{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T05:01:38Z","timestamp":1777784498947,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2005,8,1]],"date-time":"2005-08-01T00:00:00Z","timestamp":1122854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Uremic patients on regular dialytic treatment (RDT) are often affected by a complex metabolic syndrome leading to osteodystrophy. Bone changes are primarily due to high bone turn over, often combined with a mineralization defect leading to increased bone fractures and bone deformities. Although rarely considered, the craniofacial skeleton represents one of the peculiar targets of this complex metabolic disease whose more dramatic pattern is a form of leontiasis ossea. This complication, although described, has never been evaluated in depth nor quantitatively assessed. In order to assess facial deformities in uremic conditions and to understand the possible relation with hyperparathyroidism, we undertook a quantitative evaluation of soft facial structures in a cohort of uremic patients undergoing RDT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The three-dimensional coordinates of 50 soft-tissue facial landmarks were obtained by an electromagnetic digitizer in 10 male and 10 female patients with chronic renal insufficiency aged 53\u201381 years, and in 34 healthy individuals of the same age, ethnicity and sex. Uremic patients were enrolled according to hyperparathyroid status (PTH &lt; 300 pg\/mL and PTH &gt; 500 pg\/mL). From the landmarks, facial distances, angles and volumes were calculated according to a geometrical face model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, the uremic patients had significantly larger facial volumes than the reference subjects. The effect was particularly evident in the facial middle third (maxilla), leading to an inversion of the mandibular-maxillary ratio. Facial dimensions were increased in all three spatial directions: width (skull base, mandible, nose), length (nose, mandible), and depth (mid face, mandible). The larger maxilla was accompanied by a tendency to more prominent lips (reduced interlabial angle). Some of the facial modifications (nose, lips, mandible) were significantly related to the clinical characteristics of the patients (age, duration of renal insufficiency and PTH levels).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This report, the first in the literature, shows that facial structures of uremic patients are enlarged in comparison with matched normal subjects and that increased bone turnover could be responsible \u2013 at least in part \u2013 for facial bone changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/039139880502800805","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T01:16:13Z","timestamp":1516324573000},"page":"797-802","source":"Crossref","is-referenced-by-count":11,"title":["Facial Changes in Adult Uremic Patients on Chronic Dialysis: Possible Role of Hyperparathyroidism"],"prefix":"10.1177","volume":"28","author":[{"given":"V.F.","family":"Ferrario","sequence":"first","affiliation":[{"name":"Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Anatomia Umana, Facolt\u00e0 di Medicina e Chirurgia and Facolt\u00e0 di Scienze Motorie, Universit\u00e0 degli Studi di Milano, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Sforza","sequence":"additional","affiliation":[{"name":"Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Anatomia Umana, Facolt\u00e0 di Medicina e Chirurgia and Facolt\u00e0 di Scienze Motorie, Universit\u00e0 degli Studi di Milano, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Dellavia","sequence":"additional","affiliation":[{"name":"Functional Anatomy Research Center (FARC), Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico (LAFAS), Dipartimento di Anatomia Umana, Facolt\u00e0 di Medicina e Chirurgia and Facolt\u00e0 di Scienze Motorie, Universit\u00e0 degli Studi di Milano, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Galassi","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Rocca","family":"Rey","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Chiarelli","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Cozzolino","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Gallieni","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Brancaccio","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, San Paolo Hospital, Milano - Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2005,8,1]]},"reference":[{"key":"bibr1-039139880502800805","first-page":"5","volume":"18","author":"Cozzolino M.","year":"2005","journal-title":"J Nephrol"},{"issue":"6","key":"bibr2-039139880502800805","first-page":"S86","volume":"15","author":"Brancaccio D.","year":"2002","journal-title":"J Nephrol"},{"key":"bibr3-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(77)90159-1"},{"key":"bibr4-039139880502800805","first-page":"21","volume":"54","author":"Spolnik K.J.","year":"1981","journal-title":"Dent Radiogr Photogr"},{"key":"bibr5-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.199.1.8633151"},{"key":"bibr6-039139880502800805","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2001.95.4.0704"},{"key":"bibr7-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(98)70118-4"},{"key":"bibr8-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1997.12.11.1952"},{"key":"bibr9-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1159\/000186483"},{"key":"bibr10-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1107769"},{"key":"bibr11-039139880502800805","first-page":"488","volume":"56","author":"Cohen J.","year":"1953","journal-title":"Arch Pathol"},{"key":"bibr12-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1998_035_0009_peoaet_2.3.co_2"},{"key":"bibr13-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(05)80157-X"},{"key":"bibr14-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1002\/ca.10154"},{"key":"bibr15-039139880502800805","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-139X.2003.16053.x"}],"container-title":["The International Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/039139880502800805","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/039139880502800805","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:40:59Z","timestamp":1777491659000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/039139880502800805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,8]]},"references-count":15,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2005,8]]}},"alternative-id":["10.1177\/039139880502800805"],"URL":"https:\/\/doi.org\/10.1177\/039139880502800805","relation":{},"ISSN":["0391-3988","1724-6040"],"issn-type":[{"value":"0391-3988","type":"print"},{"value":"1724-6040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,8]]}}}