• Title/Summary/Keyword: Vestibular

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Retrospective analysis of keratinized tissue augmentation using a xenogeneic collagen matrix for resolving peri-implant mucositis and peri-implantitis

  • Jung Soo Park;Yeek Herr;Jong-Hyuk Chung;Seung-Il Shin;Hyun-Chang Lim
    • Journal of Periodontal and Implant Science
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    • v.53 no.2
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    • pp.145-156
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    • 2023
  • Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

Clinical Features of Fracture versus Concussion of the Temporal Bone after Head Trauma

  • Kong, Tae Hoon;Lee, Jae Woo;Park, Yoon Ah;Seo, Young Joon
    • Korean Journal of Audiology
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    • v.23 no.2
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    • pp.96-102
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    • 2019
  • Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.

Bacterial cellulose matrix and acellular dermal matrix seeded with fibroblasts grown in platelet-rich plasma supplemented medium, compared to free gingival grafts: a randomized animal study

  • Abraao Moratelli Prado;Cimara Fortes Ferreira;Luismar Marques Porto;Elena Riet Correa Rivero;Ricardo de Souza Magini;Cesar Augusto Magalhaes Benfatti;Jair Rodriguez-Ivich
    • Journal of Periodontal and Implant Science
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    • v.54 no.1
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    • pp.25-36
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    • 2024
  • Purpose: Mucogingival defects (MGDs), such as dental root recessions, decreased vestibular depth, and absence of keratinized tissues, are commonly seen in dental clinics. MGDs may result in functional, aesthetic, and hygienic concerns. In these situations, autogenous soft tissue grafts are considered the gold-standard treatment. This study compares the healing process of free gingival grafts (FGGs) to bacterial cellulose matrix (BCM) and human acellular dermal matrix (ADM) seeded with fibroblasts from culture supplemented with platelet-rich plasma in a rat model. Methods: Surgical defects were made in rats, which received the following treatments in a randomized manner: group I, negative control (defect creation only); group II, positive control (FGG); group III, BCM; group IV, BCM + fibroblasts; group V, ADM; and group VI, ADM + fibroblasts. Clinical, histological, and immunological analyses were performed 15 days after grafting. Clinical examinations recorded epithelium regularity and the presence of ulcers, erythema, and/or edema. Results: The histological analysis revealed the degree of reepithelization, width, regularity, and presence of keratin. The Fisher exact statistical test was applied to the results (P<0.05). No groups showed ulcers except for group I. All groups had regular epithelium without erythema and without edema. Histologically, all groups exhibited regular epithelium with keratinization, and myofibroblasts were present in the connective tissue. The groups that received engineered grafts showed similar clinical and histological results to the FGG group. Conclusions: Within the limitations of this study, it was concluded that BCM and ADM can be used as cell scaffolds, with ADM yielding the best results. This study supports the use of this technical protocol in humans.

The Physiological Responses and Behavior Characteristics of Sensory Stimulation of ADHD Children: A Systematic Review (ADHD아동의 감각자극에 대한 생리학적 반응 특성과 행동학적 특성: 체계적 고찰)

  • Lee, Na-Hael;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.51-60
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    • 2011
  • Objective : The characteristics of physiological responses of ADHD children to sensory stimulation were examined by types of sensory stimulation, measurement tools, and responses. In addition the behavioral characteristics were examined by analyzing items of common problems according to the measuring tool, frequency, and measurement tools. Methods : A systematic review methods were used. Papers published in the Journal between January, 1990 and December 31, 2011 were searched through Riss4U, MEDLINE /PubMed, CINAH. The main terms searched were "ADHD, Children, Sensory processing, Sensory integration, SP, SSP, SOR, TIE, CSP, SEP, EDR", and 15 papers were analyzed. Results : 1. The number of studies on physiological responses of children with ADHD to sensory stimulation was five (33.33 percent), the number of studies on behavioral responses was ten(66.67%), and the number of studies combined the two kinds of study was two (13.33%), where a total of 15 (100%) papers were analyzed. 2. In five studies on the physiological response, there were three studies using tactile and proprioceptive stimulations and two studies using olfactory, auditory, visual, tactile, and vestibular sensories. 3. In ten studies on the behavioral responses, there were five studies using SP, three studies using SSP, two studies using SOR, one study using TIE, and one study using CSP. Conclusion : In the characteristics of physiological responses of children with ADHD children to sensory stimulation, there was in the action potential of the cells in hand region of the primary sensorimotor cortex neurons. It was analyzed that there was an initial state and it appeared show a obvious and fast habituation in the later state; the time of recovery seemed to have many non-specific responses. In the characteristics of behavioral responses, there were inattention / distraction, vestibular processing, sensory processing related to endurance / tone, modulation of sensory input affecting emotional responses, low energy/weak.

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Female External Genitalia and Urethra on MR Imaging: Optimal Pulse Sequence and Comparison of Anatomy in Premenopausal and Postmenopausal Women (여성 외부 생식기와 요도의 자기공명영상 소견: 적합한 영상기법과 폐경 전후의 해부학적 변화 비교)

  • Whang, Shin-Young;Ahn, Kyung-Sik;Sung, Deuk-Jae;Park, Beom-Jin;Kim, Min-Ju;Cho, Sung-Bum;Lee, Nam-Joon
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.2
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    • pp.146-153
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    • 2011
  • Purpose : To describe normal anatomy and compare the differences of external genital organs and urethra on MR imaging in pre- and postmenopausal women. Materials and Methods : A total of 19 pre- and 18 postmenopausal healthy women underwent pelvis MR imaging at 1.5 T. Two radiologists retrospectively scored and compared the image quality of female external genitalia and urethra on axial T2-weighted images (T2WI) and axial fat-suppressed contrast-enhanced T1-weighted images (FSCE-T1WI) by using Wilcoxon signed ranks test. The radiologists compared the wall thickness or size of external genital organs and urethra on FSCE-T1WI between two groups by using Student t test. Results : Image quality was better with FSCE-T1WI than with T2WI in all subjects (p < 0.05). The vestibular bulb, clitoris and labium minor were more clearly visualized on FSCE-T1WI in premenopausal subjects rather than in postmenopausal subjects (p < 0.05). The urethra had a target-like appearance with three layers in premenopausal and postmenopausal subjects. Postmenopausal subjects were observed to have significantly smaller vaginal wall thickness, urethral wall thickness and vestibular bulb width than premenopausal subjects (p < 0.05). Conclusion : The anatomy and morphologic changes of female external genital organs and urethra were well discernible on FSCE-T1WI.

A Study of Postural Control Characteristics in Schoolchild with Intellectual Disability (초등학교 지적장애아동의 자세조절 특성)

  • Lee, Hyoung Soo
    • 재활복지
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    • v.14 no.3
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    • pp.225-256
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    • 2010
  • This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

Diagnostic Value of Susceptibility-Weighted MRI in Differentiating Cerebellopontine Angle Schwannoma from Meningioma

  • Seo, Minkook;Choi, Yangsean;Lee, Song;Kim, Bum-soo;Jang, Jinhee;Shin, Na-Young;Jung, So-Lyung;Ahn, Kook-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.24 no.1
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    • pp.38-45
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    • 2020
  • Background: Differentiation of cerebellopontine angle (CPA) schwannoma from meningioma is often a difficult process to identify. Purpose: To identify imaging features for distinguishing CPA schwannoma from meningioma and to investigate the usefulness of susceptibility-weighted imaging (SWI) in differentiating them. Materials and Methods: Between March 2010 and January 2015, this study pathologically confirmed 11 meningiomas and 20 schwannomas involving CPA with preoperative SWI were retrospectively reviewed. Generally, the following MRI features were evaluated: 1) maximal diameter on axial image, 2) angle between tumor border and adjacent petrous bone, 3) presence of intratumoral dark signal intensity on SWI, 4) tumor consistency, 5) blood-fluid level, 6) involvement of internal auditory canal (IAC), 7) dural tail, and 8) involvement of adjacent intracranial space. On CT, 1) presence of dilatation of IAC, 2) intratumoral calcification, and 3) adjacent hyperostosis were evaluated. All features were compared using Chi-squared tests and Fisher's exact tests. The univariate and multivariate logistic regression analysis were performed to identify imaging features that differentiate both tumors. Results: The results noted that schwannomas more frequently demonstrated dark spots on SWI (P = 0.025), cystic consistency (P = 0.034), and globular angle (P = 0.008); schwannomas showed more dilatation of internal auditory meatus and lack of calcification (P = 0.008 and P = 0.02, respectively). However, it was shown that dural tail was more common in meningiomas (P < 0.007). In general, dark spots on SWI and dural tail remained significant in multivariate analysis (P = 0.037 and P = 0.012, respectively). In this case, the combination of two features showed a sensitivity and specificity of 80% and 100% respectively, with an area under the receiver operating characteristic curve of 0.9. Conclusion: In conclusion, dark spots on SWI were found to be helpful in differentiating CPA schwannoma from meningioma. It is noted that combining dural tail with dark spots on SWI yielded strong diagnostic value in differentiating both tumors.

The Effects of Sensory Integrative Intervention on the Self-regulation Capacities of Children With Cerebral Palsy: Single-Subject Research Design (감각통합치료가 뇌성마비 아동의 자기조절 행동에 미치는 효과)

  • Ju, Jin-Ok;Lee, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.15-28
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    • 2011
  • Objective : The purpose of the study was to investigate effects of sensory integration therapy on self-regulation capacities of children with cerebral palsy. Methods : Subjects of this study were four years old girl and six years old boy, living in P city. Both were diagnosed as diplegia. Research design used in this study is ABA' design for a single-subject research. The experimental period was 12 weeks with 22 sessions of treatment. It was divided into three phase: 6 sessions for baseline phase (A), 14 sessions for treatment phase (B), 2 sessions for baseline phase (A'). There was no treatment on the baseline phases, and sensory integration therapy focused vestibular and proprioceptive stimuli was conducted on the treatment phase. At each session, subjects' behaviors has been recorded with a Digital Camera for 10 minutes and then the occurrence frequency of problematic behavior was identified based on the operational definition of it. Results : In comparison with the baseline phase (A), the occurrence frequency was reduced during the treatment phase for three types of problematic behavior associated with the self-regulatory capacities. The tendency of reducement was maintained during baseline phase (A'). Conclusion : Based on the result, it was implied that sensory integration therapy has a positive effect on the self-regulation capacities in children with cerebral palsy.

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Effect of somatosensory input on the gait ability and equilibrium sensory of elderly women (체성감각계 지원이 여성노인의 보행 및 평형감각 유지에 미치는 효과)

  • Jung, Chul;Park, Woo-Yung
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.1
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    • pp.205-213
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    • 2018
  • The purpose of this study was to investigate the effect of somatosensory input on the gait ability and equilibrium sensory of elderly women. The subjects who participated in this study were 31 elderly women with a mean age of 75 years or older who no using a walking stick and had no abnormality in otolaryngology. The control group consisted of 30 elderly women who did not exercise regularly more than twice a week. Dependent variables consisted of 2.44m timed up and go test, 10m usual gait, 10m fast gait and 6minute gait. The equilibrium sensory test was performed using EquiTest (NeuroCom, USA). The results of the study on gait ability were not statistically significant for 2.44m timed up and go test, and 10m usual gait. However, 10m fast gait (P<.001) and 6min gait (P<.05) showed significant differences. According to the results of the study on equilibrium sensory ability, there was no significant difference between Condition 1 and Condition 5 however Condition 2 (P<.01), Condition 3 (P<.01), Condition 4(P<.01) and Condition 6 (P<.05) showed statistically significant differences. In conclusion, walking stick have beneficial effects on walking and equilibrium sensation, and elderly women need to actively use walking stick when going out and walking.

Intraoperative Neurophysiologic Monitoring and Functional Outcome in Cerebellopontine Angle Tumor Surgery (소뇌-교각종양 수술시 수술 중 전기생리학적 신경감시에 따른 수술 후 기능적 결과)

  • Lee, Sang Koo;Park, Kwan;Park, Ik Seong;Seo, Dae Won;Uhm, Dong Ok;Nam, Do-Hyun;Lee, Jung-Il;Kim, Jong Soo;Hong, Seung Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.778-785
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    • 2000
  • Objectives : Intraoperative neurophysiologic monitoring(INM) is a well known useful method to reduce intraoperative neurological complications during neurosurgical procedures. Furthermore, INM is required in most cerebellopontine angle(CPA) surgery because cranial nerves or brain stem injuries can result in serious complications. Object of this study is to the correlation between the changes of intraoperative monitoring modalities during cerebellopontine angle tumor surgery and post-operative functional outcomes in auditory and facial functions. Material and Methods : Fifty-seven patients who underwent intraoperative neurophysiologic monitoring during CPA tumor surgery were retrospectively reviewed. Their lesions were as follows ; vestibular schwannomas in 42, other cranial nerve schwannomas in seven, meningiomas in five and cysts in three cases. Pre- and postoperative audiologic examinations and facial nerve function tests were performed in all patients. Intraoperative neurophysiologic monitoring modalities includes brainstem auditory evoked potentials(BAEP) and facial electromyographies(EMG). We compared the events of INM during CPA tumor surgeries with the outcomes of auditory and facial nerve functions. Results : The subjects who had abnormal changes during CPA tumor surgery were twenty cases with BAEP changes and facial EMG changes in twenty one cases. The changes of intraoperative neurophysiologic monitoring did not always result in poor functional outcomes. However, most predictable intraoperative monitoring changes were wave III-V complex losses in BAEP and continuous neurotonic activities in facial EMG. Conclusion : These results indicate that intraoperative neurophysiologic monitoring in CPA tumor surgery usually provide predictive value for postoperative functional outcomes.

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