• Genomics & Informatics
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• 제5권2호
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• pp.56-60
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• 2007

Nonsyndromic cleft lip with or without cleft palate (CL/P) is a common craniofacial birth defect that is the result of a mixture of genetic and environmental factors. While studies have identified a number of different candidate genes and loci for the etiology of CL/P, the results have not been consistent among different ethnic groups. To study the genetic association of the candidate genes in Korean patients affected by CL/P, we genotyped 97 nonsyndromic CL/P patients and 100 control individuals using single nucleotide polymorphic markers at the MTHFR, TGFA, and IRF6 genes. We report that the T3827C marker at TGFA showed significant association with nonsyndromic CL/P, but all the other markers tested were not significantly associated with nonsyndromic CL/P in Korean patients.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.51-61
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• 2024

Background: The influence of smoking on nonsyndromic clefts has been a topic of research for many years. However, few studies have investigated the effect of smoking on causing clefts in different gene pools. Methods: A meta-analysis was conducted of case-control studies related to smoking. Keywords such as "clefts," "cleft lip," "cleft palate," "orofacial cleft," and "smoking" were used to search the MEDLINE, Embase, and Cochrane databases. Results: In total, 51 articles were reviewed. The RevMan software was utilized for the analysis, and the Mantel-Haenszel method was employed to pool the odds ratios (ORs) and 95% confidence intervals. Although the overall OR, a measure of the association between exposure and outcome, was higher for smokers than for non-smokers, this association was significantly stronger in individuals from Asia and South America (1.73), and lowest in Europe (1.31). Among active and passive smokers in Asia, the OR was approximately 0.93, indicating an equivalent impact from both types of smoking. Conclusion: This analysis indirectly suggests that restriction measures targeting both active and passive smoking are crucial in Asia.

• 대한치과교정학회:학술대회논문집
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• 대한치과교정학회 2003년도 제36회 학술대회
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• pp.26-26
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• 2003

• 대한치과교정학회지
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• 제43권3호
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• pp.113-119
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• 2013

Objective: To compare three-dimensionally the midfacial hard- and soft-tissue asymmetries between the affected and the unaffected sides and determine the relationship between the hard tissue and the overlying soft tissue in patients with nonsyndromic complete unilateral cleft lip and palate (UCLP) by cone-beam computed tomography (CBCT) analysis. Methods: The maxillofacial regions of 26 adults (18 men, 8 women) with nonsyndromic UCLP were scanned by CBCT and reconstructed by three-dimensional dental imaging. The frontal-view midfacial analysis was based on a $3{\times}3$ grid of vertical and horizontal lines and their intersecting points. Two additional points were used for assessing the dentoalveolar area. Linear and surface measurements from three reference planes (Basion-perpendicular, midsagittal reference, and Frankfurt horizontal planes) to the intersecting points were used to evaluate the anteroposterior, transverse, and vertical asymmetries as well as convexity or concavity. Results: Anteroposteriorly, the soft tissue in the nasolabial and dentoalveolar regions was significantly thicker and positioned more anteriorly on the affected side than on the unaffected side (p < 0.05). The hard tissue in the dentoalveolar region was significantly retruded on the affected side compared with the unaffected side (p < 0.05). The other midfacial regions showed no significant differences. Conclusions: With the exception of the nasolabial and dentoalveolar regions, no distinctive midfacial hard- and soft-tissue asymmetries exist between the affected and the unaffected sides in patients with nonsyndromic UCLP.

• 대한치과교정학회지
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• 제38권2호
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• pp.133-143
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• 2008

이 연구는 한국인 비증후군성 구순구개열자에서 구순구개열과 치아결손의 중요한 원인 중 하나로 의심되는 MSX1 유전자(locus chromosome 4p16)의 특성을 밝히기 위해 시행되었다. 1998년부터 2002년까지 부산대학교병원 치과교정과에 내원한 36명(남자:23, 여자:13)의 비증후군성 구순수 개열자를 대상으로 하였다. 모든 대상의 혈액을 채취하여 중합 효소연쇄반응(polymerase chain reaction)에 기초한 유전자 분석을 시행하여, MSX1 유전자를 증폭하고, 염기서열을 분석하였으며, 추론되는 단백질 생성물에 대해서도 연구하였다. 이미 밝혀진 Homo sapiens MSX1, accession number AF426432와 NP_002439를 참고로 하여 비교 분석한 결과 공통적인 단일 염기 다형성이 존재하였다. exon 1에서, 253번째 부위의 염기 "A"가 "G"로 치환되었고, 255번째 부위에서 염기 "G"가 삽입되었다. exon 2에서 11번째 부위에서 염기"C"가 "A"로 치환되었고, 351부위에서 염기"T" 또는 "G"가 삽입되었고 352부위에서 염기"T" 또는 "A"가 삽입되었다. 한국인 비증후군성 구순구개열자에서 다른 인종에서 발견된 돌연변이와는 다른 "Thr85A1a" missense 돌연변이가 발견되었다. 이는 한국인 비증후군성 구순구개열에서도 MSX1 유전자가 중요한 원인이 될 수 있고 한국인의 독특한 돌연변이가 존재한다는 가능성을 제시한 것이다. 그러나, 구개열 부위의 치아결손과 관련해서는 어떠한 유전자 특징도 관찰되지 않았다.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.217-222
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• 2017

Background The prevalence of flap necrosis after palatoplasty in patients with cleft palate. The prevalence of mucoperiosteal flap necrosis after palatoplasty remains unknown, and this complication is rare. This event is highly undesirable for both the patient and the surgeon. We present here a new scale to evaluate the degree of hypoplasia of the palate and identify patients with cleft palate at high risk for the development of this complication. Methods In this case series, a 20-year retrospective analysis (1994-2014) identified patients from our records (medical records and screening day registries) with nonsyndromic cleft palate who underwent operations at 3 centers. All of these patients underwent operations using 2-flap palatoplasty and also underwent a physical examination with photographs and documentation of the presence of palatal flap necrosis after primary palatoplasty. Results Palatal flap necrosis was observed in 4 cases out of 1,174 palatoplasties performed at these centers. The observed prevalence of palatal flap necrosis in these groups was 0.34%. Conclusions The prevalence of flap necrosis can be reduced by careful preoperative planning, and prevention is possible. The scale proposed here may help to prevent this complication; however, further studies are necessary to validate its utility.

• 대한구순구개열학회:학술대회논문집
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• 대한구순구개열학회 2002년도 종합학술대회
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• pp.28-28
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• 2002

• BMB Reports
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• 제36권6호
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• pp.533-537
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• 2003

The nonsyndromic cleft lip and palate (NSCL/P) is a congenital deformity of multifactorial origin with a relatively high incidence in the oriental population. Various etiologic candidate genes have been reported with conflicting results, according to race and analysis methods. Recently, the ablation of the TGF-${\beta}3$ gene function induced cleft palates in experimental animals. Also, polymorphisms in the TGF-${\beta}3$ gene have been studied in different races; however, they have not been studied in Koreans. A novel A $\rightarrow$ G single nucleotide polymorphism (defined by the endonuclease SfaN1) was identified in intron 5 of TGF-${\beta}3$ (IVS5+104 A > G). It resulted in different genotypes, AA, AG, and GG. The objective of this study was to investigate the relationship between the SfaN1 polymorphism in TGF-${\beta}3$ and the risk of NSCL/P in the Korean population. The population of this study consisted of 28 NSCL/P patients and 41 healthy controls. The distribution of the SfaN1 genotypes was different between the cases and controls. The frequency of the G allele was significantly associated with the increased risk of NSCL/P [odds ratio (OR) = 15.92, 95% confidence interval (CI) = 6.3-41.0]. The risk for the disease increased as the G allele numbers increased (GA genotype: OR = 2.11, 95% CI = 0.38-11.68; GG genotype: OR = 110.2, 95% CI = 10.67 - 2783.29) in NSCL/P. A stratified study in patients revealed that the SfaN1 site IVS5+104A > G substitution was strongly associated with an increased risk of NSCL/P in males (p < 0.001), but not in females. In conclusion, the polymorphism of the SfaN1 site in TGF-${\beta}3$ was significantly different between the NSCL/P patients and the control. This may be a good screening marker for NSCL/P patients among Koreans.

• 대한치과교정학회지
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• 제34권3호
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• pp.261-267
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• 2004

비증후군성 구순구개열은 가장 빈도가 높은 선천성 기형 중의 하나로 특히 한국이나 일본과 같은 극동 지방에서 높은 발생율을 보이고 동유럽에서는 드물게 보고되고 있다. 이러한 인종에 따른 차이는 이 질환에 유전적인 배경이 있음을 의미한다. 본 연구의 목적은 한국인의 비증후군성 구개열과 연관이 있다고 알려진 SfaN1 단일 염기 다형성증의 발현빈도가 한극인 구개열 가족과 루마니아 구순구개열 가족 사이에 통계적으로 유의할만한 차이가 있는지를 알아보기 위하여 시행하였다. 한국인 26가족과 루마니아 18가족을 대상으로 하였다. 전체 인원수는 한국인의 경우 78명이었고 루마니아의 경우 41명이었다. 유전자 서열분석에 사용된 샘플은 각 참여자의 혈액이나 타액을 채취하여 분석하였다. SfaN1 단일 염기 다형성 증은 $TGF-{\beta}3$ 유전자의 5번 인트론에서 관찰된다 (A18141G) 결과를 보면 한국인과 루마니아인의 비증후군성 구개열 가족사이에는 통계적으로 유의할만한 차이 가 인지되었다. 전체 샘플 중에서 AA allele는 한국인에서는 18명(23.1%)이었으나 루마니아는 27명(65.9%)이었다. AS allele는 한국인에서는 27명 (34.6%)이었으나 루마니아에서는 13명 (31.7%)이었다. GG allele는 한국인에서는 33명 (42.3%)이었으나 루마니아에서는 1명 (2.4%)이었다. 두 집단 사이의 차이는 통계적으로 유의하였다 (p<0.001). 결론적으로 한국인과 루마니아인의 비증후군성 구개열 가족 사이에 SfaN1 단일 염기 다형성증의 발현빈도는 한국인에서 통계적으로 유의할만하게 높게 나타났으며, 이는 한국에서 루마니아보다 비증후군성 구개열의 빈도가 높게 나타나는 현상을 부분적으로 설명하여 주는 것으로 사료된다.

• Archives of Plastic Surgery
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• 제44권3호
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• pp.202-209
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• 2017

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ${\geq}17$ years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.