• Title/Summary/Keyword: Oral function

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The Diagnosis and Management of Velopharyngeal Insufficiency (연구개인두 폐쇄 부전 환자의 진단과 치료)

  • Lee, Yong-Kwon;Choi, Jae-Pyong;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.11 no.1
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    • pp.13-22
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    • 2008
  • Velopharyngeal insufficiency(VPI), characterized by hypernasal resonance and nasal air emission, is a speech disorder that can significantly compromise speech intelligibility. Cleft palate, previously repaired cleft palate and submucous cleft palate are associated with VPI. Less commonly, patients may acquire it after adenoidectomy with or without tonsillectomy or as a result of neuromuscular dysfunction. Comprehensive evaluation by a VPI team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, MRI and instrumental assessment. Options for intervention include speech therapy, intraoral prosthetic devices and surgery. Surgical methods can be categorized as palatal, palatopharyngeal or pharyngeal procedures. Each surgical approach has its strengths and limitations. Oro-maxillofacial surgeons are increasingly involved in the referral, evaluation, and treatment of velopharyngeal function. Therefore, understanding of physiology, anatomic structures, evaluation and treatment protocols in VPI is very important. This article presents protocol for evaluation of velopharyngeal function with a focus on indications for surgical interventions.

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Effects of Positioning Education Program through Oral Explanations or Brochures for Parents of Premature Infants with Brain Lesions and the Satisfaction Level of Physical Therapy at Discharge

  • Lee, Hye-Young;Kang, Dong-Yeon
    • The Journal of Korean Physical Therapy
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    • v.29 no.5
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    • pp.259-264
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    • 2017
  • Purpose: This study examined the effects of a positioning education program through the brochure or oral explanations for the parents of premature infants with a brain lesion and investigated the satisfaction level of physical therapy of parents of premature infants with a brain lesion. Methods: Forty parents of premature infants with a brain lesion participated in this study. The recruited premature infants were randomized into groups A (n=20) and B (n=20) for the purpose of the positioning education method through brochure or oral explanations. The level of satisfaction and recognition for the positioning education program was investigated by the parents of 12 month old infants. The gross motor function, measure-88, was examined at three months, six months, nine months, and twelve months of the corrected age. Results: No significant differences in the recognition of the position education program, level of satisfaction of the environment, and the attitude of the therapist were noted (p>0.05). Significantly high levels of satisfaction with the program of group B given the brochure were noted. The gross motor function measure-88 was also similar in both groups (p<0.05). Conclusion: This study suggests that the parents were satisfied with the positioning education program of the brochure. The differences in educational methods did not affect the development of premature infants.

Risk Factors of Gastrointestinal Bleeding in Patients Receiving New Oral Anticoagulants (New Oral Anticoagulants를 복용하는 환자들에서 위장관 출혈의 위험인자)

  • Lee, Ju Yup
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.219-224
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    • 2018
  • New oral anticoagulants (NOACs) are now widely used for the prevention and treatment of venous thrombosis, and for the prevention of stroke and systemic embolism in patients with atrial fibrillation. As compared with warfarin, NOACs have the advantage of rapid onset of action and less drug interaction. However, they carry a higher risk of gastrointestinal (GI) bleeding than warfarin. The risk of GI bleeding in patients using NOACs varies according to the type and dose of the drug. By contrast, apixaban and edoxaban are reported to carry similar risks as warfarin, and the risks with dabigatran and rivaroxaban are higher than that with warfarin. In patients using NOACs, old age, impaired renal function, impaired liver function, concurrent use of antiplatelet agents, and nonsteroidal anti-inflammatory drugs are considered major risk factors of GI bleeding, and gastroprotective agents such as histamine-2 receptor antagonist and proton pump inhibitor have preventive effects. To prevent GI bleeding associated with NOACs, the characteristics of each NOAC and the risk factors of bleeding should be recognized.

A Case Report of Add-On Traditional Korean Medical Treatments in a Patient with Uncontrolled Type 2 Diabetes Mellitus with Conventional Oral Hypoglycemic Agents (기존의 경구용 혈당강하제로 혈당조절이 불량한 제2형 당뇨병 환자에 대한 한양방 병용 치료 1례)

  • Lee, Hye-Yoon;Jung, Eun-sun;Yun, Youngju;Lee, Sang Yeoup
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.718-726
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    • 2021
  • This study presents a case of add-on traditional Korean medical treatments in a 77-year-old male patient with uncontrolled type 2 diabetes mellitus with conventional oral hypoglycemic agents. Chief complaints were uncontrolled glucose level and weight loss. The patient was treated with electroacupuncture (on ST36, CV4, and CV12), herbal medication, and lifestyle advice. The conventional oral hypoglycemic medications were maintained. After 12 weeks, the glycated hemoglobin A1c (HbA1c) decreased from 11.0% to 8.4%. There were significant abnormalities in the liver function and renal function tests, but no adverse event was reported. Further studies are needed to confirm the findings of this case.

Evaluation of relationship between cognitive function and occlusal status in elderly individuals using the T-scan III® system (T-scan III® system을 이용한 일부지역 노인의 교합양상과 인지기능의 관련성)

  • Shin, Hae-Eun;Cho, Min-Jeong;Choi, Youn-Hee;Song, Keun-Bae
    • Journal of Korean Academy of Oral Health
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    • v.41 no.2
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    • pp.96-101
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    • 2017
  • Objectives: The aim of this study was to investigate the relationship between cognitive function and occlusal status in elderly individuals. Methods: A total of 162 individuals aged 65 years and older, who attended the senior citizen center in Daegu city, were included after consent for participation in the study was obtained. The Korean version of the Mini-Mental State Examination (MMSE-K) was used to evaluate the level of cognitive function. Occlusal status was determined using the T-scan $III^{(R)}$ system. All collected data were analyzed by ${\chi}^2$ test, t-test, one way ANOVA, and linear regression analysis using SPSS version 23.0 for Windows. Results: There was a significant relationship between the cognitive function and the use of dentures. Individuals with posterior occlusal status had higher MMSE-K scores than those with anterior occlusal status. There was a positive correlation between the cognitive function and posterior occlusal force. Conclusions: These results suggest that occlusal status was associated with cognitive function in the elderly individuals. Active national policies to improve occlusal condition in the elderly population are needed.

The Association between Self-Reported Sensory Impairment and Cognitive Function among Korean Older Adults: Results from the 2017 National Survey of the Living Conditions and Welfare Needs of Older Koreans (한국 노인의 주관적 감각장애와 인지기능 간 관계: 2017 노인실태조사 자료를 중심으로)

  • Bae, Suhyun;Kim, Giyeon
    • 한국노년학
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    • v.39 no.2
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    • pp.389-404
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    • 2019
  • The present study aims to examine the relationship between self-reported sensory impairment and cognitive function among older adults in Korea. Drawn from the 2017 Survey of Living Conditions and Welfare Needs Korean Older Persons, a total of 10,082 adults aged 65 and over were included in analyses. Results from hierarchial multiple regression analysis show that those who reported greater subjective discomfort about vision, hearing, and oral function were more likely to have poor cognitive function. Results from hierarchial logistic regression analysis show. Results from logistic regression analysis show that having hearing and oral discomfort increased the a risk for dementia. Findings suggest that it is necessary to manage sensory function of the elderly at the government level and to develop self-evaluation tools to monitor changes in sensory function for older adults. Future research should target finding effective ways to improve health of older adults.

BLEEDING CONTROL BY CONTINUOUS WOUND DRAINAGE OF ACTIVE BLEEDING SITES OF TEETH EXTRACTION WOUND IN A PATIENT WITH ADVANCED LIVER CIRRHOSIS : REPORT OF A CASE (중증 간경변증 환자에서 발치창 과도 출혈부의 지속적 배농술을 통한 지혈 : 증례보고)

  • Mo, Dong-Yub;Yoo, Jae-Ha;Choi, Byung-Ho;Kim, Ha-Rang;Lee, Chun-Ui;Ryu, Mi-Heon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.431-436
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    • 2009
  • There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding control by continuous rubber strip & iodoform gauze drainage (without gelfoam packing) of active bleeding infection sites of three teeth extraction wounds in a 46-years-old female patient with advanced liver cirrhosis.

The Circadian Rhythm Variation of Pain in the Orofacial Region

  • Kim, Moon Jong;Chung, Jin Woo;Kho, Hong-Seop;Park, Ji Woon
    • Journal of Oral Medicine and Pain
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    • v.40 no.3
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    • pp.89-95
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    • 2015
  • All living organisms have a biological clock that orchestrates every biological process and function, and this internal clock operates following a circadian rhythm. This biological clock is known to influence various clinical indicators such as blood pressure and body temperature. Also, the fluctuation of signs and symptoms of diseases including pain disorders are affected by circadian rhythm. It has been reported that the pain intensity of various somatic and neuropathic pain disorders show unique pain patterns that depend on the passage of time. The generation of pain patterns could be explained by extrinsic (e.g., physical activity, tactile stimulation, ambient temperature) and also intrinsic factors (neural and neuroendocrine modulation) that are related to the circadian rhythm. It is important to recognize and identify the individual pain pattern in pain therapy to approve treatment outcome. Moreover, chronotherapeutics which considers pain patterns and pharmacokinetics in context of the circadian rhythm could produce greater analgesia in response to medication. However, only a limited number of studies handle the issue of pain patterns according to circadian rhythm and chronotherapeutics in the orofacial region. The present review intends to reflect on the most recent and relevant data concerning the bidirectional relation between pain disorders of the orofacial region and circadian patterns.

Mutation Analysis of the Dimer Forming Domain of the Caspase 8 Gene in Oral Submucous Fibrosis and Squamous Cell Carcinomas

  • Menon, Uthara;Poongodi, V;Raghuram, Pitty Hari;Ashokan, Kannan;Govindarajan, Giri Valanthan Veda;Ramanathan, Arvind
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4589-4592
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    • 2015
  • Background: Missense and frame-shift mutations within the dimer forming domain of the caspase 8 gene have been identified in several cancers. However, the genetic status of this region in precancerous lesions, like oral submucous fibrosis (OSMF), and well differentiated oral squamous cell carcinomas (OSCCs) in patients from southern region of India is not known, and hence the present study was designed to address this issue. Materials and Methods: Genomic DNA isolated from biopsy tissues of thirty one oral submucous fibrosis and twenty five OSCC samples were subjected to PCR amplification with intronic primers flanking exon 7 of the caspase 8 gene. The PCR amplicons were subsequently subjected to direct sequencing to elucidate the status of mutation. Results: Sequence analysis identified a frame-shift and a novel missense mutation in two out of twenty five OSCC samples. The frame-shift mutation was due to a two base pair deletion (c.1225_1226delTG), while the missense mutation was due to substitution of wild type cysteine residue with phenylalanine at codon 426 (C426F). The missense mutation, however, was found to be heterozygous as the wild type C426C codon was also present. None of the OSMF samples carried mutations. Conclusions: The identification of mutations in OSCC lesions but not OSMF suggests that dimer forming domain mutations in caspase 8 may be limited to malignant lesions. The absence of mutations in OSMF also suggests that the samples analyzed in the present study may not have acquired transforming potential. To the best of our knowledge this is the first study to have explored and identified frame-shift and novel missense mutations in OSCC tissue samples.

INTRAORAL OPEN REDUCTION OF MANDIBULAR SUBCONDYLAR FRACTURES USING KIRSCHNER WIRE (Kirschner wire를 사용한 과두하 골절의 구강내 접근법)

  • Kim, Seong-Il;Kim, Seung-Ryong;Baik, Jin-Ah;Ko, Seung-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.3
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    • pp.270-276
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    • 2001
  • The treatment of mandibular subcondylar fractures is a matter of controversy. The majority of mandibular subcondylar fracture are treated by closed reduction, but the displaced or dislocated mandibular subcondylar fractures may be treated by open reduction. The characteristics of open reduction are the anatomical reduction, the functional restoration, the rapid function, the maintenance of vertical ramus dimension, the better appearance and the less resultant TMJ problem etc. When an open reduction is considered, the wire, miniplate, lag screw and Kirschner wire are available with internal fixation. Of these, Kirschner wire is a simple method relatively and correct positioning of the wire achieves rigid fixation. But many open reduction methods for mandibular subcondylar fractures require extraoral approach. The extraoral approach has some problems, the facial scar and the risk of facial nerve injury. On the other hand, the intraoral approach eliminates the potency of the facial scar and the facial nerve injury, but is difficult to access the operation site. Since the intraoral approach was first described by Silverman (1925), the intraoral approach to the mandibular condyle has been developed with modifications. The purpose of this article is to describe the intraoral technique with the Kirschner wire on mandibular subcondylar fractures. Conclusion : The intraoral reduction with Kirschner wire on mandubular subcondylar fractures avoids the facial scar and facial nerve injury and is simple method to the extraoral approach. And it has minimal morbidity and better esthetics.

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