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Background The author addresses whether the face bow is irrelevant for all types of prosthetic work and for planning orthognathic surgery. Methods The author searched electronic databases to find studies whose investigators used the strongest clinical evidence (that is, randomized clinical trials) and studies whose investigators incorporated the use of cinefluorography. The author found 13 studies and 1 Internet video that provided strong evidence to support the irrelevancy of the face bow transfer. Results Evidence indicates that the face bow has nothing to do with speech, the fit and comfort of the prostheses, ridge morphology, facial contours, the color of the teeth and denture bases, the arrangement of the artificial teeth, chewing efficiency stability, and the psychological aspects of prosthodontic treatment. The cinefluorographic example showed that there was no condylar axis of rotation during functional activity, a sawing action of the mandibular incisors during the incising of toast and the mandible moving in a back and forth, rocking chair–like movement during functional activity. Conclusions Eliminating the face bow transfer reduces the patient’s chair time and the dentist's overhead expenses. The author found evidence in the results of randomized controlled trials and an online video that justify eliminating the use and teaching of the 133-year-old technique known as the face bow transfer. Practical Implications Patients expect their physicians and dentists to perform only treatment procedures that are essential. The findings of this study show that the face bow transfer treatment procedure is not absolutely necessary to mount dental models on an articulator. Students', professors', schools', patients', and taxpayers' time and money can be saved by no longer teaching this 133-year-old treatment procedure.

OBJECTIVES: To clarify the influence of aging and denture use on swallowing in healthy edentulous people aged 75 and older. DESIGN: A cross-sectional research design was used with participants from Hiroshima University Hospital, Hiroshima University, and Hiroshima City. SETTING: Participants were examined in Hiroshima University Hospital, Hiroshima, Japan. PARTICIPANTS: Thirteen edentulous elderly volunteers (7 male, 6 female; aged 75–86, mean age 81.2) and 19 dentulous elderly volunteers (12 male, 7 female; aged 80–87, mean age 81.2) as a control group participated in this study. Participants reported no clinical symptoms relating to dysphagia, neurological impairments, or degenerative diseases. MEASUREMENTS: Participants were asked to swallow a 10-mL barium sulfate solution three times. Edentulous older people were asked to swallow the solution while wearing dentures and with dentures removed. Functional swallowing was recorded on cine-film with a digital subtraction angiography system. Lateral cinefluorography images were obtained from seated subjects. Using a cine-projector, visual images were evaluated qualitatively and quantitatively. RESULTS: No participants exhibited aspiration. The occurrence of laryngeal penetration in the edentulous older people not wearing dentures was the only significant difference (P

The kinematics of each joint of the guinea pig Cavia porcellus were studied during the locomotor cycle at increasing speed by high-speed cinefluorography. The main objective was to reveal the functional specific features of these structural elements in each dynamic phase of the cycle and also which limb joints are important during the increase of animal speed. Most of the analysed angles in C. porcellus were affected as the speed increased, both in trot and gallop. However, only a few of them were correlated with speed. There were also differences with respect to symmetrical or asymmetrical gaits. Both pairs of limbs responded differently to the increase of speed; while the forelimb joints modified the duration of their action (frequency) more than the amplitude (stride length), the hindlimbs acted inversely. The movements of the joints during the stance phase changed dramatically with speed, particularly in the hindlimb. At knee level, the flexion amplitude increases to maintain the stiffness of the leg spring, a principle previously discussed as essential for the running process. In the swing phase, inertial effects are the main constraints and, as in the stance phase, the knee joint in the swing phase is correlated with speed both during trot and gallop, confirming the major importance of this joint to increasing speed.

Background. Although age-related changes resulting in slowing of the swallowing reflex and a decline in the neuromuscular control system have been reported, there have been few reports on swallowing function in dentate elderly persons. The purpose of this study was to clarify the primary influence of aging on swallowing in healthy dentate elderly persons older than 80 years who have more than 20 teeth. Methods. Dentate elderly persons (12 male, 7 female; mean age: 81.2 years) and dentate young participants (9 male, 5 female; mean age: 26.8 years) as a control group participated voluntarily. Participants reported no clinical symptoms relating to dysphagia, neurologic impairments, or degenerative diseases, and were asked to swallow 10 ml of barium sulfate solution (10% w/v) three times. Functional swallowing was recorded on 35 mm cinefilm at 30 frames per second with a digital subtraction angiography system. Lateral images of cinefluorography of seated participants’ mouth, pharynx, and larynx were obtained. Visual image analysis for qualitative and quantitative evaluation was made with a cine projector. Results. No participants exhibited aspiration during three trials. Occurrence and frequencies of piecemeal deglutition, premature loss of liquid, oral and pharyngeal residues, and laryngeal penetration were significantly greater in dentate elderly persons (p , .05) than in the dentate young participants. Oral transit time, pharyngeal delay time, and pharyngeal transit time in dentate elderly persons were prolonged significantly compared with those in dentate young participants (p , .01). Conclusion. Physiological swallowing functions deteriorate even in healthy dentate elderly persons. This deterioration may be explained primarily by the influence of aging on swallowing.

Jyros bileaflet rotating valves were implanted as a clinical trial conducted in Japan, and the 5-year results were assessed. Nineteen patients underwent implantation of the valves: 14 in the mitral and 5 in the aortic position. The mean follow-up period was 65.4 ± 15.7 months. There was 1 case of late death due to fatal arrhythmia and another case of cerebral thromboembolism (1.0% per patient year). All survivors were in New York Heart Association class I. On the early postoperative cinefluorography, 8 valves (42.1%) showed rotation of the leaflets. However, in the latest assessment 6 valves (33.3%) showed rotation, some valves had stopped rotation, and others had started to rotate during the follow-up period. The Jyros valve functions effectively, similar to other bileaflet valves. However, because the correlation between thromboembolism and the rotation mechanism is not clear, further follow-up of our patients and more implant studies are necessary to elucidate this issue.

The objective of the present project was the determination of the dose received by patients during cardiac procedures, such as coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. Thermoluminescent dosemeters (TLDs), suitably calibrated, were used for the measurement of the dose received at four anatomical locations on the patient's skin. A dose-area product (DAP) meter was also used. The contribution of cinefluorography to the total DAP was higher than that of fluoroscopy. A DAP to effective dose conversion factor equal to 0.183 mSv Gy-1 cm-2 was estimated with the help of a Rando phantom. Thus, the effective dose received by the patients could be assessed. Mean values of effective dose equal to 5.6 mSv, 6.9 mSv, 9.3 mSv, 9.0 mSv and 13.0 mSv were estimated for coronary angiography, PTCA, coronary angiography and ad hoc PTCA, PTCA followed by stent implantation and coronary angiography and ad hoc PTCA followed by stent implantation, respectively.

Tongue movements in three female Macaca fascicularis , with radio-opaque markers in the tongue, teeth and hyoid, feeding on apple, banana and monkey chow, were recorded using lateral projection cineradiography (± 100 f.p.s.) with synchronized frontal view cinephotography (50 f.p.s.). Marker positions were digitized and the resultant Cartesian coordinates manipulated: (a) to establish the gape time profile; (b) anteroposterior and dorsoventral movements of tongue and hyoid markers relative to an upper occlusal/palatal reference plane; and (c) expansion and contraction of tongue segments in selected sections of complete sequences. The relative timing of tongue and jaw movement events was established using interval analysis. In simple transport cycles (semisolid food), all parts of the tongue moved in synchrony, travelling forwards and expanding during early opening, and backwards and contracting during late opening and closing. In contrast, in simple chewing cycles with a power stroke (SC phase): (a) the tongue markers reached their most backward position before or at the beginning of the SC phase, travelling forwards until the teeth approached intercuspation, then paused until after the teeth had reached centric occlusion; (b) the markers moved asynchronously, so that the relation between each marker and jaw movement changed; (c) expansion and contraction was largely confined to the middle tongue segment. In complex chewing cycles, jaw movement in opening was linked to the behaviour of the anterior tongue segment: reversal from forward to backward movement of the anterior tongue marker occurred within 30 ms of the rate change at the SO (slow open)-FO (fast open) transition: the greater the amplitude of forward movement, the longer the SO phase. Hyoid (tongue base) movement occurred throughout masticatory sequences. A backward drift of the hyoid and posterior part of the tongue occurred in cycles preceding swallows. Linkages between tongue and jaw movements in feeding in macaques are more complex than those reported for non-primate mammals, as they change between successive jaw cycles. The changes observed during sequences, and between different foods, suggest that the effector systems involved are continuously modulated, and the jaw-movement profile during opening may be dependent on the pattern of tongue movement.

To follow regional deformation of the diaphragm in dogs, radiopaque markers were implanted under surgical anesthesia into different anatomic regions of the muscle in triangular arrays (approximately 1 cm to a side). After recovery from surgery, changes in area and shape of the triangles were followed with biplane cinefluorography during quiet breathing and during inspiratory efforts against an occluded airway (Mueller maneuvers). From changes in shape of the triangles during contraction, area changes were decomposed into a major direction and magnitude of shortening (Eg1) and a minor length change (Eg2) perpendicular to Eg1, both expressed as a fraction of initial length at end expiration. With the use of these techniques, systematic differences in regional area change were observed in different parts of the diaphragm during inspiratory efforts at different lung volumes. Regional area always decreased during contraction in the crural and midcostal zones of apposition to the rib cage. Area decreased less and often increased during inspiratory efforts in the costal dome near the central tendon and in the costal region near its rib cage insertion. Differences in regional area change were not due to differences in the Eg1 in different parts of the diaphragm but were a consequence of differences in widening of the muscle along Eg2 perpendicular to the direction of Eg1. As lung volume was passively increased above functional residual capacity, regional area decreased in all parts of the diaphragm except in the costal regions near rib cage insertion, where area increased.

The purpose of this study was to clarify quantitatively the differences in tongue-tip motion among the dentulous elderly people and also among the elderly edentulous, both with and without their dentures and, to identify the influence of tooth loss and denture wear on tongue-tip motion. Fourteen young dentulous people, 12 elderly dentulous people and 13 elderly edentulous people participated in this study. Subjects were asked to swallow a 10 mL barium sulfate solution three times. The elderly edentulous people were asked to swallow the solution while wearing dentures and with dentures removed. Functional swallowing was recorded on cine-film with a digital subtraction angiography system. Lateral cinefluorography images were obtained from seated subjects. Using a cine-projector, the movements of the tongue surface were traced as dots and lines frame by frame on a single tracing sheet within a definite period of time from the beginning of the oral phase to the end of the pharyngeal phase. With counting the number of 'trajectories' of tongue-tip motion, tongue movements were classified as 'stable' and 'hyperactive' types. The results was that significantly more 'hyperactive' type subjects were found among the elderly edentulous who were not wearing dentures (12 of 13) compared with the dentulous young (1 of 14), the elderly dentulous (1 of 13) or the elderly edentulous wearing dentures (1 of 13) (P < 0.001). The tongue-tip motion for the 'hyperactive' type was very complex and the tongue-tip anchoring against the palate was always instable.

Introduction: In this study, our aim was to evaluate the effectiveness of the mucosal flap barrier (MFB) upon the incompetent ureteral orifice of an experimentally produced rabbit reflux model. The rabbit reflux model was done in the first stage of the study. This method is a new and original procedure which is different from Bischoff’s and Witherington’s osteoplasty techniques. Materials and Methods: We performed the mucosal flap procedure in eight 2–2.5 kg male New Zealand rabbits with experimentally produced refluxing ureters. The first stage of our study was to create refluxing ureters. Due to the upward and inward ‘J’ fishhook course of the intravesical ureter of rabbits, we performed two deep 12- and 4-o’clock incisions by suturing the edges of the intravesical ureter apart with catgut sutures. Additionally, to stop the tilting action of the trigonum during micturition, we performed two parallel incisions between the ureteral meatus. These parallel incisions were the authors’ modifications for the rabbit reflux model and which gives long-lasting reflux for the rabbit. We checked the reflux at the end of the 3rd month and performed our new MFB antireflux procedure. This mucosal flap made a cover on the incompetent ureteral orifice. This technique is completely different from the osteoplasty techniques described by Bischoff and Witherington. Results: Four months after the MFB application, we performed intravenous urography, cystometry and cinefluorography. There was no obstruction or reflux. Two rabbits were sacrificed at the 4th month. Both flaps were fully intact without any fixation at the medial side causing obstruction. At present, 3 rabbits are still alive. We did cinefluorography and cystometry at the 15th month and there was no obstruction or reflux. We are trying to keep them alive till the end of their natural lifespan. Conclusions: During the formation of the rabbit reflux model, we observed that spontaneous reflux even at high intravesical pressures did not have high percentages as previously mentioned in the literature. But it is possible and enough to produce an experimental reflux model by using meatotomy and interureteric incisions. Moreover, in rabbits with vesicoureteral regurgitation produced by ureteral meatotomy and interureteral incisions, reflux can be eliminated the MFB procedure. This method is an easy procedure for small bladders or dilated ureters after any kind of open reimplantation applications and it could be used by pneumovesical applications in the future.

Radiation usage during fluoroscopically guided interventions can be high enough to warrant careful dosimetry and patient management. Basic compliance with the usual set of local regulatory requirements is sufficient for patient safety in the interventional environments. For example, modern systems meeting all current regulatory dose restrictions are capable of delivering table‐top air kerma rates exceeding 200 mGy/min for normal modefluoroscopy and 1,500 mGy/min for cinefluorography. Clinical dosimetry during each complex intervention is facilitated by dosimetric instrumentation built into the fluoroscopic system. The Society of Interventional Radiology has published a standard of practice recommending dosimetry for all interventional procedures. In 2008, the ACR published a technical standard for the use of radiation in fluoroscopic procedures. A DICOM Structured Report for detailed reporting of radiation usage in interventional fluoroscopy has been defined, tested and is currently being deployed in clinical systems. The Joint Commission has included fluoroscopic procedures with skin doses exceeding 15 Gy in its list of sentinel events; with the implicit challenge to facilities that they can prove the absence of such occurrences. This course reviews technical elements for a program of patient fluoroscopic radiation safety. ICRU diagnostic dosimetric quantities and their fluoroscopic extensions. Construction, dosimetric features, and performance characteristics of modern fluoroscopes. Extended QA protocols for compliance measurements, system characterization and clinical dosimetry.Dose recording and reporting, including DICOM‐DOSE. The Joint Commission fluoroscopy sentinel event. Learning Objectives 1. Understand dosimetric concepts relating to interventional fluoroscopy 2. Characterize the dosimetric features and performance of a modern fluoroscope 3. Be able to set up a clinical dose recording and reporting policy that will meet clinical and JC requirements.

Cameras and display devices transfer images from the image intensifier to the observer's eye. Cinefilm cameras and video cameras are used together for the performance of cardiac angiography. The state of the art is evolving toward digital video-based systems. This tutorial introduces underlying technology.

Previous researchers have proposed that prelingually deafened talkers do not displace the tongue body to establish vowel steady-state postures and displace the jaw excessively. The purpose of this investigation was to evaluate the opening gesture lingual displacement patterns of three deaf and two hearing adult talkers. Cinefluorography and x-ray microbeam data indicated that the deaf subjects displaced their tongue bodies during the opening gestures. However, their glossal movement trajectories were qualitatively dissimilar to those of the hearing subjects. Whereas the hearing subjects moved the tongue differently for different vowel contexts, the deaf subjects had similar trajectories for all contexts. The common trajectories suggest that some deaf talkers contract their tongue muscles such that the tongue body moves similarly for all vowels. The deaf subjects also appeared to have a less flexible tongue body during speech production than the hearing subjects. Means for quantifying and comparing the lingual behaviors of deaf and hearing talkers are considered.

Radiologists have devised many radiological procedures of varying complexity over a period of many years in order to study the normal and abnormal states of the larynx. These include plain films, tomography, fluoroscopy, cinefluorography, xeroradiography and laryngography [1–5]. In recent years computer tomography (CT) has been added. The following techniques are most commonly used: conventional tomography (planigraphy), contrast laryngography and computer tomography.

Most swallowing specialists are aware that swallowing disorders are often best appreciated with the use of dynamically recorded fluoroscopic images. In the past, specialized cinefluorography systems were the dynamic recording method of choice. More recently, dynamic recording capability has become much more widely available with the use of inexpensive videotape recorders, easily connected to existing videofluoroscopy systems. Despite some loss of image quality, videotape-recorded fluoroscopy, or videofluorography (hereafter referred to as VTF) has many advantages over conventional cinefluorography systems in that it does not require specially designed x-ray equipment, and lacks the difficulties associated with handling, processing, and viewing of cine (movie) film. VTF, however, does involve radiation exposure to both patient and practitioner, and thus incorporates some risk.

Radiation usage during fluoroscopically guided interventions can be high enough to warrant careful dosimetry and patient management. Basic compliance with the usual set of local regulatory requirements may not be sufficient for patient safety. Many of these rules date back to an era in which fluoroscopy was used for simple diagnostic procedures. The X‐ray tubes of this earlier era often overloaded and shut down before dangerous doses were delivered. Neither of these suppositions are currently valid. For example, modern systems meeting all regulatory dose restrictions are capable of delivering table top air kerma rates exceeding 200 mGy/min for normal modefluoroscopy and 1,500 mGy/min for cinefluorography. Clinical dosimetry during each complex intervention is facilitated by dosimetric instrumentation built into the fluoroscopic system. The FDA now requires such instrumentation in all new fluoroscopes. The Society of Interventional Radiology has published a standard of practice recommending dosimetry for all interventional procedures. The DICOM‐DOSE project, a joint initiative of DICOM and the IEC will shortly provide tools for automated dose reporting. The Joint Commission has included fluoroscopic procedures with skin doses exceeding 15 Gy in its list of sentinel events; with the implicit challenge to facilities that they can prove the absence of such occurrences. This course reviews technical elements needed in a program of patient fluoroscopic radiation safety. Key concepts include: ICRU diagnostic dosimetric quantities and their fluoroscopic extensions FDA and IEC compliance measurements. Construction dosimetric features, and performance of modern fluoroscopes Extended QA protocols for compliance measurements, system characterization and clinical dosimetry.Dose recording and reporting, including DICOM‐DOSE. The Joint Commission fluoroscopy sentinel event. Educational Objectives: 1. Understand dosimetric concepts relating to interventional fluoroscopy. 2. Characterize the dosimetric features and performance of a modern fluoroscope. 3. Be able to set up a clinical dose recording and reporting policy that will meet clinical and JC requirements.

Quantifying the changing shape of the tongue has been a longstanding challenge for experimental phonetics. One approach is to track the location of points on the tongue using x‐ray microbeam or EMA. This leads to a precise numerical quantification, but is limited to information from a few points. Cinefluorography, MRI, and ultrasound remove the limitation by imaging entire sections of the tongue, but it is difficult to derive quantitative information from the scans. The present work illustrates a new method for quantifying an ultrasound tongue image by automatically fitting a conic arc to the midsagittal edge of the tongue. These arcs can vary continuously in shape from elliptic to parabolic to hyperbolic, and the variation is parametrized by two phonetically meaningful geometric parameters: one correlates with constriction location and the other with constriction degree. Quantification of tongue shape change is then measured by tracking the change in these 2 unique descriptors. One arc is sufficient for ...

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Cinefluorographic techniques using a high speed camera at 50, 100, and 200 frames per second are described. The exposure at the skin surface has been measured using an R.cm2 meter for fluoroscopy and cineradiography during 334 examinations of children and adults. An analysis of the measurements is presented with particular reference to comparison of high-speed cine techniques and more conventional methods. It is concluded that 200 frames per second cinefluorography is a major advance in angiocardiographic technique, but should generally be reserved for investigation of cardiological problems presenting in infancy and early childhood. Lower frame speeds are adequate and should be chosen for assessment of less complex clinical problems in order to limit patient exposure. Measurements during combined catheterization, ventriculography, and selective coronary arteriography reveal comparatively high levels of patient exposure. For these investigations it is recommended that cine studies should be restr...

Clinical 16 mm cinefluorography and 70 mm camera fluorography were compared in 30 unselected patients undergoing coronary arteriography. Accuracy in detecting coronary arterial stenosis and collateral vessels and in assessing the degree of stenosis was similar with the two techniques. With both methods, there were significant inter- and intraobserver differences in estimating the degree of stenosis. These differences indicate that coronary arteriography is only a semiquantitative method for making decisions about treatment, prognosis and follow-up of patients. The use of more than one observer increases the likelihood that stenotic lesions will be detected. Interobserver variation in detecting collateral circulation is small.

Cinefluorography and videofluorography were used to record and analyze functional swallowing deficits of 12 dogs with spontaneously occurring oropharyngeal dysphagias and six experimental dogs with selected neurectomies. Ten of the 12 dogs had dysphagias affecting the cricopharyngeal stage of the oropharyngeal phase of swallowing. Two dogs had mixed oropharyngeal dysphagias. Clinical signs of cricopharyngeal dysphagia could not be differentiated from those of dysphagias due to pharyngeal or mixed oropharyngeal deficits. Signs of cricopharyngeal dysphagia consisted of: 1) repeated attempts to swallow; 2) excessive head movement; 3) dropping food from the mouth after unsuccessful swallowing attempts; 4) reingestion of dropped food. Nine of these dogs had cinefluorographic evidence of asynchrony between the normal pharyngeal contraction and relaxation, and subsequent cricopharyngeal relaxation and contraction. Only one dog demonstrated a consistent cricopharyngeal non-opening (achalasia). Seven of the dogs responded dramatically to cricopharyngeal myotomy. Two dogs with mixed oropharyngeal dysphagias had poor contractility of the pharyngeal muscles in addition to cricopharyngeal dysphagia. Clinical and cinefluorographic evaluation following cricopharyngeal myotomy of one dog verified exacerbation of functional deficits due to the iatrogenic cricopharyngeal chalasia. Esophagopharyngeal reflux accentuated the contrast medium retention in the pharynx and laryngotracheal aspiration. The need was stressed for careful differentiation between cricopharyngeal dysphagia and dysphagias involving the pharyngeal stage. Four experimental dogs with selective bilateral neurectomies of branches of the glossopharyngeal (IX) and vagus (X) nerves were evaluated clinically and cinefluorographically in an attempt to identify the pathogenesis of cricopharyngeal dysphagia. The variable results in the four dogs and the observed recovery in two dogs suggested that peripheral motor nerve deficits are not a major cause of cricopharyngeal dysphagia. Glossopharyngeal neurectomy in two dogs induced a profound functional disorder involving the pharyngeal and cricopharyngeal stages and the esophageal phase of swallowing. This would support a new hypothesis that the glossopharyngeal nerve is sensory to the esophagus as well as the pharynx, and may play a major role in disorders of the pharynx, upper esophageal sphincter, and esophagus, including congenital or acquired megaesophagus.

SUMMARY Fifty-six cases of duplicated renal systems have been observed by us. Abnormal peristalsis was seen in a high percentage of patients in die present series and in one of these patients pain was of sufficient severity to warrant surgical treatment. The late sequelae of chronic pyelonephritis, renal cortical destruction, pyonephrosis and non-function of an ectopic segment in a duplicated kidney is the direct result of neuromuscular dysfunction of the smooth muscle of the ureter and pelvicalycine system. Recurrent urinary infection and unexplained renal pain have been the common symptoms in adults while vesico-ureteric reflux, urinary tract infection and failure to thrive have been the main features in children. Voiding cysto-ureterography, high dose urography and cinefluorography have been proved to be of value in the diangnosis and subsequent management of our patients.

The clinical significance of cervical esophageal webs has yet to be established. Detailed examination of the pharyngoesophageal junction during the rapid passage of the barium bolus is essential for the diagnosis of the web. One hundred and ninety-one outpatients with globus symptoms were cinefluorographically examined by utilizing a 35mm cine camera incorporated in the fluoroscopy unit with a 9-inch image intensifier. Frontal and lateral views were obtained during the barium swallowing in the sitting position with the camera speed of 48 frames per second. The Tagarno projector was used for the study of cine films.The classical cervical esophageal webs were demonstrated in 33 cases (17.3%) as thin indentations at the anterior wall of the cervical esophagus just below the cricoid cartilage. The webs varied in depth; 1mm in 7 cases, 2mm in 13, 3mm in 7, 4mm in 3, 5mm in one, 7mm in one, 8mm in one, and 10mm in one. The webs were demonstrated also in various durations; 10 cases in less than 6 frames (0.125 seconds), 8 in 6 to 12 frames (0.25 seconds), 13 in 12 to 24 frames (0.5 seconds), and 2 in more than 24 frames. The depth of the indentation was apparently not correlated with the number of frames of the detectable webs.Web-like indentations were seen in the distal margin of the pyriform sinus and in the post-cricoid region of the hypopharynx as well, in 31 (16.2%) and 4 (2%), respectively.It is most likely that the incidence of cervical esophageal webs increases with the use of high-resolution and high-speed cinefluorography.

(1) The aetiology of dysphagia may be difficult to diagnose when it presents without clinical signs or an associated clinical syndrome. (2) Pharyngeal palsies present in acute and chronic forms. (3) Cinefluorographic techniques are helpful in making an objective diagnosis of pharyngeal palsy. (4) Advice may be given to the patient on head and neck positions during swallowing that is based on the findings of the cinefluorographic examination, in order to alleviate symptoms. (5) Good fluoroscopy, preferably with video-tape recording facilities may be perfectly adequate provided that the diagnosis is considered at that time.

This study utilized high speed X-ray films (cinefluorography) to study RL coarticulations of tongue apex and tongue dorsum. Subjects spoke C1C2V and VC1C2 sequences comprised of combinations of tense and lax consonant clusters and vowels. Measurements of lingual movements were obtained from cineframe tracings. Results indicate RL anticipatory movements of the tongue dorsum in C1C2V sequences, anticipatory movements toward V began on C1 in 30 % of the cases. In VC1C2 sequences, the tongue apex began RL anticipatory movements toward C2 during the steady-state vowel segment in approximately 44% of the cases. Perturbations of tongue movement related to labial closures and subsequent oral pressure build up was observed. The articulatory feature tense/lax did not vary systematically with the amount and extent of coarticulatory RL effects. Results were related to certain hypotheses concerning articulation behavior.

Considerable diagnostic data can be gathered by selectively catheterizing the portal vein and the major tributaries of the splanchnic venous system to evaluate pressure and blood flow. Combined with cinefluorography, this is a superior method for demonstrating the anatomy and hemodynamics of portal hypertension as well as the effects of splenorenal shunt surgery. Thirty-one attempts with a 19 gauge trocar in 17 patients resulted in 28 successful portal entries and 24 successful selective catheterizations. Portal vein pressure, flow, and diameter were less after shunting.

The relative significance of electrical spike potentials and intraluminal pressure waves as quantitative indicators of motility was studied from registrations in the human small intestine. The time interval between spike potentials and corresponding pressure waves was inversely proportional to the magnitude of the pressure waves. Amplitude and duration of pressure waves were proportional to the degree of visible activity as observed by synchronized cinefluorography. Duration of spike potentials also correlated well with visible intestinal activity, whereas amplitude of spike potentials showed a great range in variation. Correlations between all possible combinations of the four parameters (1) amplitude of spike potentials, (2) duration of spike potentials, (3) amplitude of pressure waves, and (4) duration of pressure waves were calculated on a computer for 1,000 corresponding pairs of spike potentials and pressure waves.

Intravesical and intra-urethral pressures were recorded in 5 continent women and 10 women with urinary stress incontinence using combined urethrocystometry and cinefluorography. At rest, two types of stress incontinence could be recognized; one involved widening of the proximal urethra and the other did not. Under stress, the proximal urethra was rather mobile in the incontinent women. Artifacts caused by axial movement of the urethral microtransducer were eliminated by fixation of the catheter against the external meatus.

Cinefluorography was used to study three stutterers and two nonstutterers repeating a passage made up of monosyllables. CVC target words of the form/cæt/were embedded in the passage and were analyzed to determine the effects of repeating the passage on velocities, displacements, and durations of movements of the tongue, jaw, and lower lip. Coordination among the articulators was also assessed. The investigation was undertaken to test the hypothesis that decreases in velocities and displacements, increased movement durations, and decreased latency between the onsets of jaw movements and of tongue tip movements would be associated with the repeated readings. The hypothesis was not supported by the results. A post hoe analysis showed that a decrease in the variability, of instantaneous velocities (and by inference a decrease in variation in muscle stiffness) was associated with practice for the three stutterers but not for the nonstutterers. Inferences about the adaptation effect are made related (a} to the stabilization of tonic muscle activity which may be associated with a decrease in arousal, and (b) to the, effects of practice.