• Title/Summary/Keyword: Oral feeding

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The Abdominal Approach for Epiphrenic Esophageal Diverticulum as an Alternative to the Thoracic Approach

  • Kim, Shin;Cho, Jong Ho
    • Journal of Chest Surgery
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    • v.52 no.4
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    • pp.227-231
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    • 2019
  • Background: There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches. Methods: We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups. Results: The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5-211 days) in the thoracic approach group and 9.5 days (range, 5-18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3-299 days) when the thoracic approach was used and 5 days (range, 1-11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group. Conclusion: The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

A Case Report of the Korean Medical Treatment of Dysphagia and Anorexia after Lumbar Compression Fracture (급성 요추 압박골절 후 발생한 폐렴과 동반된 연하곤란 및 식욕부진에 대한 치험 1례)

  • Jo, Hye-mi;Lee, Eun-chang;Youn, Hye-soo;Park, Choong-hyun;Han, Da-young;Jung, Da-hae;Lee, Jung-eun
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.219-228
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    • 2022
  • Objective: The aim of this study is to describe the effects of traditional Korean medicine on a patient with dysphagia and anorexia following an acute lumbar compression fracture. Methods: The patient was treated with acupuncture and herbal medicine (Bojungikgi-tang and Insamyangyoung-tang), and the effects of the treatment were evaluated by monitoring oral feeding and using the Modified Barium Swallow (MBS) test. Results: After treatment, the amount of oral feeding more than doubled and the MBS was also improved. Conclusion: The results suggest that traditional Korean medicine may be effective for treating dysphagia and anorexia after an acute lumbar compression fracture.

Degree of Enteral Tube Feeding in the Intensive Care Unit and Change in Nutritional Status (병원 중환자의 경관유동식 공급 현황 및 영양상태 변화)

  • Im, Hyeon-Suk;Park, Eun-Gyeong;Lee, Jong-Ho
    • Journal of the Korean Dietetic Association
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    • v.7 no.3
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    • pp.217-226
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    • 2001
  • It is important to supply adequate nutrition to critically ill patients, whose gastrointestinal system is properly functioning, through the enteral tube feeding if oral intake is impossible. In this study we investigated the changes in nutritional status with enteral tube feeding according to the volume required. We investigated the volume ordered according to the patient's requirements, volume infused according to the volume ordered in 41 enteral tube feeding patients in intensive care unit from Jannuary to July, 2000. Body weight, serum albumin level, and total lymphocyte count were evaluated to assess nutritional status. The mean fasting period was 5 days before the enteral feeding and patients whose fasting period over 3 days were 51%. The mean enteral tube feeding period was 29 days and method of feeding was nasogastric, bolus feeding 6 times per day. The volume ordered was 69.7% of the patients' recommended calorie and volume infused was 86.6% of their volume prescribed. Accordingly, the volume infused was estimated 61.7% of their volume required. Only 44.6% of their reqiured volume was infused within 3 days after enteral tube feeding was started. It took 16 days in average to meet the patients' recommended calorie; 56% of subjects still did not fully met their requirements by the end point. Among the impeding factors in supplying enteral tube feeding, factors related to the number of feeding were high residual volume in stomach, vomiting, gastrointestinal bleeding, abdominal distension and surgery. Factors related to the acctual infused volume were diarrhea, gastrointestinal bleeding, abdominal distension, airway management and tube reinsertion. Significant correlations were shown between the volume infused and changes in both the patients' weight and serum albumin level. Deviding the subjects into two groups by their infused volume, less than 70% and more than that, we compared the two to come up with a significant difference in their serum albumin level, -0.23 vs 0.21, and their body weight, -4.52 vs 0.12. In enteral tube feeding, the volume delivered in sufficient to the pateints' energy requirement can affect their nutriitional status in critically ill patient; adequate nutritional management plan is essential. It is necessary to make every effort to educate clinical staff and to set up a unified management program to prescribe adequate ammount of energy for the patient's nutritional requirement.

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In vivo Biological Function of a Fibrinolytic Enzyme after Oral Adminstration (혈전용해효소의 경구투여에 의한 생체 내 작용)

  • Lee, Young-Hoon;Lee, Sung-Ho;Park, Ki-Hoon;Choi, Young-Ju;Lee, Sang-Won;Kim, Cheol-Ho;Cho, Soo-Jeong;Gal, Sang-Wan
    • KSBB Journal
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    • v.21 no.6 s.101
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    • pp.433-438
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    • 2006
  • A fibrinolytic enzyme gene (BCF-1) was subcloned to the pEB vector which is high expression vector in the Bacillus host. The enzyme was purified by using FPLC after ammonium sulfate precipitation. The enzyme was oral-administrated to the rat and checked the bleeding time, blood clotting time and fibrinolytic effect of the serum. In the bleeding time retardation test, it was longer about 1.7 fold in the feeding rat than without feeding. The serum of rat feeded with the enzyme had the fibrinolytic activity from 1 hour to 3 hours after oral-administration. After 3 hours from feeding, the fibrinolytic activity was decreased gradually. Also blood clotting time after bleeding was longer than that of control rat. The enzyme could be detected at band of 30,000 Da in the blood by western blotting. The enzyme was not harmful to the all internal organs of the rats. Taken together, the enzyme originated from B. subtilis BB-1 can be a candidate to develop the drug for thrombosis, arteriosclerosis and myocardial infarction.

Oral malodor-reducing effects by oral feeding of Weissella cibaria CMU in Beagle dogs (Weissella cibaria CMU 경구투여가 비글의 구취 저하에 미치는 효과)

  • Do, Kyung-Hyo;Park, Ho-Eun;Kang, Mi-Sun;Kim, Jong-Tae;Yeu, Ji-Eun;Lee, Wan-Kyu
    • Korean Journal of Veterinary Research
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    • v.58 no.2
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    • pp.87-94
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    • 2018
  • This study assessed the effects of Weissella cibaria (W. cibaria) CMU on oral health in male and female beagles (n = 18) by measuring oral malodor and periodontal disease-related parameters (calculus, plaque, and gingivitis indices). Oral malodor and indicators of periodontal disease were assessed in five treatment groups: negative control (scaling and 0.24 mg of maltodextrin, n = 3), positive control (0.24 mg of maltodextrin, n = 3), and W. cibaria CMU groups (each n = 4) at low (CMU-L, $2{\times}10^7$ colony forming unit [CFU]), medium (CMU-M, $2{\times}10^8CFU$), and high (CMU-H, $2{\times}10^9CFU$) concentrations. After feeding with W. cibaria CMU for 6 weeks, total volatile sulfur compound concentrations in the CMU-L ($2.0{\pm}1.04ng/10mL$), CMU-M ($2.4{\pm}1.05ng/10mL$), and CMU-H ($2.6{\pm}1.33ng/10mL$) groups were significantly lower than in the positive control group ($3.2{\pm}1.65ng/10mL$). Also, CMU-L ($1.4{\pm}0.83ng/10mL$) and CMU-H ($1.9{\pm}1.14ng/10mL$) groups had methyl mercaptan levels lower than that in the positive control group ($2.4{\pm}1.21ng/10mL$) at week 2. The plaque index was significantly lower in the CMU-H group ($4.5{\pm}0.28$) than in the positive control group ($5.9{\pm}1.08$) at week 6. W. cibaria CMU could be useful as a novel oral hygiene probiotics for reducing volatile sulfur compounds production and inhibiting plaque growth in companion animals.

Recurrent arteriovenous malformation on palate after embolization combined surgical resection: preoperative magnetic resonance features and intraoperative angiographic findings

  • Son, Yong-Hyun;Baik, Seung-Kug;Kang, Min-Su;Kim, Yong-Deok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.6
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    • pp.346-351
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    • 2015
  • Angiography is the gold standard for the diagnosis and complete resection of arteriovenous malformations (AVMs). The absence of residual AVM after surgery is commonly believed to reduce the risk of future hemorrhage. However, AVMs can recur after proven complete angiographic resection can occur, albeit rarely, especially in the pediatric population. We report a rare case of a recurrent AVM two years after complete resection in an adult patient. This case report shows that AVMs in adults can recur despite their rarity and despite postoperative angiography confirming complete removal. Moreover, in this case, the recurrent AVM involved a new feeding vessel that was not involved with the initial lesion.

A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

  • Watanabe, Takuma;Yokoyama, Atsushi;Shimizu, Satoshi;Bessho, Kazuhisa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.4
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    • pp.232-236
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    • 2022
  • A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

Transfer of Orally Administered Terpenes in Goat Milk and Cheese

  • Poulopoulou, I.;Zoidis, E.;Massouras, T.;Hadjigeorgiou, Ioannis
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.10
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    • pp.1411-1418
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    • 2012
  • The objective of the present study was to investigate the relationships between terpenes… intake and their presence in animal tissues (blood and milk) as well as in the final product (cheese). Eight dairy goats were divided in two balanced groups, representing control (C) and treatment (T) group. In T group oral administration of a mixture of terpenes (${\alpha}$-pinene, limonene and ${\beta}$-caryophyllene) was applied over a period of 18 d. Cheese was produced, from C and T groups separately, on three time points, twice during the period of terpenes… oral administration and once after the end of experiment. Terpenes were identified in blood by extraction using petroleum ether and in milk and cheese by the use of solid phase micro-extraction (SPME) method, followed by GC-MS analysis. Chemical properties of the milk and the produced cheeses were analyzed and found not differing between the two groups. Limonene and ${\alpha}$-pinene were found in all blood and milk samples of the T group after a lag-phase of 3 d, while ${\beta}$-caryophyllene was determined only in few milk samples. Moreover, none of the terpenes were traced in blood and milk of C animals. In cheese, terpenes' concentrations presented a more complicated pattern implying that terpenes may not be reliable feed tracers. We concluded that monoterpenes can be regarded as potential feed tracers for authentification of goat milk, but further research is required on factors affecting their transfer.

Dumping Syndrome in a Child with Gastrojejunal Tube Feeding (위공장 경관식이(Gastrojejunal Tube Feeding) 환아에서 동반된 덤핑 증후군(Dumping Syndrome) 1례)

  • Lee, Sung Hyuk;Byun, Jun Chul;Choi, Won Joung;Choi, Soon-Ok;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.96-101
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    • 2005
  • Dumping syndrome is a known complication of gastric surgery in adults, but a very rare disease in the pediatric population. We report on a case of dumping syndrome in a 19-month-old child, who underwent gastrojejunal feeding tube insertion for the treatment and prevention of gastroesophageal reflux and frequent aspiration pneumonia. At 17 months of age, 2 months after the beginning of gastrojejunal tube feeding, postprandial diaphoresis, palpitation, lethargy, bloating, and diarrhea occurred, and a single episode of convulsion with hypoglycemia were noted. Early and late dumping syndrome was confirmed by an abnormal oral glucose tolerance test with early onset hyperglycemia followed by delayed onset hypoglycemia. Diet therapy including uncooked corn starch then improved the postprandial diaphoresis, abnormal glucose levels, and her nutritional status. We conclude that dumping syndrome may be considered as a complication of gastrojejunal tube feeding in a child.

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Swallowing Rehabilitation with Modified Barium Swallow after Supracricoid Partial Laryngectomy (상윤상후두부분적출술 후 Modified Barium Swallow를 이용한 연하 재활)

  • 조광재;김민식;선동일;조승호
    • Korean Journal of Bronchoesophagology
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    • v.8 no.1
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    • pp.42-49
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    • 2002
  • Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.

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