• 대한한의학회지
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• 제22권3호
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• pp.42-50
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• 2001

Objectives : Dysphagia is common and severe problems of acute stroke determining the prognosis of stroke only second to mental change, and results in secondary fatal complications such as aspiration pneumonia, malnutrition, dehydration, etc. Therefore, we were to investigate the clinical characteristics of dysphagia accompanied by acute ischemic stroke. Methods : We selected subjects through clinical notes retrospectively, whose main problems included dysphagia resulted from acute stroke within 72 hours from onset who were admitted to the Internal Medicine Department of Wonkwang Oriental Medicine Hospital from Jan. 2000 to Apr. 2001. We assessed the severity of dysphagia from admission to discharge using a staging method : stage 0 is normal without dysphagia, stage 1 is nearly normal except for intermittent dysphagia, stage 2 is compensated abnormal swallowing requiring adjusted diets or delayed feeding time, stage 3 is uncompensated abnormal swallowing resulted in weight loss down to 10% of initial and daily aspiration, coughing, and vomiting, stage 4 is uncompensated abnormal swallowing resulting in weight loss beyond 10% and recommended for non-oral feeding, and stage 5 is 100% non-oral feeding by L-tube, or gastrostomy or NPO state. Results : Dysphagia was improved statistically significantly from the mean stage of $3.6{\pm}0.29$ on admission to $1.88{\pm}0.32$ on discharge (P<0.05). On average $7.1{\pm}1.48$ days were required for improving more than one stage level. As patients were older and the stage of dysphagia was worse on admission, severity of dysphagia was more difficult to improve (correlation coefficiency was 0.55 and 0.77 respectively, P<0.05). Aspiration pneumonia was complicated in 13 patients of the total 25 at mean dysphagia stage of $3.36{\pm}0.37$. However, any specific values such as lesion size, lesion site, sex, age, past history and NIH Stroke Scale on admission did not affect it (P>0.05). Conclusion : Clinical course of dysphagia was determined about I week from the onset. Aspiration pneumonia was mainly complicated during oral feeding periods. If there were no improvement of dysphagia over 2-3 weeks, then non-oral feeding such as Levin tube or gastrostomy must be considered.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권3호
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• pp.195-204
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• 2011

Introduction: This study examined the regulatory mechanism underlying the meal-induced changes in the hypothalamic-pituitary-adrenal gland (HPA) axis activity. Materials and Methods: Male Sprague-Dawley rats (250-300 g) were hired for two different experiments as follows; 1) rats received either 8% sucrose or 0.2% saccharin ad libitum after 48 h of food deprivation with the gastric fistula closed (real feeding) or opened (sham feeding). 2). rats received 5 ml of intra-oral infusion with 0.2% saccharin or distilled water after 48 h of food deprivation. One hour after food access, all rats were sacrificed by a transcardiac perfusion with 4% paraformaldehyde. The brains were processed for c-Fos immunohistochemistry and the cardiac blood was collected for the plasma corticosterone assay. Results: Real feedings with sucrose or saccharin and sham feeding saccharin but not sucrose, following food deprivation decreased the plasma corticosterone level. c-Fos expression in the nucleus tractus of solitarius (NTS) of the fasted rats was increased by the consumption of sucrose but not saccharin, regardless of the feeding method. On the other hand, the consumption of sucrose or saccharin with real feeding but not the sham, induced c-Fos expression in the paraventricular nucleus (PVN) of the fasted rats. The intra-oral infusion with saccharin or water decreased the plasma corticosterone level of the fasted rats. Intra-oral water infusion increased c-Fos expression in both the PVN and NTS, but saccharin only in the NTS in the fasted rats. Conclusion: Neither restoration of the fasting-induced elevation of plasma corticosterone nor the activation of neurons in the PVN and NTS after refeeding requires the palatability of food or the post-ingestive satiety and caloric load. In addition, neuronal activation in the hypothalamic PVN may not be an implication in the restoration of the fasting-induced elevation of the plasma corticosterone by oropharyngeal stimuli of palatable food.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권2호
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• pp.122-131
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• 2019

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

• Molecules and Cells
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• 제40권5호
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• pp.331-338
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• 2017

Regulation of feeding is essential for animal survival. The pharyngeal sense organs can act as a second checkpoint of food quality, due to their position between external taste organs such as the labellum which initially assess food quality, and the digestive tract. Growing evidence provides support that the pharyngeal sensory neurons regulate feeding, but much is still unknown. We found that a pair of gustatory receptor neurons in the LSO, a Drosophila adult pharyngeal organ which expresses four gustatory receptors, is involved in feeding inhibition in response to high concentrations of sodium ions. RNAi experiments and mutant analysis showed that the gustatory receptor Gr2a is necessary for this process. This feeding preference determined by whether a food source is perceived as appetizing or not is influenced by nutritional conditions, such that when the animal is hungry, the need for energy dominates over how appealing the food source is. Our results provide experimental evidence that factors involved in feeding function in a context-dependent manner.

• 융합정보논문지
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• 제11권8호
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• pp.168-175
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• 2021

본 연구는 뇌성마비 아동의 대동작 기능과 먹기, 마시기 기능, 구강 운동 기능과의 상관관계를 확인해보고, 뇌성마비 아동의 대동작 기능의 심한 정도에 따른 연하 재활의 필요성을 확인하기 위해 시행되었다. 뇌성마비 진단을 받은 아동 61명을 대상으로 대동작 기능 분류 체계(GMFCS), 먹기와 마시기 기능분류 체계(EDACS), 구강 운동 기능 검사(OMAS)를 사용하여 대동작 기능, 먹고 마시기 기능, 구강 운동 기능 수준을 평가하고 각 기능 간 상관관계를 확인하였다. 본 연구의 결과는 대동작, 먹고 마시기 기능, 구강 운동 기능 사이에서 유의한 상관관계를 보였다. 즉, 대동작 기능 저하가 심할수록 먹고 마시기 기능과 구강 운동 기능 저하 역시 낮은 기능 수준을 보였다. 본 연구를 통하여 뇌성마비 아동의 섭식활동을 평가하고 치료함에 있어, 아동의 대동작 기능에 따른 먹고 마시기 기능, 구강 운동 기능에 대한 확인이 필요할 것으로 보인다.

• KSBB Journal
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• 제13권4호
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• pp.424-430
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• 1998

Immunositmulation effects of the mice fed with the cell lysate of Lactobacillus plantarum isolated from Kimchi were studied. The mice group fed with cell lysate was different from the control group on the degree of immune responses, e.g. 1) proliferation of splenocytes and Peyer's patch cells, 2) production of nitric oxide (NO) by peritoneal macrophages, 3) production of intestinal secretory lgA (slgA), 4) variation of TNF-${\alpha}$ and IL-2 concentration in blood, 5) production of specific lgG against sheep red blood cells. A general enhancement in enteric and systemic immune responses was observed with a simple oral administration of immunostimulators. With the oral feeding of L. plantarum, not only the total amount of gut secretion antibody, but also the binding capacity of antibodies to the enteric microorganisms including L. plantarum was increased. These experimental results clearly showed that the oral feeding of immunostimulators gave multifunctional effects on the mucosal and systemic immune systems of mice.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권2호
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• pp.143-151
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• 2007

One of the treatment methods for maxillary cancers or infections in maxilla is maxillectomy. Palatal defect can be resulted from this operation and it may cause functional problems with swallowing and speech, and psychological problems of patients. After maxillectomy, as rehabilitation, there can be two options. One is a prosthodontic treatment using obturator and the other is surgical reconstruction of defect with graft. As both methods have advantages and disadvantages, in determining treatment method after maxillectomy, various factors have to be considered. The purpose of this study is to compare the prosthodontic group to surgical group after maxillectomy with elapsed days prior to commencement of postoperative oral feeding, and to analyze the results of prosthodontic treatment and surgical treatment. During the period from March of 2000 to June of 2006, 74 patients were treatment by prosthodontic methods for maxillary defect. Among these patients, patients who had only velopharyngeal deficiency after surgery, whose data were incomplete, whose causes of palatal defect were not the treatment of diseases in maxilla, and who already had palatal defect due to previous surgery were excluded in this study. The patients who underwent maxillectomy for the treatment of diseases in the maxilla and were treated immediately after operation using surgical reconstruction or prosthodontic rehabilitation were included in this study. The records of 43 patients were reviewed to compare and to analyze the prosthodontic treatment and surgical reconstruction after maxillectomy. The median of days elapsed prior to commencement of postoperative oral feeding in the prosthodontic group was compared with data of surgical group. The data was analyzed using the Mann-Whitney test (${\alpha}$=.05). Days elapsed prior to postoperative oral feeding commencement in the prosthodontic group were less than those in the surgical group.

• 한국치위생학회지
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• 제12권1호
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• pp.27-35
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• 2012

Objectives : This study was performed to provide the basic data for oral health of infants, through the comparison of Streptococcus mutans activities(the representative bacteria of initial dental caries), in main nutritional foods for infants: breast milk, milk powder, and soya milk. Methods : The study targeted 30 infants and the saliva was sampled after the oral examination. The pH of sampled saliva was measured; and the sample of 'the saliva', 'the saliva and breast milk', and 'the saliva and formula milk' by researcher were produced; and the measurement was repeated 7 times. Results : As a result of examining the change of colony number of Streptococcus mutans by hour, the bacterial activity took in the source of nutrition took place in the first place; and in the group with dental caries, breast-feeding at night occurreds most frequently. Due to the combined activities, such as the increase in the contact time, the existence rate of dental caries appeared high. However, as the improvement of breast-feeding is closely related to the nutrition supply to babies, rather than the improvement of breast-feeding, the 12 hours after the culture in which Streptococcus mutans activities started was considered. Conclusions : In case of breast-feeding at night, it is necessary to remove the dental plaque in the mouth, before 12 hours has passed. Especially, using toothbrush and toothpaste to decrease the occurrence of dental caries, after the eruption of teeth, is recommended for oral administration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.82-90
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• 2021

Objectives: Cleft lip and palate (CLP) is one of the most common congenital deformities with worldwide prevalence. It causes a range of issues for infants that mainly involve difficulty in feeding due to abnormal oronasal communication. For this purpose, feeding plates are provided to infants to act as an artificial palate to aid in feeding. The most crucial procedure in fabrication of a feeding plate is creation of the impression using the traditional finger technique or impression trays. This preliminary research aims to compare the effectiveness of novel impression trays with that of the traditional finger technique for recording impressions of infants with CLP. Materials and Methods: This randomized controlled trial was conducted among 30 infants who were divided into two groups based on the method of obtaining impressions: Group I, finger technique; Group II, specialized acrylic tray (cleftray). Results: Use of cleftray required less impression time, a reduced amount of material, no incidence of cyanosis/choking in infants, and lower anxiety among doctors compared to the traditional method. Additionally, there was no distortion of cleft impressions, recorded maxillary tuberosity, or other fine details. Therefore, the novel impression tray (cleftray) exhibited superior outcomes in all the parameters compared to the finger technique. Conclusion: Within the limitations of this study, we conclude that impression trays are superior to the traditional finger, spoon, or ice cream stick methods of creating impressions of CLP. However, it is necessary to conduct more clinical trials on a larger population based on other parameters to compare the effectiveness of the two techniques to draw definitive conclusions.

• International Journal of Oral Biology
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• 제34권3호
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• pp.123-129
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• 2009

Taste is associated with hedonic evaluation as well as recognition of quality and intensity. Taste information is sent to the cortical gustatory area in a chemotopical manner to be processed for discrimination of taste quality. It is also conveyed to the reward system and feeding center via the prefrontal cortices. The amygdala, which receives taste inputs, also influences reward and feeding. In terms of neuroactive substances, palatability is closely related to benzodiazepine derivatives and $\beta$-endorphin, both of which facilitate consumption of food and fluid. The reward system contains the ventral tegmental area, nucleus accumbens and ventral pallidum and finally sends information to the lateral hypothalamic area, the feeding center. The dopaminergic system originating from the ventral tegmental area mediates the motivation to consume palatable food. The actual ingestive behavior is promoted by the orexigenic neuropeptides from the hypothalamus. Even palatable food can become aversive and avoided as a consequence of postingestional unpleasant experience such as malaise. The brain mechanism of these aspects of taste is elucidated.