• Title/Summary/Keyword: Oral feeding

검색결과 315건 처리시간 0.028초

피에르 로빈 증후군 환아의 전신마취 하 치아우식 치료 증례 보고 (DENTAL TREATMENT IN A PATIENT WITH PIERRE ROBIN SYNDROME UNDER GENERAL ANESTHESIA : A CASE REPORT)

  • 류지연;신터전;현홍근;김영재;김정욱;장기택;김종철;이상훈
    • 대한장애인치과학회지
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    • 제12권2호
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    • pp.87-91
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    • 2016
  • 저자는 소하악증으로 인해 기도유지가 어려우며 섭식 장애로 인한 다발성 우식을 보이는 피에르 로빈 증후군 환아의 증례를 보고하는 바이다. 환자는 소하악증 및 구개열, 심방중격 결손, 새끼 손가락의 측만지증(clinodactyly), 외사시(exotropia) 등의 증상을 동반하고 있었으며, 신체 발육이 매우 저하된 상태로 섭식 장애로 인한 구강내 침식 및 다발성 우식의 소견을 보이고 있었다. 환아는 가벼운 자폐 증상을 가지고 있으며 어린 나이로 협조를 구하기가 어려웠고 광범위한 치료가 필요한 상황이었으며 의식하 진정법시 하악의 발육 저하로 인한 기도 확보의 어려움이 예상되었기에 전신마취하 치과치료를 시행하였다. 피에르 로빈 증후군은 기도유지의 어려움과 섭식 장애로 구강위생 관리에 불리한 조건을 가지고 있지만 나이가 듦에 따라 점차 정상적인 하악의 성장이 이루어지므로 행동조절에 의한 일상적인 치과 처치도 가능할 것이다.

하인두암에서 후두인두 및 경부 식도 전 적출술 후 유리 공장 이식술의 합병증에 대한 후향적 분석 (Retrograde Analysis of Complications of Jejunal Free Flap after Total Pharyngo-Laryngo-Cervical Esophagectomy in Advanced Hypopharyngeal Cancer Treatment)

  • 민현진;현동우;김영호;최은창;김광문;김세헌
    • 대한두경부종양학회지
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    • 제24권1호
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    • pp.43-46
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    • 2008
  • 진행된 하인두암의 수술 후 시행한 유리 공장 이식술을 시행한 본원의 경험에서 수술 후 누공 형성, 수술 부위 협착 등의 다양한 합병증과 그 치료방법을 경험하였다. 수술 방법에 있어서 한 개의 동맥과 정맥을 연결하였고 이식한 혈관의 혈전에 의한 이식 실패는 없었다. 수술 후 연하 기능에 있어서 영향을 주는 가장 중요한 요인은 이식 부위 협착이 었으며 협착의 치료 결과에 따라 술 후 연하 기능의 회복에 차이가 있음을 확인하였다.

Pierre Robin Sequence 환아의 전신마취 하 치과 치료 증례 보고 (DENTAL TREATMENT OF A PATIENT WITH PIERRE ROBIN SEQUENCE UNDER GENERAL ANESTHESIA: A CASE REPORT)

  • 이소피아;송지수;신터전;김영재;김정욱;장기택;이상훈;현홍근
    • 대한장애인치과학회지
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    • 제15권1호
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    • pp.55-59
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    • 2019
  • PRS는 소하악증, 설하수증, 구개열의 세가지 임상적 특징을 갖는 질환으로 상기도 폐쇄로 인한 호흡곤란, 섭식장애를 나타낸다. PRS 환아는 치과 치료 시 호흡 관리에 대한 고려가 필요하고 또한 다양한 증후군이 동반될 수 있어 치과 치료시 전신적인 상태에 대한 고려가 필요하다. 본 증례에서는 다발성 치아우식증을 주소로 내원한 PRS 환자에 대한 보고로 기도 확보 및 유지의 어려움이 예상되었으나 치과적 치료를 전신마취 하 성공적으로 시행되었다.

간호기기 개발수요 조사연구 (A Study on the Demand for Equipent Development in Nursing)

  • 장순복;김의숙;황애란;강규숙;서미혜
    • 대한간호
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    • 제35권2호
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    • pp.71-91
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    • 1996
  • The objectives of thes study were to identify the need for equipment development in nursing, and to determine the priorities for that development. The study was descriptive study done between March 2 and May 30, 1995, in which the subjects, including 421 patients, 223 family members, and 198 nurses from neurosurgery, orthopedic, rehabilitation medicine, internal medicine and intensive care units of nine general hospitals in Seoul, completed a questionnarie developed by the research team. The questionnaire consisted of 35 open and closed questions. Data was analyzed using frequencies and percentages. The results ware summarized as follows: 1) The average age of the nurses was 27.9 years, 48% of the patients were between 20 and 40 years of age, and 17% were over 60. The average lingth of experience for the nurse subjects was four years five months with 36.9%. having over five years experience. The most frequent diagnoses of patients were spinal disc(35.9%), internal medicine disease(26.0%), cerebral vascular accident(16.6%) and spinal cord injury(10%) 2) Many of the nurses(96.4%) reported deficiencies with existing equipment and 96.5% of the nurses, but only 79.8% of the patients, nurses' time. Further, 82.3% of the nurses and 75.8% of the patients felt that the development of new equipment would lead to a decrease in the cost of nursing care. 3) Nurses felt that the greatest areas of inconvenience were patient feeding(71.7%), hygiene(71.2%), caring for a patient confined to bed(70.7%), patient clothing(67.2%), mobility transfers(63.5%) and urinary elimination(52.0%). However, patients and family members listed the following as being the most inconvenient: urinary elimination(58.7%), Hygiene(50.5), feeding(48.4%), mobility transfers(47.1%) and bed care(45.2%). 4) Generally the nurses listed more inconveniences and patients and family members listed more demands for the development of equipment. These included utensils with large handles, and regulators for tube feedings; mattresses that provide for automatic position change and massage, which have patient controlled levers and a place for bed pan insertion; automatic lifts or transfer from bed to wheelchair; equipment to facilitate washing and oral hygiene as well as equipment that will allow patients with spinal cord injuries easy access to showers; a bed pan/urinal for women that is comfortable and effective from which urine can be measured and disposed of easily; disposable dressing sets and tracheostomy care sets and a convenient way of measuring changes in wound size; a safe delivery system for oxygen, a variety of mask sizes and better control of humidity, tracheal material than at present, as well as a communication system for patients with tracheostomies; clothing that will allow access to various parts of the body for treament or assessment without patients having to remove all of their clothing; and finally a system that will allow the patient to control lighting, telephones and pagers. Priority areas for equipment development reported by the nurses were, urinary elimination(58. 7%), hygiene(50.5%), feeding(48.4%), mobility transfers(47..1%), bowel elimination(40.8%). Those reported by the patients family members were feeding(71.7%), hygiene(70.0%), bedcare(70.7%), clothing(67.2%), mobility transfers(63.6%), urinary elimination(52.9%) and bowel elimination(50.5%) Altogether, nurses, patients and family members listed the following as priorities; clothing (178), bed care(144), urinary elimination(92), environment(81), hygiene(70). Further, a health professional forum listed urinary elimination, oxygen delivery, medication delivery, mobility transfers, bed care and hygiene in that order as priority areas. From this study it can be concluded that the first need is to develop equipment that will address the problems of urinary elimination. To do (l)This nurses who are interested in equipment development should organize an equipment development team to provide a forum for discussion and production of equipment for nursing.

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편측성 완전 구순구개열 환자의 포괄적 치료 (COMPREHENSIVE TREATMENT OF UNILATERAL COMPLETE CLEFT LIP AND PALATE)

  • 이정근;황병남;최은주;김용빈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권4호
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    • pp.430-435
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    • 2000
  • Cleft lip and palate is one of the congenital anomalies which need comprehensive and multidisciplinary treatment plan because 1) oral cavity is an important organ with masticatory function as a start of digestive tract, 2) anatomic symmetry and balance is esthetically important in midfacial area, and 3) it is also important to prevent psycho-social problems by adequate restoration of normal facial appearance. There are many different protocols in the treatment of cleft lip and palate, but our department has adopted and modified the $Z{\"{u}}rich$ protocol, as published in the Journal of Korean Cleft Lip and Palate Association in 1998. The first challenge is feeding. Type of feeding aid ranges from simple obturators to active orthopedic appliances. In our department we use passive-type plate made up of soft and hard acrylic resin which permits normal maxillary growth. We use Millard's method to restore normal appearance and function of unilateral complete cleft lip. In consideration of both maxillary growth and phonetic problems, we first close soft palate at 18 months of age and delay the hard palate palatoplasty until 4 to 5 years of age. When soft palate is closed, posterior third of the hard palate is intentionally not denuded to allow normal maxillary growth. In hard palate palatoplasty the mucoperiosteum of affected site is not mobilized to permit residual growth of the maxilla. We have treated a patient with unilateral complete cleft lip and palate by Ajou protocol, which is a kind of modified $Z{\"{u}}rich$ protocol. It is as follows: Infantile orthopedics with passive-type plate such as Hotz plate, cheiloplasty with Millard's rotation-advancement flap, and two stage palatoplasty. It is followed by orthodontic treatment and secondary osteoplasty to augment cleft alveolus, orthognathic surgery, and finally rehabilitation with conventional prosthodontic treatment or implant installation. The result was good up to now, but we are later to investigate the final result with longitudinal follow-up study according to master plan by Ajou protocol.

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쥐에서 허혈-재관류 소장 손상에 대한 담관결찰 및 Insulin-like Growth Factor-I의 영향 (Bile Duct Ligation and Insulin-like Growth Factor-I on the Ischemia-Reperfusion Injury of the Small Bowel)

  • 차제선;이명덕
    • Advances in pediatric surgery
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    • 제3권2호
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    • pp.98-107
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    • 1997
  • To determine whether bile juice exclusion can prevent the mucosal damage, and Insulin-like growth factor-I can promote mucosal regeneration in ischemia-reperfusion injury of the bowel, 39 weanling rats with 10 cm of Thiry-Vella loop were studied. Animal groups were; Control, BL(common bile duct ligation), IGF{insulin-like growth factor-I(IGF-I) infusion} and IGF-BL(combined treatment). IGF-I(1.5 mg/kg/day) was continuously delivered through a subcutaneously implanted miniosmotic pump. After 15 minutes of superior mesenteric artery clamping, a tissue specimen(P) was taken after 30 minutes of reperfusion. Intestinal continuity was restored to allow oral feeding. A specimen of main tract(M) and another of the Thiry-Vella loop(T) were collected for histomorphometry after 48 hours of reperfusion and free feeding. Villus size ratio(VSR), crypt depth(CD), crypt-depth/villus-height ratio(CVR) and injury score(IS) were measured in 15 consecutive villi. The postoperative mortalities of bile duct ligation groups(BL and IGF-BL) were higher than those of other groups. In control group, VSR of M was lower(P<0.05) than P or T, but not in the other groups. VSR of M in control was lower than those in other groups. CD of T in control, IGF and IGF-BL group were higher than those of M. CD of M and T showed gradual increments from control, IGF and IGF-BL group, respectively. CVR of M and T in IGF group were higher than those in control. CVR in IGF-BL group, T was higher than M, and M was higher than P. About IS, M of BL($20.1{\pm}2.5$) and IGF-BL($20.9{\pm}3.3$) groups were significantly lower than that of control($32.4{\pm}2.5$). These results suggest that the exclusion of bile juice reduces the severity of the reperfusion injury of the mucosa, by inability to activate pancreatic enzymes and IGF-I stimulates mucosal regeneration in injured bowel, and the effect is potentiated by bile juice exclusion.

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비투과 표지자 KOLOMARK를 이용한 개의 위배출시간검사에 대한 유용성 (Usefulness of Gastric Emptying Time Test for Dog byUsing Radiopaque Marker KOLOMARK)

  • 조영권;김선칠
    • 한국방사선학회논문지
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    • 제6권4호
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    • pp.267-273
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    • 2012
  • 개에서 이물, 신생물, 유문동비후, 위수술, 전해질불균형, 위확장성 염전 등에 의한 비정상적인 위 배출시간은 임상에서 소화기 질환으로 중요하다. 그러므로 위장관 운동이상에 대한 정확한 진단을 위하여 정상적인 위장관 운동시간에 대한 자료가 필요하다. 이 연구의 목적은 개에서 기존의 BIPS를 이용하는 검사 방식이 아닌 국내에서 개발한 방사선 비투과성 Kolomark를 이용한 위배출시간 검사에 대한 임상적 유용성에 대한 기초자료를 제공하기 위한 것이다. Beagle 9마리가 이번 실험에 사용되었으며 평균 체중 평균 10.3kg이며 평균 2.5살이었다. 검사를 위해 12시간 금식을 시행하였으며 화학적 보정은 하지 않은 채 검사 직전 하루 사료급여량의 25%용량에 Kolomark 1개의 capsule과 함께 급여하였고 2, 4, 8, 12시간 때 Ventrodorsal, Right lateral자세로 촬영하였다. 관심판독부분은 분문에서 위유문부까지의 위장 전체를 관찰하였으며 분석방법으로는 각 시간대별로 위장 내에 남아있는 Kolomark를 카운트하여 비모수검정인 Friedman 검정방법을 이용하여 P값이 0.05 미만인 경우를 유의한 것으로 판정하였다. 구강으로 Kolomark를 섭식 후 위에서 소장으로 완전히 Kolomark가 빠져나가는데 걸리는 평균시간은 7.55시간이었다. 이번 연구에서 성숙한 개에서 음식물 투여 후에 나타나는 위장관 통과시간을 Kolomark를 이용하여 정상적인 위장관 운동시간에 대한 기초자료가 되리라 판단된다.

산후조리원의 표준화 관리 지침을 위한 연구 - 산모와 신생아 관리현황을 중심으로 - (A Study for the Development of Standardized Management Manuel in Sanhujoriwon - Centered on the Management of Women & Newborn -)

  • 정은실;유은광
    • 여성건강간호학회지
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    • 제8권2호
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    • pp.301-313
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    • 2002
  • The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

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상황버섯이 사염화탄소와 고지방을 투여한 흰쥐의 간지질 대사에 미치는 생화학적, 형태학적 연구 (Biochemical and Histological Effects of Phellinus linteus Methanol Extract on Liver Lipid Metabolism of Rats Fed $CCl_4$ and High Fat)

  • 정차권;정명은;함승시;남상명;강일준;김수진
    • 한국식품영양과학회지
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    • 제30권2호
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    • pp.331-337
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    • 2001
  • 본 연구는 상황버섯이 간 손상 물질을 투여한 흰주의 지질 대사에 미치는 영향을 조사하기 위해 수행되었다. 실험군은 $CCl_4$ 투여군, $CCl_4$와 고지방 식이군으로 분류하였고, 상황메탄올 추출물을 병용투여 함으로써 다음과 같은 결론을 얻었다. 실험동물의 체중 증가량, 사료 섭취량, 식이효율은 $CCl_4$투여로 감소되었으나, 추출물 병용투여로 증가되었다. 실험동물의 간의 무게는 $CCl_4$ 투여로 증가되었다. 이런 경향은 특히 $CCl_4$와 고지방 식이시 대조군에 비해 32% 증가하였으나 추출물 투여로 유의적인 감소를 보였다. 콜레스테롤, 중성지질, LDL 및 LDL-인지질은 $CCl_4$ 투여로 증가되었으나 상황추출물 투여로 인하여 감소를 보였다. 한편, 추출물의 투여는 간조직중 HDL-콜레스테롤의 함량을 증가시켰다. 추출물의 투여에 의한 간기능 지표효소인 GOT, GPT, AP 및 LDH의 활성이 감소되었다. 간의 전자현미경적 관찰에서 대조군은 ER이 골고루 분포하고 있으며 정상적인 cytosol의 구조를 하고 있으나, $CCl_4$ 투여군에서는 mitochondria와 ER의 분포가 국부적이고 균일하게 분포하지 않았으며, cytoplasmic matrix의 구조가 퇴화되는 양상을 나타내었다. 일부 조직에서는 fibrous filaments의 출현이 관찰되었다. 그러나, 추출물 투여군은 손상된 세포질의 회복현상이 나타났으며 mitochondria의 증가가 관찰되었다. 이상의 결과에서 상황 추출물이 흰쥐의 지질대사에 생리적인 활성효과를 가지고 있는 것으로 사료되며 간지질 대사의 개선 효과가 있어 고지혈증, 동맥경화, 고혈압 등 순환기계 및 심혈관계 질환의 예방과 치료에 효과가 있을 것으로 생각된다. 또한 건강기능성 식품으로서의 가치가 기대되며 추후 상품으로서의 개발 가치가 충분한 것으로 보인다.

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Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas

  • Dong-Yeon Kim;Hee-Jae Suh
    • 대한지역사회영양학회지
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    • 제3권5호
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    • pp.729-738
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    • 1998
  • In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritionally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group of heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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