PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.
Artifacts ; Brain ; Humans ; Male

PURPOSE: DIR image is relatively free from susceptibility artifacts therefore, DIR image can make it possible to reliably measure cortical thickness/volume. One drawback of the DIR acquisition is the long scan time to acquire the fully sampled 3D data set. To solve this problem, we applied a parallel imaging method (GRAPPA) and verify the reliability of using the volumetric study. MATERIALS AND METHODS: Six healthy volunteers (3 males and 3 females; age 25.33+/-2.25 years) underwent MRI using the 3D DIR sequence at a 3.0T Siemens Tim Trio MRI scanner. GRAPPA simulation was performed from the fully sampled data set for reduction factor 2. Data reconstruction was performed using MATLAB R2009b. Freesurfer v.4.3.0 was used to evaluate the cortical thickness of the entire brain, and to extract white matter information from the DIR image, Analyze 9.0 was used. The global cortical thickness estimated from the reconstructed image was compared with reference image by using a T-test in SPSS. RESULTS: Although reduced SNR and blurring are observed from the reconstructed image, in terms of segmentation the effect was not so significant. The volumetric result was validated that there were no significant differences in many cortical regions. CONCLUSION: This study was performed with DIR image for a volumetric MRI study. To solve the long scan time of 3D DIR imaging, we applied GRAPPA algorithm. According to the results, fast imaging can be done with reduction factor 2 with little loss of image quality at 3.0T.
Artifacts ; Brain ; Humans ; Male

Furlow's palatoplasty has been used as the primary treatment for cleft palate. From 1991 to 1999, 24 submucous cleft palate patients underwent Furlow's palatoplasty. The follow-up period was 3 months to 8 years (mean 24 months). Patients were selected after a thorough study for velopharyngeal insufficiency including intraoral examinatioin, speech assessment, digital subtraction radiography (DSR). Postoperatively velopharyngeal function was reevaluated with speech assessment and digital subtraction radiography in the 7 cooperative patients. Speech parameters including hypernasality, nasal emission, and Allison scale were improved after surgery. Digital subtraction radiography provided the value of velopharyngeal gap and the degree of the motion of lateral pharyngeal wall, both of which were improved after surgery. Furlows palatoplasty has advantage such as no impairment of nasopharyngeal physiology, no hannful effect on the hard palate and the realignment of the levator muscle which plays important role on the movement of the soft palate. The results show that a Furlow's palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected submucous cleft palate patients.
Cleft Palate* ; Follow-Up Studies ; Humans ; Palate, Hard ; Palate, Soft ; Physiology ; Radiography ; Velopharyngeal Insufficiency

PURPOSE: The objective of this study was to develop background gradient correction method using excitation pulse profile compensation for accurate fat and T2* quantification in the liver. MATERIALS AND METHODS: In liver imaging using gradient echo, signal decay induced by linear background gradient is weighted by an excitation pulse profile and therefore hinders accurate quantification of T2* and fat. To correct this, a linear background gradient in the slice-selection direction was estimated from a B0 field map and signal decays were corrected using the excitation pulse profile. Improved estimation of fat fraction and T2* from the corrected data were demonstrated by phantom and in vivo experiments at 3 Tesla magnetic field. RESULTS: After correction, in the phantom experiments, the estimated T2* and fat fractions were changed close to that of a well-shimmed condition while, for in vivo experiments, the background gradients were estimated to be up to approximately 120 microT/m with increased homogeneity in T2* and fat fractions obtained. CONCLUSION: The background gradient correction method using excitation pulse profile can reduce the effect of macroscopic field inhomogeneity in signal decay and can be applied for simultaneous fat and iron quantification in 2D gradient echo liver imaging.
Compensation and Redress ; Iron ; Liver ; Magnetics ; Magnets

The object of this study is to introduce a novel method of foreheadplasty. The new foreheadplasty can lower the anterior hairline and results in reduction of the vertical forehead length and mid-face lift can be performed at the same time. A 54 year-old female who had a long forehead visited the clinic for rejuvenation of the mid-face. The authors performed dual-vector foreheadplasty and were able to lower the anterior hairline by the advancement of the posterior scalp flap. Mid-face lift was performed by elevation of the malar fat pads. The surgical results were analyzed by measuring the length of the forehead before and 2 years after the surgery. Medical photographs were taken at the same period. The preoperative length of the forehead was 75.5 mm and decreased to 63.0 mm after the surgery. The shortened forehead was well maintained even 2 years after the operation (63.3 mm). The patient suffered from partial sensory loss of the parietal region but resolved simultaneously after 2 months. No other complications, such as, hypertrophic scarring, infection, prolonged inflammation and alopecia occurred. In conclusion the dual-vector foreheadplasty is a relatively simple and safe way to lower the anterior hair line with the elevation of the mid-face.
Adipose Tissue ; Alopecia ; Cicatrix, Hypertrophic ; Female ; Forehead ; Hair ; Humans ; Inflammation ; Rejuvenation ; Rhytidoplasty ; Scalp

Total auricular reconstruction with autogenous tissue remains one of the greatest technical challenges for reconstructive plastic surgeons because of the ear's complex morphology with delicately convoluted cartilages and very thin skin. In a successfully created ear, a natural three-dimensional illusion visualized from the patient's profile, frontal, and posterior views is crucial. Accordingly ear framework should have adequate lateral aspect as well as suitable frontal aspect even before being lifted to this purpose. For this goal, rib cartilage should be harvested from three-dimensionally adequate area. It is the most essential point in framework fabrication that the baseblock should have semi-cup curvature via multiple parallel cuts made on its medial surface. Between January 1999 and May 2003, we performed 29 cases of total ear reconstruction with autogenous rib cartilage graft using this scoring technique and obtained satisfactory results, which showed more natural appearance visualized from the patient's profile, frontal, and posterior views.
Cartilage ; Ear* ; Illusions ; Ribs ; Skin ; Transplants

Craniofacial surgery for facial advancement or correction of severe craniofacial malformations such as orbital hypertelorism, Crouzon's disease and Apert's syndrome may bring about great risk. Especially postoperative infection in the craniofacial surgery is a life threatening complication. Ascending infection via nasofrontal communication in frontofacial monobloc advancement, intracranial Le Fort III osteotomy, correction of hypertelorism(intracranial approach) and acute trauma of cribriform plate can lead to life threatening meningitis and meningoencephalitis. A 4 layer sealing technique for the closure of nasofrontal communication using Gelfoam , the inferiorly based, galeo-pericranial flap, rib bone graft, Tissel is a very effective method. Until the rib bone graft is completely uptaken, Gelfoam is used as a temporary blockage of bony defect and prevents displacement of rib bone graft. We used galeo-periosteal flap for the sufficient blood supply to the rib bone graft. And Tissel is used as a biologic adhesive and blockage of the surrounding gaps.
Adhesives ; Craniofacial Dysostosis ; Ethmoid Bone ; Fibrin Tissue Adhesive ; Gelatin Sponge, Absorbable ; Hypertelorism ; Meningitis ; Meningoencephalitis ; Nasal Cavity* ; Orbit ; Osteotomy ; Ribs ; Transplants

BACKGROUND: A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia. METHODS: From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework. RESULTS: The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases. CONCLUSIONS: Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.
Bone Transplantation ; Cartilage ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Ear ; Ear Auricle ; Fascia ; Follow-Up Studies ; Hematoma ; Humans ; Inlays ; Necrosis ; Ribs ; Skin ; Temporal Bone ; Tissue Donors ; Transplants

There exist many methods reconstructing a constricted ear. But those methods are usually lack of considerations about various components: shape of ear, height, width and circumference. Therefore we contrived a new method which we called 'a reversed banner' flap, modifying the banner flap by Tanzer. The banner flap considers only the increase of height. Moreover the transition of the flap is unnatural because of the base of the flap located medially. A total of 7 earswere reconstructed. Four patients were group I, and three patients were group II(by Tanzer's classification). To increase width and circumference as well as height, our method consists of steps as follows: (1) V-Y advancement skin flap on the root of helix. (2) Laterally based banner flap on the deformed helix, preserving the superior crus of antihelix. (3) Pooling out designed flap from root of helix and fixation to the inferior crus of antihelix. (4) Expansion of hooded helix lateral to superior crus. (5) Conchal cartilage grafts to the newly formed cartilage gaps. (6) Reinforcement of superior crus with a mattress suture. With this method we could make a more natural shape of ear and maintain the form of reconstructed ear.
Cartilage ; Ear* ; Humans ; Skin ; Sutures ; Transplants

There exist many methods reconstructing a constricted ear. But those methods are usually lack of considerations about various components: shape of ear, height, width and circumference. Therefore we contrived a new method which we called 'a reversed banner' flap, modifying the banner flap by Tanzer. The banner flap considers only the increase of height. Moreover the transition of the flap is unnatural because of the base of the flap located medially. A total of 7 earswere reconstructed. Four patients were group I, and three patients were group II(by Tanzer's classification). To increase width and circumference as well as height, our method consists of steps as follows: (1) V-Y advancement skin flap on the root of helix. (2) Laterally based banner flap on the deformed helix, preserving the superior crus of antihelix. (3) Pooling out designed flap from root of helix and fixation to the inferior crus of antihelix. (4) Expansion of hooded helix lateral to superior crus. (5) Conchal cartilage grafts to the newly formed cartilage gaps. (6) Reinforcement of superior crus with a mattress suture. With this method we could make a more natural shape of ear and maintain the form of reconstructed ear.
Cartilage ; Ear* ; Humans ; Skin ; Sutures ; Transplants