Повышение эффективности проведения геолого-технических мероприятий на месторождениях Западной Сибири

Цель работы - анализ проведенных геолого-технических мероприятий, предложение нового инновационного подхода к повышению эффективности проведения ГТМ на месторождениях Западной-Сибири. В процессе исследования проводился анализ имеющихся данных, на основе которых были выделение наиболее эффективные геолого-технические мероприятия, проводимые на месторождениях Западной Сибири.The purpose of the work is to analyze the geological and technical measures carried out, to propose a new innovative approach to improving the efficiency of GTM in the fields of Western Siberia. In the course of the study, the available data were analyzed, on the basis of which the most effective geological and technical measures carried out in the fields of Western Siberia were identified

Prism adaptation test before strabismus surgery in patients with decompensated esophoria and decompensated microesotropia

Purpose To evaluate the effect of Prism adaptation test (PAT) on the angle of squint in decompensated esophoria (decEPH) and decompensated microesotropia (decMET). Methods In this single-center retrospective study we reviewed the medical records of patients with the diagnosis of decEPH or decMET, aged at least 12 years, who were treated by strabismus surgery for the first time. The maximum Angle of squint (AOS) for far (F) and near (N) fixation and PAT results before surgery, as well as AOS (F) and AOS (N) after surgery and results of binocular function tests were considered. PAT included wearing a prism based on the largest angle for over 60 min. Results 100 patients (mean age 37 +/- 17 years) were included in the decEPH group, 82 patients (mean age 30 +/- 13 years) in the decMET group. For decEPH, before surgery AOS was 25.5 +/- 8.8 pdpt (F) and 23.5 +/- 9.8 pdpt (N). During PAT the AOS increased significantly by 2.7 +/- 4.3 to 28.2 +/- 8.6 pdpt (F) and by 4.9 +/- 4.5 to 28.3 +/- 9.5 pdpt (N). Altogether, in 82% of decEPH patients AOS (F) and/ or AOS (N) in- or decreased by at least 3 pdpt. For decMET, before surgery AOS was 28.6 +/- 10.8 pdpt for far (F) and 30.9 +/- 11.8 pdpt for near fixation (N). During PAT the AOS increased significantly by 4.2 +/- 5.8 to 32.5 +/- 9.5 pdpt (F) and by 3.7 +/- 6.1 to 34.4 +/- 9.5 pdpt (N). Altogether, in 51% of decMET patients, AOS (F) and/ or AOS (N) increased by at least 10 pdpt, therefore more than 5 degrees which would have been maximally expected from mictrotropia, or decreased by at least 3 pdpt. Conclusions The Prism adaptation test (PAT) showed remarkable changes in AOS in both decEPH and decMET. In patients with decEPH, the preoperative assessment of the true AOS under PAT reflects a pivotal requirement for successful strabismus surgery, as 82% had dose relevant angle changes >= 3 pdpt. For patients with decMET the preoperative prism adaptation test is especially of diagnostic value, but also 51% of decMET patients had changes in AOS beyond the expected microtropic angle (>= 10 pdpt) or even a dose relevant angle decrease (>= 3pdpt)

Tendon elongation with bovine pericardium in strabismus surgery-indications beyond Graves' orbitopathy

Background For some patients with complex ocular motility disorders, conventional strabismus surgery is insufficient. Surgery with tendon elongation allows correction of larger angles and maintains a sufficient arc of contact for rectus muscles. This study reports results for tendon elongation with bovine pericardium (Tutopatch (R)) in indications other than Graves' orbitopathy in which it is already widely used. Methods We reviewed the records of all patients who underwent surgery with Tutopatch (R) in our institution. Angles of squint and head postures were analyzed preoperatively, on the first postoperative day, and in the long term (median 9 weeks after the operation). Patients with Graves' orbitopathy were excluded. Results From 2011 to 2018, the procedures on 58 eyes of 54 patients (35 females, median age 35 years (3-75)) met the inclusion criteria. Horizontal rectus muscle surgery (53 eyes) was conducted on patients with residual strabismus (13), Duane's retraction syndrome with eso- (type I: 16)/exodeviation (type II: 2, type III: 1), 6th (7)/3rd nerve palsy (7), Mobius syndrome (2), congenital fibrosis of the extraocular muscles type 3A (CFEOM3A, TUBB3 mutation) (4), and orbital apex syndrome (1). Vertical rectus muscle surgery (5 eyes) was conducted on patients with myasthenia (1), vertical tropia after orbital floor fracture (1), CFEOM1 (2), and Parry-Romberg syndrome (1). 42 eyes had prior eye muscle surgery (1-5 procedures, median 1). Out of 45 patients with postoperative long-term data, 43 showed an angle reduction. Fifty-one percent had an angle of 10 Delta (prism diopter) or less, one had a significant over-effect, and 10 had revision surgery. For the heterogeneous group of residual eso- and exotropias, the median absolute horizontal angle was reduced from 35 Delta (16 to 45 Delta) to 9 Delta (0 to 40 Delta), for Duane's retraction syndrome from 27.5 Delta (9 to 40 Delta) to 7 Delta (0 to 40 Delta), and for sixth and third nerve palsies from 43 Delta (20 to 75 Delta) to 18 Delta (4 to 40 Delta). For 3 patients with vertical rectus muscle surgery, the median absolute vertical angle was reduced from 30 Delta (20 to 45 Delta) to 4 Delta (1 to 22 Delta). The motility range was shifted in the direction contrary to the elongated muscle in all subgroups. A considerable reduction of the excursion into the field of action of the elongated muscle had to be registered. Conclusions Strabismus surgery with bovine pericardium introduces new surgical options for complicated revisions and for rare and complex oculomotor dysfunctions. Yet, it has to be recognized that this type of surgery aiming at maximum effects, despite preservation or restitution of the arc of contact, leads to reduction of the excursion into the field of action of the elongated muscle. Furthermore, dose finding can be difficult depending on the underlying pathology and more than one intervention might be necessary for optimal results

Efficacy of Vertical Muscle Transpositions with and without Simultaneous Rectus Muscle Recession for Unilateral Sixth Nerve Palsy

Background We report results of a modified vertical muscle transposition procedure according to the Hummelsheim principle - with and without simultaneous rectus muscle recession - for unilateral sixth nerve palsy. We examine the influence of the duration of the palsy, preoperative angle of squint and preoperative abductive capacity on surgical results of the procedures. Patients and Methods Retrospective study of 29 consecutive patients with unilateral abducens nerve palsy who underwent surgery between 2001 and 2012. 21 patients had a modified vertical rectus muscle transposition according to the Hummelsheim principle (HUM); 8 patients had this operation combined with simultaneous medial rectus muscle recession (HUM+I). Surgery was performed at least 9 months after onset of the palsy (HUM: 9 to 98, median 19, mean 30 months; HUM+I: 12 to 65, median 25, mean 29 months). Results The median preoperative angle of squint (far distance) for the HUM group was 27.0 degrees (20.0 to 45.0; mean 28.1 degrees), and for the HUM+I group 30.5 degrees (21.8 to 50.0; mean 33.4 degrees). The median preoperative abductive capacity was for -1,6mm before midline (-8.0 to + 1.2; mean -1.8mm) for the HUM group, and -3.0mm before midline (-10.0 to -1.0; mean -4.1mm) for the HUM+I group. The median postoperative angle of squint (far distance) was 0 degrees (-11.3 to + 20.0; mean 0.1 degrees) for the HUM group, and -2.3 degrees (-11.3 to + 12.0; mean -2.1 degrees) for the HUM+ I group. The median post-operative abductive capacity was 1.0 mm (0 to + 3.0; mean + 1.1 mm) for the HUM group, and 1.1mm (-1.2 to + 3.0; mean + 0.9mm) for the HUM+ I group. The median reduction of squint angle was 27.0 degrees (9.1 to 45.0; mean 28.0 degrees) for the HUM group, and 36.8 degrees (25.2 to 41.4; mean 35.5 degrees) for the HUM+ I group. The median effect on abductive capacity was 2.5 mm (0 to 11.0; mean + 2.9 mm) for the HUM group, and 4.6 mm (2.4 to 8.8; mean + 5.0 mm) for the HUM+ I group. In the HUM group, the effect on squint angle reduced with the duration of the palsy, whereas, in the HUM+ I group, the effect improved with the duration of the palsy. Conclusions For patients with unilateral sixth nerve palsy, simultaneous medial rectus recession increases the effect of modified vertical rectus muscle surgery according to the Hummelsheim principle. The duration of the palsy is a relevant parameter for the selection of a sole or combined intervention with medial rectus recession

Kestenbaum procedure with combined muscle resection and tucking for nystagmus-related head turn

Literature has dealt extensively with dose-effect relations for recess-resect procedures for correction of horizontal nystagmus-related head turn. However, muscle tucking procedures have some advantages compared to resection procedures. Aim of this study was to evaluate dose-effect relations of Kestenbaum surgery with symmetrical combined recession and tucking (instead of resection) of the horizontal rectus muscles for the reduction of a nystagmus-related head turn. In a retrospective study, clinical findings of 42 patients who consecutively underwent treatment in our institution between 2000 and 2011 were investigated. The patients were aged 4-57 years (median age 6 years). For all patients, surgery aimed to correct a horizontal head turn (to the right: 18 patients) due to infantile nystagmus. The head turn was measured with a goniometer with the patient fixing the smallest age-appropriate target distinguishable for the patient. The median absolute head turn before surgery was 30A degrees (min. 15A degrees, max. 45A degrees). The four horizontal rectus muscles were recessed or tucked between 5.5 and 10 mm, median 9 mm. All four muscles were recessed or tucked for the same amount. At the first postoperative day, the median dose-effect relation was 1.88A degrees reduction of head turn per millimeter surgery on one eye (min. 0.5A degrees/mm, max. 3.2A degrees/mm). The median head turn was 0A degrees (min. -20A degrees, max. 15A degrees). Surgery was considered successful in 88 % of the patients with a reduction of the head turn to max. 10A degrees. Data of 36 patients were available for the long-term postoperative period (median 1.5 years; min. 6 weeks, max. 11 years). The median head turn was 10A degrees (min. -16A degrees, max. 30A degrees). The median dose-effect relation was reduced to 1.35A degrees/mm per eye (min. 0A degrees/mm, max. 2.9A degrees/mm). Surgery was considered successful in 72 % of the patients with a reduction of the head turn to max. 10A degrees. Three patients showed an overcorrection with a head turn of 8A degrees, 15A degrees and 16A degrees to the other side. A squint has not been induced. The dose-effect relation for Kestenbaum surgery with symmetrical combined recession and tucking of the horizontal rectus muscles is comparable to the dose-effect relation reported by other authors for symmetrical combined recession and resection

In dubio pro silentio – Even Loud Music Does Not Facilitate Strenuous Ergometer Exercise

Background: Music listening is wide-spread in amateur sports. Ergometer exercise is one such activity which is often performed with loud music.Aim and Hypotheses: We investigated the effects of electronic music at different intensity levels on ergometer performance (physical performance, force on the pedal, pedaling frequency), perceived fatigue and heart rate in healthy adults. We assumed that higher sound intensity levels are associated with greater ergometer performance and less perceived effort, particularly for untrained individuals.Methods: Groups of high trained and low trained healthy males (N = 40; age = 25.25 years; SD = 3.89 years) were tested individually on an ergometer while electronic dance music was played at 0, 65, 75, and 85 dB. Participants assessed their music experience during the experiment.Results: Majorities of participants rated the music as not too loud (65%), motivating (77.50%), appropriate for this sports exercise (90%), and having the right tempo (67.50%). Participants noticed changes in the acoustical environment with increasing intensity levels, but no further effects on any of the physical or other subjective measures were found for neither of the groups. Therefore, the main hypothesis must be rejected.Discussion: These findings suggest that high loudness levels do not positively influence ergometer performance. The high acceptance of loud music and perceived appropriateness could be based on erroneous beliefs or stereotypes. Reasons for the widespread use of loud music in fitness sports needs further investigation. Reducing loudness during fitness exercise may not compromise physical performance or perceived effort

Differential Diagnosis of Acquired Esotropia in the Elderly

Aim To provide an overview of the differential diagnoses of acquired esotropia that occur in the elderly and to facilitate their differentiation in everyday clinical practice. Methods The data of all patients who presented in our outpatient university department for strabology and neuroophthalmology from March 2014 to October 2015 due to esotropia with diplopia with onset after age 50 were evaluated retrospectively. Exclusion criteria were a known strabismus before the age of 50 and/or vertical deviations in the primary position. Anamnestic characteristics, accompanying findings and orthoptic parameters, were analysed. Results 85 patients were included in the study, 42 of them female and 43 male. The following diagnoses were made: abducens nerve palsy (n=34, 3 of them both sides), esotropia due to myopia magna (n=12), esotropia with accompanying neurological symptoms (n=6) and other etiology (n=5). In 4 cases, the diagnosis was still unclear at the end of the study. In 24 patients, none of the above diagnoses existed and the diagnosis of sagging eye syndrome (ETSAG) was made. The abducens nerve palsy typically showed a sudden onset of double vision, slowed abduction saccades and asymmetrical abduction ability. With unilateral abducens nerve palsy, the esotropia increased continuously from the view to the unaffected side through the primary position to the view to the affected side. Patients with ETSAG and myopia-associated esotropia, on the other hand, reported a gradual onset of double vision, showed normal abduction saccades and a slightly reduced abduction ability. The squint angle often increased slightly to both sides. Esotropia with accompanying neurological symptoms was rare and was seen in various underlying diseases. Conclusions The kind of onset of the double vision, the quality of the saccades, the incomitance pattern and the ability to abduct are important parameters for the etiological assignment of an esotropia in the elderly. The characteristics of the individual diagnoses are described and differential diagnostic aspects are discussed. Zusammenfassung Ziel der Studie Diese Studie soll einen uberblick uber die im Alter auftretenden Formen der Esotropie geben und deren Differenzierbarkeit im klinischen Alltag erleichtern. Methoden Die Daten aller Patienten, die sich von Marz 2014 bis Oktober 2015 aufgrund einer im Alter von uber 50 Jahren neu aufgetretenen Esotropie mit Diplopie in der Ambulanz unseres universitaren Schwerpunkts fur Strabologie und Neuroophthalmologie vorstellten, wurden retrospektiv ausgewertet. Ausschlusskriterien waren eine bekannte, vor dem 50.Lebensjahr bestehende Schielerkrankung und/oder Vertikalabweichungen in Primarposition. Analysiert wurden anamnestische Charakteristika, Begleitbefunde und orthoptische Parameter. Ergebnisse 85 Patienten konnten in die Studie eingeschlossen werden, davon 42 weiblich, 43 mannlich. Folgende Diagnosen wurden gestellt: Abduzensparese (n=34, davon 3 beidseits), Esotropie bei Myopia magna (n=12), Esotropien mit neurologischer Begleitsymptomatik (n=6), andere Genese (n=5). In 4 Fallen war die Diagnose zum Ende der Studie noch unklar. Bei 24 Patienten bestand keine der o.g. Diagnosen, es wurde die Diagnose Esotropie im Senium im Sinne eines Sagging-Eye-Syndroms (ETSAG) gestellt. Die Abduzensparesen zeigten typischerweise einen plotzlichen Doppelbildbeginn, verlangsamte Abduktionssakkaden und asymmetrische Abduktionsfahigkeit. Bei einseitigen Abduzensparesen vergro ss erte sich die Esotropie kontinuierlich vom Blick zur nicht betroffenen Seite uber Primarposition bis zum Blick zur betroffenen Seite. Patienten mit ETSAG und myopieassoziierter Esotropie gaben hingegen einen schleichenden Doppelbildbeginn an, zeigten normale Abduktionssakkaden und eine symmetrisch leicht verminderte Abduktionsfahigkeit. Der Schielwinkel nahm haufig zu beiden Seiten hin geringfugig zu. Eine Esotropie mit neurologischer Begleitsymptomatik war selten und zeigte sich bei unterschiedlichen Grunderkrankungen. Schlussfolgerung Die Art des Doppelbildbeginns, die Qualitat der Sakkaden, das Inkomitanzverhalten sowie die Abduktionsfahigkeit sind wegweisende Parameter fur die atiologische Zuordnung einer im Alter aufgetretenen Esotropie. Die Charakteristika der einzelnen Diagnosen werden beschrieben und differenzialdiagnostische Gesichtspunkte diskutiert