Metopic suture closure can manifest as a benign metopic ridge (BMR), a variant of normal, to “true” metopic craniosynostosis (MCS), which is associated with severe trigonocephaly. Currently, there is no gold standard for how much associated orbitofrontal dysmorphology should trigger surgical intervention. In our study, we used three-dimensional (3D) curvature analysis to separate the phenotypes along the spectrum, and to compare surgeons’ thresholds for operation. Three-dimensional curvature analyses on 43 subject patients revealed that the mean curvature of mid-forehead vertical ridge was higher for patients who underwent operation than those who did not undergo operation by 1.3 m−1 (p < 0.0001). In addition, these patients had more retruded supraorbital areas by −16.1 m−1 (p < 0.0001). K-means clustering classified patients into two different severity groups, and with the exception of 2 patients, the algorithm’s classification of deformity completely agreed with the surgeons’ decisions to offer either conservative or operative therapy (i.e. 96% agreement). The described methods are effective in classifying severity of deformity and in our experience closely approximate surgeon therapeutic decision making. These methods offer the possibility to consistently determine when surgical intervention may be beneficial and to avoid unnecessary surgeries on children with benign metopic ridge and associated minimal orbitofrontal deformity.

Background: Molding helmet therapy is used for the treatment of infants with deformational brachycephaly (DB). There is a lack of rigorous outcome measures of helmet therapy in patients with DB using 3-dimensional (3D) imaging, with most reports rely on either subjective or 2-dimensional analyses. Furthermore, the longitudinal assessment of head shape improvement over the course of helmet therapy has not been documented. Our goal was to assess the outcome of molding helmet therapy using 3D surface imaging, and to document the pace of improvement during treatment. Methods: The head shape of 18 infants with DB who underwent orthotic molding helmet therapy was assessed. The 3D scans were obtained before treatment, during treatment, and at the end of treatment. First, we applied shape analysis techniques based on template deformation to obtain average (composite) heads of the 18 patients at the 3 time points of treatment (pretreatment, during, and posttreatment). In addition, we used 3D curvature analysis to quantify the degree of flatness at the same time points. Results: Molding helmet therapy started at 6.7 ± 0.9 months of age and lasted for 4.3 ± 0.8 months. The overall difference in the occipital contour between pretreatment and end of treatment was 6.3 ± 1.7 mm. Curvature analysis revealed that 15% of the back of the head had prehelmet marked flatness (mean curvature <5/m), which decreased to 9% at 2.5 months into treatment and 7% at the end of treatment. Conclusion: Over 65% of the head shape improvement occurred during the 2.5 months of molding helmet therapy.

ABSTRAKStres oksidatif dan pembentukan radikal bebas pada lensa mata manusia lensa secara kronis dapat menghasilkan malondialdehid. Malondialdehid diketahui dapat menimbulkan degenerasi protein sehingga terbentuk katarak. astaxanthin adalah antioksidan yang dapat menurunkan kadar malondialdehid. Tujuan penelitian ini adalah untuk membuktikan apakah astaxanthin dapat menurunkan kadar malondialdehid lensa penderita katarak senilis. Penelitian ini merupakan penelitian eksperimental sederhana (post test only control group design) terhadap dua kelompok, yaitu astaxanthin dan kontrol, masing-masing terdiri dari 16 sampel, dimana dilakukan penyetaraan terhadap variabel umur, jenis kelamin, dan gradasi katarak. Kelompok astaxanthin mendapatkan suplementasi astaxanthin 4 mg dan kelompok kontrol mendapatkan plasebo selama 14 hari sebelum dilakukan bedah katarak. Nukleus lensa dikumpulkan untuk selanjutnya diukur kadar malondialdehid. Penelitian ini menunjukkan bahwa setelah mengonsumsi selama 14 hari, kelompok astaxanthin menunjukkan kadar malondialdehid yang lebih rendah (rerata=50,315 nmol/mg) daripada kelompok kontrol (rerata=50,808 nmol/mg) dimana perbedaan ini secara statistik bermakna (p=0,001). Suplementasi astaxanthin dapat menurunkan kadar malondialdehid lensa penderita katarak senilis.Kata Kunci: Astaxanthin, katarak senilis, malondialdehid, stres oksidatif ABSTRACT Oxidative stress and free radical formation occur chronically in human crystalline lens induce the production of malondialdehyde. Malondialdehyde is known to cause degeneration of the protein to form cataract. Astaxanthin is an antioxidant that can reduce levels of malondialdehyde. The objective of this study is to prove the effect of astaxanthin supplementation to reduce the levels of malondialdehyde in crystalline lens of senile cataract patients. A posttest only control group design was performed in two groups

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