To evaluate the current practices of the tube feeding and the status of tube feeding patient 76 adult in-patients at 6 hospitals located in Seoul and Chung-buk province were examined through reviewing patient charts observing patients and interviewing patients nurses dietitians patients' family or care-givers. The results were as follows : 1) An average age of the patients was 54.5 years with 41% over 60 years old. Patients with decreased mental status dysphagia esophageal obstruction and respiratory problem were fed by tubes. 2) The range of duration of tube feeding is between 4 days and 6 years. Most patients were received formula through nasogastric tube(89.5%) while 7.9% of gastrostomy and 2.6% of jejunostomy. Administration method for formula were bolus feeding regardless of the route of formula delivery. 3) Mean total calories received for men were 1590 kcal and 1450 kcal for female. Mean volume per meal was 282m, l and mean frequency of feeding was 5.68 while mean feeding interval 3$\frac{1}{4}$ hours and mean rate of infusion 68.4ml/min. All patients received hospital-blenderi-zed formula as the major source of nutrition. Home-blenderized formula and commercial formula as a supplement were used 35%, 13.2% respectively. 4) Thirty-eight percent of patients was hypoalbuminemia and 61% was at the moderate level of deficiency in hemoglobin. 5) Complications associated with tube feeding were diarrhea (22.4%) constipation(21.1%) vomiting(11.8%) and so on. 6) Serum albumin levels of patients who have complications associated with tube feeding were significantly lower than those of patients without complications In planning a tube feeding regimen the type of a formula must be integrated with both a delivery system and a protocol for administering the tube feeding. the multidisciplinary effort required to deliver enteral therapy is essential to improve current practices used at hospitals.
The leiomyosarcoma is uncommon tumor that consists of 10% of all sarcoma incidence and commonly arise from retroperitoneum or mesentery. But leiomyosarcoma arose from mediastinum is very rare and only incidental case report is present. Mediastinal leiomyosarcoma may originate from superior vena cava, pulmonary artery, small vessels of alveoli, esophagus and cardiac muscle. Common symptoms that are related with leiomyosarcoma of mediastinum are cough and dyspnea but dysphagia, chest pain and hemoptysis can be produced. Although long term survival after complete resection of tumor was reported in localized disease, there was no effective therapy that prolong the survival in patients who had disseminated disease or huge tumor mass. We report the case of posterior mediastinal leiomyosarcoma confirmed by aspiration cytology and immunohistochemical staining, along with a review of literature.
Goal of this study is to perform the correlation about Gross motor function, eating-drinking function, and oral motor function, to identify necessity for invervention of feeding disorders on severity of the function of children with cerebral palsy. Subjects were 61 children diagnosed with cerebral palsy. The subject were evaluated for oral motor function, feeding function by GMFCS, EDACS, OMAS. The results of this study showed a significant correlation between gross motor function, eating and drinking functions, and oral motor functions. That is, the more severe the deterioration of the motor function, the lower the functional level of eating and drinking and oral motor function deterioration. In evaluating and treating the eating activity of children with cerebral palsy through this study, it seems necessary to check the eating and drinking function and oral motor function according to the gross motor function.
Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.
Gil Hack Joon;Kay Chul Seung;Jang Jee Young;Yoon Sei Chul;Shinn Kyung Sub;Bahk Yong Whee
Radiation Oncology Journal
/
v.10
no.2
/
pp.193-204
/
1992
During the period between March 1983 and December 1990, 74 patients with esophageal carcinoma (EG) were treated with radiation therapy (RT) at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Of these, 6 patients were lost to follow-up, and 13 patients were interrupted. So the remaining 55 patients were analyzed, retrospectively. 32 patients were irradiated with curative aim, 12 patients with palliative intent, 10 patients postoperatively, and 1 patient pre- and post-operatively. Among these 55 patients, 28 patients were treated with chemoradiation modality, and 27 patients with RT alone. All patients were followed for a minimum of 20 months or until death. Of 32 patients irradiated by curative aim, 22 patients (69%) showed partial remission (PR), 6 patients (19%) complete remission (CR). Overall mean survival and two-year survival rate were 15.6 months and 22%. With respect to sex, age, pathologic differentiation, tumor location, tumor size, stage, RT aim, RT response, RT dose, use of chemotherapy and functional categories (FC) of dysphagia at initiation of RT and at finishing RT: Tumor size, stage, RT response had great influences on prognosis and FC at finishing RT had a slight influence on prognosis. Especially, the mean survival and 2-year survival rate in patients with postoperative RT were 24.7 months and 63%, which could be compared with 29.1 months and 43% in radically treated patients with CR. And the mean survival duration and 2-year survival rate in patients irradiated with doses more than 60 Gy were 22.4 months and 29%, and 50~60 Gy were 12.2 months and 12%, respectively. However, no significant difference was shown statistically. Among 12 patients treated with palliative intent, 9 patients (75%) had good improvement in dysphagia and the mean duration of palliative response was 10.6 months.
Purpose :We peformed the retrospective analysis to find the outcome of external beam radiotherapy alone in advanced esophageal cancer patients. Methods and Materials : One hundred and six Patients treated with external beam radiotherapy alone between July 1990 and December 1996 were analyzed retrospectively. We limited the site of the lesions to the thoracic esophagus and cell type to the squamous cell carcinoma. Follow-up was completed in 100 patients (94$\%$) and ranged from 1 month to 92 months (median; 6 months). Results :The median age was 62 years old and male to female ratio was 104 2. Fifty-three percent was the middle thorax lesion and curative radiotherapy was peformed in 83$\%$. Mean tumor dose delivered with curative aim was 58.6 Gy (55$\~$70.8 Gy) and median duration of the radiation therapy was 53 days. The median survival of all patients was 6 months and )-year and 2-year overall survival rate was 27$\%$ and 12$\%$, respectively, Improvement of dysphagia was obtained in most patients except for 7 patients who underwent feeding gastrostomy. The complete response rate immediately after radiation therapy was 32$\%$ (34/106). The median survival and 2-year survival rate of the complete responder was 14 months and 30$\%$ respectively, while those of the nonresponder was 4 months and 0$\%$ respectively (p=0.000). The median survival and 2-year survival rate of the patients who could tolerate regular diet was 9 months and 16$\%$ while those of the patients who could not tolerate regular diet was 3 months and 0$\%$, respectively (p=0.004). The survival difference between the patients with S cm or less tumor length and those with more than 5 cm tumor length was marginally statistically significant (u=0,06). However, the survival difference according to the periesophageal invasion or mediastinal tyrnphadenopathy in the chest CT imaging study was not statistically significant in this study. In a multivariate analysis, the statistically significant covariates to the survival were complete response to radiotherapy, tumor length, and initial degree of dysphagia in a decreasing order. The complication was observed in 10 patients (9$\%$). Conclusion :The survival outcome for advanced esophageal cancer patients treated by external beam radiotherapy alone was very poor. In the treatment of these patients, the brachytherapy and chemotherapy should be added to improve the treatment outcome.
Objective: This study aims to discover how tongue self-resistance exercise affects the swallowing function of patients with stroke. Method: The subjects of this study were two patients who were treated at the Y hospital in Gyeonggido. Data were gathered by VFSS regarding the degree of swallowing disability and oral intake before and after intervention. This study analyzed case studies of two patients. One patient's intervention was applied in September 2012 for three weeks. The other's intervention was applied in February 2014 for three weeks. At the first session, the VFSS examination was administered. Then, intervention began after the patients gave their consent for participation. Each session was practiced 10 times per set, but one session had 3 sets. Intervention frequency consisted of five sessions per week, and it was conducted for three weeks. Tongue self-resistance exercise included tongue protrusion, tongue lateralization, and tongue elevation on the hard palate. Results: The first tongue self-resistance exercise had a positive effect on swallowing function because of the decrease in VFS score. The second tongue self-resistance exercise showed improved oral intake based on FOIS scores. Conclusion: This study's results suggest that there are many benefits of tongue self-resistance exercise on the swallowing function when it is applied to patients with stroke.
The Journal of Korean Academy of Sensory Integration
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v.21
no.1
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pp.11-22
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2023
Objective : The purpose of this study was to examine the effects of using Kinesiology Tape (KT) for drooling in children with cerebral palsy. Methods : A single-case experimental design with an ABA design was conducted. A total of 46 sessions were conducted, consisting of three baseline sessions (A), 40 intervention sessions (B), and three baseline sessions (A'). The Drooling Impact Scale (DIS) and the Interlabial Gap (IG) were measured before and after the KT intervention, and a Goal Attainment Scale (GAS) was assessed to determine whether there was any change in the target activity for each session. The KT intervention was attached to the orbicularis oris muscle. The KT intervention time was set as the time taken for dysphagia intervention and the actual meal time, for up to one hour a day, for a total of eight weeks. Results : The results of the study showed that the KT intervention had an effect on both the DIS and the IG, and that the GAS scale indicated that target activity increased with each session. Conclusion : These results indicate that the KT intervention can easily be applied to children with cerebral palsy who suffer from drooling, whether in clinical practice, by therapists, or caregivers, and that it can be used for various purposes.
Journal of Korea Entertainment Industry Association
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v.13
no.7
/
pp.449-459
/
2019
The purpose of this study was to evaluate the status of oral health care in dementia patients living in long-term care facilities and to investigate the effects of this on swallowing function and swallowing-quality of life. The subjects were 60 demented patients who were admitted to long-term care facilities in Gwangju and Jeonnam provinces. Their Oral Health Assessment Tool(OHAT), Clinical Dysphagia Scale(CDS), and Oral Health Impact Profile 14(OHIP-14) were measured. The results of this study were as follows: First, the effect of oral health care on dentition patients using long-term care facilities on swallowing function and swallowing-quality of life was significantly different according to oral care score (p<.05)(p<.01). Second, the relationship between oral health care and swallowing function of dementia patients and swallowing-quality of life. was examined. As a result, oral health care of dementia patients was affected by swallowing function (r=.405, p<.01) the swallowing-quality of life (r=.462, p<.01) and swallowing function were significantly correlated with swallowing-quality of life (r=.351, p<.01). Therefore, the oral health care of users of long-term care facilities was closely related to swallowing function and swallowing-quality of life.
Objective : Children with autism spectrum disorder (ASD) commonly suffer from feeding disorders. Major feeding problems include mealtime behavior problems, picky eating, and a lack of food variety can lead to nutritional problems, developmental and social limitations, and stress for the caregivers. A review of the latest literature was conducted to gain an in-depth understanding of assessment tools for feeding disorders in children with ASD. Method : This study analyzed assessments to identify feeding problems in ASD based on previous studies searched through keywords such as ASD, ASD feeding problem, and ASD feeding evaluation. Results : The ASD feeding disorder assessment was divided into direct and indirect assessments. Indirect assessment, in which caregivers measure a child's situation using questionnaires, is mainly used. The assessment of feeding disorders in children with ASD was divided into 1) mealtime behavior, 2) sensory processing, 3) food consumption, and 4) others. Conclusion : As the main feeding disorder characteristics of children with ASD are very diverse, a comprehensive evaluation is necessary but is still limited. Swallowing rehabilitation experts, such as occupational therapists, should apply comprehensive assessment tools based on a basic understanding of the feeding problems, behaviors, and sensations in ASD.
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