• Korean Journal of Cleft Lip And Palate
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• v.12 no.2
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• pp.73-84
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• 2009

The treatment of cleft lip and palate must be based on a complete knowledge of the anatomy, physiology and growth of the involved deformity, because of not only the appearance but also impaired functions such as phonation, mastication, respiration and lingual posture of the maxillomandibular complex. Delaire has long studied all these aspects, and has published many numbers of articles and constructed a philosophy concerning the significance and interrelationship of the various structures. The results obtained from its application seem to be particularly valid from a clinical point of view, although it has not all been scientifically supported by experimental data. For these reasons, Delaire's primary unilateral and bilateral cheilorhinoplasty procedures are particulary good, as is his secondary gingivoalveoloplsty procedure during the course of the surgical repair of the hard palate. In order to understand Delaire's philosophy, it is necessary to consider the normal and pathologic anatomy of the structures involved in the deformity, the role of some structures, such as nasal septum, musculature, and tongue, and some functions, such as dental occlusion or nasal respiration, which play important roles in maxillary and particularly premaxillary growth. Despite of important concept and meanings, Delaire's philosophy has not been introduced widely to our Korean cleft surgeons yet. So authors will summarize the basic concepts of Delaire's philosophy according to already published literatures and lectures based on our previous treatment outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.434-437
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• 2004

Neural crest cells have embriologically important role for the development and growth in oral and maxillofacial region. If the early hereditary defect occurs or environmental factors affect these cells diminutive mesenchymal cells are disabled to make neural plate and decreased proliferation of mesenchymal cells result in hypoplastic development of neural crest. As a result, this brings about severe facial malformations such as various located facial clefts and/or loss or duplication of facial structure. These are two cases of accessory maxilla and zygomatic deformity with and without facial cleft.

• Korean Journal of Cleft Lip And Palate
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• v.11 no.1
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• pp.37-48
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• 2008

Cleft lip and palate patients often develop maxillary retrusion due to the combined effects of the congenital deformity and the scar tissue after surgical repairs. Maxillary protraction in the cleft patients using orthopedic appliances (i.e. face mask) or distraction osteogenesis during early childhood helps to achieve more balanced skeletal harmony and favorable occlusion for future growth to occur. Kinds, indication, protocol for use of the traditional orthopedic appliances will be discussed. Also the facemask with miniplate system recently developed will be introduced.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.2
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• pp.9-18
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• 2001

Cleft lip and palate is the most frequent congenital facial deformity of the orofacial area. Successful management of patients with cleft lip and palate requires a multidisciplinary approach from birth to adult stage. The early surgical intervention of lip and palate induces a significant incidence of maxillary growth restriction that produces secondary deformities of the jaws, and the severity of the skeletal discrepancies tends to increase with growth. The early growth modification treatment to utilize the patient's growth potential is necessary in the cleft lip and palate patients, and we must consider not only the existing skeletal discrepancies but the residual growth amount and the direction. However, once we have obtained good results with orthopedic treatment in mixed dentition stage, we must pay special attention to maintain the treatment results because of high relapse tendencies and the alterations of jaw relationships due to residual growth.

• Korean Journal of Cleft Lip And Palate
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• v.9 no.2
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• pp.93-100
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• 2006

Although the delayed type of rhinoplasty is currently acceptable in the correction of cleft lip and nasal deformity, Delaire tried to achieve the simultaneous nasolabial reconstruction and muscular rearrangement that affect the subsequent skeletal growth of the face. the anatomic muscular reconstruction can be achieved by making the anchorage of the nasolabial muscles of the cleft side to the nasal septum and muscles on the non-cleft side. Two cleft lip patients of 6 and 7 year-old without any previous operation history were treated with the functional cheilorhinoplasty. One patient with incomplete cleft lip underwent a cheiloplasty along with the rearrangement of orbicularis oris muscle. The other patient had a complete cleft lip and palate with accompanying nasal deformity, who underwent the functional cheilorhinoplasty with the reconstruction of anterior nasal base. All the operation was done under the general anesthesia and patients healed without any significant complications. In the incomplete case, the shapes of Cupid's bow was restored, and the length of columella was regained comparable to the non-affected side. In the complete cleft lip and palate case, the depressed nostril was reconstructed with acceptable symmetry by complete releasing of deformed alar cartilage undermined with a dissecting scissors. In summary, the functional repair of cleft lip and nose could be possible at the same time by using Delaire method. This method is effective to correct the primary nasolabial deformity, which results in the restoring favorable anatomy and its function.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.309-320
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• 1999

Medial patellar luxation in dogs is one of the most common patellar problems presented to the veterinary practitioner. It is observed in toy and miniature breed and the majority of cases is a congenital form. Because of extensor mechanism's instability, it causes deformity and disorder in the growth of the affected limb when the luxation is left without treatment As lameness is not easily detectable in puppies, early diagnosis and correction are essential for therapy. Up to now, there has not been any reports refering to the diagnostic methods and the optimal age for correction in young dogs. Thirteen 45-90 days old puppies, have grade I and/or II medial patellar luxation. Only by palpation, all 13 dogs were diagnosed of patelar luxation. Skyline radiographic view was useful to interpret patellar morphology and depth of trochlear groove only above 60 days old. However, it was difficult to make definite diagnosis patellar luxation. The caudocranial and lateral radiographic view as well as ultrasonographic skyline view were not showed of patellar luxation. 2 puppies had unilateral patellar luxation and 11 puppies had bilateral patellar luxation which more serious on the left than on the right. Only 3 puppies among 11 puppies with bilateral patellar luxation were observed of lameness degree 1. Regardless of grade of patellar luxation and lameness, we performed trochlear chondroplasty using a U-shape sculpture blade to minimize cartilage injury, transposition of tibia tuberosity with No. 1 Supramid to align extensor mechanism and lateral imbrication. After surgery, we examined the operated animal daily for 10 days and on 15, 30 and 60 days after surgery respectively. After operation, pain and fever became normal on 7 days, swelling on 10 days, respectively. On 10 days after surgery, dogs showed normal standing position, and normal walking was observed in 15 days after surgery. In force plate analysis, the operated legs were normal weight bearing at 30 days after operation. After surgery, not only patellar luxation and clinical signs have been gradually reduced but also bone growth have become normal without showing growth physeal plate injury. The survival rate of puppies over 62 days old was 100%, while 42-45 days old 37.5%. The above results suggest that optimal age for surgical correction of congenital medial patellar luxation is recommended over 60 days old. In conclusion, combination of trochlear chondroplasty, transposition of tibia tuberosity, and lateral retinacular imbrication is appropriate for over 60 days old puppies to efficiently correct patellar luxation.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.179-183
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• 2009

The triplane fracture has been described as a fracture of the distal tibial epiphysis occurring across three planes-sagittal, transverse and coronal. The characteristic pattern of fusion of distal tibial epiphysis explains the special configuration of the fragments in the triplane fracture. According to Dias-Tachdjian classification, triplane fracture is classified two part fracture, three part fracture, four part fracture and two part fracture with extension to the medial malleolus. Among four types, two part triplane fracture with extension to the medial malleolus is a relatively rare injury and generally is not treated by closed reduction. Such fractures should have an anatomic reduction and adequate fixation to restore the joint congruity and obtain an anatomic reduction of the growth plate to prevent a future growth deformity. This is usually best accomplished with an open reduction and screw fixation or k-wire fixation. We experienced two part triplane fracture with extension to medial malleolus and check the CT to define the extent of the injury completely. And then we underwent open reduction and screw fixation for the fracture. As a result, we present four cases of two part triplane fracture with extension with review of related literatures.

• Clinical and Experimental Pediatrics
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• v.48 no.6
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• pp.665-668
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• 2005

"Rickets" is the term applied to impaired mineralization at epiphyseal growth plate, resulting in deformity and impaired linear growth of long bones. Rickets may arise as a result of vitamin D deficiency or abnormality in metabolism. Vitamin D-dependent rickets(VDDR) is rare autosomal recessive disorder in which affected individuals have clinical features of vitamin D deficiency. In 1961, Prader first described this disorder including severe clinical features of rickets, such as hypophosphatemia, hypocalcemia, muscle weakness and seizure. Two distinctive hereditary defects, type I VDDR and type II VDDR have been recognized in vitamin D metabolism. Type I VDDR may be due to congenital defects of renal 1 ${\alpha}$-hydroxylase, the enzyme responsible for conversion of $25(OH)D_3$. These patients have low to detectable $1,25(OH)_2D_3$ in presence of normal to raised $25(OH)D_3$. In type II VDDR, renal production of $1,25(OH)_2D_3$ is intact but $1,25(OH)_2D_3$ is not used effectively and target organ resistant to $1,25(OH)_2D_3$ is respectively derived from the abnormality in the vitamin D receptor. We report a case of a 25 month-old girl with typical clinical features of VDDR type I rickets, hypocalcemia, increased alkaline phosphatase and secondary hyperparathyroidism.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.1
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• pp.13-26
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• 2001

Cleft lip and/or palate is the congenital orofacial malformation most commonly occurred in humans, The disease is multifactorial and is probably caused by genetic and/or environmental factors, So, there are many problems in research concerning etiology and in treatment of the disease, Even the most practiced and sophisticated methods of surgical repair are necessarily followed by scar contraction and fibrosis, which result in skeletal defects, dental abnormalities, cosmetic disfigurement, and speech impairment, As a result, Fetal surgery can be considered but practiced rarely when the deformity is not fatal to life, And treatment of cleft palate is performed in the form of medicine projection into uterus in animal experiments, Many studies show that growth factor and its receptor emerge from the developing palate; and the epidermal growth factor receptors have a important role in craniofacial development and in palatal fusion, The palatal morphogenesis of the avine is different from the mammal's; it takes the form of physiologic cleft palate, Recently, cleft palate fusion experiment was performed when the avine were in the period of palate formation through the exogenous TGF-β3 addition, and it showed that the exogenous TGF-β3 makes fusion of divided palate through certain process when cleft palate is occurred in palatal formation, In this study, I had the conformation of the fusion of cleft palate through the addition of TGF-β in case of chicken embryo, and observed the effect of TGF-β in EGF receptor distribution, And the following is the results of this study, 1. In case of the TGF-βl and β3 addition group, there was the decrease of EGFR(Epidermal Growth Factor Receptor) immunoreactivity in mesenchymal cells beneath the medial edge epithelium and also in epithelial mesenchymal interface which is between medial edge epithelium and nasal septum in 72 hours, 2, The immunoreactivity of the control group resembles that of normal chicken embryo palate in development, 3. In the view through fluorescence confocal microscopy, there was confluence in TGF-β3 addition group, This shows that the confluence induced by exogenous TGF-β3 is related to EGFR expression in palate of chicken embryo, which is a physiologic cleft palate model.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.37.1-37.7
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• 2018

Background: Fibrous dysplasia (FD) is characterized by the replacement of normal bone by abnormal fibro-osseous connective tissue and typically treated with surgical contouring of the dysplastic bone. When dysplastic lesions involve occlusion, not only is surgical debulking needed, orthognathic surgery for correction of dentofacial deformity is mandatory. However, the long-term stability of osteotomized, dysplastic bone segments is a major concern because of insufficient screw-to-bone engagement during surgery and the risk of FD lesion re-growth. Case presentation: This case report reviewed two patients with non-syndromic FD that presented with maxillary occlusal canting and facial asymmetry. Le Fort I osteotomy with recontouring of the dysplastic zygomaticomaxillary region had been performed. The stability of osseous segments were favorable. However, dysplastic, newly formed bone covered the previous plate fixation site and mild bony expansion was observed, which did not influence the facial profile. Including the current cases, 15 cases of orthognathic surgery for FD with dentition have been reported in the literature. Conclusion: The results showed that osteotomy did not appear to significantly reduce the long-term stability of the initial fixation insufficiency of the screw to the dysplastic bone. However, based on our results and those of the others, long-term follow-up and monitoring are needed, even in cases where the osteotomized segment shows stable results.