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Surgical correction of cleft lip lower-lip deformity: a report of three cases

  • Ci Young, Kim;Sung-Ho, Ha;Jin-Young, Choi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.390-396
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    • 2022
  • Cleft lip lower-lip deformity is a secondary deformity in patients who underwent primary cheiloplasty of the upper lip, characterized by an enlarged and anteriorly rotated lower lip. In these cases, soft-tissue imbalances remain even after skeletal correction with orthognathic surgery, and additional soft tissue treatment is required for lip harmony and esthetic facial balance in CLP (cleft lip palate) patients. This study describes three cases of transverse myomucosal excision of the lower lip for correction of cleft lip lower-lip deformity to restore facial esthetic balance. Each patient underwent orthognathic surgery, rhinoplasty, or upper lip revision cheiloplasty according to condition. Postoperatively, volume of the lower lip decreased and lip harmony was improved in all three patients. The surgeon should fully understand the anatomical structure around the lips and be able to evaluate overall harmony of the soft tissue. When a lower lip deformity is present, careful surgical planning and execution are important for each patient.

Reconstruction of the Lower Lip Following the Wide Excision of Squamous Cell Carcinoma (하구순 편평상피암의 절제후 재건 치험례)

  • Ryu Bong-Su
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.52-57
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    • 1996
  • Since the upper lip does not receive direct actinic radiation, only 5% of lip tumors develop in the upper lip, while the lower lip is the site of the remainder. Among the lower lip cancer, squamous cell carcinoma is the most common tumor, especially the vermillion border of lower lip is the most common site. The aims of reconstruction of the lip are both aesthetic effect and functional restoration and the ideal procedure must produce a aesthetically normal, not-tao-tight lip and a good sensation and muscle tone of the lip. We have a satisfactory reconstruction of a subtotal loss of lower lip after squamous cell carcinoma extirpation using Gillies fan flap and the case is presented with reviewing a many published reports.

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Korean Lip-Reading: Data Construction and Sentence-Level Lip-Reading (한국어 립리딩: 데이터 구축 및 문장수준 립리딩)

  • Sunyoung Cho;Soosung Yoon
    • Journal of the Korea Institute of Military Science and Technology
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    • v.27 no.2
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    • pp.167-176
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    • 2024
  • Lip-reading is the task of inferring the speaker's utterance from silent video based on learning of lip movements. It is very challenging due to the inherent ambiguities present in the lip movement such as different characters that produce the same lip appearances. Recent advances in deep learning models such as Transformer and Temporal Convolutional Network have led to improve the performance of lip-reading. However, most previous works deal with English lip-reading which has limitations in directly applying to Korean lip-reading, and moreover, there is no a large scale Korean lip-reading dataset. In this paper, we introduce the first large-scale Korean lip-reading dataset with more than 120 k utterances collected from TV broadcasts containing news, documentary and drama. We also present a preprocessing method which uniformly extracts a facial region of interest and propose a transformer-based model based on grapheme unit for sentence-level Korean lip-reading. We demonstrate that our dataset and model are appropriate for Korean lip-reading through statistics of the dataset and experimental results.

Lip Recognition Using Active Shape Model and Shape-Based Weighted Vector (능동적 형태 모델과 가중치 벡터를 이용한 입술 인식)

  • 장경식
    • Journal of Intelligence and Information Systems
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    • v.8 no.1
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    • pp.75-85
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    • 2002
  • In this paper, we propose an efficient method for recognizing lip. Lip is localized by using the shape of lip and the pixel values around lip contour. The shape of lip is represented by a statistically based active shape model which learns typical lip shape from a training set. Because this model is affected by the initial position, we use a boundary between upper and lower lip as initial position for searching lip. The boundary is localized by using a weighted vector based on lip's shape. The experiments have been performed for many images, and show very encouraging result.

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The Effect of Lip Adhesion in Unilateral Complete Cleft Lip (일측성 완전구순열에서 구순접합술의 효과)

  • Ryu Sun-Youl;Kim Tae-Hee;Hwang Ung;Kook Min-Suk;Kim Sun-Kook;Han Chang-Hun
    • Korean Journal of Cleft Lip And Palate
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    • v.7 no.1
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    • pp.1-16
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    • 2004
  • In the recent time, early correction of the congenital anomalies has become the focus of contemporary cleft lip care, The reason of that is mostly psychologic factor of children are respected, Although the propound object of lip adhesion is not esthetic improvement, that able to satisfy sufficiently parents of cleft children, In the unilateral or bilateral clefts, a preliminary lip adhesion has been advocated as a mean of narrowing the cleft at an early phase, of improving the nasal contour, of molding the alveolar arch, and of easing and improving the result of a definitive lip repair. The present study was earned out to investigate the effect of lip adhesion. We performed the Millard's high-half underminded adhesion and Seibert's lip adhesion followed by modified Millard's cheiloplasty for five infants had unilateral complete cleft lip. The lip adhesion reduced the actual deformity by molding the maxillary alveolar segments into better relationship and allows a easy cheiloplasty so that led to more perfect final lip result, Both Millard's high-half underminded adhesion and Seibert's lip adhesion were available methods to adhere a wide cleft lip, Especially, Seibert's lip adhesion had more advantages such as enhancement of the force of adhesion, correction of the deviated columella and acquirement of the esthetic upper lip continuity. These results suggest that the lip adhesion followed by cheiloplasty for wide unilateral complete cleft lip patients provide more favorable final result by molding the maxillary alveolar segments into better relationship.

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Bilateral cleft lip (양측성 구순열)

  • Kim, Jong-Ryoul
    • Korean Journal of Cleft Lip And Palate
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    • v.10 no.1
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    • pp.39-56
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    • 2007
  • The bilateral cleft lip, a more severe form of clefting than unilateral cleft lip, involves separation of the lip along philtral lines, isolating the central segment (prolabium). Bilateral cleft lip may be either symmetrical or asymmetrical, in which case the cleft lip is split more on one side than on the other. The cleft affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe. Although there would seem to be quite a variance in reported figures, ratios of cleft lip with or without cleft palate have gone as high as 1:500 and as low as 1:1000. It is known that less than 10% of cleft lips are bilateral. Although bilateral cleft lip is less common than unilateral cleft lip, the deformity is more severe, and the reconstructive technique is more complex. Surgery is the only treatment necessary for patients with bilateral cleft lip. Accompanying the evolution of surgical repair is the increasingly important role of orthodontic support with early presurgical alveolar and nasal molding. Repositioning the maxillary and alveolar segments into a more anatomic position allows the surgeon to repair the lip and associated nasal deformity under more optimal conditions. The purpose of this article is to review the related anatomy, presurgical management, and surgical management of bilateral cleft lip.

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Correction of Upper Lip Depression Using Conchal Cartilage Graft in Unilateral Cleft Lip Deformity (일측구순열변형에서 이갑개연골이식술을 이용한 상구순 함몰의 교정)

  • Han, Ki-Hwan;Yun, Sang-Ho;Yeo, Hyun-Jung;Kim, Jun-Hyung;Son, Dae-Gu
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.383-390
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    • 2011
  • Purpose: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. Methods: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectively. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch ${\times}$ 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch ${\times}$ 100 / (ch-ch).h) Results: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. Conclusion: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.

Formation of Cupid's Bow and Vermilion Tubercle using Inferior-Based Lip Skin Flap in a Secondary Bilateral Cleft Lip Deformity

  • Cho, Byung Chae
    • Archives of Craniofacial Surgery
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    • v.11 no.1
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    • pp.19-22
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    • 2010
  • The author presents a new method for the formation of Cupid's bow and the vermilion tubercle by using the inferior-based lip skin flap in a secondary bilateral cleft lip deformity. The length of the flap includes the entire length of the previous upper lip scar. Both skin flaps are elevated and turned down toward the central part of the vermilion. The distant portion of the turned-down skin flaps are deepithelialized and trimmed according to the new shape of Cupid's bow. The deepithelialized portions of both flaps are buried under the central vermilion mucosa in order to create the vermilion tubercle. The advantages of the proposed procedure are; provision of a more natural shape of Cupid's bow, the lip length is increased, and the vermilion tubercle can be reconstructed at the same time. Therefore, this technique is best suited for a case of a bilateral absence of Cupid's bow combined with a short lip in a sufficient upper lip of a bilateral cleft lip deformity. The proposed procedure, however, should be avoided in the tight upper lip because of a great deal of tension on the donor.

Expression and Purification of Three Lipases (LipAD1, LipAD2, and LipAD3) and a Lipase Chaperone (LipBD) from Acinetobacter schindleri DYL129 (Acinetobacter schindleri DYL129 유래의 3개 lipases와 chaperone의 발현과 정제)

  • Kim, Sun-Hee;Lee, Yong-Suk;Jeong, Hae-Rin;Pyeon, Hyo-Min;You, Ju-Soon;Choi, Yong-Lark
    • Journal of Life Science
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    • v.29 no.4
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    • pp.492-498
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    • 2019
  • Previously, three kinds of lipases, lipAD1, lipAD2, and lipAD3, and lipase chaperone, lipBD, of Acinetobacter schindleri DYL129 isolated from soil sample were reported. In this report, three lipase and lipase chaperone were cloned into the pET32a(+) or pGEX-6P-1 vectors for protein expression in Escherichia coli, and named as pETLAD1, pETLAD2, pETLAD3 and pETLBD or pGEXLAD1, pGEXLAD 2, pGEXLAD3 and pGEXLBD, respectively. Protein expression rate was higher in pET system than in pGEX system. Although LipAD1 and LipAD2 were produced as inclusion bodies, their expression levels were high. So LipAD1 and LipAD2 could be solubilized in 8 M urea buffer and purified. LipAD3 and LipBD were overexpressed in soluble form and purified. Those proteins were purified by His-tag affinity chromatography connected in AKTA prime system. The activities of the purified lipases were demonstrated with 1% tributyrin agar plate. After purification, molecular mass was determined with sodium dodecyl sulfate-polyacrylamide gel electrophoresis. LipAD1 showed high activity toward ${\rho}$-nitrophenyl acetate and ${\rho}$-nitrophenyl butyrate, LipAD2 showed high activity toward ${\rho}$-nitrophenyl acetate and ${\rho}$-nitrophenyl myristate, and LipAD3 showed high activity toward ${\rho}$-nitrophenyl acetate, ${\rho}$-nitrophenyl butyrate, and ${\rho}$-nitrophenyl miristate, respectively. Three lipases, LipAD1, LipAD2, and LipAD3, showed optimal reaction at $50^{\circ}C$ using ${\rho}$-nitrophenyl butyrate, as substrate.

Upper lip tie wrapping into the hard palate and anterior premaxilla causing alveolar hypoplasia

  • Heo, Woong;Ahn, Hee Chang
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.48-50
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    • 2018
  • Bony anomaly caused by lip tie is not many reported yet. There was a case of upper lip tie wrapping into the anterior premaxilla. We represent a case of severe upper lip tie of limited lip motion, upper lips curling inside, and alveolar hypoplasia. Male patient was born on June 3, 2016. He had a deep philtral sulcus, low vermilion border and deep cupid's bow of upper lip due to tension of short, stout and very tight frenulum. His upper lip motion was severely restricted in particular lip eversion. There was anterior alveolar hypoplasia with deep sulcus in anterior maxilla. Resection of frenulum cord with Z-plasty was performed at anterior premaxilla and upper lip sulcus. Frenulum was tightly attached to gingiva through gum and into hard palate. Width of frenulum cord was about 1 cm, and length was about 3 cm. He gained upper lip contour including cupid's bow and normal vermilion border after the surgery. This case is severe upper lip tie showing the premaxillary hypoplasia, abnormal lip motion and contour for child. Although there is mild limitation of feeding with upper lip tie child, early detection and treatment are needed to correct bony growth.