[Reconstructive orbital surgery]. / Rekonstruktive Orbitachirurgie.

BACKGROUND: In complex orbital reconstructions ideal positioning of the bony buttress and surrounding soft tissue is a prerequisite for an aesthetic and functional result. The use of computer-assisted surgery can support the surgeon before and during the reconstruction procedure and facilitate quality control processes. This is illustrated using three clinical examples. MATERIAL AND METHODS: The areas of interest (bony defect areas, surrounding tissues) are segmented in a 3D image series. In most cases, the contralateral non-affected side can serve as the reference in virtual reconstruction. The virtual model obtained can now be used for the manufacturing of patient specific models and implants, as well as for intraoperative navigation or direct quality control with the use of intraoperative cone beam computed tomography (CBCT). RESULTS: For the reconstruction of primary and secondary traumatic defects as well as for congenital malformations or neoplastic diseases, the presented workflow can be used. Preoperative virtual visualization, patient specific reconstruction and direct quality control using intraoperative CBCT ensure that the preoperatively planned result can be achieved. Together with the interplay of hard and soft tissue the best possible results can be achieved. CONCLUSION: Computer-assisted surgery has been continuously further developed over the last two decades and is currently used in the clinical routine. Patient specific implants in combination with the use of direct intraoperative quality control facilitate the reconstruction of complex orbital injuries and defects and enable the ideal reconstruction from both aesthetic and functional aspects.

Meta-analysis of stray voltage on dairy cattle.

A quantitative assessment of dairy cow responses to contact current (stray voltage) at 50 or 60 Hz was conducted using meta-analysis and pooled analysis methodology. The objective was to more accurately quantify the minimum exposure level (threshold) at which dairy cows respond and to identify sources of heterogeneity among studies. Several medical and agricultural databases were used to locate individual studies for the systematic literature review, from which 22 published studies of stray voltage and behavioral response or milk yield met our inclusion criteria. Meta-analysis models were constructed to assess the percentage of cows with a behavioral response at documented exposure levels, and the summary relative risk estimate for all exposure pathways combined was calculated for each 1-mA increment from 1.0 through 5.0 mA. The meta-analysis of percentage response showed that cows exhibited statistically significant first behavioral responses at 3.0 mA, response probability increased with exposure levels, and exposure pathways contributed to heterogeneity in the model. The pooled analysis of mean behavioral response threshold was based on experimental studies of ascending series of current exposures on 355 cows. The overall weighted mean for first behavioral response to current was 4.0 mA. Ten of the studies that met the inclusion criteria addressed milk production, but heterogeneity in exposure pathways, patterns, and duration precluded meta-analysis or data pooling. The milk production studies ranged in size from 4 to 48 cows and used switchback or paired design to increase power. A qualitative narrative review of these studies indicated that production was not affected by exposure to contact current at levels of 3 mA or lower for exposures of up to 21 d or 4 wk.

Family size effects: a review.

Larger families are more frequent with early marriage and rapid birth of the first child. In larger families, child rearing becomes more rule ridden, less individualized, with corporal punishment and less investment of resources. Smaller families tend to result in higher IQ, academic achievement, and occupational performance. Large families produce more delinquents and alcoholics. Perinatal morbidity and mortality rates are higher in large families as birth weights decrease. Mothers of large families are at higher risk of several physical diseases. Common methodological errors are indicated and exemplary studies are described.

Child spacing effects: a comparison of institutionalized and normal children.

Data were collected on 52 psychiatrically abnormal and 101 normal children, as part of a study of the effects of sibship constellation variables on intellect, achievement, personality traits, and social adjustment. The two groups are closely equivalent with respect to age, social class (lower and lower-middle) and sibship size. There was a significantly higher percentage of psychiatrically abnormal than normal children having a sibling less than two years older. conversely, the normal children had a significantly higher percentage of widely spaced (to the next older) than did the psychiatrically abnormal children. Unwantedness by parents (especially the mother) may be a factor in increasing the likelihood of learning and behavioral difficulties and other social disarticulation.

Sibship-constellation effects on psychosocial development, creativity, and health.

PIP: This contribution provides a summary and integration of the abundant research findings culled from over 2000 articles dealing with the effects of sibship variables on child development. The review covers the effects of each of the sibship variables: sibship size, ordinal position, and sibling age spacing with regard to intelligence, achievement, creativity, personality, and health. All descriptions included are based on at least 1 reported research finding. Speculative literature is consistently excluded. Each and all of the sibship variables have effects, from just demonstrable to uncommonly powerful, on intelligence, academic achievement, occupational success, creativity, emotional control, socialization, health, and longevity. Despite the fact that they are derived from variously oriented and designed investigations, the studies reviewed present overall amazingly consistent results. Intelligence and personality traits are powerfully influenced by parental behavior and sibling interaction, particularly during the child's 1st 3 years of life. Yet, both cognitive and conative characteristics lend themselves to improvement by positively altering parental behavior through psychotherapy, or better yet, by widespread open recognition of the importance and the intricacies of child rearing which has been almost totally left to parental whims and folklore The available basic knowledge needs to be used as a foundation for high school and college cources aimed at upgrading child rearing practies. Reseach and clinical evidence strongly and definitely indicate that socially desirable personality traits result from small families in which the children are spaced 3 or more years apart. Both the displaced and displacing child are seriously disturbed by close spacing -- the displaced child showing the greatest disturbance. Early displacement leads to early and persistent cognitive effects on intelligence and psychosocial development. Considering the effects of size of the family: large families seem to produce greater risk of arthritis, peptic ulcer, and cancer, as well as greater neonatal and early childhood morbidity and higher mortality rates. The goal in family planning and education in parenting would be to have each child wanted and welcomed and to have the parents devote sufficient time to the child to understandhis/her needs. widely spaces and fewer children are associated not only with upward mobilithy and an improved standard of living but also with greater overall individual ability, well being, and creativity.^ieng

Effect of potassium on utilization of (1-14C)palmitic acid in renal cortex of the rat.

The renal cortex has an unusually high rate of palmitic acid utilization. The uptake, oxidation, and distribution of this fatty acid in the cortex, unlike other tissues, responds to variations in medium and tissue potassium content. This potassium dependency is mimicked and amplified by rubidium. These observations indicate that in the renal cortex, both potassium and rubidium promote the accumulation, oxidation, and esterification of palmitic acid.

Family constellation and creativity: firstborn predominance among classical music composers.

Biographies of classical musci composers were examined for family constellation information. Usable data were found for 80 composers. Firstborns, especially only children, were found significantly more frequently than in a sample of creative writers studied by Bliss. Increased frequency of firstborns was also suggested in a study of musical performers by Raychaudhuri. Classical musci composition was seen as an ability more similar to usual academic pursuits than creative writing.