Preservation Of Contour Research Articles

Radiologic and clinical evaluation of children with first febrile urinary tract infection.

Background and objectivesAccurate diagnosis of acute pyelonephritis (APN) is clinically challenging in young children. The evaluation methods for APN and its major risk factor, vesicoureteral reflux (VUR), have been revised in recent years. The aim of this study was to evaluate the value of different radiologic investigations in children experiencing the first episode of APN.Materials and methodsThis study included 425 children of 2–12 months of age (17.5% male, 82.5% female) with APN. APN was defined as a positive urine culture associated with focal or diffuse decreased cortical uptake and preservation of renal contour indicated by DMSA renal scan.ResultsThe mean age at diagnosis was 39.2 ± 1.56 months. The following signs were observed in the patients: fever ≥ 38.5 °C, 66.8%; positive CRP, 85.4%; ESR > 25, 78.6%; and leukocytosis > 13,000/mm3, 53.4%.Pyelocalyceal fullness and increased parenchymal echogenicity were the most common renal ultrasonography findings, and ultrasonography had 34% sensitivity and 53% specificity for these two findings. DMSA scan and ultrasound findings of APN were not significantly correlated (P = .112).VUR was found in 42.2% of patients. DMSA scanning was not reliable for the diagnosis of VUR (P = .956), with 42% sensitivity and specificity.VUR was identified in 42.7% of patients by ultrasound (P = .001), and the diagnostic rate was related to the VUR severity. Ultrasound had 42.7% sensitivity and 27% specificity for the diagnosis of VUR.ConclusionDetermination of inflammatory markers is recommenced for the evaluation of children with APN. In addition, normal ultrasound is a valuable imaging tool for excluding high grade VUR.

Enucleation combined with peripheral ostectomy: Its role in the management of large cystic ameloblastomas of the mandible

AimAggressive resection of a large mandibular cystic ameloblastoma may cause severe deformity and dysfunction, while simple enucleation may carry a high risk of recurrence. The purpose of this study was to evaluate, in terms of both recurrence and the preservation of contour and function, the effectiveness of enucleation combined with peripheral ostectomy (Enu/PO) in managing large mandibular cystic ameloblastomas. Materials and methodsFourteen patients who had large mandibular cystic ameloblastoma (11 unicystic, 3 multicystic) and had been treated with the Enu/PO were reviewed. ResultsThe follow-up period was 19–117 months. Using Enu/PO, mandibular continuity was preserved in all patients, and only one patient complained of permanent lip numbness. With bone regeneration, the thinned bone plate significantly thickened and the residual cavity shrank. No pathological fracture occurred. There was recurrence in 3 patients. Two recurrences were treated with radical surgery, and the other with Enu/PO. No new recurrence was found thereafter. All patients were satisfied with their facial appearance. ConclusionsThe Enu/PO technique is excellent in preserving appearance and functions and with a low risk of recurrence, is a reliable option for the management of large mandibular cystic ameloblastomas.

Surface and contour-preserving origamic architecture paper pop-ups

Origamic architecture (OA) is a form of papercraft that involves cutting and folding a single sheet of paper to produce a 3D pop-up, and is commonly used to depict architectural structures. Because of the strict geometric and physical constraints, OA design requires considerable skill and effort. In this paper, we present a method to automatically generate an OA design that closely depicts an input 3D model. Our algorithm is guided by a novel set of geometric conditions to guarantee the foldability and stability of the generated pop-ups. The generality of the conditions allows our algorithm to generate valid pop-up structures that are previously not accounted for by other algorithms. Our method takes a novel image-domain approach to convert the input model to an OA design. It performs surface segmentation of the input model in the image domain, and carefully represents each surface with a set of parallel patches. Patches are then modified to make the entire structure foldable and stable. Visual and quantitative comparisons of results have shown our algorithm to be significantly better than the existing methods in the preservation of contours, surfaces, and volume. The designs have also been shown to more closely resemble those created by real artists.

Efficacy of triple therapy in auricular keloids.

Background:Keloids are characterised by their continued growth following trauma, extension into normal tissue and their high recurrence rate following excision. Auricular keloids are common following ear piercing or flame burns. These lesions are highly conspicuous and cosmetically unappealing. Multiple methods including surgery, radiotherapy, antimitotic agents, silicone sheet, pressure clips and cryotherapy have been advocated. The risk of recurrence and the need to prevent distortion of the three-dimensional structure of the ear following resection is a challenge to the cutaneous surgeon.Objectives:To devise a standard protocol for management of auricular keloids with minimal distortion and recurrence.Setting and Design:The patients underwent day-care surgery and subsequent out-patient follow-up for a minimum period of 1 year.Methods:Ten patients presenting with 22 ear keloids were enrolled into a keloid protocol: (a) surgical excision and keloid rind flap cover with (b) intra-operative and post-operative intra-lesional steroid and (c) silicone sheet application. Subjective assessment on follow-up was using Patient Observer Scar Assessment Scale and objective assessment was by Beausang scale.Statistical Analysis used:Microsoft Excel and Statistical Package for the Social Sciences (SPSS). Kaplan-Meier survival analysis curve used to calculate Recurrence Free period.Results:Two out of 22 (9.1%) keloids developed post-excision recurrence after a mean follow -up period of 16 months. The average keloid recurrence free interval was 21 months.Conclusion:Triple combination therapy for keloids on the ear is a simple technique for management with preservation of contour of the ear and a low recurrence rate.

Conversion of an existing metal ceramic crown to an interim restoration and nonfunctional loading of a single implant in the maxillary esthetic zone: A clinical report

Implant placement and immediate placement of an interim restoration can be a safe therapeutic approach with high survival rates. The technique is often used in the anterior esthetic area because of the better preservation of the periimplant soft tissue contours. Traditionally this procedure involves the fabrication of an acrylic resin implant-supported interim restoration. This clinical report describes the modification of an existing metal ceramic crown to be used as an implant-supported interim restoration for immediate nonfunctional loading to achieve an improved esthetic result and optimal support of the adjacent soft tissues.

Neoareolar Wise Pattern Reduction in Patients Requiring Central Partial Mastectomy

Oncoplastic surgery integrates breast cancer resection with tissue transfer techniques to preserve breast cosmesis. With the novel methods developed in the oncoplastic movement, we are capable of performing larger resections with clear margins while minimizing the cosmetic deformity caused by more traditional surgical techniques. Central and retroareolar breast cancers continue to be a cosmetic challenge because removal of the central portion of the breast can be particularly deforming. An inferior pedicle Wise pattern reduction mammoplasty is performed. The inferior pedicle is de-epithelized except for a circular disc of skin superiorly, which will become the neoareola. The breast cancer is removed along with the nipple-areolar complex (NAC). Part of the NAC may be preserved if tumor resection can be performed with sufficient margins. A standard reduction is performed, removing more tissue as indicated by cosmetic need. The reduction is completed in standard fashion using the neoareola as a replacement for the previously removed NAC. The video demonstrates the feasibility of this technique, highlighting both preservation of breast shape and contour, and creation of a substitute for the NAC. Complex reduction techniques have been reported in the literature as feasible options for breast conservation surgery. The neoareolar Wise pattern reduction mammoplasty offers an option that allows for oncologically sound cancer surgery while simultaneously preserving cosmesis.

NOISY DISTORTED IMAGES RECOVERY USING BLIND DECONVOLUTION

The problem of noisy and linearly distorted images recovery is considered. For the solving the blind deconvolution method is proposed. This method ensures contour preservation and high quality of restoration.

Tongue reduction for macroglossia in Beckwith Wiedemann syndrome: review and application of new technique

Beckwith Wiedemann syndrome (BWS) is a rare, congenital overgrowth disorder that is characterized by macroglossia, anterior abdominal wall defects, visceromegaly, gigantism, and neonatal hypoglycaemia. Macroglossia may contribute to anterior open bite malocclusion with prognathism, speech articulation disturbances, drooling and the perception of intellectual disability. It was the purpose of this study to review a series of BWS patients who underwent surgical reduction of the tongue by a modified technique with respect to aesthetic and functional outcomes. Seven BWS patients, age 6 months to 21 months, had a ‘stellate/anterior wedge’ reduction with an anterior rotation flap and were followed up from 4 months to 9 years postoperatively. Assessment of aesthetics together with tongue morphology and mobility were recorded and a postoperative speech evaluation was performed. Minor contour deformities were present in two patients during function but all parents were satisfied with the results. The speech pathology assessment results indicated positive outcomes for speech, oral structure and function, and feeding for all children assessed. This modified technique allows for an adequate reduction of tongue volume with conservation of motor and sensory function as well as preservation of anatomical contour.

Evaluation of a biodegradable synthetic hydrogel used as a guided bone regeneration membrane: an experimental study in dogs

To test whether or not an experimental polyethylene glycol (PEG) membrane maintains the bone graft volume and contributes to the preservation of the ridge contour in comparison with a commercially available synthetic membrane. In 18 dogs, all mandibular premolars and the first molars were extracted. Ten weeks later, acute standardized defects were prepared. The defects of four dogs were randomly assigned to three modalities: (1) PEG plus deproteinized bovine bone mineral (DBBM) (PEG), (2) a resorbable glycolide trimethylene carbonate membrane plus DBBM (PGA-TMC), and (3) DBBM alone (DBBM). These dogs were then sacrificed for the baseline measurements. The remaining defects of 14 dogs were randomly assigned to (1) PEG plus DBBM, (2) PGA-TMC plus DBBM, (3) DBBM, and (4) empty defect. The dogs were sacrificed at baseline (n=4), 4 weeks (n=7), or at 16 weeks (n=7). Mixed model regressions and the non-parametric Brunner-Langer method were applied for statistical analysis. At baseline, equal tissue augmentation was observed in all groups. At 4 and 16 weeks, the greatest augmented area fractions were calculated for PEG (103%; 107%, respectively), followed by PGA-TMC (98%; 91%), DBBM (85%; 78%), and empty (46%; 54%), being statistically significant different (P<0.001) between PEG and empty at 4 and 16 weeks, and PEG and DBBM at 16 weeks. The overall decrease (P≤0.01) in the amount of bone graft between baseline and 16 weeks was -14% (PEG), -22% (PGA-TMC), and -23% (DBBM). The study demonstrates that the combination of the PEG membrane with DBBM maintains the bone graft volume over time better than controls. The PEG membrane with DBBM was also the most effective method to preserve the ridge contour.

Magnesium-enriched hydroxyapatite at immediate implants: a histomorphometric study in dogs

To evaluate the influence of magnesium-enriched hydroxyapatite (MHA) (SintLife(®)) on bone contour preservation and osseointegration at implants placed immediately into extraction sockets. In the mandibular pre-molar region, implants were installed immediately into extraction sockets of six Labrador dogs. MHA was placed at test sites, while the control sites did not receive augmentation materials. Implants were intended to heal in a submerged mode. After 4 months of healing, the animals were sacrificed, and ground sections were obtained for histomorphometric evaluation. After 4 months of healing, one control implant was not integrated leaving n=5 test and control implants for evaluation. Both at the test and the control sites, bone resorption occurred. While the most coronal bone-to-implant contact was similar between test and control sites, the alveolar bony crest outline was maintained to a higher degree at the buccal aspect of the test sites (loss: 0.7 mm) compared with the control sites (loss: 1.2 mm), even though this difference did not reach statistical significance. The use of MHA to fill the defect around implants placed into the alveolus immediately after tooth extraction did not contribute significantly to the maintenance of the contours of the buccal alveolar bone crest.

Pitch error analysis of young piano students’ music reading performances

This study analyzed the music reading performances of 6—13-year-old piano students ( N = 35) in their second year of piano study. The stimuli consisted of three piano pieces, systematically constructed to vary in terms of left-hand complexity and input simultaneity. The music reading performances were recorded digitally and a code of error analysis was constructed from the data. The effect of age on the types of errors made was investigated. The age differences found were in terms of error frequency, performance continuity, contour preservation, and stimulus complexity. The study sheds light on what may be typical music reading errors of piano students in their second year of study and suggests some trends of age-related development in music reading among piano students.

Joint Curettage Arthrodesis Technique in the Foot: A Histological Analysis

Arthrodesis via joint contour preservation using the curettage method has become popular in foot and ankle surgery to avoid segmental shortening and the need to bone graft. Despite its popularity, the effect of joint curettage has never been histologically evaluated. Knowledge of the histological appearance after joint curettage would be helpful to the foot and ankle surgeon to better understand the function of joint surface preparation for arthrodesis. Five cadaver specimens were used to harvest the first metatarsocuneiform and subtalar joints for routine histological analysis after performing joint curettage technique. One specimen was used as a reference, whereas the remaining specimens were processed after joint surface preparation. Results show a residual layer of calcified cartilage overlying the subchondral plate interface on all osteochondral specimens after joint curettage. This suggests there is a natural histological barrier that may interfere with arthrodesis consolidation. 5.

Application of Skeletal Buttress Analogy in Composite Facial Reconstruction

Reconstructive algorithms for composite craniofacial defects have focused on soft tissue flaps with or without bone grafts. However, volumetric loss over time limits long-term preservation of facial contour. Application of craniofacial skeletal buttress principles to high-energy trauma or oncologic defects with composite vascularized bone flaps restores the soft tissue as well as the buttresses and ultimately preserves facial contour. We conducted a retrospective review of 34 patients with craniofacial defects treated by a single surgeon with composite bone flaps at R Adams Cowley Shock Trauma Center and Johns Hopkins Hospital from 2001 to 2007. Data collected included age, sex, mechanism of injury, type of defect, type of reconstructive procedures, and outcome. Thirty-four patients with composite tissue loss, primarily males (n = 24) with an average age of 37.4 years, underwent reconstruction with vascularized bone flaps (28 fibula flaps and 6 iliac crest flaps). There were 4 cranial defects, 8 periorbital defects, 18 maxillary defects, and 4 maxillary and periorbital defects. Flap survival rate was 94.1% with an average follow-up time of 20.5 months. Restoration of facial height, width, and projection is achieved through replacement of skeletal buttresses and is essential for facial harmony. Since 2001, our unit has undergone a paradigm shift with regard to treatment of composite oncologic and traumatic defects, advocating vascularized bone flaps to achieve predictable long-term outcomes.

O.374 Genioplasty – modiflcations of mandibular body osteotomies

Aggressive resection of a large mandibular cystic ameloblastoma may cause severe deformity and dysfunction, while simple enucleation may carry a high risk of recurrence. The purpose of this study was to evaluate, in terms of both recurrence and the preservation of contour and function, the effectiveness of enucleation combined with peripheral ostectomy (Enu/PO) in managing large mandibular cystic ameloblastomas.Fourteen patients who had large mandibular cystic ameloblastoma (11 unicystic, 3 multicystic) and had been treated with the Enu/PO were reviewed.The follow-up period was 19–117 months. Using Enu/PO, mandibular continuity was preserved in all patients, and only one patient complained of permanent lip numbness. With bone regeneration, the thinned bone plate significantly thickened and the residual cavity shrank. No pathological fracture occurred. There was recurrence in 3 patients. Two recurrences were treated with radical surgery, and the other with Enu/PO. No new recurrence was found thereafter. All patients were satisfied with their facial appearance.The Enu/PO technique is excellent in preserving appearance and functions and with a low risk of recurrence, is a reliable option for the management of large mandibular cystic ameloblastomas.

Preservation of Contour in Periorbital and Midfacial Craniofacial Microsurgery: Reconstruction of the Soft-Tissue Elements and Skeletal Buttresses

Microsurgical reconstructive algorithms for craniofacial defects have focused on soft-tissue flaps with or without conventional bone grafts. However, volumetric loss from muscle atrophy, bone resorption, and soft-tissue contraction limits long-term preservation of facial contour. Applying craniofacial principles of skeletal buttress support, the authors used composite vascularized bone flaps to reconstruct the soft tissue and the vertical and horizontal buttresses of the face. In this manner, facial proportions and aesthetics are maintained in composite tissue defects resulting from high-energy trauma or oncologic extirpation. The authors conducted a retrospective review of 31 patients with craniofacial defects treated by a single surgeon with composite bone flaps at the R Adams Cowley Shock Trauma Center and The Johns Hopkins Hospital from 2001 to 2006. Charts were reviewed and data were collected on age, sex, mechanism of injury, type of defect, type of reconstructive procedure, and outcome. Thirty-one patients with composite tissue loss, primarily men (n = 21) with an average age of 37.4 years, underwent reconstruction with vascularized bone flaps (25 fibula flaps and six iliac crest flaps). There were three cranial defects, eight periorbital defects, 17 maxillary defects, and three maxillary and periorbital defects. The flap survival rate was 93.5 percent, with an average follow-up of 13.5 months. Restoration of facial height, width, and projection through skeletal buttress replacement is essential for achieving facial harmony. Since 2001, the authors' unit has pursued a paradigm shift with regard to treatment of composite oncologic or traumatic defects, advocating vascularized bone flaps to achieve excellent long-term functional and aesthetic outcomes.

Tragal cartilage grafts in rhinoplasty: A viable alternative in the graft-depleted patient

To describe a simple technique for harvesting tragal cartilage and describe its use in rhinoplasty. Retrospective review. Rhinoplasties performed between January 2005 and June 2007 in which tragal cartilage grafts were utilized by the senior author (CSC) were reviewed to assess type of graft, preservation of tragal contour, and donor-site morbidity. Tragal cartilage grafts were used in three primary and three secondary rhinoplasty patients. Postoperative follow-up ranged from six months to 12 months. Tragal cartilage was used as five alar contour grafts, one lateral crural onlay graft, one dorsal onlay graft, and one infratip lobule graft. Tragal cartilage was used to close the septal perforation of one patient. Tragal contour was preserved in all patients, and there were no complications noted with this procedure. The tragus provides a simple, convenient alternative source of cartilage for rhinoplasty in graft-depleted patients.

Preservation of soft tissue contours with immediate screw-retained provisional implant crown

When a patient with a missing or failing maxillary anterior tooth desires immediate tooth replacement, fabrication of a provisional restoration can be challenging. Due to individual anatomical variations in tooth shape, size, and supporting soft and hard tissue structures, there are no premanufactured components with an anatomical emergence profile that universally suits all individual situations. This article describes the fabrication of a screw-retained immediate provisional restoration that fulfills anatomic, biologic, and esthetic requirements.

ICA based algorithms for computing optimal 1-D linear block transforms in variable high-rate source coding

The Karhunen–Loève Transform (KLT) is optimal for transform coding of Gaussian sources, however, it is not optimal, in general, for non-Gaussian sources. Furthermore, under the high-resolution quantization hypothesis, nearly everything is known about the performance of a transform coding system with entropy constrained scalar quantization and mean-square distortion. It is then straightforward to find a criterion that, when minimized, gives the optimal linear transform under the abovementioned conditions. However, the optimal transform computation is generally considered as a difficult task and the Gaussian assumption is then used in order to simplify the calculus. In this paper, we present the abovementioned criterion as a contrast of independent component analysis modified by an additional term which is a penalty to non-orthogonality. Then we adapt the icainf algorithm by Pham in order to compute the transform minimizing the criterion either with no constraint or with the orthogonality constraint. Finally, experimental results show that the transforms we introduced can (1) outperform the KLT on synthetic signals, (2) achieve slightly better PSNR for high-rates and better visual quality (preservation of lines and contours) for medium-to-low rates than the KLT and 2-D DCT on grayscale natural images.

Fingertip injuries

Background:Fingertip injuries are extremely common. Out of the various available reconstructive options, one needs to select an option which achieves a painless fingertip with durable and sensate skin cover. The present analysis was conducted to evaluate the management and outcome of fingertip injuries.Materials and Methods:This is a retrospective study of 150 cases of fingertip Injuries of patients aged six to 65 years managed over a period of two years. Various reconstructive options were considered for the fingertip lesions greater than or equal to 1 cm2. The total duration of treatment varied from two to six weeks with follow-up from two months to one year.Results:The results showed preservation of finger length and contour, retention of sensation and healing without significant complication.Conclusion:The treatment needs to be individualized and all possible techniques of reconstruction must be known to achieve optimal recovery.

Addison's disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation

Purpose To describe CT morphology of untreated adrenal tuberculosis during the different stages of the natural history of the disease and to evaluate the diagnostic implications of CT features. Materials and methods We retrospectively evaluated CT features in 42 patients with documented adrenal tuberculosis for the location, size, morphology, and enhancement patterns shown on CT images. The clinical duration were correlated with the CT features. Results Of the 42 patients with untreated adrenal tuberculosis, bilaterally enlarged adrenal glands were revealed in 38 cases (91%), unilaterally enlarged in 3 cases (7%), and normal size in 1 case (2%). Of the 41 cases (98%) with enlargement, mass-like enlargement was seen in 20 cases (49%) and enlargement with preserved contours in 21 cases (51%). Peripheral rim enhancement presented in 22 cases (52%) on contrast-enhanced CT. Non-enhanced CT scan revealed calcification in 21 cases (50%). As the duration of Addison's disease increased, the presence of calcification and contour preservation increased concomitantly ( p < 0.001), whereas peripheral rim enhancement and mass-like enlargement decreased concomitantly on CT images ( p < 0.001). Conclusion CT may be helpful in diagnosing adrenal tuberculosis when clinically suspected, and CT features are correlated to the clinical duration of Addison's disease.