperature range 1633-1640 K, and gamma(sup prime)-Ni3Al forms via the peritectoid, gamma + Beta (+ Al2O3)=gamma(sup prime) (+ Al2O3), at 1633 +/- 1 K. This behavior is consistent with the current Ni-Al phase diagram and a new diagram is proposed. This new Ni-Al phase diagram explains a number of unusual steady-state solidification structures reported previously and provides a much simpler reaction scheme in the vicinity of the gamma(sup prime)-Ni2Al phase field.

Chemical trend of superconducting transition temperature in hole-doped delafossite of CuAlO2, AgAlO2 and AuAlO2

NASA Astrophysics Data System (ADS)

Nakanishi, Akitaka; Katayama-Yoshida, Hiroshi

2012-12-01

We have performed the first-principles calculations about the superconducting transition temperature Tc of hole-doped delafossite CuAlO2, AgAlO2 and AuAlO2. Calculated Tc are about 50 K (CuAlO2), 40 K (AgAlO2) and 3 K(AuAlO2) at maximum in the optimum hole-doping concentration. The low Tc of AuAlO2 is attributed to the weak electron-phonon interaction caused by the low covalency and heavy atomic mass.

Contralateral Anterior Interhemispheric Transparaterminal Gyrus Approach for Thalamopeduncular Pilocytic Astrocytoma in an Adult: Technical Report.

PubMed

Kumar, Amandeep; Sharma, Raghavendra; Garg, Ajay; Sharma, Bhawani S

2016-03-01

Thalamopeduncular gliomas arise at the junction of the thalamus and cerebral peduncle and constitute a subgroup of thalamic gliomas. These are surgically challenging lesions because of close proximity to important neural structures including corticospinal tracts (CSTs) and the thalamus. These tumors usually displace CSTs anterolaterally or extend to the lateral ventricular surface. Such tumors can be removed by either temporal or transventricular approaches. However, if CSTs cover the entire lateral surface of tumor and tumor does not extend to the ventricular surface, temporal and transventricular approaches cannot be used because the trajectories of both approaches would pass through normal eloquent structures (CSTs and thalamus), and consequently there would be a very high risk of postoperative neurologic deficits developing. A 50-year-old woman presented with contralateral hemiparesis. Radiologic evaluation revealed a right Thalamopeduncular glioma that displaced CSTs laterally and was covered by normal thalamus superiorly. Some CST fibers passed through the tumor. Because both lateral and superior surfaces were covered by eloquent structures, we used an anterior interhemispheric transparaterminal gyrus approach to access the tumor successfully and achieved subtotal excision. The patient had transient neurologic deterioration postoperatively that recovered to preoperative level within 2 weeks. The anterior interhemispheric transparaterminal gyrus approach has not been described previously for accessing brainstem lesions. This approach can be used to access tumors of the cerebral peduncle that displace CSTs laterally and are covered by normal thalamus superiorly. The anterior interhemispheric transparaterminal gyrus approach adds to the armamentarium of neurosurgeons for treatment of cerebral peduncular lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

Atomistic simulation of Al-graphene thin film growth on polycrystalline Al substrate

NASA Astrophysics Data System (ADS)

Zhang, Lan; Zhu, Yongchao; Li, Na; Rong, Yan; Xia, Huimin; Ma, Huizhong

2018-03-01

The growth of Al-Graphene composite coatings on polycrystalline Al substrate was investigated by using classical molecular dynamics (MD) simulations. Unlike the diffusion behaviors on single crystal surface, most of adatoms were easily bound by the steps on polycrystalline Al surface, owing to the local accelerated energy. Both Ehrlich-Schwoebel (ES) barriers and the steering effect backed up the volmer-weber growth mode, which was consistent with the dynamic growth process observed in the deposit. The morphology of composite coatings was significantly affected by graphene flakes. Enrichment of graphene flakes gave rise to an increase of the local thickness, and graphene flakes only existed in Al grain boundaries. The size of Al grains in the composite coating visibly decreased when compared with that in the pure Al coating. This grain refinement and the mechanical property can be reinforced by the increase of graphene flakes.

Insulator-semiconductor interface fixed charges in AlGaN/GaN metal-insulator-semiconductor devices with Al2O3 or AlTiO gate dielectrics

NASA Astrophysics Data System (ADS)

Le, Son Phuong; Nguyen, Duong Dai; Suzuki, Toshi-kazu

2018-01-01

We have investigated insulator-semiconductor interface fixed charges in AlGaN/GaN metal-insulator-semiconductor (MIS) devices with Al2O3 or AlTiO (an alloy of Al2O3 and TiO2) gate dielectrics obtained by atomic layer deposition on AlGaN. Analyzing insulator-thickness dependences of threshold voltages for the MIS devices, we evaluated positive interface fixed charges, whose density at the AlTiO/AlGaN interface is significantly lower than that at the Al2O3/AlGaN interface. This and a higher dielectric constant of AlTiO lead to rather shallower threshold voltages for the AlTiO gate dielectric than for Al2O3. The lower interface fixed charge density also leads to the fact that the two-dimensional electron concentration is a decreasing function of the insulator thickness for AlTiO, whereas being an increasing function for Al2O3. Moreover, we discuss the relationship between the interface fixed charges and interface states. From the conductance method, it is shown that the interface state densities are very similar at the Al2O3/AlGaN and AlTiO/AlGaN interfaces. Therefore, we consider that the lower AlTiO/AlGaN interface fixed charge density is not owing to electrons trapped at deep interface states compensating the positive fixed charges and can be attributed to a lower density of oxygen-related interface donors.

Effects of Al(III) and Nano-Al13 Species on Malate Dehydrogenase Activity

PubMed Central

Yang, Xiaodi; Cai, Ling; Peng, Yu; Li, Huihui; Chen, Rong Fu; Shen, Ren Fang

2011-01-01

The effects of different aluminum species on malate dehydrogenase (MDH) activity were investigated by monitoring amperometric i-t curves for the oxidation of NADH at low overpotential using a functionalized multi-wall nanotube (MWNT) modified glass carbon electrode (GCE). The results showed that Al(III) and Al13 can activate the enzymatic activity of MDH, and the activation reaches maximum levels as the Al(III) and Al13 concentration increase. Our study also found that the effects of Al(III) and Al13 on the activity of MDH depended on the pH value and aluminum speciation. Electrochemical and circular dichroism spectra methods were applied to study the effects of nano-sized aluminum compounds on biomolecules. PMID:22163924

Effects of Al(III) and nano-Al13 species on malate dehydrogenase activity.

PubMed

Yang, Xiaodi; Cai, Ling; Peng, Yu; Li, Huihui; Chen, Rong Fu; Shen, Ren Fang

2011-01-01

The effects of different aluminum species on malate dehydrogenase (MDH) activity were investigated by monitoring amperometric i-t curves for the oxidation of NADH at low overpotential using a functionalized multi-wall nanotube (MWNT) modified glass carbon electrode (GCE). The results showed that Al(III) and Al(13) can activate the enzymatic activity of MDH, and the activation reaches maximum levels as the Al(III) and Al(13) concentration increase. Our study also found that the effects of Al(III) and Al(13) on the activity of MDH depended on the pH value and aluminum speciation. Electrochemical and circular dichroism spectra methods were applied to study the effects of nano-sized aluminum compounds on biomolecules.

26Al- 26Mg and 207Pb- 206Pb systematics of Allende CAIs: Canonical solar initial 26Al/ 27Al ratio reinstated

NASA Astrophysics Data System (ADS)

Jacobsen, Benjamin; Yin, Qing-zhu; Moynier, Frederic; Amelin, Yuri; Krot, Alexander N.; Nagashima, Kazuhide; Hutcheon, Ian D.; Palme, Herbert

2008-07-01

The precise knowledge of the initial 26Al/ 27Al ratio [( 26Al/ 27Al) 0] is crucial if we are to use the very first solid objects formed in our Solar System, calcium-aluminum-rich inclusions (CAIs) as the "time zero" age-anchor and guide future work with other short-lived radio-chronometers in the early Solar System, as well as determining the inventory of heat budgets from radioactivities for early planetary differentiation. New high-precision multi-collector inductively-coupled plasma mass spectrometry (MC-ICP-MS) measurements of 27Al/ 24Mg ratios and Mg-isotopic compositions of nine whole-rock CAIs (six mineralogically characterized fragments and three micro-drilled inclusions) from the CV carbonaceous chondrite, Allende yield a well-defined 26Al- 26Mg fossil isochron with an ( 26Al/ 27Al) 0 of (5.23 ± 0.13) × 10 - 5 . Internal mineral isochrons obtained for three of these CAIs ( A44A, AJEF, and A43) are consistent with the whole-rock CAI isochron. The mineral isochron of AJEF with ( 26Al/ 27Al) 0 = (4.96 ± 0.25) × 10 - 5 , anchored to our precisely determined absolute 207Pb- 206Pb age of 4567.60 ± 0.36 Ma for the same mineral separates, reinstate the "canonical" ( 26Al/ 27Al) 0 of 5 × 10 - 5 for the early Solar System. The uncertainty in ( 26Al/ 27Al) 0 corresponds to a maximum time span of ± 20 Ka (thousand years), suggesting that the Allende CAI formation events were culminated within this time span. Although all Allende CAIs studied experienced multistage formation history, including melting and evaporation in the solar nebula and post-crystallization alteration likely on the asteroidal parent body, the 26Al- 26Mg and U-Pb-isotopic systematics of the mineral separates and bulk CAIs behaved largely as closed-system since their formation. Our data do not support the "supra-canonical" 26Al/ 27Al ratio of individual minerals or their mixtures in CV CAIs, suggesting that the supra-canonical 26Al/ 27Al ratio in the CV CAIs may have resulted from post

Fracture toughness of Ti-Al3Ti-Al-Al3Ti laminate composites under static and cyclic loading conditions

NASA Astrophysics Data System (ADS)

Patselov, A. M.; Gladkovskii, S. V.; Lavrikov, R. D.; Kamantsev, I. S.

2015-10-01

The static and cyclic fracture toughnesses of a Ti-Al3Ti-Al-Al3Ti laminate composite material containing at most 15 vol % intermetallic compound are studied. Composite specimens are prepared by terminating reaction sintering of titanium and aluminum foils under pressure. The fracture of the titanium layers is quasi-cleavage during cyclic crack growth and is ductile during subsequent static loading.

Co-existence of a few and sub micron inhomogeneities in Al-rich AlGaN/AlN quantum wells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iwata, Yoshiya; Oto, Takao; Banal, Ryan G.

2015-03-21

Inhomogeneity in Al-rich AlGaN/AlN quantum wells is directly observed using our custom-built confocal microscopy photoluminescence (μ-PL) apparatus with a reflective system. The μ-PL system can reach the AlN bandgap in the deep ultra-violet spectral range with a spatial resolution of 1.8 μm. In addition, cathodoluminescence (CL) measurements with a higher spatial resolution of about 100 nm are performed. A comparison of the μ-PL and CL measurements reveals that inhomogeneities, which have different spatial distributions of a few- and sub-micron scales that are superimposed, play key roles in determining the optical properties.

Aluminium (Al) speciation in serum and urine after subcutaneous venom immunotherapy with Al as adjuvant.

PubMed

Michalke, Bernhard; Kramer, Matthias F; Brehler, Randolf

2018-02-21

Aluminium is associated with disorders and is the commonly used vaccine adjuvant. Understanding the mechanisms of how Al is transported, metabolized or of its toxicity depends on the knowledge of Al-interactions with bioligands, i.e. Al-species. Al-speciation in serum is difficult because of low concentration and the risk of exogenous Al contamination. Furthermore, Al-measurements may be hampered according to various interferences. This study aims for developing quality controlled protocols for reliable Al- and Al-species determination and for investigating probable differences in Al (-speciation) after Al-containing subcutaneous immunotherapy (SIT). Sample donors were recruited either for the control group ("class-0", they never had been treated with SIT containing an Al-depot extract) or for the SIT-group ("class-1", they previously had been treated with SIT for insect venom allergy with an Al-depot extract). Blood was drawn for medical reasons and serum prepared. Additionally, some sample donors collected 24-h-urine. They had been informed (and they consented) about the scientific use of their samples. The study was approved by the ethic committee of the "Medical Association Westphalia-Lippe" and of the University of Münster, evaluating the study positively (No. 2013-667-f-S). We applied quality controlled sample preparation and interference-free Al detection by ICP sectorfield-mass spectrometry. Al-species were analysed using size-exclusion-chromatography-ICP-qMS. Al-concentrations or speciation in urine samples showed no differences between class-0 and class-1. Al-citrate was the main uric Al-species. In serum elevated Al-concentrations were found for both classes, with class-1 samples being significantly higher than class-0 (p = 0.041), but class-0 samples being approximately 10-fold too high compared to reference values from non-exposed persons. We identified gel-monovettes as contamination source. In contamination-free samples from HNO 3 -prewashed gel

Synthesis of core-shell AlOOH hollow nanospheres by reacting Al nanoparticles with water

NASA Astrophysics Data System (ADS)

Lozhkomoev, A. S.; Glazkova, E. A.; Bakina, O. V.; Lerner, M. I.; Gotman, I.; Gutmanas, E. Y.; Kazantsev, S. O.; Psakhie, S. G.

2016-05-01

A novel route for the synthesis of boehmite nanospheres with a hollow core and the shell composed of highly crumpled AlOOH nanosheets by oxidizing Al nanopowder in pure water under mild processing conditions is described. The stepwise events of Al transformation into boehmite are followed by monitoring the pH in the reaction medium. A mechanism of formation of hollow AlOOH nanospheres with a well-defined shape and crystallinity is proposed which includes the hydration of the Al oxide passivation layer, local corrosion of metallic Al accompanied by hydrogen evolution, the rupture of the protective layer, the dissolution of Al from the particle interior and the deposition of AlOOH nanosheets on the outer surface. In contrast to previously reported methods of boehmite nanoparticle synthesis, the proposed method is simple, and environmentally friendly and allows the generation of hydrogen gas as a by-product. Due to their high surface area and high, slit-shaped nanoporosity, the synthesized AlOOH nanostructures hold promise for the development of more effective catalysts, adsorbents, vaccines and drug carriers.

Millimeter distance effects of surface plasmon polaritons in electroformed Al-Al2O3-Ag diodes

NASA Astrophysics Data System (ADS)

Hickmott, T. W.

2017-02-01

Electroforming of metal-insulator-metal diodes is a soft dielectric breakdown that changes the high resistance of as-prepared diodes to a low resistance state. Electroforming of Al-Al2O3-metal diodes with anodic Al2O3 results in voltage-controlled negative resistance in the current-voltage (I-V) characteristics, electroluminescence (EL), and electron emission into vacuum (EM). EL is due to electrons injected at the Al-Al2O3 interface combining with radiative defects in Al2O3. Surface plasmon polaritons (SPPs) are electromagnetic waves that can be excited by photons or electrons. SPPs are confined to a metal-dielectric interface, cause large electric fields in the metal and dielectric, and have ranges of micrometers. The temperature dependence of I-V curves, EL, and EM of a group of electroformed Al-Al2O3-Ag diodes with Al2O3 thicknesses between 12 nm and 20 nm, group A, was measured between 200 K and 300 K. After a sequence of temperature measurements, the Al-Al2O3-Ag diodes, the Al-Al2O3 regions between diodes, and portions of the Ag on the glass region that provides contacts to the diodes are darkened. The range of darkening is >7 mm in a diode with 12 nm of Al2O3 and 2.0-3.5 mm in diodes with Al2O3 thicknesses between 14 nm and 20 nm. Darkening is attributed to the occurrence of SPPs generated by EL photons at the Ag-Al2O3 and Al-Al2O3 interfaces. The results are compared to a second group of Al-Al2O3-Ag diodes with identical Al2O3 thicknesses, group B, that were prepared in the same way as the diodes of group A except for a difference in the deposition of Al films for the two groups. Al-Al2O3-Ag diodes of group B exhibit enhanced EL, which is attributed to spontaneous emission of recombination centers in Al2O3 being enhanced by large electromagnetic fields that are due to SPPs that are generated by EL photons.

Electronic transport through Al/InN nanowire/Al junctions

DOE PAGES

Lu, Tzu -Ming; Wang, George T.; Pan, Wei; ...

2016-02-10

We report non-linear electronic transport measurement of Al/Si-doped n-type InN nanowire/Al junctions performed at T = 0.3 K, below the superconducting transition temperature of the Al electrodes. The proximity effect is observed in these devices through a strong dip in resistance at zero bias. In addition to the resistance dip at zero bias, several resistance peaks can be identified at bias voltages above the superconducting gap of the electrodes, while no resistance dip is observed at the superconducting gap. The resistance peaks disappear as the Al electrodes turn normal beyond the critical magnetic field except one which remains visible atmore » fields several times higher than critical magnetic field. An unexpected non-monotonic magnetic field dependence of the peak position is observed. As a result, we discuss the physical origin of these observations and propose that the resistance peaks could be the McMillan-Rowell oscillations arising from different closed paths localized near different regions of the junctions.« less

PubMed

Beas, Renato; Anduaga-Beramendi, Alexander; Maticorena-Quevedo, Jesus; Mayta-Tristán, Percy

2018-03-26

Objetivo: Identificar los factores asociados al Síndrome de Burnout (SB) en trabajadores de salud del Perú en el año 2014.Métodos: Estudio transversal analítico mediante un análisis secundario de la Encuesta Nacional de Usuarios de Salud del año 2014 en Perú. El SB fue medido mediante el Maslach Burnout Inventory - Human Services Survey (MBI-HSS). Se realizó un análisis descriptivo, también un análisis bivariado y multivariado calculando los valores de p y los OR crudos y ajustados mediante Regresión Logística.Resultados: La prevalencia del SB en los profesionales de la salud fue 2,8%, encontrándose asociadas las variables: género, tiempo en el sector salud, horas de trabajo e ingreso mensual total.Conclusiones: Se encontró que los factores asociados al SB en el personal de Perú en el año 2014 fueron el género, el tiempo en el sector salud, las horas de trabajo y el ingreso mensual total.

Rechargeable Al/Cl2 battery with molten AlCl4/-/ electrolyte.

NASA Technical Reports Server (NTRS)

Holleck, G. L.; Giner, J.; Burrows, B.

1972-01-01

A molten salt system based on Al- and Cl2 carbon electrodes, with an AlCl3 alkali chloride eutectic as electrolyte, offers promise as a rechargeable, high energy density battery which can operate at a relatively low temperature. Electrode kinetic studies showed that the electrode reactions at the Al anode were rapid and that the observed passivation phenomena were due to the formation at the electrode surface of a solid salt layer resulting from concentration changes on anodic or cathodic current flow. It was established that carbon electrodes were intrinsically active for chlorine reduction in AlCl3-alkali chloride melts. By means of a rotating vitreous carbon disk electrode, the kinetic parameters were determined.

Two-Phase Eutectic Growth in Al-Cu and Al-Cu-Ag

NASA Astrophysics Data System (ADS)

Senninger, Oriane; Peters, Matthew; Voorhees, Peter W.

2018-02-01

The microstructure developed by two-phase lamellar eutectics (α ) -(θ {-Al}2{Cu}) in Al-Cu and Al-Cu-Ag alloys is analyzed. A model of two-phase eutectic growth in multicomponent alloys is used to determine the scaling law of the eutectic microstructure using the alloy thermophysical properties. The application of the model to these alloys shows that the addition of Ag to Al-Cu alloys does not significantly change the length scale of the microstructure, which is in agreement with previous experimental studies. This is explained by the combined phenomena of the decrease in interface energies with the addition of Ag and the superheating of the (α ) phase interface induced by the Ag composition profile.

Defining the Relationship between Patient Decisions to Undergo Breast Reconstruction and Contralateral Prophylactic Mastectomy

PubMed Central

Agarwal, Shailesh; Kidwell, Kelley M.; Kraft, Casey T.; Kozlow, Jeffrey H.; Sabel, Michael S.; Chung, Kevin C.; Momoh, Adeyiza O.

2016-01-01

BACKGROUND Recent studies suggest that the decision to undergo breast reconstruction and contralateral prophylactic mastectomy (CPM) are closely related. Here we describe the relationship between method of reconstruction and decision to undergo CPM. We also evaluate recent trends in CPM use in the context of literature questioning its oncologic benefit. STUDY DESIGN Female patients with unilateral breast cancer were identified and data extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 through 2010. Logistic regression analyses were performed to study the relationship between having CPM and key demographic, oncologic and reconstructive factors among women with unilateral breast cancer. RESULTS A total of 157,042 patients with unilateral breast cancer were included. CPM rate increased from 7.7% to 28.3% during the study period, and the proportion of reconstructed patients who underwent CPM increased from 19% to 46%. Reconstruction was associated with higher odds of CPM (odds ratio (OR) 2.79, 95% CI 2.70-2.88, p<0.0001) after controlling for oncologic and demographic factors. Among women who had reconstruction, implant-based reconstruction was associated with significantly higher odds of CPM than autologous tissue reconstruction (OR 1.38, p<0.0001). Over the study period Implant reconstruction rates increased from 28.2% to 43.5% while autologous reconstruction rates decreased from 32.2% to 27.3% in CPM patients. CONCLUSIONS The frequency of CPM continues to increase in spite of literature questioning its oncologic benefit. Our study confirms that reconstruction and the decision to undergo CPM are closely related, with implant reconstruction dominating in patients who undergo CPM. Given the relationship between reconstruction and the choice for CPM, plastic surgeons should play an active role in educating patients to avoid decisions made based on inaccurate information. PMID:25719688

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis: A Randomized Trial

PubMed Central

Knutson, Jayme S.; Gunzler, Douglas D.; Wilson, Richard D.; Chae, John

2016-01-01

Background and Purpose It is unknown whether one method of neuromuscular stimulation for post-stroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) to cyclic neuromuscular electrical stimulation (cNMES). Methods Stroke patients with chronic (> 6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/week of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the lab over 12 weeks. The task practice for the CCFES group was stimulation-assisted. The primary outcome was change in Box and Blocks Test (BBT) score at 6-months post-treatment. Upper extremity Fugl-Meyer (UEFM) and Arm Motor Abilities Test (AMAT) were also measured. Results At 6-months post-treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% CI: 2.2, 7.0), than the cNMES group, 1.8 (95% CI: 0.6, 3.0); between-group difference, 2.8 (95% CI: 0.1, 5.5), p=0.045. No significant between-group difference was found for the UEFM (p=.888) or AMAT (p=.096). Participants who had the largest improvements on BBT were less than two years post-stroke with moderate (i.e., not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI: 5.6, 13.6), were greater than those of the cNMES group, 4.1 (95% CI: 1.7, 6.5); between-group difference, 5.5 (95% CI: 0.8, 10.2), p=0.023. Conclusions CCFES improved hand dexterity more than cNMES in chronic stroke survivors. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319. PMID:27608819

Contralaterally Controlled Functional Electrical Stimulation Improves Hand Dexterity in Chronic Hemiparesis: A Randomized Trial.

PubMed

Knutson, Jayme S; Gunzler, Douglas D; Wilson, Richard D; Chae, John

2016-10-01

It is unknown whether one method of neuromuscular electrical stimulation for poststroke upper limb rehabilitation is more effective than another. Our aim was to compare the effects of contralaterally controlled functional electrical stimulation (CCFES) with cyclic neuromuscular electrical stimulation (cNMES). Stroke patients with chronic (>6 months) moderate to severe upper extremity hemiparesis (n=80) were randomized to receive 10 sessions/wk of CCFES- or cNMES-assisted hand opening exercise at home plus 20 sessions of functional task practice in the laboratory for 12 weeks. The task practice for the CCFES group was stimulation assisted. The primary outcome was change in Box and Block Test (BBT) score at 6 months post treatment. Upper extremity Fugl-Meyer and Arm Motor Abilities Test were also measured. At 6 months post treatment, the CCFES group had greater improvement on the BBT, 4.6 (95% confidence interval [CI], 2.2-7.0), than the cNMES group, 1.8 (95% CI, 0.6-3.0), between-group difference of 2.8 (95% CI, 0.1-5.5), P=0.045. No significant between-group difference was found for the upper extremity Fugl-Meyer (P=0.888) or Arm Motor Abilities Test (P=0.096). Participants who had the largest improvements on BBT were <2 years post stroke with moderate (ie, not severe) hand impairment at baseline. Among these, the 6-month post-treatment BBT gains of the CCFES group, 9.6 (95% CI, 5.6-13.6), were greater than those of the cNMES group, 4.1 (95% CI, 1.7-6.5), between-group difference of 5.5 (95% CI, 0.8-10.2), P=0.023. CCFES improved hand dexterity more than cNMES in chronic stroke survivors. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00891319. © 2016 American Heart Association, Inc.

Glioblastoma (GBM) effects on quantitative MRI of contralateral normal appearing white matter.

PubMed

Mehrabian, Hatef; Lam, Wilfred W; Myrehaug, Sten; Sahgal, Arjun; Stanisz, Greg J

2018-03-28

The objective was to investigate (with quantitative MRI) whether the normal appearing white matter (NAWM) of glioblastoma (GBM) patients on the contralateral side (cNAWM) was different from NAWM of healthy controls. Thirteen patients with newly diagnosed GBM and nine healthy age-matched controls were MRI-scanned with quantitative magnetization transfer (qMT), chemical exchange saturation transfer (CEST), and transverse relaxation time (T 2 )-mapping. MRI scans were performed after surgery and before chemo-radiation treatment. Comprehensive qMT, CEST, T 2 data were acquired. A two-pool MT model was fit to qMT data in transient state, to calculate MT model parameters [Formula: see text]. CEST signal was isolated by removing the contributions from the MT and direct water saturation, and CEST signal was calculated for Amide (CEST Amide ), Amine (CEST Amine ) and nuclear overhauser effect, NOE (CEST NOE ). There was no difference between GBM patients and normal controls in the qMT properties of the macromolecular pool [Formula: see text]. However, their free water pool spectrum was different (1/R a T 2a , patient  = 28.1 ± 3.9, 1/R a T 2a , control  = 25.0 ± 1.1, p = 0.03). This difference could be attributed to the difference in their T 2 time ([Formula: see text] = 83 ± 4, [Formula: see text] = 88 ± 1, p = 0.004). CEST signals were statistically significantly different with the CEST Amide having the largest difference between the two cohorts (CEST Amide,patient  = 2.8 ± 0.4, CEST Amide,control  = 3.4 ± 0.5, p = 0.009). CEST in cNAWM of GBM patients was lower than healthy controls which could be caused by modified brain metabolism due to tumor cell infiltration. There was no difference in MT properties of the patients and controls, however, the differences in free water pool properties were mainly due to reduced T 2 in cNAWM of the patients (resulting from structural changes and increased cellularity).

Contralateral botulinum toxin injection to improve facial asymmetry after acute facial paralysis.

PubMed

Kim, Jin

2013-02-01

The application of botulinum toxin to the healthy side of the face in patients with long-standing facial paralysis has been shown to be a minimally invasive technique that improves facial symmetry at rest and during facial motion, but our experience using botulinum toxin therapy for facial sequelae prompted the idea that botulinum toxin might be useful in acute cases of facial paralysis, leading to improve facial asymmetry. In cases in which medical or surgical treatment options are limited because of existing medical problems or advanced age, most patients with acute facial palsy are advised to await spontaneous recovery or are informed that no effective intervention exists. The purpose of this study was to evaluate the effect of botulinum toxin treatment for facial asymmetry in 18 patients after acute facial palsy who could not be optimally treated by medical or surgical management because of severe medical or other problems. From 2009 to 2011, nine patients with Bell's palsy, 5 with herpes zoster oticus and 4 with traumatic facial palsy (10 men and 8 women; age range, 22-82 yr; mean, 50.8 yr) participated in this study. Botulinum toxin A (Botox; Allergan Incorporated, Irvine, CA, USA) was injected using a tuberculin syringe with a 27-gauge needle. The amount injected per site varied from 2.5 to 3 U, and the total dose used per patient was 32 to 68 U (mean, 47.5 +/- 8.4 U). After administration of a single dose of botulinum toxin A on the nonparalyzed side of 18 patients with acute facial paralysis, marked relief of facial asymmetry was observed in 8 patients within 1 month of injection. Decreased facial asymmetry and strengthened facial function on the paralyzed side led to an increased HB and SB grade within 6 months after injection. Use of botulinum toxin after acute facial palsy cases is of great value. Such therapy decreases the relative hyperkinesis contralateral to the paralysis, leading to greater symmetric function. Especially in patients with medical

Hot Corrosion Behavior of Stainless Steel with Al-Si/Al-Si-Cr Coating

NASA Astrophysics Data System (ADS)

Fu, Guangyan; Wu, Yongzhao; Liu, Qun; Li, Rongguang; Su, Yong

2017-03-01

The 1Cr18Ni9Ti stainless steel with Al-Si/Al-Si-Cr coatings is prepared by slurry process and vacuum diffusion, and the hot corrosion behavior of the stainless steel with/without the coatings is studied under the condition of Na2SO4 film at 950 °C in air. Results show that the corrosion kinetics of stainless steel, the stainless steel with Al-Si coating and the stainless steel with Al-Si-Cr coating follow parabolic laws in several segments. After 24 h corrosion, the sequence of the mass gain for the three alloys is the stainless steel with Al-Si-Cr coating < the stainless steel with Al-Si coating < the stainless steel without any coating. The corrosion products of the three alloys are layered. Thereinto, the corrosion products of stainless steel without coating are divided into two layers, where the outside layer contains a composite of Fe2O3 and FeO, and the inner layer is Cr2O3. The corrosion products of the stainless steel with Al-Si coating are also divided into two layers, of which the outside layer mainly consists of Cr2O3, and the inner layer is mainly SiO2. The corrosion film of the stainless steel with Al-Si-Cr coating is thin and dense, which combines well with substrate. Thereinto, the outside layer is mainly Cr2O3, and the inside layer is Al2O3. In the matrix of all of the three alloys, there exist small amount of sulfides. Continuous and protective films of Cr2O3, SiO2 and Al2O3 form on the surface of the stainless steel with Al-Si and Al-Si-Cr coatings, which prevent further oxidation or sulfide corrosion of matrix metals, and this is the main reason for the much smaller mass gain of the two alloys than that of the stainless steel without any coatings in the 24 h hot corrosion process.

Microstructural and Phase Composition Differences Across the Interfaces in Al/Ti/Al Explosively Welded Clads

NASA Astrophysics Data System (ADS)

Fronczek, Dagmara Malgorzata; Chulist, Robert; Litynska-Dobrzynska, Lidia; Lopez, Gabriel Alejandro; Wierzbicka-Miernik, Anna; Schell, Norbert; Szulc, Zygmunt; Wojewoda-Budka, Joanna

2017-09-01

The microstructure and phase composition of Al/Ti/Al interfaces with respect to their localization were investigated. An aluminum-flyer plate exhibited finer grains located close to the upper interface than those present within the aluminum-base plate. The same tendency, but with a higher number of twins, was observed for titanium. Good quality bonding with a wavy shape and four intermetallic phases, namely, TiAl3, TiAl, TiAl2, and Ti3Al, was only obtained at the interface closer to the explosive material. The other interface was planar with three intermetallic compounds, excluding the metastable TiAl2 phase. As a result of a 100-hour annealing at 903 K (630 °C), an Al/TiAl3/Ti/TiAl3/Al sandwich was manufactured, formed with single crystalline Al layers. A substantial difference between the intermetallic layer thicknesses was measured, with 235.3 and 167.4 µm obtained for the layers corresponding to the upper and lower interfaces, respectively. An examination by transmission electron microscopy of a thin foil taken from the interface area after a 1-hour annealing at 825 K (552 °C) showed a mixture of randomly located TiAl3 grains within the aluminum. Finally, the hardness results were correlated with the microstructural changes across the samples.

Frontoparietal regions may become hypoactive after intermittent theta burst stimulation over the contralateral homologous cortex in humans.

PubMed

He, Xiaofei; Lan, Yue; Xu, Guangqing; Mao, Yurong; Chen, Zhenghong; Huang, Dongfeng; Pei, Zhong

2013-12-01

Brain injury to the dorsal frontoparietal networks, including the posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (DLPFC), commonly cause spatial neglect. However, the interaction of these different regions in spatial attention is unclear. The aim of the present study was to investigate whether hyperexcitable neural networks can cause an abnormal interhemispheric inhibition. The Attention Network Test was used to test subjects following intermittent theta burst stimulation (iTBS) to the left or right frontoparietal networks. During the Attention Network Test task, all subjects tolerated each conditioning iTBS without any obvious iTBS-related side effects. Subjects receiving real-right-PPC iTBS showed significant enhancement in both alerting and orienting efficiency compared with those receiving either sham-right-PPC iTBS or real-left-PPC iTBS. Moreover, subjects exposed to the real-right-DLPFC iTBS exhibited significant improvement in both alerting and executive control efficiency, compared with those exposed to either the sham-right-DLPFC or real-left-DLPFC conditioning. Interestingly, compared with subjects exposed to the sham-left-PPC stimuli, subjects exposed to the real-left-PPC iTBS had a significant deficit in the orienting index. The present study indicates that iTBS over the contralateral homologous cortex may induce the hypoactivity of the right PPC through interhemispheric competition in spatial orienting attention.

Response of rice to Al stress and identification of quantitative trait Loci for Al tolerance.

PubMed

Ma, Jian Feng; Shen, Renfang; Zhao, Zhuqing; Wissuwa, Matthias; Takeuchi, Yoshinobu; Ebitani, Takeshi; Yano, Masahiro

2002-06-01

Rice (Oryza sativa L.) shows the highest tolerance to Al toxicity among small-grain cereal crops, however, the mechanisms and genetics responsible for its high Al tolerance are not yet well understood. We investigated the response of rice to Al stress using the japonica variety Koshihikari in comparison to the indica variety Kasalath. Koshihikari showed higher tolerance at various Al concentrations than Kasalath. The Al content in root apexes was less in Koshihikari than in Kasalath, suggesting that exclusion mechanisms rather than internal detoxification are acting in Koshihikari. Al-induced secretion of citrate was observed in both Koshihikari and Kasalath, however, it is unlikely to be the mechanism for Al tolerance because there was no significant difference in the amount of citrate secreted between Koshihikari and Kasalath. Quantitative trait loci (QTLs) for Al tolerance were mapped in a population of 183 backcross inbred lines (BILs) derived from a cross of Koshihikari and Kasalath. Three putative QTLs controlling Al tolerance were detected on chromosomes 1, 2 and 6. Kasalath QTL alleles on chromosome 1 and 2 reduced Al tolerance but increased tolerance on chromosome 6. The three QTLs explained about 27% of the phenotypic variation in Al tolerance. The existence of QTLs for Al tolerance was confirmed in substitution lines for corresponding chromosomal segments.

All About ALS

MedlinePlus

... by storm with videos of people pouring ice water on themselves for the Ice Bucket Challenge. The worldwide phenomenon raised awareness—and millions of research dollars—for a fatal disease called ALS. ALS ...

Amyotrophic lateral sclerosis (ALS)

MedlinePlus

Lou Gehrig disease; ALS; Upper and lower motor neuron disease; Motor neuron disease ... One out of 10 cases of ALS is due to a genetic defect. The cause is unknown in most other cases. In ALS, motor nerve cells (neurons) waste away ...

An epidemiological study of cutaneous leishmaniasis in Al-jabal Al-gharbi, Libya.

PubMed

Abdellatif, Manal Z M; El-Mabrouk, Khamis; Ewis, Ashraf A

2013-02-01

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

PubMed Central

Abdellatif, Manal Z. M.; El-Mabrouk, Khamis

2013-01-01

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed. PMID:23467624

Formation of epitaxial Al 2O 3/NiAl(1 1 0) films: aluminium deposition

NASA Astrophysics Data System (ADS)

Lykhach, Y.; Moroz, V.; Yoshitake, M.

2005-02-01

Structure of epitaxial Al 2O 3 layers formed on NiAl(1 1 0) substrates has been studied by means of reflection high-energy electron diffraction (RHEED). The elucidated structure was compared to the model suggested for 0.5 nm-thick Al 2O 3 layers [K. Müller, H. Lindner, D.M. Zehner, G. Ownby, Verh. Dtsch. Phys. Ges. 25 (1990) 1130; R.M. Jaeger, H. Kuhlenbeck, H.J. Freund, Surf. Sci. 259 (1991) 235]. The stepwise growth of Al 2O 3 film, involving deposition and subsequent oxidation of aluminium onto epitaxial 0.5 nm-thick Al 2O 3 layers, has been investigated. Aluminium was deposited at room temperature, whereas its oxidation took place during annealing at 1070 K. The Al 2O 3 thickness was monitored by means of Auger electron spectroscopy (AES). It was found that Al 2O 3 layer follows the structure of 0.5 nm thick Al 2O 3 film, although a tilting of Al 2O 3(1 1 1) surface plane with respect to NiAl(1 1 0) surface appeared after Al deposition.

Oxidation behavior of Al/Cr coating on Ti2AlNb alloy at 900 °C

NASA Astrophysics Data System (ADS)

Yang, Zhengang; Liang, Wenping; Miao, Qiang; Chen, Bowen; Ding, Zheng; Roy, Nipon

2018-04-01

In this paper, the Al/Cr coating was fabricated on the surface of Ti2AlNb alloy via rf magnetron sputtering and double glow treatment to enhance oxidation resistance. The protective coating with an outer layer of Al and inner layer of Cr has great bonding strength due to the in-diffusion of Cr and the inter-diffusion between Al and Cr to form Al-Cr alloyed layer which has great hardness. Acoustic emission curve which was detected via WS-2005 scratch tester indicates the bonding strength between Al/Cr coating and substrate is great. Morphology of Ti2AlNb alloy with Al/Cr coating after scratch test shows that the scratch is smooth without disbanding, and the depth and breadth of scratch are changed uniformly. The mass change was reduced after oxidation test due to the Al/Cr protective coating. Isothermal oxidation test at 900 °C was researched. Results indicate that Al/Cr coating provided oxidation resistance of Ti2AlNb alloy with prolonged air exposure at 900 °C. Al2O3 was detected by XRD patterns and SEM images, and was formed on the surface of Ti2AlNb alloy to protect substrate during oxidation test. A certain content of Cr is beneficial for the formation of Al2O3. Besides, Cr2O3 was produced under Al2O3 by outward diffusion of Cr to protect substrate sequentially, no cracks were discovered on Al/Cr protective coating. The process of Ti outward diffusion into surface was suppressive due to integration of Cr-Ti and Al-Ti intermetallics. A steady, adherent and continuous coated layer of Al/Cr on Ti2AlNb alloy increases oxidation resistance.

Elastocaloric effect in CuAlZn and CuAlMn shape memory alloys under compression

PubMed Central

Qian, Suxin; Wang, Yi; Pillsbury, Thomas E.; Hada, Yoshiharu; Yamaguchi, Yuki; Fujimoto, Kenjiro; Hwang, Yunho; Radermacher, Reinhard; Cui, Jun; Yuki, Yoji; Toyotake, Koutaro; Takeuchi, Ichiro

2016-01-01

This paper reports the elastocaloric effect of two Cu-based shape memory alloys: Cu68Al16Zn16 (CuAlZn) and Cu73Al15Mn12 (CuAlMn), under compression at ambient temperature. The compression tests were conducted at two different rates to approach isothermal and adiabatic conditions. Upon unloading at a strain rate of 0.1 s−1 (adiabatic condition) from 4% strain, the highest adiabatic temperature changes (ΔTad) of 4.0 K for CuAlZn and 3.9 K for CuAlMn were obtained. The maximum stress and hysteresis at each strain were compared. The stress at the maximum recoverable strain of 4.0% for CuAlMn was 120 MPa, which is 70% smaller than that of CuAlZn. A smaller hysteresis for the CuAlMn alloy was also obtained, about 70% less compared with the CuAlZn alloy. The latent heat, determined by differential scanning calorimetry, was 4.3 J g−1 for the CuAlZn alloy and 5.0 J g−1 for the CuAlMn alloy. Potential coefficients of performance (COPmat) for these two alloys were calculated based on their physical properties of measured latent heat and hysteresis, and a COPmat of approximately 13.3 for CuAlMn was obtained. This article is part of the themed issue ‘Taking the temperature of phase transitions in cool materials’. PMID:27402936

Structural and compositional evolution of Al{sub 3}(Zr,Y) precipitates in Al-Zr-Y alloy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gao, Haiyan, E-mail: gaohaiyan@sjtu.edu.cn

Structural and compositional evolution of Al{sub 3}(Zr,Y) precipitates in aged Al-Zr-Y alloy was investigated through atom probe tomography (APT) and transmission electron microscope (TEM) analysis and first principles calculations. The results show that short-bar-shaped D0{sub 19}-Al{sub 3}Y with some Zr atoms dissolved in precipitated at the very beginning of decomposition and worked as heterogeneous nuclei for L1{sub 2}-Al{sub 3}Zr with spherical morphology after being aged at 400 °C for 2 h. Quasi-static coarsening happened as the aging treatment lasted from 2 h to 200 h. However, distribution of Zr and Y atoms in Al{sub 3}(Zr,Y) is nearly uniform and Al{submore » 3}(Zr,Y) do not have the typical “Al{sub 3}RE core-Al{sub 3}Zr shell” structure which observed in other RE containing Al-Zr-RE alloys with L1{sub 2}-Al{sub 3}RE as nuclei. First principles calculations revealed that binding energy between Y and Zr is strong during the growth of Al{sub 3}(Zr,Y), which led to the co-precipitation of Y and Zr atoms and attribute to the evolution of Al{sub 3}(Zr,Y). - Highlights: •Al{sub 3}Y precipitated firstly and then became nuclei for Al{sub 3}Zr during aging of Al-Zr-Y. •Al{sub 3}(Zr,Y) precipitates do not have the typical “Al{sub 3}Y core-Al{sub 3}Zr shell” structure. •Strong binding between Y and Zr led to the co-precipitation of Y and Zr atoms.« less

Revisiting Deng et al.'s Multiparty Quantum Secret Sharing Protocol

NASA Astrophysics Data System (ADS)

Hwang, Tzonelih; Hwang, Cheng-Chieh; Yang, Chun-Wei; Li, Chuan-Ming

2011-09-01

The multiparty quantum secret sharing protocol [Deng et al. in Chin. Phys. Lett. 23: 1084-1087, 2006] is revisited in this study. It is found that the performance of Deng et al.'s protocol can be much improved by using the techniques of block-transmission and decoy single photons. As a result, the qubit efficiency is improved 2.4 times and only one classical communication, a public discussion, and two quantum communications between each agent and the secret holder are needed rather than n classical communications, n public discussions, and 3n/2 quantum communications required in the original scheme.

Fabrication of Al/Mg/Al Composites via Accumulative Roll Bonding and Their Mechanical Properties

PubMed Central

Nie, Jinfeng; Liu, Mingxing; Wang, Fang; Zhao, Yonghao; Li, Yusheng; Cao, Yang; Zhu, Yuntian

2016-01-01

Al(1060)/Mg(AZ31)/Al(1060) multilayered composite was successfully produced using an accumulative roll bonding (ARB) process for up to four cycles at an elevated temperature (400 °C). The microstructure evolution of the composites and the bonding characteristics at the interfaces between Al and Mg layers with increasing ARB cycles were characterized through optical microscopy, field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM). It was found that the grains of Al and Mg layers were significantly refined and Al3Mg2 and Al12 Mg17 intermetallic compound layers formed at the Al/Mg bonding interfaces. The strength increased gradually and the ultimate tensile strength (UTS) reached a maximum value of about 240 MPa at the third pass. Furthermore, the strengthening mechanism of the composite was analyzed based on the fracture morphologies. PMID:28774072

Suppression of gate leakage current in in-situ grown AlN/InAlN/AlN/GaN heterostructures based on the control of internal polarization fields

NASA Astrophysics Data System (ADS)

Kotani, Junji; Yamada, Atsushi; Ishiguro, Tetsuro; Yamaguchi, Hideshi; Nakamura, Norikazu

2017-03-01

This paper investigates the gate leakage characteristics of in-situ AlN capped InAlN/AlN/GaN heterostructures grown by metal-organic vapor phase epitaxy. It was revealed that the leakage characteristics of AlN capped InAlN/AlN/GaN heterostructures are strongly dependent on the growth temperature of the AlN cap. For an AlN capped structure with an AlN growth temperature of 740 °C, the leakage current even increased although there exists a large bandgap material on InAlN/AlN/GaN heterostructures. On the other hand, a large reduction of the gate leakage current by 4-5 orders of magnitudes was achieved with a very low AlN growth temperature of 430 °C. X-ray diffraction analysis of the AlN cap grown at 740 °C indicated that the AlN layer is tensile-strained. In contrast to this result, the amorphous structure was confirmed for the AlN cap grown at 430 °C by transmission electron microscopy. Furthermore, theoretical analysis based on one-dimensional band simulation was carried out, and the large increase in two-dimensional electron gas (2DEG) observed in Hall measurements was well reproduced by taking into account the spontaneous and piezo-electric polarization in the AlN layer grown at 740 °C. For the AlN capped structure grown at 430 °C, it is believed that the reduced polarization field in the AlN cap suppressed the penetration of 2DEG into the InAlN barrier layer, resulting in a small impact on 2DEG mobility and density. We believe that an in-situ grown AlN cap with a very low growth temperature of 430 °C is a promising candidate for high-frequency/high-power GaN-based devices with low gate leakage current.

Depolarization currents in Al 2O 3 and MgAl 2O 4 oxides

NASA Astrophysics Data System (ADS)

Carvalhaes, R. P. M.; Rocha, M. S.; de Souza, S. S.; Blak, A. R.

2004-06-01

In the present work, dipole defects in γ-irradiated and thermally treated samples of Al 2O 3 and MgAl 2O 4 oxides are investigated, applying the thermally stimulated depolarisation currents technique (TSDC). The TSDC spectra of MgAl 2O 4 doped with Fe 2+, Fe 3+, Co 2+, Cr 3+ and Mn 2+ show four bands at 130 K, 160 K, 250 K and 320 K, and the spectra of Al 2O 3 doped with Mg 2+, Cr 3+ and Fe 3+ show bands between 230 K and 260 K. It has been observed that the bands at 130 K, 160 K and 250 K in MgAl 2O 4 spinel and that the 230 K and 240 K bands in Al 2O 3 are related to dipole defects. The other bands are possibly related to different types of charge storage mechanisms (space-charge and interfacial polarisation) or deal with distributions in activation energies and/or in relaxation times. A thermal decrease of the TSDC bands for heat treatments above 1000 K has been observed. In MgAl 2O 4 spinel, the 250 K band could be recovered after γ-irradiation and the two dipole peaks in Al 2O 3 were partially recovered. Thermal treatments affect the dipole aggregation processes in both oxides. Optical absorption (AO) results indicate that the presence of bands of water molecules in the infrared region obstructs the appearance of the TSDC bands in both Al 2O 3 and MgAl 2O 4. The 250 K peak in MgAl 2O 4 was correlated to V-type centres and the 250 K peak in Al 2O 3 to a substitutional Mg 2+ ion near a trapped hole localised on an adjacent oxygen ion.

The growth of high-Al-content InAlGaN quaternary alloys by RF-MBE

NASA Astrophysics Data System (ADS)

Wang, B. Z.; Wang, X. L.; Wang, X. Y.; Guo, L. C.; Wang, X. H.; Xiao, H. L.; Liu, H. X.

2007-02-01

High-Al-content InxAlyGa1-x-yN (x = 1-10%, y = 34-45%) quaternary alloys were grown on sapphire by radio-frequency plasma-excited molecular beam epitaxy. Rutherford back-scattering spectrometry, high resolution x-ray diffraction and cathodoluminescence were used to characterize the InAlGaN alloys. The experimental results show that InAlGaN with an appropriate Al/In ratio (near 4.7, which is a lattice-match to the GaN under-layer) has better crystal and optical quality than the InAlGaN alloys whose Al/In ratios are far from 4.7. Some cracks and V-defects occur in high-Al/In-ratio InAlGaN alloys. In the CL image, the cracks and V-defect regions are the emission-enhanced regions.

Preparation, deformation, and failure of functional Al-Sn and Al-Sn-Pb nanocrystalline alloys

NASA Astrophysics Data System (ADS)

Noskova, N. I.; Vil'Danova, N. F.; Filippov, Yu. I.; Churbaev, R. V.; Pereturina, I. A.; Korshunov, L. G.; Korznikov, A. V.

2006-12-01

Changes in the structure, hardness, mechanical properties, and friction coefficient of Al-30% Sn, Al-15% Sn-25% Pb, and Al-5% Sn-35% Pb (wt %) alloys subjected to severe plastic deformation by equal-channel angular pressing (with a force of 40 tonne) and by shear at a pressure of 5 GPa have been studied. The transition into the nanocrystalline state was shown to occur at different degrees of plastic deformation. The hardness exhibits nonmonotonic variations, namely, first it increases and subsequently decreases. The friction coefficient of the Al-30% Sn, Al-15% Sn-25% Pb, and Al-5% Sn-35% Pb alloys quenched from the melt was found to be 0.33; the friction coefficients of these alloys in the submicrocrystalline state (after equal-channel angular pressing) equal 0.24, 0.32, and 0.35, respectively. The effect of disintegration into nano-sized powders was found to occur in the Al-15% Sn-25% Pb, and Al-5% Sn-35% Pb alloys after severe plastic deformation to ɛ = 6.4 and subsequent short-time holding.

Temperature dependence of the dielectric response of anodized Al-Al2O3-metal capacitors

NASA Astrophysics Data System (ADS)

Hickmott, T. W.

2003-03-01

The temperature dependence of capacitance, CM, and conductance, GM, of Al-Al2O3-metal capacitors with Cu, Ag, and Au electrodes has been measured between 100 and 340 K at seven frequencies between 10 kHz and 1 MHz. Al2O3 films between 15 and 64 nm thick were formed by anodizing evaporated Al films in borate-glycol or borate-H2O electrolyte. The interface capacitance at the Al2O3-metal interface, CI, which is in series with the capacitance CD due to the Al2O3 dielectric, is determined from plots of 1/CM versus insulator thickness. CI is not fixed for a given metal-insulator interface but depends on the vacuum system used to deposit the metal electrode. CI is nearly temperature independent. When CI is taken into account the dielectric constant of Al2O3 determined from capacitance measurements is ˜8.3 at 295 K. The dielectric constant does not depend on anodizing electrolyte, insulator thickness, metal electrode, deposition conditions for the metal electrode or measurement frequency. By contrast, GM of Al-Al2O3-metal capacitors depends on both the deposition conditions of the metal and on the metal. For Al-Al2O3-Cu capacitors, GM is larger for capacitors with large values of 1/CI that result when Cu is evaporated in an oil-pumped vacuum system. For Al-Al2O3-Ag capacitors, GM does not depend on the Ag deposition conditions.

Polarization and Fowler-Nordheim tunneling in anodized Al-Al2O3-Au diodes

NASA Astrophysics Data System (ADS)

Hickmott, T. W.

2000-06-01

Polarization in anodic Al2O3 films is measured by using quasi-dc current-voltage (I-V) curves of Al-Al2O3-Au diodes. A reproducible polarization state is established by applying a negative voltage to the Au electrode of a rectifying Al-Al2O3-Au diode. The difference between subsequent I-V curves with Au positive is a measure of polarization in the sample. The magnitude of polarization charge in Al2O3 depends on the anodizing electrolyte. Al2O3 films formed in H2O-based electrolytes have approximately ten times the polarization charge of Al2O3 films formed in ethylene glycol-based electrolyte. Anodizing conditions that produce greater polarizing charge in anodic Al2O3 result in voltage-time curves during anodization under galvanostatic conditions that are nonlinear. Anodic films with greater polarizing charge also have a greater apparent interface capacitance which is independent of Al2O3 thickness. I-V curves of Al-Al2O3-Au diodes for increasing voltage are dominated by polarization. I-V curves for decreasing voltage are reproducible and parallel but depend on the maximum current and voltage reached during the measurement. There is no single current corresponding to a given voltage. I-V curves for decreasing voltage are analyzed assuming that the conduction mechanism is Fowler-Nordheim (FN) tunneling. There is a qualitative difference between the FN tunneling parameters for Al2O3 films formed in H2O-based electrolytes and those formed in ethylene glycol-based electrolyte. For the former the value of the exponential term in the FN analysis increases as the value of maximum voltage and current in an I-V characteristic increases, while the value of the pre-exponential term is nearly constant. For the latter, the exponential term is nearly constant as maximum voltage and current increase, but the pre-exponential term decreases by about 5 decades. Thus polarization charge incorporated during formation of anodized Al2O3 strongly affects the formation of the insulating

From Snow to Hill to ALS: An epidemiological odyssey in search of ALS causation.

PubMed

Armon, Carmel

2018-05-21

Establishing mechanisms of disease causation in neurodegenerative diseases has long seemed to be beyond the pale of traditional epidemiological tools. Establishing a plausible mechanism for initiation of amyotrophic lateral sclerosis (ALS) has appeared a particularly elusive goal. This review shows that a likely mechanism for ALS initiation may be inferred by applying classical methods of epidemiological inference. Advances in characterizing the biology of ALS suggest that most cases of ALS are cortically-generated, part of the ALS-FTD spectrum, with focal onset and spread by contiguity within the motor super-network. Evidence-based methods identified the most credible exogenous risk factor - smoking. AB Hill's nine viewpoints to inferring causation from association were invoked. The most likely mechanism consistent with smoking being a risk factor for ALS was inferred: cumulative DNA damage, akin to cumulative somatic mutations in carcinogenesis. Focal onset supports the concept that these changes, occurring in a single cell, may trigger the cascade leading to clinical ALS. The plausibility of this mechanism was affirmed by its coherence/consistency with other observations in sporadic, familial and western Pacific ALS. Application of traditional epidemiological reasoning suggests that cumulative DNA damage may contribute to disease onset in ALS. Copyright © 2018 Elsevier B.V. All rights reserved.

Three-Dimensional FIB/EBSD Characterization of Irradiated HfAl3-Al Composite

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hua, Zilong; Guillen, Donna Post; Harris, William

2016-09-01

A thermal neutron absorbing material, comprised of 28.4 vol% HfAl3 in an Al matrix, was developed to serve as a conductively cooled thermal neutron filter to enable fast flux materials and fuels testing in a pressurized water reactor. In order to observe the microstructural change of the HfAl3-Al composite due to neutron irradiation, an EBSD-FIB characterization approach is developed and presented in this paper. Using the focused ion beam (FIB), the sample was fabricated to 25µm × 25µm × 20 µm and mounted on the grid. A series of operations were carried out repetitively on the sample top surface tomore » prepare it for scanning electron microscopy (SEM). First, a ~100-nm layer was removed by high voltage FIB milling. Then, several cleaning passes were performed on the newly exposed surface using low voltage FIB milling to improve the SEM image quality. Last, the surface was scanned by Electron Backscattering Diffraction (EBSD) to obtain the two-dimensional image. After 50 to 100 two-dimensional images were collected, the images were stacked to reconstruct a three-dimensional model using DREAM.3D software. Two such reconstructed three-dimensional models were obtained from samples of the original and post-irradiation HfAl3-Al composite respectively, from which the most significant microstructural change caused by neutron irradiation apparently is the size reduction of both HfAl3 and Al grains. The possible reason is the thermal expansion and related thermal strain from the thermal neutron absorption. This technique can be applied to three-dimensional microstructure characterization of irradiated materials.« less

Mowafak Al-Jassim | NREL

Science.gov Websites

Mowafak Al-Jassim Photo of Mowafak Al-Jassim Mowafak Al-Jassim Group Research Manager III-Materials researcher and advancing to a principal scientist and a technical manager. His research group has contributed numerous international conferences. Research Interests His research interests include the multiscale

CuAlO2 and CuAl2O4 thin films obtained by stacking Cu and Al films using physical vapor deposition

NASA Astrophysics Data System (ADS)

Castillo-Hernández, G.; Mayén-Hernández, S.; Castaño-Tostado, E.; DeMoure-Flores, F.; Campos-González, E.; Martínez-Alonso, C.; Santos-Cruz, J.

2018-06-01

CuAlO2 and CuAl2O4 thin films were synthesized by the deposition of the precursor metals using the physical vapor deposition technique and subsequent annealing. Annealing was carried out for 4-6 h in open and nitrogen atmospheres respectively at temperatures of 900-1000 °C with control of heating and cooling ramps. The band gap measurements ranged from 3.3 to 4.5 eV. Electrical properties were measured using the van der Pauw technique. The preferred orientations of CuAlO2 and CuAl2O4 were found to be along the (1 1 2) and (3 1 1) planes, respectively. The phase percentages were quantified using a Rietveld refinement simulation and the energy dispersive X-ray spectroscopy indicated that the composition is very close to the stoichiometry of CuAlO2 samples and with excess of aluminum and deficiency of copper for CuAl2O4 respectively. High resolution transmission electron microscopy identified the principal planes in CuAlO2 and in CuAl2O4. Higher purities were achieved in nitrogen atmosphere with the control of the cooling ramps.

Data supporting Al-Abed et al., Environ. Sci.: Nano, 2016,

EPA Pesticide Factsheets

Data files representing each of the Figures and Tables published in Al-Abed et al., Environ. Sci.: Nano, 2016,3, 593. The data file names identify the Figure or Table and each file contains an internal set of data definitionsThis dataset is associated with the following publication:Al-Abed, S.R., J. Virkutyte, J. Ortenzio , R.M. McCarrick, L. Degn, R. Zucker , N. Coates , K. Cleveland, H. Ma, S. Diamond, K. Dreher , and W. Boyes. Environmental aging alters AI(OH)3 coating of TiO2 nanoparticles enhancing their photocatalytic and phototoxicity activities. Environmental Science: Nano. RSC Publishing, Cambridge, UK, N/A, (2016).

The Genyornis Egg: Response to Miller et al.'s commentary on Grellet-Tinner et al., 2016

NASA Astrophysics Data System (ADS)

Grellet-Tinner, Gerald; Spooner, Nigel A.; Handley, Warren D.; Worthy, Trevor H.

2017-04-01

Williams (1981) and Williams and Rich (1991) attributed Australian Quaternary fossil eggshell that differed from that of emu Dromaius novaehollandiae to the extinct bird Genyornis newtoni without any osteological or embryonic support. Such association by proximity or abundance mirrors the case of the mistaken association of oviraptor eggs to Protoceratops in the 1920's by Andrews (Grellet-Tinner and Makovicky, 2006). No other candidate species was considered, and this attribution has been unchallenged and followed by everyone thereafter. Much research has been done on this Australian eggshell, with one result being that the extinction of the parent of this eggshell is the most well documented for a taxon in Australia (e.g., Miller et al., 1999, 2005). Grellet-Tinner et al. (2016) raised several problems with the identity of the eggshell Williams (1981) attributed to Genyornis newtoni and suggested that extinct megapodes of the genus Progura were the more likely layer of this eggshell type, therein referred to as ;putative Genyornis oological material; (PGOM). Miller et al. (2017) challenged our hypothesis stating that ;Based on the dimensions of the reconstructed Spooner Egg,Grellet-Tinner et al. (2016)argue that PGOM is too small for a bird with the body mass estimated for Genyornis (168-275 kg) … …[and] …. None of the additional PGOM observations reported byGrellet-Tinner et al. (2016)are inconsistent with a Genyornis parent;. Here we take the opportunity to respond to their critique, the basis of which resolves into a few points, which we address in turn.

Two-Phase (TiAl+TiCrAl) Coating Alloys for Titanium Aluminides

NASA Technical Reports Server (NTRS)

Brady, Michael P. (Inventor); Smialek, James L. (Inventor); Brindley, William J. (Inventor)

1998-01-01

A coating for protecting titanium aluminide alloys, including the TiAl gamma + Ti3Al (alpha(sub 2)) class, from oxidative attack and interstitial embrittlement at temperatures up to at least 1000 C. is disclosed. This protective coating consists essentially of titanium, aluminum. and chromium in the following approximate atomic ratio: Ti(41.5-34.5)Al(49-53)Cr(9.5-12.5)

Al Qaeda in the Arabian Peninsula (AQAP): An Al Qaeda Affiliate Case Study

DTIC Science & Technology

2017-10-01

Underwear Bombing ” and an unsuccessful 2010 plan to put parcel bombs on U.S.-bound airplanes. AQAP also seeks to inspire “lone jihad” attacks in the... bomb -maker,5 and Sudanese national Ibrahim al-Qosi, a former bookkeeper for Osama Bin Laden.6 Below the emir are regional commanders and heads of...5 “Profile: Al-Qaeda ‘ Bomb Maker’ Ibrahim al-Asiri,” BBC News, July 4, 2014, http://www.bbc.com/news/world-middle-east-11662143. See also al-Asiri

Transformation to Ni5Al3 in a 63.0 at. pct Ni-Al alloy

NASA Technical Reports Server (NTRS)

Khadkikar, P. S.; Locci, I. E.; Vedula, K.; Michal, G. M.

1993-01-01

Microstructures of 63 at. pct P/M Ni-Al alloys with a composition close to the stoichiometry of the Ni5Al3 phase were investigated using homogenized and quenched specimens aged at low temperatures for various times. Results of analyses of XRD data and electron microscopy observations were used for quantitative phase analysis, performed to calculate the (NiAl + Ni5Al3)/Ni5Al3 phase boundary locations. The measured lattice parameters of Ni5Al3 phase formed at 823, 873, and 923 K indicated an increase in tetragonality of the phase with increasing nickel content.

Screw dislocation-induced growth spirals as emissive exciton localization centers in Al-rich AlGaN/AlN quantum wells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Funato, Mitsuru, E-mail: funato@kuee.kyoto-u.ac.jp; Banal, Ryan G.; Kawakami, Yoichi

2015-11-15

Screw dislocations in Al-rich AlGaN/AlN quantum wells cause growth spirals with an enhanced Ga incorporation, which create potential minima. Although screw dislocations and their surrounding potential minima suggest non-radiative recombination processes within growth spirals, in reality, screw dislocations are not major non-radiative sinks for carriers. Consequently, carriers localized within growth spirals recombine radiatively without being captured by non-radiative recombination centers, resulting in intense emissions from growth spirals.

Formation of Al3Ti/Mg composite by powder metallurgy of Mg-Al-Ti system.

PubMed

Yang, Zi R; Qi Wang, Shu; Cui, Xiang H; Zhao, Yu T; Gao, Ming J; Wei, Min X

2008-07-01

An in situ titanium trialuminide (Al 3 Ti)-particle-reinforced magnesium matrix composite has been successfully fabricated by the powder metallurgy of a Mg-Al-Ti system. The reaction processes and formation mechanism for synthesizing the composite were studied by differential scanning calorimetry (DSC), x-ray diffractometry (XRD), scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). Al 3 Ti particles are found to be synthesized in situ in the Mg alloy matrix. During the reaction sintering of the Mg-Al-Ti system, Al 3 Ti particles are formed through the reaction of liquid Al with as-dissolved Ti around the Ti particles. The formed intermetallic particles accumulate at the original sites of the Ti particles. As sintering time increases, the accumulated intermetallic particles disperse and reach a relatively homogeneous distribution in the matrix. It is found that the reaction process of the Mg-Al-Ti system is almost the same as that of the Al-Ti system. Mg also acts as a catalytic agent and a diluent in the reactions and shifts the reactions of Al and Ti to lower temperatures. An additional amount of Al is required for eliminating residual Ti and solid-solution strengthening of the Mg matrix.

Bulk Al-Al3Zr composite prepared by mechanical alloying and hot extrusion for high-temperature applications

NASA Astrophysics Data System (ADS)

Pourkhorshid, E.; Enayati, M. H.; Sabooni, S.; Karimzadeh, F.; Paydar, M. H.

2017-08-01

Bulk Al/Al3Zr composite was prepared by a combination of mechanical alloying (MA) and hot extrusion processes. Elemental Al and Zr powders were milled for up to 10 h and heat treated at 600°C for 1 h to form stable Al3Zr. The prepared Al3Zr powder was then mixed with the pure Al powder to produce an Al-Al3Zr composite. The composite powder was finally consolidated by hot extrusion at 550°C. The mechanical properties of consolidated samples were evaluated by hardness and tension tests at room and elevated temperatures. The results show that annealing of the 10-h-milled powder at 600°C for 1 h led to the formation of a stable Al3Zr phase. Differential scanning calorimetry (DSC) results confirmed that the formation of Al3Zr began with the nucleation of a metastable phase, which subsequently transformed to the stable tetragonal Al3Zr structure. The tension yield strength of the Al-10wt%Al3Zr composite was determined to be 103 MPa, which is approximately twice that for pure Al (53 MPa). The yield stress of the Al/Al3Zr composite at 300°C is just 10% lower than that at room temperature, which demonstrates the strong potential for the prepared composite to be used in high-temperature structural applications.

On the Solar Stimuli That Initiate Makkah Al Mukaramah, Al-Madinah Al-Munawarah And Jeddah Flash Floods

NASA Astrophysics Data System (ADS)

Elfaki, H.; Yousef, S.; Mawad, Ramy; Algafari, Y. H. O.; Amer, M.; Abdel-Sattar, W.

2017-12-01

Severe solar events manifested as highly energetic X-Ray events accompanied by coronal mass ejections ( CMEs) and proton flares caused flash floods in Makkah Al-Mukaramah, Al-Madinah Al-Munawarah and Jeddah. In the case of the 20 January 2005 CME that initiated severe flash on the 22 of January. it is shown that the CME lowered the pressure in the polar region and extended the low pressure regime to Saudi Arabia passing by the Mediterranean. Such passage accelerated evaporation and caused Cumulonimbus clouds to form and discharge flash floods over Makkah Al-Mukaramah. On the other hand, solar forcing due coronal holes have a different technique in initiating flash floods. The November 25 2009 and the 13-15 January 2011 Jeddah flash floods are attributed to prompt events due to fast solar streams emanated from two coronal holes that arrived the Earth on 24 November 2009 and 13 January 2011. We present evidences that those streams penetrated the Earth's magnetosphere and hit the troposphere at the western part of the Red Sea, dissipated their energy at 925mb geopotential height and left two hot spots. It follows that the air in the hot spots expanded and developed spots of low pressure air that spread over the Red Sea to its eastern coast. Accelerated evaporation due to reduced pressure caused quick formation of Cumulonimbus clouds that caused flash floods over Makkah Al-Mukaramah and Jeddah.

Enhancing phosphate adsorption by Mg/Al layered double hydroxide functionalized biochar with different Mg/Al ratios.

PubMed

Li, Ronghua; Wang, Jim J; Zhou, Baoyue; Awasthi, Mukesh Kumar; Ali, Amjad; Zhang, Zengqiang; Gaston, Lewis A; Lahori, Altaf Hussain; Mahar, Amanullah

2016-07-15

Mg/Al ratio plays a significant role for anion adsorption by Mg/Al-layered double hydroxides (Mg/Al-LDHs) modified biochar. In this study, Mg/Al-LDHs biochar with different Mg/Al ratios (2, 3, 4) were prepared by co-precipitation for phosphate removal from aqueous solution. Factors on phosphate adsorption including Mg/Al ratio, pH, and the presence of other inorganic anions were investigated through batch experiments. Increasing Mg/Al ratio in the Mg/Al-LDHs biochar composites generally enhanced phosphate adsorption with Langmuir adsorption maximum calculated at 81.83mg phosphorous (P) per gram of 4:1Mg/Al-LDHs biochar at pH3.0. The adsorption process was best described by the pseudo-second-order kinetic model. Solution pH had greater effects on the phosphate adsorption by Mg/Al LDHs biochar composites with lower Mg/Al ratios. The presence of other inorganic anions decreased the phosphate adsorption efficiency in the order of F(-) > SO4(2-) > NO2(-) >Cl(-). Phosphate adsorption mechanism involves ion exchange, electrostatic attraction and surface inner-sphere complex formation. Overall, Mg/Al-LDHs biochar composites offer a potential alternative of carbon-based adsorbent for phosphate removal from aqueous solution. Copyright © 2016 Elsevier B.V. All rights reserved.

Ultrafast decay of hot phonons in an AlGaN/AlN/AlGaN/GaN camelback channel

NASA Astrophysics Data System (ADS)

Leach, J. H.; Wu, M.; Morkoç, H.; Liberis, J.; Šermukšnis, E.; Ramonas, M.; Matulionis, A.

2011-11-01

A bottleneck for heat dissipation from the channel of a GaN-based heterostructure field-effect transistor is treated in terms of the lifetime of nonequilibrium (hot) longitudinal optical phonons, which are responsible for additional scattering of electrons in the voltage-biased quasi-two-dimensional channel. The hot-phonon lifetime is measured for an Al0.33Ga0.67N/AlN/Al0.1Ga0.9N/GaN heterostructure where the mobile electrons are spread in a composite Al0.1Ga0.9N/GaN channel and form a camelback electron density profile at high electric fields. In accordance with plasmon-assisted hot-phonon decay, the parameter of importance for the lifetime is not the total charge in the channel (the electron sheet density) but rather the electron density profile. This is demonstrated by comparing two structures with equal sheet densities (1 × 1013 cm-2), but with different density profiles. The camelback channel profile exhibits a shorter hot-phonon lifetime of ˜270 fs as compared with ˜500 fs reported for a standard Al0.33Ga0.67N/AlN/GaN channel at low supplied power levels. When supplied power is sufficient to heat the electrons > 600 K, ultrafast decay of hot phonons is observed in the case of the composite channel structure. In this case, the electron density profile spreads to form a camelback profile, and hot-phonon lifetime reduces to ˜50 fs.

Contralateral delay activity tracks the influence of Gestalt grouping principles on active visual working memory representations.

PubMed

Peterson, Dwight J; Gözenman, Filiz; Arciniega, Hector; Berryhill, Marian E

2015-10-01

Recent studies have demonstrated that factors influencing perception, such as Gestalt grouping cues, can influence the storage of information in visual working memory (VWM). In some cases, stationary cues, such as stimulus similarity, lead to superior VWM performance. However, the neural correlates underlying these benefits to VWM performance remain unclear. One neural index, the contralateral delay activity (CDA), is an event-related potential that shows increased amplitude according to the number of items held in VWM and asymptotes at an individual's VWM capacity limit. Here, we applied the CDA to determine whether previously reported behavioral benefits supplied by similarity, proximity, and uniform connectedness were reflected as a neural savings such that the CDA amplitude was reduced when these cues were present. We implemented VWM change-detection tasks with arrays including similarity and proximity (Experiment 1); uniform connectedness (Experiments 2a and 2b); and similarity/proximity and uniform connectedness (Experiment 3). The results indicated that when there was a behavioral benefit to VWM, this was echoed by a reduction in CDA amplitude, which suggests more efficient processing. However, not all perceptual grouping cues provided a VWM benefit in the same measure (e.g., accuracy) or of the same magnitude. We also found unexpected interactions between cues. We observed a mixed bag of effects, suggesting that these powerful perceptual grouping benefits are not as predictable in VWM. The current findings indicate that when grouping cues produce behavioral benefits, there is a parallel reduction in the neural resources required to maintain grouped items within VWM.

Contralateral delay activity tracks the influence of Gestalt grouping principles on active visual working memory representations

PubMed Central

Peterson, Dwight J.; Gözenman, Filiz; Arciniega, Hector; Berryhill, Marian E.

2015-01-01

Recent studies have demonstrated that factors influencing perception, such as Gestalt grouping cues, can influence the storage of information in visual working memory (VWM). In some cases, stationary cues such as stimulus similarity lead to superior VWM performance. However, the neural correlates underlying these benefits to VWM performance remain unclear. One neural index, the contralateral delay activity (CDA) is an event-related potential that shows increased amplitude according to the number of items held in VWM and asymptotes at an individual’s VWM capacity limit. Here, we applied the CDA to determine whether previously reported behavioral benefits supplied by similarity, proximity and uniform connectedness were reflected as a neural savings such that the CDA amplitude was reduced when these cues were present. We implemented VWM change detection tasks with arrays including similarity and proximity (Experiment 1); uniform connectedness (Experiments 2a and 2b); similarity/proximity and uniform connectedness (Experiment 3). The results indicated that when there was a behavioral benefit to VWM, this was echoed by a reduction in CDA amplitude, which suggests more efficient processing. However, not all perceptual grouping cues provided a VWM benefit in the same measure (e.g., accuracy) or of the same magnitude. We also found unexpected interactions between cues. We observed a mixed bag of effects, suggesting that these powerful perceptual grouping benefits are not as predictable in VWM. The current findings indicate that, when grouping cues produce behavioral benefits, there is a parallel reduction in the neural resources required to maintain grouped items within VWM. PMID:26018644

Prospective Study of Surgical Decision-making Processes for Contralateral Prophylactic Mastectomy in Women With Breast Cancer.

PubMed

Parker, Patricia A; Peterson, Susan K; Bedrosian, Isabelle; Crosby, Melissa A; Shen, Yu; Black, Dalliah M; Babiera, Gildy; Kuerer, Henry M; Ying, Jun; Dong, Wenli; Cantor, Scott B; Brewster, Abenaa M

2016-01-01

We prospectively examined the psychosocial predictors and the decision-making process regarding contralateral prophylactic mastectomy (CPM) among women with sporadic breast cancer. Increasing numbers of women with breast cancer are seeking CPM. Data are limited about the surgical decision-making process and the psychosocial factors that influence interest in CPM. Women with early-stage unilateral breast cancer (n = 117) were recruited before their first surgical visit at MD Anderson and completed questionnaires assessing knowledge of and interest in CPM and associated psychosocial factors. After the appointment, women and their surgeons completed questions about the extent that various surgical options (including CPM) were discussed; also, the women rated their perceived likelihood of having CPM and the surgeons rated the appropriateness of CPM. Before their first visit, 50% of women were moderately to extremely interested in CPM and 12 (10%) of women had CPM at the time of their primary breast cancer surgery. Less knowledge about breast cancer (P = 0.02) and greater cancer worry (P = 0.03) predicted interest in CPM. Greater cancer worry predicted who had CPM (P = 0.02). Interest in CPM before surgical visit and the likelihood of having CPM after the visit differed (P ≤ 0.001). Surgeons' rating of the appropriateness of CPM and the patient's reported likelihood of having CPM were not significantly different (P = 0.49). Interest in CPM is common among women with sporadic breast cancer. The informational and emotional aspects of CPM may affect the decision to have CPM and should be addressed when discussing surgical options.

Electronic structures of Al-Si clusters and the magic number structure Al8Si4

NASA Astrophysics Data System (ADS)

Du, Ning; Su, Mingzhi; Chen, Hongshan

2018-02-01

The low-energy structures of Al8Sim (m = 1-6) have been determined by using the genetic algorithm combined with density functional theory and the Second-order Moller-Plesset perturbation theory (MP2) models. The results show that the close-packed structures are preferable in energy for Al-Si clusters and in most cases there exist a few isomers with close energies. The valence molecular orbitals, the orbital level structures and the electron localisation function (ELF) consistently demonstrate that the electronic structures of Al-Si clusters can be described by the jellium model. Al8Si4 corresponds to a magic number structure with pronounced stability and large energy gap; the 40 valence electrons form closed 1S21P61D102S21F142P6 shells. The ELF attractors also suggest weak covalent Si-Si, Si-Al and Al-Al bonding, and doping Si in aluminium clusters promotes the covalent interaction between Al atoms.

Sintering of (Ni,Mg)(Al,Fe)2O4 Materials and their Corrosion Process in Na3AlF6-AlF3-K3AlF6 Electrolyte

NASA Astrophysics Data System (ADS)

Xu, Yibiao; Li, Yawei; Yang, Jianhong; Sang, Shaobai; Wang, Qinghu

2017-06-01

The application of ledge-free sidewalls in the Hall-Héroult cells can potentially reduce the energy requirement of aluminum production by about 30 pct (Nightingale et al. in J Eur Ceram, 33:2761-2765, 2013). However, this approach poses great material challenges since such sidewalls are in direct contact with corrosive electrolyte. In the present paper, (Ni,Mg)(Al,Fe)2O4 materials were prepared using fused magnesia, reactive alumina, nickel oxide, and iron oxide powders as the starting materials. The sintering behaviors of specimens as well as their corrosion resistance to molten electrolyte have been investigated by means of X-ray diffraction and scanning electron microscope. The results show that after firing at temperature ranging from 1673 K (1400 °C) up to 1873 K (1600 °C), all the specimens prepared are composed of single-phase (Ni,Mg)(Al,Fe)2O4 composite spinel, the lattice parameter of which increases with increasing Fe3+ ion concentration. Increasing the iron oxide content enhances densification of the specimens, which is accompanied by the formation of homogeneously distributed smaller pores in the matrix. The corrosion tests show that corrosion layers consist of fluoride and Ni(Al,Fe)2O4 composite spinel grains are produced in specimens with Fe/Al mole ratio no more than 1, whereas dense Ni(Al,Fe)2O4 composite spinel layers are formed on the surface of the specimens with Fe/Al mole ratio more than 1. The dense Ni(Al,Fe)2O4 composite spinel layers formed improve the corrosion resistance of the specimens by inhibiting the infiltration of electrolyte and hindering the chemical reaction between the specimen and electrolyte.

Relationship between Al content and substitution mechanism of Al-bearing anhydrous bridgmanites

NASA Astrophysics Data System (ADS)

Noda, M.; Inoue, T.; Kakizawa, S.

2017-12-01

It is considered that two substitution mechanisms, Tschermak substitution and oxygen vacancy substitution, exist in MgSiO3 bridgmanite for the incorporation of Al in anhydrous condition. Kubo and Akaogi (2000) has conducted the phase equilibrium experiment in the system MgSiO3-Al2O3, and established the phase diagram up to 28 GPa. However the careful observation in the bridgmanite shows that the chemical compositions are slightly deviated from Tschermak substitution join. The same tendency can be also observed in the run products by Irifune et al. (1996). This result indicates that pure Tschermak substitution bridgmanite cannot be stable even in the MgSiO3-Al2O3 join experiment. However, the previous studies used powder samples as the starting materials, so the absorbed water may affect the results. Therefore, we tried to conduct the experiment in the join MgSiO3-Al2O3 in extremely anhydrous condition to clarify whether the pure Tschermak substitution bridgmanite can be stable or not. In addition, we also examined the stability of oxygen vacancy bridgmanite in the extremely anhydrous condition for the comparison. The high pressure synthesis experiments were conducted at 28 GPa and 1600-1700° for 1hour using a Kawai-type multi-anvil apparatus. Four different Al content samples were prepared as the starting materials along the ideal substitution line of Tschermak (Al=0.025, 0.05, 0.1, 0.15 mol) and oxygen-vacancy (Al=0.025, 0.05, 0.075, 0.1 mol) substitutions, respectively (when total cation of 2). The glass rods were used as the starting materials to eliminate the absorbed water on the sample surface. The chemical compositions of the synthesized bridgmanite could not be measured by EPMA because of small grain size less than submicron. Therefore the chemical compositions were estimated from the result of the XRD pattern by subtracting the amount of the other phases. The estimated chemical compositions of Tschermak substitution bridgmanites were consistent with the

Acoustic resonator with Al electrodes on an AlN layer and using a GaAs substrate

DOEpatents

Kline, Gerald R.; Lakin, Kenneth M.

1985-12-03

A method of fabricating an acoustic wave resonator wherein all processing steps are accomplished from a single side of said substrate. The method involves deposition of a multi-layered Al/AlN structure on a GaAs substrate followed by a series of fabrication steps to define a resonator from said composite. The resulting resonator comprises an AlN layer between two Al layers and another layer of AlN on an exterior of one of said Al layers.

Imaging of Al/Fe ratios in synthetic Al-goethite revealed by nanoscale secondary ion mass spectrometry.

PubMed

Pohl, Lydia; Kölbl, Angelika; Werner, Florian; Mueller, Carsten W; Höschen, Carmen; Häusler, Werner; Kögel-Knabner, Ingrid

2018-04-30

Aluminium (Al)-substituted goethite is ubiquitous in soils and sediments. The extent of Al-substitution affects the physicochemical properties of the mineral and influences its macroscale properties. Bulk analysis only provides total Al/Fe ratios without providing information with respect to the Al-substitution of single minerals. Here, we demonstrate that nanoscale secondary ion mass spectrometry (NanoSIMS) enables the precise determination of Al-content in single minerals, while simultaneously visualising the variation of the Al/Fe ratio. Al-substituted goethite samples were synthesized with increasing Al concentrations of 0.1, 3, and 7 % and analysed by NanoSIMS in combination with established bulk spectroscopic methods (XRD, FTIR, Mössbauer spectroscopy). The high spatial resolution (50-150 nm) of NanoSIMS is accompanied by a high number of single-point measurements. We statistically evaluated the Al/Fe ratios derived from NanoSIMS, while maintaining the spatial information and reassigning it to its original localization. XRD analyses confirmed increasing concentration of incorporated Al within the goethite structure. Mössbauer spectroscopy revealed 11 % of the goethite samples generated at high Al concentrations consisted of hematite. The NanoSIMS data show that the Al/Fe ratios are in agreement with bulk data derived from total digestion and demonstrated small spatial variability between single-point measurements. More advantageously, statistical analysis and reassignment of single-point measurements allowed us to identify distinct spots with significantly higher or lower Al/Fe ratios. NanoSIMS measurements confirmed the capacity to produce images, which indicated the uniform increase in Al-concentrations in goethite. Using a combination of statistical analysis with information from complementary spectroscopic techniques (XRD, FTIR and Mössbauer spectroscopy) we were further able to reveal spots with lower Al/Fe ratios as hematite. Copyright © 2018 John

Burden of rare variants in ALS genes influences survival in familial and sporadic ALS.

PubMed

Pang, Shirley Yin-Yu; Hsu, Jacob Shujui; Teo, Kay-Cheong; Li, Yan; Kung, Michelle H W; Cheah, Kathryn S E; Chan, Danny; Cheung, Kenneth M C; Li, Miaoxin; Sham, Pak-Chung; Ho, Shu-Leong

2017-10-01

Genetic variants are implicated in the development of amyotrophic lateral sclerosis (ALS), but it is unclear whether the burden of rare variants in ALS genes has an effect on survival. We performed whole genome sequencing on 8 familial ALS (FALS) patients with superoxide dismutase 1 (SOD1) mutation and whole exome sequencing on 46 sporadic ALS (SALS) patients living in Hong Kong and found that 67% had at least 1 rare variant in the exons of 40 ALS genes; 22% had 2 or more. Patients with 2 or more rare variants had lower probability of survival than patients with 0 or 1 variant (p = 0.001). After adjusting for other factors, each additional rare variant increased the risk of respiratory failure or death by 60% (p = 0.0098). The presence of the rare variant was associated with the risk of ALS (Odds ratio 1.91, 95% confidence interval 1.03-3.61, p = 0.03), and ALS patients had higher rare variant burden than controls (MB, p = 0.004). Our findings support an oligogenic basis with the burden of rare variants affecting the development and survival of ALS. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.