PURPOSE: In order to determine the differences in speech outcome based on timing of operation in submucous cleft palate, we have reviewed our experiences in the Furlow palatoplasty over the last 11 years. METHODS: From March 1996 to March 2006, 38 submucous cleft palate patients received Furlow palatoplasty. 10 developmentally delayed patients were excluded and 5 patients were lost to follow up. The rest 23 patients were reviewed. Speech was evaluated preoperatively and postoperatively, and speech therapy was performed accordingly. Perceptual speech assessment included hypernasality, nasal emission and articulation disorder. Cinefluorography was performed to aid perceptual assessment. Based on timing of operation, the patients were divided into 3 groups as following: Group A under 24 months(8 patients), Group B from 25 to 48 months(6 patients), and Group C over 49 months (9 patients). Except 1 patient under speech therapy yet, resultant speech was compared. RESULTS: The rate of abnormal speech was higher in Group C(3/9, 33.3%) than in Group A(0%) or B(0%). All 3 patients who had been discontinued of speech therapy from the parent's judgment had abnormal speech. The reason for the discontinuation was that the regular speech therapy was a burden at school age. Any patients who had continued speech therapy had normal speech. CONCLUSION: The results of our study shows that operative timing is associated with speech development. Maintenance of speech therapy was an important factor for normal speech development. It will be helpful to perform a palatoplasty before 48 months of age to complete speech therapy before the school age.
Articulation Disorders ; Cineradiography ; Cleft Palate ; Humans ; Judgment ; Lost to Follow-Up ; Speech Therapy

OBJECTIVETo develop an imaging system suitable for cochlear implant research on small laboratory animals.

METHODSA novel micro-focus X-ray imaging system was developed. The key features of the system were the use of a micro-focus X-ray source (less than 10 micrometers) and an appropriate choice of source-object and object-image distance. The new X-ray modality was evaluated on heads of cats, guinea pigs and rats.

RESULTSIt proved to be an useful tool to provide excellent image of small animal cochlea, allowing a clear electrode position to be established, and also helped greatly in detecting the breakage of electrode array.

CONCLUSIONSExperimental studies performed in cats, guinea pigs and rats confirmed that micro-focus radiography was an important tool for cochlear implant research in laboratory

Animals ; Cats ; Cineradiography ; methods ; Cochlea ; diagnostic imaging ; Cochlear Implantation ; Cochlear Implants ; Guinea Pigs ; Rats ; X-Rays

The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consisitsof transposition of great arteries and ventricular inversion, and which is caused by abnormal developement ofconotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to getaccurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented,in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul NationalUniversity Hospital between Sep. 1976 and June 1981. The clinical, radiogrpahic ,and operative findings with theemphasis on the angiocardiographic findings were analized. The resuls are as follows; 1. Among 18 cases, 13 caseshave normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situsinversus and 1 case has levocardia with situs inversus. 2. Segmental sets are {S.L.L.} in 15 cases, and {I.D.D} in3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and bothsemilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5.Associated cardiac malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively.6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is anessential procedure.
Angiocardiography ; Aorta, Thoracic ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Cineradiography ; Conus Snail ; Dextrocardia ; Diagnosis ; Levocardia ; Mitral Valve Insufficiency ; Prolapse ; Seoul ; Situs Inversus ; Transposition of Great Vessels

The field of application of fluoroscopy as an aid to ophthalmologist has been considerably enhanced by image intensification (electron acceleration for amplification of the fluoroscopic image), which has made possible the development of practical techniques of cinefluorography, television monitoring and recording. The use of a television monitoring system allows viewing by several observers in addition to the fluoroscopist, and the advantage of working in a lighted fluoroscopic room, instead of in the dark, contributes to both safety and efficiency. A monoplane TV fluoroscope (SIEMEN 500mA) and a 90 degrees rotating "two-planes" TV fluoroscope (Siremobile 2, SIEMEN) recently installed in the Departments of Radiology and Orthopedic Surgery at St. Mary's Hospital, Catholic Medical College (Fig. 3). Author has removed successfully an intra-vitreal metal foreign body under direct visualization with the TV fluoroscopy image intensifier. CASE 1. Man, aged 29, stevedore, with a penetrating wound of the left eye from a hammer upon an old mobile-engine, had ocular pain and visual disturbance with posterior synechia and a visible well-defined grayish-white exudate mass at inferior portion of vitreous body near the equator. X-ray studies for the localization of FB, revealed that the body was about 1 X 4mm in size and embedded in the exudate which is locating 8~12mm apart from the corneal limbus of 5 : 30 o'clock portion. A removal attempt using a hand magnet was unsuccessful, and then the scleral wound was closed. 22 days later the inferior conjunctiva was incised, a sclerotomy (posterior route procedure) was done and 6-0 black silk sutures were preplaced with cryothermy (-70 degrees C) around the sclerotomy site. The pars plana was perforated with a knife, and teethless iris forceps(Gill) was introduced into the vitreous. The metal foreign body was visualized under the aid of TV fluoroscopy. The forceps was gradunlly inserted until the foreign body (iron) war grasped and removed. EXPERIMENTS: Rabbits, weighed 2~3kg, were used as experimental animals. Under general anesthesia a stab-wound on the sclera (3 mm long) after the fixation of eye ball by traction sutures wasmade and then copper-wire piece (1 X 1 X 1 mm) as a nonmagnetic foreign body was inserted in to the vitrous body. A removal attemp using a toothless iris-forceps was done under the x-ray with fluoroscopy image intensifier television monitoring system (Siremobile 2). The body was visualized by rotating 90 degrees of an image intensifier. The forceps was then inserted until the F.B. was grasped and removed, with more easy way. Anathor experiments for intra-orbital copper foreign body were also performed. And same results were obtained as intra-vitreal foreign bodies experiment. COMMENTS AND SUMMERY: Presently, nonmagnetic intraocular foreign bodies are more difficult to remove and tend generally to be more toxic than magnetic bodies. Opaque media from extensive hemorrhages or exudates would be caused the difficulty of direct visualization. The use of ultrasonic technique may make a help for the localization of F.B. and requires a second operator. Most hospitals have a TV fluoroscopy(image intensifier) mounted on a C arm or bi-planed fluoroscopy. The total fluoroscopy time in the present instances was the range of 5~8 minutes. Irradiation was estimated about 5~10 R. to the eye and 300M/Y maximum of secondary irradiation to the operatior's hand. The application of the image intensification TV monitoring system in the cases of media hazy intraocular nonmagnetic F.B. or intra-orbital nonmagnetic F.B. combines the advantages of accurate localization and the ease and simplicity of direct visualization in TV monitor. With 90 degrees rotation, both the forceps and foreign body could be viewed in two planes 90 degrees apart; with alternating vertical and horizontal projections, the forceps could be guided to the foreign body. This technique is surely a practical efficient way to remove non-magnetic opaque intraocular and/or intra-orbital foreign bodies at safe radiation levels. It would be also possible as a second step in cases of magnetic foreign bodies which were failed to removal with a magnet aid.
Acceleration ; Anesthesia, General ; Animals ; Arm ; Cineradiography ; Conjunctiva ; Copper ; Exudates and Transudates ; Fluoroscopy* ; Foreign Bodies* ; Hand ; Hand Strength ; Hemorrhage ; Iris ; Limbus Corneae ; Orbit* ; Orthopedics ; Rabbits ; Sclera ; Silk ; Surgical Instruments* ; Sutures ; Television* ; Traction ; Ultrasonics ; Vitreous Body ; Wounds and Injuries ; Wounds, Penetrating

The field of application of fluoroscopy as an aid to ophthalmologist has been considerably enhanced by image intensification (electron acceleration for amplification of the fluoroscopic image), which has made possible the development of practical techniques of cinefluorography, television monitoring and recording. The use of a television monitoring system allows viewing by several observers in addition to the fluoroscopist, and the advantage of working in a lighted fluoroscopic room, instead of in the dark, contributes to both safety and efficiency. A monoplane TV fluoroscope (SIEMEN 500mA) and a 90 degrees rotating "two-planes" TV fluoroscope (Siremobile 2, SIEMEN) recently installed in the Departments of Radiology and Orthopedic Surgery at St. Mary's Hospital, Catholic Medical College (Fig. 3). Author has removed successfully an intra-vitreal metal foreign body under direct visualization with the TV fluoroscopy image intensifier. CASE 1. Man, aged 29, stevedore, with a penetrating wound of the left eye from a hammer upon an old mobile-engine, had ocular pain and visual disturbance with posterior synechia and a visible well-defined grayish-white exudate mass at inferior portion of vitreous body near the equator. X-ray studies for the localization of FB, revealed that the body was about 1 X 4mm in size and embedded in the exudate which is locating 8~12mm apart from the corneal limbus of 5 : 30 o'clock portion. A removal attempt using a hand magnet was unsuccessful, and then the scleral wound was closed. 22 days later the inferior conjunctiva was incised, a sclerotomy (posterior route procedure) was done and 6-0 black silk sutures were preplaced with cryothermy (-70 degrees C) around the sclerotomy site. The pars plana was perforated with a knife, and teethless iris forceps(Gill) was introduced into the vitreous. The metal foreign body was visualized under the aid of TV fluoroscopy. The forceps was gradunlly inserted until the foreign body (iron) war grasped and removed. EXPERIMENTS: Rabbits, weighed 2~3kg, were used as experimental animals. Under general anesthesia a stab-wound on the sclera (3 mm long) after the fixation of eye ball by traction sutures wasmade and then copper-wire piece (1 X 1 X 1 mm) as a nonmagnetic foreign body was inserted in to the vitrous body. A removal attemp using a toothless iris-forceps was done under the x-ray with fluoroscopy image intensifier television monitoring system (Siremobile 2). The body was visualized by rotating 90 degrees of an image intensifier. The forceps was then inserted until the F.B. was grasped and removed, with more easy way. Anathor experiments for intra-orbital copper foreign body were also performed. And same results were obtained as intra-vitreal foreign bodies experiment. COMMENTS AND SUMMERY: Presently, nonmagnetic intraocular foreign bodies are more difficult to remove and tend generally to be more toxic than magnetic bodies. Opaque media from extensive hemorrhages or exudates would be caused the difficulty of direct visualization. The use of ultrasonic technique may make a help for the localization of F.B. and requires a second operator. Most hospitals have a TV fluoroscopy(image intensifier) mounted on a C arm or bi-planed fluoroscopy. The total fluoroscopy time in the present instances was the range of 5~8 minutes. Irradiation was estimated about 5~10 R. to the eye and 300M/Y maximum of secondary irradiation to the operatior's hand. The application of the image intensification TV monitoring system in the cases of media hazy intraocular nonmagnetic F.B. or intra-orbital nonmagnetic F.B. combines the advantages of accurate localization and the ease and simplicity of direct visualization in TV monitor. With 90 degrees rotation, both the forceps and foreign body could be viewed in two planes 90 degrees apart; with alternating vertical and horizontal projections, the forceps could be guided to the foreign body. This technique is surely a practical efficient way to remove non-magnetic opaque intraocular and/or intra-orbital foreign bodies at safe radiation levels. It would be also possible as a second step in cases of magnetic foreign bodies which were failed to removal with a magnet aid.
Acceleration ; Anesthesia, General ; Animals ; Arm ; Cineradiography ; Conjunctiva ; Copper ; Exudates and Transudates ; Fluoroscopy* ; Foreign Bodies* ; Hand ; Hand Strength ; Hemorrhage ; Iris ; Limbus Corneae ; Orbit* ; Orthopedics ; Rabbits ; Sclera ; Silk ; Surgical Instruments* ; Sutures ; Television* ; Traction ; Ultrasonics ; Vitreous Body ; Wounds and Injuries ; Wounds, Penetrating

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).
Cineangiography ; Coronary Vessels* ; Echocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia

One family with asymmetric septal hypertrophy was reported. The propositus of this family was 31 years old man who was admitted because of transient syncope. His father and one brother were affected but asymptomatic. His sister was suddenly died at age 21 years. The interventricular septal thickness to left ventricular posterior wall thickness ratios were measured using M-mode echocard ogram. In the affected family, echocardiogram revealed asymmetric septal hypertrophy (1.5:1, 2:1, 1.9:1 respectively). In the propositus, cardiac catheterization and simultaneous biventricular cineangiography were performed. Pressure study revealed mild peak systolic pressure gradient within left ventricular apex and left ventricular outflow tract (4mm Hg respectively). Biventricular cineangiogram showed the septal width increased inferiorly, and left ventricular endocardial surface of the septum was straight, while the right ventricular border convex toward the right ventricle.
Adult ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic* ; Cineangiography ; Fathers ; Heart Ventricles ; Humans ; Siblings ; Syncope

Regional left ventricular dysfunction is common in patients with coronary artery disease and accurate analysis of regional dysfunction is of particular interest. For the quantitative assessment of regional dysfunction, we measured regional ejection fraction by radial sector division method in 19 patients with acute myocardial infarction and 13 normal controls who had multigated blood pool scan. And two independent observer analyzed regional wall motion using 5 point grading system in 18 patients undergoing radionuclide ventricular cineangiography. The results obtained were as follows : 1) Regional wall motion scores for the gated blood pool study agreed completely in 72 of 108 segments (66.7%) and agreed within 1 grade in 88 of 108 segments(81.5%) and agreement rate is lowest in the septal area. 2) Global left ventricular ejection fraction was 63.2+/-4.2% in normal controls, 36.6+/-6.8% in extensive anterior wall infarction group and 52.6+/-9.7% in inferior wall infarction group. The value of extensive anterior wall infarction group was significantly lower than that of inferior wall infarction group(p<0.005). 3) Regional left ventricular ejection fraction by radial sector division method in normal control group were as follows : area 1 ; 56.5+/-6.7%, area 2 : 77.9+/-4.8%, area 3 ;84.3+/-5.5%, area 4 : 76.8+/-6.6%, area 5 ; 84.7+/-7.6%, area 6 ; 85.9+/-11.2%, area 7 ; 75.5+/-12.3%, area 8 ; 74.9+/-14.0%, area 9 ; 75.5+/-8.8%, area 10 ; 54.2+/-11.0%, 11 ; 34.5+/-16.3, area 12 ; 37.1+/-18.0%. 4) Mean regional ejection fraction in 7 patients with anterior wall infarction showed significantly lower values in area 4 to area 8, and in area 2 to area 5 in case of inferior wall infarction group. 5) We thought that regional ejection fraction obtained by radial sector division method is valuable index for the management and evaluation of patients with coronary artery disease.
Cineangiography ; Coronary Artery Disease ; Humans ; Infarction ; Myocardial Infarction* ; Septum of Brain ; Stroke Volume ; Ventricular Dysfunction, Left

BACKGROUND AND METHOD: For decades, the presence of aortic insufficiency (AI) has been considered a potential hazard in military aviation and has generally excluded aircrew from high performance flight. The cardiovascular effect of repeated exposure of high +Gz forces associated with AI is largely unknown. To evaluate whether the flying of High Performance Aircraft (HPA) was detrimental to subjects with AI, we performed a retrospective review. we studied 32 asymptomatic patients in whom 16 of them had flying time with AI in HPA(Group I), others(GroupII, Control Gr.) in Low-G Aircraft(LGA). Among them, the data of 24 patients were available, 12 in group I., and 12 in group II. The two groups were matched for age, severity of AI, and flying time. RESULTS: Interval echocardiographic, and cineangiographic studies were obtained over a mean period of 4.6+/-2.6 years in group I and 5.9+/-4.2 years in group II (range, 0.9 to 12.7 years) and mean flying time with AI of 528.1+/-435.0 hours in group I and 865.0+/-816.1 hours in group II (range, 50 to 2290 hours). By paired-t test, there were no significant differences between both groups in left ventricular end-diastolic dimension (LVEDD), end-systolic dimension (LVESD), aortic dimension (Ao.D) and fractional shortening (FS) by echocardiography (p>0.05) and by multiple linear regression, there were no significant interval changes of above values in Gr. I according to increasing of flying time with AI (p>0.05). Visual grade by doppler echocardiography or aortic cineangiography increased 1 patient in Gr.I and 2 patients in Gr.II within no more than one grade. CONCLUSION: Thus, this study demonstrated that : 1) Quantitative echocardiographic measurements such as LEVDD, LVESD, Ao.D and FS didn't show significant interval change in Gr.I.2) A single subject with a minor increase in AI severity together with no difference between the HPA and LPA groups argue for a relatively chronic effect of high G exposure in aircrew with mild AI.
Aircraft ; Aviation ; Cineangiography ; Diptera* ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Linear Models ; Military Personnel ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease. However, exposure to ionizing radiation delivered during CAG has various negative biological effects on humans. In this study, there was an evaluation of whether fluorography resulted in decreased radiation exposure, as compared with cineangiography. SUBJECTS AND METHODS: Fifty-five patients were prospectively enrolled and divided into two CAG groups, in accordance with the operator's professional discretion: a conventional cineangiography group versus a fluorography group. Fluorography refers to the photography of fluoroscopic images that are retrospectively stored, e.g., using the "Store fluoro" function of the Siemens cardiac angiography system. The primary outcomes included the air kinetic energy released per unit mass {air kerma (AK) mGy} and the dose (kerma)-area product (DAP; microGy . m2), both measured using built-in software in the Siemens system. The secondary outcomes included the total procedure time and amount of contrast agent used with each CAG method. RESULTS: The total AK and DAP were significantly lower in the fluorography group (159.3+/-64.9 mGy and 1337.9+/-629.6 microGy . m2, respectively) than in the cineangiography group (326.9+/-107.5 mGy and 2341.1+/-849.9 microGy . m2, respectively; p=0.000 for both). The total procedure time (cineangiography vs. fluorography, 12.8+/-4.7 vs. 12.5+/-2.9 min; p=0.779) and contrast agent amount (136.1+/-28.3 vs. 126.3+/-25.7, p=0.214) were comparable between the two groups. CONCLUSION: Fluorography is a useful method to decrease the radiation exposure in selected patients requiring CAG.
Angiography ; Cineangiography* ; Coronary Angiography* ; Coronary Artery Disease ; Fluoroscopy ; Humans ; Photography ; Prospective Studies ; Radiation, Ionizing ; Retrospective Studies