Lee, Kee-Joon;Nah, Hyun-Duck;Tjoa, Stephen T. J.;Park, Young-Chel;Baik, Hyoung-Seon;Yun, Tae-Min;Song, Jin-Wook
The korean journal of orthodontics
/
v.36
no.4
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pp.284-294
/
2006
Objective: Activating mutations in the fibroblast growth factor receptor-2 (FGFR2) have been shown to cause syndromic craniosynostosis such as Apert and Crouzon syndromes. The purpose of this pilot study was to investigate the resultant phenotypes induced by the two distinctive bone-targeted gene constructs of FGFR2, Pro253Arg and Cys278Phe, corresponding to human Apert and Crouzon syndromes respectively. Methods: Wild type and a transgenic mouse model with normal FGFR2 were used as controls to examine the validity of the microinjection. Micro-CT and morphometric analysis on the skull revealed the following results. Results: Both Apert and Crouzon mutants of FGFR2 induced fusion of calvarial sutures and anteroposteriorly constricted facial dimension, with anterior crossbite present only in Apert mice. Apert mice differed from Crouzon mice and transgenic mice with normal FGFR2 in the anterior cranial base flexure and calvarial flexure angle which implies a possible difference in the pathogenesis of the two mutations. In contrast, the transgenic mice with normal FGFR2 displayed normal craniofacial phenotype. Conclusion: Apert and Crouzon mutations appear to lead to genotype-specific phenotypes, possibly causing the distinctive sites and sequence of synostosis in the calvaria and cranial base. The exact function of the altered FGFR2 at each suture needs further investigation.
This study was conducted to discern differences of craniofacial, dentoalveolar structure and model measurements between sex and between class n openbite group and non-openbite group. The sample consisted of 49 adult patients with class Il malocclusion. 24 linear measurements, 22 angular measurements and 12 ratios were selected in lateral cephalometry. Also, arch width, length, anterior crowding, average molar relation were measured or calculated in diagnostic model. The data were evaluated by t-test and multiple discriminant analysis. The results were as follows, 1. Most linear measurements, with the exception of MnBL and AUDH, were significantly larger in male(p<0.05). but, intermaxillary relations and spatial position of maxilla and mandible relative to cranial base were not different for both sex. 2. With the exception of upper and lower anterior crowding, lower arch width, upper arch length, AMR, male exhibited significantly larger measurements in model analysis (p<0.05). 3. Size differences of maxilla and mandible between openbite and non-openbite group were not significant(p>0.05). but openbite group showed significantly increased genial angle(p<0.05), FH-CoGo(p<0.01), FH-NA(p<0.01) and FH-NB, FH-NPog (p<0.05). 4. ALFH and PUDH were larger(p<0.05) in openbite group. this result served as compensation for the spatial position of mandible relative to cranial base. AUPUDH (p<0.001) and ALPLDH(p<0.05) were lower in openbite group. upper anterior crowding was the only measurement which showed difference between openbite and non-openbite group(p<0.05). 5. For the purpose of classifying adult class n openbite and non-openbite group, multiple discriminant analysis was done genial angle, ALPLDH, AUPUDH, FH-NA were included in multiple discriminant equation. 39 cases($92.86\%$) were correctly classified when applied to the sample used in this study.
The purpose of this study was to compare the difference of the growth aspects in three facial growth patterns. The biennial serial cephalometric radiographs of 33 samples(19males, 14females) with normal occlusion from 8.5 years to 18.5 yews of age were used in this study. The facial growth patterrn was categorized in 3 types(Drop type, Neutral type, Forward type) by the total amounts of the Y-axis which changed from 8.5 years to 18.5 years of age. The growth change of the craniofacial area during 10 years in each growth type was analyzed and was compared among the 3 growth types. The results of this study might be summarized as follows. 1. The samples that were classified by total change of the Y-axis during this study period were distributed to 52% of the neutral type, 27% of the forward type, 21% of the drop type. 2. The anterior growth of the maxilla to the cranial base(N per A) showed larger in the forward type than in other 2 types(p<0.05). 3. The palatal plane to the FH plane showed more anterior-superior inclination in the forward type with age during this study period. 4. The anterior growth of the mandible to the cranial base(N per Pog) appeared large in rank order, of largest the forward type, second the neutral type, and third the drop type(p<0.05). 5. During this study period the mandibular plane(SN/MN,FMA) showed more counterclockwise rotation in the forward type than in the drop type(p<0.05), and this tendency was stronger in males than in females(p<0.05). 6. The growth of the mandibular corpus length(Go-Me) showed smaller in the drop type than in the other 2 types(p<0.05). 7. In the forward type and the neutral type, the anterior growth of the mandible was larger than that of the maxilla(p<0.05). 8. In the craniofacial growth distances and angulations turned out to be somewhat variable, but the vertical proportion had a strong tendency whose original relation was maintained consistently during this study period. 9. Through these analyzed data, the profilograms on each growth type were constructed to evaluate individual growth pattern in the orthodontic diagnosis.
Kim In-Ah;Choi Ihl-Bhong;Jang Ji-Young;Kang Ki-Mun;Jho Seung-Ho;Kim Hyung-Tae;Lee Kyung-Jin;Choi Chang-Rak
Korean Journal of Head & Neck Oncology
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v.14
no.2
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pp.156-163
/
1998
Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin $100mg/m^2$) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after $1^{st}$ FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to $114.9cm^2$. IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.
Enlow's counterpart analysis explains the complex with anatomic and developmental characteristics where craniofacial aspect of individuals has been developed. The analysis does not compare individual measurement with the normal value from the average of majority but analyzes by comparison of values that each individual has. This study was to clarify the Korean craniofacial skeletal pattern using Enlow's counterpart analysis considering the fact that the craniofacial skeletal pattern has racial and regional variations. This research will be helpful in the future for growth research and research of the orthognathic surgery. For this study, the samples were consisted of 100 Korean adult subjects(50 males and 50 females) who had normal occlusion and pleasing face. Measurement points and lines were established using Enlow's counterpart analysis and they were statistically evaluated. The results indicated that : 1. The average angle between PCF and PMV was $38.54^{\circ}$ in males and $38.43^{\circ}$ in females, and the average Wits' appraisal was -2.51 in males and -2.3 in females. The ramus alignment(R4) was 1.89 in males and 2.36 in females. 2. It shows that females have a longer ramus than the PCF compared to the males, because there was a significant difference in Ramus/PCF horizontal dimensions (Skeletal A3-B3) between female and male subjects 3. It shows that males have a longer mandibular corpus than the maxilla compared to the females, because there was a significant difference in Maxillary/Mandibular arches(Skeletal A4-B4) between male and female subjects 4. In cranial floor+maxilla/ramus+corpus at A and B points(Al-Bl), which represents difference in total horizontal length between the maxilla and mandible, there was no significant difference between males and females. In conclusions, compared to Caucasian, Korean have more depressed midface, prognathic mandible, and ramus that rotates inferioposterior. Also, we observe that Korean women have target ramus posterior cranial base, as compared with Korean men. Consequently, the total length of maxilla and mandible does not show any difference, because man's mandible is longer than maxilla in comparison with woman's one.
A 1.6-year-old, intact male beagle dog was presented with three day history of odynophagia and anorexia. According to the history and radiographic findings, the patient was diagnosed with esophageal and gastric foreign body due to ingesting fishhooks. Gastroesophagoscopy revealed that one fishhook located in the thoracic esophagus cranial to the heart base and the other located in the cardia region were connected with a single fishing line. Gastrotomy was performed to remove the fishhook in the cardia region and to sever the connecting fishing line. After gastrotomy, endoscopic attempts to remove the esophageal fishhook with a three, five pronged endoscopic grasping forceps, and a biopsy were unsuccessful because the fishhook was embedded deeply in the mucosa membrane. A handmade cerclage wire(16G) shaped like a snare forceps was advanced into the esophagus while visualizing the fishhook endoscopically. The cerclage wire was used to hang and retract the foreign body. The fishhook was retracted orally, resulting in successful removal. Ten days after the operation, the patient fully recovered and was discharged.
The purpose of this study was to investigate the characteristics of craniofacial morphology in adult with crowded dentition. The craniofacial morphology associated with normal and crowded of mandibular dentition was studied in lateral cephalometric radiograph obtained from 145 subjects grouped 44 males and 40 females in normal group, 33 males and 28 females in crowded group. The conclusions were as follows: Means, standard deviations and facial polygons from measurements were obtained from normal and crowded groups. Palatal plane to SN, occlusal plans to SN, mandibular plane to SN, mandibular plane to palatal plane and gonial angle measurements of crowded group were significantly different from normal group and were larger than normal group. SNA, SNB measurements of crowded group were significantly different from normal group and were smaller than normal group. Significant differences were observed between normal group and crowded groups on the basis of $SN/{\underline{1}}$, PP/1, $MP/{\bar{1}}$, and compared with normal group, upper incisors of crowded group were inclined more labially, whereas lower incisors of crowded group were inclined more lingually. Posterior facial height and ramal height were shorter in males of crowded group than those of normal group. Posterior facial height, mandibular length and posterior cranial base length were shorter in females of crowded group than those of normal group. Anterior facial height was longer in females of crowded group than those of normal group.
The purpose of this study was to evaluate the position of tongue and hyoid bone in relation to vortical facial patterns in the adult and child. Lateral cephalograms taken in adults(63 cases, 11.7 years in average age) and children(69 cases, 22.6 years in average age) were traced and measured about position and posture of tongue and hyoid bone using the horizontal and vertical reference lines. The angle of mandibular plane to SN Plane was employed to classify the samples into groups of hypodivergent and hyperdivergent. The comparison of the tongue/hyoid bone measurements between hypodivergent group and hyperdivergent group in the adult and child were statistically executed with Student's f-test. The results were as follows, 1. The tongue height was lower in the hyperdivergent group than in hypodivergent group, and higher in children than in adults. 2. The vertical height of hyoid bone was higher in hypodivergent group than in hyperdivergent group and also higher in children than in adults. 3. The anteroposterior position was of no significant difference in relation to age or vortical facial pattern. 4. The inclination of hyoid bone in relation to cranial base was steeper in children than in adults.
This study was carried out in order to find out the changes of the pharyngeal airway, hyoid bone and head posture before and after tonsillectomy in functional class III malocclusion patients. For this study, 21 Angle's class I patients and 21 Angle's class III patients, totally 42 subjects were chosen. The results were as follows; 1. In comparison to Class I group, tongue was more anteriorly and hyoid bone was more inferiorly positioned in functional Class III group 2. In comparison to pre-tonsillectomy, tongue was more posteriorly positioned and larger nasopharynx depth was shown in post-tonsillectomy. In post tonsillectomy, the hyoid bone was displaced posteriorly and superiorly and counterclockwise rotation was shown. 3. The level of significance for the correlation shown was 5 percent (p<0.05) indicating that: The change of nasopharyx depth was correlated to the inclination of lower incisors. Vertical change of tongue posture was correlated to the hyoid axis change. Vertical change of hyoid bone was correlated to the horizontal change of hyoid bone, craruocervical inclination. The change of craniocervical inclination was correlated to the inclination of lower incisors. 4. After the tonsillectomy, counterclockwise rotation of hyoid axis was associated with decease of hya-NL and large nasopharyngeal airway. High posture of the tongue was associated with decrease of hya-NL. Posterior posture of the tongue was associated with increase of h-hl,and decrease of hya-ba-n.
Recently, according to the Increase of adult patient, it is neccessory to understand the growth changes of adult after cessation of active pubertal growth in clinical orthodontics. The purpose of this study was to investigate the growth changes of craniofacial structure after active growth period(adult) in order to use as reference in clinical orthodontics. Authors followed the 40 sample(male 25, female 15) from 24 to 31 years of age. By analysing the serial cephalograms, authors could get the following findings. $\cdot$ The mandible rotated clockwise in female, but not in male, and no incremental growth change in both genders. $\cdot$ The anterior facial height and lower anterior facial height were increased in both genders, the increase of lower anterior facial height exceed the posterior facial height increase in female. $\cdot$ The cranial base was stable throughout observation period. $\cdot$ The upper incisors uprighted slightly in female. $\cdot$ There were great the individual variation in the growth change of craniofacial structure in adult.
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