• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.401-406
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• 1999

Secondary deformities of the lip and nose in individuals with repaired unilateral and bilateral clefts may vary in severity, depending on the state of the original defect, the care taken in the initial surgical procedure, the pattern of the patient's facial growth, and the effectiveness of interceptive orthodontic technique. Because each patient has a unique combination of deformities, their surgical reconstruction usually requires the modification and combination of several surgical techniques. Residual lip deformities after primary repair may be esthetic or functional and include scars, skin shortage or excess(vertical and transverse), orbicularis oris muscle malposition or diastasis. The key to accurate repair of secondary cleft lip deformities is a precise diagnosis. This requires observation of the patient in animation and repose. The quality of the scar is not the only factor determining the overall appearance of the lip. Observing the patient in the animated position is critical to assess muscular function. Factors that require precise analysis include lip length, the appearance of the Cupid's bow and philtrum, and nasal symmetry. Only after this detailed analysis can a decision be made as to wether a major or minor deformity exists. We report successful cases using various techniques for the secondary lip deformities.

• Development and Reproduction
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• v.21 no.4
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• pp.391-397
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• 2017

Skeletal deformities are significant problems that affect the growth and commercial value of fish reared in hatcheries. However, studies of bone metabolic process related to skeletal deformities are limited. We investigated the potential correlation between bone deformities and plasma calcium, phosphorus, and estradiol-$17{\beta}$ levels in reared red spotted grouper (Epinephelus akaara) juveniles. We collected E. akaara frys from private farms at 110, 140, 180 and 300 days after hatching (DAH), and classified the normal and deformed fish by observing their external shape and inner frame by soft X-ray. We also analyzed the calcium, phosphorous, and estradiol-$17{\beta}$ levels in their plasma. A comparison between normal and deformed fish, indicated that calcium and estradiol-$17{\beta}$ levels were higher in deformed fish than in the normal at 180 and 300 DAH. The level of phosphorus was also higher in deformed individuals than in normal fish, but only at 300 DAH. These results suggest that skeletal deformities are associated with increases in plasma calcium, phosphorus, and estradiol-$17{\beta}$ levels.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.410-412
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• 2003

A male, 11-month-old, Shih-tzu dog weighing 5.2kg showing knuckling secondary to severe cranial bowing of left antebrachium with valgus deformity of the carpus was presented to the Veterinary Medicine Teaching Hospital of Seoul National University. Radiographic findings were a premature closure of the distal ulnar physis, a cranial bowing of the radius, subluxation of the elbow joint, and degenerative changes in the carpal joint. The patient was treated by performing an oblique osteotomy of the radius and ulna, followed by application of External Skeletal Fixations. At 18 weeks postoperatively, the radius was healed. An incongruency of the elbow joint and radial angular deformity was corrected.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.395-408
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• 2016

We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.102-107
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• 2005

With the advent of hemodialysis, the success of renal transplants in the 1960s and the wide use of continuous ambulatory peritoneal dialysis at the end of the 1970s, children with renal failure now enjoy an extended life span. As a result, several children experience renal osteodystrophy and growth retardation. Renal osteodystrophy is induced by phosphorus retention, hypocalcemia, low vitamin D levels and hyperparathyroidism. The pharmacologic interventions are used to prevent bone deformities and to normalize growth velocity. But surgical intervention is required sometimes whorl osteodystrophy is severe and poorly controlled. We report an eight-year-old boy with ctironic renal failure who developed severe bone deformities and needed osteotomy.

• The korean journal of orthodontics
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• v.52 no.2
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• pp.112-122
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• 2022

Objective: This study aimed to present and evaluate a new deep learning model for determining cervical vertebral maturation (CVM) degree and growth spurts by analyzing lateral cephalometric radiographs. Methods: The study sample included 890 cephalograms. The images were classified into six cervical stages independently by two orthodontists. The images were also categorized into three degrees on the basis of the growth spurt: pre-pubertal, growth spurt, and post-pubertal. Subsequently, the samples were fed to a transfer learning model implemented using the Python programming language and PyTorch library. In the last step, the test set of cephalograms was randomly coded and provided to two new orthodontists in order to compare their diagnosis to the artificial intelligence (AI) model's performance using weighted kappa and Cohen's kappa statistical analyses. Results: The model's validation and test accuracy for the six-class CVM diagnosis were 62.63% and 61.62%, respectively. Moreover, the model's validation and test accuracy for the three-class classification were 75.76% and 82.83%, respectively. Furthermore, substantial agreements were observed between the two orthodontists as well as one of them and the AI model. Conclusions: The newly developed AI model had reasonable accuracy in detecting the CVM stage and high reliability in detecting the pubertal stage. However, its accuracy was still less than that of human observers. With further improvements in data quality, this model should be able to provide practical assistance to practicing dentists in the future.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.192-196
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• 2016

Understanding the development of a skull deformity requires an understanding of the normal morphogenesis of the cranium. Craniosynostosis is the premature, pathologic ossification of one or more cranial sutures leading to skull deformities. A review of the English medical literature using textbooks and standard search engines was performed to gather information about the prenatal development and growth of the cranial vault of the neurocranium. A process of morphogenic sequencing begins during prenatal development and growth, continues postnatally, and contributes to the basis for the differential manner of growth of cranial vault bones. This improved knowledge might facilitate comprehension of the pathophysiology of craniosynostosis.

• Journal of Veterinary Clinics
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• v.29 no.2
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• pp.177-180
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• 2012

Angular limb deformities (ALD) are common in foals. A 30-days-old Thoroughbred foal was presented for the evaluation of severe ALD of the both forelimbs. On radiographic examination, both distal radiuses were diagnosed as valgus angular limb deformities. But the degree of deviation of right forelimb was so severe that we tried to correct one after the other. We tried new surgical correction method combination of one screw implant on medial aspect for growth retardation and periosteal transection on lateral aspect of the right forelimb. 40 days later, successfully corrected and then removed the screw. After the right forelimb correction, the periosteal transection on left forelimb was performed. We did the inhalation anesthesia using isoflurane. There were no complications such as fibrosis over the screw heads, and overcorrection that produces an opposing deformity identified. These results suggest that combination of one screw implant and periosteal transection technique is able to be a safe and effective method to correct severe ALD in the foal.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.43.1-43.4
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• 2016

Background: Supernumerary nostril is a congenital anomaly that contains additional nostril with or without accessory cartilage. These rare congenital nasal deformities result from embryological defects. Since 1906, Lindsay (Trans Pathol Soc Lond. 57:329-330, 1906) has published the first research of bilateral supernumerary nostrils, and only 34 cases have been reported so far in the English literature. Case presentation: A 1-year-old female baby was brought to our department group for the treatment of an accessory opening above the left nostril which had been presented since her birth. Medical history was non-specific and her birth was normal. The size of a supernumerary nostril was about 0.2 cm diameter and connected to the left nostril. The right one was normal. Minimal procedure was operated for the anomaly. After 1 year, rhinoplasty was performed for the nostril asymmetry. Conclusions: At 1 year follow-up, the functional and cosmetic result was satisfactory. In this case, it is important that we have early preoperative diagnosis. Also, it is desirable that we should perform a corrective surgery as soon as possible for the patient's psychosocial growth.

• Childhood Kidney Diseases
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• v.24 no.2
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• pp.115-119
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• 2020

Distal renal tubular acidosis (dRTA) is a rare renal tubular disorder characterized by normal anion gap metabolic acidosis, hypokalemia, and high urine pH. It can be inherited or acquired. In untreated pediatric patients with dRTA, rickets and growth retardation are common. We report the case of a 12-year-old Lao girl who presented with typical clinical features of dRTA with severe bone deformities that developed after a bed-ridden state due to a bicycle accident at the age of 8 years. Initial laboratory tests revealed metabolic acidosis with a normal anion gap, hypokalemia, and alkali urine. Renal ultrasonography revealed bilateral medullary nephrocalcinosis. Whole exome sequencing revealed no pathogenic mutations. After treatment with oral alkali, potassium, and vitamin D, she could walk and run. Later, she underwent corrective orthopedic surgeries for bony deformities. Thus, in pediatric dRTA patients, despite severe symptoms remaining untreated, accurate diagnosis and proper management can improve quality of life.