Pre- and Postoperative Quantitative Analysis of Contour Abnormalities in Graves Upper Eyelid Retraction

Purpose: One of the most common problems of the surgical management of Graves upper eyelid retraction is the occurrence of eyelid contour abnormalities. In the present study, the postoperative contour of a large sample of eyelids of patients with Graves orbitopathy was measured. Methods: The postoperative upper eyelid contour of 62 eyes of 43 patients with Graves orbitopathy was subjectively classified by 3 experienced surgeons in 3 categories: poor, fair, and good. The shape of the eyelid contours in each category was then measured with a recently developed custom-made software by measuring multiple midpupil eyelid distances each 15 degrees along the palpebral fissure. The upper eyelid contour of 60 normal subjects was also quantified as a control group. Results: The mean ratio between the sum of the lateral and medial midpupil eyelid distances (lateral/medial ratio) was 1.10 +/- 0.11 standard deviation in controls and 1.15 +/- 0.13 standard deviation in patients. Postoperatively, the mean midpupil eyelid distance at 90 degrees was 4.16 +/- 1.13 mm standard deviation. The distribution lateral/medial ratios of the eyelids judged as having good contours was similar to the distribution of the controls with a modal value centered on the interval between 1.0 and 1.10. The distribution of lateral/medial ratios of the eyelids judged as having poor contour was bimodal, with eyelids with low and high lateral/medial ratios. Low lateral/medial ratios occurred when there was a lateral overcorrection, giving the eyelid a flat or a medial ptosis appearance. High lateral/medial ratios were due to a central or medial overcorrection or a lateral peak maintenance. Conclusions: Postoperative upper eyelid contour abnormalities can be quantified by comparing the sum of multiple midpupil eyelid distances of the lateral and medial sectors of the eyelid. Low and high lateral/medial ratios are anomalous and judged as unpleasant. (Ophthal Plast Reconstr Surg 2012;28:429-433)

Soil sulfur fractions dynamics and distribution in a tropical grass pasture amended with nitrogen and sulfur fertilizers

Soil sulfur (S) partitioning among the various pools and changes in tropical pasture ecosystems remain poorly understood. Our study aimed to investigate the dynamics and distribution of soil S fractions in an 8-year-old signal grass (Brachiaria decumbens Stapf.) pasture fertilized with nitrogen (N) and S. A factorial combination of two N rates (0 and 600?kg N ha1 y1, as NH4NO3) and two S rates (0 and 60?kg S ha1 y1, as gypsum) were applied to signal grass pastures during 2 y. Cattle grazing was controlled during the experimental period. Organic S was the major S pool found in the tropical pasture soil, and represented 97% to 99% of total S content. Among the organic S fractions, residual S was the most abundant (42% to 67% of total S), followed by ester-bonded S (19% to 42%), and C-bonded S (11% to 19%). Plant-available inorganic SO4-S concentrations were very low, even for the treatments receiving S fertilizers. Low inorganic SO4-S stocks suggest that S losses may play a major role in S dynamics of sandy tropical soils. Nitrogen and S additions affected forage yield, S plant uptake, and organic S fractions in the soil. Among the various soil fractions, residual S showed the greatest changes in response to N and S fertilization. Soil organic S increased in plots fertilized with S following the residual S fraction increment (16.6% to 34.8%). Soils cultivated without N and S fertilization showed a decrease in all soil organic S fractions.

Multiple Radial Midpupil Lid Distances: A Simple Method for Lid Contour Analysis

Purpose: To describe a new computerized method for the analysis of lid contour based on the measurement of multiple radial midpupil lid distances. Design: Evaluation of diagnostic technology. Participants and Controls: Monocular palpebral fissure images of 35 patients with Graves' upper eyelid retraction and of 30 normal subjects. Methods: Custom software was used to measure the conventional midpupil upper lid distance (MPLD) and 12 oblique MPLDs on each 15 degrees across the temporal (105 degrees, 120 degrees, 135 degrees, 150 degrees, 165 degrees, and 180 degrees) and nasal (75 degrees, 60 degrees, 45 degrees, 30 degrees, 15 degrees, and 0 degrees) sectors of the lid fissure. Main Outcome Measures: Mean, standard deviation, 5th and 95th percentiles of the oblique MPLDs obtained for patients and controls. Temporal/nasal MPLD ratios of the same angles with respect to the midline. Results: The MPLDs increased from the vertical midline in both nasal and temporal sectors of the fissure. In the control group the differences between the mean central MPLD (90 degrees) and those up to 30 degrees in the nasal (75 degrees and 60 degrees) and temporal sectors (105 degrees and 120 degrees) were not significant. For greater eccentricities, all temporal and nasal mean MPLDs increased significantly. When the MPLDs of the same angles were compared between groups, the mean values of the Graves' patients differed from control at all angles (F = 4192; P<0.0001). The greatest temporal/nasal asymmetry occurred 60 degrees from the vertical midline. Conclusions: The measurement of radial MPLD is a simple and effective way to characterize lid contour abnormalities. In patients with Graves' upper eyelid retraction, the method demonstrated that the maximum amplitude of the lateral lid flare sign occurred at 60 degrees from the vertical midline. Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article. Ophthalmology 2012; 119: 625-628 (C) 2012 by the American Academy of Ophthalmology.

Contour integration and principles of perceptual grouping

Ziel der Arbeit ist die Analyse von Prinzipien der Konturintegration im menschlichen visuellen System. Die perzeptuelle Verbindung benachbarter Teile in einer visuellen Szene zu einem Ganzen wird durch zwei gestalttheoretisch begründete Propositionen gekennzeichnet, die komplementäre lokale Mechanismen der Konturintegration beschreiben. Das erste Prinzip der Konturintegration fordert, dass lokale Ähnlichkeit von Elementen in einem anderen Merkmal als Orientierung nicht hinreicht für die Entdeckung von Konturen, sondern ein zusätzlicher statistischer Merkmalsunterschied von Konturelementen und Umgebung vorliegen muss, um Konturentdeckung zu ermöglichen. Das zweite Prinzip der Konturintegration behauptet, dass eine kollineare Ausrichtung von Konturelementen für Konturintegration hinreicht, und es bei deren Vorliegen zu robuster Konturintegrationsleistung kommt, auch wenn die lokalen merkmalstragenden Elemente in anderen Merkmalen in hohem Maße zufällig variieren und damit keine nachbarschaftliche Ähnlichkeitsbeziehung entlang der Kontur aufweisen. Als empirische Grundlage für die beiden vorgeschlagenen Prinzipien der Konturintegration werden drei Experimente berichtet, die zunächst die untergeordnete Rolle globaler Konturmerkmale wie Geschlossenheit bei der Konturentdeckung aufweisen und daraufhin die Bedeutung lokaler Mechanismen für die Konturintegration anhand der Merkmale Kollinearität, Ortsfrequenz sowie der spezifischen Art der Interaktion zwischen beiden Merkmalen beleuchten. Im ersten Experiment wird das globale Merkmal der Geschlossenheit untersucht und gezeigt, dass geschlossene Konturen nicht effektiver entdeckt werden als offene Konturen. Das zweite Experiment zeigt die Robustheit von über Kollinearität definierten Konturen über die zufällige Variation im Merkmal Ortsfrequenz entlang der Kontur und im Hintergrund, sowie die Unmöglichkeit der Konturintegration bei nachbarschaftlicher Ähnlichkeit der Konturelemente, wenn Ähnlichkeit statt über kollineare Orientierung über gleiche Ortsfrequenzen realisiert ist. Im dritten Experiment wird gezeigt, dass eine redundante Kombination von kollinearer Orientierung mit einem statistischen Unterschied im Merkmal Ortsfrequenz zu erheblichen Sichtbarkeitsgewinnen bei der Konturentdeckung führt. Aufgrund der Stärke der Summationswirkung wird vorgeschlagen, dass durch die Kombination mehrerer Hinweisreize neue kortikale Mechanismen angesprochen werden, die die Konturentdeckung unterstützen. Die Resultate der drei Experimente werden in den Kontext aktueller Forschung zur Objektwahrnehmung gestellt und ihre Bedeutung für die postulierten allgemeinen Prinzipien visueller Gruppierung in der Konturintegration diskutiert. Anhand phänomenologischer Beispiele mit anderen Merkmalen als Orientierung und Ortsfrequenz wird gezeigt, dass die gefundenen Prinzipien Generalisierbarkeit für die Verarbeitung von Konturen im visuellen System beanspruchen können.

Numerical loop calculations with contour deformation

Gegenstand dieser Arbeit ist die nummerische Berechnung von Schleifenintegralen welche in höheren Ordnungen der Störungstheorie auftreten.rnAnalog zur reellen Emission kann man auch in den virtuellen Beiträgen Subtraktionsterme einführen, welche die kollinearen und soften Divergenzen des Schleifenintegrals entfernen. Die Phasenraumintegration und die Schleifenintegration können dann in einer einzigen Monte Carlo Integration durchgeführt werden. In dieser Arbeit zeigen wir wie eine solche numerische Integration unter zu Hilfenahme einer Kontourdeformation durchgeführt werden kann. Ausserdem zeigen wir wie man die benötigeten Integranden mit Rekursionsformeln berechnen kann.

Stability of Contour Augmentation and Esthetic Outcomes of Implant Supported Single Crowns in the Esthetic Zone. 3-Year Results of a Prospective Study With Early Implant Placement Post Extraction

Early implant placement is one of the treatment options after tooth extraction. Implant surgery is performed after a healing period of 4 to 8 weeks and combined with a simultaneous contour augmentation using the guided bone regeneration technique to rebuild stable esthetic facial hard- and soft-tissue contours.

Comparison of non-calibrated pulse-contour analysis with continuous thermodilution for cardiac output assessment in patients with induced hypothermia after cardiac arrest

Induced mild hypothermia after cardiac arrest interferes with clinical assessment of the cardiovascular status of patients. In this situation, non-invasive cardiac output measurement could be useful. Unfortunately, arterial pulse contour is altered by temperature, and the performance of devices using arterial blood pressure contour analysis to derive cardiac output may be insufficient.

Perception of mode, rhythm, and contour in unfamiliar melodies: Effects of age and experience

We explored the ability of older (60-80 years old) and younger (18-23 years old) musicians and nonmusicians to judge the similarity of transposed melodies varying on rhythm, mode, and/or contour (Experiment 1) and to discriminate among melodies differing only in rhythm, mode, or contour (Experiment 2). Similarity ratings did not vary greatly among groups, with tunes differing only by mode being rated as most similar. In the same/different discrimination task, musicians performed better than nonmusicians, but we found no age differences. We also found that discrimination of major from minor tunes was difficult for everyone, even for musicians. Mode is apparently a subtle dimension in music, despite its deliberate use in composition and despite people's ability to label minor as "sad" and major as "happy."

Combined bone and soft-tissue augmentation surgery in temporo-orbital contour reconstruction

Temporal hollowing due to temporal muscle atrophy after standard skull base surgery is common. Various techniques have been previously described to correct the disfiguring defect. Most often reconstruction is performed using freehand molded polymethylmethacrylate cement. This method and material are insufficient in terms of aesthetic results and implant characteristics. We herein propose reconstruction of such defects with a polyetheretherketone (PEEK)-based patient-specific implant (PSI) including soft-tissue augmentation to preserve normal facial topography. We describe a patient who presented with a large temporo-orbital hemangioma that had been repaired with polymethylmethacrylate 25 years earlier. Because of a toxic skin atrophy fistula, followed by infection and meningitis, this initial implant had to be removed. The large, disfiguring temporo-orbital defect was reconstructed with a PEEK-based PSI. The lateral orbital wall and the temporal muscle atrophy were augmented with computer-aided design and surface modeling techniques. The operative procedure to implant and adopt the reconstructed PEEK-based PSI was simple, and an excellent cosmetic outcome was achieved. The postoperative clinical course was uneventful over a 5-year follow-up period. Polyetheretherketone-based combined bony and soft contour remodeling is a feasible and effective method for cranioplasty including combined bone and soft-tissue reconstruction of temporo-orbital defects. Manual reconstruction of this cosmetically delicate area carries an exceptional risk of disfiguring results. Augmentation surgery in this anatomic location needs accurate PSIs to achieve satisfactory cosmetic results. The cosmetic outcome achieved in this case is superior compared with previously reported techniques.

The meanings of pasture in resource degradation negotiations: Evidence from post-socialist rural Kyrgyzstan

Pasture use in the Kyrgyz Republic has changed significantly as a result of fundamental political, economic, and societal changes following the collapse of the Soviet Union and the subsequent changes in people’s livelihoods. Government institutions criticize current land use patterns as unsustainable and the cause of degradation. But at the local level, pasture quality is rarely seen as a major problem. This article uses a qualitative approach to examine the tension between these views and addresses current land use practices and related narratives about pasture degradation in rural Kyrgyzstan. By focusing on meanings ascribed to pastures, it shows how people closely relate current practices to the experiences and value systems of the Soviet period and to changing identities emerging in the post-Soviet transformation process. It argues that proper understanding of resource degradation issues requires adequate consideration of the context of meaning constructed by local resource users when they make sense of their environment.

Equine botulism and acute pasture myodystrophy: new soil-borne emerging diseases in Switzerland?

In Switzerland, the incidence of equine botulism and acute pasture myodystrophy have remarkably increased in the last five years. Equine fodder-borne botulism in Europe is most likely caused by Clostridium botulinum types C and D that produce the toxins BoNT/C and BoNT/D. Horses showing signs suggestive of botulism (muscle weakness and tremors, reduced tongue tone, slow chewing, salivation and difficulties swallowing, drooping eyelids, mydriasis), especially patients that have fed on suspect fodder (mostly haylage), must be treated with anti-serum as soon as possible.They also need intensive care, which is often difficult to provide and always expensive in the face of a guarded to poor prognosis. Therefore, prevention (high standards of forage quality and vaccination) is all the more important. Pasture myodystrophy is an acute disease with signs of rhabdomyolysis and lethality rate over 90%. It affects grazing horses under frosty, windy and rainy conditions. Preliminary results indicate that Clostridium sordellii and Clostridium bifermentans producing lethal toxin may play a role in pasture myodystrophy. Our efforts concentrate on developing a new subunit vaccine for equine botulism and understanding the ethiology and pathogenesis of pasture myodystrophy with the goal of improving prevention against these highly fatal diseases that present a significant risk to our horse population.

Ocular pulse amplitude in healthy subjects as measured by dynamic contour tonometry

OBJECTIVES: To test whether dynamic contour tonometry yields ocular pulse amplitude (OPA) measurements that are independent of corneal thickness and curvature, and to assess variables of observer agreement. METHODS: In a multivariate cluster analysis on 223 eyes, the relationship between central corneal thickness, corneal curvature, axial length, anterior chamber depth, intraocular pressure, sex, age, and OPA measurements was assessed. Intraobserver and interobserver variabilities were calculated from repeated measurements obtained from 8 volunteers by 4 observers. RESULTS: The OPA readings were not affected by central corneal thickness (P = .08), corneal curvature (P = .47), anterior chamber depth (P = .80), age (P = .60), or sex (P = .73). There was a positive correlation between OPA and intraocular pressure (0.12 mm Hg/1 mm Hg of intraocular pressure; P<.001) and a negative correlation between OPA and axial length (0.27 mm Hg/1 mm of length; P<.001). Intraobserver and interobserver variabilities were 0.08 and 0.02 mm Hg, respectively, and the intraclass correlation coefficient was 0.89. CONCLUSIONS: The OPA readings obtained with dynamic contour tonometry in healthy subjects are not influenced by the structure of the anterior segment of the eye but are affected by intraocular pressure and axial length. We found a high amount of agreement within and between observers.

Pulse contour analysis: a valid assessment of central arterial stiffness in children?

In adults the contour analysis of peripheral pressure waves in the upper limb reflects central aortic stiffness. Here, we wanted to demonstrate the appropriateness of pulse contour analysis to assess large artery stiffness in children. Digital volume pulse analysis, with the computation of the stiffness index and pulse wave velocity between carotid and femoral artery, were simultaneously determined in 79 healthy children between 8 years and 15 years (mean age 11.4 years, 32 girls). The stiffness index of 42 healthy adults (mean age 45.6 years, 26 women) served as control. Pulse wave velocity between carotid and femoral artery was directly correlated with systolic pressure and mean blood pressure, as well as with pulse pressure. The results from the stiffness index of children revealed the expected values extrapolated from the linear regression of adulthood stiffness index vs. age. Childhood stiffness index positively correlated with pulse wave velocity (r(2) = 0.07, P = 0.02) but not with blood pressure parameters. The exclusion of individuals with an increased vascular tone, as indicated by a reflexion index > 90%, improved the correlation between stiffness index and pulse wave velocity (r(2) = 0.13, P = 0.001). Our data indicate that digital volume pulse-based analysis has limitations if compared with pulse wave velocity to measure arterial stiffness, mostly in patients with a high vascular tone.