A Standardized Digital Photography System with Computerized Eyelid Measurement Analysis

PurposeTo evaluate the changes in eyelid parameters after the endonasal approach compared with transcaruncular medial wall decompression combined with the transconjunctival inferior wall decompression approach with inferomedial strut preservation.MethodsIn total, 71 patients with thyroid eye disease who underwent orbital decompression were retrospectively evaluated. The data collected included Hertel exophthalmometry, marginal reflex distance 1, marginal reflex distance 2, interpalpebral fissure, levator function test measures, and complications related to surgery.ResultsProptosis reduction produced a statistically significant improvement across all decompression groups. Lower eyelid retraction produced a statistically significant improvement in the two-wall decompression groups but not in the one-wall decompression groups. No statistical difference was observed in the upper eyelid retraction and levator function after surgery across all decompression groups. In the post-hoc analysis, statistical improvement was not observed in the lower eyelid retraction between the endonasal and transcaruncular approach in the one-wall and two-wall decompression groups, although statistically significant exophthalmos reduction and improvement in the lower eyelid retraction was noted in the two-wall decompression subgroups compared with one-wall decompression subgroups.ConclusionsOur study showed no differences in eyelid parameters between the endonasal and transcaruncular decompression approaches in one-wall and two-wall decompression. In the two-wall decompression group, proptosis reduction was greater with the endonasal approach than with the transcaruncular approach when the strut was preserved; however, it does not lead to a significant difference in the improvement of lower eyelid retraction.

In this paper, the author use the DORIS software to conduct the differential interferometric processing of existing data and extracts ground deformation fields in different periods of Yaoqiao mining area, Xuzhou. After that, the analysis is carried out by combining with characteristics of ground exploitation subsidence, and the comparative analysis of land subsidence data obtained by conventional methods is conducted. The results show that: the land subsidence of Yaoqiao mining area is quite consistent to the exploitation subsidence rules; in addition, D-InSAR can monitor minor changes of exploitation subsidence boundaries in mining areas and the evolution trend of subsidence surface, and also can measure the subsidence speed. It has proved that the InSAR technology can conduct continuously effective dynamic monitoring of ground deformation in mining areas from this example. In terms of the regional continuous ground depression, DInSAR is much better than the traditional methods of measurement. The development of this new Earth observation technology has important practical significance in promoting the improvement of China's digital mine system and guiding the planning and preservation of buildings and road systems in mining areas.

Platinum chains are thinner than gold weights (GWs) and may confer a better eyelid curvature profile with reduced visibility. Outcomes compared eyelid measurements, cosmesis, and complications. Forty-two primary GW and 17 primary platinum chain insertions were identified and subsequently matched for laterality, pathology, and weight of implant. Twenty-two patients were randomly allocated into 2 groups for comparison; those receiving a GW (n = 11) or platinum chain (n = 11) to formulate a retrospective case-controlled study. Primary upper eyelid loading surgery with both implants involved a standard technique of a high tarsal placement with levator recession. Blinded assessment of preoperative and 6-month postoperative photographs calculated eyelid parameters: upper marginal reflex distance and lagophthalmos. Standardized photographs were used to define cosmesis in terms of abnormal eyelid contour and prominence. Gold weights demonstrated an improvement in eyelid parameters. Nine eyelids had prominent implants: mild (2), moderate (3), and severe (4). Eyelid contour was affected in 7 patients, 5 with droop, and 2 with flattened contour. Platinum chain improved eyelid measurements. Mild eyelid prominence was noted in 2 cases, but eyelid contour remained normal in all patients. No complications were noted with either the GW or the platinum chain implants. Both devices are successful in treating complications of lagophthalmos. Platinum chains appear less prominent and maintain normal eyelid contour. Although more expensive, platinum chains appear to be as safe and effective as GWs yet provide better cosmesis.

Most patients with myasthenia gravis (MG) develop ocular manifestations during their illness and up to 22% may have isolated ocular myasthenia gravis (OMG). Apraclonidine elevates the eyelid by activating alpha-2 receptors on Muller's muscle, an accessory eyelid elevator muscle. In this study we evaluate the effect of apraclonidine in alleviating ptosis secondary to MG. This clinical trial (NCT05045248) was done at the American University of Beirut Medical Center. Patients with ptosis secondary to MG were administered two drops of apraclonidine 0.5% solution to the most affected eye. We measured palpebral fissure height (PF), marginal reflex distance-1 (MRD1), marginal reflex distance-2 (MRD2), and levator function (LF) before drug administration and at 1, 5, 30, and 60 minutes after administration. Ten participants were enrolled in the study. Improvement in all eyelid measurements was noted in all participants as early as 1 minute after apraclonidine administration. From baseline to 60 minutes after administration, average PF increased from 8.8 ± 1.9 mm to 14.2 ± 2.6 mm, MRD-1 from 1.7 ± 1.4 mm to 5.4 ± 2.9 mm, MRD-2 from 7.1 ± 1.3 mm to 8.8 ± 1.7 mm, and LF from 13.4 ± 2.9 mm to 17.5 ± 2.4 mm. All increases were statistically significant. Apraclonidine may alleviate ptosis secondary to MG and may be an effective alternative treatment for this group of patients.

This paper develops a one-dimensional norm detector for nanosecond-level transient electric field (E-field) measurement based on the digital measurement technology. It has two main advantages over the traditional measurement method. First, the measured signals can be stored and no transmission line is needed. Hence, it can detect the E-field coupled in hermetically sealed cavities, such as the cockpit of an aircraft or a vehicle under electromagnetic compatibility test. Second, commonly used norms of the measured waveform can be acquired by the signal processing software quickly and conveniently. Therefore, the efficiency of the measurement experiment can be improved. This paper describes the detailed realization of the norm detector and the design of its signal processing software. The maximum sampling rate of the norms detector is 2 GSPS and the memory depth is 8 kB. Via adjusting the height of the antenna, the measuring range can be 0.1-55 kV/m and the estimated operation bandwidth is 1 kHz-460 MHz. The norm detector is tested and compared with the traditional E-field sensor with the fiber-optic link by measuring the square waveform and the actual electromagnetic pulse waveform. Furthermore, the norm detector can measure magnetic field, coupled current or high-voltage pulse by a simple structural modification.

A gas discharge induced in the air-vapor medium and made it possible to obtain plasma objects with a lifetime of 1/30 to 1/5 s is investigated. Initiation, formation, and decay of the spherical plasmoid with a diameter of about 10–12 cm are investigated in detail with a digital photographic system. It was fixed that the increasing of humidity leads to the increasing of the plasmoid lifetime. The current-voltage characteristic of the process was measured, as well as the dependences of the current and voltage on the time. The analysis of the experimental data was carried out and, based on it, a thermodynamical hypothesis of the plasmoid explaining its spherical shape was created.

Volumetric measurement of artificial pure ground-glass nodules at low-dose CT: Comparisons between hybrid iterative reconstruction and filtered back projection

Purpose: Poor levator function (LF) blepharoptosis can be corrected surgically using frontalis muscle suspension with a variety of materials. Autogenous grafts such as fascia lata are commonly used. The need for a remote surgical site and the risk of an unattractive leg scar makes the use of an autogenous temporalis fascia (ATF) graft appealing as the scar is concealed in the hair. We describe the use of a pleated, lengthened ATF graft that is easy to prepare and insert, and provides a cosmetically acceptable outcome.Methods: Prospective case series describing six patients with previous multiple failed lid surgeries and recurrent poor (≤5 mm) LF (mean 2.87 ± 1.72 mm) ptosis. The pleated graft technique was used to yield a strip of ATF up to 18-cm long from a short 2-cm temporal incision. Eight eyelids then underwent ATF graft frontalis suspension surgery using the modified Fox pentagon technique. Outcomes included eyelid measurements with 4.5-year follow-up.Results: All patients achieved good functional and esthetic outcome. The mean central palpebral aperture 6 weeks postsurgery was 7.14 ± 1.67 mm, equating to a mean increase of 3.27 mm (p < 0.05 using the paired t-test). The improvement in eyelid height was maintained at the 4.5-year follow-up in all patients, except one who died of unrelated cause.Conclusion: A pleated strip of ATF graft provides a simpler alternative to fascia lata grafting for frontalis suspension in poor LF ptosis in adult patients with good long-term results.

Aim The specialty of Plastic and reconstructive surgery has long been at the forefront of innovation. However, perceptions of individuals focusing on entrepreneurship, particularly at a junior level, remain unclear. Anecdotally, trainees can be discouraged from participating in entrepreneurial efforts for fear of seniors’ disapproval. Method A questionnaire was circulated amongst doctors at the Royal Free Plastic Surgery department aiming to establish knowledge and perceptions of entrepreneurship. It included 10 questions to be answered anonymously. Results 18 individuals responded, including Foundation doctors (n = 2), Junior clinical fellows (n = 2), Core surgical trainees (n = 3), Specialty registrars (n = 5), Senior clinical fellows (n = 2) and Consultants (n = 4). All respondents (n = 18) understood the meaning of the term “entrepreneurship” and 44.4% (n = 8) had prior entrepreneurship experience. Perceptions of the connotations of the word “entrepreneurship” in surgery varied. 33% (n = 6) reported “strongly negative” and 33% (n = 6) “strongly positive” connotations. Notably, of those reporting “strongly negative” connotations, 80% (n = 4) were junior trainees at Core surgical training or below, and 20% (n = 1) were specialty registrars. Amongst the 4 consultants, mean perception on a 5-point scale was 3.75, indicating an overall “positive” connotation. Furthermore, 83.3% (n = 15) of respondents felt their surgical career had not provided them with opportunities to develop entrepreneurship skills and 94.4% (n = 17) would like further opportunities to develop entrepreneurship skills. Conclusions Perceptions on involvement in entrepreneurship in surgery are predominantly positive. Those associating entrepreneurial efforts with negative connotations seem to be predominantly junior. This result will hopefully encourage Plastic surgeons at all levels to become involved in entrepreneurial efforts.

To assess interobserver and intraobserver variabilities in measuring the maximal standardized uptake value (SUV) of non-small-cell lung cancer. Positron emission tomography-computed tomography examinations of 20 consecutive patients referred for initial evaluation of newly diagnosed non-small-cell lung cancer were retrospectively reviewed by 5 experienced positron emission tomography-computed tomography readers, who independently measured the maximal SUV/body weight of the primary tumors. Interobserver and intraobserver variabilities were assessed by using 4 statistical methods: correlation, regression analysis, Bland-Altman analysis, and analysis of variance. The SUV measurements derived in the study were compared with the SUV measurements documented in the original reports using correlation and regression analysis. The percentages of tumors whose retrospective SUV measurements were more than 20% different and more than 25% different from those in the original report were assessed. Both interobserver and intraobserver SUV measurements were highly reproducible. Pearson correlation coefficients were greater than 0.95 and 0.94, respectively. Good interobserver and intraobserver agreement was shown with regression analysis (F test P value >0.05), the Bland-Altman analysis, and analysis of variance (F test P value >0.95). The mean original SUV was much less than the mean study SUV (P<0.05). The study SUV differed from the SUV of the original report by more than 20% in 50% of the tumors, and by more than 25% in 45% of the tumors. There was excellent interobserver and intraobserver agreement in SUVs measured in the study environment but poor agreement between study SUVs and those documented in original reports, which can affect treatment decisions substantially.

Purpose: Changes in the flared end of balloon-expandable covered stent (BECS) may precede BECS-associated complications but are not regularly assessed with computed tomographic angiography (CTA) after fenestrated endovascular aneurysm repair (FEVAR). Validation of the flare geometric analysis (FGA) and assessment of intraobserver and interobserver variability are investigated in this study. Methods: Two series of 3 BeGraft BECSs (Bentley InnoMed GmbH, Hechingen, Germany) and 1 series of 3 Advanta V12 BECSs (Getinge AB, Göteborg, Sweden) were deployed in 3 side branches (45°, 60°, and 90° aortic branch angles) of an aorta phantom model. A standard post-FEVAR CTA scan was acquired. Computed tomographic angiography–derived measurements consisted of centerline reconstructions and placement of 3-dimensional coordinate markers by 2 observers in a vascular workstation. Flare geometric analysis calculates 3 BECS parameters: the circumferential flare-to-fenestration distance (FFD), which is the distance from the proximal end of the flare to fenestration, and diameters at the proximal end of the flare (Dflare) and at the fenestration (Dfenestration). Computed tomographic angiography–derived measurements were validated against microscopy measurements. Bland-Altman plots were used to determine the intraobserver and interobserver variability of the BECS parameters and intraclass correlation coefficient (ICC). Results: For each BECS, the FFD at 4 equidistant quadrants of the circumference, Dflare, and Dfenestration were calculated. The mean difference and repeatability coefficient (RC) of the validation were 0.8 (2.1) mm for FFD, 0.4 (1.0) mm for Dflare, and −0.2 (1.2) mm for Dfenestration. The mean intraobserver and interobserver difference (RC) was 0.5 (1.6) mm and 0.7 (2.6) mm for FFD, 0.1 (0.6) mm and 0.1 (0.7) mm for Dflare, and −0.1 (0.8) mm and −0.8 (1.0) mm for Dfenestration. The mean ICC of intraobserver variability was 0.86 for FFD, 0.94 for Dflare, and 0.78 for Dfenestration. The mean ICC of interobserver variability was 0.77 for FFD, 0.92 for Dflare, and 0.48 for Dfenestration. Conclusion: This study showed that FGA of the flared ends of BECS can be performed with high accuracy in a phantom model, with good intraobserver and interobserver variability. Flare geometric analysis can be used to determine flare geometry of the BECS on standard post-FEVAR CTA scans.

Accuracy of left ventricular volumes and ejection fraction using high-intensity echo band as a landmark: Comparison between two-dimensional echocardiography and cardiac magnetic resonance imaging.

Clinical accuracy and responsiveness of 3D software for measuring facial dimensions at altered vertical dimensions.

4D cardiac magnetic resonance flow in patients with pulmonary hypertension associated with congenital heart disease

BackgroundMyocardial deformation can be key to clinical decision. 2D feature-tracking of cardiovascular magnetic resonance (CMR-FT) imaging is user-friendly but has poor reproducibility, particularly for radial strain. 3D CMR-FT may improve...